A study on impact of training programme on knowledge of maternal health care among ASHA workers in a tribal population of Tamil Nadu

Mohamed Jainul Azarudeen, M. Buvnesh Kumar, M. Logaraj, Balaji Ramraj


Background: Accredited Social Health Activist (ASHA) forms the backbone of NRHM who provides promotive, preventive, and curative health facilities in especially the vulnerable groups. There is a need to comprehensively look into the knowledge and performance of ASHA in terms of her job responsibilities in maternal health, hence this study was conducted to assess knowledge regarding maternal health care among the ASHA workers and to assess the impact achieved after the training programme.

Methods: Community based interventional study was conducted among ASHA’s in Jawadhu Hills between April to July 2017, a pretested semi structured questionnaire was administered to elicit the knowledge of ASHA in regard to maternal health care. After the initial assessment, an intervention training programme was conducted based on a module prepared in their native language and post training assessment was done after two months. The statistical tests used were proportions, chi-square test. A p value less than 0.05 was considered to be significant.

Results: Based on the initial assessment around 60% of ASHA knew about the core ANC, which statistically (p<0.05) improved after the training programme. Based on danger signs of pregnancy less than 10% knew about vaginal bleeding (3.8%), swelling of legs (4.8%), visual disturbances (6%) which statistically (p<0.05) improved after the training.

Conclusions: Knowledge of ASHAs on various aspects of maternal health care was moderately adequate, before the training programme and it was significantly improved after the training programme, which shows that there is a need for regular fixed training programme to maintain the performance of ASHA.



ASHA, Tribal health, Maternal health care

Full Text:



World Health Organization. Maternal health. Available at: URL: Accessed 10 December 2018.

World Health Organization. Maternal Mortality: Key facts. Available at: http://www. Accessed 10 December 2018.

National Health Mission, Gujarat: Maternal Health. Available at: Accessed 10 December 2018.

National Health Mission, India. Communitisation: About Accredited Social Health Activist (ASHA). Available at: Accessed on 8 October 2018.

National Rural Health Mission. Guidelines for Community Processes. ASHA Guidelines, 2013 Available at: communitisation/asha/OrdersGuidelines/Guidelines_for_Community_Processes_2014_English.pdf. Accessed 15 December 2018.

Dholakia RH, Bajpai N. Improving the performance of Accredited Social Health Activists in India, 2011. Available at: https://academiccommons.columbia. edu/doi/10.7916/D8988G63. Accessed 15 December 2018.

Valiveti PDSK, Vinjam BN, Bandarupalli T, Rachamadugu NR. A cross sectional study of the knowledge, attitude and practice of ASHA workers in implementation of Janani Suraksha Yojana in Tadikonda Mandal, Guntur, Andhra Pradesh, India. Int J Res Med Sci. 2017;5(2):551-553.

Kohli C, Kishore J, Sharma S, Nayak H. Knowledge and practice of Accredited Social Health Activists for maternal healthcare delivery in Delhi. J Family Med Prim Care. 2015;4(3):359–63.

Kaur R, Chauhan HS, Gupta N, Thakur P, Pahari S. Assessment of accredited social health activist's knowledge and services in district Ludhiana, Punjab. J Res Educ Indian Med. 2015;11:101-6.

Rajendra M, Dilip R, Lovesh S, Anamika T, Mahendra K, Kusum G. Knowledge Status of Accredited Social Health Activist (ASHA) of Jaipur City. IMJ Health. 2016;2(12):18-25.

Dinesh P, Shanta G, Priyanka S. Functioning of Accredited Social Health Activists (Ashas) In ICDS: An Evaluation. Health and Population. Perspectives Issues. 2013;36(3-4):78-89.

Ishaque S, Mundodan J M. Awareness about breast-feeding practices among anganwadi workers and ASHAS. J res preventive soc med. 2017;1(1):5–7.

Darshan KM, Mitali GP, Girija K, Shyamal KP, Sunita SN. A cross sectional study of the knowledge, attitude and practice of ASHA workers regarding child health (under five years of age) in Surendra Nagar District. Healthline. 2011;2(2):50-3.

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 PopulNutr. 2015;33(1):137-45.