Community Health Workers and Reproductive and Child Health Care: An Evaluative Study on Knowledge and Motivation of ASHA (Accredited Social Health Activist) Workers in Rajasthan, India
Ghan Shyam Karol, Dr. B K Pattanaik

Abstract
ASHA-The Community Health Workers are the friends, philosophers and guides to women and children in reproductive and child health care in rural areas. Through orientation training, the Health Care System in India has build up their knowledge and capabilities to deal with Reproductive and Child Health Care at the grassroots. They deliver their duties and responsibilities through participatory approach along with other grassroots level health related workers i.e ANMs(Axiliary Nurse Midwife) and AWWs(Anganwadi Workers) and workers and volunteers of the community based organizations such as Mahila Mandals, Youth Clubs and Panchayati Raj Institutions. In this study, ASHAs knowledge on reproductive and child health care have been assessed with the help of standardized knowledge test which depict that they have scored 90.5, 86.7, and 86.62 percent in general reproductive awareness, maternal health care and child health care respectively. However, their knowledge score in family planning and HIV/AIDS is lower (64.16%) as compared to maternal and child health care. Findings also tells that out of the total number of cases those have adopted ANC(Antenatal Care), conducted deliveries in health institutions, received PNC(Postnatal Care), availed child immunization care facilities and number of eligible couples adopting various family planning methods in ASHA’s operational area, 67.33,72.28,74.97 , 80.78 and 30.49 percent of cases respectively have been motivated by the ASHAs. As the study finding shows that their capacity is low in motivating family planning cases for restricting high fertility in rural areas, therefore, ASHAs need motivational and leadership training in the delivery of family planning services and dealing with problems of STDs, HIV/AIDS. However, ASHAs needs to be encouraged and religiously involved in RCH activities to give 100% output and the full potential of ASHA seeds to be used in all areas of reproductive and child health care particularly immunization of children and women and safe institutional deliveries which would prevent infant and maternal mortality in rural areas of Rajasthan. Moreover, another important positive finding of the study is that the representation of different communities as ASHA workers shows the adherence to affirmative action and inclusiveness principle in the selection process of ASHAs. ASHAs are really the ‘hope’ for impoverished rural women, as they provide counseling and motivational reproductive and child health care services at the door step. Time to time training and taking appropriate steps in solving their grievances will go a long way to strengthen the delivery of reproductive and child health care services through ASHAs at the grassroots.

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