Lok Sabha Question No. 1054 (UNSTARRED), answered on 2019-02-08
Subject: Accredited Social Health Activists (ASHAs)
Ministry: HEALTH AND FAMILY WELFARE
Asked by: SUNIL BALIRAM GAIKWAD, ARJUNLAL MEENA, BALABHADRA MAJHI

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 1054 TO BE ANSWERED ON 08 TH FEBRUARY, 2019

## ACCREDITED SOCIAL HE ALTH ACTIVISTS (ASHA s)

## 1054. DR. SUNIL BALIRAM GAIKWAD: SHRI ARJUN LAL MEENA: SHRI BALABHADRA MAJHI:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

(a)  the  total  number  of  Accredited Social  Health  Activists  (ASHAs) appointed  under  the National Rural Health Mission (NRHM) in the country alongwith the incentives/wages provided tothem, State/UT - wise;

(b) whether the Government has assessed the performance of ASHAs in reducing various health problems  including infant  mortality  rate/maternal  mortality  rate in  the  country  and  if  so,  the details thereof;

(c)  the  total  funds  allocated/released/ spent  on  ASHAs  during  each  of  the  last three  years, State/UT - wise;

(d) whether the Government proposes to increase the honorarium to ASHA workers in the Tribal Sub-Plan(TSP) areas and if so, the details thereof; and

(e) the further steps taken/being taken by the Government for the welfare of the ASHAs?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI ASHWINI KUMAR CHOUBEY)

(a): The  state - wise  details  of  ASHAs  Selected  under  NRHM  as  on  September  2018  is  at Annexure-I.Under the National Health Mission, ASHAs are envisaged to be community health volunteers and are entitled to task/activity based incentives. List of various activiti es for which incentives are provided to ASHAs is placed as Annexure -II. Apart from incentives approved for ASHAs at national level, States have the flexibility to design ASHA incentives.

(b): Improvement in health indicators including Infant Mortality Rat e and Maternal Mortality Ratio is dependent on a number of factors. However, Review Mission reports and evaluatio ASHA programme in select states demonstrate that ASHAs have been effective in mobilisati for immunisation and in increasing institutiona l deliveries. An ASHA evaluation, commissioned  by  the  National  ASHA  Mentoring  Group  and  coordinated  by  National  Health System Resource Centre (NHSRC) was conducted in three rounds in 16 States as follows:

| Round one ( 2010- 11)   | Assam, Bihar, Odisha, Rajas th n, Jharkhand, Andhra Pradesh, Kerala and West   |
|-------------------------|--------------------------------------------------------------------------------|
| Round two ( 2011- 2012) | Madhya Pradesh, Uttar Pradesh and Utt arakhand                                 |
| Round three (2013- 14)  | Delhi, Gujarat, Haryana, Punjab and Maharashtr a                               |

The  key  findings  with  regard  to  service  provision  by  ASHAs  to  pregnant  women, newborn and children is as under:

- About 71% of women who delivered in last six months and 61% who reported an episode of childhood illnesses received services from ASHAs.
- About  8 6%  of  service  users  opted  for  institutional  deliveries,  of  which  67%  quo ASHA  as  the  main  motivator.    In  case  of  maternal  complications , 60%  respondents contacted ASHA.
- 99% of service users received immunization, of which in 84% cases ,it was facilitated by ASHAs.
- About 50% of the respondents with a sick newborn sought advice from ASHAs for care Importance of early initiation of breastfeeding for new born was also found to be high i.e, 95%.
- In  cases  of  diarrhoea  and  symptoms  of  AR I,  84%  beneficiaries  reported  that  ASHAs helped them.

(c): The  details  of  approvals  and  expenditure  on  ASHAs  under  National  Health  Mission (NHM) for the last three years are at Annexure -III.

(d): There  is  no  such  proposal  under  consideration.  However, G overnment  of  India  has recently approved  increase in the amount of routine and recurring incentives under Na Health Mission for ASHAs that will enable ASHAs to get at least Rs 2000/ -per month subject to ASHAs carrying out the activities.

(e): The Government has approved inclusion of ASHAs and ASHA facilitators that meet the eligibility criteria to be enrolled in social security schemes implemented by Government namely,  the  Pradhan  Mantri  Jeevan  Jyoti  Bima  Yojana  and  Pradhan  Mantri  Suraks ha  Bima Yojana. Further, States have the flexibility to design welfare schemes for ASHAs.

Total

Source: NHM -MIS report

## Annexure - I

| Details of ASHAs Selected under NRHM (as on September 2018)   | Details of ASHAs Selected under NRHM (as on September 2018)   | Details of ASHAs Selected under NRHM (as on September 2018)   |
|---------------------------------------------------------------|---------------------------------------------------------------|---------------------------------------------------------------|
| Sl. No.                                                       | States/UTs                                                    | ASHAs selected                                                |
| 1                                                             | Bihar                                                         | 87841                                                         |
| 2                                                             | Chhattisgarh                                                  | 66713                                                         |
| 3                                                             | HimachalPradesh                                               | 32342                                                         |
| 4                                                             | Jammu & Kashmir                                               | 11853                                                         |
| 5                                                             | Jharkhand                                                     | 40964                                                         |
| 6                                                             | Madhya Pradesh                                                | 71656                                                         |
| 7                                                             | Odisha                                                        | 46839                                                         |
| 8                                                             | Rajasthan                                                     | 59175                                                         |
| 9                                                             | Uttar Pradesh                                                 | 154776                                                        |
| 10                                                            | Uttarakhand                                                   | 11086                                                         |
| 11                                                            | Arunachal Pradesh                                             | 3838                                                          |
| 12                                                            | Assam                                                         | 30920                                                         |
| 13                                                            | Manipur                                                       | 4009                                                          |
| 14                                                            | Meghalaya                                                     | 6516                                                          |
| 15                                                            | Mizoram                                                       | 1091                                                          |
| 16                                                            | Nagaland                                                      | 1887                                                          |
| 17                                                            | Sikkim                                                        | 641                                                           |
| 18                                                            | Tripura                                                       | 7590                                                          |
| 19                                                            | Andhra Pradesh                                                | 39009                                                         |
| 20                                                            | Goa                                                           | 0                                                             |
| 21                                                            | Gujarat                                                       | 39463                                                         |
| 22                                                            | Haryana                                                       | 17369                                                         |
| 23                                                            | Karnataka                                                     | 37500                                                         |
| 24                                                            | Kerala                                                        | 28115                                                         |
| 25                                                            | Maharashtra                                                   | 60675                                                         |
| 26                                                            | Punjab                                                        | 18879                                                         |
| 27                                                            | Tamil Nadu                                                    | 3905                                                          |
| 28                                                            | Telangana                                                     | 29257                                                         |
| 29                                                            | West Bengal                                                   | 54826                                                         |
| 30                                                            | A & N Islands                                                 | 412                                                           |
| 31                                                            | Chandigarh                                                    | 14                                                            |
| 32                                                            | D & N Haveli                                                  | 456                                                           |
| 33                                                            | Daman & Diu                                                   | 96                                                            |
| 34                                                            | Delhi                                                         | 0                                                             |
| 35                                                            | Lakshadweep                                                   | 110                                                           |
| 36                                                            | Puducherry                                                    | 0                                                             |
| Total                                                         | Total                                                         | 969823                                                        |

