Summary

Sangoshthi: Empowering Community Health Workers through Peer Learning in

Rural India

In this article the authors propose a low cost mobile based training and learning
platform named “Sangoshthi” for Community Health Workers (CHWs) in rural areas.
Accredited Social Health Activists (ASHAs) are CHWs, who are local people selected from
village communities and are trained to act as an interface between people and public health
system. The ASHAs should be provided with training and refresher programs for continued
improvement of skills. Here the authors address the problem of educating ASHAs working in
rural area wherein factors such as poor infrastructure, low connectivity, low literacy, and
financial limitations pose major challenges in conducting effective health education. With the
help of a non government organisation SWACH, the authors identify the key components of
training as creation of standard content and its delivery to ASHAs timely and uniformly.
Further, peer discussions were found to be the primary source of learning for the ASHAs.
The authors find that introducing innovative training mechanisms along with the existing
training programmes will highly benefit the stake holders. Further, it will address the issues
faced in providing face to face training. Since Internet access was limited in these areas,
mobile phones were identified as a potential medium to provide training and learning. The
Sangoshthi platform combines Internet and Interactive Voice Response (IVR) technologies to
provide training to ASHAs who work in low connectivity areas and do not have access to
smart phones.

Sangoshthi follows a client server architecture in which an android application built on

Citizen Radio acted as the client and a software built upon Freeswitch(an open source
telephony platform) acted as server. The client allows hosts to create, prepare and manage
shows (ie. training sessions) and server handle call related functions. The leaners have to
register with the host who will intern create a show id for a particular topic and inform the
registered learners about the schedule of the show. At the scheduled time of show, the server
will connect the leaners and host in a conference call over GSM network. The learners are

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connected in mute mode. Once the delivery of topic content is finished, upon the invitation
of host, the learners can participate in the question and answer session by pressing “1” on
their phone keypads . The listeners are given chance to participate in a first come first serve
basis.
The interactive learning platform was analysed for feasibility, efficacy and usability
goals. Data collected from Call logs, Questionnaire and interview were used for analysis, of
which questionnaire test scores played the role of the primary metric of evaluation.
Significant improvement in the knowledge level of ASHAs was identified. Also the system was
found to be user friendly. Even though, Sangoshthi emphasised on providing instructor-
learner interaction, the scope for learner - learner interaction and content-learner interaction
were addressed. The evolution of the platform along with the increased access to
smartphones is also envisioned by the authors. Even though several platforms are available for
interactive learning, there was lack of availability of platforms for training a group of CHWs
which is addressed by the introduction of Sangoshthi. With the use of state of the art
technologies the potential of this platform in rural health care education is huge.

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