Interplaying role of healthcare activist and homemaker: a mixed-methods exploration of the workload of Community Health Workers (Accredited Social Health Activists) in India

Anand Shantaram Kawade, Manisha Gore, Pallavi Lele, Uddhavi Chavan, Hilary Pinnock, Pam Smith, Sanjay Juvekar

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Background
Globally, Community Health Workers (CHWs) are integral contributors to many health systems. In India, Accredited Social Health Activists (ASHAs) have been deployed since 2005. Engaged in multiple health care activities, they are a key link between the health system and population. ASHAs are expected to participate in new health programmes, prompting interest in their current workload from the perspective of the health system, community and their family.
Methods
This mixed methods design study was conducted in rural and tribal Primary Health Centers (PHCs), in Pune district, Western Maharashtra, India. All ASHAs affiliated with these PHCs were invited to participate in the quantitative study, those agreeing to contribute in-depth interviews (IDI) were enrolled in an additional qualitative study. Key informants’ interviews were conducted with the Auxiliary Nurse Midwife (ANM), Block Facilitators (BFF) and Medical Officers (MO) of the same PHCs. Quantitative data were analysed using descriptive statistics. Qualitative data were analysed thematically.
Results
We recruited 67 ASHAs from the two PHCs. ASHAs worked up to 20 hours/week in their village of residence, serving populations of approximately 800-1200, embracing an increasing range of activities, despite a workload that contributed to feelings of being rushed and constant tiredness. They juggled household work, other paid jobs and their ASHA activities. Practical problems with travel added to time involved, especially in tribal areas where transport is lacking. Their sense of benefiting the community and respect and recognition in village brought happiness and job satisfaction. They were willing to take on new tasks. ASHAs perceived themselves
Original languageEnglish
Article number7
JournalHuman Resources for Health
Volume19
DOIs
Publication statusPublished - 6 Jan 2021

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