National Health Mission, Assam issues Covid guidelines for ASHA workers

The order further talks about vaccinations, Covid appropriate protocols

Office of the Mission Director, National Health Mission, Assam recently issued guidelines for strengthening PHSM (Public Health & Social Measures) in Assam to tackle COVID-19. In a recently issued order, the health ministry of the state has emphasised strengthening preventive and promotive measures while increasing the bed capacity (normal beds, oxygen supported beds, ICU beds and ICU beds with ventilator) for accommodating more patients at different hospitals (after triaging), accelerating the pace of COVID-19 vaccination and addressing myths around COVID vaccination urgently.

PHSM in Assam has initiated the following steps for ASHA workers.

Urgent zoom meeting with all DCMs & BCMs to ensure that ASHA supervisors and ASHAs are made aware of the current situation and once are trained they will be expected to carry out the activities. The order suggested the need for reorientation as the virus is now prevalent in villages which is a big challenge.

Firstly, 3Ws are to be promoted hugely – wearing mask properly, wash hands (sanitization of hands) and watch distance (minimum six feet apart) and secondly, 3Cs are to be remembered and to be avoided – crowded place, close contact setting, confined and closed places (proper ventilation is to be ensured).

Testing needs to be popularised followed by tracing positive cases and isolating them. On identifying positive cases, one has to ensure that either the person goes to hospital (if s/he has health issues) or remain at home adhering to all SoP of home isolation (separate room with a washroom, well-ventilated room, separate utensils, wearing of masks by all members of the family, using of the pulse oximeter (if below 95 then to rush to hospital urgently), monitoring physical condition, getting teleconsultation and to follow guidance strictly etc.).

If the positive person does not have that facility at home (because of space constraints), s/he needs to rush to the hospital. People older than 60 years and with medical comorbidities are at higher risk of developing serious complication due to covid infection. The discharge SoP must be followed strictly and the discharge protocols must be truly followed. A mass awareness campaign needs to be created and the discharge protocol must be pasted at the post office, gaon panchayat office, NGO premises, SHG office etc.

ASHAs need to keep a close update of each positive case areas and to guide each patient as appropriate and inform the same ASHA Supervisor, who in turn will inform BCM for necessary action. In case of death due to covid, the COVID protocol (not with more than 10 people) must be adhered to (to perform the last rites). ASHAs have to ensure that no violation of SoP is done in organising any celebration (not more than 10 people) in the village. Awareness activities in the villages are to be carried out regularly.

The order further emphasised ASHAs to promote downloading of e-sanjeevani OPD App for teleconsultation and the ASHA supervisor has to guide/ assist if someone does not have a smartphone.

ASHAs are to work closely with the community members, groups, civil society organisations functioning in areas on popularising COVID vaccination and in minimising myths around vaccination and can seek support from Block MO & BCM. The staff should ensure that no wrong message is circulated on social media which may create panic and is requested to report fake messages and rumours. The source of the information is to be verified before sharing on social media like Facebook, Twitter etc. Village Health and Nutrition Day (VHND) and UHND needs to be organised adhering to complete COVID Appropriate behaviour (staggered timing of vaccination, use of mask by the beneficiaries, sanitisation, social distancing etc). In the pandemic scenario, neonates, infants, children are always at high risk, as no vaccine has so far been prescribed for them. So, ASHA must ensure that all planned HBNC and HBYC visits are done after confirming that she is not COVID positive and adheres to all the guideline/norms of COVID Appropriate Behavior (CAB) and encourages the family members on the following CAB.

In case of an alarming situation, ASHA workers should be the first responder of information to the Block Medical Officer through BCM. Non-COVID essential health care services (which are time-bound and priority in nature, like ANC and PNC care, Immunization, managing any other diseases and follow up treatment and regular refilling of drugs etc.) are to be continued adhering to complete COVID Appropriate behaviour; Regular follow-ups of NCD cases and refilling of drugs should be ensured. All ASHAs and ASHA supervisors along with their family members are to be watchful about the above messages and that itself will be a great service in this hour of crisis.