14th

1 This incentive is provided only on completion of 45days after birth of the child and should meet the follow criteria - birth registration, weight - record in the MCP Card, immunization with BCG, first dose of OPV and DPT complete with due entries in the MCP card and both mother and new born are safe until 42nd day of delivery.

| Updated list of ASHA Incentives   | Updated list of ASHA Incentives                                                                                                                                                                                                                                                                               | Updated list of ASHA Incentives                                      | Updated list of ASHA Incentives               | Updated list of ASHA Incentives                                                              |
|-----------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------------------------------------------|-----------------------------------------------|----------------------------------------------------------------------------------------------|
|                                   | Activities                                                                                                                                                                                                                                                                                                    | Amount in Rs/case                                                    | Source of Fund and Fund Linkages              | Documented in                                                                                |
| I                                 | Maternal Health                                                                                                                                                                                                                                                                                               | Maternal Health                                                      | Maternal Health                               | Maternal Health                                                                              |
| 1                                 | JSY financial package                                                                                                                                                                                                                                                                                         |                                                                      |                                               | MOHFW Order No. Z 14018/1/2012/ - JSY JSY - section of Health and Welfare                    |
| a.                                | For ensuring antenatal care for the woman                                                                                                                                                                                                                                                                     | Rs.300 for Rural and Rs. 200 for Urban areas                         | areas Maternal Health - NRHM - RCH Flexi pool |                                                                                              |
| b.                                | For facilitating delivery                                                                                                                                                                                                                                                                                     | institutional Rs. 300 for Rural areas and Rs. 200 for Urban areas    | areas Maternal Health - NRHM - RCH Flexi pool | - 6th. Febuary - 2013                                                                        |
| 2                                 | Reporting Death of women (15 - 49 years age group) by ASHA to PHC Medical Officer                                                                                                                                                                                                                             | Rs. 200 for reporting within 24 hours occurrence of death phone      | of by HSC/ U - PHC - Un - tied Fund           | MOHFW - OM - 120151/148/2011/M CH; Maternal Health Division; Febuary - 2013                  |
| II                                | Child Health                                                                                                                                                                                                                                                                                                  | Child Health                                                         | Child Health                                  | Child Health                                                                                 |
| 1                                 | Undertaking Home Visit for care of the New Born and Post Partum mother 1 - Six Visits Case of Institutional Delivery (Days 3 rd , 7 th , 14th, 21 st , 28 th & 42 nd ) - Seven visits in case Home Deliveries (Days 1 st , 3 rd , 7 th , 14th, 21 st , 28 th & 42 nd )                                        | the in of Rs. 250                                                    | Child Health - NHM - RCH Flexi pool total     | HBNC Guidelines - August- 2014                                                               |
| 2                                 | Undertaking Home Visits Young Child for Strengthening of Health & Nutrition of child through Home Visits - ( recommended schedule -3 rd , 6 th , 9 th , 12 th and 15 th months) - (Rs.50 x 5 visits) - in 1st phase the programme is proposed implement only in 235 POSHAN Abhiyan and Aspirational districts | of young to Rs. 50/visit with Rs. 250/per child making 05 visits     | for                                           | D.O. No. Z - 28020/177/2017 - CH 3 rd May - 2018                                             |
| 3                                 | For follow up visits to a discharged from facility Severe Acute Malnutrition (SAM) management centre                                                                                                                                                                                                          | child or Rs. 150 only after MUAC is equal to nor - more than 125mm   | Child Health - NHM - RCH Flexi pool total     | Order on revised of ASHA incentives - D.O. No. P17018/14/13 - NRHM -IV                       |
| 4                                 | 1 Ensuring quarterly follow up low birth weight babies newborns discharged treatment from Specialized New born Care Units 2                                                                                                                                                                                   | of and after Rs. 50/ Quarter - f om the 3 rd month until year of age | 1                                             | Order on revised of ASHA incentives - D.O - Z.28020/187/2012 - CH, MoHFW - Would be subsumed |

