SHARAVATHI DENTAL COLLEGE &

HOSPITAL
SHIMOGA

DEPARTMENT OF PUBLIC HEALTH DENTISTRY

AN EXPLORATORY ANALYSIS OF KNOWLWDGE & PRACTICE,

JOB RELATED DIFFICULTIES & DISSATISFACTION OF ASHA
WORKERS IN SHIMOGA TOWN - A QUESTIONNAIRE SURVEY

Presented by:

DR. KOUSHIK.V
DR. M. SINCHANA. S. SHETTY

2023-2024

UNDER THE ABLE GUIDANCE OF:

DR. MEGHASHYAM BHAT DR. ALWIN ANTONY

( Professor & Head of Department ) (Assistant Professor)
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 ACKNOWLEDGEMENT

We would like to express our deepest gratitude to Dr.

Meghashyam Bhat, Professor and Head and Dr. Alwin
Antony, Senior Lecturer in the department of Public Health
Dentistry for giving me this opportunity and also providing
me valuable guidance. We offer my sincere thanks to Dr.
Samrat M.R, Honorable Principal, Sharavathi Dental College
and Hospital, Shivamogga, Dr. Shrinidhi M.S., Vice principal,
Sharavathi Dental College, Shivamogga and the management
for learning opportunities. Likewise, we would also like to
commend my thanks to ASHA workers in Shivamogga town
for their kind cooperation and participation in the survey.

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 INDEX

Sl No TOPICS PAGE NO.

1 INTRODUCTION 4-5

2 AIMS AND 6
OBJECTIVES
3 METHODOLOGY 7

4 RESULTS 8-14

5 DISCUSSION 15

6 CONCLUSION 16

7 REFERENCES 17

3
 INTRODUCTION
The Accredited Social Health Activist (ASHA), a volunteer who works in
India's rural health system, is the main task force of the National Rural Health
Mission (NRHM). In an effort to meet the MDGs in India, the Indian
government unveiled the NRHM in April 2005. By offering complete
healthcare, especially to women and children residing in rural regions, NRHM
seeks to enhance reproductive and child health (RCH) services. The gradually
increasing role of community health workers (CHWs) is being recognized, as
they are indispensable for achievement of the MDGs. In general, CHWs
workers are healthcare providers who belong to a particular community, are
selected from and trained in the same community, work for the same
community and are acceptable to that community. ASHA workers stand for the
cornerstone of the NRHM. The proper operation of ASHA workers is necessary
for the attainment of NRHM objectives. ASHA workers are taught in
accordance with modules and are intended to act as a liaison between the rural
population and the healthcare system.1

There is a growing concern about shortage of medical personnel and health

workers worldwide as the population continues to rise 1.As a result of increased
urbanization, the number of urban poor people living in slums has increased
quickly. The necessity for enhancing urban impoverished people's health care
has become more and more apparent, as evidenced by RCH-II, 5-year plans,
and National Health Policy. In 430 cities, NUHM was established in January
2008 to meet this demand. It includes 210 million people who live in cities, with
a concentration on the 62.5 million urban poor who live in slums. Urban Health
Center's principal goal is to give urban poor people access to primary healthcare
that is trustworthy, affordable, accountable, and efficient. Workers for Urban

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ASHA workers act as a link between the community and the healthcare system. 2

Job satisfaction has been defined as a pleasurable emotional state resulting

from the appraisal of one’s Job an affective reaction to one’s job. It is simply
how people feel about their jobs and different aspects of the job, the extent to
which people satisfaction or dissatisfaction their job. It suggests that job
satisfaction is an important indicator of how employees feel about their jobs. A
major part of man’s life is spent in work which is a social reality and social
expectation to which man seem to confirm. Even then only economic motive
has never satisfied men. It is always of greater interest to know why men work
and at which level and how he/she satisfied with the job. Therefore the current
study was undertaken to assess the level of job satisfaction among ASHA
workers and find out constraints faced by them.3

It is assumed that findings from the study will help in planning & implementing
appropriate technical, legal or administrative measures to improve the work
efficiency of Urban ASHA workers and will have a long-term impact on
indicators of urban health.2

The current study set out to evaluate the expertise and methods of ASHA
workers in Shimoga town, identify the factors that contribute to subpar
performance, and conduct an exploratory examination of the challenges and
root reasons of ASHA workers dissatisfaction.1

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 AIMS AND OBJECTIVES

AIMS :1. To assess knowledge & practice , job related difficulties &
dissatisfaction of ASHA workers in Shimoga town .

