Abstract
BackgroundCommunity Health Workers (CHWs) play an instrumental role in promoting socio-behavioural change at the community level, which results in changed indicators of community health. While outcomes are mostly reviewed for achieving program objectives, it is pertinent to understand the process of program implementation mainly from the perception of participating CHWs.MethodsA qualitative study to understand the perception of Sakhi’s (CHWs) regarding the outcomes of their participation in Home-Based Neonatal Care (HBNC) Program implemented by a non-governmental organization (NGO). Data consisted of 3 FGDs and 20 in-depth unstructured interviews with participating Sakhis.ResultsSakhis perceived their ability to take decisions at critical phases of the program as an important factor influencing their performance. The opportunity to participate as a Sakhi in the health programme initiated a process of change at the personal level. The changes perceived by Sakhis were enhancement in knowledge, skills and capabilities of Sakhis. The combination of improved skills, knowledge and attitude had culminated in the process of experiencing self-empowerment for the participating Sakhis. Their ability to positively influence the individuals and community with their initiatives to improve women and child health and save lives in critical situations facilitated development of a new identity and improved societal status in their communities. Changed power-relations at the family and community level promoted the involvement of Sakhis in the broader development agenda. Sakhis’ ability to strategize goals, evaluate their own abilities, their willingness to upgrade knowledge and take others along in bringing social change, was an evident movement towards self-development.ConclusionAn opportunity for local women to participate in development programs creates potential for self-development as a cascading effect in addition to the accomplishment of planned program objective.
Highlights
Community Health Workers (CHWs) play an instrumental role in promoting socio-behavioural change at the community level, which results in changed indicators of community health
In 2005, India embarked on a massive reform of its health system by forming the National Rural Health Mission (NRHM), under which it legitimized the role of CHW by forming a cadre of women CHW called Accredited Social Health Activists (ASHA) [4]
We present in this paper Sakhis’ perception of how being a CHW in a home-based neonatal care (HBNC) program impacted their selves
Summary
Community Health Workers (CHWs) play an instrumental role in promoting socio-behavioural change at the community level, which results in changed indicators of community health. A large national CHW scheme was established in the late 1970s that aimed to provide one CHW for every 1000 people in order to provide adequate health care to rural people and to educate them in matters of preventive and promotive health care [1] This approach of involving CHW for larger health and development goals continued in India and got a fillip with the Alma Ata declaration of 1978, which called for integrated approaches to healthcare in low-income countries [2], and the Cairo Population Conference in 1994, which recognized the need for involvement of communities for providing sexual and reproductive health services [3].
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