Lok Sabha Question No. 3004 (UNSTARRED), answered on 2019-12-06
Subject: Free Insurance Cover for ASHA Workers
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Ramya  Haridas

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

## LOK SABHA UNSTARRED QUESTION NO. 3004 TO BE ANSWERED ON 6 TH DECEMBER, 2019

## FREE INSURANCE COVER FOR ASHA WORKERS

## 3004. MS. RAMYA HARIDAS:

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

- (a) whether the Government has taken any decision to provide free insurance cover to A workers, if so, the details thereof; and
- (b) whether the Government has taken any other decisi on to ncentivise ASHA workers, if so, the details thereof?

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

- (a):          The  benefit  of    Pradhan  Mantri  Jeevan  Jyoti  Beema  Yojana  and  Pradhan  Mant Suraksha Beema Yojana (for which premium of Rs. 330 and Rs. 12 per annum respectively, is fully  contributed  by  Government  of  India)  are  extended  to  eligible    ASHAs  and  ASH A facilitators.
- (b): Under  the  National  Health  Mission,  ASHAs  are  envisaged  to  be  community  health volunteers  and  are  entitled  to  task/activity  based  incentives. The  incentives  to  ASHAs  for different  tasks  are  regularly  reviewed  from  time  to  time.  Acc ordingly,  during  financial  year 2018- 19, the Government of India has  approved increase in the amount of routine and recur incentives under National Health Mission for ASHAs that will enable ASHAs to get at leas 2000/ - per month subject to carrying out assigned tasks. A list of various activities for which performance -based incentives are provided to ASHAs, is annexed.

Apart from incentives approved for ASHAs at national level, States have the flexibil design  ASHA  incentives.  15  States  have  introduced  fixed  monthly  honorarium  or  top  u incentives for ASHAs from State funds.

| List of ASHA Incentives   | List of ASHA Incentives                                                                                                                                                                                                                                                                                         | in Rs/case                                                            |
|---------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------|
|                           | Activities                                                                                                                                                                                                                                                                                                      | Amount                                                                |
| I 1                       | Maternal Health JSY financial package                                                                                                                                                                                                                                                                           |                                                                       |
| a.                        | For ensuring antenatal care for the woman                                                                                                                                                                                                                                                                       | Rs.300 for Rural areas and Rs. 200 for areas                          |
| b.                        | For facilitating institutional delivery                                                                                                                                                                                                                                                                         | Rs. 300 for Rural areas and Rs. 200 for Urban areas                   |
| 2                         | Reporting Death of women (15 - 49 years age group) by ASHA to PHC Medical Officer                                                                                                                                                                                                                               | Rs. 200 for reporting within 24 hours of occurrence of death by phone |
| II                        | Child Health                                                                                                                                                                                                                                                                                                    |                                                                       |
| 1                         | Undertaking Home Visit for the care of the New Born Post Partum mother 1 - Six Visits in Case of Institutional Delivery (Days 3 rd , 7 th , 14th, 21 st , 28 th & 42 nd )- Seven visits in case of Home Deliveries (Days 1 st , 3 rd , 7 th , 14th, 21 st , 28 th & 42 nd )                                     | and Rs. 250                                                           |
| 2                         | Undertaking Home Visits of Young Child for Strengthening ofHealth & Nutrition of young child through Home - (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 to implement only in 235 POSHAN Abhiyan and Aspirational districts | Visits Rs. 50/visit with total Rs. 250/per child for making 05 visits |
| 3                         | For follow up visits to a child discharged from Severe Acute Malnutrition (SAM) management centre                                                                                                                                                                                                               | facility or Rs. 150 only after MUAC is equal to nor - more than 125mm |
| 4                         | Ensuring quarterly follow up lowof birth weight babies newborns discharged after treatment from Specialized born Care Units 2                                                                                                                                                                                   | and New Rs. 50/ Quarter - f om the 3 rd month until 1 year age        |
| 5                         | Child Death Review for reporting child death of under 5 years of age                                                                                                                                                                                                                                            | children Rs. 50                                                       |
| 6                         | For mobilizing and ensuring every eligible child - 19 years out - of- school and non - enrolled) is administered Albendazole.                                                                                                                                                                                   | (1 Rs. 100/ ASHA/Bi - Annual                                          |
| 7                         | Week - 1- ASHA incentive for prophylactic distribution ORS to families with under - five children                                                                                                                                                                                                               | of Rs. 1 per ORS packet for 100 under five                            |
| 8                         | Week - 2-ASHA incentive for facilitating growth of all children in village; screening and referral undernourished children to Health centre; IYCF counselling to under - five children household                                                                                                                | monitoring of Rs. 100 per ASHA for completing at least household      |
| 9                         | MAA(Mother's Absolute Affection) Programme Promotion of Breastfeeding -Quarterly mother meeting                                                                                                                                                                                                                 | Rs. 100/ASHA/ Quarterly meeting                                       |

