Measuring communication competence and effectiveness of ASHAs (accredited social health activist) in their leadership role at rural settings of Uttar Pradesh (India)

This paper aims to find out accredited social health activists’ (ASHA) communication competence and effectiveness while working as leaders with groups in the rural setting. ASHA, as the “first point of contact” for pregnant women in rural areas, plays a significant role in building awareness and disseminating key information at critical times (e.g. antenatal and post-natal period), promotes healthy maternal and newborn care practices and facilitates identification and referral of maternal and newborn complications. ASHA plays critical role of a leader in bridging the gap between health system and community. In the entire process, effective communication competency is the key to her effectiveness.

The study adopts seven items from the farmers communication (FACOM) scale of communication measures developed by Udai Pareek and Y.P Singh. Preliminary editing of the items was done keeping certain points in mind such as the items should not be judgemental, should be acts of behaviour, should be observable and should be simple. This scale was adopted for the study, as it was designed to measure farmers’ communication competence and suited the context. The evaluation criteria included the seven essential elements of communication identified in the FACOM scale.

Results from the study identified a need to sensitise ASHAs on the critical role of effective communication and need for investing more in building her capacity for health communication. The trainings being imparted to ASHAs have to be strengthened in terms of communication skills. They should focus upon developing all three variables of communication skills equally and integrating them to get desired results.

The study was conducted in one state while the programme is running across the country. The sample size was small.

The learning of the study will help in developing a better understanding of the beneficiaries’ perspectives and their expectations regarding ASHAs communication process in the leadership role which she performs. Such understanding will not only be instructive but may also prove transformative for the benefit of both ASHAs and her community, whose support is critical to the success of the programme. This learning will feed into the policy planning and communication and capacity building strategy of the ASHA programme and may lead to better and more effective strategies and tools of communication.

Research study is original. Keeping the observers’ status in mind, questionnaire was translated in Hindi language. Twenty ASHAs were selected randomly from small villages of Uttar Pradesh, the largest state in India. The scale was presented to at least five observers (all females) for one ASHA. These observers/judges were the ones who knew ASHA well and with whom she had communicated at some point of time as part of her work.