Guwahati: The secondary healthcare services in Assam have received a big boost with the World Bank approving a $251 million loan to strengthen management capacity, access, and quality of services.
The Assam State Secondary Healthcare Initiative for Service Delivery Transformation (ASSIST) project will increase access to comprehensive emergency obstetric and newborn care services and improve treatment and management of non-communicable diseases. The project will also upgrade around 10 lower-level facilities to district hospitals in essential districts and strengthen the capacity of nurses and healthcare managers for better service delivery.
The World Bank stated, “Lack of district hospitals, non-availability of beds and shortage of human resources for health are other major proximal causes of poor performance of the state’s secondary health system.”
It added that 6 districts in the state have no district hospitals and 4 districts need additional district hospitals due to the growing population and geographical location.
The World Bank also informed that hospitals in the state have a lower number of district level beds, compared to the national average. District hospitals in Assam have 18 beds/100,000 population compared to the national average of 24 beds, it reported.
Additionally, human resources for health at the existing district hospitals is severely constrained, with only 12 percent of the district hospitals meeting the requirement for doctors, 4 percent for nurses and 52 percent for paramedical staff as per the Indian Public Health Standards (IPHS) norms.
“None of the district hospitals in the state have qualified hospital managers, which results in clinical staff spending time on administrative and managerial duties for which they are not trained. This suboptimal allocation of the limited human resources for health thus impacts efficiency and quality of secondary healthcare services,” the report stated.
The report also informed that only 10 of the 14 essential health services and 9 of 14 prescribed diagnostic services are available on average in district hospitals in Assam. Only 2 of the 25 existing district hospitals are National Quality Assurance Standards (NQAS) certified and none offer all 14 essential services.
Similarly, essential drug availability is inadequate. 44 percent of the patients are not able to procure medicines from their full prescription when seeking care in district hospitals.
Hospitalisation rates in Assam are reportedly half the national average and the state has the lowest in-patient care uptake if childbirth is excluded.
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The reasons mentioned by beneficiaries for not accessing public hospital care in the state include lack of trust, low quality of services as well as lack of medicines and services when required.
“The rise in non-communicable diseases such as hypertension and diabetes poses a double burden on the state’s healthcare system,” said World Bank team leaders Amith Nagaraj and Elina Pradhan.
The team asserted that this project will enhance the quality and efficiency of health care in the state and can potentially serve as a model for healthcare innovations in the northeast region and beyond.
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