Access to quality healthcare is a right of every individual but lack of basic facilities at public facility centers and dearth of qualified medical professionals is a major roadblock in securing this objective. Community health workers play an important role in improving the healthcare service delivery on ground by acting as a link between healthcare facilities and the communities. They are the key role holders offering an opportunity for the government and policy makers and practitioners to improve health.
There is need for better understanding of the opportunities and challenges faced by them in diverse Indian contexts. Community Health workers face a number of challenges in performing their jobs, including high workloads, insufficient training, poor credibility in the community, difficulty addressing sensitive topics with families, poor support for home visits, and little or no feedback about performance. In remote rural locations of the Country, the health workers have to travel through the tough terrains and deliver services in hard to reach locations.
It becomes much more difficult when communities become non-cooperative due to local taboos and customs. Overcoming the perverse community attitude in such conditions is a major challenge for health workers in ensuring the healthcare delivery to the last mile beneficiary. Competition within Public & Private sectors again makes it difficult for healthcare providers to gain trust of the communities while performing their job. The role of community health workers as social activists is much less visible than what is envisioned. Access to fair monetary incentives is a critical element limiting their role both within the health system and the communities as well.
The NRHM views at community engagement as an organic link to health systems strengthening; and community health workers are the key drivers of it. The shortage of qualified health professionals in India, particularly in rural areas, means that the contributions of Community Healthcare providers must be mobilized more to overcome the challenge. Success of such endeavors depends on several factors such as a well-developed health system, strong referral systems and linkages, availability of transport networks and emergency services.
There is no doubt that a sturdy community-embedded health worker program is crucial to health systems in India and over time India will have to make its Community Health Worker program more robust to address the current and emerging needs of the healthcare system.
Ref: Community health workers in rural India: analyzing the opportunities and challenges Accredited Social Health Activists (ASHAs) face in realizing their multiple roles; Assisting community health workers in India