Rural Research

Rural Survey (Research Based)
Rural Survey
On
“Healthcare scenario in Rural India”
A project report submitted in partial fulfilment
Of
the requirements for the degree
of
Master of Business Administration (MBA)
Submitted to:
Dr.Yatish Joshi
Submitted By:
Utkarsh Sharma (2020MB39)
Shubhi Jain (2020MB36)
Saurabh Kumar (2020MB35)
Pragati Singh (2020MB26)
School of Management Studies

Motilal Nehru National Institute of Technology Allahabad
1
TABLE OF CONTENTS
UNDERTAKING i
CERTIFICATE ii
ACKNOWLEDGEMENT iii
CHAPTER-1 INTRODUCTION 1
1.1 Rural healthcare structure in India 1
1.1.1 Sub Centres (SCs) 1
1.1.2 Primary Health Centre (PHC) 2
1.1.3 Community Health Centre (CHCs) 2
1.2 Statistics of healthcare services in rural India 3
1.2.1 Shortfall of Human Resources at Sub-Centres (SCs) (Rural) (as on March 31, 2019) 3
1.2.2 Shortfall of Human Resources at Primary Health Centres (PHCs) (Rural & Urban) (as on
March 31, 2019) 5
1.2.3 Shortfall of Human Resources at Community Health Centres (CHCs) (Rural & Urban) (as on
March 31, 2019) 7
1.3 Challenges in rural healthcare system 10
1.4 Health issues faced by farmers in rural areas 10
1.4.1 Salient features of agriculture workers 11
1.4.2 Occupational health issues of farmers 11
1.4.3 Compensation schemes for agricultural accident victims 13
1.5 OBJECTIVES OF THE STUDY 13
CHAPTER-2 LITERATURE REVIEW 14
CHAPTER 3 - RESEARCH METHODOLOGY 26
3.1 Introduction 26
3.2 Research Question 26
3.3. Factors and Sample 26
3.3.1 Target factors 27
3.3.2 Sampling Technique 27
3.4 Sample Size 27
2
3.5 Questionnaire Design 27
3.6 Data Collection 28
CHAPTER 4: DATA ANALYSIS AND FINDINGS 29
4.1 Data from general public 29
4.2 Data from the doctors of rural healthcare centre 45
CHAPTER 5 - CONCLUSION 60
REFERENCES 62
Works Cited 65
3
LIST OF TABLES
Table 1:Gender Distribution ...................................................................................................... 29

Table 2: Age distribution of the respondents from general public .............................................. 30
Table 3: Annual income distribution of the respondents ............................................................ 31
Table 4: Responses on the rural healthcare centre visit .............................................................. 32
Table 5: Responses on any sickness or disease from the public.................................................. 33
Table 6: Responses on the availability of medicines .................................................................. 34
Table 7: Availability of female doctors...................................................................................... 35
Table 8: Average time spent by doctors ..................................................................................... 36
Table 9: Availability of period products .................................................................................... 37
Table 10: Facility of ambulance and blood bottles ..................................................................... 38
Table 11:Instances of medical negligence .................................................................................. 39
Table 12:Complying doctor patient confidentiality clause ......................................................... 40
Table 13: cleanness of the equipment & machines ..................................................................... 41
Table 14:improvement needed in the healthcare centre .............................................................. 42
Table 15: Treatment of COVID-19 Patients............................................................................... 43
Table 16: use of mask, sanitizers and social distancing .............................................................. 44
Table 17: State wise distribution ............................................................................................... 45
Table 18: No, of staff ................................................................................................................ 46
Table 19: No. of patients visit in a week .................................................................................... 47
Table 20: Condition of the testing and diagnostics equipment’s ................................................. 48
Table 21: Refer patient to city hospital ...................................................................................... 49
Table 22: Farmers health problems ............................................................................................ 50
Table 23: Quality of medicines .................................................................................................. 51
Table 24:benefit of the schemes provided by the government of India ....................................... 52
Table 25: Health issues faced by the women ............................................................................. 54
Table 26:: Gender Ratio ............................................................................................................ 55
Table 27: Knowledge regarding sex education .......................................................................... 56
Table 28: Awareness regarding safe sex .................................................................................... 57
Table 29: Availability of period products ................................................................................. 58
Table 30: Availability of Covid-19 testing ................................................................................. 59
4
LIST OF FIGURES
Figure 1: Gender Distribution ................................................................................................................ 29

