Govt mulling incentives for ASHA workers to mobilise individuals for sickle cell disease screening

The government is planning to give incentives to ASHA health activists for mobilising eligible individuals for sickle cell disease screening and distribution of sickle cell cards for prevention and early detection of the disease.

Sickle cell disease is a group of inherited red blood disorders and a National Sickle Cell Anaemia Elimination Mission has been launched to tackle the burden of the disease in India, particularly among tribals.

The mission aims to eliminate sickle cell disease before 2047 and entails screening of 7 crore population in the age range of 0 to 40 years; pre-marital and pre-conceptional genetic counselling for prevention of sickle cell disease and holistic care for those who have the disease across both primary and secondary public health facilities.

The screening will be undertaken at both facility level through the Ayushman Bharat Health and Wellness Centre (AB-HWC) and in the community through screening camps.

To take the mission forward, the Union Health Ministry is planning to bring in a provision of giving incentive to the Accredited Social Health Activist (ASHA), official sources said.

About 9.15 lakh ASHAs are in position in rural areas and 76,795 in urban areas, the sources said.

"The current mission aims to cover seven crore population with screening and counselling for prevention and care of people with SCD in three years. It is proposed that each ASHA receives Rs 20 to mobilise each individual for sickle cell disease screening using Government of India approved point of care tests through public health facilities and an additional Rs 20 for ensuring each screened individual has received the appropriate sickle cell card," the sources said.

"ASHAs are an important part of the National Health Mission. They bridge the community and the public health system, playing the role of health activists. Their primary responsibilities include creating awareness about health and its social determinants, mobilising the community for local health planning, and encouraging the utilisation of existing health services," the sources said.

ASHAs serve as the first point of contact for health-related needs in the community and work towards increasing accountability of the health system, they noted.

The National Sickle Cell Anaemia Elimination Mission is being implemented in 17 high prevalence states of Gujarat, Maharashtra, Rajasthan, Madhya Pradesh, Jharkhand, Chhattisgarh, West Bengal, Odisha, Tamil Nadu, Telangana, Andhra Pradesh, Karnataka, Assam, Uttar Pradesh, Kerala, Bihar, and Uttarakhand.

It focuses on universal screening of all individuals up to 40 years of age using mass screening approach.

States have the flexibility to either follow a one-step approach (using government approved point of care tests as a one-step confirmatory test) or two-step approach (initial screening using solubility test and then confirmation using government approved point of care tests).