What is the difference between Anganwadi workers, ANM and ASHA- Check all details here

Community Health workers are major role players in the promotion of reproductive health services and antenatal and postnatal care of women and children. Check out the difference between ASHA, Anganwadi and Auxiliary Nurse Midwife workers or ASHA, ANM and AWW workers here
Created On: Dec 1, 2020 11:13 IST
Modified On: Dec 3, 2020 19:01 IST
Community Healthcare Workers
Community Healthcare Workers

The Community Health workers are major role players in the promotion of reproductive health services and antenatal and postnatal care of women and children. They also help the government perform activities such as immunization on a large scale across the country. 

One of the key components of the National Rural Health Mission is to provide every village in the country with a trained female community health activist ASHA or Accredited Social Health Activist. 

ASHA- Accredited Social Health Activist

These are an all-female cadre of community health workers that have been constituted by the Ministry of Health and Family Welfare under the National Rural Health Mission in 2006. They are the first point of address for any health-related issues faced by the poor sections of the population. They are involved with the primary health care of especially women and children of the poor and deprived.

Selected from the village itself and accountable to it, the ASHA will be trained to work as an interface between the community and the public health system. She must be a woman resident of the village married/ widowed/ divorced, preferably in the age group of 25 to 45 years. She should be a literate woman with due preference in selection to those who are qualified up to 10 standards wherever they are interested and available in good numbers.

Three-point tasks of ASHA workers

They create awareness on health and its social determinants, mobilize the community towards local health planning, and provide access to the rural population for existing health services

As per the Government of India, every ASHA worker must have the following responsibilities:

  1. The ASHAs would be responsible for promoting universal immunization, referral and escort services for Reproductive & Child Health (RCH) and other healthcare programmes, and construction of household toilets.
  2. Empowered with knowledge and a drug-kit to deliver first-contact healthcare, every ASHA would aid in community participation in public health programmes in her village.
  3. It is the job of ASHA worker to be a health activist in the community creating awareness on health and its social determinants to mobilise the community towards local health planning and increased utilisation and accountability of the existing health services.
  4. She will counsel women on birth preparedness, the importance of safe delivery, breast-feeding and complementary feeding, immunization, contraception and prevention of common infections including Reproductive Tract Infection/Sexually Transmitted Infections (RTIs/STIs) and care of the young child.
  5. ASHA will mobilise the community and facilitate them in accessing health and health-related services available at the Anganwadi/sub-centre/primary health centres, such as immunisation, Ante Natal Check-up (ANC), Post Natal Check-up supplementary nutrition, sanitation and other services being provided by the government.
  6. At the village level, it is recognised that ASHA cannot function without adequate institutional support. Women's committees (like self-help groups or women's health committees), Village Health & Sanitation Committee of the Gram Panchayat, peripheral health workers especially ANMs and Anganwadi workers, and the trainers of ASHA and in-service periodic training would be a major source of support to ASHA.

What is an Anganwadi worker?

The Anganwadi worker is a functionary of the Integrated Child Development Scheme (ICDS) in charge of managing the Anganwadi. Anganwadi is a type of child and mother care centre that was established as a part of the ICDS. The AWW is supported by a part-time assistant, called an Anganwadi Helper (AWH)

Functions of Anganwadi  worker

The main functions of AWW are:

  1. To elicit community support and participation in running the programme.
  2. To weigh each child every month, record the weight graphically on the growth card, use referral card for referring cases of mothers/children to the sub-centres/PHC etc., and maintain child cards for children below 6 years and produce these cards before visiting medical and para-medical personnel
  3. To carry out a quick survey of all the families and to organise non-formal pre-school activities in the Anganwadi of children in the age group 3-6 years of age
  4. To organise supplementary nutrition feeding for children (0-6 years) and expectant and nursing mothers by planning the menu based on locally available food and local recipes.
  5. To make home visits for educating parents to enable mothers to plan an effective role in the child’s growth and development with special emphasis on a newborn child.
  6. To assist the PHC staff in the implementation of health component of the Programme viz. immunization, health check-up, antenatal and postnatal check etc.
  7. To bring to the notice of the Supervisors/ CDPO any development in the village this requires their attention and intervention, particularly in regard to the work of the coordinating arrangements with different departments.
  8. To maintain liaison with other institutions (Mahila Mandals) and involve lady school workers and girls of the primary/middle schools in the village which have relevance to her functions.

Auxiliary Nurse Midwife

Auxiliary Nurse Midwife (ANM) is a female health worker based at a health sub-centre or Primary health centre. They are also known as the essential frontline workers under the National Rural Health Mission. This cadre was created in the 1950s to help the Government focus on basic maternal health including midwifery and child health. After this, the ANMs were designated as multipurpose workers (MPW) and their responsibilities included family planning, immunisation, infectious disease prevention and care, in addition to maternal health and childbirth.

At the time the ANM program was launched, ANMs received two years of training focused primarily on MCH, with midwifery being the focus of nine out of the 24 months of training

Difference between Anganwadi workers, ANM and AWW

  1. India has three cadres of Community Health Workers. The first one is the Auxiliary Nurse-Midwife (ANM), based at a sub-centre, visiting various villages in addition to providing care at the subcenter. The second is the Anganwadi Worker (AWW), working solely in her village and focusing on the provision of food supplements to young children, adolescent girls, and lactating women. The final cadre is the Accredited Social Health Activist (ASHA), who also works in the village assigned to her. These workers focus on the promotion of MCH, including immunizations and institutional-based deliveries, for which they receive a performance-related fee.
  2. There are at present 208,000 ANMs, 1.2 million AWWs, and 857,000 ASHA workers. They each have their own supervisory systems and payment systems.
  3. ANMs receive 18 months of training while AWWs and ASHA workers each receive 3–4 weeks with additional pieces of training from time to time.
  4. ANMs are paid a government salary. AWWs are considered to volunteers but are paid an “honorarium” of about 2000-2500 rupees per month. ASHA workers receive performance-based incentives, such as 700-800 rupees for the facilitation of institutional delivery and 250 rupees for the facilitation of a child’s completion of immunizations. They also now receive around rupees 1200 per month for completing their day-to-day routine tasks independent of the specific tasks for which they receive performance-based incentives.