Figure 2: Age Distribution of the general public respondents ................................................................. 30
Figure 3: Annual income Distribution of the Respondents ...................................................................... 31
Figure 4: Responses on visiting rural healthcare facility ......................................................................... 32
Figure 5:Response to sickness ............................................................................................................... 33
Figure 6: Availability of the medicines in the healthcare centre .............................................................. 34
Figure 7: Availability of the female doctors ........................................................................................... 35
Figure 8: Average time spent by doctors ................................................................................................ 36
Figure 9: Availability of period products ................................................................................... 37
Figure 10: Facility of ambulance and blood bottles .................................................................... 38
Figure 11: Instances of medical negligence in the hospital ......................................................... 39
Figure 12: Complying doctor patient confidentiality clause ....................................................... 40
Figure 13:cleanness of the equipment & machines .................................................................... 41
Figure 14: Improvement needed in the healthcare centre ........................................................... 42
Figure 15: Treatment of COVID-19 Patients ............................................................................. 43
Figure 16: use of mask, sanitizers and social distancing............................................................. 44
Figure 17: State wise distribution .............................................................................................. 45
Figure 18: No. of staff ............................................................................................................... 46
Figure 19: No. of patients visit in a week................................................................................... 47
Figure 20: Condition of the testing and diagnostics equipment’s ............................................... 48
Figure 21: Refer patient to city hospital ..................................................................................... 49
Figure 22: disease and sickness faced by the farmer: ................................................................. 51
Figure 23: Quality of medicines ................................................................................................ 52
Figure 24: benefit of the schemes provided by the government of India ..................................... 53
Figure 25: health problems faced by the women ........................................................................ 54
Figure 26:Ratio of male and female patients .............................................................................. 55
Figure 27: sex education knowledge .......................................................................................... 56
Figure 28: Awareness regarding safe sex ................................................................................... 57
Figure 29: Availability of period products ................................................................................. 58
Figure 30: Availability of Covid-19 testing ............................................................................... 59
5
UNDERTAKING
I declare that the work presented in this report titled “Rural research survey on Healthcare
scenario of Rural India” submitted to the School of Management Studies, Motilal Nehru National
Institute of Technology, Prayagraj for the partial fulfillment of the degree of Master of Business
Administration (MBA) is my original work. It is not submitted anywhere else for the award of any
other degree.
Date: 05/01/2021 Utkarsh Sharma (2020MB39)

Place –Prayagraj Pragati Singh (2020MB26)
i
CERTIFICATE
This is to certify that the project titled “Rural research survey on healthcare scenario of rural
India” being submitted by Utkarsh Sharma (2020Mb39), Shubhi Jain (2020Mb36), Surabhi
Kumar (2020MB35), and Pragati Singh (2020MB26) to School of Management Studies, Motilal
Nehru National Institute of Technology, Prayagraj in the partial fulfilment of the requirements for the
degree of Master of Business Administration (MBA), is a record of original work carried out by him
under my supervision and guidance.
Date: 05/01/2021
Dr.Yatish Joshi
Course Coordinator & Supervisor
ii
ACKNOWLEDGEMENT
We are highly thankful to Dr.Yatish Joshi for giving us the wonderful opportunity to study on the
'Rural research survey on Healthcare scenario of Rural India'.
We express our sincere gratitude to him for his guidance, suggestions and help in making the project.
Without his help it wouldn’t have been possible for us to complete the project.
We are also thankful to Dr. Rakesh Kumar, Research Scholars and Administrative Staff for their help
and guidance till the completion of our project work by providing all necessary information. We are
also thankful to our family and friends for their help and guidance. We express thanks to all those
people who helped us to complete this project successfully.
Utkarsh Sharma (2020Mb39)
Pragati Singh (2020MB26
iii
CHAPTER-1 INTRODUCTION
Health has always been one of the major concerns of the government and the public. Despite the
efforts of the government, private companies and the NGOs, the health index of India has been
deteriorating, especially that of rural India.
According to Rural Health Survey 2019, against the requirement of 5,335 physicians at CHCs,
there is a shortfall of 4,002. Against the requirement of 157,411 male health workers in SCs,
there is a shortfall of 98,063. In PHCs, there is a requirement of 21,340 specialist doctors. But
they face a shortfall of 17,459. PHCs must subscribe to Indian Public Health Standards
parameters in terms of infrastructure and manpower, according to the Economic Survey 2018-19.
Only 20 per cent PHCs in India fulfil these norms. (kaur, 2020)
Rural Health care is one of biggest challenge for the Health Ministry of India. This study will
help in analyzing the current situation of healthcare scenario in rural India and thereby
determining the causes of the poor health of people living in rural areas. We want to study about
Healthcare in rural area and medical facilities available to people and to know whether these
schemes are really benefitting the people. The focus of the study will also be to analyse the
health conditions of farmers in rural areas, the health issues faced by them and to identify if the
farmers are benefitted by the health schemes provided by the government.
1.1 Rural healthcare structure in India

