3 min readPuneFeb 9, 2024 04:59 PM IST
First published on: Feb 9, 2024 at 11:58 AM IST
From heavy workloads to completing tasks in a limited time-frame, a recent study shows how strengths-based coaching intervention can address work stress among Accredited Social Health Activists.
Anant Bhan, principal investigator of the study — published recently in Social Science and Medicine, a peer-reviewed journal — told The Indian Express that it was part of a formative work that has contributed to the development of positive psychology intervention for addressing work stress among ASHAs in rural Madhya Pradesh.
“As part of our ongoing project we found that these interventions will aim to coach ASHAs to use and leverage their existing personal strengths for responding to work stress,” Bhan said.
Addressing ASHA well-being and burnout for improving depression care (AANAND) is a joint collaboration between Sangath, a non-profit committed to improving health and evidence-based interventions in mental healthcare, and the National Health Mission of MP government.
As part of the project, researchers, in their formative study, tried to gain perspectives into the experiences of work stress, the related health symptoms, and the responses to stress among ASHAs in the country.
More than a million ASHAs deliver primary care services in India with one ASHA serving a village of 1,000 people. Burnout and poor well-being are prevalent among rural healthcare workers who provide last-mile care in various areas such as pregnancy care, vaccinations, child care and basic mental health care services, study researchers said.
“Since its inception in 2005, the ASHA cadre has been deprived of a structured, contextually-rooted intervention to strengthen their abilities in coping with recurrent work stress,” says Dr Vikram Patel, who is the Paul Farmer Professor and Chair, Department of Global Health and Social Medicine, Harvard Medical School, and one of the study researchers. “This study demonstrates the diverse factors, ranging from structural to personal, which contribute to work stress in the daily lives of ASHAs, the backbone of India’s primary healthcare system. These findings will help Sangath design an intervention, in participation with ASHAs, to support them in managing these stressful experiences better and, ultimately, promoting their well-being,” Patel told The Indian Express.
Several fixed group discussions with 59 ASHAs from Sehore district of MP generated themes like unstructured work, ASHAs relationships with seniors — feelings of being disrespected, blamed or targeted, low access to physical and administrative resources apart from feelings of guilt. “ASHAs felt guilty for putting less time for family/child care and at times, despite their efforts, there was low acceptance by the villagers for some of their services. Work stress reached a point where headache, exhaustion, and ruminating on difficult work situations became common symptoms,” said Ritu Shrivastava, the lead investigator of the study.
Researchers also identified pathways between the conditions that trigger stressful events and approaches used by ASHAs to respond to it. ASHAs draw motivation from the support offered by their peers, family members and also draw a sense of identity and pride in their work. “All these findings from our formative study merits a tailored intervention that builds on existing strengths and coping mechanisms,” says Bhan. Researchers including Ritu Shrivastava from Sangath and others said that their findings were relevant to build evidence on work stress among other cadres of female frontline health workers for similar interventions in low-resource settings globally.
As part of the project, researchers, in their formative study, tried to gain perspectives into the experiences of work stress, the related health symptoms, and the responses to stress among ASHAs in the country. (Source: AANAND Project Team) 
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