A Qualitative Examination of Interpersonal Communication Between Community Health Workers (CHW) and Pregnant Women, Kerala, India.

Abstract

Communication between community health workers and pregnant women plays a significant role in increasing the antenatal and postnatal care they receive. Guided by Social Exchange Theory and the Patient-Provider Communication Model, this study examines how communicative interactions between Accredited Social Health Activists (ASHAs) and pregnant women influence trust, perceived support, and engagement with maternal healthcare services. A qualitative design was adopted, and in-depth interviews were conducted with 18 pregnant women aged 23–29 years from Vayalar Panchayath, Alappuzha district, between June and August 2024, using purposive sampling.

Four themes have been identified from the thematic analysis. Women reported that their ASHA workers communicate with them regularly and provide information on maternal healthcare services, including those offered by both central and state governments, pregnancy complications, nutrition and dietary plans, and mental health and well-being. These interactions were perceived as productive and generally positive. However, despite these positive perceptions, there remains a need for more targeted training for public health workers to strengthen their ability to provide effective, comprehensive information exchange, particularly on nuanced and complex aspects of maternal health. Also, the integration of Social Exchange Theory and the Patient Provider Communication Model in the study emphasised the relational and communicative dynamics that shape maternal health engagement.