Mira Aghi, PhD ASHA: an Accreted Social Health Activist } primarily - PowerPoint PPT Presentation

Mira Aghi, PhD

ASHA: an Accreted Social Health Activist } primarily a woman health worker selected from the village } the first port of call for any health problem } the fountainhead of community participation in public health program in her village } in touch with the whole community One ASHA works with 1000 people

} Literate and trainable } Educates the villagers on health issues, e.g. a) To stay away from tobacco if they are non-users b) To quit tobacco if they are users } Not a specialist, has to be trained to deliver tobacco control education } Trained for empowerment to deal with villagers who indulge in a variety of tobacco products } Information needs assessed to find out the exact entry point for her training

Needs assessed by focus groups (5) research and through individual interviews Sample: In each group } 5 Asha workers ◦ one male multi-purpose health worker, ◦ one (female) Ancillary Nurse, ◦ one midwife (ANM), ◦ two women who were visiting the health center were also interviewed

The guiding questions include: } What they think about tobacco (smoke and smoke free) } What it does to the human body } Need for quitting the use of tobacco } How to achieve that

What they knew } Tobacco is harmful } It causes cancer } Any other diseases? } Chronic cough } Tobacco cannot be harmful ◦ It is being promoted everywhere ◦ Government wouldn’t allow its sale if it was harmful

What would they like to learn about tobacco? } Why is tobacco implicated in so many diseases among ◦ Women ◦ Men ◦ Children ◦ Youth } How and what to tell elder family members, including women, who smoke hookah?

What information would be helpful for them in their work? } The statistics, both global and Indian } Why global? ◦ To impress educated women and men } The statistics should be expressed in a manner that they will understand and in a way that is compelling and moving ◦ “Half the smokers will die in their productive years”

What should they do to help young people stay tobacco free } How to reduce initiation } Impotence: “this affects everyone, but young boys are especially concerned about it” } Girls want to ◦ be pretty ◦ be feminine ◦ smell good

Other information that would help } Women want to ◦ appear young ◦ remain vivacious } Men want to ◦ Appear macho ◦ walk erect

What did they know about the anti-tobacco legislation? } Only the male worker had heard of it ◦ He had heard that “one cannot smoke everywhere”

} A rough draft was prepared ◦ Field tested with two groups } Group one ◦ 36 ANMs and 17 Asha workers, all female } Group two ◦ 8 multi-purpose workers (MPW) and 10 basic health workers (BHW), all male

} Participants were grateful and excited to see something done specifically for them, utilizing their input. } In their words, objective of manual was to help them to educate people about the risks that tobacco use carries. } They were happy that booklet ◦ does not just tell them about tobacco ◦ shows them how they can help people not take up tobacco ◦ shows how to help individuals who use tobacco give it up

} Participants happy with the way the facts were shown ◦ facts would help them to inform people in community ◦ numbers would help them to interact with educated members of community } Women health workers suggested that they would also like to know a number on mouth cancer ◦ this would be of great value when they talk to tobacco users

} Appearing 10 years older vs. dying 10 years earlier ◦ Participants preferred that the order of the two facts be changed. The mention of number 10 is very impressive } Information on impotency seen as being very impressive for youth

} Appreciated addition of special risks to women. ◦ it is not often that they hear about the problems that women go through as separate from men ◦ knowing this would help them to talk to women more effectively. } Asked for further clarity on how to help people quit ◦ benefits of quitting? ◦ is there a general feeling of wellbeing once you have passed the hurdle and have quit?

} Wanted to ensure that manual emphasizes that a health worker should never be spotted smoking or chewing and that s/he should not indulge in tobacco use, even in private ◦ Health worker has to be tobacco-free. } Found numbers 50 and 100 very helpful ◦ would impress the young and their parents a great deal

Body poster } Comments were quite revealing } Although they did not know about many of the diseases mentioned in the poster, long list would help them to impress on people that there are so many diseases that tobacco causes. } Asked why only part of the body was shown ◦ wanted to have the whole body shown ◦ know how tobacco use can harm legs, feet, etc.

Body poster (cont.) } A few participants wanted to use photocopy of the poster to educate people } Not bothered by it being abstract } Liked that it shows some pictures, e.g., mouth cancer, breast cancer, etc.