ASHA Radio Programme under NRHM, Assam

 Background

National Rural Health Mission (NRHM), Assam has selected and trained 28798 Accredited Social Health Activists (ASHAs) as a bridge of communication between the community and health service delivery. ASHAs play a major role in the implementation of all MCH related schemes of NRHM, as they are the ones who directly communicate with the community which they belong to. Therefore, it is imperative to keep the ASHAs updated with various kind of information related to MCH services and schemes, build communication capacity enabling them to effectively engage at the family level and hold dialogues with mothers.

Keeping this communication need in mind, National Rural Health Mission, Assam in collaboration with All India Radio (AIR), Guwahati initiated a bi-weekly radio programme for ASHAs namely “ASHA Radio Programme” in August’2007. The touchy music and notes of the title song helped in mobilizing the ASHAs and increase the listenership.

 Partnership and Alliances

Along with NRHM and AIR, the partnership was further extended with the involvement of UNICEF Assam, specifically to strengthen the area of content development. NRHM provides fund for the Radio Programme and AIR is executing the plans for production of radio programme under the guidance of NRHM. The responsibility for the broadcasting of the programme is with the Marketing Division of AIR along with the IEC/BCC division of NRHM. The contents of the programme are supplied by NRHM one month ahead of the broadcast of the programme and accordingly AIR plans the programme, arrange artist and produce the programme for broadcast.

 Major Elements of the project

At the initial stage the duration of programme is aired for 30 minutes and its target is also general public along with the ASHAs as the main target audience. In a week the programme is aired twice, i.e. in the same week the programme is repeated, hence the programme is aired 4 times in a month. At the first stage it will be broadcasted in three languages viz. Assamese, Bodo and Bangla and later in other local languages. The content of the programme includes updating the ASHAs with new development and also informing them about the mission for upgrading the standard of life of the rural people in respect to health and hygiene and particularly promoting the healthy environment for mother and child. Along with health topics a programme on Village Health Nutrition Day will also be broadcasted every month in which the content will be to inform the ASHAs on health day & their roles & responsibilities in organizing the health day along with Auxiliary Nurse Midwives (ANM) & Anganwadi Worker (AWW).

The methodology used is infotainment which means information with entertainment that includes discussion with a representative from the health department, songs and play. Further, the topical issues are also discussed to provide information, e.g. before the immunization week information & discussion on this is done. Similarly, before any specific day/ event the topic related to that event/ day is discussed in the programme.

At present after the launch of the programme following issues were discussed – roles and responsibility of ASHAs under NRHM, Importance of Immunization, Family Planning, Safe Drinking Water and Village Health Nutrition Day and role of ASHAs in it. Similarly, till March’08 the issues to be discussed have been planned, they are on – Malaria, Anemia, Breastfeeding, Diarrhea, Sanitation, Measles, Tuberculosis and Anti Tobacco and other health related issues prevalent in the community.

 Feedback Mechanism

The programme is a two way process, meaning feedbacks and suggestions are taken from the ASHAs. For this pre paid post cards with printed address of office of the AIR, Guwahati along with health messages for IEC will be provided to ASHAs through Block Programme Managers, and no postal charges taken for these post cards. The AIR, Guwahati is given the responsibility to sort the letters and the queries that need special attentions are sent to the office of the Mission Directorate. At present the address of the AIR is told at the end of the programme as the post card is yet to be implemented. Each ASHA will be given 12 postcards and if required then they can get it from the BPMs. The feedback mechanism is divided into individual and general queries/complains. In case of individual queries/ complains the office of Mission Directorate will take the necessary actions whereas for general queries/complains which is beneficial for all the ASHAs are addressed in the radio programme. Along with this the experience of ASHAs are also shared in the programme.

 Monitoring & Evaluation

1. The District Media Expert (DME) with the District Programme Manager (DPM) and Block Programme Manager is responsible for collecting the response from ASHAs. For this a pre designed questionnaire will be given to them which will be analyzed by the districts.To know the impact of the programme a survey by an independent agency will be conducted. At the initial stage this will be done after every six months.

 Cost Analysis

If we analyze the cost of the radio programme then it is seen that the procurement cost for 26247 radio sets is Rs. 1.3 Cr. Consequently, for production of ASHA programme total cost incurred is Rs. 94100/-, out of which per episode the amount spent is Rs. 48000/- for developing the ASHA programme and Rs.23050/- which is one time expenditure for developing the theme song in one language.

