2.5 The COVID-19 Pandemic and Project RISE

The COVID-19 pandemic has had, and will have, a major impact the landscape of health needs and services in Bihar. Similar to much of the world, this will cause changes in norms and expectations surrounding health behaviors. CHWs will be called upon as messengers and to help facilitate many aspects of the pandemic response, in many parts of the world (Bhaumik et al. 2020), and it is clear that ASHAs will be affected by this in major ways. ASHAs will be asked to help manage and distribute information about the pandemic, while also having to manage greatly increased risks of exposure.

As the team discusses various plans for the future, it is important to realize that ASHAs are critical in the frontline response to COVID-19. There is a need to prepare and support them to handle current and future emergencies. ASHAs have been first responders. They have been given additional responsibilities - house-to-house surveys, collecting travel history, contact tracing, creating awareness, ensuring that home quarantine is being followed and undertaking other healthcare and relief measures assigned to them. The pandemic has highlighted the gaps in support for the ASHA and her ability to respond to emergency situations. It presents an opportunity to learn from the crisis and design solutions to prepare the cadre for potential future pandemics.

It is likely that part of the ASHA’s newly emerging role will be that of a myth-buster, which certainly will require an expanded toolkit. This kind of role would be in cooperation with other CHWs and community organizations.

The COVID-19 pandemic influence Project RISE in many ways. The timeline for the project was extended but, more importantly, key aspects of the research and co-design processes had to be changed or removed due to travel restrictions and the need to ensure we did not introduce any inadvertent transmission risks. We modified the design process by focusing more on ideation and less on prototyping and co-design with ASHAs. Rather than test concepts in the field with ASHAs we had a series of virtual sessions with a few ASHAs via WhatsApp that were a highly useful substitute for in-person prototyping (all things considered) (see Chapter 10 for more details).


Bhaumik, Soumyadeep, Sandeep Moola, Jyoti Tyagi, Devaki Nambiar, and Misimi Kakoti. 2020. “Community Health Workers for Pandemic Response: A Rapid Evidence Synthesis.” BMJ Global Health 5 (6). https://doi.org/10.1136/bmjgh-2020-002769.