The National Rural Health Mission (NRHM) was launched on 12th April 2005 throughout India
with a commitment of the government to carry out the necessary architectural corrections in the
basic health care delivery system. Under NRHM the healthcare system in India has been
developed as a three tier based which consists of:
1.1.1 Sub Centres (SCs)

The Sub Centre is the most peripheral and first contact point between the primary health care
system and the community.
1
Sub Centres are assigned tasks relating to interpersonal communication in order to bring about
behavioural change and provide services in relation to maternal and child health, family welfare,
nutrition, immunization, diarrhoea control and control of communicable diseases programmes.
Each Sub Centre is required to be manned by at least one auxiliary nurse midwife (ANM) /
female health worker and one male health worker. Under National Rural Health Mission
(NRHM), there is a provision for one additional second ANM on contract basis. One lady health
visitor (LHV) is entrusted with the task of supervision of six Sub Centres. Government of India
bears the salary of ANM and LHV while the salary of the Male Health Worker is borne by the
State governments.
1.1.2 Primary Health Centre (PHC)

PHC is the first contact point between village community and the medical officer.
The PHCs were envisaged to provide an integrated curative and preventive health care to the
rural population with emphasis on preventive and promotive aspects of health care. The PHCs
are established and maintained by the State governments under the Minimum Needs Programme
(MNP)/ Basic Minimum Services (BMS) Programme.
As per minimum requirement, a PHC is to be manned by a medical officer supported by 14

paramedical and other staff. Under NRHM, there is a provision for two additional staff nurses at
PHCs on contract basis. It acts as a referral unit for 6 Sub Centres and has 4-6 beds for patients.
The activities of PHC involve curative, preventive, promotive and family welfare services.
1.1.3 Community Health Centre (CHCs)

CHCs are being established and maintained by the State government under MNP/BMS
programme.
As per minimum norms, a CHC is required to be manned by four medical specialists i.e. surgeon,
physician, gynaecologist and paediatrician supported by 21 paramedical and other staff. It has 30
in-door beds with one OT, X-ray, labour room and laboratory facilities.
It serves as a referral centre for 4 PHCs and also provides facilities for obstetric care and
specialist consultations. (Vikaspedia, 2020)
2
1.2 Statistics of healthcare services in rural India
The shortage of human resource in public healthcare facilities varies from state to state
depending upon their policies and context.
The following data is based on Rural Health Statistics 2018-19.
As per Rural Health Statistics 2018-19 — as on March 31, 2019 — brought out by the Ministry
of Health and Family Welfare based on the information provided by states and UTs, the state/UT
wise number of shortfall of physicians (specialists, doctors and general duty medical officers),
nurses and other health workers at sub-centres (SCs), primary health centres (PHCs), community
health centres (CHCs) and across India are given in this report.
1.2.1 Shortfall of Human Resources at Sub-Centres (SCs) (Rural) (as on March 31, 2019)
ANM/Health Worker (Female )& Health

