Asha Workers In Need Of Empowerment

The strongest link in India's public health system, the Ashas are faced with several challenges..Their stories reveal some stark realities of the bureaucracy, corruption within the system and atrocities imposed by nurses, paramedics and senior medical staff working in the government sector.

- Raelene Kambli

In January 2018, Jamena Khatun — an Asha worker from the Assam’s Chikonmati village in Darrang district during her routine checkup identified that a four-year-old girl child, Nurjahan Begum was suffering from severe acute malnutrition (SAM). In a family of five siblings, Nurjahan’s parents working on daily wages were unaware of the condition. Due to lack of finances, the parents were unable to provide their kids with nutritious food and medicine. Moreover, the family was not willing to take help of the Kharupetia Nutrition Rehabilitation Center (NRC) of Darrang district as they lacked trust in the system.

In Assam, prevalence of under-nutrition is relatively high among under 5 children. The recent data from NFHS-4 (2015-16) reveals that almost one third (29.8 per cent) children under five years of age are under-weight, 36.4 per cent children are stunted and 17 per cent children are wasted with 6.2 per cent of children are severely wasted.

Darrang district records a high load of severe acute malnourished children and is identified as an National Nutrition Mission (NNM) plus Aspirational district in Assam. Among the whole under population (123840) of drawing district, the percentage of stunting, wasting and anaemia is 43.5 per cent, 19.2 per cent and 45.5 per cent respectively and severity is more among the social economically backward population. Though children with SAM are identified in different vulnerable pockets, it is very difficult for an ASHA to motivate the child to admit in the Nutritional Rehabilitation Centre.