for for

|    |                                                                                                                                                                                       |                                                                                     | 5 6 is 7 8                | with HBYC incentive                                                            |
|----|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------|---------------------------|--------------------------------------------------------------------------------|
|    | Child Death Review reporting child death children under 5 years of                                                                                                                    | for of Rs. 50                                                                       | 5 6 is 7 8                | Operational Guidelines for Death Review -2014                                  |
|    | For mobilizing and ensuring every eligible child (1 - 19 years out - of - school and non - enrolled) administered Albendazole.                                                        | age Rs. 100/ ASHA/Bi - Annual                                                       | 5 6 is 7 8                | Operational Guidelines National Deworming Day January - 2016                   |
|    | Week - 1- ASHA incentive for prophylactic distribution ORS to families with - five children                                                                                           | of under Rs. 1 per ORS packet for 100 under five children                           | 5 6 is 7 8                | OGs f or Intensified Diarrhoea Control Fortnight - June - 2015                 |
|    | Week - 2- ASHA incentive for facilitating growth of all children in screening and referral undernourished children Health centre; IYCF counselling to under - five children household | monitoring village; of to Rs. 100 per ASHA for completing at least 80% of household | 5 6 is 7 8                | OGs f or Intensified Diarrhoea Control Fortnight - June - 2015                 |
| 9  | MAA (Mother's Absolute Affection) Programme Promotion of Breastfeeding - Quarterly mother meeting                                                                                     | Rs. 100/ASHA/ Quarterly meeting                                                     | 5 6 is 7 8                | Operational Guidelines Promotion of Breastfeeding - MAA - 2016                 |
|    | Immunization                                                                                                                                                                          |                                                                                     | III                       |                                                                                |
| 1  | Full immunization for a under one year                                                                                                                                                | child Rs. 100                                                                       | Routine Immunization Pool | Order on Revised Financial Norms under UIP - T.13011i01/2077 - CC - May - 2012 |
| 2  | Complete immunization child up - to two years age vaccination received between 1st and second year of age completing full immuniz ation after one year                                | per (all after Rs. 75 3                                                             | Routine Immunization Pool | Order no - T.13011/01/2012/ - CC& V                                            |
| 3  | Mobilizing children for immunization under Pulse polio Programme                                                                                                                      | OPV Rs. 100/day 4                                                                   | IPPI funds                | Order on revised of ASHA incentives - D.O. No. P17018/14/13 - NRHM -IV         |
| 4  | DPT Booster at -5 6years of                                                                                                                                                           | ageRs.50                                                                            | IPPI funds                | Order no -                                                                     |

|    |                                                                       |                                                                                                                                                                                                                           |                                      | T.13011/01/2012/ - CC& V                                                               |
|----|-----------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------|----------------------------------------------------------------------------------------|
| IV | Planning                                                              |                                                                                                                                                                                                                           | Family                               |                                                                                        |
| 1  | Ensuring spacing of 2 after marriage 5                                | years Rs. 500                                                                                                                                                                                                             | Family planning - NHM RCH Flexi Pool | Order No - D.O - N - 11012/11/2012 - FP, May -2012                                     |
| 2  | Ensuring spacing of 3 years after birth of 1 st child 5               | Rs. 500                                                                                                                                                                                                                   | Family planning - NHM RCH Flexi Pool | Order No - D.O - N - 11012/11/2012 - FP, May -2012                                     |
| 3  | Ensuring a couple to opt permanent limiting method after 2 children 6 | for Rs. 1000                                                                                                                                                                                                              | Family planning - NHM RCH Flexi Pool | Order No - D.O - N - 11012/11/2012 - FP, May -2012                                     |
| 4  | Counselling, motivating follow up of the cases Tubectomy              | and for Rs. 200 in 11 states with high fertility rates (UP, Bihar, MP, Rajasthan, Chhattisgarh, Jharkhand, Odisha, Uttarakhand, Assam, Haryana and Gujarat) Rs.300 in 146 MPV districts Rs. 150 in remaining states       | Family planning - NHM RCH Flexi Pool | Revised Compensation package for Planning - September DO - N 11026/11/2014 - FP - 2014 |
| 5  | Counselling, motivating follow up of the cases Vasectomy/ NSV         | and for Rs. 300 in 11 states with high fertility rates (UP, Bihar, MP, Rajasthan, Chhattisgarh, Jharkhand, Odisha, Uttarakhand , Assam, Haryana and Gujarat) and 400 in 146 MPV districts and Rs. 200 in remaining states | Family planning - NHM RCH Flexi Pool | Revised Compensation package for Planning - September DO - N 11026/11/2014 - FP - 2014 |
| 6  | Female Postpartum sterilization                                       | Rs. 300 in 11 states with high fertility rates (UP, Bihar, MP, Rajasthan, Chhattisgarh, Jharkhand, Odisha, Uttarakhand , Assam, Haryana and Gujarat) and                                                                  | Family planning - NHM RCH Flexi Pool | Revised Compensation package for Planning - September DO - N 11026/11/2014 - FP - 2014 |

Uttarakhand, Arunachal Pradesh, Assam, Manipur, Meghalaya, Mizoram, Nagaland, Sikkim,

Tripura, Gujarat, Haryana, Karnataka, Maharashtra, Andhra Pradesh, Telangana, West Benga l & Daman and Diu

6 Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Odisha ,Rajasthan, Uttar Pradesh,

