Association Between Individual-Level Knowledge and Motivation among Community Health Workers in Rural Areas of Northern States of India

The present study was done to assess influence of Accredited Social Health Activist’s (ASHA) knowledge, performance of health centers, satisfaction of other Community Health Workers (CHWs), and beneficiaries on motivation level of ASHAs in rural areas of northern India. In a study district, stratified random sampling was done to select high-performing (HP) and low-performing (LP) health centers. A total of 24 (12: PHCs and 12: SCs), 12 HP and LP each, were selected. From each SC, ASHAs, co-workers, and beneficiaries (pregnant, postnatal, and eligible couple women) were interviewed. The mean level of satisfaction was observed to be high among beneficiaries (71.4 vs. 64.3; P = 0.023) and AWWs (76.1 vs. 65.4; P = 0.003) of HP-PHCs except among MPHW-Fs, where it was high in LP-PHCs for (92.3 vs. 86.9; P = 0.003). Multilevel linear modeling showed that with one unit increase in knowledge, the level of motivation significantly increases by 0.22 ( P = 0.03) units, with insignificant effects of HP and LP categorization. It was found that the baseline knowledge is a significant predictor for motivation among ASHAs irrespective of level of performance of PHCs.