From engagement to competency: The pathway to making disability naïve frontline workers competent in the delivery of an evidence-based autism intervention in New Delhi, India
BackgroundAs countries like India improve access to maternal and infant care, the health systems need to develop services that enable all children to thrive. A key demographic which needs to be supported are children with disabilities, such as autism. With an estimated prevalence of one percent, the...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-07-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2022.903341/full |
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| author | Lavangi Naithani Priya Sangwan Sanjana Guha Roy Sreepriya Menon Zakiya Azar Shweta Lakhera Divya Kumar Minal Kakra Abhilashi Reetabrata Roy Vivek Vajaratkar Carol Taylor Vikram Patel Jonathan Green Gauri Divan |
| author_facet | Lavangi Naithani Priya Sangwan Sanjana Guha Roy Sreepriya Menon Zakiya Azar Shweta Lakhera Divya Kumar Minal Kakra Abhilashi Reetabrata Roy Vivek Vajaratkar Carol Taylor Vikram Patel Jonathan Green Gauri Divan |
| author_sort | Lavangi Naithani |
| collection | DOAJ |
| description | BackgroundAs countries like India improve access to maternal and infant care, the health systems need to develop services that enable all children to thrive. A key demographic which needs to be supported are children with disabilities, such as autism. With an estimated prevalence of one percent, there are over five million young children who need services to support their needs. However, the paucity of specialist care makes access to interventions difficult. In this context a public health research not-for-profit is evaluating the effectiveness of the task-sharing approach to support the delivery of an evidenced social communication intervention for young children with autism. This paper describes the process of engaging and training the non-specialist frontline Accredited Social Health Activists (ASHAs), who are embedded within the Ministry of Health and Family Welfare under the Delhi State Health Mission, to deliver a complex intervention for autism to inform the future scalability of services for neurodevelopmental disorders.MethodsThe present study describes the process which included (i) engagement meetings, (ii) recruitment, (iii) training, (iv) internship, and (v) competency evaluation. The shortlisted ASHAs received a 7-day classroom training followed by an internship period with practice cases. Finally, competency assessments, comprising of a test of knowledge and skills through role-plays, was administered.ResultsTwenty three Primary Urban Health Centers across seven districts of Delhi were approached and 408 ASHAs were engaged in initial meetings. Telephonic screening with 127 ASHAs resulted in 72 ASHAs being selected for in-person interviews. Of the 45 ASHAs who attended, 33 were shortlisted for training and 18 completed it. Fifteen ASHAs entered the internship of which 7 ASHAs achieved competency.Discussion and conclusionThere was significant attrition along the pathway to having a competent non-specialist worker deliver a complex autism intervention. The lessons learnt from this process can inform the possibility of developing a cadre of disability specific frontline health workers who can deliver evidence-based interventions for neurodevelopmental disorders under supervision. |
| first_indexed | 2024-04-14T07:29:43Z |
| format | Article |
| id | doaj.art-f26adc7203d5439a8d9e59463ffdfab3 |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-04-14T07:29:43Z |
| publishDate | 2022-07-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Psychiatry |
| spelling | doaj.art-f26adc7203d5439a8d9e59463ffdfab32022-12-22T02:05:55ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402022-07-011310.3389/fpsyt.2022.903341903341From engagement to competency: The pathway to making disability naïve frontline workers competent in the delivery of an evidence-based autism intervention in New Delhi, IndiaLavangi Naithani0Priya Sangwan1Sanjana Guha Roy2Sreepriya Menon3Zakiya Azar4Shweta Lakhera5Divya Kumar6Minal Kakra Abhilashi7Reetabrata Roy8Vivek Vajaratkar9Carol Taylor10Vikram Patel11Jonathan Green12Gauri Divan13Sangath, New Delhi, IndiaSangath, New Delhi, IndiaSangath, New Delhi, IndiaSangath, New Delhi, IndiaSangath, New Delhi, IndiaSangath, New Delhi, IndiaSangath, New Delhi, IndiaSangath, New Delhi, IndiaSangath, New Delhi, IndiaSangath, New Delhi, IndiaDivision of Neuroscience and Experimental Psychology, University of Manchester, Manchester, United