Exploring the Digital Challenges Faced by Community Health Workers in a District of Telangana, India: A Qualitative Study

Abstract

Background: Community health workers (CHWs), including Accredited Social Health Activists (ASHAs) and Auxiliary Nurse Midwives (ANMs), play a central role in delivering primary healthcare in India. As digital health initiatives like Ayushman Bharat grow, proportionately CHWs are expected to use technology but often face challenges. This study examines the digital challenges faced by Community Health Workers (CHWs) in Telangana, India. Methods: A descriptive, cross-sectional qualitative study was conducted in between January and April 2023 in Suryapet district, Telangana. Thirty ASHAs and thirty ANMs from rural and urban areas were selected through purposive sampling. Data were collected via in-depth, semi-structured interviews and analyzed thematically using a grounded theory approach with the assistance of Atlasti software. Ethical approval was obtained from the Institutional Ethics Committee of University of Hyderabad. Results: The Participants of the study were mostly aged 26-45, with ASHAs having basic education and ANMs possessing nursing diplomas. Most CHWs came from lower socioeconomic classes. Work experience varied, with religious and caste diversity present in both CHW groups. The study identified key digital challenges: limited smartphone and internet access, insufficient training, usability issues, language and literacy barriers, data security concerns, resistance to change among senior CHWs, and lack of real-time technical support. Conclusion: The study underscores the significant digital barriers faced by CHWs in delivering healthcare services and managing patient records. Addressing these challenges is essential to empower CHWs and improve healthcare delivery within the CPHC and CBAC frameworks, thereby ensuring that initiatives like Ayushman Bharat achieve their full potential.