The Poor and Health Services Use in India

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Abstract

This paper summarizes empirical findings from recent World Bank financed analysis on the use of health services by the poor in India (Mahal et al 2000) and some additional analysis conducted with the same data. Three factors motivate the choice of approach taken here and in the background paper. First, the size of the population, the diversity within India, and the unique governance structure provide an opportunity for comparative analysis to support learning about equity in health service use. This led to analysis below the national level where state-level comparisons are used. This paper and the analytical work supporting the findings summarized in it are part of a set of studies intended to provide information for public and professional discussion around the shape of India's future health system. Other studies included private health sector analysis, consumer protection in the health sector, health insurance, pharmaceutical sector analysis, and analysis of the quality of health services. The underlying purpose is to find ways to improve health outcomes in India, particularly for the poor, and to develop sustainable health systems and financing to achieve better health outcomes. The whole effort originated out of a longstanding dialogue between the Government of India and the World Bank. A brief description of the data and methodology is presented in the next section. A summary of national- level findings is provided and state-level findings are also discussed. A discussion of the relevance of the findings, including study limitations, is presented in the final section.