Impact of health sector reforms on utilization of health care services in rural assam (India)

To analysis the impact of health reforms on the pattern of utilization of health care services and to identify the factors affecting choice of health care facilities based on a cross section study in rural Assam.

In this paper an attempt has been made to present some preliminary results of the significant changes that occurred during 1887–88, 1995–96 and 2004. The study has used the published reports of 42nd (1887–88), 52nd (1995–96) and 60th (2004) round of National Sample Survey Organization (NSSO). To identify the factors affecting accessibility to public health care facilities the study relied upon a household survey conducted in Nagaon and Nalbari district of Assam during 2014–15. A binary logistic regression model has been used to identify the factors affecting accessibility to public health care facilities.

The analysis imply that the dependence and utilization of public health care facilities for outpatient care has declined drastically in Assam since the period from 1987–88 to 2004. In case

of inpatient care the dependence is very high on public health facilities but the rate of utilization has declined since the inception of health reform measures. Results of the binary logistic regression model indicate that the non-poor, highly educated people have greater likelihood of using private health facilities than their counterparts.

The state requires greater public investment for improving the quality of care in the government health facilities. Moreover, there is a need to regulate the private health care market as majority of the rural population depends on public hospitals for treatment.