Uttarakhand, Arunachal Pradesh, Assam, Manipur, Meghalaya,

Mizoram, Nagaland, Sikkim, Tripura, Gujarat, Haryana and Dadar& Nagar Haveli of

by on

|                                                                                                |                                                                                                                                                                                                             | 400 in 146 MPV districts                                                                       |                                                                                                |                                                                                                |                                                                                                |
|------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------|
| 7                                                                                              | Social marketing contraceptives - as home delivery through ASHAs                                                                                                                                            | of Rs. 1 for a pack of 03 condoms, Rs. 1 for a cycle of OCP, Rs. 2 for a pack of ECPs          | of Rs. 1 for a pack of 03 condoms, Rs. 1 for a cycle of OCP, Rs. 2 for a pack of ECPs          |                                                                                                | Guidelines on delivery contraceptives ASHAs - Aug - 2011- N 11012/3/2012 - FP                  |
| 8                                                                                              | Escorting or facilitating beneficiary to the health for the PPIUCD insertion                                                                                                                                | facility Rs. 150/per case                                                                      | facility Rs. 150/per case                                                                      |                                                                                                | Order on revised of ASHA incentives - D.O. No. P17018/14/13 - NRHM -IV                         |
| 9                                                                                              | Escorting or facilitating beneficiary to the health for the PAIUCD insertion                                                                                                                                | facility Rs. 150/case                                                                          | facility Rs. 150/case                                                                          |                                                                                                | Order on revised of ASHA Incentives - 2016                                                     |
| Mission ParivarVikas -In selected 146 districts in seven states -                              | Mission ParivarVikas -In selected 146 districts in seven states -                                                                                                                                           | Mission ParivarVikas -In selected 146 districts in seven states -                              | Mission ParivarVikas -In selected 146 districts in seven states -                              | Mission ParivarVikas -In selected 146 districts in seven states -                              | Mission ParivarVikas -In selected 146 districts in seven states -                              |
| (57 in UP, 37 in Bihar, 14 RJS, 9 in Jharkhand, 02 in Chhattisgarh, Madhya Pradesh 25 and 2 in | (57 in UP, 37 in Bihar, 14 RJS, 9 in Jharkhand, 02 in Chhattisgarh, Madhya Pradesh 25 and 2 in                                                                                                              | (57 in UP, 37 in Bihar, 14 RJS, 9 in Jharkhand, 02 in Chhattisgarh, Madhya Pradesh 25 and 2 in | (57 in UP, 37 in Bihar, 14 RJS, 9 in Jharkhand, 02 in Chhattisgarh, Madhya Pradesh 25 and 2 in | (57 in UP, 37 in Bihar, 14 RJS, 9 in Jharkhand, 02 in Chhattisgarh, Madhya Pradesh 25 and 2 in | (57 in UP, 37 in Bihar, 14 RJS, 9 in Jharkhand, 02 in Chhattisgarh, Madhya Pradesh 25 and 2 in |
| 10                                                                                             | Injectable Contraceptive (Antara Program) and a non - hormonal weekly centchroman pill(Chhaya) - Incentive ASHA                                                                                             | MPA to Rs. 100 per dose                                                                        | MPA to Rs. 100 per dose                                                                        | Family planning - RCH - NHM Flexi Pool                                                         | D.O.No.N. 110023/2/2016 - FP dated 10 th November 2016                                         |
| 11                                                                                             | Mission ParivarVikas Campaigns Block level activities -ASHA to be oriented on eligible couple survey estimation of beneficiaries will be expected to conducted eligible couple survey - maximum four rounds | for and Rs. 150/ ASHA/ro und                                                                   | for and Rs. 150/ ASHA/ro und                                                                   | Family planning - RCH - NHM Flexi Pool                                                         | D.O.No.N. 110023/2/2016 - FP dated 10 th November 2016                                         |
| 12                                                                                             | NayiPahel -an FP kit for weds- a FP kit would be to the newly wed couple ASHA (In initial phase ASHA may be given 2 kits/ ASHA)                                                                             | newly given by Rs. 100/ASHA/NayiPahel distribution                                             | kit                                                                                            | Family planning - RCH - NHM Flexi Pool                                                         | D.O.No.N. 110023/2/2016 - FP dated 10 th November 2016                                         |
| 13                                                                                             | SaasBahuSammelan - mobilize SaasBahu for the Sammelan - maximum four rounds                                                                                                                                 | Rs. 100/ per meeting                                                                           | Rs. 100/ per meeting                                                                           | Family planning - RCH - NHM Flexi Pool                                                         | D.O.No.N. 110023/2/2016 - FP dated 10 th November 2016                                         |
| 14                                                                                             | Updating of EC survey before each MPV campaign- Note- updating of EC survey register incentive is part of routine and incentive                                                                             | already recurring Rs.150/ASHA/Quarterly round                                                  | already recurring Rs.150/ASHA/Quarterly round                                                  | Family planning - RCH - NHM Flexi Pool                                                         | D.O.No.N. 110023/2/2016 - FP dated 10 th November 2016                                         |
| V Adolescent Health                                                                            | V Adolescent Health                                                                                                                                                                                         | V Adolescent Health                                                                            | V Adolescent Health                                                                            | V Adolescent Health                                                                            | V Adolescent Health                                                                            |
| 1                                                                                              | Distributing sanitary napkins adolescent girls                                                                                                                                                              | to Rs. 1/ pack of 6 sanitary                                                                   | napkins Me trual hygiene Scheme - RCH - NHM Flexi VHSNC                                        | pool Operational guidelines Scheme Promotion Menstrual August- 2010                            | for of Hygiene                                                                                 |
| 2                                                                                              | Organizing monthly meeting with adolescent girls pertaining                                                                                                                                                 | Rs. 50/meeting                                                                                 | Rs. 50/meeting                                                                                 | Funds                                                                                          | for of Hygiene                                                                                 |

