scholarly journals Community health workers in India: Challenges and vulnerabilities of Accredited Social Health Activists working in conflict-affected settings in the state of Assam, India

2020 ◽  
Author(s):  
Preety R Rajbangshi ◽  
Devaki Nambiar ◽  
Aradhana Srivast
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Social Relations ◽  
Health Workers ◽  
Social Health ◽  
Access To Health Services ◽  
North East ◽  
The North ◽  
Post Conflict ◽  
East Region

Abstract Introduction:. It is well acknowledged that India’s Community Health workers known as Accredited Social Health Activists (ASHA) are the bedrock of its health system. Many ASHAs are currently working in fragile and conflict-affected settings. No efforts have yet been made to understand the challenges and vulnerabilities of these female workers. This paper seeks to address this gap by bringing attention to the situation of ASHAs working in the fragile and conflict settings and how conflict impacts them and their work.Methods: Qualitative fieldwork was undertaken in four conflict-affected villages in two post-conflict districts -Kokrajhar and Karbi Anglong of Assam state situated in the North-East region of India. Four ASHAs from the majority (Bodo or Karbi) and minority (Adivasi or Koch) communities serving roughly 4000 people were interviewed in their language of preference after administering written consent. Data transliterated into English were analysed by authors by developing a codebook using grounded theory and thematic organisation of codes. Results: ASHAs reported facing challenges in ensuring access to health services during and immediately after outbreaks of conflict. They experienced difficulty in arranging transport and breakdown of services at remote health facilities. Their physical safety and security were at risk during episodes of conflict. ASHAs reported hostile attitudes of the communities they served due to the breakdown of social relations, trauma due to displacement, and loss of family members, particularly their husbands. Conclusion: Conflict must be recognised as an important context within which community health workers operate, with greater policy focus and research devoted to understanding and addressing the barriers they face as workers and as persons affected by conflict.

scholarly journals Community Health Workers: Challenges and Vulnerabilities of Accredited Social Health Activists Working in Conflict-affected Settings in the State of Assam, India

2020 ◽  
Author(s):  
Preety R Rajbangshi ◽  
Devaki Nambiar ◽  
Aradhana Srivast
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Social Relations ◽  
Health Workers ◽  
Social Health ◽  
Access To Health Services ◽  
North East ◽  
The North ◽  
East Region ◽  
Access To Health

Abstract Introduction:. It is well acknowledged that India’s Community Health workers known as Accredited Social Health Activists (ASHA) are the bedrock of its health system. Many ASHAs are currently working in fragile and conflict-affected settings. No efforts have yet been made to understand the challenges and vulnerabilities of these female workers. This paper seeks to address this gap by bringing attention to the situation of ASHAs working in the fragile and conflict settings and how conflict impacts them and their work. Methods: Qualitative fieldwork was undertaken in four conflict-affected villages in two conflict-affected districts -Kokrajhar and Karbi Anglong of Assam state situated in the North-East region of India. Detailed account of four ASHAs from the majority (Bodo or Karbi) and minority (Adivasi or Koch) communities serving roughly 4000 people is presented. Data transliterated into English were analysed by authors by developing a codebook using grounded theory and thematic organisation of codes. Results: ASHAs reported facing challenges in ensuring access to health services during and immediately after outbreaks of conflict. They experienced difficulty in arranging transport and breakdown of services at remote health facilities. Their physical safety and security were at risk during episodes of conflict. ASHAs reported hostile attitudes of the communities they served due to the breakdown of social relations, trauma due to displacement, and loss of family members, particularly their husbands. Conclusion: Conflict must be recognised as an important context within which community health workers operate, with greater policy focus and research devoted to understanding and addressing the barriers they face as workers and as persons affected by conflict.

scholarly journals Community health workers: challenges and vulnerabilities of Accredited Social Health Activists working in conflict-affected settings in the state of Assam, India

