Lok Sabha Question No. 2287 (UNSTARRED), answered on 2015-12-11
Subject: ASHAs
Ministry: HEALTH AND FAMILY WELFARE
Asked by: BOORA NARSAIAH GOUD, KINJARAPU RAM MOHAN NAIDU, PREM DAS RAI, ABHISHEK SINGH, DUSHYANT CHAUTALA

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

## LOK SABHA UNSTARRED QUESTION NO. 2287 TO BE ANSWERED ON 11 TH DECEMBER, 2015

## ASHAs

## 2287. DR. BOORA NARSAIAH GOUD:

SHRI RAM MOHAN NAIDU KINJARAPU:

SHRI PREM DAS RAI:

SHRI ABHISHEK SINGH:

SHRI DUSHYANT CHAUTALA:

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

- (a)  whether  the  Government  has received  any  proposal  to  regulate  the education,  training, recruitment  and supervision  of Accredited  Social  Health Activists  (ASHAs)  if  so,  the  details thereof along with the action taken/being taken by the Government thereon;
- (b) the number of ASHAs recruited and trained under the National Health Mission along with the funds sanctioned, relea sed and utilized thereunder during each of the last three  years and the current year, State/UT - wise;
- (c) whether the Government proposes to increase financial incentives or honorarium in order to ensure less dropouts of ASHAs, if so, the details thereof a nd if not, the reasons therefor; and
- (d) the steps taken/being taken by the Government to improve the link between community and public health system specially in maoist affected areas?

## ANSWER THE MINISTER OF HEALTH AND FAMILY WELFARE

## (SHRI JAGAT PRAKASH NADDA)

- (a): Public Health is a st te subject. Under the National Health Mission (NHM) support is provided to States/UTs for strengthening their healthcare system including for ASHAs. No proposal has been received.
- (b): The State/UT wise information on number of ASHAs selected and trained since inception of the National Rural Health Mission upto June 2015 is at Annexure I. The State wise det funds approved and expenditure during each of the last three years and the current yea Annexure II.
- (c): The  ASHA  incentives  at  the  national  level  are  reviewed  from  time  to  time  and December, 2013, the Mission Steering Group of the National Health Mission not only approve the  enhancement  in  rates  of  some  existing  incentives  to  ASHAs  but  also  app roved  new incentives including those for routine and recurring activities so as to enable each ASHA at least Rs. 1000 per month subject to her performing the said routine activities. Under the NHM,

States  have  also  been  given  the  flexibility  to design ASHA  incentives  and  support  is  also provided for State specific ASHA incentives.

(d): Under the National Health Mission, ASHAs are envisaged as a critical link between community and the public health system and support is provided to States for engaging ASHAs as per proposals received from State Governments. Public Health being a State subject, i responsibility  of  the  State  Governments    to  ensure  ASHAs  perform  the  slated  role  as between the community and public health system includi ng  in Maoist affected areas.

## Annexure -I

(As on June 2015):

