Udaipur Project

Health care delivery and health status in Udaipur district, Rajasthan

A. Ojectives of the project

The main objective of this project is to obtain a comprehensive picture of health care delivery, health seeking behavior and health status in rural areas in Udaipur district of Rajasthan, India.

There are three basic questions that interest us:
First, what is the structure of the health care system on the ground? What services are delivered in different types of public and private facilities? What are the physical conditions of the building and the availability of drugs and equipment? What are the respective roles of the public, the private sectors, Non Governmental Organizations, and traditional doctors?

Second, what types of health seeking behavior are present in rural India. Where are individuals obtaining health care and how much are they spending? What particular types of health care are they buying?

Finally, what is the health status of the population? What are the patterns of morbidity and mortality by age and gender? What are people's perception of their own physical and mental health situation? How does this relate to their economic status?

There are important policy consequences of not knowing these basic facts. Without an accurate picture of the situation, there cannot be an informed debate on what basic needs are met or unmet, and where are the gaps that NGO or governmental action could fill.

B. The project

The study will have three major components:
1) A census of all health options available to a sample of 100 villages in 5 blocks
2) A study of facilities (public and private) serving these villages
3) A household survey (10 households per village)

Below, we briefly describe what we want to do under each of these heads.
1) Census of health options
This will be obtained through Participatory Resource Apraisal exercises (PRA), which we will conduct in 100 villages. Through the PRA, we will obtain a list of water sources and their state, and a list of all facilities (private and public) visited by households in the village for each major type of diseases.

2) Facilities study
There will be three sources of information for the facility survey:
   -The administrative list of all public facilities present in the blocks under study
   -One time relatively detailed survey of all facilities (public & private) serving 100 sample villages
   -A series of short visits to these facilities, to record their usage

3) Household survey: Health status and health seeking behavior
This household survey will build and expand on existing survey instruments (NSS, NFHS) to measure household economic well-being, health status, and health seeking behavior. We will administer it to 10 households in each of the 100 sample villages. Poor households will be over-represented in the sample. We may also conduct basic physical check up of the sample households.

C. Project timeline

February 2002: Selection of sample of villages and facilities, hiring and training investigators
March 2002-May 2002:
Participatory resources appraisal
Beginning of Facility survey
June 2002-August 2003
Facility survey (continuing)
Household surveys