Ahmedabad, India
#00180
Case study of
#00187 Door-to-door heat outreach through existing community health workers
Implementer
Ahmedabad Municipal Corporation with IIPH Gandhinagar and NRDC; Mahila Housing Trust for ASHA training
Timeline
Since Jan 1, 2013
Location
Description
The ASHA outreach layer is the social core of the Ahmedabad Heat Action Plan, South Asia's first, launched in 2013. ASHA community health workers, already embedded in the city's informal settlements, were trained to conduct pre-alert door-to-door outreach: heat-illness awareness, hydration advice, symptom spotting and first response, with intensified rounds when color-coded alerts are issued. Mahila Housing Trust trained about 1,500 ASHAs. The plan was evaluated in a peer-reviewed study (Hess et al. 2018): approximately 1,190 avoided deaths per year and a 27 percent drop in mortality on days at or above 45°C. Attribution belongs to the whole plan (early warning, outreach, health-worker training, cool roofs), not the ASHA layer alone.
Metrics
4Funding
Lessons learned
- Low honorariums (5,000–15,000 rupees/month) and the workers' own heat exposure during rounds are structural weak points that reduce reliability and retention.
- Training arrived late in the season in multiple years — a recurring failure mode; training must be completed before the hot season begins.
- The CHW outreach layer depends on the surrounding heat action plan infrastructure (color-coded alert system, health-system referral pathways) to function effectively; deploying the outreach layer alone is insufficient.
Documented Jul 24, 2026