| State Name        | ASHAs    | Training of ASHAs   | Training of ASHAs   | Training of ASHAs   | Training of ASHAs   | Training of ASHAs   | Training of ASHAs   | Training of ASHAs   | Training of ASHAs   | Training of ASHAs   |
|-------------------|----------|---------------------|---------------------|---------------------|---------------------|---------------------|---------------------|---------------------|---------------------|---------------------|
| State Name        | ASHAs    | Mod.1               | Mod.2               | Mod.3               | Mod.4               | Mod.5               | Module 6&7          | Module 6&7          | Module 6&7          | Module 6&7          |
| State Name        | Selected | Mod.1               | Mod.2               | Mod.3               | Mod.4               | Mod.5               | Round 1             | Round 2             | Round 3             | Round 4             |
| Bihar             | 85018    | 68592               | 52859               | 52859               | 52859               | 77034               | 77034               | 67274               | 53770               | 923                 |
| Chhattisgarh      | 66713    | 61378               | 62113               | 63579               | 63702               | 63505               | 66023               | 66023               | 66023               | 66023               |
| Himachal Pradesh* | 24385    | 7343                | 7343                | 7343                | 7343                | 7343                | 0                   | 0                   | 0                   | 0                   |
| Jammu & Kashmir   | 11686    | 11775               | 11775               | 11775               | 11775               | 11200               | 9249                | 0                   | 0                   | 0                   |
| Jharkhand         | 40964    | 40115               | 40115               | 40115               | 40115               | 40964               | 37045               | 37271               | 35982               | 32927               |
| Madhya Pradesh    | 59073    | 49789               | 48379               | 47915               | 46685               | 52054               | 54475               | 53061               | 40785               | 0                   |
| Odisha            | 44583    | 43350               | 43350               | 43350               | 43350               | 43235               | 42485               | 42415               | 42597               | 4937                |
| Rajasthan         | 52173    | 40310               | 40310               | 33811               | 33797               | 75255               | 44895               | 30192               | 1764                | 0                   |
| Uttar Pradesh     | 134124   | 135191              | 129150              | 129150              | 129150              | 129150              | 79624               | 44717               | 0                   | 0                   |
| Uttarakhand       | 11086    | 11086               | 11086               | 11086               | 11086               | 8978                | 10313               | 10381               | 10286               | 5494                |
| Arunachal Pradesh | 3827     | 3682                | 3683                | 3567                | 3632                | 3643                | 3669                | 3424                | 3424                | 375                 |
| Assam             | 30619    | 28618               | 28585               | 28544               | 28497               | 28422               | 29257               | 29560               | 17157               | 7101                |
| Manipur           | 3959     | 3878                | 3878                | 3878                | 3878                | 3878                | 3878                | 3878                | 3878                | 3878                |
| Meghalaya         | 6354     | 6258                | 6258                | 6258                | 6258                | 5588                | 5927                | 5873                | 5710                | 2924                |
| Mizoram           | 987      | 987                 | 987                 | 987                 | 987                 | 987                 | 987                 | 987                 | 987                 | 987                 |
| Nagaland          | 1887     | 1507                | 1570                | 1538                | 1588                | 1690                | 1576                | 1570                | 1624                | 0                   |
| Sikkim            | 666      | 666                 | 666                 | 666                 | 666                 | 666                 | 666                 | 666                 | 666                 | 666                 |
| Tripura           | 7531     | 7367                | 7367                | 7367                | 7367                | 7367                | 7276                | 7276                | 7188                | 3975                |
| Andhra Pradesh    | 42681    | 33769               | 33769               | 33769               | 33769               | 33769               | 33603               | 27374               | 1271                | 0                   |
| Goa               | 0        | 0                   | 0                   | NA                  | NA                  | NA                  | 0                   | NA                  | NA                  | 0                   |
| Gujarat           | 35259    | 29283               | 28723               | 28361               | 28174               | 27587               | 32451               | 31962               | 30410               | 27377               |
| Haryana           | 17404    | 20385               | 19944               | 19944               | 19944               | 17767               | 16151               | 15674               | 0                   | 0                   |
| Karnataka         | 34860    | 29916               | 29916               | 29916               | 29916               | 29916               | 29651               | 29651               | 29543               | 29543               |
| Kerala            | 31829    | 33209               | 31712               | 30709               | 29913               | 29045               | 26685               | 0                   | 0                   | 0                   |
| Maharashtra       | 59118    | 58771               | 58299               | 57482               | 56717               | 52247               | 53389               | 44123               | 18525               | 0                   |
| Punjab            | 18487    | 16375               | 16375               | 16375               | 16375               | 16403               | 16243               | 16243               | 16363               | 15956               |
| Tamil Nadu        | 3905     | 2650                | 2650                | 2650                | 2650                | 2650                | 2307                | 2456                | 2142                | 1953                |
| Talengna          | 28229    | 28019               | 28019               | 28019               | 28019               | 28019               | 24497               | 22149               | 0                   | 0                   |
| West Bengal       | 50351    | 42211               | 41163               | 40165               | 39163               | 37577               | 46621               | 44909               | 41042               | 0                   |
| A & NIslands      | 407      | 407                 | 407                 | 407                 | 407                 | 407                 | 407                 | 407                 | 407                 | 407                 |
| Chandigarh        | 50       | 47                  | 0                   | 0                   | 0                   | 0                   | 0                   | 0                   | 0                   | 0                   |
| D&NHaveli         | 255      | 255                 | 255                 | 255                 | 255                 | 255                 | 180                 | 180                 | 0                   | 135                 |
| Daman & Diu       | 82       | 68                  | 68                  | 68                  | 69                  | 69                  | 55                  | 55                  | 0                   | 0                   |
| Delhi             | 6698     | 4176                | 2992                | 3568                | 3568                | 5255                | 4609                | 4382                | 1270                | 0                   |
| Lakshadweep       | 110      | 110                 | 110                 | 110                 | 110                 | 110                 | 105                 | 0                   | 0                   | 0                   |
| Puducherry        | 0        | 0                   | 0                   | 0                   | 0                   | 0                   | 0                   | 0                   | 0                   | 0                   |
| Total             | 915360   | 821543              | 793876              | 785586              | 781784              | 842035              | 761333              | 644133              | 432814              | 205581              |

