ASHA Workers Research Articles

Assessment of risk factors of non- communicable diseases among healthcare workers in Nelamangala: a cross sectional study

Background: India is facing a new challenge of epidemiological health transition where the disease spectrum has changed from communicable diseases to non-communicable diseases. Diabetes mellitus, hypertension, stroke and cardiovascular diseases have emerged as major public health problems. Health care workers considered as mentors to general public are becoming victims to these life style disorders. Hence this study was conducted to assess the risk factors of non-communicable diseases among health care workers.Methods: A cross sectional study was carried out for a period of 2 months- October to November 2016 among 120 health care workers working under the primary health centre’s of Nelamangala. Data was collected by interview method using NCD’s risk factors survey India questionnaire.Results: Among 120 study subjects, males were 14 (11.7%) and females were 106 (88.3%). The mean age of study subjects was 39.19 (8.62). Anganwadi workers were 57 (47.50%), 35 (29.10%) were ASHA workers, 8 (6.60%) were senior health assistants and 20 (16.66%) were junior health assistants. Among these 11 (9.2%) had hypertension. 75 (62.5%) had abnormal waist-hip ratio. 33.3% were overweight and 8.3% were obese.Conclusions: There was an association between physical activity and development of risk factors of NCD’s. Most of them are exposed to second hand smoke i.e. passive smoking. Improved literacy status and creation of awareness about the risk factors and sedentary lifestyle among the health care professionals can protect them for Non communicable diseases.

Effectiveness of an Awareness Programme on Exclusive breastfeeding for the AShA Workers of Udupi District

The basic food for infant feeding is milk. Breastfeeding is the most natural way to feed the child. It offers nutrients and energy which are essential for the requirement during the first 6 months and it continuous to provide up to the 2 year of age. At the community level ASHA workers play vital role for the effective implementation MCH services at the grass root level. Their knowledge and skills on educating mothers on breastfeeding can prevent malnutrition among children. The study Objectives were to assess the knowledge of ASHA workers on exclusive breastfeeding, determine the effectiveness of an awareness programme on Knowledge regarding exclusive breastfeeding and to find the association between level of knowledge on exclusive breastfeeding and selected variables. Methodology: One group pretest posttest test design was adopted to achieve the objectives. The 86 ASHA workers were selected by purposive sampling techniques from four PHCs and 2 CHCs of Udupi taluk, Karnataka. After obtaining consent from study participants Knowledge questionnaire was administered and Awareness progamme was implemented in selected PHCs and CHCs. The posttest was conducted after 7 days. Results: About 66.6% of them were in the age group of 31-50 years, 64% of them had more than 5 years of Experience and 77% of ASHA workers reported they have undergone training on MCH service activities. In pretest mean knowledge score was 13. 6 and 17.4 during the posttest which shows there was a significant improvement in the knowledge score. Conclusion: The ASHA workers are having knowledge on the exclusive breastfeeding and need reinforcement which will help them in updating their knowledge and skills on feeding practices.

Healthcare Providers Views on Husband-Participation in Maternal Healthcare

This research paper analyses the healthcare providers’ views on husband participation in maternal healthcare services. This paper is divided into 3 sections. Firstly, the paper looks into roles and responsibilities of healthcare providers (doctors, ANMs and ASHA workers) in maternal healthcare services. Secondly, the health providers’ views on husband participation in maternal healthcare. Lastly, the paper concludes and suggests by emphasising the significance of improving the husband participation in maternal healthcare of their wives and newborn child.

Community Health Nursing-A Study to assess the Level of job Satisfaction among Asha workers of Waghodia Taluka

Community Health Nursing-A Study to assess the Level of job Satisfaction among Asha workers of Waghodia Taluka

Assessment of Home Based Newborn Care provided by ASHA worker in a Rural Block of Haryana

Assessment of Home Based Newborn Care provided by ASHA worker in a Rural Block of Haryana

Professional stress levels among healthcare workers of Nelamangala: a cross sectional study

Background: Occupational stress can impair one’s health and reduce the efficiency and productivity of work. Delivering health services in rural areas is a tedious job for healthcare workers due to various factors. Inadequate staffing of workers leading to overloaded work and many other factors make them less motivated and experience work stress. Methods: A cross sectional study done in Nelamangla, rural field practice area of BMCRI. A multi stage random sampling technique was applied for the study. 5 PHCs were randomly chosen. Healthcare workers (such as LHV, ANM, Health Assistants, ASHA workers and AWWs) were recruited by probability proportion to sample size. 140 study participants were interviewed using pre tested semi structured questionnaire to collect socio demographic details and work related details; validated professional life stress scale was used to assess stress levels. Descriptive statistics and chi square test were used. Results: 37.1% (52) had mild stress, 52.1% (73) were moderately stressed, 10.7% (15) were severely stressed and none of them were very severely stressed that needed immediate intervention. Working hours, job satisfaction, clarity about work, amount of work exceeding stipulated time, loss of interest at work, not being rewarded and valued for their work are few of the factors that are found to be associated with stress levels. Conclusions: Work related factors have been the main stressors and higher stress levels might impede the performance of the workers and hence addressing this is necessary.

