Use of chatbots in different spheres of life is continuously increasing since a couple of years. We attempt to understand the potential of chatbots for breastfeeding education by conducting an Wizard-of-Oz experiment with 22 participants. Our participants included breastfeeding mothers and community health workers from the slum areas of Delhi, India. We prototyped our chatbot as an interactive question-answering application and analyzed users' interaction patterns, perceptions, and contexts of use. The chatbot use cases emerged primarily as the first line of support. The participants, especially the mothers, were enthusiastic with the opportunity to ask questions and get reliable answers. We also observed the influencing role of female relative, e.g. mothers-in-law, in breastfeeding practices. Our analysis of user information-seeking suggests that a majority of questions (88%) are of nature that can be answered by a chatbot application. We further observe that the queries are embedded deeply into myths and existing belief systems. Therefore requiring the designers to focus on subtle aspects for providing information such as positive reinforcement and contextual sensitivity. Further, we discuss, different societal and ethical issues associated with Chatbot usage for a public health topic such as breastfeeding education.

https://dl.acm.org/doi/pdf/10.1145/3359272

Feedpal: Understanding Opportunities for Chatbots in Breastfeeding Education of Women in India

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To Assess the Job-Related Difficulties and Dissatisfaction of Asha Workers in Selected Rural Area

Digital training for non-specialist health workers to deliver a brief psychological treatment for depression in India: Protocol for a three-arm randomized controlled trial.

Globally, community health workers (CHWs) are integral contributors to many health systems. In India, Accredited Social Health Activists (ASHAs) have been deployed since 2005. Engaged in multiple health care activities, they are a key link between the health system and population. ASHAs are expected to participate in new health programmes prompting interest in their current workload from the perspective of the health system, community and their family. This mixed-methods design study was conducted in rural and tribal Primary Health Centers (PHCs), in Pune district, Western Maharashtra, India. All ASHAs affiliated with these PHCs were invited to participate in the quantitative study, those agreeing to contribute in-depth interviews (IDI) were enrolled in an additional qualitative study. Key informants’ interviews were conducted with the Auxiliary Nurse Midwife (ANM), Block Facilitators (BFF) and Medical Officers (MO) of the same PHCs. Quantitative data were analysed using descriptive statistics. Qualitative data were analysed thematically. We recruited 67 ASHAs from the two PHCs. ASHAs worked up to 20 h/week in their village of residence, serving populations of approximately 800–1200, embracing an increasing range of activities, despite a workload that contributed to feelings of being rushed and tiredness. They juggled household work, other paid jobs and their ASHA activities. Practical problems with travel added to time involved, especially in tribal areas where transport is lacking. Their sense of benefiting the community coupled with respect and recognition gained in village brought happiness and job satisfaction. They were willing to take on new tasks. ASHAs perceived themselves as ‘voluntary community health workers’ rather than as ‘health activists”. ASHAs were struggling to balance their significant ASHA work and domestic tasks. They were proud of their role as CHWs and willing to take on new activities. Strategies to recruit, train, skills enhancement, incentivise, and retain ASHAs, need to be prioritised. Evolving attitudes to the advantages/disadvantages of current voluntary status and role of ASHAs need to be understood and addressed if ASHAs are to be remain a key component in achieving universal health coverage in India.

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Interplaying role of healthcare activist and homemaker: a mixed-methods exploration of the workload of community health workers (Accredited Social Health Activists) in India.

Copyright © 2020 Phcog.Net. This is an openaccess article distributed under the terms of the Creative Commons Attribution 4.0 International license. Cite this article : Meena S, Rathore M, Kumawat P, Singh A. Challenges Faced by ASHAs during their Field Works: A Cross Sectional Observational Study in Rural Area of Jaipur, Rajasthan. Int J Med Public Health. 2020;10(3):97-9. ABSTRACT Introduction: ASHA, the grass root level worker is a bridge between population and health system. Objectives: To determine the challenges and hurdles faced by ASHA during their field work in rural area of district Jaipur, Rajasthan. Methods and Materials: A field based descriptive, observational study was conducted among 135 ASHA’s of ten PHC’s of two blocks of Jaipur, Rajasthan from September 2018 to April 2019 by using a pretested, semi structured questionnaire for socio-economic profile of ASHA and in-depth interview to find out challenges faced by ASHAs during their field work. Results: Majority of ASHA’s (67%) were in the age group of 25-35 yrs, there were six (4%) young ASHAs who were 25 yrs of age. Majorities ASHA were studied up to secondary (32%) and higher secondary (28%), around 20% were only eighth passed (i.e. minimum education criteria) and (few) seven percentages were graduated. Majorities (84%) of ASHA were satisfied with their work but experience few challenges in field work however 15% ASHA are totally satisfied with their job and found none challenges in field work. Conclusion: Multiple inter related factors affects work performance of ASHAs in field. Financial incentives, self-identity and working for society were motivation for joining this profession. However, delayed and inadequate payment, overburden of work, poor transport and conflict between ICDS and Health staff were common challenges.