## Annexure - II

## Statement showing State wise SPIP Approval and Expenditure under ASHA training for the FY 2012- 13 to 2015 - 16

|                      |                   | 2012-13       | 2012-13      | 2013-14       | 2013-14      | 2014-15       | 2014-15      | 2015-16       | 2015-16      |
|----------------------|-------------------|---------------|--------------|---------------|--------------|---------------|--------------|---------------|--------------|
| S.No.                | State             | SPIP Approval | Expenditur e | SPIP Approval | Expenditu re | SPIP Approval | Expenditur e | SPIP Approval | Expenditu re |
| A. High Focus States |                   |               |              |               |              |               |              |               |              |
| 1                    | Bihar             | 2,889.00      | 1,585.42     | 6,265.68      | 2,255.28     | 1,329.55      | 1,292.38     | 1,335.64      | 29.35        |
| 2                    | Chattisgarh       | 2,275.08      | 2,724.83     | 3,239.81      | 2,579.43     | 2,541.21      | 2,331.97     | 2,677.85      | 792.75       |
| 3                    | Himachal Pradesh  | -             | 4.48         | -             | -            | 294.50        | 1,115.26     | 414.27        | 41.05        |
| 4                    | Jammu & Kashmir   | 332.89        | 71.34        | 533.50        | 376.57       | 264.38        | 96.76        | 251.99        | 52.03        |
| 5                    | Jharkhand         | 1,834.49      | 804.77       | 2,063.93      | 791.84       | 1,473.26      | 733.88       | 2,090.34      | 415.45       |
| 6                    | Madhya Pradesh    | 1,649.05      | 1,490.59     | 1,495.14      | 1,830.89     | 3,329.11      | 3,316.00     | 3,423.15      | 1,480.44     |
| 7                    | Orissa            | 2,707.53      | 1,911.96     | 2,941.90      | 2,672.54     | 1,316.83      | 954.48       | 1,025.58      | 311.63       |
| 8                    | Rajasthan         | 1,045.90      | 552.78       | 3,867.54      | 564.26       | 1,715.51      | 334.01       | 2,454.62      | 43.12        |
| 9                    | Uttar Pradesh     | 2,368.00      | 135.45       | 4,929.89      | 1,082.18     | 1,468.16      | 1,814.68     | 7,353.46      | 913.35       |
| 10                   | Uttarakhand       | 408.84        | 435.17       | 227.01        | 280.47       | 374.14        | 236.74       | 145.45        | 279.34       |
|                      | Sub Total         | 15,510.78     | 9,716.79     | 25,564.40     | 12,433.46    | 14,106.65     | 12,226.16    | 21,172.35     | 4,358.50     |
| B. NE States         |                   |               |              |               |              |               |              |               |              |
| 11                   | Arunachal Pradesh | 136.62        | 172.19       | 94.84         | 80.58        | 90.89         | 56.68        | 167.16        | 19.57        |
| 12                   | Assam             | 1,330.40      | 1,344.26     | 1,074.82      | 1,334.51     | 1,140.53      | 393.90       | 527.08        | 180.29       |

