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International Journal of MCH and AIDS
Volume 2, Issue 1, 2013, Pages 121 – 128
Evaluating Birth Preparedness and Pregnancy Complications Readiness Knowledge
and Skills of Accredited Social Health Activists in India
Smitha Kochukuttan, BDS, MPH 1; TK Sundari Ravindran,
PhD1; Suneeta Krishnan, PhD2
1Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute
for Medical Sciences and Technology, Trivandrum, Kerala, India
2RTI International, San Francisco Office, 114 Sansome Street, Suite 500, San
Francisco, CA-94104-3812, USA
Background: The National Rural Health Mission (NRHM) in
India relies on Accredited Social Health Activists (ASHAs) to act as a link
between pregnant women and health facilities. All ASHAs are required to have a
birth preparedness plan and be aware of danger signs of complications to
initiate appropriate and timely referral to obstetric care.
Objectives: To examine the extent to which Accredited
Social Health Activists (ASHAs) are equipped with necessary knowledge and
skills and the adequacy of support they get from supervisors to carry out their
assigned tasks in a rural district in Karnataka, (South) India.
Methods: A cross-sectional descriptive study was
carried out among 225 ASHAs between June -July 2011. Quantitative and
qualitative data were collected using pre-tested semi-structured interview
schedule. The data were analyzed using SPSS version 17. Chi-square test was
used to determine associations between categorical variables.
Results: The response rate was 207(92%). In terms of
knowledge of all key danger signs (Complication Readiness), 2(1%), 10(4.8%),
and 15(7.2%) ASHAs were aware of key danger signs for labor and child birth,
postpartum period and pregnancy period, respectively. Knowledge of key danger
signs was associated with repeated, recent and practical training (p <0.05).
A majority (71%) scored 4-7 of the maximum score out of 8 for knowledge
regarding Birth Preparedness.
Conclusion and Public health implications: ASHAs in
rural Karnataka, India, are poorly equipped to identify obstetric complications
and to help expectant mothers prepare a birth preparedness plan. There is
critical need for the implementation of appropriate training and follow-up
supervision of ASHAs within a supportive, functioning and responsive health
Key Words: Birth preparedness and complication
Readiness • National Rural Health Mission • Accredited Social Health Activists