India

The India country profile provides an overview of the community health system in India according to the most up-to-date policies available. It particularly focuses on the country’s community health providers, the structures that support them, and the services they deliver across many health areas – with a spotlight on family planning. The profile is targeted towards policymakers, program implementers, donors, researchers, and others interested in the country’s community health system.

The table below captures key information from the full, downloadable country profile. The complete CHS Catalog data set is also available for download, including information for India.

Community Health Quick Stats

Main Community Health Policy / Strategy | Last Updated
  • Guidebook for Enhancing the Performance of Multipurpose Worker (Female) | Not specified
  • Guidelines for Community Processes | 2013
  • Home–Based Newborn Care Operational Guidelines | 2014
  • Induction Training Modules for ASHAs | Not specified
  • National Health Mission: Framework for Implementation 2012–2017 | Not specified
Number of Community Health Provider Cadres

3 main cadres

  • Auxiliary nurse midwives (ANMs) 
  • Accredited social health activists (ASHAs)
  • Anganwadi workers (AWWs)
Recommended Number of Community Health Providers
  • 178,963 ANMs¹
  • 961,113 ASHAs¹
  • 1,366,766 AWWs¹
Estimated Number of Community Health Providers
  • 212,185 ANMs¹
  • 859,331 ASHAs¹
  • 1,174,388 AWWs¹
Recommended Ratio of Community Health Providers to Beneficiaries
  • 1 ANM: 5,000 people (3,000 in hilly or hard to reach areas)
  • 1 ASHA: 1,000 people (rural); 1 ASHA: 1,000–2,500 people (urban)
  • 1 AWW: 1,000 people
Community-Level Data Collection Yes
Levels of Management of Community-Level Service Delivery

National, state, district, block/primary health center (PHC), community
Key Community Health Program(s)

Home-based distribution of contraceptives; Home-based Newborn Care Program; Integrated Child Development Services (ICDS) scheme; prevention of postpartum hemorrhage through community-based distribution of misoprostol; Rashtriya Bal Suraksha Karyakram; Universal Immunization Program

1 Data on ANMs and ASHAs are from 2015; data on AWWs are from 2012.

Key Policies and Strategies

Central Monitoring Unit of ICDS, National Institute of Public Cooperation and Child Development. 2015. Integrated Child Development Services Scheme: Monitoring and Supervision. New Delhi: Ministry of Women and Child Development, Government of India.

Central Pollution Control Board. 2004. Guidelines for Disposal of Bio-medical Waste Generated during Universal Immunisation Programme (UIP). New Delhi: Central Pollution Control Board.

Comptroller and Auditor General of India. 2013. Report No. 22 of 2012–13 Performance Audit of Integrated Child Development Services ICDS Scheme of Union Government, Ministry of Women and Child Development. New Delhi: Comptroller and Auditor General of India.

Drug Controller of India. 2015. National List of Essential Medicines 2015 (accessed August 2016).

India Nursing Council. 2013. File No. 1-6/2012/INC: Eligibility Criteria for admission to ANM, GNM & B.Sc. (N) programmes – reg. New Delhi: Indian Nursing Council (accessed August 2016).

Ministry of Environment, Forest, and Climate Change. 2015. Biomedical Waste (Management & Handling) (draft). New Delhi: Ministry of Environment, Forest, and Climate Change (accessed August 2016).

Ministry of Health and Family Welfare, Government of India. n.d. Universal Immunization Program. New Delhi: Ministry of Health and Family Welfare, Government of India (accessed August 2016).

———. 2010. File No. 16-3/2004ME(Pt): Guidelines for Monitoring and Supervision Visits to ICDS Blocks and AWCs by Officials and State and Central Governments. New Delhi: Ministry of Health and Family Welfare, Government of India (accessed August 2016).

———. 2011. File No. N-11012/3/2010-FP: Home delivery of contraceptives (condoms, OCPs, ECPs) by ASHA at the doorstep of beneficiaries. New Delhi: Ministry of Health and Family Welfare, Government of India (accessed August 2016).

———. 2006a. Direction No. Z.28020/50/2003-CH: Review of the Policy Regarding Micronutrients – Iron Folic Acid (IFA). New Delhi: Ministry of Health and Family Welfare, Government of India.

———. 2006b. No. Z.28020/06/2005-CH: Use of zinc as an alternate therapy in the treatment of diarrhea. New Delhi: Ministry of Health and Family Welfare, Government of India.

———. 2006c. Direction No. Z.28020/30/2003-CH: Vitamin A & IFA Supplementation. New Delhi: Ministry of Health and Family Welfare, Government of India (accessed August 2016).

Ministry of Health and Family Welfare, Department of AIDS Control, Government of India. 2013. Updated Guidelines for Prevention of Parent to Child Transmission (PPTCT) of HIV Using Multi Drug Antiretroviral Regimen in India. New Delhi: Ministry of Health and Family Welfare, Government of India.