F

|      | to Menstrual Hygiene                                                                                                                                                                                                                                                                                                                                                            |                                                                                                                                                                                            |                                                                                                                                                                                            |                                                                                                                                                                                            |                                                                                                                                                                                            |
|------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| 3    | Incentive for support to Educator (for facilitating selection process of educators)                                                                                                                                                                                                                                                                                             | Peer peer Rs. 100/ Per PE                                                                                                                                                                  | RKSK - NHM Flexi pool                                                                                                                                                                      | Operational framework RashtriyaKishorSwa sthyaKaryakram January - 2014                                                                                                                     | for                                                                                                                                                                                        |
| 4    | Incentive for mobilizing adolescents for Adolescent Health day                                                                                                                                                                                                                                                                                                                  | Rs. 200/ Per AHD                                                                                                                                                                           | RKSK - NHM Flexi pool                                                                                                                                                                      | Operational framework RashtriyaKishorSwa sthyaKaryakram January - 2014                                                                                                                     | -                                                                                                                                                                                          |
| VI   | Incentive for Routine Recurrent Activities                                                                                                                                                                                                                                                                                                                                      | Incentive for Routine Recurrent Activities                                                                                                                                                 | Incentive for Routine Recurrent Activities                                                                                                                                                 | Incentive for Routine Recurrent Activities                                                                                                                                                 | Incentive for Routine Recurrent Activities                                                                                                                                                 |
| 1    | Mobilizing and attending VHND or (outreach session/Urban Health and Nutrition Days)                                                                                                                                                                                                                                                                                             | Rs. 2000 7                                                                                                                                                                                 | NHM - Flexi Pool                                                                                                                                                                           | Order on revised of ASHA incentives D.O. P17018/14/13 - NRHM -IV                                                                                                                           | - No.                                                                                                                                                                                      |
| 2    | Convening and guiding monthly meeting of VHSNC/MAS                                                                                                                                                                                                                                                                                                                              | Rs. 2000 7                                                                                                                                                                                 | NHM - Flexi Pool                                                                                                                                                                           | Order on revised of ASHA incentives D.O. P17018/14/13 - NRHM -IV                                                                                                                           | - No.                                                                                                                                                                                      |
| 3    | Attendingmonthly meeting at Block PHC/5U-PHC                                                                                                                                                                                                                                                                                                                                    | Rs. 2000 7                                                                                                                                                                                 | NHM - Flexi Pool                                                                                                                                                                           | Order on revised of ASHA incentives D.O. P17018/14/13 - NRHM -IV                                                                                                                           | - No.                                                                                                                                                                                      |
| 4    | a) Line listing of households done at beginning of the and updated every six months b) Maintaining records as the desired norms like - village health register c) Preparation of due list children to be immunized updated on monthly basis d) Preparation of due list ANC beneficiaries to updated on monthly basis e) Preparation of list of couples updated on monthly basis | year per of of be eligible                                                                                                                                                                 | NHM - Flexi Pool                                                                                                                                                                           | Order No. No7(84)/2018 -I. September                                                                                                                                                       | NHM 2018                                                                                                                                                                                   |
| VII  | Participatory Learning and Action -(In selected 10 states that have low RMNCH+A indicators - Assam, Bihar, Chhattisgarh, Jharkhand , MP, Meghalaya, Odisha, Rajasthan, Uttarakhand and UP)                                                                                                                                                                                      | Participatory Learning and Action -(In selected 10 states that have low RMNCH+A indicators - Assam, Bihar, Chhattisgarh, Jharkhand , MP, Meghalaya, Odisha, Rajasthan, Uttarakhand and UP) | Participatory Learning and Action -(In selected 10 states that have low RMNCH+A indicators - Assam, Bihar, Chhattisgarh, Jharkhand , MP, Meghalaya, Odisha, Rajasthan, Uttarakhand and UP) | Participatory Learning and Action -(In selected 10 states that have low RMNCH+A indicators - Assam, Bihar, Chhattisgarh, Jharkhand , MP, Meghalaya, Odisha, Rajasthan, Uttarakhand and UP) | Participatory Learning and Action -(In selected 10 states that have low RMNCH+A indicators - Assam, Bihar, Chhattisgarh, Jharkhand , MP, Meghalaya, Odisha, Rajasthan, Uttarakhand and UP) |
| 1    | Conducting PLA meetings - 2 meetings per month - Note-Incentive is also applicable for AFs @Rs.100/ - per meeting for 10 meetings a month                                                                                                                                                                                                                                       | in Rs. 100/ASHA/per meeting for 02 meetings in a month                                                                                                                                     |                                                                                                                                                                                            | D.O. Z.15015/56/2015 NHM - 1 Dated 4 th 2016                                                                                                                                               | No. - (Part) - January -                                                                                                                                                                   |
| VIII | Revised National Tuberculosis Control Programme 8                                                                                                                                                                                                                                                                                                                               | Revised National Tuberculosis Control Programme 8                                                                                                                                          | Revised National Tuberculosis Control Programme 8                                                                                                                                          | Revised National Tuberculosis Control Programme 8                                                                                                                                          | Revised National Tuberculosis Control Programme 8                                                                                                                                          |
|      | Honorarium and counselling charges for being a DOTS provider                                                                                                                                                                                                                                                                                                                    |                                                                                                                                                                                            | RNTCP Funds                                                                                                                                                                                | Order on of ASHA D.O. P17018/14/13 - NRHM -IV                                                                                                                                              | revised incentives - No.                                                                                                                                                                   |
| 1    | For Category I of TB (New cases of Tuberculosis)                                                                                                                                                                                                                                                                                                                                | patients Rs. 1000 for 42 contacts over orseven months of treatment                                                                                                                         | six                                                                                                                                                                                        | Order on of ASHA D.O. P17018/14/13 - NRHM -IV                                                                                                                                              | revised incentives - No.                                                                                                                                                                   |
| 2    | For Category II of TB                                                                                                                                                                                                                                                                                                                                                           | patients Rs. 1500 for 57 contacts                                                                                                                                                          | over                                                                                                                                                                                       | Order on of ASHA D.O. P17018/14/13 - NRHM -IV                                                                                                                                              | revised incentives - No.                                                                                                                                                                   |