/pdf/challenges-faced-by-ashas-during-their-field-works-a-cross-v5xpru0o2y.pdf

Challenges Faced by ASHAs during their Field Works: A Cross Sectional Observational Study in Rural Area of Jaipur, Rajasthan

Background: The National Rural Health Mission has introduced village-level female community health worker, accredited social health activist (ASHA) who acts as an interface between the community and the public health system. The is study was conducted to assess the awareness and perceptions of ASHA regarding their roles and responsibilities in health-care system and factors affecting their performance in delivering health-care services. Methodology: A qualitative study was conducted in seven selected villages under Talegaon Primary Health Centers, Wardha district, Maharashtra, which is also field practice area of a medical college. Nonprobability sampling (purposive sampling) was done. In-depth interviews were conducted on ASHAs (n = 7) of those selected villages till saturation of data. Data were analyzed using the thematic framework approach. Results: ASHAs perception regarding their job responsibilities appeared to be incomplete. They had good awareness regarding their roles and responsibilities as a link worker. They were found to be mostly interested in higher incentive performances. ASHAs clarity regarding their roles and responsibilities as facilitator, social activist, and service provider was found to be somewhat compromised. They were ignorant about their roles and responsibilities under various newly launched national programs. The positive factors influencing ASHAs performances were regular supervision of their performances and appraisal by higher authority and support from community, family, and good relations with coworkers and staff. Challenges faced by most of the ASHAs were more workload, poor orientation to program, lack of quality training, and inadequate and delayed monetary incentives. Conclusion: Good quality training with regular refresher training sessions and regularization of incentives are required to motivate them ASHAs.

Qualitative Assessment of Accredited Social Health Activists (ASHA) Regarding their roles and responsibilities and factors influencing their performance in selected villages of Wardha

Background: The “Adolescents for Health Action model,” Kishori Panchayat (KP) is an innovative approach for mobilizing and empowering adolescent girls by enhancing their life skills by participating in various community health activities, a platform for interaction with peer-groups, villagers, community leaders, and health-care providers. Aim: The aim of the study is to follow-up the quantitative data regarding the effectiveness of KP in enhancing life skill education among adolescent girls who are members of KP compared to Non-KP girls. Objectives: The main objectives are: (1) to study the knowledge and perceptions regarding life skills among adolescent girls (12–18 years) of KP and non-KP and (2) to identify features of KP and related contextual factors that contributed to the outcome. Methodology: The qualitative study was carried out among 100 KP girls and non-KP girls, respectively (12–18 years), under 20 villages of rural Wardha district over 1-year period after obtaining consent in writing from participants and Institutional Ethics Committee. Focus group discussion was conducted in each village. Key informant interviews of social workers of KPs and school teachers conducted until data saturation. Results: Findings suggest that KP girls had more knowledge and perception regarding life skills and their application compared to non-KP girls. Life skill education program by KP was found to be received positively by adolescent girls. Conclusion: Institutionalization of this can help in building a sustainable model for empowerment of adolescent girls.

Qualitative Assessment of Life Skill Development of Adolescent Girls through Kishori Panchayat: An Adolescents for Health Action Model in Selected Villages of Rural Central India.

Ishita Guha

Papers

Qualitative Assessment of Accredited Social Health Activists (ASHA) Regarding their roles and responsibilities and factors influencing their performance in selected villages of Wardha

Qualitative Assessment of Life Skill Development of Adolescent Girls through Kishori Panchayat: An Adolescents for Health Action Model in Selected Villages of Rural Central India.