S. No. State/ UTs
Worker (Male)
1 Andhra Pradesh 107
2 Arunachal Pradesh 108
3 Assam *
4 Bihar *
5 Chhattisgarh 563
6 Goa 166
7 Gujarat 1761
8 Haryana *
9 Himachal Pradesh 1856
10 Jammu & Kashmir 824
3
11 Jharkhand 389
12 Karnataka 8038
13 Kerala 2382
14 Madhya Pradesh 5871
15 Maharashtra *
16 Manipur *
17 Meghalaya *
18 Mizoram *
19 Nagaland 62
20 Odisha 1988
21 Punjab 247
22 Rajasthan 13848
23 Sikkim 105
24 Tamil Nadu 6499
25 Telangana 193
26 Tripura 730
27 Uttarakhand 1910
28 Uttar Pradesh 10749
29 West Bengal *
30 A& N Islands *
4
31 Chandigarh 0
32 D & N Haveli *
33 Daman & Diu *
34 Delhi 10
35 Lakshadweep *
36 Puducherry 67
All India/ Total 58,473
*: There is a Surplus of ANM / Health Worker (Female)some of States/UTs
1.2.2 Shortfall of Human Resources at Primary Health Centres (PHCs) (Rural & Urban)
(as on March 31, 2019)
Lab Nursing
S. No. State/ UTs ANM/HW (F) Doctors Pharmacists
Technicians Staffs
Andhra
1 2214 * 524 746 *
Pradesh
Arunachal
2 * 26 89 93 *
Pradesh
3 Assam * * * * *
4 Bihar * * 1610 1541 543
5 Chhattisgarh * 454 114 313 *
6 Goa * * * 1 *
7 Gujarat 582 * 75 188 *
5
8 Haryana * * 122 242 *
Himachal
9 494 98 376 563 381
Pradesh
Jammu &
10 213 * * 84 *
Kashmir
11 Jharkhand * * 244 239 205
12 Karnataka 1740 70 413 909 *
13 Kerala * * * 483 *
Madhya
14 346 164 360 854 584
Pradesh
15 Maharashtra * * 619 1101 800
16 Manipur * * * 44 *
17 Meghalaya * * * * *
18 Mizoram 67 * 11 * *
19 Nagaland * * 32 55 *
20 Odisha 470 453 95 1229 777
21 Punjab 183 * * 66 *
22 Rajasthan 608 287 1596 961 *
23 Sikkim * * 16 0 *
24 Tamil Nadu 306 * 581 1235 *
25 Telangana 1134 * 323 293 *
6
26 Tripura * * * 16 *
27 Uttarakhand 122 * 57 242 196
28 Uttar Pradesh 403 380 1599 3172 3560
29 West Bengal 2797 * 123 850 *
30 A& N Islands * * * 12 *
31 Chandigarh 115 0 * 32 34
32 D & N Haveli * * * * *
33 Daman & Diu 4 1 0 0 *
34 Delhi 1025 * * 298 489
35 Lakshadweep * * * * *
36 Puducherry * * * 13 *
All India/Total 12823 1933 8979 15875 7569
*: There are a surplus of ANM/HW, doctors, pharmacists, lab technicians and nursing staffs in
some of states/UTs.
1.2.3 Shortfall of Human Resources at Community Health Centres (CHCs) (Rural &
Urban) (as on March 31, 2019)
Lab
Specialist GDM Radiogra Pharmacist Nursin
S. No. State/ UTs Technician
s O -phers s g Staff
s
1 Andhra Pradesh 403 62 127 36 64 *
2 Arunachal Pradesh 248 11 46 17 0 *
7
3 Assam 571 * 88 * * 22
4 Bihar 518 * 149 98 * 716
5 Chhattisgarh 635 * 13 * * *
6 Goa 15 0 * * * *
7 Gujarat 1351 * 184 52 21 46
8 Haryana 491 * 71 * * *
9 Himachal Pradesh 371 * 67 15 57 432
Jammu & Kashmi