|    | (previously treated TB                                                                                                                               | cases) eight to nine months of treatment including 24 - 36 injections in intensive phase                                                             | 3 4                                             |                                                                              |
|----|------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------|------------------------------------------------------------------------------|
|    | For treatment and support drug resistant TB patients                                                                                                 | to Rs. 5000 for completed course of treatment (Rs. 2000 should be given at the end on intensive phase and Rs. 3000 at the end of consolidation phase | 3 4                                             |                                                                              |
|    | For notification if referred is diagnosed to be patient by MO/Lab 9                                                                                  | suspect TB Rs.100                                                                                                                                    | 3 4                                             | Revised National Tuberculosis Program- Guidelines for partnership -Year 2014 |
| IX | National Leprosy Eradication Programme 10                                                                                                            | National Leprosy Eradication Programme 10                                                                                                            | National Leprosy Eradication Programme 10       | National Leprosy Eradication Programme 10                                    |
| 1  | Referral and ensuring compliance for complete treatment in pauci - bacillary cases of Leprosy -for 33 states (except Goa, Chandigarh & Puducherry).  | Rs. 250 (for facilitating of leprosy case)+ Rs. 400 (for follow up completion of treatment)                                                          | diagnosis on NLEP Funds                         | Order on revised of ASHA incentives - D.O. No. P17018/14/13 - NRHM -IV       |
| 2  | Referral and ensuring compliance for complete treat ment in multi - bacillary cases of Leprosy - for 33 states (except Goa, Chandigarh &Puducherry). | Rs. 250 (for facilitating diagnosis of leprosy case)+ Rs. 600 (for follow up on completion of treatment)                                             | diagnosis on NLEP Funds                         | Order on revised of ASHA incentives - D.O. No. P17018/14/13 - NRHM -IV       |
| X  | National Vector Borne Disease Control Programme                                                                                                      | National Vector Borne Disease Control Programme                                                                                                      | National Vector Borne Disease Control Programme | National Vector Borne Disease Control Programme                              |
| A) | Malaria 11                                                                                                                                           | Malaria 11                                                                                                                                           | Malaria 11                                      | Malaria 11                                                                   |
| 1  | Preparing blood slides or testing through RDT                                                                                                        | Rs. 15/slide or test                                                                                                                                 | NVBDCP Funds for Malaria control                | Order on revised of ASHA incentives - D.O. No. P17018/14/13 - NRHM -IV       |
| 2  | Providing complete treatment for RDT positive Pf cases                                                                                               | Rs. 15/slide or test                                                                                                                                 | NVBDCP Funds for Malaria control                | Order on revised of ASHA incentives - D.O. No. P17018/14/13 - NRHM -IV       |
| 3  | Providing complete radical treatment to positive Pf and case detected by blood slide, per drug regime                                                | Rs.75/ -per positive cases Pv as                                                                                                                     | NVBDCP Funds for Malaria control                | Order on revised of ASHA incentives - D.O. No. P17018/14/13 - NRHM -IV       |
| 4  | For referring a case ensuring complete treatment                                                                                                     | and Rs. 300 (not in their updated list)                                                                                                              | NVBDCP Funds for Malaria control                | Order on revised of ASHA incentives - D.O. No. P17018/14/13 - NRHM -IV       |

| B)   | Lymphatic Filariasis                                                                                                                                                                                                                                | Lymphatic Filariasis                                                                                                                                          | Lymphatic Filariasis                                                                   | Lymphatic Filariasis                                                                        |
|------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------|
| 1    | For one time line listing lymphoedema and hydrocele cases in all areas of - endemic and endemic districts                                                                                                                                           | of non Rs. 200                                                                                                                                                | NVBDCP funds for control Lymphati c Filariasis three 250                               | of Order on revised of ASHA incentives - D.O. No. P17018/14/13 - NRHM -IV                   |
| 2    | For annual Mass Drug Administration for cases Lymphatic Filariasis 12                                                                                                                                                                               | of Rs. 200/day for maximum days to cover 50 houses and persons                                                                                                | NVBDCP funds for control Lymphati c Filariasis three 250                               | of Order on revised of ASHA incentives - D.O. No. P17018/14/13 - NRHM -IV                   |
| C)   | Acute Encephalitis Syndrome/Japanese Encephalitis                                                                                                                                                                                                   | Acute Encephalitis Syndrome/Japanese Encephalitis                                                                                                             | Acute Encephalitis Syndrome/Japanese Encephalitis                                      | Acute Encephalitis Syndrome/Japanese Encephalitis                                           |
| 1    | Referral of AES/JE cases to nearest CHC/DH/Medical College                                                                                                                                                                                          | the Rs. 300 per case                                                                                                                                          | NVBDCP funds                                                                           | Order on revised of ASHA incentives - D.O. No. P17018/14/13 - NRHM -IV                      |
| D)   | Kala Azar elimination                                                                                                                                                                                                                               | Kala Azar elimination                                                                                                                                         | Kala Azar elimination                                                                  | Kala Azar elimination                                                                       |
| 1    | Involvement of ASHAs during the spray rounds (IRS) sensitizing the community accept indoor spraying 13                                                                                                                                              | for to Rs. 100/ -per round during Indoor Residual Spray i.e. Rs 200 total for two rounds                                                                      | in NVBDCP funds                                                                        | Minutes Mission Steering Group meeting - Febuary - 2015                                     |
| 2    | ASHA Incentive for referring a suspected case and ensuring complete treatment.                                                                                                                                                                      | Rs. 500/per notified case                                                                                                                                     | NVBDCP funds                                                                           | Minutes Mission Steering Group meeting - Febuary - 2018                                     |
| E)   | Dengue and Chikungunya                                                                                                                                                                                                                              | Dengue and Chikungunya                                                                                                                                        | Dengue and Chikungunya                                                                 | Dengue and Chikungunya                                                                      |
| 1    | Incentive for source & IEC activities for prevention and control of Dengue Chikungunya in 12 High endemic States (Andhra Pradesh, Assam, Gujarat, Karnataka, Kerala, Maharashtra, Odisha, Punjab, Rajasthan, Tamil Nadu, Telangana and West Bengal) | reduction and Rs. 200/ - (1 Rupee /House maximum 200 houses PM for months-during peak transmission season). The incentive should be exceed Rs. 1000/ASHA/Year | for 05 not NVBDCP funds                                                                | Updated list NVBDCP incentive shared by MoHFW - NVBDCP Division - Dated- 16 th August- 2018 |
| F)   | National Iodine Deficiency Disorders Control Programme                                                                                                                                                                                              | National Iodine Deficiency Disorders Control Programme                                                                                                        | National Iodine Deficiency Disorders Control Programme                                 | National Iodine Deficiency Disorders Control Programme                                      |
| 1    | ASHA incentive for salt                                                                                                                                                                                                                             | testing Rs.25 a month for testing samples                                                                                                                     | 50 salt NIDDCP Funds                                                                   | National Deficiency Control Programme - Octuber - 2006                                      |
| XI   | Incentives under Comprehensive Primary Health Care (CPHC) and Universal NCDs Screening                                                                                                                                                              | Incentives under Comprehensive Primary Health Care (CPHC) and Universal NCDs Screening                                                                        | Incentives under Comprehensive Primary Health Care (CPHC) and Universal NCDs Screening | Incentives under Comprehensive Primary Health Care (CPHC) and Universal NCDs Screening      |
| 1    | Maintaining data validation collection of additional information - per completed form/family for NHPM - under Ayushman Bharat                                                                                                                       | and Rs. 5/form/family                                                                                                                                         | NHM funds                                                                              | D.O.No.7 (30)/2018 - NHM -I Dated 16 th April - 2018                                        |
| 2    | Filling up of CBAC forms every individual - onetime                                                                                                                                                                                                 | of Rs. 10/per form/per individual one time incentive                                                                                                          | as NPCDCS Funds                                                                        | D.O.No.Z- 1505/39/2017 -                                                                    |