Focused Group Discussion of urban ASHA workers regarding their workrelated issues

Background: Urban ASHA workers bridge the gap between the Urban Health system and urban poor to provide accessible, affordable, accountable, reliable & effective primary health care. Amis & Objectives: To identify work related problems faced by urban ASHA workers and to seek suggestions for their work-related issues. Settings and Design: FGD of Urban ASHA workers posted at Urban Health Centres of Ahmedabad. Methods and Material: Random sampling was used to select two UHCs and 8 Urban ASHA workers from both the UHCs for conducting FGDs. Statistical analysis used: interview transcribing. Results: Service gave them satisfaction, Salary did not!!! Some of the other important issues related to their work include transportation, cooperation from community, environmental issues & extended working hours. Conclusions: The problems identified and suggestions received needs to be taken seriously, addressed promptly and timely to improve service delivery.

Assessment of quality of life of ASHA workers using WHOQoL-BREF questionnaire

Background: ASHA represents a vital role in the strategy of NRHM. There is scarcity of information on quality of life and factors influencing it on ASHA workers. The assessment of quality of life in this group may help to better understand and develop an insight for measures that can be improved in their lives. The objective of the study was to assess the quality of life among ASHA workers of Mangalore and Udupi taluk, Karnataka. Methods: This is a questionnaire based, cross sectional study conducted for a period of 3 months (June 2015 - Aug 2015) on ASHA workers of Mangalore and Udupi Taluk, Karnataka. Local language Kannada version of WHO QoL BREF questionnaire consisting of 26 questions was used. Results: The mean age of ASHA workers across the study group was 42.40 years. With respect to perception of QoL and health, around 60% felt their quality of life (QoL) was good and health was satisfactory. Maximum and minimum mean scores was observed for self-esteem and financial resources respectively. Among the various domains of QoL, the ASHA workers had higher mean score in social domain, followed by physical, psychological and environmental. Conclusions: The ASHA workers had higher mean score in social domain, followed by physical, psychological and environmental.

A Comparative Study to Assess Knowledge on Prevention of Sexually Transmitted Diseases among Anganwadi Workers and Asha Workers at Selected Villages of Waghodia Taluka

A Comparative Study to Assess Knowledge on Prevention of Sexually Transmitted Diseases among Anganwadi Workers and Asha Workers at Selected Villages of Waghodia Taluka

Effectiveness of Oral Health Education among Community Health Workers Based on Communication-Behavior Change Model

The purpose of this study wasassess the effectiveness of health education based on Communicationbehavior change model (McGuire, 1984) in improving the knowledge, attitude and practices of the ASHA and Anganwadi workers regarding oral health.

A Study To Assess The Effectiveness Of A Planned Teaching Programme On Diabetes Mellitus And Its Management Among Asha Workers In Selected Areas Of Udupi District, Karnataka.

Abstract Background: Diabetes is a chronic metabolic disorder which is prevalent throughout the world. ASHA workers are the grass root workers who have direct contact with the people in the community who can be of great help in empowering the diabetes individuals in their management. Methods: The study used evaluative approach with one group pre-testpost-test design. Sixty ASHA workers of selected PHC's and CHC''s of Udupi District were selected for the study using non probability convenient sampling, technique. The instruments used for the study were Demographic Proforma, structured knowledge questionnaire on diabetes mellitus and its management. Descriptive and inferential statistics were used for analysis of the data. Results: Majority 42(70%) of ASHA workers belongs to the age group of 31-40yrs and 28 (46.7%) of them had experience as ASHA worker with high school education. In the pre-test 17(28.3%)of ASHA workers had poor knowledge but in post-test, 28(46.7%) of them gained good knowledge which indicated that the planned teaching programme on diabetes mellitus and its management was found to be effective in improving the knowledge of ASHA workers. (T value- 14.226, p value -0.002). Conclusion: The study concluded that the teaching programme was effective in bringing desirable changes in knowledge of ASHA workers.

Task shifting of frontline community health workers for cardiovascular risk reduction: design and rationale of a cluster randomised controlled trial (DISHA study) in India.