10 94 * * * * *
r
11 Jharkhand 640 * 118 * * 106
12 Karnataka 343 196 40 * 24 339
13 Kerala 876 * 229 * 211 233
14 Madhya Pradesh 1191 31 96 * * *
15 Maharashtra 778 175 243 * * *
16 Manipur 89 * * * * *
17 Meghalaya 108 * 10 * * *
18 Mizoram 36 3 4 1 * 12
19 Nagaland 76 9 18 * * *
20 Odisha 1258 * 317 * * 552
21 Punjab 486 * * * * *
22 Rajasthan 1885 * 229 87 87 *
8
23 Sikkim 8 0 * 0 * *
24 Tamil Nadu 1407 * 308 * * 713
25 Telangana 70 * 41 21 28 *
26 Tripura 86 * 10 * * *
27 Uttarakhand 241 * 62 * 19 201
28 Uttar Pradesh 2280 604 609 * 116 *
29 West Bengal 1269 * 183 * * *
30 A& N Islands 16 8 4 * * *
31 Chandigarh * * * * * *
32 D & N Haveli 8 0 0 * * *
33 Daman & Diu 3 * * * * *
34 Delhi * * * 0 * *
35 Lakshadweep 12 * * * * *
Publi
Puducherry 13 * 0 * * *
c 36
All India/ Total 17876 1099 3266 327 627 3372
*: There are surplus of specialists, GDMO, radiographers, pharmacists, lab technicians and
nursing staff in some of states and UTs.
health being a state subject, all the administrative and personnel matters, including that of
recruitment of specialist doctors in public health facilities lie with the respective state
governments. (Bureau, 2020)
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1.3 Challenges in rural healthcare system
The main challenges confronting the public hospitals in today’s context are :
● Deficient Infrastructure
● Lack of manpower
● Poor condition of medical equipments in public healthcare units
● Low trust of people of rural areas on hospitals
● Lack of awareness about health issues
● Health issues faced by the farmers
● Improper implementation of government healthcare schemes
● Non preparedness to fight with epidemic in rural areas
● Dominance of unregulated Private medical professionals
● Inclination towards home based deliveries
● Lack of community participation
1.4 Health issues faced by farmers in rural areas
Agriculture is not a safe occupation. Agricultural workers face a large number of health
problems in the form of physical factors like extreme weather conditions, sunrays, etc.; chemical,
toxicological hazards in the form of pesticides/fertilizers, etc. many of which arise from their
work.
With the expansion of agricultural technology there is growing concern that agricultural workers
will face, new occupational health and safety hazards, in addition to traditional health risks.
Many new techniques and processes are being introduced to improve efficiency in agricultural
production. However, they may also give rise to health problems that are not readily recognized.
(Shaifali Mathur, 2014)
10
1.4.1 Salient features of agriculture workers
● The work is carried out in the open air, exposing the workers to climatic conditions.
● The work is of a seasonal nature and certain tasks are urgent in specific periods.
● The same person must perform a variety of tasks.
● There is great variation in working postures and the length of the tasks performed.
● Contact with animals and plants bring exposure to bites, infections, allergies and other
health problems.
● There is contact with chemical and biological products viz: pesticides, rodenticides
● A variety of machines are used.
● Emergency services are often delayed in me of accidents due to the remoteness of a high
percentage of the work sites.
● The worker's home is often embedded in the farm for a high percentage of farm
populations, increasing the risk of farm-related accidents to children.
● There are high proportions of young and old workers.
1.4.2 Occupational health issues of farmers
Respiratory hazards
● Asthma and rhinitis: Immunoglobin Emediated asthma

● Non-immunologic asthma (grain dust asthma)
● Mucous membrane inflammation
● Bronchospasm, acute and chronic bronchitis
● Hypersensitivity pneumonitis
● Bagassosis
● Farmer's lung
● Maple bark stripper's disease
● Wheat weevil disease
● Grain fever
● Silo unloader's syndrome
● Tuberculosis
Skin hazards
● Irritant contact dermatitis
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● Grain itch
● Allergic contact dermatitis
● Tulip Finger
● Sun induced dermatitis, lip cancer
● Heat induced dermatitis
Injury hazards
● Fatalities
● Crushing of the chest, extravasations (escape of fluids-e.g., bloodand surrounding tissue)
● Hypovolemia (loss of blood), sepsis and asphyxia
● Electrocutions
● Non-fatal injuries, injury infection (e.g., tetanus)
● Friction burns, crushing, neurovascular disruption, avulsion, fractures, amputation
● Skin or scalp avulsion or de-gloving, multiple blunt injury, amputation
● Hand injuries (friction burns, crushing, avulsion or degloving, finger amputation)
● Serious or fatal burns, smoke inhalation
● Tetanus
Mechanical and thermal stress Hazards
● Tendon-related disorders (tendinitis, tenosynovitis)

● Carpal tunnel syndrome
● Reynaud’s syndrome
● Degenerative changes, low-back pain, intervertebral disk herniation; peripheral nerve and
vascular, gastrointestinal and vestibular system injuries
● Hearing loss
● Heat cramps, heat exhaustion, heat stroke
● Frost nip, chilblains, systemic hypothermia
Behavioural hazards
● Depression, anxiety, suicide, poor coping