| III                                                                                                                                  | Immunization                                                                                                                                                |                                                                                                                                                                                                      |
|--------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------|------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| 1                                                                                                                                    | Full immunization for a child under one year                                                                                                                | Rs. 100                                                                                                                                                                                              |
| 2                                                                                                                                    | Complete immunization per child up - to two years age vaccination received between 1st and 2 nd year of age after completing full immunization after 01year | (all Rs. 75 3                                                                                                                                                                                        |
| 3                                                                                                                                    | Mobilizing children for OPV immunization under polio Programme                                                                                              | Pulse Rs. 100/day 4                                                                                                                                                                                  |
| 4                                                                                                                                    | DPT Booster at -5 6years of age                                                                                                                             | Rs.50                                                                                                                                                                                                |
| IV                                                                                                                                   | Family Planning                                                                                                                                             | Family Planning                                                                                                                                                                                      |
| 1                                                                                                                                    | Ensuring spacing of 2years after marriage 5                                                                                                                 | Rs. 500                                                                                                                                                                                              |
| 2                                                                                                                                    | Ensuring spacing of 3 years after birth of 1 st child 5                                                                                                     | Rs. 500                                                                                                                                                                                              |
| 3                                                                                                                                    | Ensuring a couple to opt for permanent limiting method after 2 children 6                                                                                   | Rs. 1000                                                                                                                                                                                             |
| 4                                                                                                                                    | Counselling, motivating and follow up of the Tubectomy                                                                                                      | cases for Rs. 200 in 11 states with high fertility Bihar, MP, Rajasthan, Chhattisgarh, Odisha, Uttarakhand, Assam, Haryana and Gujarat) Rs.30 0 in 146 MPV districts Rs. 150 in remaining states     |
| 5                                                                                                                                    | Counselling, motivating and follow up of the Vasectomy/ NSV                                                                                                 | cases for Rs. 300 in 11 states with high fertility Bihar, MP, Rajasthan, Chhattisgarh, Odisha, Uttarakhand, Assam, Haryana and Gujarat) and 400 in 146 MPV districts and Rs. 200 in remaining states |
| 6                                                                                                                                    | Female Postpartum sterilization                                                                                                                             | Rs. 300 in 11 states with high fertility Bihar, MP, Rajasthan, Chhattisgarh, Odisha, Uttarakhand, Assam, Haryana and Gujarat) and 400 in 146 MPV districts                                           |
| 6                                                                                                                                    | Social marketing of contraceptives -as home delivery through ASHAs                                                                                          | Rs. 1 f or a pack of 03 condoms, Rs. 1 for of OCP, Rs. 2 for a pack of ECPs                                                                                                                          |
| 7                                                                                                                                    | Escorting or facilitating beneficiary to the health the PPIUCD insertion                                                                                    | facility for Rs. 150/per case                                                                                                                                                                        |
| 8                                                                                                                                    | Escorting or facilitating beneficiary to the health thePAIUCD insertion                                                                                     | facility for Rs. 150/case                                                                                                                                                                            |
| Mission Parivar Vikas -In selected 146 districts in six states -(57 in UP, 37 in Bihar, 14 RJS, 9 in in Chhattisgarh and 2 in Assam) | Mission Parivar Vikas -In selected 146 districts in six states -(57 in UP, 37 in Bihar, 14 RJS, 9 in in Chhattisgarh and 2 in Assam)                        | Mission Parivar Vikas -In selected 146 districts in six states -(57 in UP, 37 in Bihar, 14 RJS, 9 in in Chhattisgarh and 2 in Assam)                                                                 |

