In a region in Assam once defined by conflict, a powerful public health initiative is taking root. Over the past two years, the Rog Nirmul BTR Mission has been steadily rolling out a comprehensive program that blends mobile healthcare, community volunteers, targeted support for high-risk groups, and patient assistance schemes.
Driven by the Bodoland Territorial Council (BTC) and its Chief Executive Member (CEM) Pramod Boro’s office, the mission aims to bring primary and secondary health services to remote corners of the region, reducing the financial and logistical burdens of illness for all families, both tribal and non-tribal.
Remarkable Progress in Maternal and Infant Health
The mission has already delivered significant results. Over the past five years, there has been a notable reduction in maternal and infant mortality rates across all BTR districts. The number of maternal deaths per 100,000 live births has declined by approximately 46%, falling from 264 in 2021-22 to 136 in 2024-25.
Similarly, the number of deaths of children under one year old has decreased by about 31%, from 22 per 1,000 live births in 2021-22 to just 15 in 2024-25. This figure is now well below the national average of 28, according to the latest SRS data. This decline is largely due to the tireless efforts of 36,500 women from self-help groups who were trained as “change vectors” to lead the movement for maternal and child health and nutrition. They have helped spread a “Neighbourhood of Care” model to build a healthier Bodoland.
A key part of this success is the ‘Aai Onsai Bithanki’ program, a direct benefit transfer (DBT) project that provides financial assistance to pregnant women identified as high-risk. This critical intervention in a region where maternal health outcomes have historically lagged has delivered fantastic results. The program will provide 10,000 rupees in two installments to 5,000 pregnant women with high-risk conditions, aiming to reduce complications in these cases.
How the Mission Works on the Ground
The Rog Nirmul BTR Mission has several visible components. In mid-2023, the BTR government flagged off a fleet of 36 Mobile Medical Units (MMUs) to serve far-flung villages across the five BTR districts. These units bring diagnostic, screening, and primary care services to hamlets that previously had to travel for hours to reach the nearest clinic. The MMUs, a joint effort between the BTR administration and philanthropic partners, operate as regular visiting clinics.
Alongside the MMUs, the mission has established community-centric programs that have recruited 248 youth to serve as health volunteers at the village level. These volunteers are now driving community health assessments across 420 VCDCs, generating vital data to strengthen a localized health strategy. The volunteers provide local health education, early screening, and referral support, acting as a crucial information bridge to formal health facilities. They are designed to make health interventions locally owned and culturally appropriate, building trust in areas where people might be wary of outside interventions or face linguistic barriers.
The mission has also created targeted patient support instruments. The BTR government has provided financial assistance of 5,000 rupees each to patients living with chronic illnesses, a modest but important relief to help with travel costs, medicines, or diagnostics. Additionally, specialized entities like the Bodoland Cancer Care Trust (BCCT) have been announced under the mission’s umbrella to assist cancer patients and their families. The trust connects patients with existing cancer hospitals, provides regular home visits, identifies new cases, and ensures continuity of care.
Local health melas, free medical camps, and outreach screening drives have become routine features of the Rog Nirmul BTR Mission, with awareness programs organized jointly with the National Health Mission and civil society partners.
Public Health Infrastructure and Partnerships
Over the past few years, there has been considerable progress in strengthening the public health infrastructure in BTR. A key achievement is the establishment of two medical college hospitals: one in Kokrajhar, which is already operational, and another in Tamulpur, currently under construction. At the Primary Health Center (PHC) level, the situation is encouraging, with 143 PHCs in place, exceeding the required number. The number of healthcare workers has also seen significant growth, increasing from 1,225 in 2004-05 to 2,792 in 2024-25, a 127.96% growth.
The Rog Nirmul BTR Mission is not just a state project; it has relied on strong partnerships with several philanthropic organizations, allowing BTR to expand its health services more quickly. The Hans Foundation, for example, has funded the 36 MMUs, which have delivered services across 871 villages each month and treated over 5 lakh patients. The SELCO Foundation has powered 437 health facilities with solar energy, while the NTPC is set to deploy four motorized boat ambulances to improve healthcare access in waterlogged areas. The mission also partners with organizations like CINI on community health and KHPT on the National TB Elimination Program.
Early Impacts and Future Outlook
Although a formal evaluation is not yet publicly available, the mission’s outputs point to several measurable and qualitative impacts affecting both tribal and non-tribal residents. The MMUs and outreach camps have improved geographic access and reduced travel costs for patients in isolated locations. The combination of screening camps, health volunteers, and patient assistance helps with earlier detection and ongoing care for chronic illnesses. The mission’s focus on serving all communities helps reduce health inequities and builds trust, as community volunteers drawn from local populations lower cultural and linguistic barriers to care. The financial and psychological support offered also reduces out-of-pocket spending for poor families and increases confidence in the health system.
In a region still healing from decades of conflict, delivering visible public services sends a powerful message that the government is present, responsive, and committed to inclusive development. The mission’s emphasis on serving all communities helps to temper identity-based grievances by delivering a common public good.
To move from a successful pilot to a durable regional health architecture, policymakers will need to focus on three key areas: securing predictable financing, investing in data systems and formal evaluations to demonstrate health outcomes, and strengthening referral pathways. The mission has already moved health services from the margins to the village square, but sustaining these gains will require careful planning, rigorous monitoring, and steady funding to ensure that the progress seen in the past two years becomes a permanent feature of healthcare in Bodoland.