| 13                       | Manipur        | 102.61   | 8.47     | 4.20     | 5.74     | 19.52    | 65.70    | 1.51     | 2.61   |
|--------------------------|----------------|----------|----------|----------|----------|----------|----------|----------|--------|
| 14                       | Meghalaya      | 301.50   | 143.73   | 179.47   | 82.36    | 327.90   | 32.55    | 256.68   | 95.32  |
| 15                       | Mizoram        | 43.97    | 22.92    | 32.53    | 117.05   | 56.01    | 84.76    | -        | -      |
| 16                       | Nagaland       | 4.05     | 29.04    | 56.34    | 57.52    | 124.28   | 0.20     | 187.14   | 65.96  |
| 17                       | Sikkim         | 55.60    | 49.73    | 46.73    | 43.16    | 29.35    | 20.20    | 26.87    | 2.82   |
| 18                       | Tripura        | 303.08   | 152.55   | 150.23   | 97.28    | 1,419.89 | 451.33   | 488.07   | 243.17 |
|                          |                | 2,277.83 | 1,922.89 | 1,639.16 | 1,818.20 | 3,208.37 | 1,105.31 | 1,654.51 | 609.74 |
| C. Non-High Focus States |                |          |          |          |          |          |          |          |        |
| 19                       | Andhra Pradesh | 2,332.39 | 879.75   | -        | -        | -        | 11.38    | 2,283.02 | 179.81 |
| 20                       | Goa            | -        | -        | -        | -        | -        | -        | -        | -      |
| 21                       | Gujarat        | 955.64   | 416.17   | 760.85   | 394.18   | 3,479.53 | 2,125.48 | 3,096.66 | 778.46 |
| 22                       | Haryana        | 200.00   | 190.14   | 1,061.20 | 960.90   | 342.19   | 122.03   | 817.27   | 11.38  |
| 23                       | Karnataka      | 1,570.75 | 1,148.84 | 999.81   | 293.77   | 2,511.25 | 66.87    | 1,676.78 | 466.32 |
| 24                       | Kerala         | 644.91   | 751.83   | 370.14   | 210.06   | 136.73   | 82.73    | 274.50   | 86.12  |
| 25                       | Maharashtra    | 1,073.74 | 1,115.81 | 1,459.49 | 1,024.18 | 1,282.34 | 1,040.46 | 1,540.35 | 254.42 |
| 26                       | Punjab         | 584.03   | 428.93   | 29.63    | 332.09   | 138.73   | 222.79   | 718.27   | 80.68  |
| 27                       | Tamil Nadu     | -        | 53.81    | -        | 41.24    | 329.58   | 64.95    | -        | 38.40  |
| 28                       | Telangana      |          |          |          |          | 0.55     | -        | 443.73   | 4.00   |

| 29                  | West Bengal               | 1,240.63   | 1,054.48   | 2,137.66   | 1,314.36   | 2,588.30   | 1,225.82   | 2,400.14   | 811.68   |
|---------------------|---------------------------|------------|------------|------------|------------|------------|------------|------------|----------|
|                     | Sub Total                 | 8,602.09   | 6,039.76   | 6,818.78   | 4,570.78   | 10,809.20  | 4,962.51   | 13,250.72  | 2,711.27 |
| D. Small States/UTs |                           |            |            |            |            |            |            |            |          |
| 30                  | Andaman & Nicobar Islands | 6.50       | 4.41       | 6.74       | 5.95       | 2.06       | 0.90       | -          | -        |
| 31                  | Chandigarh                | -          | -          | -          | -          | -          | -          | -          | -        |
| 32                  | Dadra & Nagar Haveli      | 7.15       | 3.57       | 2.22       | 1.37       | 9.16       | 2.04       | 20.81      | -        |
| 33                  | Daman & Diu               | -          | 4.16       | 15.43      | 9.02       | 5.44       | -          | 5.44       | -        |
| 34                  | Delhi                     | 463.69     | 114.60     | 277.56     | 148.75     | -          | 8.84       | -          | -        |
| 35                  | Lakshadweep               | 6.00       | 0.90       | -          | -          | -          | -          | 0.50       | -        |
| 36                  | Puducherry                | -          | -          | -          | -          | -          | -          | -          | -        |
|                     | Sub Total                 | 483.34     | 127.64     | 301.95     | 165.09     | 16.66      | 11.78      | 26.75      | -        |
|                     | Grand Total               | 26,874.04  | 17,807.09  | 34,324.29  | 18,987.53  | 28,140.88  | 18,305.77  | 36,104.32  | 7,679.52 |

## Note:

a) SPIP-State Programme Implementation Plan.

b) Above mentioned expenditure figures are provisional, as reported by States/UTs

c) Expenditure is inclusive of previous years nsp nt balances