BackgroundEffective task-shifting interventions targeted at reducing the global cardiovascular disease (CVD) epidemic in low and middle-income countries (LMICs) are urgently needed.MethodsDISHA is a cluster randomised controlled trial conducted across 10 sites (5 in phase 1 and 5 in phase 2) in India in 120 clusters. At each site, 12 clusters were randomly selected from a district. A cluster is defined as a small village with 250–300 households and well defined geographical boundaries. They were then randomly allocated to intervention and control clusters in a 1:1 allocation sequence. If any of the intervention and control clusters were <10 km apart, one was dropped and replaced with another randomly selected cluster from the same district. The study included a representative baseline cross-sectional survey, development of a structured intervention model, delivery of intervention for a minimum period of 18 months by trained frontline health workers (mainly Anganwadi workers and ASHA workers) and a post intervention survey in a representative sample. The study staff had no information on intervention allocation until the completion of the baseline survey. In order to ensure comparability of data across sites, the DISHA study follows a common protocol and manual of operation with standardized measurement techniques.DiscussionOur study is the largest community based cluster randomised trial in low and middle-income country settings designed to test the effectiveness of ‘task shifting’ interventions involving frontline health workers for cardiovascular risk reduction.Trial registrationCTRI/2013/10/004049. Registered 7 October 2013.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-2891-6) contains supplementary material, which is available to authorized users.

Retrospective analysis of tubectomy beneficiaries in rural area (PHC KINAYE): one year record based study

Background: Population explosion has become a major concern in India. As per NFHS- IV report in Karnataka, 52.8% adopted the female sterilization other methods like male sterilization 0.0%, Intrauterine devices 0.6% and pills users were 0.3%, condom 0.6% in rural areas. The study of female sterilization as the method of choice in rural field practice area of Kinaye, PHC, Belagavi was done for a period of one year. Methods: Retrospective Data Analysis of 200 women undergoing sterilization at PHC, Kinaye in Belagavi district of Karnataka state from 1st April 2015 to 31st March 2015 was done. The variables considered were age of beneficiary, husband’s age, religion, educational status of beneficiary and of husband, total number of living children, number of sons, number of daughters, socio-economic status and their motivators etc. Results: Out of 200 women adopting sterilization, 57.0% (114) were from the age group of 25-29 years. The maximum percentage (81.0%) of their husbands were from the age group of 30-34 years. 95.0% of the participants were Hindus. Nearly two thirds of the beneficiaries had attained secondary education (61.0%). 60.0% of the beneficiaries were belonging to the BPL group (Below Poverty Line). 55.5% of the participants had two living children. 58.0% of them had one male child, 33.5% of them had two male children, 51.0% of them had one female child. 53.0% of the participants were motivated by ASHA workers. Conclusions: More than half of the tubectomy beneficiaries belonged to the age group of 24-29 years. Of them around two third belonged to the BPL group and more than half were motivated by the ASHA workers. More than half of the women undergoing tubectomy were having two live children, around three fifth of them were having one male child and around half of them were having one female child.

How effective is the Menstrual Hygiene Scheme? An evaluation study from North India

Background: Menstrual hygiene is not up to the mark for Indian women residing in rural areas. To increase the use of napkins a social marketing scheme was launched. As the program is in preliminary stage of implementation the factors influencing it need to be evaluated. Our study aimed to analyze the influencing factors of this scheme. Methods: A qualitative study was carried out during 2015 in a village of Northern India. Twenty in-depth interviews were carried out. Study design: It was a cross sectional study. Results: It was found that 80% women were aware about sanitary napkins. 79% was motivated. Use was only 30%. They perceived that sanitary napkin was beneficial to them. The ASHA workers were disappointed due to fewer margins of profit and irregular supply. The other stakeholders in the community were not actively involved in the implementation of this scheme. Conclusions: To conclude, there is a huge marketing potential of low cost napkins in rural India. The programme needs actively involvement of various stakeholders and to ensure regular supply of napkins.

A Quasi Experimental Study to Assess the Effectiveness of Structured Training Programme on Practices of Asha Workers Related to New Born Care Based on Asha Module- 6

A Quasi Experimental Study to Assess the Effectiveness of Structured Training Programme on Practices of Asha Workers Related to New Born Care Based on Asha Module- 6

Assesment of Roles and Responsibilities of ASHA workers in Bijapur taluk of Karnataka

The discourse on the ASHA's role centres around three typologies - ASHA as an activist, ASHA as a link worker or facilitator, and ASHA as a community level health care provider. She will counsel women on birth preparedness, importance of safe delivery, breastfeeding and complementary feeding, immunization, contraception and prevention of common infections including Reproductive Tract Infection/Sexually Transmitted Infection (RTIs/STIs) and care of the young child. A cross sectional study was done on 132 ASHA workers selected from 5 random PHCs in Bijapur taluk. Data was collected in a prestructured proforma using interview technique from June to October, 2012. Most of the ASHA workers were not aware about the newer roles and responsibilities been implied on them under various national programmes including the immunization guidelines and schedule. All the ASHA workers were aware about the performance based incentive for the their work in the community and its their right to claim that incentive. Under the cascade model of training to the ASHA, trainings should provide complete knowledge and skills to the trainees within the stipulated time. Quality of training should be enhanced and refresher trainings should be planned regularly.

