Facilitating behavioral change: A comparative assessment of ASHA efficacy in rural Bihar
Community health worker (CHW) programs are essential for expanding health services to many areas of the world and improving uptake of recommended behaviors. One of these programs, called Accredited Social Health Activists (ASHA), was initiated by the government of India in 2005 and now has a workfor...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2022-01-01
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| Series: | PLOS Global Public Health |
| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021476/?tool=EBI |
| _version_ | 1797701058131132416 |
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| author | Oskar Burger Faiz Hashmi Maciej J. Dańko Santosh Akhauri Indrajit Chaudhuri Emily Little Hannah G. Lunkenheimer Sudipta Mondal Nachiket Mor Neela Saldanha Janine Schooley Palash Singh Tracy Johnson Cristine H. Legare |
| author_facet | Oskar Burger Faiz Hashmi Maciej J. Dańko Santosh Akhauri Indrajit Chaudhuri Emily Little Hannah G. Lunkenheimer Sudipta Mondal Nachiket Mor Neela Saldanha Janine Schooley Palash Singh Tracy Johnson Cristine H. Legare |
| author_sort | Oskar Burger |
| collection | DOAJ |
| description | Community health worker (CHW) programs are essential for expanding health services to many areas of the world and improving uptake of recommended behaviors. One of these programs, called Accredited Social Health Activists (ASHA), was initiated by the government of India in 2005 and now has a workforce of about 1 million. ASHAs primarily focus on improving maternal and child health but also support other health initiatives. Evaluations of ASHA efficacy have found a range of results, from negative, to mixed, to positive. Clarity in forming a general impression of ASHA efficacy is hindered by the use of a wide range of evaluation criteria across studies, a lack of comparison to other sources of behavioral influence, and a focus on a small number of behaviors per study. We analyze survey data for 1,166 mothers from Bihar, India, to assess the influence of ASHAs and eight other health influencers on the uptake of 12 perinatal health behaviors. We find that ASHAs are highly effective at increasing the probability that women self-report having practiced biomedically-recommended behaviors. The ASHA’s overall positive effect is larger than any of the nine health influencer categories in our study (covering public, private, and community sources), but their reach needs to be more widely extended to mothers who lack sufficient contact with ASHAs. We conclude that interactions between ASHAs and mothers positively impact the uptake of recommended perinatal health behaviors. ASHA training and program evaluation need to distinguish between individual-level and program-level factors in seeking ways to remove barriers that affect the reach of ASHA services. |
| first_indexed | 2024-03-12T04:29:50Z |
| format | Article |
| id | doaj.art-774c91920ec34a2b9863b20bcbecb933 |
| institution | Directory Open Access Journal |
| issn | 2767-3375 |
| language | English |
| last_indexed | 2024-03-12T04:29:50Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLOS Global Public Health |
| spelling | doaj.art-774c91920ec34a2b9863b20bcbecb9332023-09-03T10:08:35ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752022-01-0128Facilitating behavioral change: A comparative assessment of ASHA efficacy in rural BiharOskar BurgerFaiz HashmiMaciej J. DańkoSantosh AkhauriIndrajit ChaudhuriEmily LittleHannah G. LunkenheimerSudipta MondalNachiket MorNeela SaldanhaJanine SchooleyPalash SinghTracy JohnsonCristine H. LegareCommunity health worker (CHW) programs are essential for expanding health services to many areas of the world and improving uptake of recommended behaviors. One of these programs, called Accredited Social Health Activists (ASHA), was initiated by the government of India in 2005 and now has a workforce of about 1 million. ASHAs primarily focus on improving maternal and child health but also support other health initiatives. Evaluations of ASHA efficacy have found a range of results, from negative, to mixed, to positive. Clarity in forming a general impression of ASHA efficacy is hindered by the use of a wide range of evaluation criteria across studies, a lack of comparison to other sources of behavioral influence, and a focus on a small number of behaviors per study. We analyze survey data for 1,166 mothers from Bihar, India, to assess the influence of ASHAs and eight other health influencers on the uptake of 12 perinatal health behaviors. We find that ASHAs are highly effective at increasing the probability that women self-report having practiced biomedically-recommended behaviors. The ASHA’s overall positive effect is larger than any of the nine health influencer categories in our study (covering public, private, and community sources), but their reach needs to be more widely extended to mothers who lack sufficient contact with ASHAs. We conclude that interactions between ASHAs and mothers positively impact the uptake of recommended perinatal health behaviors. ASHA training and program evaluation need to distinguish between individual-level and program-level factors in seeking ways to remove barriers that affect the reach of ASHA services.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021476/?tool=EBI |
| spellingShingle | Oskar Burger Faiz Hashmi Maciej J. Dańko Santosh Akhauri Indrajit Chaudhuri Emily Little Hannah G. Lunkenheimer Sudipta Mondal Nachiket Mor Neela Saldanha Janine Schooley Palash Singh Tracy Johnson Cristine H. Legare Facilitating behavioral change: A comparative assessment of ASHA efficacy in rural Bihar PLOS Global Public Health |
| title | Facilitating behavioral change: A comparative assessment of ASHA efficacy in rural Bihar |
| title_full | Facilitating behavioral change: A comparative assessment of ASHA efficacy in rural Bihar |
| title_fullStr | Facilitating behavioral change: A comparative assessment of ASHA efficacy in rural Bihar |
| title_full_unstemmed | Facilitating behavioral change: A comparative assessment of ASHA efficacy in rural Bihar |
| title_short | Facilitating behavioral change: A comparative assessment of ASHA efficacy in rural Bihar |
| title_sort | facilitating behavioral change a comparative assessment of asha efficacy in rural bihar |
| url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021476/?tool=EBI |
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