● Interpersonal illness
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1.4.3 Compensation schemes for agricultural accident victims
● Schemes operated by State Agricultural Marketing Boards in Punjab and Haryana
● KrishakSaathiYojna in Rajasthan
● KhatedarKhedutAksmikMruitu/ Apangata Sahay Yojna in Gujarat
● Farmers Janta Accident Insurance Scheme in Maharashtra
● Farmers Janta Accident Insurance Scheme in Uttar Pradesh
● Krishak Kalyan Yojna in Madhya Pradesh
1.5 OBJECTIVES OF THE STUDY

● To study of the current situation of the Healthcare facilities in the rural India and find out
the underlying causes of the deteriorating health condition.
● To study about health issues faced by the farmers.
● To analyze the accessibility and affordability to the public healthcare units by the people
in the rural areas of India.
● To analyze the quality of healthcare services provided in the public healthcare units.
● To find the problems faced the Doctors in the hospitals.
● To study about the health issues faced by the farmers
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CHAPTER-2 LITERATURE REVIEW
Ashok VikhePatil, (et.al) (2002): In their paper on “Current Health Scenario in Rural
India”. They attempt to analysis critically the current health status of India, with a special
reference to vast rural population of the beginning of the 21st century. The author concentrated
to improve the prevailing situation, the problem of rural health both in macro and micro level in
a holistic way, to bring ensure good health for poorest of population. He applied the model that, a
paradigm shift from current „biomedical model‟ to a „socio-cultural model‟ is required to meet
the needs of the rural population.
ShashidharS.Mathapati (2002) made a study on “Environment and Health in Belgaum

Division of Karnataka State- a Spatial Analysis”. He attempts to explain the Environment
conditions of the study area to know the prevalence of various diseases and causes of the
diseases are linked to the geographical surrounding and to the socio-cultural factors. He also
concentrates on Utilization pattern of healthcare facilities to minimize the health problems. The
study is confined only to the government health centres and major diseases their causative
factors. Author concluded that, the present research has done in improving the health literacy and
provide better facilities for improvement of public health by proper planning, organizing and
establishing of the healthcare system both in rural and urban areas.
Luo Wei and Wang Fahui (2003) “Measures of Spatial Accessibility to Healthcare in a GIS
Environment: Synthesis and a case study in the Chicago City”, in this article the authors have
Synthesized two GIS- based accessibility measures into one frame work and applied the methods
to examine spatial accessibility to primary healthcare in the Chicago ten-country region. In this
article author used Floating Catchment Area (FCA) method which defines the service area of
physicians by their surrounded demands. The gravity-based method considers a nearby physician
more accessible than a remote one and discounts of physician‟s availability by a gravity-based
potential. Here former is a special case of the latter. Based on the 2000 census and primary
physician data, this article assess the variation of spatial accessibility to primary care in the
14
Chicago region and analysis the sensitivity of results by experimenting with ranges of threshold
travel times is a FCA method and travel friction co-efficient in the gravity model.
Shankar. K.N and SathishSelvakumar (2003), have worked on “Spatio-info Health map-
A Health GIS application”, in this article the author analyzed to implement a custom GIS
application which would be an interactive spatial North Asian International Research Journal of
Multidisciplinary ISSN: 2454 - 2326 Vol. 1, Issue 5 October 2015 North Asian International
research Journal consortium www.nairjc.com 5 analysis tool enabling the health officer to
perform re-distributing, re-locating health jurisdictions for effective utilization of health
infrastructure. Methodology was done in two phases, phase-1 activity was to create the health
jurisdiction for the entire Karnataka state, created a template and sent to each District Health
Office to collect PHC and Sub-Centre data. This list was mapped to the village boundary and
entire PHC & SC jurisdiction was compiled. Phase-2 activity develops a custom GIS software
specific to the needs of the Health Department. Based on the uses requirements specification
document was prepared and circulated with the department for feedback and approval. Outcome
of this robust GIS software with specific tools catering to Health Department.
Gary Higgs (2004): “A Literature Review of the Use of GIS-Based Measures of Access to
Health Care Services”: In his article he attempts to analyze the use of GIS-based measures in
exploring the relationship between geographic access, utilization, quality and health outcomes.
The varieties of approaches taken by him concerned with testing out the relative importance of
geographical factors that may influence access are examined. He also concentrated on critically
evaluates the situation with regard to the use of such measures in a broad range of accessibility
studies using GIS and GPS. However, this review of the literature has also drawn attention to the
different definitions attached to the term accessibility in health concept it highlighted some
conceptual issues with the application of GIS.
Luis Rosero-Bixby (2004): wrote an article entitled-“Spatial access to healthcare in Costa