Study to Assess Effectiveness of a Structured Teaching Programme on Knowledge and Practices of ASHA Workers Regarding the Case Management of Children with Diarrhea at Home Situation as per IMNCI Guidelines

Study to Assess Effectiveness of a Structured Teaching Programme on Knowledge and Practices of ASHA Workers Regarding the Case Management of Children with Diarrhea at Home Situation as per IMNCI Guidelines

CDC Kerala 17: Early detection of developmental delay/disability among children below 3 y in Kerala--a cross sectional survey.

To conduct a community survey to understand the prevalence and type of developmental delay/disability among a representative state wide community sample of children below 3 y. A state wide community based cross sectional survey was done with the help of the Integrated Child Development Services (ICDS) network in Kerala after giving one day training program at Child Development Centre (CDC), for one randomly selected anganwadi worker in each of the panchayath/municipal ward, from all districts of Kerala, to equip them to screen all children below 3 y in their anganwadi areas, using simple community screening tools like Trivandrum Developmental Screening Chart (TDSC) 0-3 and Language Evaluation Scale Trivandrum (LEST) 0-3. Those children with one or more item delay in TDSC or LEST were called to the developmental evaluation camps held at ICDS block level and trained pediatrician/medical officer re-evaluated the children with developmental delay. A total of 32,664 children below 3 y were screened across the state and overall 2.5% prevalence of developmental delay was observed using TDSC and 2.8% using LEST 0-3 y and 3.4% using TDSC and/or LEST positive. Out of the total 1,110 children clinically evaluated by a trained pediatrician, 69.3% children had developmental delay, 14.3% speech delay, 5.7% global delay, 5.3% gross motor delay and 3.6% suspected of hearing impairment. The study results showing 3.4% prevalence of developmental delay using TDSC and/or LEST by trained anganwadi workers or ASHA workers could be replicated in other states in India, under Rashtria Bal Swasthya Kariyakram.

The Impact of a Community Health Worker Program on Childhood Immunization: Evidence from India's 'ASHA' Workers

In 2005-06 the Indian government introduced a new cadre of Community Health Workers known as Accredited Social Health Activists or ASHA workers to improve basic health outcomes through community engagement. The initial roll-out of the program, between 2005 and 2009, was heavily focused on 18 "high focus Indian states", lagging behind on public health indicators. Using multiple rounds of data from the District Level Household & Facility Survey (DLHS), I create cohorts of 12-23 month old infants, spanning a period of ten years, to establish that immunization trends of infants prior to the program were not increasing at a statistically different rate in high focus states relative to non-focus Indian states. I establish that the introduction of the program caused a sharp deviation away from trend in these states relative to their non-focus counterparts. I employ a difference-in-differences framework to identify the effect of the program and use detailed public health data to control for state and time varying factors that could pose potential threats to identification. The model estimates statistically significant increases in the range of 14-22 percentage points in the coverage of specific vaccines and the provision of full immunization in high focus states and a reduction in the incidence of infants with no immunization of up to 16 percentage-points. Finally, the paper makes use of additional information available as part of the DLHS surveys, to establish that the large increases in immunization coverage in high focus Indian states between 2004 & 2008 was most likely due to increased outreach as opposed to other improvements in the supply-chain of immunization services.

English

BACKGROUND: Currently Government of India is providing comprehensive integrated health care to the rural people under the umbrella of National Rural Health Mission (NRHM). A village level community health worker “Accredited Social Health Activist” (ASHA)’ acts as an interface between the community and the public health system. OBJECTIVE: To assess the socio-demographic profile of ASHA workers and to evaluate their knowledge and practice of their responsibilities. SETTINGS & DESIGN: Cross-sectional study, Obedullaganj and Sanchi blocks of Bhopal district of Madhya Pradesh. METHODS & MATERIAL: A cross-sectional study was conducted at obedullaganj and Sanchi in the Bhopal district of Madhya Pradesh for a period of 1 year from October 2007 to October 2008 The study participants were trained ASHA workers working in the Sanchi & Obedullaganj block. Statistical Analysis: Chi Square test using MS excel & SPSS ver 17. RESULT: Majority of ASHA workers were aware about helping in immunization, accompanying clients for delivery, providing ANC and family planning services as a part of responsibility. About 99% of ASHAs knew registration of births and deaths, assisting Auxiliary Nurse Midwife (ANM) in village health planning, creating awareness on basic sanitation and personal hygiene. CONCLUSION: Despite the training given to ASHAs, lacunae still exists in their knowledge regarding various aspects of child health morbidity. Monthly meetings can be used as a platform for the reinforcement of various aspects of child health. Periodical refresher training should be conducted for all of the recruited ASHA workers. In the future training sessions, more emphasis should be given to high risk cases requiring prompt referral.