The online version of this article (doi: https://doi.org/10.1186/s12905-018-0511-6) contains supplementary material, which is available to authorized users.
In India, community health workers’ (CHW) effectiveness in providing home-based neonatal care (HBNC) has been well documented. The nature of challenges faced and strategies adopted while providing HBNC services need to be studied in-depth.
A qualitative study to understand the challenges faced and strategies used by Sakhis (women CHW) while providing services as part of a HBNC program implemented by a non-profit organization. Data consisted of 20 in-depth interviews and three focus group discussions (FGD) with Sakhis.
Sakhis negotiated with the community to start working as a CHW. They faced challenges while changing behaviors at individual level and also while bringing about a change in harmful normative practices that increased chances of maternal and neonatal mortality. Managing crises at the time of deliveries and facilitating a safe delivery was the most critical challenge faced by many Sakhis.
The key strategies used by Sakhis included: proactively and persistently providing services even when they faced resistance from the woman or her family; evolving contextually suitable counseling techniques and tactics to bring about behavioral change; balancing compliance to traditional practices and promoting HBNC; defying traditional practices and assisting the woman in times of an emergency to save lives. Having on-call support from supervisors and cultivating a good working relationship with health providers facilitated effective service provision by Sakhis.
CHWs having a strong sense of commitment can develop strategies to address challenges and provide HBNC services effectively if they also have strong supervisory support.
Additional file 1: Guide for interview and discussion with Sakhis. (DOCX 14 kb)12905_2018_511_MOESM1_ESM.docx
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- Surmounting difficulties to provide home based neonatal care – reflections of community health workers
Abhijit Shrinivas Prabhughate
Vallaree Anant Morgaonkar
Ajay Gajanan Phatak
Somashekhar Marutirao Nimbalkar
Anagha Anand Mahajani
- BioMed Central
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