Ministry of Health and Family Welfare, Family Planning Division, Government of India. 2013. IUCD Reference Manual for Medical Officers and Nursing Personnel. New Delhi: Ministry of Health and Family Welfare, Government of India (accessed August 2016).

Ministry of Health and Family Welfare, Maternal Health Division, Government of India and National Rural Health Mission. 2013. Operational Guidelines & Reference Manual: Prevention of Postpartum Haemorrhage through Community Based Distribution of Misoprostol. New Delhi: Ministry of Health and Family Welfare, Government of India (accessed August 2016).

Ministry of Women and Child Development, Government of India. n.d.a. Components of Job Training Course of Anganwadi Workers. Ministry of Women and Child Development, Government of India.

———. n.d.b. Curriculum for Refresher Training of AWWs. Ministry of Women and Child Development, Government of India.

———. n.d.c. Programme Schedule for Job Training Course for Anganwadi Workers. Ministry of Women and Child Development, Government of India.

———. 2015. “Integrated Child Development Services (ICDS) Scheme” (accessed August 2016).

National Health Mission and Ministry of Health and Family Welfare, Government of India. n.d.a. Frame­work for Implementation of National Health Mission 2012–2017. New Delhi: Ministry of Health and Family Welfare, Government of India (accessed August 2016).

———. n.d.b. Operational Guidelines: Injection of Vitamin K Prophylaxis at Birth (In Facilities). New Delhi: Ministry of Health and Family Welfare, Government of India (accessed August 2016).

———. n.d.c. Guidebook for Enhancing Performance of Multi-Purpose Worker (Female). New Delhi: Ministry of Health and Family Welfare, Government of India.

———. 2014a. Home Based Newborn Care: Operational Guidelines (Revised 2014). New Delhi: Ministry of Health and Family Welfare, Government of India (accessed August 2016).

———. 2014b. INAP: India Newborn Action Plan. New Delhi: Ministry of Health and Family Welfare, Government of India (accessed August 2016).

———. 2015. Guidelines for Rogi Kalyan Samities in Public Health Facilities. New Delhi: Ministry of Health and Family Welfare, Government of India.

National Rural Health Mission and Ministry of Health and Family Welfare, Government of India. n.d.a. ASHA Module 6: Skills that Save Lives – Focus on Maternal and Newborn Health. New Delhi: Ministry of Health and Family Welfare, Government of India (accessed August 2016).

———. n.d.b. ASHA Module 7: Skills that Save Lives – Focus on Child Health and Nutrition. New Delhi: Ministry of Health and Family Welfare, Government of India (accessed August 2016).

———. n.d.c. Induction Training Module for ASHAs. New Delhi: Ministry of Health and Family Welfare, Government of India (accessed August 2016).

———. 2006. Guidelines for Antenatal Care and Skilled Attendance at Birth by ANMs/LHVs/SNs. New Delhi: Ministry of Health and Family Welfare, Government of India (accessed August 2016).

———. 2008. Community Monitoring of Health Services Under NHRM: Managers’ Manual. New Delhi: Ministry of Health and Family Welfare, Government of India (accessed August 2016).

———. 2013a. Guidelines for Enhancing Optimal Infant and Young Child Feeding Practices. New Delhi: Ministry of Health and Family Welfare, Government of India (accessed August 2016).

———. 2013b. Loving Couples, Happy Families: Importance of Family Planning. New Delhi: Ministry of Health and Family Welfare, Government of India.

———. 2013c. D.O. No. Z 28014/1/13-NHRM-IV. New Delhi: Ministry of Health and Family Welfare, Government of India.

———. 2013d. Guidelines for Community Processes: ASHA, Village Committee, Support Structure. New Delhi: Ministry of Health and Family Welfare, Government of India (accessed August 2016).

———. 2013e. Rashtriya Bal Swasthya Karyakram (RBSK): Child Health Screening and Early Prevention Services under NRHM: Operational Guidelines. New Delhi: Ministry of Health and Family Welfare, Government of India (accessed August 2016).

National Rural Health Mission and Ministry of Health and Family Welfare, Adolescent Division, Government of India. 2013a. Guidelines for Control of Iron Deficiency Anaemia. New Delhi: Ministry of Health and Family Welfare, Government of India (accessed August 2016).

———. 2013b. Guidelines for Monthly Meeting of ASHAs at PHC. New Delhi: Ministry of Health and Family Welfare, Government of India (accessed August 2016).

National Urban Health Mission and Ministry of Health and Family Welfare, Government of India. 2015. Guidelines for ASHA and Mahila Arogya Samiti in the Urban Context. New Delhi: Ministry of Health and Family Welfare, Government of India (accessed August 2016).

Social Justice Department, Government of Kerala. 2010. “Roles and Responsibilities of Anganwadi Workers” (accessed August 2016).