INTRODUCTIONPrimary health care providers cater to the basic health needs of people in urban and rural areas and endeavour to provide critically needed outreach services in urban slums and remotest villages. For providing credible and good quality services to those in need, it is imperative that these primary health care providers have the basic knowledge and a positive conducive attitude regarding the services they deliver. Urban health posts (UHPs), launched under the Urban Revamping Scheme to provide primary health care in urban slums, are staffed by auxiliary nurse midwives (ANMs), also known as multipurpose health workers (female), who are trained paraprofessional health care providers and function as the first contact between the community and the formal health care system. Link workers (LWs) are primarily female volunteers from local communities, who identify high-risk groups and mobilise vulnerable and inaccessible sub-groups in the community. Various studies have emphasized the ABSTRACT Background: Primary health care providers, who cater to the basic health care needs in urban and rural areas, ought to have the basic knowledge and a positive attitude in relation to the services they deliver. This cross-sectional, complete-enumeration, before-and-after study was conducted to determine the outcome of refresher training on the knowledge, attitudes and practices of auxiliary nurse midwives (ANMs), and link workers (LWs) in an urban area in Western India. Methods: Each willing participant answered a structured pre-test questionnaire containing 25 questions in the local language (Marathi), following which, Government-approved refresher training (3 days for ANMs and 1 day for LWs) was conducted in the same language. The participants took the same questionnaire after the refresher training (posttest). The pre-and post-test scores were tabulated and statistically analysed. Results: In case of ANMs (n=60), the post-test scores (mean=20.7; SD=1.8) improved over the pre-test scores (mean=17.5; SD=2.76). The LWs (n=170) also bettered their post-test scores (mean=20.9; SD=2.52), over their pretest scores (mean=14.4; SD=4.41). The degree of improvement in scores varied from marginal to statistically significant. Conclusions: Though the post-test results were encouraging, sustained efforts would be required to bring about the desired attitudes and practices. As a consequence of the widespread use of mobile phones, it is possible to conduct periodic refresher training through mobile phones at a much lower cost.