Injectable Contraceptive MPA (Antara Program) and

3 Revised from Rs. 50 to Rs, 75

4 Revised from Rs 75/day to Rs 100/day

5 Bihar,  Chhattisgarh,  Jharkhand,  Madhya  Pradesh,  Odisha  ,Rajasthan,  Uttar  Pradesh,  Uttarakhand,  Arunachal  Pradesh,  Assam,  Manipur, Meghalaya, Mizoram, Nagaland, Sikkim, Tripura, Gujarat, Haryana, Karnataka, Maharashtra, Andhra Pradesh, Telangana, West Bengal & 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

9

a no -

Rs. 100 per dose

|      | hormonal weekly centchroman pill (Chhaya)-Incentive to                                                                                                                                                                                                                                                                                                                      | ASHA                                                                                                                                                                                      |                                                                                                                                                                                           |
|------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| 10   | Mission Parivar Vikas Campaigns Block level activities -ASHA to be oriented on eligible couple survey for estimation of and will be expected to conducted eli gible couple survey - maximum four rounds                                                                                                                                                                     | beneficiaries Rs. 150/                                                                                                                                                                    | ASHA/round                                                                                                                                                                                |
| 11   | Nayi Pahel -an FP kit for newly weds -a FP kit would be given the newly wed couple by ASHA (In initial phase ASHA given 2 kits/ ASHA)                                                                                                                                                                                                                                       | to may be Rs. 100/ASHA/Nayi Pahel                                                                                                                                                         | kit                                                                                                                                                                                       |
| 12   | Saas Bahu Sammelan -mobilize Saas Bahu for the Sammelan - maximum four rounds                                                                                                                                                                                                                                                                                               | Rs. 100/                                                                                                                                                                                  | per meeting                                                                                                                                                                               |
| 13   | Updating of EC survey before each MPV campaign - Note- updating of EC survey register incentive is already and recurring incentive                                                                                                                                                                                                                                          | part of routine                                                                                                                                                                           | Rs.150/ASHA/Quarterly round                                                                                                                                                               |
| V    | Adolescent Health                                                                                                                                                                                                                                                                                                                                                           |                                                                                                                                                                                           |                                                                                                                                                                                           |
| 1    | Distributing sanitary napkins to adolescent girls                                                                                                                                                                                                                                                                                                                           | Rs. 1/ pack of 6 sanitary napkins                                                                                                                                                         | Rs. 1/ pack of 6 sanitary napkins                                                                                                                                                         |
| 2    | Organizing monthly meeting with adolescent girls pertaining to Menstrual Hygiene                                                                                                                                                                                                                                                                                            | Rs. 50/meeting                                                                                                                                                                            | Rs. 50/meeting                                                                                                                                                                            |
| 3    | Incentive for support to Peer Educator (for selection process of peer educators)                                                                                                                                                                                                                                                                                            | facilitating Rs. 100/ Per PE                                                                                                                                                              | facilitating Rs. 100/ Per PE                                                                                                                                                              |
| 4    | Incentive for mobilizing adolescents for Adolescent day                                                                                                                                                                                                                                                                                                                     | Health Rs. 200/ Per AHD                                                                                                                                                                   | Health Rs. 200/ Per AHD                                                                                                                                                                   |
| VI   | Incentive for Routine Recurrent Activities                                                                                                                                                                                                                                                                                                                                  |                                                                                                                                                                                           |                                                                                                                                                                                           |
| 1    | Mobilizing and attending VHND or (outreach session/Urban Health and Nutrition Days)                                                                                                                                                                                                                                                                                         | Rs. 200 per session                                                                                                                                                                       | Rs. 200 per session                                                                                                                                                                       |
| 2    | Convening and guiding monthly meeting of VHSNC/MAS                                                                                                                                                                                                                                                                                                                          | Rs. 150                                                                                                                                                                                   | Rs. 150                                                                                                                                                                                   |
| 3    | Attending monthly meeting at Block PHC/5U - PHC                                                                                                                                                                                                                                                                                                                             |                                                                                                                                                                                           |                                                                                                                                                                                           |
| 4    | a) Line listing of households done at beginning of the and updated every six months b) Maintaining records as per the desired norms - village health register c) Preparation of due list of children to be updated on monthly basis d) Preparation of due list of ANC beneficiaries to be updated on monthly basis e) Preparation of list of eligible couples updated basis | Rs. 150 year like immunized on monthly Rs. 1500 7                                                                                                                                         | Rs. 150 year like immunized on monthly Rs. 1500 7                                                                                                                                         |
| VI I | 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 in a month                                                                                                                                                                                                                                 | Rs. 100/ASHA/per meeting for 02 meetings month                                                                                                                                            | Rs. 100/ASHA/per meeting for 02 meetings month                                                                                                                                            |

