India Accredited Social Health Activist Program

India's national community health worker program, begun in 2005 by the Ministry of Health and Family Welfare as part of the National Rural Health Mission and built around a cadre of Accredited Social Health Activists, or ASHAs, who bridge marginalized rural populations with the country's public healthcare infrastructure. ASHAs create awareness of health and its social determinants, mobilize their communities toward local health planning, encourage institutional childbirth, organize childhood immunizations and promote family planning, while also treating minor ailments, maintaining local demographic health records and distributing basic supplies such as oral rehydration salts and contraceptives. Each ASHA is a local female resident, generally married or widowed and between 25 and 45 years old with at least a tenth-grade education, and although formally classified as a volunteer she receives performance-based incentive payments, for example around 600 rupees for facilitating an institutional delivery and 150 rupees per child immunized, that combine with a fixed component to produce average monthly earnings of roughly 10,000 rupees; by 2018 the program had approximately 939,978 ASHAs active nationwide, approaching an official target of just over one million.