The healthcare sector of Assam is undergoing a significant transformation, addressing challenges posed by its diverse geography and population distribution. From the tea gardens and riverine areas to the flood-prone plains, ensuring accessible and quality healthcare has been a long-standing concern. However, with strategic government interventions like Ayushman Asom-Mukhya Mantri Jan Arogya Yojana, Atal Amrit Abhiyan, and the establishment of AIIMS Guwahati, the state is making remarkable progress toward affordable and inclusive healthcare.
Additionally, initiatives such as mobile medical units, boat clinics, and Swasthya Sewa Utsav are bridging critical gaps in medical service delivery. This blog explores the evolving healthcare sector of Assam, highlighting key policies, infrastructure developments, and ongoing efforts to ensure better healthcare for all.
An Overview of the Healthcare Sector of Assam
With about 3.4 crore population, Assam is poised in a unique context both demographically and topographically and is the largest State with 68.4% population of the country’s northeastern region. One must look at Assam’s healthcare delivery system in this context.
Assam is committed to reduce out-of-pocket expenditure and make healthcare affordable. Hence, the Chief Minister’s Free Diagnostics Services, a PPP model with HLL Lifecare Ltd was introduced.
In context of accessibility, quality of services and affordability, we need to look at various factors: Accessibility: Difficult geographical terrain with hard to reach riverine/ Char areas, tea garden areas, hilly and forest areas spread across the State are the major accessibility issues for healthcare delivery system in the State.
a) Tea garden areas
About 20% of Assam’s population belongs to the tea growing communities. They are one of the most backward and exploited communities in Assam. Assam faces a high Maternal Mortality Ratio (MMR) in districts with high tea garden populations. A survey by the Regional Resource Centre for North Eastern States revealed that only 57% of tea gardens have functional hospitals and 49.9% have Allopathic medical officers.
The poor health infrastructure, availability of doctors, nurses, and paramedics, and the challenge of implementing the Plantation Labour Act, 1951 in these areas remain.
b) Riverine areas
Around 10% of population of the State reside in the riverine/char areas where healthcare remains a critical challenge due to inadequate number of Health Infrastructure, doctors, nurses and critical topographical condition is another challenge to reach these areas.
c) Hilly Areas
The hilly terrain and poor road connectivity in Karbi Anglong and Dima Hasao hilly districts lead to inadequate referral transport systems, low population density accessibility, and significant manpower availability issues.
d) Border areas
The geographical location of the State itself is quite unique, sharing borders with seven States and countries like Bhutan and Bangladesh, and having 2276.3 km of inter-State and 529 km of international borders witnessed low coverage of health care services due to accessibility issues.
e) Flood and erosion
Assam is a multi-hazard state, prone to floods, earthquakes, storms, and landslides. The Brahmaputra valley and Barak valley areas experience annual flooding, flash floods, and erosion from river changes, causing health institution damage.
Gap in Health Infrastructure
There is huge gap of health infrastructure as per population norms. Till last year, not a single facility was Indian Public Health Standards (IPHS) compliant.
Quality
Quality of healthcare service providers remains an issue with acute shortage of skilled healthcare service providers.
Shortage of skilled healthcare service provider
Availability of specialists in the State remains a challenge. Of the State’s 6 medicalcolleges, only 3 are offering post graduate courses. Only 50% of the PG seats are available to the State which needs to cater to both the public and the private sectors. Shortage of MBBS Doctors, Staff Nurse and other paramedical staff is the major challenge in the health system. Rational posting of manpower is another challenge.
Measures have been taken by NHM, Assam
To cover the hard-to-reach areas and areas where healthcare facility is inadequate, the Assam Government has deployed 130 Mobile Medical Units (MMUs) of which 80 are deployed in the tea garden areas.
At present 414 tea gardens are covered by these MMUs every month. MMUs are basically “hospital on wheel” manned with doctor, nurse, paramedical staff equipped with basic free diagnostic services and free medicines. More than 20.31 lakh patients have been treated in 47,020 camps organized by these MMUs from June 2017 to January 2019.
To provide healthcare services in the riverine and char areas, one-of-its kind Boat Clinics have been deployed with 15 Boat Clinics operating across 13 districts from 2008. These are basically “Floating Hospitals” manned with doctor, nurse, paramedical staff equipped with basic free diagnostic services and free medicines.
Assam government’s important healthcare schemes
Ayushman Asom-Mukhya Mantri Jan Arogya Yojana
Assam government’s recent launch of the Ayushman Asom – Mukhya Mantri Jan Arogya Yojana signifies a major milestone in the quest for accessible and affordable healthcare. Ayushman Asom: Ensuring Comprehensive
Healthcare Coverage
Ayushman Asom is a family-floater health assurance scheme designed to provide families in Assam with access to cashless medical treatment
up to Rs.5 lakh per year. This progressive step aims to break down financial barriers and ensure that quality healthcare services are available to all residents, irrespective of their economic standing.
