Is there a role for male community health workers to complement ashas in rural India?

Concern Worldwide's Innovation for Maternal, Newborn & Child Health and local partner WOSCA tested a new approach in India, introducing male community health workers who complemented female Accredited Social Health Activists (ASHAs) in improving maternal and newborn health. Skilled birth attendance, in Keonjhar, a district in Odisha where this was tested, is only 35% and coverage of post-natal care within two weeks of delivery is 30%. This pilot is designed to encourage husbands to take an active role in improving mothers and children's health and help support ASHAs in their work.

A mixed method evaluation was conducted in 2012.Qualitative research methods include Participatory Ethnographic Evaluation and Research, In-Depth and Key Informant interviews. Quantitative data was collected from facility records and through monitoring.

The evaluation shows that male community health workers – local residents trained and supported to work in their own villages – have gained significant support from the local communities. They have been particularly effective in influencing the knowledge and care-seeking practices of men with pregnant wives and young children in terms of home and facility-based care. More specifically, achievements are seen in the area of male contraception, changing some medically harmful traditional practices around newborns, and encouraging ante-natal care and immunization. They have also supported ASHAs in areas where such support was needed.

Male community health workers can contribute towards improving maternal and newborn health. By working alongside ASHAs and influencing male knowledge and behavior, they can support household decision-making around care-seeking and facilite community level changes.