Both financial and non-financial factors matter for ASHAs: Study

Preferences change depending on factors including level of education, size of family, status as main earner

By Monika Kundu Srivastava
Published: Thursday 06 June 2019

A major challenge faced by the Indian health system is to keep its Accredited Social Health Activists (ASHAs) motivated and retain them in service. A new study has found that ASHA workers get motivated most by prospects of promotions than other factors.

Researchers from The George Institute for Global Health and Sydney University undertook a survey of 318 health workers to find out their priorities. The workers had to choose one of two jobs, based on salary, workload, travel allowance, supervision and other job benefits. The study was done in Guntur district of Andhra Pradesh.

Results indicated that prospects of promotion were the main motivator for 85 per cent of the health workers. This was because promotion meant higher salary, more authority and recognition. The other factors that led to job satisfaction included a fixed salary as well as non-financial factors like free family health-checks and lesser workload.

The study also highlighted the fact that priorities of ASHAs were linked to their socio-economic conditions. Community health workers who had other paid jobs prioritised free family health checks. This could be because they may have had larger families needing more health visits and were more concerned that training might take them away from their families or cost them more days off their second jobs.

Those who did not have second jobs and were less likely to be the main income earners for their families were more motivated by training and salaries.

Higher-educated ASHAs prioritised career progression with a better pay and recognition. Relatively less-educated ASHAs were more interested in immediate high pay, with no intention for further training to be promoted. The lesser-educated also preferred jobs with a lighter workload. This could be because they had larger families to look after and needed more time for that.

“There is a need to understand the preferences of health workers and certain aspects of career development valued by ASHAs. Non-financial and financial incentives should be combined to improve health workers satisfaction and their performance, which ultimately leads to better health outcomes,” said Rohina Joshi, a member of the research team.

Marwa Abdel-All, lead author of the research study, recommended policies considering the preferences of health workers and prioritising them. This way, shortfall of health workers could be ovecome.

The study results have been published in journal BMJ Global Health. The research team included Blake Angell, Stephen Jan, Martin Howell, Kirsten Howard, Seye Abimbola and Joshi. (India Science Wire)

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