ANNOUNCEMENTS
This study investigates how India’s flagship healthcare reform, the Ayushman Bharat policy, has affected the information dissemination practices of Community Health Workers (CHWs), particularly in the context of antenatal care. As frontline providers and facilitators of maternal health, CHWs such as ASHAs and ANMs have long played a vital role in educating women about pregnancy-related services and complications. However, with Ayushman Bharat’s implementation in 2018—which introduced Health and Wellness Centres (HWCs) and expanded insurance coverage under PM-JAY—CHWs were expected to take on additional responsibilities, including digital enrolments, insurance education, and patient navigation. This study asks whether these added roles compromised their core communicative functions.
Using a Difference-in-Differences (DiD) methodology, the study evaluates changes in three key indicators: frequency of antenatal care visits, whether CHWs informed women about pregnancy complications, and whether women were told where to seek care. The analysis compares Mumbai (treatment group) and Delhi (control group) using NFHS-4 and NFHS-5 data.
Findings reveal no significant change in the frequency of antenatal visits but demonstrate statistically significant declines in CHW communication regarding pregnancy complications and referral guidance. These results suggest that Ayushman Bharat may have strained the time and capacity of CHWs, inadvertently reducing the quality of maternal health information shared.
The study highlights the need to preserve CHWs’ communicative role amid health policy reforms. Future interventions must align incentives, reduce administrative burden, and invest in communication training to ensure that frontline health workers can continue to provide timely, accurate, and empathetic maternal care education.
