title: Performance of accredited social health activists to provide home-based newborn care: a situational analysis.
abstract: OBJECTIVE
  To assess Accredited social health activists' (ASHAs) ability to recognize illness in infants aged less than 2 months.
  
  
  METHODS
  Investigators observed 25 ASHAs conducting 47 visits.
  
  
  RESULTS
  ASHA-investigator agreement on the need to further assess infants was intermediate (kappa 0.48, P<0.001). Using IMNCI's color codes, ASHAs misclassified 80% of infants. ASHAs did not follow home-based newborn care formats and skipped critical signs. Overall ASHA-investigator agreement on diagnosis was poor (kappa=0.23, P=0.01).
  
  
  CONCLUSIONS
  There is a need for improved training, tools, and supportive supervision.
authors.affiliation: Manthan Project, Intra Health International, India. Correspondence to: Dr. Emily Das, D-503, Indra Prastha Estate, Opposite IT College, 2-3 Faizabad Road, Lucknow 226 007, Uttar Pradesh, India. emilydas@hotmail.com.
authors.forename: Emily
authors.initials: E
authors.lastname: Das
authors.forename: Dharmendra Singh
authors.initials: DS
authors.lastname: Panwar
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Fischer
authors.forename: Girdhari
authors.initials: G
authors.lastname: Bora
authors.forename: Martha C
authors.initials: MC
authors.lastname: Carlough
mesh_terms: D003150:Community Health Workers; D005260:Female; D006699:Home Care Services; D006792:House Calls; D006801:Humans; D007224:Infant Care; D007231:Infant, Newborn; D011785:Quality Assurance, Health Care