Refresher Training through Digital and Physical, Card-Based Game for Accredited Social Health Activists (ASHAs) and Anganwadi Workers (AWWs) in India

India's recent health surveys have highlighted a worrying trend of incomplete child immunization rates across several district clusters in India. Conventional training methods for community healthcare workers (CHWs) in India are inadequate for improving their skills and knowledge. Smartphone games could be a viable and cost-effective method of refresher training specifically targeting immunization practices. A refresher training game was designed both as a physical card-based and digital app-based game, focusing on enhancing CHWs' knowledge and practices related to child immunization. A quasi-experimental study was conducted with 368 participants. Quantitative gameplay analytics and qualitative feedback from players were collected through interviews. The findings show that game-based refresher training significantly improves CHWs' knowledge gain and retention in the area of child immunization. The discussion highlights the study's implications and insights while developing effective digital tools for training CHWs. The research contributes to the growing body of work on digital tools for training CHWs in resource-constrained settings. The study underscores the potential of smartphone games as a scalable and effective method of refresher training for improving child immunization rates.