Rica and its equity: a GIS-based study” this article reports a GIS based analysis of access to
healthcare by the Costa Rican population according to 2000 census. He discuss that, it is
important to know the supply and demand of health services and to understand how these two
factors converge in accessibility of health services for the population, in order to monitor and
15
evaluate the impact of current reforms in the health sector in the study area. The author has
concluded by studying the map of access to health services allowed to identify geographic
inequities and to pinpoint specific communities in need. He has shown the study region need to
centrally organize a complete healthcare by feasibility of using GIS technology for monitoring
and evaluating the reform process and to optimize decisions on location allocation to make
access more equitable.
Mark F Guagliard (2004) has studied the “Spatial accessibility of primary care: concepts,
methods and challenges”, He analyze the basic concepts and measurements of access, provides
some historical background, outlines the major questions concerning geographic accessibility of
primary care, describes recent developments in GIS and spatial analysis, and presents examples
of promising work.
Wei Luo (et.al) (2004):They contributed a joint paper on “Temporal Changes of Access to
Primary HealthCare in Illinois (1990-2000) and Policy Implications”. In this paper the authors
have examined temporal changes of access to primary health care in Illinois “between” 1990-
2000, by using GIS. Census data were used to define the population distribution and related
socio economic data were used to measure the non spatial access. Both the spatial and non
spatial data were used to access the primary shortage areas. By this study the author identify that
spatial accessibility to primary care are majority of the state was improved from 1990-2000.
Areas with worsened spatial accessibility were primarily concentrated in rural areas and limited
in urban areas, mainly because of population with high scores of socio economic disadvantages
and socio cultural barriers, and healthcare needs. He suggest to improving those disadvantaged
population groups for the success of future policies.
Fahui Wang & Wei Luo (2005), have worked on “Assessing spatial and non-spatial factors
for healthcare access: towards an integrated approach to defining health professional shortage
areas”, in this article authors have discussed about Spatial access the importance of geographic
barrier between consumer and provider, and non-spatial factors include non-geographic barriers
or facilitators such as age, sex, ethnicity, income, social class, education and language ability. A
two-step floating catchment area method is implemented in Geographic Information Systems is
used to measure spatial accessibility based on travel time. Secondly, the factor analysis method is
16
used to group various sociodemographic variables into three factors: (1) socioeconomic
disadvantages, (2) socio-cultural barriers and (3) high healthcare needs. Finally, spatial and non-
spatial factors are integrated to identify areas with poor access to primary healthcare. The
research is intended to develop an integrated approach for defining Health Professional Shortage
Areas (HPSA) that may help the US Department of Health and Human Services and state health
departments improve HPSA designation.
Michael Black (et.al) (2005) : have worked on “Using GIS to Measure Physical Accessibility
to Health Care”. In this article they have analysis two possible methods for measuring and
analyzing physical accessibility to health services using several layers of information integrated
in a GIS. These methods are presented and compared in relation to a particular public health
problem in Central America; they selected only PHC to identify accessibility problems using
GIS. Mainly author discussed the benefits for better health planning and policy development
through the use of this method before describing potential improvement to the models in the
future. By this study it will provide information to assist the restricting of health resources for
disadvantaged population in their study area.
Carsten Butsch (2007), has studied the “Access to healthcare in the fragmented setting of
India‟s fast growing agglomerations” UNO Summer Academy for Social Vulnerability, in this
article author discussed about India‟s healthcare sectors, healthcare problems in India, taken
Pune as research area, mapped healthcare facility centres. The major finding of the article is the
rapid urbanization lead to disparities in the access to healthcare.
M. NawalLutfiyya, (et.al) (2007): have worked on “A Comparison of quality of care

indicators in urban acute care hospitals and rural critical access hospitals in the United States”. In
this paper the author was compare the quality of hospital care provided in urban acute care
hospitals to that provided in rural critical access hospitals. In this paper cross sectional study
analyzed, secondary hospital data were compared and T-test was computed on weighted data to
ascertain of differences were statistically significant. They had taken examples for 8 of the 12
hospital quality indicators the different between urban and rural access hospitals. In 7 instances
these differences favored urban hospitals. One indicator related to favored rural hospitals. In
findings suggested that there may be differences in quality in rural critical access hospital and
17
urban acute care hospitals and support the need for future studies by highlighting the disparities
between urban acute care and rural critical access hospitals.
Allan Brimicombe& Yang Li (2008) , have worked on “Spatial Analysis of Accessibility to