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Preety R Rajbangshi ◽  
Devaki Nambiar ◽  
Aradhana Srivastava
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Social Relations ◽  
Health Workers ◽  
Social Health ◽  
Access To Health Services ◽  
North East ◽  
The North ◽  
East Region ◽  
Access To Health

Abstract Introduction It is well acknowledged that India’s community health workers known as Accredited Social Health Activists (ASHA) are the bedrock of its health system. Many ASHAs are currently working in fragile and conflict-affected settings. No efforts have yet been made to understand the challenges and vulnerabilities of these female workers. This paper seeks to address this gap by bringing attention to the situation of ASHAs working in the fragile and conflict settings and how conflict impacts them and their work. Methods Qualitative fieldwork was undertaken in four conflict-affected villages in two conflict-affected districts -Kokrajhar and Karbi Anglong of Assam state situated in the North-East region of India. Detailed account of four ASHAs serving roughly 4000 people is presented. Data transliterated into English were analysed by authors by developing a codebook using grounded theory and thematic organisation of codes. Results ASHAs reported facing challenges in ensuring access to health services during and immediately after outbreaks of conflict. They experienced difficulty in arranging transport and breakdown of services at remote health facilities. Their physical safety and security were at risk during episodes of conflict. ASHAs reported hostile attitudes of the communities they served due to the breakdown of social relations, trauma due to displacement, and loss of family members, particularly their husbands. Conclusions Conflict must be recognised as an important context within which community health workers operate, with greater policy focus and research devoted to understanding and addressing the barriers they face as workers and as persons affected by conflict.

Global health's durable dreams: ethnography, ‘community health workers’ and health without health infrastructure

Africa ◽  
2020 ◽  
Vol 90 (1) ◽  
pp. 95-111
Author(s):  
Ramah McKay
Keyword(s):  
Public Health ◽  
Global Health ◽  
Community Health ◽  
Community Health Workers ◽  
Health Systems ◽  
Social Relations ◽  
Health Workers ◽  
Health Coverage ◽  
Global Health Policy ◽  
Public Health Officials

AbstractTracing the persistence of community health workers (CHWs) as a key category in both global health policy and anthropological representation, this article asks how enduring scholarly investments in CHWs can reveal changing political stakes for both health work and ethnographic research. Amid renewed calls for a focus on health systems and universal health coverage, the article suggests that the durability of attention to CHWs is instructive. It simultaneously points to the imbrication of health with political and social relations and clinical and technological infrastructures as well as to how ethnographic investments in health systems can sometimes obscure the ambivalent politics of health. Drawing on fieldwork with CHWs, NGO staff and public health officials, and on public health literature on CHWs, it argues for greater attention to the political ambivalence of health labour. It suggests that the experiences of health workers themselves can serve as analytical examples in this regard, pointing to analyses that begin not with normative notions of health systems or the conceptual boundaries of global health ‘projects’ but with a focus on the contested relations through which health labour is realized over time. Such attention can also indicate possibilities for health beyond dreams of projects, clinics or health systems.

scholarly journals Community health workers’ attitudes, practices and perceptions towards the COVID-19 pandemic in brazilian low-income communities

Work ◽  
2021 ◽  
pp. 1-9
Author(s):  
Nilson do Rosário Costa ◽  
Hugo Bellas ◽  
Paulo Roberto Fagundes da Silva ◽  
Paulo Victor Rodrigues de Carvalho ◽  
Deborah Uhr ◽  
...  
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Low Income ◽  
Online Survey ◽  
Health Workers ◽  
Sampling Error ◽  
Access To Health Services ◽  
The Face ◽  
Modes Of Interaction ◽  
Poor Communities