OBJECTIVES: Objectives of this survey are

1. To find out the predictors of poor performance

2. To identify for causes of dissatisfaction and difficulties faced by

ASHA workers during work.

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 METHODOLOGY

STUDY POPULATION & LOCATION

This questionnaire survey was conducted in Taluk health office (THO) ,
Shimoga town , Karnataka under the permission of taluk health officer
Shimoga, for a period of 1 month, starting from June 2024 to July 2024.

The study population comprised of 110 ASHA worker’s working in the

Shimoga town area. An informed consent was given prior to the start of survey.

PROCEDURE
A questionnaire containing 15 close ended questions regarding the knowledge
& practice , job related difficulties & dissatisfaction of ASHA workers in
Shimoga town .The study was conducted at district health office Shimoga .
Ethical clearance was obtained from college and district health officer ( DHO ).

STATISTICAL ANALYSIS
The data were collected & tabulated using the Microsoft excel sheet . The
recorded data were subjected to frequency distribution and chi square statistical

tests using the IBM SPSS software version 22 (P<0.05)

RESULTS
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Table 1. Demographic data
Frequency ( n ) Percentage ( % )
Age  <30 8 7.3%
 31-35 47 42.7%
 36-40 37 33.6%
 >41 18 16.4%
Education  Secondary 64 58.2%
 Higher secondary 29 26.4%
 Graduation 15 13.6%
 Post graduation 2 1.8%
Marital status  Married 49 44.5%
 Unmarried 47 42.7%
 Widowed 14 12.7%
Caste  Sc 51 46.4%
 St 29 26.4%
 Obc 23 20.9%
 General 7 6.4%
Income  <2000 64 58.2%
 >2000 46 41.8%
Training  <5 17 84.5%
 >5 93 15.5%
Job experience  <2 Years 95 86.4%
 >2 Years 15 13.6%
Job satisfaction  No 67 60.9%
 Yes 43 39.1%

Table 2. Frequency

Questions Responses Frequencies Percentage p

8
 (n) (%)
Medicine Supply  Regular & 24 21.8%
Adequate 0.000
 Irregular & 86 78.2%
Inadequate
Behaviour of  Harsh 92 83.6% 0.000
people  Polite 18 16.4%
Cooperation of  Present 31 26.9% 0.000
people  absent 79 73.1%
Travelling long  Yes 79 71.8
distance for work  No 31 28.2 0.000
Work load  Too much 84 76.4 0.000
 Minimal 26 23.6
Less remuneration  Yes 97 88.2 0.000
for more work  No 13 11.8
Fixed income  No 78 70.9 0.000
 Yes 32 29.1

GRAPHS
Graph 1.AGE

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 AGE
<30 31-35 36-40 >41

<30
>41 7%
16%

31-35
43%
36-40
34%

Graph 2. Education

EDUCATION
70 64
60
50
40
29
30
Frequency

20 15
10 2
0
Y .. N ..
AR C. IO U.
ND SE AT A D
R
CO HE AD
U GR
SE HI
G R
Education
G ST
PO

Graph 3. Marital status

Marital status
60
50 49 47
40
30

20
14
10

0
m ar r i ed u n m ar r i ed w i d o w ed

Graph 4 . Caste

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 Caste

Gen 7

Obc 23
Frequency

St 29

Sc 51

0 10 20 30 40 50 60
Caste

Graph 5 . Income

INCOME
<2000 >2000

46; 42%

64; 58%

Graph 6 . Modular training

MODULAR TRAINING

100
80
Frequency

60 93
40
20 17
0
<5 >5
Modular training

Graph 7 . Work Experience

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 WORK EXPERIENCE
100
95
90
80
70
FREQUENCY

