“Does ASHA make any difference in utilizing maternal health care services in India? Study based on National Rural Health Mission (NRHM)”

Maternal health care services utilization depends upon various socio-economic, demographic and cultural factors. But availability and accessibility are another important factor which determined the extent of health care utilization.

This study tries to assess the role of ASHA in utilizing maternal health care services and see the level of awareness about the benefits given to JSY scheme and utilization of those benefits by using data from National Rural Health Mission (NRHM) initiated by the Government of India in 2005.

Data collected for concurrent evaluation of National Rural Health Mission (NRHM) in 2009 was used. The analysis was done only on women who have given any birth since January 2005. The total sample comes around 78, 205 women at reproductive age. Socio-economic and demographic characteristics and work done by ASHA were used as an explanatory variable to access the maternal health care utilization. The Chi-square test and "binary logit" model was used for analysis.

A unit increase in referral facility by ASHA or any other health personnel, increases the probability of institutional delivery by 2.03 times (p<0.001). While if ASHA arranged or helped in arranging transport facility increases the probability of institutional delivery 1.67 times (p<0.01) than if she is not organizing transport service. If ASHA discusses about JSY, institutional delivery/approaches to get register than the probability of getting TT injection are 0.61, 1.88 and 1.64 times higher than that if she did not discuss those facilities. The probability of Awareness about JSY was significantly lower among age 30–39 years (OR 0.89; P<0.001) in India. The probability of Awareness about JSY was less among the wealthiest quintile (OR.53; P<0.001). Awareness about ASHA is 1.09 times higher among higher age group women and Christian (p<0.001). Probability of benefits from JSY schemes is 1.25 (p<0.001) times greater among women who get married after 18 years.

ASHA plays a significant role in using maternal health care facility. Results clearly show that the work done has a significantly positive impact on maternal health care utilization. If ASHA facilitated to get JSY card, then the probability of getting more than one TT injection are increased. Similarly, the probability of institutional delivery also increases if ASHA arranged or helped in arranging transport facility.