Over-Reliance on frontline health workers in India

Abstract

The roles of the frontline health workers (auxiliary nurse midwives (ANMs) and Accredited Social Health Activists (ASHAs)) in Indian public health system has been invaluable. Originally aimed at delivering the maternal and child health services, their roles have been changing with the changing public health needs of the country. They primarily provide preventive, promotive and some administrative roles encompassing various health programs including communicable and non-communicable diseases. The health workers also document their activities and outcomes in both the register-based and mobile application-based formats. These reports are critical in monitoring and evaluating the programs and as a support to a careful decision making. However, the capacity of these health workers’ in balancing their abilities and workload is unfortunately one of the most often ignored aspect within the primary health care delivery. Additionally, their challenges are worsened with inadequate services of the essential training and supervision programs that are required for strengthening of skills and adequate execution of duties and responsibilities. Thus, to enhance efficient public health delivery, India must consider additional human resource allocation and task shifting options at the earliest.