11 Reproductive Health Facts from India and Beyond That Need More Awareness

9. Lesson for the US: community health workers can narrow access gaps

India’s ASHA program is a reminder that locally rooted health workers can move the needle on service use and health behaviors. In the United States, community health worker (CHW) programs have shown promise in reaching underserved populations, improving chronic-disease outcomes, and bridging cultural or language barriers. The ASHA experience underscores a few practical points for US programs: invest in sustainable pay and training, build clear referral links to higher-level care, and measure long-term behavior change rather than only short-term outputs. CHWs are most effective when communities trust them and when they are supported by functioning clinics and supply chains. For policymakers, funding CHW programs as part of routine primary care rather than temporary grants helps embed them in health systems. Evaluations should include both service-use metrics and measures of patient experience so the human value of CHW relationships is visible alongside clinical outcomes.