Akhil Dhanesh Goel1, Mudita Gosain2, Ritvik Amarchand3, Hanspria Sharma4, Sanjay Rai3, Suresh K Kapoor5, Anand Krishnan3. 1. Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India. doc.akhilgoel.aiims@gmail.com. 2. Translational Health Science and Technology Institute, Faridabad, Haryana, India. 3. Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India. 4. Department of Development Communication and Extension, Delhi University, New Delhi, India. 5. Centre for Chronic Disease Control, Gurgaon, Haryana, India.
Abstract
OBJECTIVE: To present evaluation of a quality improvement program for Accredited Social Health Activists (ASHAs). METHODS: This community intervention trial was conducted in Ballabgarh, India during 2012-2014 with two Primary Health Center (PHC) areas being the intervention areas and two PHC areas being non-intervention areas receiving standard care. Interventions included two-day training in technical and communication skills of ASHAs followed by supportive supervision in the field. Intervention was evaluated by comparing pre and post training scores, feedback from postnatal mothers and a difference-in-difference (DID) analysis on baseline and endline knowledge-practice survey of recently delivered mothers with 95% confidence intervals. RESULTS: Only 11.1% ASHAs addressed specific barriers for adopting healthy behaviors. Sixty eight (91.8%) ASHAs attended the training after which knowledge improved by 33.3% (p < 0.001). ASHAs in intervention areas were rated by mothers (n = 69) to have better communication skills (81.2% vs. 59.7%, p = 0.005), make more postnatal visits (52.2% vs. 22.2%; p < 0.001), give advice on newborn care (64% vs. 50.5%; p < 0.001) as compared to standard care area ASHAs. Endline survey (n = 1360) showed a significant improvement in frequency of antenatal visits (0.26;0.19-0.33), knowledge about free transport (0.12;0.05-0.18), better cord-care practices (0.15;0.07-0.22), kangaroo mother care (0.19;0.13-0.25), delayed first bath (0.13;0.06-0.20), restrictive handling (0.11;0.06-0.15) and hand-washing (0.19;0.13-0.25). CONCLUSIONS: Quality improvement program can help improve ASHA's performance which in turn can address higher neonatal mortality in India.
OBJECTIVE: To present evaluation of a quality improvement program for Accredited Social Health Activists (ASHAs). METHODS: This community intervention trial was conducted in Ballabgarh, India during 2012-2014 with two Primary Health Center (PHC) areas being the intervention areas and two PHC areas being non-intervention areas receiving standard care. Interventions included two-day training in technical and communication skills of ASHAs followed by supportive supervision in the field. Intervention was evaluated by comparing pre and post training scores, feedback from postnatal mothers and a difference-in-difference (DID) analysis on baseline and endline knowledge-practice survey of recently delivered mothers with 95% confidence intervals. RESULTS: Only 11.1% ASHAs addressed specific barriers for adopting healthy behaviors. Sixty eight (91.8%) ASHAs attended the training after which knowledge improved by 33.3% (p < 0.001). ASHAs in intervention areas were rated by mothers (n = 69) to have better communication skills (81.2% vs. 59.7%, p = 0.005), make more postnatal visits (52.2% vs. 22.2%; p < 0.001), give advice on newborn care (64% vs. 50.5%; p < 0.001) as compared to standard care area ASHAs. Endline survey (n = 1360) showed a significant improvement in frequency of antenatal visits (0.26;0.19-0.33), knowledge about free transport (0.12;0.05-0.18), better cord-care practices (0.15;0.07-0.22), kangaroo mother care (0.19;0.13-0.25), delayed first bath (0.13;0.06-0.20), restrictive handling (0.11;0.06-0.15) and hand-washing (0.19;0.13-0.25). CONCLUSIONS: Quality improvement program can help improve ASHA's performance which in turn can address higher neonatal mortality in India.
Entities:
Keywords:
Accredited social health activists; Communication skills; Home-based care; Neonatal; Quality improvement program
Authors: S B Neogi; J Sharma; M Chauhan; R Khanna; M Chokshi; R Srivastava; P K Prabhakar; A Khera; R Kumar; S Zodpey; V K Paul Journal: J Perinatol Date: 2016-12 Impact factor: 2.521