Operational Readiness of Accredited Social Health Activists for Community-Based Noncommunicable Disease Screening in Rural Gujarat: A Cross-sectional Study

Background: Noncommunicable diseases (NCDs) are a major contributor to premature morbidity and mortality in India. Accredited Social Health Activists (ASHAs) play a key role in implementing community-based NCD screening through household-level risk assessment and referral using the Community-Based Assessment Checklist (CBAC). The aim of the study was to evaluate the operational readiness of ASHA workers for population-based NCD screening regarding logistics, training, supportive supervision, incentive distribution, and digital infrastructure. Material and Methods: A descriptive cross-sectional study was conducted at two Primary Health Centres (Sokhda and Varnama) in the rural Vadodara district, Gujarat. All eligible and available ASHAs were included using a universal sampling approach. Data were collected between September and November 2023 using a pre-tested semi-structured questionnaire. Descriptive statistics were generated using Microsoft Excel 2019 and Jamovi 2.3.38. Continuous variables were presented as mean (standard deviation) and median; categorical variables as frequencies and percentages. Results: A total of 49 ASHAs participated, with a mean work experience of 9.4 years and mean population coverage of 1,217 individuals. CBAC forms were available to 86% of ASHAs, while family folders (45%) and smartphones (31%) were limited. CBAC training coverage was high (86%); however, only 39% had received CPHC-NCD application training. Supportive supervision was widely reported (92%), but incentive disbursement was predominantly irregular (90%). Referral (22%) and follow-up (55%) incentives were inconsistently received. Conclusion: ASHAs demonstrated substantial field experience and supervisory support but faced significant gaps in digital readiness, logistical supplies, and incentive regularity. Addressing these systemic gaps is critical to strengthen community-based NCD screening under NP-NCD.