P-210. ASHAs as Agents of Change: Tackling the Burden of UTIs and Fostering Antibiotic Stewardship in Underserved Communities of India

Abstract Background Women living in slums in India often experience stigma when seeking treatment for urinary tract infections (UTIs), especially when care is provided by male healthcare workers at public primary health care (PHC) centers. To address this issue and other barriers, community health workers known as Accredited Social Health Activists (ASHAs) were leveraged to assist with outreach and improve access to UTI care. Methods Educational sessions were held at eight Anganwadi centres (public child and mother-care centres) to educate women about urinary tract infections (UTIs), including their causes, symptoms, and the importance of treatment adherence. Additionally, training sessions for Accredited Social Health Activists (ASHAs) focused on antimicrobial stewardship. ASHAs identified women with UTI symptoms, collected urine samples, and sent them to an accredited laboratory for analysis. If bacterial growth was confirmed, ASHAs helped these women access appropriate treatment by accompanying them to local primary health centres (PHCs). Results Through active surveillance conducted by ASHAs, 54 women with urinary symptoms were identified. Among these, 31 samples were excluded from the study because they did not meet the inclusion criteria, specifically due to the absence of pyuria. Of the remaining 23 samples, 14 exhibited sterile pyuria, while 9 (40%) grew bacteria, which were subsequently treated with appropriate antimicrobials. Conclusion This initiative underscores the essential role of last-mile health providers in addressing women’s health by enabling the timely identification and treatment of urinary tract infections (UTIs) through active surveillance. The project empowers Accredited Social Health Activists (ASHAs) to improve access to care for women who avoid seeking treatment due to stigma, while fostering trust and encouraging symptom reporting. Disclosures All Authors: No reported disclosures