Chapter 4 Qualitative Part 2: Extended discussions, ASHA interviews, focal follows, and participant observation
In this second of three chapters summarizing Project RISE qualitative data streams we focus on the extended qualitative effort that uses methods derived from ethnography to gain a deeper understanding of ASHA social dynamics and ASHA-mother relationships (the previous chapter presents the focus group discussions and key informant interviews and the following presents our interviewing-the-interviewers data). We present searchable tables for a coded list of ethnographic observations, overviews of key case studies (see Appendix A for the full case-studies document), and a discussion of key themes from this second wave of qualitative inquiry.
In addition to adding several nuances and deeper perspectives on themes from the FGDs and KIIs, this chapter finds that ASHA support networks are critical to her well-being and successful management of her role with husbands and older daughters being key sources of support. We also add extensive support for a key Insight: that the very positioning of the ASHA as an embedded health worker creates unique and under-appreciated challenges and opportunities for her role. This speaks to the ASHA’s challenge of being between worlds, she is positioned between systems and at times doesn’t fully belong in either of the worlds she is connecting. This also means that do to factors of age, status, and the nature of the role itself the ASHA can be doubly-powerless in ways that interventions designed to assist her role should take into account.