Utilization of ASHA services under NRHM in relation to maternal health in rural Lucknow, India

Abstract

To address poor utilization of maternal and child health services by the rural community, the National Rural Health Mission (NRHM) was launched in 2005 in India. Under NRHM, ASHA (Accredited Social Health Activist) was identified as an effective link between the government and poor pregnant women. The aim of the present study was to examine the utilization of ASHA services under NRHM in relation to maternal health by the Recently Delivered Women (RDW) in the study area. A cross-sectional study was conducted at PHC Sarojini Nagar, Lucknow and its rural field areas. A sample of 350 RDW, chosen by simple random sampling, were interviewed at bedside by a preformed schedule and then were followed up after six weeks. Antenatal registration was reported by 97% RDW of which 73% registered early. About 53% RDW had three or more antenatal care visits. Two dose Tetanus Toxoid coverage was 92.9%. Receipt and consumption of iron and folic acid was low. ASHA was the major facilitator for higher utilization of antenatal care services, except for Iron and Folic Acid receipt/consumption. Low utilization of postnatal care (21.5% RDW had at least one postnatal check-up) is a matter of concern. Knowledge and awareness of ASHA on importance of postnatal care needs to be enhanced via hands on training by specialists and regular orientation programs. Better and intense advocacy in the community regarding importance of availing services of ASHA in relation to maternal health needs to be addressed.South East Asia J Public Health | Jan-June 2012 | Vol 2 Issue 1 | 24-27 DOI: http://dx.doi.org/10.3329/seajph.v2i1.15261

Assessment of knowledge of ASHA workers regarding MCH services and practices followed by mothers – A field study

“…Regarding exclusive breastfeeding, keeping the baby warm, and immunization, maximum percentage of mothers (>70%) were counseled. The findings of the present study were similar to the study conducted by Grover et al ,[ 21 ] Fathima et al ,[ 5 ] and Singh et al ,[ 31 ] where most of the mothers were counseled by ASHA workers in relation to breastfeeding and immunization. Present study findings were again similar to the study conducted by Sinha et al ,[ 32 ] as per which the counseling given by ASHA workers to mothers with regard to danger signs in newborn and care of eyes of newborn was less.…”

Male engagement as a strategy to improve utilization and community-based delivery of maternal, newborn and child health services: evidence from an intervention in Odisha, India

“…Our findings tend to suggest that while engagement with men was regarded as a key component of ASHAs’ work [ 26 , 27 ], the challenges associated with gender dynamics in Indian society were largely neglected. The ASHAs we interviewed welcomed the addition of male CHWs as partners in creating awareness among and motivating men to embrace positive behaviors and supporting roles regarding the health of their wives and children, including on sensitive issues such as use of family planning services.…”

“…While the introduction of ASHAs and other interventions designed under the NRHM have undoubtedly contributed to the recent improvements [12,26,29], progress remains hampered in rural and remote settings by lack of men’s understanding of, and interest in the health of mothers and children [6,19]. …”

“…Efforts to provide accessible, affordable and quality health care in India’s deprived and underserved communities through the National Rural Health Mission (NRHM) notwithstanding [ 8 , 11 ], most parts of rural India remain characterized by worrying high levels of poor maternal and child health indicators. While the introduction of ASHAs and other interventions designed under the NRHM have undoubtedly contributed to the recent improvements [ 12 , 26 , 29 ], progress remains hampered in rural and remote settings by lack of men’s understanding of, and interest in the health of mothers and children [ 6 , 19 ].…”

“…The role of community health workers to counsel and provide information on reproductive and child health is well recognized. In the context of rural India, the ASHA, Anganwadi Workers (AWWs), and Auxiliary Nurse Midwives (ANMs) are women who initiate and maintain a dialogue with mothers and other women in the community, provide health information and facilitate referrals to health facilities [ 26 , 27 ]. Figure 1 presents a brief description of AWWs and ANMs.…”