By Dr. Bibhuti Bhusan Nayak
BHUBANESWAR:Odisha has emerged as a model for inclusive healthcare delivery through a series of targeted interventions aimed at improving the health and well-being of people living in remote tribal and inaccessible regions of KBK Districts of Odisha and there are severe shortages of healthcare infrastructure left millions of the people struggling for even the most basic medical services. Odisha has quietly initiated one of the most ambitious rural healthcare transformations in the country. Through targeted interventions focused on maternal care, malaria elimination, anaemia reduction, doorstep healthcare delivery and decentralized wellness infrastructure, the state is reshaping healthcare access in the remote KBK districts.
One of the most impactful initiatives in this transformation has been the establishment of Maa Gruha, or maternity waiting homes. The concept was first introduced in 2009 in the Kalimela block of Malkangiri district, an area where pregnant women often had to travel long distances through forests and poor roads to reach health facilities. Many women delivered at home without skilled assistance, contributing to high maternal and neonatal mortality. Maa Gruha changed this reality by providing safe residential spaces for pregnant women in the final days before delivery. Women from remote villages are admitted near healthcare facilities before their expected delivery date, ensuring timely institutional deliveries.
According to Odisha’s Annual Activity Report (2024-25), 92 Maa Gruha projects are operational across 17 districts, with over 2.39 lakh pregnant women having utilized the service. Importantly, nearly 96 percent of admitted women subsequently underwent institutional delivery at nearby healthcare facilities equipped with emergency obstetric care.
Complementing Maa Gruha is the strengthening of BeMOC (Basic Emergency Obstetric Care) services. In inaccessible tribal regions, lack of emergency obstetric support often turned childbirth complications into fatal incidents. Odisha addressed this gap by upgrading nearby health centres with BeMOC facilities, enabling management of normal deliveries and emergency maternal complications at the grassroots level. The Maa Gruha-BeMOC linkage has become a lifeline for pregnant women in the KBK districts, significantly reducing delays in accessing skilled care during labour.
Another major challenge in rural Odisha has been widespread anaemia among women and adolescents. High rates of nutritional deficiency, poverty, and limited awareness contributed to maternal weakness, low birth weight, and increased health complications. To tackle this crisis, the state launched AMLAN (Anaemia Mukta Laqshya Abhiyan), a targeted campaign aimed at reducing anaemia prevalence through screening, iron supplementation, nutrition awareness and community mobilization. Under AMLAN, frontline health workers conduct regular haemoglobin testing among adolescent girls, pregnant women, and lactating mothers. The programme also emphasizes dietary diversification and nutrition counselling at the village level. In tribal and rural communities where awareness about anaemia was traditionally low, the campaign has created a stronger culture of preventive healthcare. AMLAN reflects Odisha’s growing shift from reactive treatment to preventive public health management.
Perhaps the most visible symbol of healthcare outreach in the KBK region is the deployment of Mobile Medical Units (MMUs). In villages where permanent healthcare infrastructure remains difficult to establish due to terrain and population distribution, mobile healthcare has emerged as a practical solution.
Odisha’s mobile healthcare strategy, including the “Arogya Plus” model operating in partnership with NGOs, brings doctors, pharmacists, health workers, and diagnostic services directly to remote habitations. Government documents note that these mobile health units regularly visit inaccessible villages on fixed schedules, conducting health camps, screenings, immunization drives, and school health services.
For many tribal communities in Malkangiri, Koraput, and Rayagada, MMUs represent the first consistent contact with formal healthcare systems. Patients no longer need to walk for hours through hilly terrain for routine consultations. Early diagnosis of diseases such as tuberculosis, malaria, hypertension, and diabetes has also improved due to doorstep healthcare delivery.
The state’s healthcare transformation has further accelerated through the expansion of Ayushman Arogya Mandirs, which are being developed as comprehensive primary healthcare and wellness centres. These centres aim to provide preventive, primitive, curative, rehabilitative, and palliative healthcare services closer to communities. Across India, over 1.73 lakh Ayushman Arogya Mandirs have already been operationalised, with Odisha contributing more than 7,500 centres.
The Odisha government has announced plans to establish Ayushman Arogya Mandirs in every panchayat, particularly strengthening rural healthcare delivery systems. These centres are expected to bridge long-standing healthcare gaps in underserved districts by integrating primary care, wellness activities, teleconsultation, and community health outreach. Equipped with health workers, yoga instructors, and expanded services, these centres are gradually transforming rural healthcare from a treatment-oriented system into a holistic wellness ecosystem.
Among Odisha’s most internationally recognized public health interventions is DAMaN (Durgama Anchalare Malaria Nirakaran), a programme specifically designed to combat malaria in inaccessible and high-burden tribal areas. The KBK districts historically recorded some of the highest malaria incidences in the country, particularly due to forested terrain and difficult access for healthcare workers. DAMaN adopted an aggressive community-based strategy involving mass screening, rapid diagnosis, treatment distribution, vector control, and awareness campaigns. Healthcare workers travelled to remote villages carrying rapid testing kits and medicines, ensuring early detection and treatment before the disease spread widely. The initiative significantly reduced malaria cases and deaths in several tribal districts, demonstrating how targeted rural health interventions can produce measurable outcomes even in geographically challenging regions.
The cumulative impact of these programmes is now visible across the KBK landscape. Institutional deliveries have improved, maternal and infant mortality rates are declining, malaria prevalence has reduced, and healthcare outreach has expanded into previously neglected villages. Importantly, the transformation is not merely infrastructural it reflects a deeper change in governance philosophy. Odisha’s rural healthcare model increasingly emphasizes decentralization, prevention, mobility, and community participation.
Challenges, however, remain substantial. Many areas still face shortages of specialist doctors, diagnostic infrastructure and digital connectivity. Seasonal migration, malnutrition, and difficult terrain continue to affect healthcare outcomes. Yet, the progress made in recent years demonstrates that even the most remote regions can witness meaningful transformation through sustained political commitment and localized public health innovation.
The story of healthcare in Odisha’s KBK districts is therefore no longer only about deprivation and neglect. It is increasingly a story of resilience, innovation, and inclusion. Odisha is proving that healthcare access in rural India can be remained not as a privilege for urban populations, but as a fundamental right reaching the last village in the remotes test corner of the state.
(The Writer Dr. Bibhuti Bhusan Nayak is an ICSSR Post Doctoral Fellow at the Department of Department of Public Administration, Utkal University, Vani Vihar, Bhubaneswar, Odisha, India can be reach at bibhutibhusanna@gmail.com )
