New Study Highlights How Community Health Workers and Traditional Birth Attendants Work Together

Traditional birth attendants (Dais) and Accredited Social Health Activists (ASHAs) both play important roles in maternal and newborn care in rural India, yet little is known about how families navigate these two healthcare systems.

Methods

The mixed-methods study combined focus group discussions, key informant interviews, ethnographic observations, and surveys of 1,166 mothers and 400 ASHAs across rural Bihar to compare the roles of traditional and biomedical providers.

Key Findings

ASHAs primarily influenced recommended biomedical practices during pregnancy and labor, including antenatal care and institutional delivery, while Dais played a stronger role during the postpartum period by supporting traditional newborn care and family rituals. Families often combined both systems, suggesting that respectful collaboration could improve the cultural relevance and uptake of maternal and newborn health programs.

Citation

Hashmi, F. A., Burger, O., & Legare, C. H. (2025). Coexisting traditional and biomedical healthcare systems: A mixed-methods analysis of community health workers and traditional birth attendants’ contributions to perinatal health behaviors in rural India. Frontiers in Health Services, 5, 1623426.