BACKGROUND: Community Health Workers (CHW) are a category of social workers described in many countries’ health systems as responsible for engaging people in their residences and communities, and other non-clinical spaces to enable access to health services, especially in low-income areas. These professionals have been exposed to numerous new risks during the COVID-19 pandemic. OBJECTIVE: This study describes how the COVID-19 pandemic is perceived by CHWs who work in poor communities or slums in Brazil. METHODS: We conducted an online survey with a random sample of 775 CHWs operating in 368 municipalities of the 26 Brazilian states. At a confidence level of 95% , results of the survey were subject to a maximum sampling error of 4% . RESULTS: Our data indicate that the negationist agenda increases the challenges to the performance of CHWs within low-income communities, preventing the consensus on the necessity of social distancing, business closures and other measures to face the COVID-19 pandemic. CONCLUSION: The pandemic imposes unexpected challenges on the usual modes of interaction of public health officers with poor communities. This study provides evidence that these challenges have been ignored or minimized in Brazilian policy prescriptions for primary care in the face of the COVID-19 pandemic.

scholarly journals Promoting Hispanic Immigrant Health via Community Health Workers and Motivational Interviewing

2020 ◽  
Vol 41 (1) ◽  
pp. 3-6
Author(s):  
Erin M. Portillo ◽  
Denise Vasquez ◽  
Louis D. Brown
Keyword(s):  
Health Services ◽  
Motivational Interviewing ◽  
Community Health ◽  
Community Health Workers ◽  
Immigrant Health ◽  
Health Workers ◽  
Health Resources ◽  
Health Promotion Program ◽  
Public Health Department ◽  
Access To Health Services

Hispanic immigrant health disparities are among the highest in the nation, especially related to obesity and access to health services. Healthy Fit (En Forma Saludable) is a health promotion program that leverages public health department infrastructure to address these disparities through the use of three key innovations explored in this article: community health workers (CHWs), motivational interviewing (MI), and vouchers for free preventative health services. CHWs trained in MI conduct a health screening and then distribute preventive service vouchers and health resources as needed based on screening results. Vouchers cover breast, cervical, and colorectal cancer screening, and several vaccinations including flu and human papillomavirus. Resources to support exercise, to support a healthy diet, to quit smoking, and to reduce risky drinking are also distributed as needed. CHWs then use MI to address perceived barriers and strengthen intrinsic motivation to make use of the health resources. Integrating these strategies provides a low-cost approach to promote healthy behavior in an underserved immigrant population.

scholarly journals Timely Access to Maternal, Neonatal and Child Healthcare for rural communities in Rwanda: Job satisfaction of Community Health Workers delivering Community Based Maternal, Newborn and Child Healthcare

2020 ◽  
Author(s):  
Jean Bosco BIGIRIMANA ◽  
Isaac Luginaah
Keyword(s):  
Job Satisfaction ◽  
Rural Communities ◽  
Community Health ◽  
Community Health Workers ◽  
Health Workers ◽  
Care Delivery ◽  
Access To Health Services ◽  
Community Based ◽  
Cross Sectional ◽  
Child Healthcare

Abstract Background In Rwanda, although there has been progressing in health care delivery as expressed in the reduction in maternal and child mortality, rates are still high and geographically variable. For the improvement of equitable access to health services for maternal, newborn and child healthcare (MNCH), community-based maternal, newborn and child healthcare (CBMNCH) depends on the use of “community health workers” (CHWs). However, the CHW program faces challenges that disrupt the quality delivery of a full package of services. Yet little is known about the satisfaction of CHWs in delivering CBMNCH. Methods This quantitative cross-sectional study involved a survey of 500 sampled CHWs delivered CBMNCH in three selected rural districts of the southern province, Rwanda. Ordinal regression was used to examine the determinants of CHWs` job satisfaction. Results Multivariate analysis shows that the determinants of job satisfaction were motivation (OR = 8.59, p < 0.001), formal training in CBMNCH (OR = 2.24, p < 0.05), individual supervision (OR = 6.19, p < 0.001), and peer support (OR = 2.66, p < 0.01), knowledge about CBMNCH (OR = 0.51, p < 0.05), access to essential materials (OR = 0.32, p < 0.05), and incentives (OR = 0.53 (p < 0.01). Conclusion The findings indicated that the managers of CHW programs and other stakeholders need to improve the working conditions of CHWs to enhance their job satisfaction, to enable the effective provision of CBMNCH.

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