Abstract

Community health workers (CHW) faced increased challenges in delivering maternal and child health services during the current COVID-19 pandemic. In addition to routine services, they were also engaged in pandemic management. In view of a dearth of evidence, the current study explores the challenges faced by CHWs while rendering maternal and child health services. A qualitative study through in-depth interviews (IDI) and focus group discussions (FGD) in six districts of Odisha was conducted from February to April 2021. Data were analyzed using MAXQDA software. Personal-level challenges, like lack of family support, stress, and fear of contracting COVID-19; facility-level challenges, like transportation problems and inadequate personal protective measures; and community-level challenges, like stigma, resistance, and lack of community support were major hindrances in provisioning routine MCH services. Prevailing myths and misconceptions concerning COVID-19 were factors behind stigma and resistance. Sharing experiences with family, practicing yoga and pranayam, engaging ambulance bikes, financial assistance to mothers, counseling people, and involving community leaders were some effective strategies to address these challenges. Development and implementation of appropriate strategy guidelines for addressing the challenges of frontline warriors will improve their work performance and achieve uninterrupted MCH services during pandemics or similar health emergencies.

Highlights

  • The COVID-19 pandemic has demonstrated the need for investment in the health workforce [1]

  • We carried out a qualitative study among Community health workers (CHW) (ASHA, Auxiliary Nurse Midwives (ANMs), Lady health visitors (LHVs)) using in-depth interviews (IDI) and focus group discussions (FGD)

  • This is the first study in eastern in Odisha state (India) to explore the challenges faced by CHWs and the strategies they adopted to ensure maternal and child health (MCH) services during the COVID-19 pandemic in Odisha

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Summary

Introduction

The COVID-19 pandemic has demonstrated the need for investment in the health workforce [1]. The COVID-19 pandemic has provided a unique scope to understand the working conditions of community health workers (CHWs) involved in the provision of healthcare services including maternal and child health services for community people. Community health workers (CHWs) have undertaken a series of new tasks in addition to their routine services, including maternal and child health (MCH) services. These new tasks include conducting household surveys for COVID-19 case detection, creating awareness about COVID-19, COVID testing, door-to-door visits, and contact tracing. Prior to the onset of the pandemic, the state of Odisha was making great efforts to improve its maternal and child health indicators [11] to achieve the figures targeted under sustainable development goals (SDG)

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