Community health workers (CHWs), and the barriers they face in providing services, have been studied extensively. Less examined is how CHWs respond to these barriers. The USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project conducted a qualitative study of the challenges and opportunities Accredited Social Health Activists (ASHAs) in India encounter and how they respond. ASHAs did feel their work resulted in positive changes in the communities they served and in return the work gave them a sense of self-worth and purpose. However, socio-cultural norms often presented barriers to effective service delivery and influenced ASHAs’ response. This paper presents potential opportunities for improving ASHA capacity in light of the reciprocal relationship with socio-cultural norms and individual self-efficacy.