What Drives Community Health Worker Motivation? A Qualitative Study of ASHAs and AWWs Experiences and Systemic Challenges in Central Maharashtra

Community health workers are central to India’s primary health system, yet sustaining their motivation remains challenging due to increasing workload &systemic constraints. This qualitative exploratory study was conducted in Seloo-block of Central-Maharashtra (September2023–February2024), involving 258-participants, including ASHAs, supervisors, family members &mothers. Data were collected through in-depth interviews, Force-Field Analysis, and Root-Cause Analysis, &analysed using inductive-thematic analysis. Motivation emerged as a balance between enabling &constraining forces. Six-themes were identified, including workload burden, incentive misalignment, administrative strain, field barriers, supervisory support, and social determinants. The findings highlight burnout risks and the need for integrated, context-specific strategies to sustain motivation and performance.KeywordsHealth System Constraints, Frontline Health Workforce, Primary Health Care Delivery, Supportive Supervision, Health Worker Motivation, Rural Health Systems, Participatory Learning and Action