Evidence map›Paper›PMID 31263591›Full record

ArticleBMJ global health2019

What do community health workers want? Findings of a discrete choice experiment among Accredited Social Health Activists (ASHAs) in India.

Marwa Abdel-All, Blake Angell, Stephen Jan, Martin Howell, Kirsten Howard, Seye Abimbola, Rohina Joshi

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ global health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
33citing papers in PubMed, 1 pooled it
15.7field-weighted citation impact, top 1% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

33 citing papers in PubMed, 1 synthesis or guideline pooled it, 62 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Marwa Abdel-AllSydney Medical School, University of Sydney, Sydney, New South Wales, Australia.ORCID 0000-0001-8103-1498
Blake AngellThe George Institute for Global Health, Newtown, New South Wales, Australia.ORCID 0000-0002-7188-7740
Stephen JanSydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
Martin HowellSchool of Public Health, University of Sydney, Sydney, New South Wales, Australia.
Kirsten HowardSchool of Public Health, University of Sydney, Sydney, New South Wales, Australia.
Seye AbimbolaSydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
Rohina JoshiSydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
The University of Sydney · AUThe George Institute for Global Health · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionA number of factors contribute to the performance and motivation of India's Accredited Social Health Activists (ASHAs). This study aims to identify the key motivational factors (and their relative importance) that may help retain ASHAs in service.

methodsA discrete choice experiment (DCE) survey presented ASHAs with eight unlabelled choice sets, each describing two hypothetical jobs that varied based on five attributes, specifically salary, workload, travel allowance, supervision and other job benefits. Multinomial logit and latent class (LC) models were used to estimate stated preferences for the attributes.

resultWe invited 318 ASHAs from 53 primary health centres of Guntur, a district in south India. The DCE was completed by 299 ASHAs using Android tablets. ASHAs were found to exhibit a strong preference for jobs that incorporated training leading to promotion, a fixed salary and free family healthcare. ASHAs were willing to sacrifice 2530 Indian rupee (INR) from their monthly salary, for a job offering training leading to promotion opportunity and 879 INR for a free family health-check. However, there was significant heterogeneity in preferences across the respondents. The LC model identified three distinct groups (comprising 51%, 35% and 13% of our cohort, respectively). Group 1 and 2 preferences were dominated by the training and salary attributes with group 2 having higher preference for free family health-check while group 3 preferences were dominated by workload. Relative to group 3, ASHAs in groups 1 and 2 were more likely to have a higher level of education and less likely to be the main income earners for their families.

conclusionASHAs are motivated by both non-financial and financial factors and there is significant heterogeneity between workers. Policy decisions aimed at overcoming workforce attrition should target those areas that are most valued by ASHAs to maximise the value of investments into these workers. TRIAL REGISTRATION NUMBER: CTRI/2018/03/012425.

Indexed as

discrete choice experiment (DCE)latent class analysismotivationpreferencesthe accredited social health activists (ASHAs)willingness to sacrifice salary

Identifiers

PMID31263591
PMCPMC6570975
OpenAlexW2947067587

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.