Community survey reveals acute deficiencies in health sector
SHILLONG, July 2: Across the villages of Meghalaya, a slow but heavy health burden is settling over families. Lifestyle diseases such as high blood pressure, diabetes, breathlessness, or the struggle of addiction are pulling entire households into uncertainty even as most parts of rural Meghalaya struggles with acute shortage of essential medicines.
A community-based assessment by the State Health Systems Resource Centre (SHSRC) under the Community Feedback Mechanism has brought these concerns into sharp focus. The survey, which covered 1,028 villages and 155 health facilities, found that lifestyle diseases have emerged as the most widespread health worry. Non-communicable conditions such as hypertension and diabetes were identified as the top concern in 61% of the villages surveyed.
Substance abuse ranked a close second, flagged by 58% of communities, while respiratory illnesses troubled 53%. Many villages also highlighted anaemia among women and the growing number of teenage pregnancies and home deliveries — issues that place added strain on young families and already stretched local health services.
Beyond the illnesses themselves, people spoke of a healthcare system that often fails to meet them where they are. Shortages of essential medicines were reported in 60% of villages, making it the most common barrier to care. More than half the respondents also pointed to the shortage of doctors and other healthcare workers. In many places, patients must travel long distances, only to return without medicines or proper tests because stocks have run out or facilities are understaffed.
The difficulties multiply in remote areas. Poor road connectivity and unreliable transport turn even short journeys into exhausting ordeals, especially for the elderly, pregnant women, and those needing regular treatment. Long waiting times, inadequate diagnostic services, poor sanitation at health centres, and limited awareness of government health schemes add to the daily frustration.
The survey revealed that health priorities are not the same everywhere. Hypertension stands out most sharply in North Garo Hills and East Khasi Hills. In Ri-Bhoi, communities placed teenage pregnancy at the top of their concerns. Substance abuse dominated discussions in West Jaintia Hills, while water-related health problems were the leading worry in South Garo Hills.
These differences paint a picture of a state where geography, age, and social conditions shape who falls ill and how hard it is to recover.
For many families, the absence of timely medicines and care in government hospitals forces them to spend what little they have on private treatment — deepening the cycle of worry and debt.
The SHSRC has said the findings will help shape more responsive health planning under the state’s Outcome-Based Budgeting framework. By bringing community voices directly into the process through the Community Feedback Mechanism, the state hopes future decisions on doctors, medicines, and programmes will reflect what people are actually living through.
For now, in villages across Meghalaya, the gap between illness and care remains significantly bigger than what existing government policies can address.
