Unpacking the Complex Determinants of the Performance of Accredited Social Health Activists in Bihar: A Qualitative Study.
The Accredited Social Health Activist (ASHA) programme has been associated with many improvements in health outcomes. However, the understanding of contextual performance constraints, particularly how these vary for different tasks, has been acknowledged as deficient. Relying on a means, motives and...
| Publicado en: | Journal of Health Management Vol. 27; no. 4; pp. 512 - 523 |
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| Autores principales: | , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Sage Publications Inc.
Aug2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=187888645&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 187888645 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09720634 54B jtl: Journal of Health Management issn: 09720634 maglogo: N pubinfo: dt: Aug2025 vid: 27 iid: 4 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 187888645 185979443 187888645 187888645 10.1177/09720634251344748 187888645 ppf: 512 ppct: 11 formats: tig: atl: Unpacking the Complex Determinants of the Performance of Accredited Social Health Activists in Bihar: A Qualitative Study. aug: au: Srinivasan, Shuchi John, Aparna Newton-Lewis, Thomas affil: Oxford Policy Management, Oxford, United Kingdom sug: subj: Community Health Workers Accreditation Task Performance and Analysis Human Qualitative Studies India Thematic Analysis Semi-Structured Interview Home Health Agencies Grounded Theory Exploratory Research Funding Source ab: The Accredited Social Health Activist (ASHA) programme has been associated with many improvements in health outcomes. However, the understanding of contextual performance constraints, particularly how these vary for different tasks, has been acknowledged as deficient. Relying on a means, motives and opportunity (MMO) framework, this article qualitatively explores the context-specific constraints on the performance of four ASHA tasks. We undertake qualitative research to unpack ASHA's perspectives and conduct a thematic analysis of the interview data. We find that different combinations of MMO factors affect different services differently, although many affect all services. Immunisation day, survey and record-keeping duties and escorting for institutional deliveries were deemed 'core' deliverables due to the administrative focus, preference or the incentives tied to the task. Home visits for home-based newborn care (HBNC) were not preferred and were seen as effort-intensive. The rapidly evolving role of ASHAs in responding to evolving health system needs in Bihar demands special effort if the different factors are to be diagnosed. This article attempts to offer the various avenues to unlock ASHA performance and contributes to the current partial global evidence base on factors affecting the performance of community health workers (CHWs) in different contexts. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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