In many parts of India, frontline health workers known as Accredited Social Health Activists (ASHAs) are the first and often only connection between communities and the health system. They are neighbors, informal counselors, and guides through deeply personal decisions about health and family planning.
For years, their training has focused largely on technical knowledge: what services to provide and what information to share. But less attention has been given to something equally critical: how to listen, how to build trust, and how to navigate the social dynamics that shape whether someone seeks care at all.
Work from the Johns Hopkins Center for Communication Programs and the Center for Communication and Change–India (CCC-I) sought to change that.
Through the Engenderhealth-led MOMENTUM Safe Surgery in Family Planning and Obstetrics project, CCP and partners developed a set of 18-to-20-minute self-guided video modules designed to strengthen how ASHAs communicate with clients. The videos are available in Hindi and Kannada, with English subtitles, and are grounded in real situations ASHAs face in their daily work.
Instead of lectures, the videos show conversations: An ASHA speaking to a less experienced colleague and demonstrating how to connect with a hesitant client, a discussion shaped by family pressure, scenes where male partners are engaged in family planning conversations and moments where listening matters as much as advising.
The modules introduce a simple framework called REDI: Rapport Building, Exploring, Decision Making, and Implementing. It gives ASHAs a structure for empathetic counseling while still allowing space to respond to each client’s needs and concerns.
Before scaling the program, the team tested the videos with 65 ASHAs in Chhattisgarh and Karnataka. The response went beyond feedback on training materials.
Many ASHAs said the scenarios felt familiar and reflected challenges they face every day but rarely see acknowledged in formal training. And that recognition mattered.
“ASHAs reported greater confidence in counseling sessions and more ease handling difficult conversations,” says Sanjeeta Agnihotri, director of CCC-I. “Some said they felt more motivated in their roles. Others described changes in how clients responded. People were more open. Conversations felt less rushed and more collaborative.”
At the same time, the experience exposed system gaps, including limited supervision, few opportunities for emotional debriefing, and insufficient recognition of ASHAs’ relational work.
The approach reflects a broader shift in training design. Grounded in lived experience and tested for emotional resonance and cultural relevance, the project moves beyond one-size-fits-all instruction. “It shows how digital tools can support reflection as well as skill-building,” says Uttara Bharath Kumar, who led the work for CCP on the Momentum for Safe Surgery project.
As digital tools become more common in global health, this work offers a clear lesson: technology is most effective when it strengthens human connection rather than replacing it. For ASHAs, that means tools that reflect their reality and reinforce what they already do well — listen, connect, and guide.
“In that sense, empathy is not just an idea,” Bharath Kumar says. “It is a practice.”
This work will be presented at the 2026 International Social and Behavior Change Communication Summit June 22-26 in Panama, highlighting how empathy-based digital tools can strengthen frontline care. There is still time to register.
