Role and Function of Frontline Health Workers During the COVID-19 Pandemic in a Rural Health Center in Kerala: A Qualitative Study.

Introduction Accredited Social Health Activists (ASHAs) are community health workers established under the National Rural Health Mission (NRHM). ASHAs have played a crucial role in responding to the COVID-19 pandemic. The COVID-19 pandemic has prompted ASHAs to adapt their strategies and methods to effectively address the challenges and ensure the well-being of the communities they serve. Objectives This study was done to explore the impact of the COVID-19 pandemic on the duties and performance of ASHAs. Methods A qualitative study was conducted over one month in the rural Primary Health Center (PHC) area of Thrissur district, Kerala. Focus group discussions (FGDs) were conducted among ASHAs and in-depth interviews with a Junior Health Inspector (JHI) and a Junior Public Health Nurse (JPHN). Results During the COVID-19 pandemic, the healthcare system shifted its focus toward managing the virus, leading to changes in the responsibilities of ASHA workers. They were assigned additional duties, and their routine services were disrupted due to lockdown measures. Despite the challenges, several factors played a crucial role in facilitating their services, including social support, teamwork, and personal satisfaction. However, there were several barriers that affected their effectiveness, such as inadequate and inconsistent remuneration, lack of recognition, transportation difficulties, safety concerns, and out-of-pocket expenses. Conclusion ASHAs effectively managed the challenging situation during the COVID-19 pandemic by taking diligent measures and showing a high level of commitment to their duties. It is essential to prioritize regular evaluations of their performance to ensure ongoing quality and effectiveness.