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Training program for ASHAs on hypertension found effective in managing high blood pressure

Hypertension is a major risk factor for cardiovascular disease, a leading cause of premature death and disability in India. Since access to health services is poor in rural India and Accredited Social Health Activists (ASHAs) are available throughout India for maternal and child health, a potential solution for improving hypertension control is by utilising this available workforce.

A team of researchers lead by Prof Amanda Thrift, from Monash University Australia aimed to develop and pilot a training package for Accredited Social Health Activists (ASHAs) to identify and control hypertension in the community and evaluate the effectiveness of the training program.

The intervention spanned over 3 months with an aim to improve hypertension outcomes in 3 districts of South India. Training materials incorporated details on managing hypertension, goal setting, facilitating group meetings, and measuring blood pressure and body weight.

15 ASHAs attended a five-day training workshop that was delivered using interactive instructional strategies. ASHAs then led community-based education support groups for 3 months. The ASHA’s knowledge and skill set was evaluated using Kirkpatrick's evaluation model for measuring reactions, learning, behaviour and results using tests on knowledge at baseline, post-training and post-intervention, observation of performance during meetings and post-intervention interviews.

Researchers found in their evaluation that the ASHAs' knowledge of hypertension improved from a mean score of 64% before training to 76% post-training and 84% after the 3-month intervention.

Associate Prof Rohina Joshi, Senior Research Fellow at The George Institute for Global Health, senior author of the paper, says:

ASHAs can be trained to lead community-based group educational discussions and support individuals for the management of high blood pressure.

Research officers, who observed the community meetings, also reported that ASHAs delivered the self-management content effectively without additional assistance. The ASHAs reported that the training materials were easy to understand and useful in educating community members.