Abstract
Community healthcare workers(CHWs) play acrucial role in providing vital healthcare services, particularly in the field of reproductiveand sexual health, as well as other healthcare issues such as maternal care, neonatal health, and child nutrition (RMNCHN) in India. By actively involving the community as healthcare recipients, CHWs contribute to increased acceptance and trust among individuals seeking healthcare services. Therefore, it is crucial to assess the performance motivations and the underlying factors that influence the effectiveness and efficiency of Accredited Social Health Activists (ASHA), Anganwadi Workers (AAW), and Auxiliary Nurse Midwives (ANM).
Objective:The objective of this study is to conduct a comprehensive assessment of the performance motivations and barriers that influence the effectiveness of community health workers, specifically focusing on the ASHAs, ANMs, and AAWs operating in the urban slum areas of Noida-Greater Noida, Uttar Pradesh, India.
Methodology: Thisresearch adopts a cross-sectional design, incorporating a qualitative approach featuring surveys and focus group discussions. The collected data were analysed through NVIVO to extract insights from qualitative data, shedding light on the underlying performance motivations and their determinants.
Conclusions: This study establishes that CHWs in India are overworked and underpaid while highlighting their contributions and relevance to the underserved marginalised masses of India. A high level of performance motivation was found among these frontline workers despite limited resources. However, the sources of motivation seemed to be rooted in concepts such as morality, religion, spirituality, identity, and autonomy. Organisational support, lack of recognition and appreciation from superiors, associated monetary benefits and infrastructure were found to be barriers and demotivators.