KingdomHarvard Medical School, Boston, MA, United StatesDivision of Neuroscience and Experimental Psychology, University of Manchester, Manchester, United KingdomSangath, New Delhi, IndiaBackgroundAs countries like India improve access to maternal and infant care, the health systems need to develop services that enable all children to thrive. A key demographic which needs to be supported are children with disabilities, such as autism. With an estimated prevalence of one percent, there are over five million young children who need services to support their needs. However, the paucity of specialist care makes access to interventions difficult. In this context a public health research not-for-profit is evaluating the effectiveness of the task-sharing approach to support the delivery of an evidenced social communication intervention for young children with autism. This paper describes the process of engaging and training the non-specialist frontline Accredited Social Health Activists (ASHAs), who are embedded within the Ministry of Health and Family Welfare under the Delhi State Health Mission, to deliver a complex intervention for autism to inform the future scalability of services for neurodevelopmental disorders.MethodsThe present study describes the process which included (i) engagement meetings, (ii) recruitment, (iii) training, (iv) internship, and (v) competency evaluation. The shortlisted ASHAs received a 7-day classroom training followed by an internship period with practice cases. Finally, competency assessments, comprising of a test of knowledge and skills through role-plays, was administered.ResultsTwenty three Primary Urban Health Centers across seven districts of Delhi were approached and 408 ASHAs were engaged in initial meetings. Telephonic screening with 127 ASHAs resulted in 72 ASHAs being selected for in-person interviews. Of the 45 ASHAs who attended, 33 were shortlisted for training and 18 completed it. Fifteen ASHAs entered the internship of which 7 ASHAs achieved competency.Discussion and conclusionThere was significant attrition along the pathway to having a competent non-specialist worker deliver a complex autism intervention. The lessons learnt from this process can inform the possibility of developing a cadre of disability specific frontline health workers who can deliver evidence-based interventions for neurodevelopmental disorders under supervision.https://www.frontiersin.org/articles/10.3389/fpsyt.2022.903341/fullAccredited Social Health Activist (ASHA)autism spectrum disorders (ASD)evidence-based interventionengagementrecruitmentcompetency |
| spellingShingle | Lavangi Naithani Priya Sangwan Sanjana Guha Roy Sreepriya Menon Zakiya Azar Shweta Lakhera Divya Kumar Minal Kakra Abhilashi Reetabrata Roy Vivek Vajaratkar Carol Taylor Vikram Patel Jonathan Green Gauri Divan From engagement to competency: The pathway to making disability naïve frontline workers competent in the delivery of an evidence-based autism intervention in New Delhi, India Frontiers in Psychiatry Accredited Social Health Activist (ASHA) autism spectrum disorders (ASD) evidence-based intervention engagement recruitment competency |
| title | From engagement to competency: The pathway to making disability naïve frontline workers competent in the delivery of an evidence-based autism intervention in New Delhi, India |
| title_full | From engagement to competency: The pathway to making disability naïve frontline workers competent in the delivery of an evidence-based autism intervention in New Delhi, India |
| title_fullStr | From engagement to competency: The pathway to making disability naïve frontline workers competent in the delivery of an evidence-based autism intervention in New Delhi, India |
| title_full_unstemmed | From engagement to competency: The pathway to making disability naïve frontline workers competent in the delivery of an evidence-based autism intervention in New Delhi, India |
| title_short | From engagement to competency: The pathway to making disability naïve frontline workers competent in the delivery of an evidence-based autism intervention in New Delhi, India |
| title_sort | from engagement to competency the pathway to making disability naive frontline workers competent in the delivery of an evidence based autism intervention in new delhi india |
| topic | Accredited Social Health Activist (ASHA) autism spectrum disorders (ASD) evidence-based intervention engagement recruitment competency |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2022.903341/full |
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