Can Person-Centered Interactions with Community Health Care Workers Improve Women's Breastfeeding and Infant Feeding Practices in India?

Abstract Objectives Breastfeeding and complementary feeding practices in India do not meet recommendations. Community health care workers (CHWs) are often the primary source of information for pregnant and postpartum women about Infant and Young child Feeding (IYCF) practices. While existing research has evaluated the effectiveness of content and delivery of information through CHWs, little is known about person-centric soft-skills in interpersonal communication. We analyzed the effect of high quality person-centered interactions based on respect and trust on recommended IYCF practices. Methods We use data from evaluation of an at-scale mHealth intervention in India that serves as a job aid to the CHWs and as a monitoring tool for their supervisors (N = 6635 mothers of children <12 m from 841 villages in 2 Indian states). The binary indicator variable for high-quality interaction is constructed using a set of 7 questions related to trust, respect, friendliness during these interactions. The binary outcomes variables are exclusive breastfeeding, timely introduction of complimentary feeding, and minimum diet diversity for infants. The estimation controlled for socio-economic-demographic characteristics, exposure to other health workers, number of interactions with the CHW, and other CHW services. Results Overall, 66% mothers reported exclusive breastfeeding, 69% reported timely introduction of complimentary feeding, but only 13% reported minimum dietary diversity in infant feeding. Perhaps because of the low base levels, mothers who reported higher-quality interactions were more likely to feed at least 4 food groups to infants 6–12 m (b = 0.05). Associations also existed for increased exclusive breastfeeding (b = 0.07). There was no effect on timely introduction of complimentary feeding. Conclusions Person-centered interactions with CHWs appears to be significantly associated with some behaviors around infant feeding. Focusing on improving social and soft skills of CHWs that can translate into better CHW-beneficiary interactions can pay rich dividend for certain behaviors which are currently less prevalent such as minimum dietary diversity or those which are perhaps more in mothers control such as exclusive breastfeeding. Funding Sources The Bill and Melinda Gates Foundation.

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Identification and comparison of workplace stressors in different profiles of health care workers in primary and secondary community health care

10.26226/morressier.5971be86d462b80290b52725 ◽

2017 ◽

Author(s):

Alma Dzubur Kulenovic

Keyword(s):

Health Care ◽

Community Health ◽

Health Care Workers ◽

Community Health Care ◽

Workplace Stressors ◽

Care Workers

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A mixed reception: perceptions of pregnant adolescents’ experiences with health care workers in Cape Town, South Africa

Reproductive Health ◽

10.1186/s12978-021-01211-x ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Ronel Sewpaul ◽

Rik Crutzen ◽

Natisha Dukhi ◽

Derrick Sekgala ◽

Priscilla Reddy

Keyword(s):

South Africa ◽

Health Care ◽

Antenatal Care ◽

Health Care Workers ◽

Cape Town ◽

Pregnant Adolescents ◽

High Quality ◽

Care Workers ◽

Antenatal Clinics ◽

Antenatal Services

Abstract Background Maternal mortality among adolescent mothers in South Africa is higher than many middle-income countries. This is largely attributable to conditions that can be prevented or managed by high quality antenatal care. The way in which pregnant adolescents are treated at antenatal clinics influences their timely utilization of antenatal services. This qualitative study reports on the experiences of pregnant adolescents with health care workers when accessing antenatal care. Methods Pregnant girls aged 13–19 (n = 19) who attended public health care facilities that provide Basic Antenatal Care (BANC) services in Cape Town, South Africa were recruited. Four face to face in-depth interviews and four mini focus group discussions were undertaken, facilitated by a topic guide. Thematic analyses were used to analyse the data. Results Experiences that reinforce antenatal attendance, such as respectful and supportive treatment, were outweighed by negative experiences, such as victimization; discrimination against being pregnant at a young age; experiencing disregard and exclusion; inadequate provision of information about pregnancy, health and childbirth; clinic attendance discouragement; and mental health turmoil. Conclusions There is evidence of a discordant relationship between the health care workers and the pregnant adolescents. Adolescents feel mistreated and discriminated against by the health care workers, which in turn discourages their attendance at antenatal clinics. Maternal health care workers need to receive support and regular training on the provision of youth friendly antenatal care and be regularly evaluated, to promote the provision of fair and high quality antenatal services for adolescent girls.

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Promoting Health in Rural India: Enhancing Job Performance of Lay Health Care Activists

IIM Kozhikode Society & Management Review ◽

10.1177/2277975219857411 ◽

2019 ◽

Vol 9 (2) ◽

pp. 226-242 ◽

Cited By ~ 1

Author(s):

Jatin Pandey ◽

Manjari Singh ◽

Biju Varkkey ◽

Dileep Mavalankar

Keyword(s):

Health Care ◽

Job Performance ◽

Community Health ◽

Health Care Workers ◽

Rural Areas ◽

Health Care Services ◽

Rural India ◽

Community Health Care ◽

Care Services ◽

Care Workers

The health of people in a nation is a potential indicator of its development. Over and above that, the job performance of people involved in the delivery and facilitation of health care services within a nation reflects the actual health conditions in it. In developing countries, where a large chunk of the population lives in rural areas, the job performance of grass-roots health care workers gains significant importance in order to ensure effective and efficient delivery of health care services to the masses and marginalized communities. The present study takes the case of Accredited Social Health Activists (ASHAs) in difficult rural areas of India to identify factors that affect their job performance and suggests interventions through which it could be enhanced. Fifty-five ASHAs were interviewed and five focused group discussions (FGDs) were conducted. Additionally, triangulation was done by interviewing other stakeholders, while studying relevant documents. Through content analysis of these interviews and documents, this study identifies the demands, resources and stressors that affect the job performance of these important intermediaries in the health care supply chain (in the Indian context). The study also suggests policy-level decisions that could help in enhancing job performance of ASHAs by managing demands, increasing resources and reducing stressors. Key Messages We have developed a model that delineates the demands, resources and stressors that affect job performance of women workers in rural India. We have studied Accredited Social Health Activists (ASHAs) who are part of community health care sector. However, our findings are applicable to a wider set of similar job roles. We have studied the nuances of factors affecting job performance for a category of community health care workers who are not full-time employees, have received minimal training and work in close proximity of their residence in a closely knit society. We have looked at job performance of ASHAs who are women community health workers, with low educational qualifications, based in rural setting of a developing country. We have recommended policy implications that would aid in enhancing the performance of ASHAs and thus improve the health care situation in rural India.

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