Awareness, Access, and Advice: Assessing ASHA Worker Engagement Across Educational Strata in Rural Kashmir

Abstract

Objectives This study assesses the relationship between accredited social health activists (ASHAs) on rural health awareness and service utilisation, with a focus on how education influences beneficiaries’ engagement with ASHA-led services in the districts of Kulgam and Anantnag, Jammu & Kashmir. Material and Methods A cross-sectional descriptive design was used, involving semi-structured interviews with 400 female beneficiaries selected through multi-stage purposive sampling across eight primary health centres (PHCs). The study aimed to assess beneficiaries’ awareness of and interaction with ASHA workers. Statistical analysis involved descriptive measures, Chi-Square tests, and Cramer’s V to examine the strength and significance of associations between education status and various ASHA-related outcomes. Results Results indicated that 96.5% of respondents were aware of ASHA workers, and 95.8% expressed satisfaction with their services. Education emerged as a significant factor shaping interaction patterns: illiterate women relied heavily on direct contact with ASHAs, while those with higher education levels accessed information through media sources (Cramer’s V = 0.962). The frequency of monthly home visits, reproductive health advice, and participation in Health Day activities were all significantly associated with education level. Particularly, many illiterate women were advised to seek “spiritual advice” for infertility, while all educated women were referred to medical professionals (Cramer’s V = 0.644). Conclusion The ASHA program continues to be a vital conduit for health empowerment among underserved populations. However, to maximise its potential and achieve universal health equity, programmatic efforts must address the socio-educational determinants that influence access, awareness, and quality of care. The findings from Kulgam and Anantnag offer crucial insights for scaling and refining community health strategies in similarly situated rural regions across the country.