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.

印度政府在统筹项目“全国农村卫生使命（现更名为全国卫生使命）”框架下，设立了ASHA工作者（Accredited Social Health Activist）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：评估现有认知水平，以及相关认知提升项目在改善ASHA工作者对高危妊娠认知方面的有效性。
研究方法：本研究采用干预性研究设计，于印度卡纳塔克邦马加迪塔卢克地区选定的基层医疗保健中心（Primary Health Centre, PHC）及分中心内开展，采用全面普查法招募研究对象。初始纳入的159名ASHA工作者中，共有110名参与了本定量研究。
研究结果：研究显示，干预后ASHA工作者对高危妊娠的认知水平较干预前显著提升。本次干预在孕产妇健康多维度认知层面均带来了显著改善：对正确足月妊娠时长（37~42周）、产前检查（Antenatal Care, ANC）最低次数及血红蛋白临界值的认知率均有所提高；针对流产、HIV传播风险以及高危妊娠（High-Risk Pregnancy, HRP）转诊服务必要性的认知误区得到有效纠正；参与者对产前出血、重度子痫、宫内生长受限以及妊娠糖尿病等并发症的认知水平明显提升。此外，关于两次剖宫产（Cesarean Section, C-section）后的推荐受孕间隔，以及妊娠期高血压相关风险的认知也得到了改善。
研究结论：综上，干预后ASHA工作者对高危妊娠的整体认知水平得到显著提升。但未来仍需开展进一步研究，深入探索对孕产妇及胎儿健康结局具有整体性干预效果的项目，以确保护理孕产妇与儿童健康的相关工作实现持续改善。