Sustainability of performance based incentivized community health worker’s model in high priority districts of Odisha, India

Abstract: Mixed method approach was used to explore the sustainability of Accredited Social Health Activists (ASHAs) model in high priority districts of Odisha, India. A survey was conducted among 134 ASHAs followed by qualitative study among anganwadi workers auxiliary nurse midwives and non-governmental field coordinators. A conceptual framework was developed using grounded theory approach. The sustainability of ASHA model depended on the balance relationship between motivating and demotivating factors – the model may collapse if demotivating factors will be more than the motivating factors. In order to sustain the program, the demotivating factors should be minimized through eight mechanisms – incentive, insurance, free transport, recognition, role definition, training, hand holding support and supplies of logistics for sustainability of the ASHAs model. This study recommends the further research on policy or decision makers and program implementer’s prospective towards ASHA model in India.

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