DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20150606

Utilization of ASHA services by the pregnant women of rural Tripura, India

Himadri Bhattacharya, Nimaichand Luwang, Mousumi Sarkar, Tanusree Chakraborty, Subrata Baidya

Abstract


Background: India’s National Rural Health Mission (NRHM) introduced Accredited Social Health Activists (ASHA) at the community level. Their vital role is to promote antenatal care and increase the utilization of the existing health services. The objectives were to find out utilization of ASHA services by the pregnant women and to study its determinants in rural area of Tripura, India.

Methods: A community based cross-sectional study was conducted during February – April 2015 using a validated interview schedule among 306 recently delivered women residing in Mohanpur block of Tripura, chosen by multistage sampling.

Results: Utilization rate of ASHA services by pregnant women was found to be 89.7%. Pregnancy registration rate was 95% and 90% of these registrations were facilitated by ASHA. Adequate antenatal check-up rate facilitated by ASHA was 76.69%. Regarding Iron and Folic Acid prophylaxis, 67.88% of the adequate recipients were facilitated by ASHA. For laboratory tests, 80.23% of the women were motivated by ASHA. About 90% of the study women have heard about Janani Suraksha Yojona (JSY) scheme from ASHA and 70% of them got the benefit through ASHA. Literacy, parity, community, economic class, home visit by ASHA and family decision maker were identified as the significant determinants of utilization of ASHA services by the pregnant women.

Conclusions: Utilization rate of the ASHA services by the pregnant women needs improvement. Apart from IEC activities, active home visits by ASHA, empowering couples to make their own fertility decisions, improvement in female literacy etc. may enhance utilization of ASHA services by this community which will intern enhance maternal health care utilization.

 


Keywords


ASHA, NRHM, JSY, Antenatal Care, Utilization

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References


IFPS Technical Project: Community based Workers Improving Health Outcomes in Uttarkhand, India 2012; IFPS Technical Assistance Project, USAID.

MOHFW. National Rural Health Mission: Framework for Implementation 2005-2012; Ministry of Health & Family Welfare, Government of India, New Delhi.

Joshi SR. George M. “Health Care through community participation”. Economic & Political Weekly. 2012;18(10):70-6.

MOHFW: Indian Public Health Standards, Guidelines for Community Health Centre 2006; Ministry of Health & Family Welfare, Government of India, New Delhi.

Bhatnagar R, Singh K, Bir T, Datta U, Raj S, Nandan D. An assessment of performance based incentive system for ASHA Sahyogini in Udaipur, Rajasthan. Indian J Public Health. 2009;53(3):166-70.

Bajpai N, Dholakia R H. Improving the performance of Accredited Social Health Activists in India, Working Paper Series 2011; Columbia Global Centers, South Asia, Columbia University.

Mane AB, Khandekar SV. Strengthening Primary Health Care through ASHA workers: A novel approach in India, Primary Health Care 2014; 4: p - 149. Available at: http://www.omicsgrouporg/Journals/strengthening-primary-health-care-through-asha-worker. Accessed 22/01/2015.

National Family Health Survey (NFHS-3), India, International Institute for Population Sciences (IIPS) and Macro International 2007; Vol. 1. p. 192-222. Available at: http://www. Nfhsindia.org. Accessed 07.02.15.

International institute for population sciences, Mumbai, Ministry of Health and Family Welfare, Govt. of India, District Level Household and Facility Survey -4, State Fact Sheet Tripura, 2012-13. Available at: http: //www.rchiips.org/pdf/dlhs4/report/TR.pdf. Accessed 03.02.15.

SPSS Inc. Released 2006. SPSS for Windows, version 15.0. Chicago, SPSS Inc. Accessed 20/01/2015.

Provisional data of census India 2011. Office of The Registrar General & Census Commissioner, India, New Delhi, Ministry of Home Affairs, Government of India. Available at: http://www.censusindia.gov.in. Accessed 11.02.15.

Venkatesh RR, Umakantha AG, Yuvaraj J. Safe motherhood status in the urban slums of Davangere city. Indian J Community Med. 2005;30:6-7.

Singh MK, Singh J, Ahmad N, Kumari R, Khanna A. Factors influencing utilization of ASHA services under NRHM in relation to maternal health in rural Lucknow. Indian J Community Med. 2010;35:414-9.

Das R, Ali A, Nath P. Utilization and coverage of services by women of Jawan Block in Aligarh. Indian J Community Med. 2001;26(2):94-100.

Kapoor SL, Vashist BM, Punia MS. Coverage & Quality of Maternal & Child Health Services at Sub centre level. Indian J Community Med. 2001;26(1):16-20.

Padda P, Devgun S, Gupta V, Chaudhari S, Singh G. Role of ASHA in Improvement of Maternal Health Status in Northern India: An Urban Rural Comparison. Ind J Comm Health. 2013;25(4):465-71.

Amit Shukla, Tarun Bhatnagar. Accredited Social Health Activists and pregnancy-related services in Uttarakhand, India. BMC Proceedings. 2012;6(1):4.

Das NP, Mishra VK, Saha PK. Does community access affect the use of health and family welfare services in rural India? NFHS subject report No.18. 2001; Mumbai, India and Honolulu, USA. Mumbai and East‑West Centre, Honolulu: International Institute of Population Sciences.

Van Eijk AM, Bles HM, Odhiambo F, Ayisi JG, Blokland IE, Rosen DH. Use of antenatal services and delivery care among women in rural western Kenya: A community based survey. Reprod Health. 2006;3:2.