  Content of the programme

The UNICEF support to this unique initiative focuses on the content development of episodes, by incorporating key messages from Facts For Life. The other areas looked after by the HR support provided are checking with ASHAs at the field level about the programme content, receive feedback on the spot and also promote listenership by using the platform of VHNDs on Wednesdays. The subjects of the radio programme covered ANC, PNC, Diarrhoea/Malaria management, Communication technique for ASHAs etc. Special episodes are arranged on special/ occasions like, child protection month, World Population Week etc or during emergency.

The duration of the bi-weekly, bi-lingual Radio Programme is 30 minutes and the target audience are both the ASHAs as well as other health or related service providers and the community members. The programme is aired twice a week, the second episode in the week being a repeat broadcast of the first. It is broadcast in two languages: Assamese and Bengali. The present programme schedule is as follows:

ASHA Radio Programme Schedule

The content of the programme mainly focuses on updating the ASHAs on new developments pertaining to NRHM and also suggest newer ways to help upgrade the lives of the rural masses in respect to health and hygiene and promoting a healthy environment for the mother and child. This programme educates the ASHAs on the importance of organizing Village Health & Nutrition Day (VHND) and their roles and responsibilities in organizing the same along with the Auxiliary Nurse Midwives (ANMs) and Aanganwadi Workers (AWW).

The methodology used in this programme is aptly described as infotainment, which suggests information wrapped in a package of entertainment that includes discussions, song and drama. Further, topical issues are also discussed as and when required to provide information, e.g. before the immunization week information & discussion on this is done. Similarly, before any specific day/ event the topic related to that event/ day is discussed in the programme.

At the beginning, the radio programme was presented in narrative way, but following HR support provided by UNICEF on content development, the format of the programme had been changed and a drama portion has been included in the programme to render it listener friendly. The main characters of the of this infotainment serial have become popular among both the primary and secondary listeners which are: Tarulata (the ASHA) Bakuli Jethai (elderly woman of the village), Nanda Master (village school teacher) and others. These characters are easily identified by the listeners in their own settings and additional characters like the Gaon Burah, panchayat ward member are coined as and when required keeping in mind their roles in social development.

Topics discussed in ASHA Radio Programme:

Following issues have been discussed in the ASHA Radio programme till July’2010 – Roles and responsibility of ASHAs under NRHM, Importance of Breast Feeding, Immunization, Family Planning, Safe Drinking Water, Hygiene & Sanitation, Importance of Institutional Deliver, ANC, PNC, Complementary Feeding, Child care, Village Health Nutrition Day and role of ASHAs in it, Malaria, Diarrhoea, Anaemia, Measles, Tuberculosis, Anti Tobacco, AIDS and other health related issues prevalent in the community. Detailed list of episodes with the topics is enclosed in the Annexure.

Feedback Mechanism & Monitoring

As far as feedback is concerned, a proper mechanism is put in place. For this purpose, pre-paid post cards with printed address of the office of the AIR, Guwahati along with health messages for IEC have been provided to ASHAs through Block Programme Managers, and no postal charges are taken for these post cards. Each ASHA is given 12 postcards and in case of further requirement, they can collect the same from the BPM. In case of individual queries/ complains the office of Mission Directorate takes necessary actions. Also, general queries and complaints, which are beneficial to all ASHAs are addressed in the programme itself. Already more than 20,000 postcards from the ASHAs have been received and the queries of them have been sorted out and time to time the answers are broadcast through the programme.

The content developers for ASHA Radio programme regularly conduct district/ block visits to monitor various activities of ASHAs, holding of VHNDs, etc. During their visit and during the training programme or any gathering of ASHAs the feedback are taken through focussed discussions and filling up of specific questionnaires.

Fig (a) – Post Card for ASHAs

Cost Analysis

The production cost per episode for ASHA radio programme is approx. Rs. 38000/-.

Conclusion:

The ASHA radio programme is an initiative of NRHM, Assam to provide relevant and current information on NRHM programmes to the frontline workers working in the field and to be in direct touch with them to obtain feedback on access to entire NRHM driven programme. Along with this, the programme also targets the health issues that are prevalent in the community keeping the community as the target audience which ASHAs need to know to discuss with the community in village. In this way, even the ASHAs can work effectively as they know about the current programmes and health issues to discuss with the community and a feeling that they are also a part of the system. The ASHA Radio Programme is a useful tool to upgrade the knowledge level of ASHAs regarding various aspects of health and communication and hygiene, practices.

All the ASHAs have been provided with a radio set in Assam to encourage the programme listening and its promotion. Programme broadcast on Wednesdays during VHND sessions have further helped the cause. But there are challenges faced due to poor radio signal received in many areas of the state which needs to be addressed along with sustaining the interest of the programme listening by innovative measures and addressing the communication need properly.

ANNEXURE

Fig (a) ASHA Radio	Fig (b) ASHA with Radio