Publication:

Evaluation of training effectiveness and patient referral patterns in palliative care by ASHAs and ANMs in Jodhpur

Background Access to palliative care is still limited in India with Rajasthan and this is accompanied by a lack of awareness and trained personnel. Frontline workers like ASHAs and ANMs can help to improve early identification and referral of patients in need of palliative care. To assess effectiveness of palliative care training of ASHAs and ANMs and its effect on the pattern of referrals to patients in Jodhpur.

Methods A quasi-experimental study was carried out in selected 21 Urban Primary Health Centres in the period from before (Sept-2024 to Jun-2025). The participants went through a two-day structured training programme. Knowledge was evaluated by a validated 18-item questionnaire in pre- and post-tests and referrals were followed for 6 months. Data were analysed with paired t-test and descriptive statistics.

Results Significant improvement of knowledge scores was noted post training (P<0.05) with similar improvement among ASHAs and ANMs. A total of patients were identified and referred with a steady increase in referrals over time. Field exposure through home visits increased use of referral activity.

Conclusions Structured training has been effective in improving knowledge and referral practices. Integrating trained frontline workers with supportive supervision and referral systems in community-based palliative care in resource limited settings.