of

Iodine

12 Incentive has been revised from Rs 100 to Rs 200 per day for maximum three days to cover 50 houses or 250 persons

13 In order to ensure vector control, the role of the ASHA is to mobilize the family for IRS. She does not carry out the DDT spray. During the spray rounds her involvement would be for sensitizing the community to accept indoor spraying and cover 100% houses and help Kala Azar elimination.  She may be incentivized of total Rs 200/- (Rs.100 for each round) for the two rounds of insecticide spray in the affected districts of Uttar Pradesh, Bihar, Jharkhand and West Bengal.

Water

|     | activity for enumeration individuals, filling CBAC all individuals 30 or > 30 of age                                             | of all for years                         |                                           | NHM -I Dated 19 th July - 2017                                                                           |
|-----|----------------------------------------------------------------------------------------------------------------------------------|------------------------------------------|-------------------------------------------|----------------------------------------------------------------------------------------------------------|
| 3   | Follow up of patients diagnosed with Hypertension/Diabetes and three common cancer for ignition of treatment ensuring compliance | and Rs. 50/per case/Bi - Annual          |                                           | NHM -I Dated 19 th July - 2017                                                                           |
| 4   | Delivery of new service packages under CPHC component                                                                            | Rs.1000/ASHA/PM (linked with activities) | NHM funds                                 | D.O.No.Z- 1505/11/2017 - NHM -I -Dated 30th May -2018                                                    |
| XII | Drinking water and sanitation                                                                                                    | Drinking water and sanitation            | Drinking water and sanitation             | Drinking water and sanitation                                                                            |
| 1   | Motivating Households construct toilet and promote use of toilets.                                                               | to the Rs. 75 per household              | Ministry of Drinking Water and Sanitation | Order No. Jt.D.O.No.W - 11042/7/2007 - CRSP - part - Ministry of Drinking and Sanitation - 18 th May -12 |
| 2   | Motivating Households to individual tap connections                                                                              | take Rs. 75 per household                | Ministry of Drinking Water and Sanitation | Order No. - 11042/31/2012 - Water II Ministry Drinking Water Sanitation - Febuary - 2013                 |

## Details of State Programme Implementation Plan (SPIP) Approval and Expenditure under National Health Mission from FY 2015-16 to FY 2017-18

| S. No                    | State                    | 2015-16                  | 2015-16                  | 2016-17                  | 2016-17                  | 2017-18                  | 2017-18                  |
|--------------------------|--------------------------|--------------------------|--------------------------|--------------------------|--------------------------|--------------------------|--------------------------|
| .                        |                          | SPIP                     | Exp                      | SPIP                     | Exp                      | SPIP                     | Exp                      |
| A. High Focus States     | A. High Focus States     | A. High Focus States     |                          |                          |                          |                          |                          |
| 1                        | Bihar                    | 27470.29                 | 20652.55                 | 34126.38                 | 18797.72                 | 40002.01                 | 22843.34                 |
| 2                        | Chattisgarh              | 8131.82                  | 9272.01                  | 19360.58                 | 20198.86                 | 17959.24                 | 20378.77                 |
| 3                        | Himachal Pradesh         | 1823.89                  | 1114.06                  | 1576.11                  | 2098.41                  | 2473.43                  | 2214.55                  |
| 4                        | Jammu & Kashmir          | 2514.67                  | 2234.03                  | 3092.37                  | 2642.17                  | 3461.07                  | 3071.61                  |
| 5                        | Jharkhand                | 10786.03                 | 9221.69                  | 13181.28                 | 9960.73                  | 14618.00                 | 11897.59                 |
| 6                        | Madhya Pradesh           | 17539.77                 | 19880.50                 | 20696.23                 | 21039.02                 | 23957.05                 | 22938.54                 |
| 7                        | Orissa                   | 9760.74                  | 9628.15                  | 10060.92                 | 10608.44                 | 13570.97                 | 12942.01                 |
| 8                        | Rajasthan                | 19572.25                 | 10208.59                 | 16056.60                 | 14032.09                 | 18567.73                 | 11862.31                 |
| 9                        | Uttar Pradesh            | 56119.09                 | 36855.52                 | 66936.67                 | 45300.41                 | 65316.27                 | 62560.31                 |
| 10                       | Uttarakhand              | 3253.01                  | 4177.82                  | 2694.08                  | 3076.60                  | 2973.27                  | 2933.66                  |
|                          | Sub Total                | 156971.56                | 123244.92                | 187781.23                | 147754.46                | 202899.04                | 173642.70                |
| B. NE States             | B. NE States             | B. NE States             | B. NE States             | B. NE States             | B. NE States             | B. NE States             | B. NE States             |
| 11                       | Arunachal Pradesh        | 1145.95                  | 438.90                   | 1117.08                  | 460.48                   | 1300.94                  | 757.68                   |
| 12                       | Assam                    | 14697.67                 | 12174.88                 | 13819.03                 | 12634.11                 | 15342.65                 | 13305.04                 |
| 13                       | Manipur                  | 989.11                   | 485.48                   | 1205.86                  | 394.62                   | 1182.33                  | 576.77                   |
| 14                       | Meghalaya                | 1634.45                  | 821.33                   | 1604.92                  | 977.61                   | 1987.80                  | 1309.17                  |
| 15                       | Mizoram                  | 359.01                   | 194.22                   | 455.27                   | 225.99                   | 550.78                   | 267.20                   |
| 16                       | Nagaland                 | 694.56                   | 288.16                   | 629.57                   | 266.13                   | 797.86                   | 160.48                   |
| 17                       | Sikkim                   | 187.66                   | 125.94                   | 145.41                   | 103.80                   | 185.86                   | 89.68                    |
| 18                       | Tripura                  | 1933.15                  | 1697.18                  | 2219.67                  | 1604.24                  | 2300.74                  | 2198.09                  |
|                          | Sub Total                | 21641.57                 | 16226.09                 | 21196.81                 | 16667.00                 | 23648.96                 | 18664.12                 |
| C. Non-High Focus States | C. Non-High Focus States | C. Non-High Focus States | C. Non-High Focus States | C. Non-High Focus States | C. Non-High Focus States | C. Non-High Focus States | C. Non-High Focus States |
| 19                       | Andhra Pradesh           | 11220.44                 | 13454.72                 | 8918.19                  | 9343.88                  | 10002.89                 | 12377.50                 |
| 20                       | Goa                      | 0.40                     | 0.33                     | 0.00                     | 6.35                     | 7.25                     | 7.19                     |
| 21                       | Gujarat                  | 15725.02                 | 15298.95                 | 16242.49                 | 15806.92                 | 18724.93                 | 17353.45                 |
| 22                       | Haryana                  | 5224.56                  | 5242.37                  | 6395.94                  | 4872.49                  | 7924.28                  | 6160.36                  |
| 23                       | Karnataka                | 11589.22                 | 8388.82                  | 12869.38                 | 8935.80                  | 10473.43                 | 10685.33                 |
| 24                       | Kerala                   | 1758.20                  | 1944.33                  | 2382.74                  | 2163.10                  | 3007.68                  | 2611.55                  |
| 25                       | Maharashtra              | 17267.80                 | 13005.11                 | 23100.11                 | 15270.82                 | 22363.23                 | 20093.21                 |