Responsibility of the Department of Medical Education & Research
The Department of Medical Education & Research, operating under the Government of Assam, assumes the crucial responsibility of
implementing Ayushman Asom. This department plays a pivotal role in overseeing the smooth execution and management of the scheme,
ensuring its success in reaching the intended beneficiaries.
Mukhya Mantri Lok Seva Arogya Yojana
Healthcare Benefits for Government Employees. In addition to Ayushman Asom, the Government of Assam has introduced the Mukhya Mantri LokSeva Arogya Yojana, a healthcare benefit scheme specifically catering to government employees. This scheme, scheduled to roll out from August 15, eliminates the cumbersome reimbursement process for medical expenses incurred by employees and their dependents.
It ensures comprehensive healthcare coverage, enabling government employees to access quality medical services conveniently.
The Assam Arogya Nidhi (AAN)
AAN Initiative provides financial assistance up to Rs. 1,50,000/- to BPL families and families having a monthly income of less than Rs. 10,000/- (Rupees Ten Thousand) for general and specialized treatment of (i) life threatening diseases, (ii) of injuries caused by natural and manmade disasters, such as industrial/farm/road/rail accidents, bomb blasts, etc.
Life threatening diseases includes Heart Diseases and Heart Surgery, Cancer, Kidney and Urinary diseases, Orthopedic, Thallassemia, Bone marrow Transplant, AIDS, and chronic Mental Illness with Surgical Treatment. Beneficiaries are selected by a Selection Committee that has been notified by the Government of Assam. Under the AAN, Government of India contributes 50% of the funds sanctioned by the State Government.
Swasthya Sewa Utsav
Swasthya Sewa Utsav is a state initiative to assess to the quality of the service providers and service delivery of the health institutions. The objective of the programme is to assess the health institutions, its infrastructure, human resource and quality of services rendered through independent assessors to attain quality of services in each health facility. The initiative has been undertaken by the state government as per the vision and intent of Hon’ble Chief Minister of Assam to improve the quality and service delivery of all public health facilities.
This will be achieved by addressing the identified gaps though capacity building of the service providers, improving infrastructure and ensuring coverage of all programs at all levels. The Department of Health & Family Welfare in Assam has formed a State level Steering Committee, a State-level Core team, and a district-level core team to implement the Swasthya Sewa Utsav, a three-day event
organized by the National Health Mission with the help of volunteers.
Objective of Swasthya Sewa Utsav
The basic objectives of the programme are:
• To provide comprehensive health care services to the community.
• To make the health facilities IPHS compliance
• To create and share sustainable practices related to key areas of concern in public health facilities linked to positive health outcomes.
• To promote cleanliness, hygiene and infection control practices in public health facilities.
• To reduce infant mortality rate and maternal mortality ratio.
• To reduce the patients waiting time for consultation.
• To reduce out of pocket expenditure of the service users.
AIIMS in Northeast
Prime Minister Narendra Modi on April 14 inaugurated the first All India Institute of Medical Sciences (AIIMS) in the Northeast at Changsari near Guwahati.
The AIIMS and a medical college each in Kokrajhar, Nagaon, and Nalbari were among various projects worth more than ₹3,400 crore he initiated and dedicated to the nation in Assam. Mr.Modi had laid the foundation stone of the AIIMS, built at a cost of ₹1,120 crore, in May 2017.
• The super speciality hospital has a capacity of 750 beds including 30 AYUSH beds and will admit 100 MBBS students annually.
Assam Atal Amrit Abhiyan Health Insurance Scheme
Atal Amrit Abhiyan is a health insurance scheme by the State Government of Assam. The government is providing insurance coverage up to 2 lakh per year to each family of the state under this scheme. It was launched originally on 25 December 2016 (Good Governance Day).
Eligibility
1. The person must be an Assamese residing in Assam.
2. BPL families with income less than ₹1.2 lakh per annum.
3. APL (Above Poverty Level) category with income between 1.2 lakh and 5 lakh per annum.
4. Employees who are working or retired in the service of the Central and State Governments will not be eligible.
Benefits:
• Cardiovascular diseases
• Cancer
Cashless treatment of 438 diseases, segregated into the following six groups:
• Kidney diseases
• Neo-natal diseases
• Neurological conditions
• Burns
This scheme is expected to cover 92% of Assam’s population, offering cashless care and treatment at empanelled hospitals both within and outside the state.
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