CHW Central: India’s Auxiliary Nurse-Midwife, Anganwadi Worker, and Accredited Social Health Activist Programs

1 September, 2020

A feature article describes the roles, training, incentives and impact of these community health worker cadres in India. Extracts below. Full text here:

'Auxiliary Nurse-Midwives (ANMs), Accredited Social Health Activists (ASHAs), and Anganwadi Workers (AWWs) constitute the three cadres that make up India’s government-supported CHWs. ANMs work at health sub-centers or PHC centers and provide immunizations, health education, and antenatal care as a part of their village outreach. AWWs operate in village anganwadi (childcare) centers and conduct health and nutrition education. ASHAs conduct home-visits and assist ANMs and AWWs to promote maternal and child health. Research shows ASHAs are associated with advancements in health and care-seeking but also indicate gaps in ASHA knowledge, insufficient supervision, and weak community and referral linkage systems. Evidence on the effectiveness, impact and outcomes of ANMs and AWWs is lacking or inconclusive.'...

Impact: No impact evaluations of ANMs have been published. Assessments of the Integrated Child Development Services and its AWWs consistently note the widespread geographic coverage of the program but vary in terms of their conclusions about the program’s impact on child nutritional outcomes. The ASHA program has been associated with improvements in neonatal health, some aspects of care-seeking, and increased immunization and health-related awareness in certain areas. However, research has also identified ASHA knowledge gaps, inadequacies in ASHA training or supervision, low community engagement with and awareness of ASHAs, challenges related to referrals (limited transportation, coordination and health facility resources), and subpar performance or coverage.'

Best wishes, Neil

Coordinator, WHO-HIFA Collaboration: Empowering Community Health Workers (CHWs) to accelerate progress towards Universal Health Coverage

HIFA Project on Community Health Workers

Let's build a future where people are no longer dying for lack of healthcare information - Join HIFA:

HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - ), a global community with more than 19,000 members in 177 countries, interacting on six global forums in four languages in collaboration with WHO. Twitter: @hifa_org FB: