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Title: A study of Roles and Performances of Accredited Social Health Activists (ASHAs) in Home Based Newborn Care Practices in the State of Uttar Pradesh
Authors: Tripathy, Tridibesh
Keywords: School of Health System Studies
Shankar Das
Accredited Social Health Activists - Home Based New Born Practices - Uttar Pradesh
Issue Date: 2018
Abstract: The first month of life is the most crucial part of life as every child has to cross that barrier to live further. We all know that not all children are fortunate enough to cross this barrier. The current study was an effort to study these barriers and factors associated with these barriers in the context of role and performance of ASHAs. The unit through which the current research chose to study was the ASHAs who are volunteers of Panchayati Raj Institutions and seconded as health personnel in the public health system. It was in this premise that the efficiency, effectiveness and result oriented timely visits by ASHAs to the houses of newborns was the base of the study. The research encompassed the capacity and skills of ASHAs on home based newborn care practices and examined the work of ASHAs through the actual actions at house-holds. An ASHA is a health activist in the community who creates awareness on health and its social determinants and mobilizes the community towards local health planning and increased utilization and accountability of existing health services. An Accredited Social Health Activist is primarily a woman resident of the village who is Married/Widow/Divorced and preferably in the age group of 25 to 45 yrs. These are incentive based community workers who are appointed by the Local Self Governance (GOI guidelines on ASHA, 2005). There are 859,331 ASHAs in 32 states and union territories as per the data provided by the states on December, 2014 (MOHFW, 2015). The ASHAs have creditably established themselves as activists, facilitators and providers of community level care across various contexts. The principle of local selection, experiential training in a set of specific competencies and skills has enabled them to play a significant role in behavior change for households. (NHP, GOI, 2015). The study focused on the role and performance of ASHAs (Accredited Social Health Activist) regarding home based newborn care practices. ASHAs are supposed to visit the houses of the newborns as part of Home Based Newborn Care (HBNC) package of Government of UP that was developed on the lines of HBNC guidelines and India Newborn Action Plan (INAP) of Government of India. National Rural Health Mission (NRHM) is currently operational in 18 states of India. Uttar Pradesh is one such state. The study was done in four selected districts in Uttar Pradesh (UP). There were five objectives and eight research questions of the study. The first was to explore the roles, responsibilities and performances of ASHAs in HBNC practices in UP. The related research question to this objective was to find out how and when the ASHAs paid timely visits to the houses of the newborns. Further to understand the HBNC practices, the prevalent need based communication practices of ASHAs with the significant members of households of newborns were also explored in the second objective. The first research question related to the objective was to find out how ASHAs provide home based newborn care education to the pregnant women. The second research question related to this objective was to find out how and when do the ASHAs reinforce the messages of home based newborn care during the home visits. The next question was to find out how and when did the ASHAs did follow up home visits to ensure adoption of home based newborn care practices by the mothers. The last question of this objective was to see the relationship between the number of home visits and the survival of newborns. The third objective was perception of RDWs regarding efficacy of these need based communication practices given by ASHAs. The related research question was to find out how the community members support ASHAs during their home visits. The fourth objective was to find out the adopted behaviors by the households regarding home based newborn care practices. The related research question of this objective was to find out how and when do the significant members of the households adopt the newborn care practices at home for the newborns. Besides the community perspective, the study also focused on the policy makers where the objective was to find out about prioritization of HBNC practices in designing programs at the district and state level. The related research question was to find out how and why did the policy makers prioritized home based newborn care practices in the package for newborns while designing programs.
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01_Title Page.pdf40.14 kBAdobe PDFView/Open
02_Declaration.pdf177.13 kBAdobe PDFView/Open
03_Certificate.pdf162.22 kBAdobe PDFView/Open
04_Acknowledgement.pdf29.73 kBAdobe PDFView/Open
05_Acronyms.pdf42.61 kBAdobe PDFView/Open
06_Contents.pdf42.48 kBAdobe PDFView/Open
07_Box & Figures.pdf65.59 kBAdobe PDFView/Open
08_Abstract.pdf60.14 kBAdobe PDFView/Open
09_Chapter 1.pdf161.21 kBAdobe PDFView/Open
10_Chapter 2.pdf216.53 kBAdobe PDFView/Open
11_Chapter 3.pdf1.18 MBAdobe PDFView/Open
12_Chapter 4.pdf629.47 kBAdobe PDFView/Open
13_Chapter 5.pdf59 kBAdobe PDFView/Open
14_References.pdf98.04 kBAdobe PDFView/Open
15_Annexure.pdf212.73 kBAdobe PDFView/Open

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