Abstract

This report examines the necessity and challenges of establishing a dedicated Public Health (PH) cadre in the North Eastern (NE) states of India, focusing on Assam, Manipur, Meghalaya, and Nagaland. The study utilised a variety of research methods, including expert consultations, literature reviews, personal interviews with stakeholders, and data analyses, to assess the prerequisites for a PH cadre in these regions. Interviews with government officials and public health experts revealed a strong consensus on the need for a dedicated cadre, highlighting implications such as improved health outcomes and enhanced governance.

The report also evaluated the current healthcare system’s alignment with the World Health Organization’s 12 Essential Public Health Functions (EPHF) through an EPHF mapping tool administered to district health officials. Conducted between the second and third waves of COVID-19, the study faced challenges such as limited access to officials burdened by pandemic duties and a lack of documentation outlining PH roles within health departments.

The NE region, home to 7.9% of India’s population, faces unique geographical challenges that complicate healthcare delivery. The states rely heavily on central government funding, with significant contributions from the National Health Mission (NHM), which constitutes over 50% of public health expenditures in these states. Despite its influence on decision-making and workforce funding, the NHM does not provide permanent employment benefits for its workers.

The findings underscore the urgent need for a structured PH cadre to address existing health disparities and improve public health infrastructure in the NE states. For detailed insights into each state’s specific context and recommendations, please refer to the respective chapters in the full report.

Raghuraman, G., Prasad, S., Jha, J., Rao, M. B. V., Sundar, S. (2022). Does the Northeast Need a Public Health Cadre? A Study of Four North Eastern States.