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Interview with Aruna - an ASHA, in Bangalore

An Asha is an Accredited Social Health Activist - government employed version of the Community Health Worker we saw in Kenya. With 1 week of training, Aruna works as part of a small team of 14 covering 475 houses locally in a peri-urban part of Bangalore. They offer basic medical care, advice around hygiene and run small awareness programs e.g. around TB.

Key takeaways

1. She is not allowed to distribute medicines but plays a vital role in healthcare outreach

“We are teaching people about cleanliness and hygiene, we weigh new babies and offer contraception. We also do testing for things people don’t want to go to the doctors for, like TB. They don’t like getting the test because they’re afraid of the results.”

The role of the ASHA (originally a rural role) is under review by the government - it’s likely that in urban areas they will increase in number and be given more responsibility. Especially given that public facilities can have queues for hours, they’re a key access point for primary care, and could soon be given the training and ability to offer antibiotics as they do in Kenya.

2. Struggles to be taken seriously

“We go frequently to make visits to people, my patch is around 125 houses, and there will be a problem in 3-4 of them per day. Often people are asking, why are you here again? I take it in my stride, I’m used to it. I tell them I’m there for their own good.”

We also found this in Kenya - that the CHW’s despite their enormous potential are not always welcomed in communities. There’s a big opportunity to help these workers optimise their efforts - for example with tools that enable them to only visit houses where there is a problem - and also to offer more care through training tools.

3. Is open to learning using simple tech

“I would like to use my phone to learn about new things, like how to make the relationship with people better, and learning about what else people should take aside from paracetamol”

Because the training for Asha’s is very limited, they tend to do once off extra days of training now and then, but this is often focused on communications campaigns rather than improving broad medical knowledge. There’s huge potential to enable them to learn more on their own terms, for example with the ‘Stay on Top training’ that all CHW’s in both markets responded really well to.