In terms of area Sikkim is the second-smallest state in India after Goa. It is also the least populated in the country with just 600,000 people. Despite this, in some matters, this Himalayan state towers over others, leading the way where the rest of India falters.
Among the most innovative schemes undertaken in this state is the Comprehensive Annual and Total Check-up for Healthy (CATCH) Sikkim. This programme is aimed at tracking the health status of people in the state, so prevention, rather than cure, can become the order of the day when it comes to public health.
Launched in August 2010, CATCH covered 50 percent of the state's population by the end of 2012.
CATCH is aimed at prevention rather than cure, a cheaper and more effective way to address the healthcare needs of a population than providing for expensive treatment once disease sets in.
The aim of CATCH is to ensure a comprehensive check-up on an annual and periodical basis to all people in the state. A database of the health status of individuals would be maintained. Check-ups and healthcare under this programme are provided free of charge.
Chief Minister Pawan Chamling, launching the programme two years ago, said: "Our aim is to provide community-based comprehensive annual check-ups and care, free of charge. We will bring healthcare to the doorsteps of the people and make Sikkim the healthiest state."
The Political and Economic Journal of Sikkim reports that the primary focus is to get an annual health check-up done for all citizens. After that, comprehensive care based on the history of the patient would be provided.
Ramesh Dahal, a resident from Yangang, told the Journal: "This is a good initiative for those who are poor and cannot afford treatment. In a recently concluded CATCH health check-up camp, the doctors checked my sugar and blood pressure. I was advised what to eat and how to lead a healthy lifestyle. It was extremely informative for the villagers."
He added: "We hardly get any time to think of our health since we are so occupied with our farms. But with this system, at least we will be able to get regular check-ups."
Scattered health-based programmes are now being converged by building partnerships in the health sector.
Currently, one state referral hospital, four district hospitals, 25 primary healthcare (PHC) centres, 147 sub-PHC centres and one medical college function in the state. All of these establishments are working together to implement CATCH.
A detailed medical history of each citizen would be created under CATCH, which can be updated on each annual check-up. A physical check-up, during which a screening of major health problems is done, would be part of the programme. In case a disease is detected, the patient is sent for free consultation.
After the physical check-up, a laboratory investigation is done, and citizens are counselled by an expert on how to maintain a healthy lifestyle.
"We live near Nimtar in Sumic-Mangthang village. The main road is far away from here. So it was helpful when doctors came to us and conducted check-ups," said a grateful Mansingh Subba, resident of Mangthang.