At the Doorstep: How ASHA Workers Motivate Preventive and Promotive Health in Rural and Urban area of West Bengal

Abstract

Accredited Social Health Activists (ASHAs) are India's flagship community health worker (CHW) cadre under the National Health Mission (NHM), designed to bridge the health access gap in underserved communities (Scott et al., 2019). This paper synthesizes national guidelines, state-specific practices, and contemporary literature to explain how ASHA workers in West Bengal motivate households, deliver doorstep services, and educate communities on preventive and promotive health. Drawing on program documents (ASHA, VHSND, NUHM-MAS, MAA), recent parliamentary replies on incentives, NFHS-5 indicators, and empirical studies, we develop an actionable framework of platforms (home visits, VHSND/MAS), tactics (micro-counselling, due-list reminders, escorted referrals, peer learning), and enablers (incentives, supervision, local legitimacy). We map these to population-level outcomes (e.g., institutional delivery, immunization) and propose a mixed-methods design to empirically test these pathways in West Bengal. Implications include strengthening micro-planning, peer-group pedagogy, and incentive alignment for sustained behaviour change.