Background: The National Rural Health Mission (NRHM) aimed to bridge the gap in rural health care with the introduction of the Accredited Social Health Activist (ASHA) in 2005. It is essential to identify the motivators and barriers to work performance by the ASHAs in order to facilitate better health care in the community. Objective: To identify the motivators and barriers to the work performance of ASHAs in the Solur PHC area, Ramanagara district, Karnataka. Material & Methods: A qualitative study was conducted in one PHC area of Ramanagara District, Karnataka. Four KIIs with government health functionaries and one FGD with nine ASHAs were conducted. A thematic frame-work approach was used for data analysis. Results: The main personal motivators were altruism and intrinsic satisfaction, while social support and team-work were important environmental motivators. De-motivating factors were financial problems such as insufficient pay and irregular financial incentives, as well as logistic difficulties, including transportation and safety. Conclusion: Personal, cultural, financial considerations and working conditions affect the performance of an ASHA. It is essential to address relevant issues faced by these health workers in order to improve their work satisfaction and efficiency.

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Background and Objectives: Fecal sludge management (FSM) is an unorganised sector, which is wrought with occupational health hazards for fecal sludge operators (FSOs). This study was conducted to identify the knowledge, attitude, and practices regarding FSM among FSOs. Study Setting and Design: This cross-sectional study was conducted in a rural area of Anekal Taluk, Bengaluru Urban District, Karnataka and in Hosur, Krishnagiri District, Tamil Nadu. Methods and Materials: Snowball method of sampling was employed and, 60 participants were interviewed using an interviewer administered semi-structured questionnaire. Statistical Analysis: The data has been described using measures of central tendency, frequencies, and percentages. Results: All 60 participants were males with a mean age of 33.7 ± 7.9 years. Majority practised Hindu religion (98.3%) and 95.0% belonged to the scheduled castes; only 3.3% were illiterate. According to modified SLI, 45.0% belonged to high standard of living. The common occupational hazards reported were injuries, social stigma, and alcoholism. Although 91.7% felt that personal protective equipment (PPE) would protect against health hazards, 65.0% felt that it hampered work. Most (86.7%) felt that FSM was attached to social stigma. None reported the use of the full set of required PPE. All participants reported washing their hands and feet with only water at the end of each operation. Conclusion: The knowledge and practices followed by the FSOs were found to be inadequate in this study. Health awareness generation and provision of PPE must be employed to ensure sustained behaviour change.