What they know about their work, barriers, and challenges faced by the community health workers while performing their multiple roles: mixed method study in India

Authors

  • Rekha Rani Bist Asian Institute of Public Health, Bhubaneswar, Odisha, India
  • Kripalini Patel Regional Medical Research Centre, Indian Council of Medical Research, Bhubaneswar, Odisha, India
  • Sudeshna Pradhan Siksha 'O' Anusandhan University, Bhubaneswar, Odisha, India
  • Binod Kumar Patro All India Institutes of Medical Sciences, Sijua, Patrapada, Bhubaneswar, Odisha, India
  • Sandeep Kumar Tripathy Saheed Laxman Nayak Medical College, Koraput, Odisha, India
  • Pavan Kumar Gollapalli Chettinad Hospital and Research Institute, Kelambakkam, Tamil Nadu, India
  • Sunita Jena All India Institutes of Medical Sciences, Sijua, Patrapada, Bhubaneswar, Odisha, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20231708

Keywords:

ASHA, Barriers, Challenges, Multiple roles, Work responsibility

Abstract

Background: Accredited social health activist (ASHA) forms the backbone of National Health Mission (NHM) as they are the important link between the community and the health system, her services become very crucial for the success of NHM. They are occupied by multiples roles, responsibilities and they are expected to perform at optimum level. Aim was to assess the knowledge and practice of ASHA workers regarding their work responsibilities and to explore the barriers and challenges faced by them while performing their multiple roles.

Methods: An explanatory mixed-methods study was conducted among community health workers (ASHA) of having at least one years of experience at Uttarakhand, India with 150 ASHAs for quantitative and 14 for qualitative. Purposive sampling was employed for both the approaches.

Results: Quantitative approach shown that almost 91% of ASHA are having the knowledge about the importance of colostrum milk followed by importance of Anganwadi center (83%), immunization (79%), general health (70%), and birth preparedness (69%). The core thematic areas in qualitative result represented as personal, psychological, economic, social and environmental factors. They showed a level of unhappiness and distress related to their work overload and incentives.

Conclusions: In general, ASHAs are having adequate knowledge about their job responsibilities, there is more training needed about maintaining the records and documentation process. There is immediate need to overcome the barriers and challenges they are facing, which can hamper their performance level.

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References

Bansal SC, Nimbalkar SM, Shah NA, Shrivastav RS, Phatak AG. Evaluation of knowledge and skills of home based newborn care among accredited social health activists (ASHA). Indian Pediatr. 2016;53:689-91..

Venkata Lakshmi D, Sujitha Devi P. A study on evaluation of work performance of ASHA workers and gathering a feedback for its improvement in Chittoor (D)., AP. IOSR J Dent Med Sci. 2016;15(6):2279-861.

Meena R, Raj D, Saini L, Tomar A, Khanna M, Gaur K. Knowledge status of accredited social health activist (ASHA) of Jaipur city. Int Multispecialty J Health. 2016;2(12):2395-6291.

Choudary M, Varia K, Kothari N, Ghandhi S, Makwana NR, Parmar D. Evaluation of knowledge of ASHA workers regarding various health services under NRHM in Saurashtra Region of Gujarat. Nat J Community Med. 2015;6(2):193-7.

Mony P, Raju M. Evaluation of ASHA programme in Karnataka under the National Rural Health Mission. BMC Proc. 2012;6(5):P12.

Fathima FN, Raju M, Varadharajan KS, Krishnamurthy A, Ananthkumar SR, Mony PK. Assessment of ‘accredited social health activists’-a national community health volunteer scheme in Karnataka state, India. J Health Popul Nutr. 2015;33(1):137-45.

Saprii L, Richards E, Kokho P, Theobald S. Community health workers in rural India: analysing the opportunities and challenges accredited social health activists (ASHAs) face in realising their multiple roles. Hum Resour Health. 2015;13(1):1-13.

Ravichandran H, Janakiraman B, Yitayeh A, Fessiha B, Sundaram S. Muscle energy technique compared to eccentric loading exercise in the management of Achilles tendinitis: a pilot randomized controlled trial. Int J Adv Med Health Res. 2017;4(1):18-22.

Scott K, Shanker S. Tying their hands ? Institutional obstacles to the success of the ASHA community health worker programme in rural north India. AIDS Care. 2010;22:1606-13.

Shashank KJ, Angadi MM, Masali KA, Wajantri P, Bhat S, Jose AP. A study to evaluate working profile of accredited social health activist (ASHA) and to assess their knowledge about infant health care. Int J Curr Res Rev. 2013;5(12):97-103.

Shet S, Sumit K, Phadnis S. A study on assessment of ASHA’s work profile in the context of Udupi Taluk, Karnataka, India. Clin Epidemiol Glob Health. 2018;6(3):143-7.

Saxena S, Maheshwari S, Saxena A. Evaluation of knowledge of ASHA regarding family planning services provided under NRHM in Bhojipura block, District Bareilly. Religion. 2017;3(12):56-61.

Shukla A, Bhatnagar T. Accredited Social Health Activists and pregnancy-related services in Uttarakhand, India. BMC Proc. 2012;6(S1):4-6.

Saxena V, Kakkar R, Semwal VD. A study on ASHA- a change agent of the society. Indian J Community Health. 2012;24(1):15-8.

Gopalan SS, Mohanty S, Das A. Assessing community health workers’ performance motivation: A mixed-methods approach on India's Accredited Social Health Activists (ASHA) programme. BMJ Open. 2012;2:e001557.

Shashank KJ. A study to evaluate the knowledge of ASHA workers on antenatal and postnatal care in Bijapur district. Int J Res Med Sci. 2015;3(9):2299-302.

Meena R, Ramani SK, Saini L. Accredited social health activist (ASHA) performance indicator assessment of Jaipur city: a cross-sectional study. Int Multidiscipl J Health. 2017;3(2):40-4.

Kohli C, Kishore J, Sharma S, Nayak H. Knowledge and practice of Accredited Social Health Activists for maternal healthcare delivery in Delhi. J Fam Med Prim Care. 2015;4(3):359.

Shrivastava SR, Shrivastava PS. Evaluation of trained Accredited Social Health Activist (ASHA) workers regarding their knowledge, attitude and practices about child health. Rural Remote Health. 2012;12(4):1-7.

Thakre SS, Thakre SB, Thakre AD, Golawar SH, More SM, Humne AY. Effectiveness of the training course of asha on infant feeding practices at a rural teaching hospital: a cross sectional study. J Clin Diagn Res. 2012;6(6).

Parmar A, Parmar N, Pandya C, Mazumdar VS. Process evaluation of routine immunization (RI) and growth monitoring serveices during mamta day (village health and nutrition day) in Sinor block of Vadodara District, Gujarat, India. Nat J Community Med. 2014;5(4):378-82.

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Published

2023-05-31

How to Cite

Bist, R. R., Patel, K., Pradhan, S., Patro, B. K., Tripathy, S. K., Gollapalli, P. K., & Jena, S. (2023). What they know about their work, barriers, and challenges faced by the community health workers while performing their multiple roles: mixed method study in India. International Journal Of Community Medicine And Public Health, 10(6), 2228–2233. https://doi.org/10.18203/2394-6040.ijcmph20231708

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Original Research Articles