Kurapati Jyothi, Anitha C T
Department of Public Health, School of Medical Sciences, University of Hyderabad, Hyderabad, Telangana, India.
Indian J Community Med. 2025 May-Jun;50(3):520-524. doi: 10.4103/ijcm.ijcm_53_23. Epub 2024 Oct 3.
Accredited social health activists (ASHAs) and auxiliary nurse midwives (ANMs) as community health workers (CHWs) have been crucial in providing health assistance and information during the COVID-19 pandemic. These CHWs face various challenges, such as discrimination, long hours of work, and low wages, which were exacerbated during the pandemic. The study uses an intersectionality framework to understand CHWs' marginalization and challenges. A qualitative study with ASHAs and ANMs was conducted in selected primary health centers (PHCs) and subcenters in Suryapet district, Telangana, in 2021. The in-depth interviews of 60 CHWs were analyzed using the software Atlas-ti. The inductive thematic analysis highlighted several challenges faced by CHWs. These challenges include barriers such as discrimination based on class and caste, pay parity, increased workload, lack of training, inadequate safety equipment, and instances of assaults and mistreatment. CHWs, who are often rural women with minimal education, face stigmatization and attacks from community members. They struggled with maintaining records and understanding online training and dealt with rapid adaptation to technology. The study highlights the importance of implementing policies and support systems to protect and empower community health workers. This includes training, fair compensation, safety equipment, and measures against discrimination and violence.
经认可的社会健康活动家（ASHAs）和辅助护士助产士（ANMs）作为社区卫生工作者（CHWs），在新冠疫情期间提供健康援助和信息方面发挥了关键作用。这些社区卫生工作者面临各种挑战，如歧视、长时间工作和低工资，而在疫情期间这些情况更加恶化。该研究采用交叉性框架来理解社区卫生工作者的边缘化和挑战。2021年，在特伦甘纳邦苏里亚佩特地区选定的初级卫生中心（PHCs）和分中心对ASHAs和ANMs进行了定性研究。使用Atlas-ti软件对60名社区卫生工作者的深度访谈进行了分析。归纳主题分析突出了社区卫生工作者面临的几个挑战。这些挑战包括基于阶级和种姓的歧视、薪酬平等、工作量增加、缺乏培训、安全设备不足以及攻击和虐待事件等障碍。社区卫生工作者通常是受教育程度极低的农村妇女，面临着社区成员的污名化和攻击。他们在记录保存和理解在线培训方面遇到困难，并要应对对技术的快速适应。该研究强调了实施政策和支持系统以保护和赋权社区卫生工作者的重要性。这包括培训、公平薪酬、安全设备以及针对歧视和暴力的措施。
