Knowledge Assessment on High-Risk Pregnancies Among ASHA Workers in Magadi Taluk: An Interventional Study-Manuscript data

Government of India under an umbrella program "National Rural Health Mission (Now known as National Health Mission) introduced group of workers called as ASHA’s in view of Constructing bridge between the Community and Public health system. Objective: To assess the existing knowledge and effectiveness of the awareness program on improving the knowledge regarding high-risk pregnancies among ASHA workers. Method: An interventional study using educational videos and facilitated discussions was conducted in selected PHC and Subcentre of Magadi Taluk, Karnataka, India using complete enumeration method. Out of 159 ASHA workers 110 were engaged in the Quantitative study. Result: The study revealed that the knowledge of the ASHA workers on high-risk pregnancy after intervention was considerably high when compared to pre-intervention phase. The intervention led to significant improvements in ASHAs' knowledge on multiple aspects of maternal health. Awareness of the correct full-term pregnancy duration (37–42 weeks), the minimum number of ANC visits, and the hemoglobin cutoff increased. Misconceptions about miscarriage, HIV transmission risks, and the need for referral services for high-risk pregnancies (HRP) were addressed. Participants showed better understanding of complications like antepartum hemorrhage, severe eclampsia, intrauterine growth restriction, and gestational diabetes. Additionally, knowledge about the recommended conception gap after two C-sections and the risks of high blood pressure during pregnancy improved. Conclusions: The overall knowledge of ASHA workers regarding high-risk pregnancies boosted after intervention. However further research is needed to delve deeper into interventions of holistic effects on maternal and foetal health outcomes to ensure sustained improvements in Maternal and Child Health.印度政府在“全国农村卫生使命（现更名为全国卫生使命）”这一综合项目框架下，设立了ASHA工作者（ASHA）队伍，旨在搭建社区与公共卫生系统之间的沟通桥梁。 研究目的：评估ASHA工作者的现有知识储备，以及该认知项目在提升其高危妊娠（HRP，High-Risk Pregnancy）相关知识水平方面的实施效果。 研究方法：本研究采用干预性研究设计，采用教育视频与引导式讨论相结合的干预方式，于印度卡纳塔克邦马加迪塔卢克辖区内选定的初级卫生保健中心（PHC，Primary Health Centre）及基层卫生分中心开展，采用全面调查法招募研究对象。在159名ASHA工作者中，共有110名参与了本次定量研究。 研究结果：本研究结果显示，干预后ASHA工作者对高危妊娠的知识掌握水平较干预前显著提升。本次干预在孕产妇健康多维度知识层面均使ASHA工作者的认知得到显著改善：具体包括对足月妊娠正确时长（37~42周）、产前检查（ANC，Antenatal Care）最低次数以及血红蛋白临界值的认知水平提升；针对流产、HIV传播风险以及高危妊娠转诊服务必要性的认知误区均得到纠正；参与者对产前出血、重度子痫前期、宫内生长受限及妊娠糖尿病等并发症的理解更为透彻；此外，两次剖宫产术后推荐的受孕间隔以及妊娠期间高血压风险的相关知识也得到了完善。 研究结论：干预后，ASHA工作者关于高危妊娠的整体知识水平得到显著提升。但仍需开展进一步研究，深入探究对孕产妇及胎儿健康结局具有整体改善作用的干预措施，以确保护理孕产妇与儿童健康的相关工作能够实现持续提升。