India’s child and maternal mortality rates are among the highest in the world. Increased use of maternal child health and family planning information and services improves health for this vulnerable population. In northern India, where child and maternal mortality rates are high, effective family planning and reproductive health services are limited.

One of the primary approaches added under the National Rural Health Mission (NRHM) is the recruitment of community-based Accredited Social Health Activists known as ASHAs. The main responsibilities of ASHAs include mobilizing community support, facilitating access to services, providing basic services, and maintaining linkages with elected representatives and health workers. In view of the difficult, hilly terrain, poor road connectivity, and small and scattered settlements of Uttarakhand where this project is being implemented, the ASHA scheme required major modifications so as to be suitable to local conditions. Upon request from Uttarakhand Government, the Innovations in Family Planning Services (IFPS) project has designed the ASHA-plus scheme which is being implemented in six blocks of three Upper Himalayan districts. The ASHA Plus scheme was designed after a series of consultations with public and private sector partners and a detailed study of local conditions.