| VI II   | 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                                                                                     |                                                                                                                                                  |                                                                                                                                                |
| 1       | For Category I of TB patients (New cases of Tuberculosis)                                                                                        | Rs. 1000 for 42 contacts over six or seven of treatment                                                                                          | Rs. 1000 for 42 contacts over six or seven of treatment                                                                                        |
| 2       | ForCategory II of TB patients (previously cases)                                                                                                 | treated TB Rs. 1500 for 57 contacts over eight to nine of treatment including 24 - 36 injections in phase                                        | treated TB Rs. 1500 for 57 contacts over eight to nine of treatment including 24 - 36 injections in phase                                      |
| 3       | For treatment and support to drug resistant TB                                                                                                   | patients Rs. 5000 for completed course of treatment (Rs. 2000 should be given at the end on intensive and Rs. 3000 at the end of consolidation   | patients Rs. 5000 for completed course of treatment (Rs. 2000 should be given at the end on intensive and Rs. 3000 at the end of consolidation |
| 4       | For notification if suspect referred is diagnosed patient by MO/Lab 9                                                                            | to be TB Rs.100                                                                                                                                  | to be TB Rs.100                                                                                                                                |
| IX      | National Leprosy Eradication Programme 10                                                                                                        | National Leprosy Eradication Programme 10                                                                                                        | National Leprosy Eradication Programme 10                                                                                                      |
| 1       | Referral and ensuring compliance for complete treatment pauci - bacillary cases of Leprosy -for 33 states (except Goa, Chandigarh & Puducherry). | Referral and ensuring compliance for complete treatment pauci - bacillary cases of Leprosy -for 33 states (except Goa, Chandigarh & Puducherry). | in Rs. 250 (for facilitating diagnosis case)+ Rs. 400 (for follow up on completion treatment)                                                  |
| 2       | Referral and ensuring compliance for complete treatment multi - bacillary cases of Leprosy -f r 33 states (except Goa, Chandigarh & Puducherry). | Referral and ensuring compliance for complete treatment multi - bacillary cases of Leprosy -f r 33 states (except Goa, Chandigarh & Puducherry). | in Rs. 250 (for facilitating diagnosis case)+ Rs. 600 (for follow up on of treatment)                                                          |
| X       | National Vector Borne Disease Control Programme                                                                                                  | National Vector Borne Disease Control Programme                                                                                                  | National Vector Borne Disease Control Programme                                                                                                |

