Context

Odisha is paradoxically one of the richest states in terms of resources but has the largest number of poor people in the country. Compared with other states, Odisha has the largest percentage of people who are socioeconomically disadvantaged, with large inequities and disparities (including access to health services) between different segments of the population.¹ Based on data from the Planning Commission, Odisha is one of the poorest states in India. It is also prone to floods and drought-like conditions.²

The incidence of poverty in rural Odisha in 2001–2012 was 36 percent compared with the national average of 26 percent.³ To bridge these socioeconomic inequities and improve access to health care, the state of Odisha has invested in comprehensive planning, policies, and programs to increase the coverage of health care services and continues to introduce new initiatives to align with the Sustainable Development Goals. In Odisha, the health care system has seen significant progress against the backdrop of high economic growth and a strong political will to reduce health inequities. Health policy makers are committed to health sector reform and developed a state health sector plan that included equity objectives to guide the reform agenda.⁴ The state focused on improved health services by including the construction and renovation of health facilities, training of community health workers (known as accredited social health activist workers), and introduction of mobile health units. Mobile health units became the major source of health care in remote and inaccessible villages such as those located in its tribal belts.⁵

Odisha has made a dedicated effort to increase women’s access to health services––its focus being on increasing women’s and girl’s access to health and nutrition services and responding to their specific health needs. This was done by establishing gender-sensitive infrastructure such as the construction of toilets for women and partitions in labor rooms for facilitating their privacy and dignity. Increasing the availability of female doctors in rural areas is more challenging and Odisha continues to work toward strengthening the capacity of existing female frontline workers.⁶

The Odisha government has come to rely heavily on modernizing health services with the support of information technology. Examples of information technology innovations in the health sector include health workforce information systems, eBlood banks, eAttendance immunization and malaria information systems, drug inventory management systems, surveillance systems for epidemic-prone diseases, health management information systems, and dashboard monitoring systems. Better accessibility of accurate information at all levels of the health sector has supported better planning and decision making and increased transparency in the state. There is still a lot of opportunity for improvement, such as improving the quality of reporting through regular supervision and monitoring through sentinel sites like the private sector, and better analysis through the use of epidemiological tools and technology like geographic information systems.⁷