How female community health workers navigate work challenges and why there are still gaps in their performance: a look at female community health workers in maternal and child health in two Indian districts through a reciprocal determinism framework
Abstract Background Accredited Social Health Activists (ASHAs) are community health workers tasked to deliver health prevention in communities and link them with the health care sector. This paper examines the social, cultural, and institutional influences that either facilitate or impede ASHAs’ abi...
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| Format: | Article |
| Language: | English |
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BMC
2017-07-01
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| Series: | Human Resources for Health |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12960-017-0222-3 |
| _version_ | 1818047290845167616 |
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| author | Enisha Sarin Sarah Smith Lunsford |
| author_facet | Enisha Sarin Sarah Smith Lunsford |
| author_sort | Enisha Sarin |
| collection | DOAJ |
| description | Abstract Background Accredited Social Health Activists (ASHAs) are community health workers tasked to deliver health prevention in communities and link them with the health care sector. This paper examines the social, cultural, and institutional influences that either facilitate or impede ASHAs’ abilities to deliver services effectively through the lens of the reciprocal determinism framework of social cognitive theory. Methods We conducted 98 semi-structured, in-depth interviews with ASHAs (n = 49) and their family members (n = 49) in Gurdaspur and Mewat districts. Data were analyzed by comparing and contrasting codes leading to the identification of patterns which were explained with the help of a theoretical framework. Results We found that while the work of ASHAs led to some positive health changes in the community, thus providing them with a sense of self-worth and motivation, community norms and beliefs as well as health system attitudes and practices limited their capacity as community health workers. Conclusion We outline potential mechanisms for improving ASHA capacity such as improved sensitization about religious, cultural, and gender norms; enhanced communication skills; and sensitization and advocating their work with health and state officials. |
| first_indexed | 2024-12-10T10:03:27Z |
| format | Article |
| id | doaj.art-7e86cd10504c45b580acf385088ccdd1 |
| institution | Directory Open Access Journal |
| issn | 1478-4491 |
| language | English |
| last_indexed | 2024-12-10T10:03:27Z |
| publishDate | 2017-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Human Resources for Health |
| spelling | doaj.art-7e86cd10504c45b580acf385088ccdd12022-12-22T01:53:18ZengBMCHuman Resources for Health1478-44912017-07-0115111010.1186/s12960-017-0222-3How female community health workers navigate work challenges and why there are still gaps in their performance: a look at female community health workers in maternal and child health in two Indian districts through a reciprocal determinism frameworkEnisha Sarin0Sarah Smith Lunsford1University Research Co., LLCEnCompass LLCAbstract Background Accredited Social Health Activists (ASHAs) are community health workers tasked to deliver health prevention in communities and link them with the health care sector. This paper examines the social, cultural, and institutional influences that either facilitate or impede ASHAs’ abilities to deliver services effectively through the lens of the reciprocal determinism framework of social cognitive theory. Methods We conducted 98 semi-structured, in-depth interviews with ASHAs (n = 49) and their family members (n = 49) in Gurdaspur and Mewat districts. Data were analyzed by comparing and contrasting codes leading to the identification of patterns which were explained with the help of a theoretical framework. Results We found that while the work of ASHAs led to some positive health changes in the community, thus providing them with a sense of self-worth and motivation, community norms and beliefs as well as health system attitudes and practices limited their capacity as community health workers. Conclusion We outline potential mechanisms for improving ASHA capacity such as improved sensitization about religious, cultural, and gender norms; enhanced communication skills; and sensitization and advocating their work with health and state officials.http://link.springer.com/article/10.1186/s12960-017-0222-3Community health workerHealth worker performanceSocial cognitive theoryReproductive and maternal healthGender normsIndia |
| spellingShingle | Enisha Sarin Sarah Smith Lunsford How female community health workers navigate work challenges and why there are still gaps in their performance: a look at female community health workers in maternal and child health in two Indian districts through a reciprocal determinism framework Human Resources for Health Community health worker Health worker performance Social cognitive theory Reproductive and maternal health Gender norms India |
| title | How female community health workers navigate work challenges and why there are still gaps in their performance: a look at female community health workers in maternal and child health in two Indian districts through a reciprocal determinism framework |
| title_full | How female community health workers navigate work challenges and why there are still gaps in their performance: a look at female community health workers in maternal and child health in two Indian districts through a reciprocal determinism framework |
| title_fullStr | How female community health workers navigate work challenges and why there are still gaps in their performance: a look at female community health workers in maternal and child health in two Indian districts through a reciprocal determinism framework |
| title_full_unstemmed | How female community health workers navigate work challenges and why there are still gaps in their performance: a look at female community health workers in maternal and child health in two Indian districts through a reciprocal determinism framework |
| title_short | How female community health workers navigate work challenges and why there are still gaps in their performance: a look at female community health workers in maternal and child health in two Indian districts through a reciprocal determinism framework |
| title_sort | how female community health workers navigate work challenges and why there are still gaps in their performance a look at female community health workers in maternal and child health in two indian districts through a reciprocal determinism framework |
| topic | Community health worker Health worker performance Social cognitive theory Reproductive and maternal health Gender norms India |
| url | http://link.springer.com/article/10.1186/s12960-017-0222-3 |
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