This project seeks to identify the determinants of health among the rural population of Udaipur district in Rajasthan, India. We have collected data on healthcare facilities and the health status of people in 100 villages in the district. The data sources include an integrated household questionnaire about socio-economic and health status; a survey of village infrastructure; detailed surveys of public, private, and traditional health facilities available to villagers; and a yearlong continuous absenteeism survey in all public health facilities serving the sample villages. Together, these sources provide a comprehensive picture of healthcare delivery, health seeking behavior, and health status in rural areas of Udaipur district.

Preliminary data analysis has revealed that the health status of the population is very poor. This is likely due to a variety of factors, including poor levels of nutrition, bad sanitation infrastructure, a very low quality of healthcare, and poor take-up of preventative health measures. On the basis of what has been learned in this study so far, Seva Mandir, a local NGO, is initiating an action research project composed of four pilot projects, each designed to influence health status through a different channel.

These four pilot projects are: (1) iron fortification of flour using village-level mills, (2) chlorination of drinking water sources in the village, (3) improving subcenter reliability by adding a part-time nurse who is accountable to Seva Mandir, and (4) improving immunization take-up by administering immunization camps and offering incentives to parents who bring their children to be immunized. We will use a randomized evaluation to identify the short and long run impacts of these interventions on various outcomes of health and well-being.

1,000 households, 143 public facilities, 600 private doctors, and 225 practitioners of traditional medicine in Udaipur district.

The weekly absenteeism survey reveals that, on average, 45% of medical personnel are absent in subcenters and aidposts, and 36% are absent in the (larger) Primary Health Centers and Community Health Centers. Moreover, there is no pattern, either in terms of the day of the week or the time of the day, by which the centers are found to be open.

Households report spending 7.3% of their monthly budget on healthcare. Visits to traditional healers account for 19% of all health visits in the last month, and 12% of the health expenditure of the average household. Poorer households are more likely to visit traditional healers than richer households (27% of the visits and 19% of the average monthly health expenditure), especially in villages served by public health facilities that are more closed.

Abhijit Banerjee, Angus Deaton, Esther Duflo.

Health Care Delivery in Rural Rajasthan
Abhijit Banerjee, Angus Deaton, Esther Duflo.
February 2004

Wealth, health, and health services in rural Rajasthan
Abhijit Banerjee, Angus Deaton, Esther Duflo.
May 2004

Seva Mandir, Vidhya Bhawan

India

Health

MacArthur Foundation, Center for Health and Well being at Princeton University, NIH, MIT

To read about this project in the News click the link(s) below:
MIT steps in to find a doctor for this village
Deserted by Doctors, India's Poor Turn to Quacks
Health checkup