Global evidence suggests that Community Health Workers (CHWs) improve access to and coverage of communities with basic health services and enhance the resilience of health systems, in countries like India. Positioned as front-line health workers, the CHWs called Accredited Social Health Activists (ASHAs) in India, target underserved populations, improve access to primary healthcare and facilitate reduction in inequities in maternal and neonatal mortality since their introduction in 2005. Despite this, access and utilization of maternal and child health services and associated disease burden is borne disproportionately by 9 states called the Empowered Action Group states and Assam (EAGA). It also varies substantially by low socio-economic status and marginalized communities. For this study, we first assess the association between access to ASHA services and individual and socio-demographic characteristics of women in the pre- natal period in India. Second, we evaluate the impact of ASHAs on uptake of institutional deliveries.