Assam: CAG report reveals low child immunisation, negligible cancer screening rates

Guwahati: The CAG report on the compliance audit of public health infrastructure and health service management has highlighted low immunisation coverage and poor cancer screening in the state.

The report stated that only 66.4% of children aged 12-23 months received immunisation, and cancer screening reached a negligible 1.4%, far below the target of 25%.

The state assembly tabled the report on Saturday.

“Immunisation coverage for children aged 12-23 months was 66.4%, which was far below the national average of 76.4%,” the report stated. “Screening for cancer was negligible (1.4%) in the state against the target of 25% by 2019-20,” it added.

The low vaccination rate was attributed to fear or lack of trust in vaccines among caregivers, vaccine hesitancy, and the absence of ASHA/ANM workers in non-registered and forest areas of the state.

The report also noted that while the Maternal Mortality Rate (MMR) improved between 2015-17 and 2017-19, it remained below the national average.

“In order to address high MMR in Assam, there is a need for strengthening and ensuring ANC check-ups for pregnant women, institutional deliveries and birth access to health professionals for home deliveries,” the report said.

Out of 41 national health indicators under the Sustainable Development Goal (SDG)-3 targets, Assam has yet to map 22 indicators with the state SDG action plan.

Diseases such as TB, HIV, and suicidal behaviour-related illnesses are not fully aligned with the state SDG framework.

According to NFHS-5, Assam’s Neonatal Mortality Rate (NMR) is 22.5, Infant Mortality Rate (IMR) is 31.9, and under-5 Child Mortality Rate (CMR) is 39.1, all slightly below the national averages of NMR 24.9, IMR 35.2, and under-5 mortality 41.9. The report noted that Assam could meet the SDG targets for IMR and CMR, but the latest SRS (2017-19) showed the Maternal Mortality Ratio at 205 per 100,000 live births, nearly double the national average of 103.

The report further highlighted concerns regarding home deliveries. “A vast majority (97.4%) of home deliveries were conducted without the assistance and supervision of any skilled health professionals,” while only 2.6% of home deliveries were attended by trained staff.

Additionally, the audit revealed that 137 children, accounting for 23% of the 599 test-checked cases, were born with low birth weight and died within a few days of delivery.