Suresh Kumar, a 20-year-old native of Bahraich (Huzorpur Block, Nibuhi Kala village), worked at a juice shop in Mumbai city. He returned home along with other migrant workers in a truck in early May, 2020 after travelling for five days. As soon as Suresh reached home, the local ASHA Chandra Prabha met him and recorded his details. She informed the Rapid Response Team (RRT) of district Bahraich, which advised Suresh to quarantine himself at home. Chandra Prabha also counselled the family members and explained in detail the steps to be taken during home quarantine. She undertook regular follow up visits and kept in touch with the family. Her alertness, motivational skills and support ensured that as soon as Suresh began experiencing symptoms, he was sent to the Community Health Centre, Chitaura, which is also a designated COVID Care facility. Chandra Prabha also ensured that Suresh’s family members and his fellow migrants were referred for COVID testing.
With the surge in the cases of COVID-19 in the country and the influx of migrant population from hotspot areas, one of the major challenges in Uttar Pradesh (UP) was to cater to the healthcare needs of returnees and arrest the spread in its rural population. ASHAs have played a critical role in supporting the state’s COVID-19 management during this crisis.
In a gigantic exercise, UP’s 1.6 lakh ASHAs have tracked over nearly 30.43 lakh migrant returnees in two phases- 11.24 lakh in the first and 19.19 lakh in the second phase. They have assisted in contact tracing and community level surveillance. The ASHAs not only identified 7965 persons with symptoms but also regularly followed up on their health status. They have facilitated sample collection from 2232 returnees of which 203 were found to be positive and were referred to COVID health care services. Nigrani Samitis (Vigilance Committee) have been formed in all the villages under the Gram Pradhan. The Samiti members/ volunteers community patrols keep in touch with the ASHAs and provide her details of the migrants in the village, who in turn help with the follow up on the migrants. ASHAs have played a critical role in sensitising the communities about the preventive measures to be adopted such as regular hand washing with soap and water, importance of wearing masks when out in public spaces, and maintaining adequate physical distancing. As a result of their efforts, there has been enhanced awareness about essential and non-essential healthcare services and how to access these. The ASHAs are provided basic protective gear like masks and soap/sanitizers as they go about their duties.
ASHAs have assisted the Panchayati Raj Department in development of the community quarantine centers, in buildings like Anganwadi centres and primary schools. They have ensured adoption of Aarogya Setu app at the community level through awareness generation and supporting in its installation.
The contribution of ASHAs in non-COVID essential services has been exemplary. At the Ayushman Bharat – Health and Wellness Centres, ASHAs are contributing in conducting line listing of all individuals, risk assessment and mobilization for screening for chronic illness like Hypertension, Diabetes, three cancers (oral, breast and cervical cancers), TB and Leprosy. They have also been instrumental in providing of Reproductive Maternal Neonatal and Child Health (RMNCH) services which were directly affected by the lockdown measures and the necessity of maintaining of physical distancing. They have created awareness about the availability of these services and helped people to access them.
The National Health Mission supports nearly 10 lakh ASHAs in rural and urban areas of most parts of the country. Nearly 1/6th (1.67 lakh) are from Uttar Pradesh.