Jharkhand’s Sahiyas: An inspiration to Community Health Workers everywhere

On 13th March, 2020, Kamarunisha and her husband Noor Mohammad, of Telo village in Bokaro district, Jharkhand returned home after participating in the Jamaat. They were tested for COVID-19 at the airport and advised home quarantine in their village.  The village Accredited Social Health Activist (ASHA), known as Sahiya, Reena Devi, obtained this information during the household survey.

She immediately informed the medical officer-in-charge of the block, counselled the couple to follow home quarantine as per norms and followed up regularly regarding their health status and healthcare needs. Kamarunisha tested positive and was immediately quarantined at Bokaro General Hospital. The Sahiya, Reena Devi, coordinated for a medical team to be sent to the couple’s house the next day and helped in home quarantine for the family members.  She continued to actively follow-up of the couple and played a crucial role in creating awareness in the family as well as in the community for prevention of COVID-19. Timely action and persistent efforts by Reena Devi helped in preventing spread of infection to other members in the family and in her community.

The ASHAs in Jharkhand, known as “Sahiyas”, have been supporting delivery of health care services to the last mile, especially in the tribal areas. The State has about 42,000 Sahiyas, supported by 2260 Sahiya Sathis (ASHA facilitators), 582 block trainers, 24 district community mobilizers and a State level community processes resource centre. Since the launch of the programme, the Sahiyas have been widely acknowledged for their commitment and agency in enabling access to health care, even in the hard to reach and remote tribal areas.

Sahiyas have been actively engaged in various activities related to COVID-19 since March 2020, such as creating awareness about preventive measures of COVID-19 like frequent hand washing with soap and water, use of masks/face covers when stepping out in public spaces, following proper etiquette while coughing and sneezing, etc. They are also involved in contact tracing, line listing and follow up of the COVID-19 cases.

Jharkhand launched the week long Intensive Public Health Survey (IPHS) to identify the high risk population for COVID-19 from 18th to 25thJune.  On first day of the IPHS week, community meetings at the village level and in the cities were held for planning of field level activities. Subsequently for three consecutive days, active House-to-House Survey was conducted. About 42,000 Sahiyas played a crucial role in this survey. They conducted house-to-house survey of thousands of households to identify the local high risk population such as individuals with Influenza like Illness (ILI)/ Severe Acute Respiratory Illness (SARI) symptoms, population more than 40 yrs with co-morbid conditions, under-five children who missed vaccination as per the schedule and pregnant women due for Ante Natal Check-up (ANC). Testing of individuals with ILI/SARI symptoms was also ensured the same day. The details of individuals identified with higher vulnerabilities are shared with the linked Sub Centre and block /district health teams for active follow-up. 

During the survey, the Sahiyas carried out multiple tasks (such as counselling for ANC/PNC, home based new-born care, home-based care of the young child, follow-up of those on treatment with chronic diseases), during their household visits, reducing the need to undertake multiple visits to the same household for different activities.

Jharkhand’s ASHAs, or Sahiyas, who have demonstrated their commitment in addressing maternal, newborn, and child health have arisen to the occasion in supporting COVID 19 related activities.