Purpose & Scope

This document sets out an example workflow for the delivery of services and the processing of incentives for ASHAs and allied frontline service-delivery workers. It traces the maternal-health process from the identification of a pregnant woman in the community through to the upload of the incentive claim onto the financial-management system.

The process is described in a general sense. Steps specific to a High-Risk Pregnancy (HRP) are included only where they arise within the standard flow (see Step 8).

The Incentive, Frequency and Verification columns are drawn from the ASHA maternal-health incentive schedule. The Verification column lists the verifying authorities at four stages of the verification reform — Defined State (as originally designed by NHM Uttarakhand), Current State (present practice), Future State (the streamlined target routing) and Ideal State (a target architecture in which an ANM/CHO-verified claim is approved by a single State-Level Approval Officer and disbursed instantly via the IFMS API). These four states are also drawn as full workflow diagrams after the reference table. A dash (—) marks a step that carries no separate incentive.

Process at a Glance

The claim moves through five phases and the following chain of responsibility:

ASHA → ANM → ASHA → Facility Administrator → AF → BCM → BLA → MOIC → IFMS Portal

Phase 1 — Identification & Mobilisation

Lead role: ASHA. The ASHA identifies pregnant women in the community and brings them to the nearest facility for confirmation and care.

Note: Step 2 retains the ₹300 / month Due List incentive recorded earlier. This activity is not listed in the current incentive schedule, so its verification routing is not shown.

Phase 2 — Pregnancy Confirmation & Registration

Lead role: ANM (at the facility). The ANM confirms the pregnancy, registers the woman on the RCH portal and opens her maternal-health record.

Phase 3 — Antenatal Care & Documentation

Lead roles: ANM & ASHA. Risk screening, supplementation and parallel record-keeping. The three incentive lines in Step 8 align with PMSMA Annexures 2, 3 and 4 respectively.

Phase 4 — Post-Delivery Documentation & Incentive Claim

Lead role: ASHA. After the required ANC visits and delivery, the ASHA assembles the JSY claim and routes it for verification. Step 12 carries two JSY incentive lines — the antenatal and the institutional-delivery components.

Phase 5 — Block-Level Aggregation, Verification & Data Entry

Lead roles: AF → BCM → BLA → MOIC. Claims are aggregated up the block hierarchy, verified by the Medical Officer and finally entered into the financial-management system.

General Timelines & Main Blockers

1. ASHA submits all incentive forms and the ASHA Diary to the ANM once a month.
2. The AF verifies the incentive forms within 5 days of receiving them.
3. The AF submits the verified forms to the BCM.
4. No verification-time analysis is available for BCM, BLA and MOIC. The total time from Day 1 to the incentive reaching the ASHA’s IFMS account is 3 to 6 months.
5. The Future-State design should resolve this delay.

Related Maternal-Health Incentives (Reference)

These maternal-health-related ASHA incentives fall outside the linear workflow above.

Workflow State Diagrams — Verification & Approval Routing

The four diagrams below trace the complete maternal-health workflow across all nine stages (Identification through Disbursement) and five role lanes. Steps 1 to 7 (service delivery) are identical across them; the verification and approval routing in the later steps differs by state. The Defined State (original NHM design) is shown clean; the Current State carries the Gaps and Blockers observed in present practice; the Future State shows the planned Closures that resolve them; and the Ideal State is a target-architecture that bypasses all block-level and MOIC approval, routing an ANM/CHO-verified claim to a single State-Level Approval Officer for one-click validation and instant IFMS-API disbursement.

Connectors:  —— process flow    – – – rejection / return    ◇ decision

The four diagrams are available on the Defined, Current, Future and Ideal tabs of this viewer.

1. Defined State — Chain: ANM → AF → BCM → BLA → MOIC

The original NHM design, shown without gaps or blockers. The ANM verifies the claim at field level, the ASHA Facilitator aggregates it, the BCM compiles the block sheet and the MOIC approves before the BLA uploads to IFMS. There is no separate Medical Officer verification step.

2. Current State — Chain: AF / ANM → MO → BCM → BLA → MOIC

Present practice, with the Gaps (amber) and Blockers (red) observed on each step. The AF and ANM jointly verify the field report and a Medical Officer verification step (Step 9) is added before block compilation, lengthening the approval chain.

3. Future State — Chain: ANM → BLA → MOIC

The streamlined target routing, showing the planned Closures (green) that resolve the current-state gaps and blockers. The Medical Officer verification (Step 9) and the BCM compilation (Step 10) are removed; the ANM-verified claim passes directly to the BLA cross-check and the MOIC approval.

4. Ideal State — Chain: ANM / CHO → State-Level Approval Officer → IFMS API

The target architecture. ASHA verification is performed only by the ANM or CHO at field level; all block-level compilation, BLA cross-check and MOIC approval are bypassed. On approval, a new State-Level Approval Officer at the NHM office receives the request in real time and performs a single one-click validation. Payment is pushed to the IFMS portal via the IFMS API and credited to the ASHA's account instantly, removing the present 3-to-6-month delay. All applicable Future-State closures are retained.

Roles & Abbreviations