60
50
40
30
20
15
10
0
<2 years 2 to 5 years
WORK EXPERIENCE

Graph 8 . Work Satisfaction

Work satisfaction

yes
39% no

61%

Graph 9 . Medicine Supply

Medicine Supply

86

24

regular & adequate irregular & inadequate

Graph 10. Behaviour of people

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 B

92
Frequency

18
h ar sh polite
Behaviour of People

Graph 11. Cooperation of People

cooperation of people
90
84
80
70
60
50
40
30
26
20
10
0
absent present

Graph 12 .Travelling Long distance for Work

Travelling Long Distance for

Work
120
79
100
Frequency

80

60

40
31
20

0
yes no
TRavelling Long Distance For Work

Graph 13 . Work Load

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 Work load

24% too much

minimal

76%

Graph 14. Less remuneration for more work

Less remunerati on
For More Work
97
Frequency

13

y es no
Less Remuneration for More Work

Graph 15 . Fixed Income

Fixed Income

yes 32

no 78

0 10 20 30 40 50 60 70 80 90

DISCUSSION
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 Majority of ASHA belonged to age group of 31-35 years 47 (42.7%), Sc caste 51
(46.4%), married 49 (44.5%), educated up to Secondary 64 (58.2%), & monthly
income of ASHA workers were below 2000 rupees 64 (58.2%). Our study findings
was similar to the findings of Saxena et al where most of the ASHA workers were
age group of 31-40 years 27 (42.2%), married 57 (89.1%), educated up to middle
class 45 (70.3%), joint family 42 (65.6%) and 33 (51.6%) ASHA workers from
social class II (Upper middle). But contrary to this in the study Shashank K.J where
majority 71 (53.8%) of ASHA in the age group of 26 to 30 years. The above
findings is similar to the findings of Garg P.K where out of 105 ASHA, 93
(88.57%) were married, 101 (96.19%) of ASHA worker completed 8th standard of
the schooling and 89 (84.76%) of ASHA worker were Hindus. Whereas study done
by Kansal S who found that out of 135 ASHA, 59 (43.7%) were from OBC caste
and 42 (31.1%) educated up to eighth standard.

Major problems encountered by ASHA were as follows: Irregular & inadequate

medicine supply 86 (78.2%), harsh behaviour of people 92 (83.6), poor
cooperation of people 79 (73.1%), travelling long distance for work 79 (71.8%),
too much work load 84 (76.4%), less remuneration for more work 97 (88.2%), and
has 78 (70.9%) has no fixed income. On the other hand study done by Saxena et al
found in their study that major Problems encountered in ASHAs work were either
related to transport 48 (32%) or problems related with health 155 centers 23
(15.3%) while except for few of them who have problem in getting honorarium 20
(13.3%), nearly one third 49 (32.7%) have no problem in their working. Whereas
Prasotet al13reported that main constraints faced by ASHA were incentives did not
get total and timely 338 (84.5%), staying problems at the delivery centres 259
(64.8%), inappropriate behaviours of the health staff 199 (49.8%), transport and
security problems especially at night 220 (55.0%), inadequate facilities for
institutional deliveries 200 (50.0%).

CONCLUSION
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 The present study, in spite of having a small sample size and cross-sectional
nature, hints at probable factors which might influence proper functioning of
ASHAs. Mostly ASHA workers had said that they are not satisfied with their
work. They added that their pay did not reflect the amount of labor they did.
The majority of ASHA employees believe that their pay scale is unfairly low for
the quantity of work they accomplish. Instead of incentives, the majority of
ASHA prefers fixed salaries. The current study makes it abundantly clear that
the ASHA workers require timely activity-based incentives, and that their
demand for a regular monthly salary should also be taken into consideration.
However, large-scale longitudinal and interventional research are needed to
develop practical strategies to enhance ASHA workers performance and enable
beneficiaries to utilize ASHA services appropriately. We think that this study
may pave the way for more investigation into ASHA workers' improper
performance in the future.

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 REFERENCES
1) Das A, Dasgupta A. An exploratory analysis of knowledge and practice,
job-related difficulties and dissatisfaction of ASHAs in rural India.
International Journal of Current Research and Review. 2015 May
15;7(10):14.
2) Saxena S, Srivastava A, Saxena A. Job satisfaction among ASHA’s
working in villages: A cross sectional study from district Bareilly.
Religion. 2005;50(02):3-1.
3) Brahmbhatt MM, Sheth JK. Focused Group Discussion of urban ASHA
workers regarding their workrelated issues. Indian Journal of Community
Health. 2017 Jun 30;29(2):187-90.

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