Oars of hope: boat-based healthcare and public health equity in flood-prone char/sapori communities
1
Population Research Centre, Ministry of Health and Family Welfare, Delhi, India
Popul. Med. 2026;8(Supplement Supplement 1):A3403
ABSTRACT
INTRODUCTION:
Flood-prone riverine areas of Assam face severe healthcare access barriers due to geographic isolation and recurrent inundation. Char sapori communities are disproportionately affected by the state as nearly 39.6% flood-vulnerable land area. Seasonal floods often render primary health facilities inoperable and heighten disease risk. Despite the introduction of boat clinics in 2008, gaps persist in service continuity, emergency response, and community awareness, warranting critical evaluation.
METHODS:
This study employs a descriptive-analytical research design, synthesizing secondary data sources. The approach incorporates quantitative data on health indicators and flood vulnerability with qualitative narratives from published reports and prior field- based studies in assam. Data comprises National Health Mission (Assam) Annual Reports (2020-2024), Flood reports (2023-2024) from Assam State Disaster Management Authority (ASDMA), C-NES annual reports, and peer-reviewed studies (2008-2024). Morbidity trends, flood vulnerability, and healthcare utilization data were triangulated with narrative evidence from community case studies to assess accessibility, adaptability, and systemic gaps in boat-based service delivery.
RESULTS:
The findings show notable seasonal variations in healthcare access and morbidity. Fever ascended from 28.4% to 42.7% during floods, while skin infections, diarrheal illnesses, and dysentery also rose markedly. Reliance on informal providers increased as public health facility utilization declined from 62% to 38%. During floods, Boat clinics served 13.7% of the patients, demonstrating their role as an interim facility when road-based services became inaccessible. Although maternity and reproductive health care remained scarce, service utilization data from 2020-21 to 2021-22 illustrate consistent and increased outreach through boat clinics, particularly in general health services and immunization.
CONCLUSIONS:
Boat-based healthcare services play a pivotal role in extending essential healthcare to the geographically isolated, and flood-prone communities. When integrated with referral systems, renewable energy, and community participation, these services strengthen resilience and trust, embodying principle of health without borders and advancing equitable and sustainable health outcomes.
Flood-prone riverine areas of Assam face severe healthcare access barriers due to geographic isolation and recurrent inundation. Char sapori communities are disproportionately affected by the state as nearly 39.6% flood-vulnerable land area. Seasonal floods often render primary health facilities inoperable and heighten disease risk. Despite the introduction of boat clinics in 2008, gaps persist in service continuity, emergency response, and community awareness, warranting critical evaluation.
METHODS:
This study employs a descriptive-analytical research design, synthesizing secondary data sources. The approach incorporates quantitative data on health indicators and flood vulnerability with qualitative narratives from published reports and prior field- based studies in assam. Data comprises National Health Mission (Assam) Annual Reports (2020-2024), Flood reports (2023-2024) from Assam State Disaster Management Authority (ASDMA), C-NES annual reports, and peer-reviewed studies (2008-2024). Morbidity trends, flood vulnerability, and healthcare utilization data were triangulated with narrative evidence from community case studies to assess accessibility, adaptability, and systemic gaps in boat-based service delivery.
RESULTS:
The findings show notable seasonal variations in healthcare access and morbidity. Fever ascended from 28.4% to 42.7% during floods, while skin infections, diarrheal illnesses, and dysentery also rose markedly. Reliance on informal providers increased as public health facility utilization declined from 62% to 38%. During floods, Boat clinics served 13.7% of the patients, demonstrating their role as an interim facility when road-based services became inaccessible. Although maternity and reproductive health care remained scarce, service utilization data from 2020-21 to 2021-22 illustrate consistent and increased outreach through boat clinics, particularly in general health services and immunization.
CONCLUSIONS:
Boat-based healthcare services play a pivotal role in extending essential healthcare to the geographically isolated, and flood-prone communities. When integrated with referral systems, renewable energy, and community participation, these services strengthen resilience and trust, embodying principle of health without borders and advancing equitable and sustainable health outcomes.
| eISSN: | 2654-1459 |
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