Rs. In lakh

| 26                  | Punjab                    | 5667.17             | 5208.18   | 4763.89   | 5194.28   | 6386.70   | 5592.89   |
|---------------------|---------------------------|---------------------|-----------|-----------|-----------|-----------|-----------|
| 27                  | Tamil Nadu                | 421.62              | 567.30    | 682.76    | 884.32    | 1243.18   | 1137.91   |
| 28                  | Telangana                 | 6780.42             | 3718.81   | 7089.84   | 5094.21   | 6123.45   | 14387.80  |
| 29                  | West Bengal               | 18047.39            | 14783.97  | 18147.63  | 16017.76  | 21483.34  | 17100.58  |
|                     | Sub Total                 | 93702.24            | 81612.89  | 100592.97 | 83589.92  | 107740.36 | 107507.79 |
| D. Small States/UTs | D. Small States/UTs       | D. Small States/UTs |           |           |           |           |           |
| 30                  | Andaman & Nicobar Islands | 37.98               | 5.67      | 83.47     | 28.93     | 96.49     | 49.23     |
| 31                  | Chandigarh                | 10.12               | 3.15      | 17.03     | 26.19     | 13.85     | 5.68      |
| 32                  | Dadra & Nagar Haveli      | 128.18              | 70.93     | 119.97    | 74.76     | 114.64    | 65.58     |
| 33                  | Daman & Diu               | 46.37               | 32.83     | 48.46     | 28.76     | 74.43     | 44.12     |
| 34                  | Delhi                     | 1367.20             | 994.29    | 1687.18   | 1194.05   | 2206.63   | 1627.44   |
| 35                  | Lakshadwee p              | 29.91               | 7.88      | 31.38     | 21.45     | 25.70     | 19.00     |
| 36                  | Puducherry                | 0.66                | 2.16      | 54.90     | 0.40      | 28.69     | 0.20      |
|                     | Sub Total                 | 1620.42             | 1116.91   | 2042.39   | 1374.53   | 2560.43   | 1811.25   |
|                     | Grand Total               | 273935.79           | 222200.80 | 311613.39 | 249385.90 | 336848.80 | 301625.86 |

Note

1. Expenditure includes expenditure against Central Release, State share & unspent balances at the beginning of  the year. It is updated upto 31-03-2017, hence provisional.
2. 2.The Above Figures are as per FMR reported by State/UTs.
3. SPIP stands for State Programe Implementation Plan

4.Activities of  ASHA includes:  a) Incentives to ASHAs b) Orientation/review  of ASHA/ANM/AWW (as applicable)for  Scheme  for  home  delivery  of  contraceptives  (HDC),  c)  Ensuring  spacing  at  birth  (ESB {wherever  applicable}),  d)  Pregnancy  Testing  Kits  (PTK),  e)  Immunization-ASHA  Incentive,  f)  NIDDCPASHA Incentive, g) Community Processess h) ASHA (Urban), i)Training-ASHA, j) AWW and MPW, k) ASHA Honorarium,  l)  NVBDCP-Asha  Incentives,  m)  ASHA  Insentivization  for  sensitizing  community,  n) Lymphatic Filariasis-Honorarium to drug distributors including ASHA and supervisors involved in MDA, 0) ASHA incentive for one time linelisting of Lymphoedema and Hydrocele cases in non-endemic distt., p) Kala Azar-Asha Incentives, q)  NLEP-ASHA Involvement, r) NLEP-Incentive to ASHA, Training/Refresher training -ASHA  (one  day),  s)  Printing  of  HBNC  Monitoring  format  for  6  &  7  module  trained  ASHA,  t) Procurement of ASHA Drug Kit, u) ASHA Incentive for fever testing, v) ASHA Incentive for treatment, w) ASHA Refresher Training, x) Incentive for distribution of LLIN by ASHAs and Printing of ASHA Training Modules.