"We are everyone's ASHAs but who's there for us?" a qualitative exploration of perceptions of work stress and coping among rural frontline workers in Madhya Pradesh, India.

OBJECTIVE: More than a million female village-level lay providers called 'Accredited Social Health Activists (ASHAs)', who deliver primary care, face high levels of stress due to work demands and low compensation, within the context of poverty and gender inequality. Evidence on ASHAs has focused on workplace challenges from a system perspective, without sufficient probing into individual-level stress. This study aims to gain perspectives into the experiences of work stress, the related health symptoms, and the responses to stress among ASHAs in India. METHODS: Focus group discussions (FGDs) conducted with ASHAs in Sehore district, Madhya Pradesh, were audio-recorded and transcribed. Grounded theory was used to generate themes under the various domains of ASHAs' work and domestic life. We identified pathways between the conditions that trigger stressful events, experiences of these events, resulting perceptions, effects on health and wellbeing, and approaches used by ASHAs to respond to stress. RESULTS: Six FGDs with 59 ASHAs generated the following themes: (a) Facility: Workload, undue pressures, unstructured work; ASHAs' relationships with seniors (e.g., feelings of being disrespected, blamed, or targeted), and low access to physical and administrative resources; (b) Home: Feelings of guilt for putting less time for family/child care; disrespect by the elderly for a poorly incentivised job; (c) Community: Low acceptance by the villagers; caste- and gender-bias; difficult community-level relationships (emotional labour, fear/stigma towards her services); (d) Somatic and psychological symptoms: headache, exhaustion, depressive symptoms (to cite a few); and (e) Responses to stress: Motivation (support from peers, family, a sense of identity/pride, incentives), Individual strengths (e.g., social responsibility), and spiritual recourse mechanisms. CONCLUSIONS: This study will inform the development of a strengths-based coaching intervention to address work stress among ASHAs. The findings are relevant to building the evidence on alleviation of work stress among female frontline cadres in low-resource settings globally.

Acclimation response and management strategies to combat heat stress in wheat for sustainable agriculture: A state-of-the-art review.

Unpredicted variability in climate change on the planet is associated with frequent extreme high-temperature events impacting crop yield globally. Wheat is an economically and nutritionally important crop that fulfils global food requirements and each degree rise in temperature results in ∼6% of its yield reduction. Thus, understanding the impact of climate change, especially the terminal heat stress on global wheat production, becomes critically important for policymakers, crop breeders, researchers and scientists to ensure global food security. This review describes how wheat perceives heat stress and induces stress adaptation events by its morpho-physiological, phenological, molecular, and biochemical makeup. Temperature above a threshold level in crop vicinity leads to irreversible injuries, viz. destruction of cellular membranes and enzymes, generation of active oxygen species, redox imbalance, etc. To cope with these changes, wheat activates its heat tolerance mechanisms characterized by hoarding up soluble carbohydrates, signalling molecules, and heat tolerance gene expressions. Being vulnerable to heat stress, increasing wheat production without delay seeks strategies to mitigate the detrimental effects and provoke the methods for its sustainable development. Thus, to ensure the crop's resilience to stress and increasing food demand, this article circumscribes the integrated management approaches to enhance wheat's performance and adaptive capacity besides its alleviating risks of increasing temperature anticipated with climate change. Implementing these integrated strategies in the face of risks from rising temperatures will assist us in producing sustainable wheat with improved yield.