Abstract / Summary
Background: Maternal health disparities persist in remote and tribal regions of India, where women face significant obstacles in accessing antenatal care (ANC). Accredited Social Health Activists (ASHAs) serve as the primary link between these communities and health services, making their role critical in early identification of high-risk pregnancies. Aims and Objectives: This study aimed to (1) describe the sociodemographic characteristics of antenatal women, (2) evaluate the contribution of ASHAs in detecting high-risk pregnancies, and (3) explore ASHA’s lived experiences, perceptions, and operational challenges. Materials and Methods: A mixed methods design was implemented between September 2025 and November 2025 in a tribal block of southern Odisha. Quantitative data were collected from antenatal women using a structured questionnaire, while qualitative insights were generated through key informant interviews with ASHA workers. Quantitative data were analysed descriptively, and qualitative data were analysed using thematic analysis. Results: Of 348 antenatal women, most were illiterate (57.7%) and lived in nuclear families (80.4%). Early pregnancy registration and ANC uptake were high, with 95% delivering in institutions and strong compliance with tetanus immunization. ASHAs play a vital role in facilitating ANC visits and institutional deliveries, though they reported barriers such as difficult terrain, sociocultural resistance, and limited training in danger sign recognition. Conclusion: ASHA workers play an indispensable role in promoting ANC and identifying high-risk cases in geographically isolated regions. Strengthening training, ensuring logistic support, and addressing community-level barriers may enhance safe motherhood outcomes.