While frontline workers in India such as the ‘Accredited Social Health Activists (ASHAs)’ delivering primary health care at the village-level, experience high levels of work-related stress and burnout, we know little about the potential of interventions leveraging individual character-strengths to help them respond to stress. Our study describes a systematic approach to designing and developing a character-strengths based coaching program (workshop) for ASHAs to help reduce their burnout and improve their delivery of routine services. Over 11 months, we conducted formative work, developed the program blueprint, coaching content, a ‘pre-pilot’ workshop with ASHAs and focus groups discussions(by a separate team) with workshop participants, followed by thematic analysis to inform program modifications. The final material consisted of a ‘content manual’ (for ASHAs) with four modules including character-strengths based ‘strategies’ to address challenges/stressors arising out of various situations at the health facilities, village communities and domestic/home settings; and ‘facilitator manual’ having session-wise detailed instructions, list of ‘energizers’, and plans for the workshop operations. Consistent efforts were made to tailor the case-examples and session activities (e.g., roleplays, videos, reflections or discussion-based activities) to the local culture and context. This study illustrates a step-wise methodology to combine the evidence-based character-strengths approaches with iterative feedback from stakeholders (ASHAs) to develop a face-to-face coaching program aiming to reduce their stress and burnout, tailored to a rural low-resource setting. Further research is needed to evaluate the effectiveness of this program in reducing burnout among ASHAs, while considering whether its development can be replicated in similar global settings.
Azaz Khan, Sangath India, India
Lochan Sharma, Sangath India, India
Surbhi Agrawal, Sangath India, India
Sneha Rani Nayak, Sangath India, India
Ameya Bondre, Sangath India, India
Deepak Kumar Tugnawat, Sangath India, India
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