ArticleBMJ open2012
Assessing community health workers' performance motivation: a mixed-methods approach on India's Accredited Social Health Activists (ASHA) programme.
Article in BMJ open, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 104 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
104 citing papers in PubMed, 6 syntheses or guidelines pooled it, 232 citations in OpenAlex.
- Understanding pathways from primary health care to universal health coverage outcomes: a realist review.Frontiers in public health · 2026Pooled it
- Workload and emerging challenges of community health workers in low- and middle-income countries: A mixed-methods systematic review.PloS one · 2023Pooled it
- Stock-outs of essential medicines among community health workers (CHWs) in low- and middle-income countries (LMICs): a systematic literature review of the extent, reasons, and consequences.Human resources for health · 2022Pooled it
- Contribution of women's development army to maternal and child health in Ethiopia: a systematic review of evidence.BMJ open · 2019Pooled it
- Taking stock of 10 years of published research on the ASHA programme: examining India's national community health worker programme from a health systems perspective.Health research policy and systems · 2019Pooled it
- Integrating national community-based health worker programmes into health systems: a systematic review identifying lessons learned from low-and middle-income countries.BMC public health · 2014Pooled it
- Perceptions of ASHA workers in the HOPE collaborative care mental health intervention in rural South India: a qualitative analysis.BMJ open · 2021Trial
- Trial
- Trial
- Health workers' perspectives, knowledge and skills regarding community case management of childhood diarrhoea and pneumonia: a qualitative inquiry for an implementation research project "Nigraan" in District Badin, Sindh, Pakistan.BMC health services research · 2016Trial
- Inspiring health worker motivation with supportive supervision: a survey of lady health supervisor motivating factors in rural Pakistan.BMC health services research · 2016Trial
- Strengthening malaria service delivery through supportive supervision and community mobilization in an endemic Indian setting: an evaluation of nested delivery models.Malaria journal · 2014Trial
- Psychometric properties of MERIT: A concise tool for community health workers to screen priority mental disorders.Indian journal of psychiatry · 2026Article
- Factors influencing performance motivation of Accredited Social Health Activists, the community health volunteers of India - A mixed method study.Journal of family medicine and primary care · 2026Article
- Article
- Article
- Factors that influence acute malnutrition detection and treatment by community health promoters in Samburu and Turkana counties, Kenya: A mixed methods study.PLOS global public health · 2026Article
- A model for developing the competencies of Village Health Volunteers in the prevention and control of communicable diseases at the community level: a case study of Chaiyaphum Province, Thailand.Frontiers in public health · 2026Article
- Lived experiences in action: Relations between community health workers' and clients' perinatal health behaviours in India.Global public health · 2025Article
- Association of affirmative action with health and education outcomes and services in India.Proceedings of the National Academy of Sciences of the United States of America · 2025Article
44 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThis study examined the performance motivation of community health workers (CHWs) and its determinants on India's Accredited Social Health Activist (ASHA) programme.
designCross-sectional study employing mixed-methods approach involved survey and focus group discussions.
settingThe state of Orissa.
participants386 CHWs representing 10% of the total CHWs in the chosen districts and from settings selected through a multi-stage stratified sampling. PRIMARY AND SECONDARY OUTCOME MEASURES: The level of performance motivation among the CHWs, its determinants and their current status as per the perceptions of the CHWs.
resultsThe level of performance motivation was the highest for the individual and the community level factors (mean score 5.94-4.06), while the health system factors scored the least (2.70-3.279). Those ASHAs who felt having more community and system-level recognition also had higher levels of earning as CHWs (p=0.040, 95% CI 0.06 to 0.12), a sense of social responsibility (p=0.0005, 95% CI 0.12 to 0.25) and a feeling of self-efficacy (p=0.000, 95% CI 0.38 to 0.54) on their responsibilities. There was no association established between their level of dissatisfaction on the incentives (p=0.385) and the extent of motivation. The inadequate healthcare delivery status and certain working modalities reduced their motivation. Gender mainstreaming in the community health approach, especially on the demand-side and community participation were the positive externalities of the CHW programme.
conclusionsThe CHW programme could motivate and empower local lay women on community health largely. The desire to gain social recognition, a sense of social responsibility and self-efficacy motivated them to perform. The healthcare delivery system improvements might further motivate and enable them to gain the community trust. The CHW management needs amendments to ensure adequate supportive supervision, skill and knowledge enhancement and enabling working modalities.
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.