| A)   | Malaria 11                                                                                                                                                                                                                                   |                                                                                                                                                                          |
|------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| 1    | Preparing blood slides or testing through RDT                                                                                                                                                                                                | Rs. 15/slide or test                                                                                                                                                     |
| 2    | Providing complete treatment for RDT positive Pf                                                                                                                                                                                             | cases                                                                                                                                                                    |
| 3    | Providing complete radical treatment to positive Pf and detected by blood slide, as per drug regime                                                                                                                                          | Rs. 75/ -per positive cases Pv case                                                                                                                                      |
| 4    | For referring a case and ensuring complete treatment                                                                                                                                                                                         | Rs. 300 (not in their updated list)                                                                                                                                      |
| B)   | Lymphatic Filariasis                                                                                                                                                                                                                         | Lymphatic Filariasis                                                                                                                                                     |
| 1    | For one time line listing of lymphoedema and hydrocele cases all areas of -non endemic and endemic districts                                                                                                                                 | in Rs. 200                                                                                                                                                               |
| 2    | For annual Mass Drug Administration for cases of Filariasis 12                                                                                                                                                                               | Lymphatic Rs. 200/day for maximum three days to cover 50 houses and 250 persons                                                                                          |
| C)   | Acute Encephalitis Syndrome/Japanese Encephalitis                                                                                                                                                                                            | Acute Encephalitis Syndrome/Japanese Encephalitis                                                                                                                        |
| 1    | Referral of AES/JE cases to the nearest CHC/DH/Medical College                                                                                                                                                                               | Rs. 300 per case                                                                                                                                                         |
| D)   | Kala Azar elimination                                                                                                                                                                                                                        |                                                                                                                                                                          |
| 1    | Involvement of ASHAs during the spray rounds (IRS) sensitizing the community to accept indoor spraying 13                                                                                                                                    | for Rs. 100/ -per round during Indoor Spray i.e. Rs 200 in total for two                                                                                                 |
| 2    | ASHA Incentive for referring a suspected case and complete treatment.                                                                                                                                                                        | ensuring Rs. 500/per notified case                                                                                                                                       |
| E)   | Dengue and Chikungunya                                                                                                                                                                                                                       | Dengue and Chikungunya                                                                                                                                                   |
| 1    | Incentive for source reduction & IEC activities for prevention control of Dengue and Chikungunya in 12 High endemic (Andhra Pradesh, Assam, Gujarat, Karnataka, Kerala, Maharashtra, Odisha, Punjab, Rajasthan, Tamil Nadu, and West Bengal) | and States Telangana Rs. 200/ -(1 Rupee /House for maximum 200 houses PM for 05 months -during peak transmission season). The incentive not be exceed Rs. 1000/ASHA/Year |
| F)   | National Iodine Deficiency Disorders Control Programme                                                                                                                                                                                       | National Iodine Deficiency Disorders Control Programme                                                                                                                   |
| 1    | ASHA incentive for salt testing                                                                                                                                                                                                              | Rs.25 a month for testing 50 salt                                                                                                                                        |
| XI   | 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 and collection of additional information -per completed form/family for NHPM - Ayushman Bharat                               | Rs.5/form/family                                         |
|------|----------------------------------------------------------------------------------------------------------------------------------------------------------|----------------------------------------------------------|
| 2    | Filling up of CBAC forms of every individual - onetime activity for enumeration of all individuals, filling CBAC for individuals 30 or > 30 years of age | all Rs. 10/per form/per individual as incentive          |
| 3    | Follow up of patients diagnosed with Hypertension/Diabetes three common cancer for ignition of treatment and ensuring compliance                         | and Rs. 50/per case/Bi - Annual                          |
| 4    | Delivery of new service packages under CPHC component                                                                                                    | Rs.1000/ASHA/PM (linked with new packages of activities) |
| XI I | Drinking water and sanitation                                                                                                                            | Drinking water and sanitation                            |
| 1    | Motivating Households to construct toilet and promote toilets.                                                                                           | the use of Rs. 75 per household                          |
| 2    | Motivating Households to take individual tap connections                                                                                                 | Rs. 75 per household                                     |