ABSTRACT
Background: The accredited social health activist (ASHA) is a link between community and health systems, so her services are very crucial for attainting universal health coverage. Comprehensive understanding of the demotivating factors, affecting the work efficacy of ASHA workers in the tribal areas, will not only help us in framing new ideas for providing them a positive work environment but also in retaining these health providers in their current job and increase their productivity and efficiency. Objectives: The study aims to find out the challenges and demotivating factors that ASHA workers face while implementing their responsibilities in tribal areas and frame recommendations based on study findings. Materials and Methods: An observational cross-sectional study conducted in a tribal area falling within the scope of a primary health care (PHC) center affiliated to a medical college. A semi-structured interview schedule was utilized to interview trained ASHA workers to understand the practical in-field challenges while implementing duties. Results: About 63% of ASHA workers were satisfied working in the tribal area. However, the major causes of de-motivation were community resistance (71.7%), less/irregular incentives (69.5%), transportation problems (52.2%), workload and stress (56.5%), and lack of training (23.9%). Family support and cooperation by auxiliary nurse midwife/multipurpose worker and other health-care staff in referral units were satisfactory for ASHAs in tribal areas. Conclusion: Most of the ASHA workers of the tribal area were satisfied with their job responsibilities, but timely activity-based incentives for the ASHA workers and regularity in their monthly salary and more community awareness about ASHA can motivate ASHA workers and increase their efficiency in providing PHC.
ABSTRACT
Background: Accredited Social Health Activist (ASHA) workers and their activity are considered as one of the key components of National Health Mission (NHM). ASHA workers serve as an important link between community and health facilities. Objectives: The objectives of the study were to assess the work profile of ASHA workers in Kathua district of Jammu and Kashmir. Materials and Methods: The present prospective cross-sectional study was conducted in Parole Block of district Kathua in Jammu and Kashmir from February 2019 to May 2019. A total of 176 rural ASHA workers were interviewed using a predesigned, pretested questionnaire after seeking informed consent. Results: About 52.2% catered to a population of 500–1000. About 34% of the workers were educated up to 10th standard and 10.7% up to 12th standard. About 64.2% of the ASHA workers are active in supporting institutional deliveries and 88% of the ASHAs made household visits for nutrition counseling. Conclusions: ASHA acts as a first link between the community and health-care services. Thus, it is necessary to strengthen the role of ASHA on promotive and preventive health care services through regular joint training of ASHAs.