Barriers encountered by accredited social health activists (ASHA) in arthritis rehabilitation: A qualitative study

Introduction: Healthy behaviour through education of individuals with arthritis is the mainstay of long term management. Time and access constraints restrict medical professionals from active involvement in arthritis education in the community. Reaching the community through the Accredited Social Health Activists (ASHAs) is the plan of action operational in India. Hence, the factors encountered by ASHAs while delivering arthritis education programs need to be studied. Aim: The aim of the study was to explore the experiences of ASHAs while delivering arthritis education program. Materials and Methods: Qualitative exploratory design employing semi-structured interviews was adapted for the study. The interviews were conducted using focus groups of ASHAs from two geographically similar villages. Inductive analysis of focus group discussions was undertaken to determine themes, categories and codes. Results: Three broad themes were identified from the interviews which influenced the performance of ASHAs. Categories identified show the influence of training, characteristics of ASHAs, geographical features, family characteristics and community attitude. Few problems reported were means of transport, time constraints, multiple tasks, type of incentive and frequency of on-field demonstrations. Conclusion: Providing motivation for altruistic services has always been a challenge to governing bodies. The issues identified in this study can be addressed prior to integrating ASHAs for rehabilitation services.