IndOSS - Indian Obstetric Surveillance System - Assam

The Indian Obstetric Surveillance and Research System in Assam (IndOSS-Assam) is a hospital-based surveillance and research platform initiated as a collaboration between clinicians and public health specialists in Assam, India through the Srimanta Sankaradeva University of Health Sciences and the National Perinatal Epidemiology Unit (NPEU), University of Oxford, UK. The model is adapted from the UK Obstetric Surveillance System UKOSS.


To develop a simple maternal morbidity surveillance and research system in the state of Assam in order to describe the changing epidemiology of risk factors, management and outcomes associated with maternal deaths and specific life-threatening complications.


To use the Assam model to establish and scale up IndOSS in the other north-eastern states in India with an ultimate aim of setting up a national system

Why set up IndOSS in Assam

Assam is one of the eight north-eastern states in India and has a high maternal mortality ratio (MMR = 301/100,000 live births in 2012-13)[1]. The proportion of health facility-based childbirths in Assam has increased from 58% in 2010-11[2] to 66% in 2012-13[3], thereby increasing the need for a meaningful and straightforward means of monitoring the quality of maternity care in hospitals. Once established, a hospital-based surveillance system will provide a platform to conduct epidemiological studies to generate evidence to prevent severe maternal morbidity (defined as life-threatening complications during pregnancy and childbirth) and to guide management of severe obstetric complications to reduce mortality.


  • Completed testing the feasibility of and the methods for establishing IndOSS-Assam (September 2014 to October 2015).
  • IndOSS-Assam is already established in the two medical colleges that participated in this pilot study (Fakhruddin Ali Ahmed Medical College and Hospital (FAAMCH), Barpeta and Guahati Medical College and Hospital (GMCH).
  • Plans to scale up IndOSS-Assam to 14 government tertiary hospitals in the state are in development.

IndOSS-Assam collaborators

Oxford, UK

  1. Dr. Manisha Nair, Senior Epidemiologist / Health Services Researcher, NPEU, University of Oxford
  2. Prof. Marian Knight, Professor of Maternal and Child Population Health, NPEU, University of Oxford
  3. Dr. Premila Webster, Head of School of Public Health, Oxford deanery / Director of Public Health Education and Training, Nuffield Department of Population Health, University of Oxford

Assam, India

  1. Prof. U C Sarma, Vice Chancellor, Srimanta Sankaradeva University of Health Sciences, Guahati, Assam
  2. Prof. Manoj Kumar Choudhury, Registrar, Srimanta Sankaradeva University of Health Sciences and Joint Director Medical Education, Guahati, Assam
  3. Dr. Saswati Sanyal Choudhury, Associate Professor of Obstetrics & Gyanaecology, FAAMCH, Barpeta, Assam.
  4. Dr. Swapna D. Kakoty, Associate Professor of Community Medicine, FAAMCH, Barpeta, Assam.



  1. ^ Office of Registrar General India. Special bulletin on maternal mortality in India 2010-12: Sample registration system. New Delhi: Office of Registrar General, India - Vital Statistics Division, 2013
  2. ^ Office of Registrar General and Census Commissioner  India. Annual Health Survey 2010-11: Fact sheet. New Delhi: Ministry of Home Affairs, Government of India, 2012
  3. ^ Office of Registrar General and Census Commissioner  India. Annual Health Survey 2012-13: Fact sheet. New Delhi: Ministry of Home Affairs, Government of India, 2014

Updated: Monday, 16 March 2020 10:44 (v14)