Work, job satisfaction and role performance among ASHA workers in Karnataka: an overview of existing evidence

Abstract

Accredited social health activists (ASHAs) are an important component of community-based health service delivery in India. Their responsibilities have expanded considerably and include maternal and child health, health education, community mobilisation, referral services, disease prevention and support for national health programmes. The conditions under which ASHAs work may influence their job satisfaction and role performance. Evidence from Karnataka is available, but it is dispersed across studies examining workload, incentives, training, motivation, stress, digital reporting and performance. An overview was undertaken of published evidence concerning work environment, job satisfaction, motivation, workload and role performance among ASHA workers in Karnataka. Relevant studies published predominantly from 2020 onwards were identified from electronic databases, journal websites and other academic sources. Studies were examined according to geographical setting, population, study design, major variables and findings. The evidence was narratively synthesised under the themes of work environment, training, job satisfaction and motivation, role performance, and emerging challenges. Studies from Karnataka indicate that ASHAs perform a wide range of community health activities but face challenges related to workload, extended working hours, additional responsibilities, transportation, incentives, resources, training and organisational support. Digital systems have created opportunities for improved documentation and monitoring but may also add reporting responsibilities. Recent studies have increasingly examined job motivation, occupational stress, quality of life and job satisfaction. Performance studies indicate generally active participation in several maternal, child and community health activities, although gaps remain in selected areas of knowledge and service delivery. Existing evidence suggests that work environment is an important context for understanding job satisfaction and role performance among ASHAs in Karnataka. However, evidence integrating all three constructs remains limited. Future studies using standardised measures should examine their interrelationships and determine whether work environment modifies the relationship between job satisfaction and role performance.