Chapter 12 Discussion

In this discussion chapter, we synthesize information from the datastreams presented in Chapters 3 to 9 to build key project themes. These include the Project RISE concepts of liminality, lived-experience, and connectedness. We also discuss ASHA positioning and issues related to ASHA reach and access. We show that rituals are uniformly motivated to improve health or avoid risks, and typically do not conflict with biomedically-informed health goals. Liminality creates tensions that have been under-appreciated in past evaluations of ASHAs or the ASHA program. Helping to resolve these tensions can help facilitate a shift from service extension to cultural facilitator. We present recommendations and guiding principles for designing programs aimed at improving ASHA motivation or ability.