Health Services in Greater London”, the authors have analyze the spatial analysis of accessibility
to health and health related services with the objective of contributing such analysis to the
modeling and planning of social infrastructure at the level of the Primary Care Trust. The
facilities analyzed are: GP Surgeries, dental surgeries, pharmacies, opticians, general hospitals
and bus stands (as an example of access to the public transport network). The three techniques of
mapping accessibility are used, concentric circles of Euclidean distance around facilities show
general coverage of an area and are simple to carryout using standard buffering techniques in
Geographical Information System, and Drive time along a road network outwards from a facility
is more sophisticating and relies on specialist functionality within GIS.
Diego F. Angel (et.al) (2008):They contributed a joint paper on “Equity, Access to Health
Care Services and Expenditures on Health in Nicaragua” (Atlantic Region). They discuss in the
study area the basic facilities still large inequities in access and quality of health services across
socio-economic groups and regions. Particularly in rural areas poor people who engaged in
agriculture they have below-average access to healthcare services and preventive care. The
authors have highlighted the problems like long distances, lack of medicines, and high costs are
the main constraint. They also face several main challenges in order to improve the health status
of its population. Inefficiencies in the allocation and utilization of resources, low levels of
financial protection, high expenses for the poor, difficulties in access to and poor utilization of
health care services, an unregulated private sector and limited capacity.
Ann Graves (2009): has studied the “A model for Assessment of Potential Geographical
Accessibility- A case for GIS”: In this paper he made an attempt to identify the need for
strategies to improve access to healthcare services and to support improvement of health
outcomes in the United States. Because to increase the quality of life and to eliminate health
disparities (Social and political issues) in healthcare access and health outcomes. The author also
uses the Andersen Behavioral model for health services it provides one approach to access to
18
health services. He concluded that GIS technology can be of great value in health planning, the
development of health policies and the allocation of healthcare resources.
Lakshmi.K (2008) “Rural Health Care Access -A case study of Madurai district”. The study
mainly concentrates on Primary healthcare services in village level, block level and their
infrastructure facilities in rural areas of Madurai district. The author made an attempt to identify
the gap between the availability and requirement of quality health care to rural areas. It also
concentrates the problem areas for improvement of primary healthcare in rural area of Madurai
district.
RajivSharma, (et.al), (2009): They contributed a joint paper on “GIS-Health Infrastructure

mapping for Andhra Pradesh State”. In their article they have analyzed the distribution and
functionalities of health facilities in a serviceable area with proximity to their respective village
using GIS and they also apply web application in health to get accurate information to support in
decision making activities like planning infrastructure, to create new facilities based on gap
analysis which can be determined on the basis of the spatial distribution of existing facilities. The
authors concluded that by the application of management information system, which may further
help in analyzing different parameters. Such as, disease spread, disaster management under
major health calamities, providing the immediacy of facility form an emergency services.
Nasser Bagheri, George L. Benwell and Alec Holt (2005) , have worked on “Measuring
Spatial Accessibility to Primary Healthcare”, discussed about a new approach for calculating
spatial accessibility to primary healthcare services. The results showed the best route with
shortest time.
Nagarajan N.S (2006): has studied the “Health Education among the Rural People in Tamil
nadu-A Sociological study”: The study was based on the secondary data. In this article the author
discuss the socio-economic status, health education, current policies and programs in
Kanyakumari district of Tamil nadu state. Socio-economic plays an important role on the health
behavior of the Kanyakumari district and suggests more realistic approaches for promoting the
health education among these areas.
19
MilindDeogaonkar (2004) , has studied the “Socio-economic Inequality and its effect on
Healthcare Delivery in India: Inequality and Healthcare”, he attempts to review the effects of
growing Socio-economic inequality in Indian population and its effect on the healthcare system.
It tries to identify the factors responsible for the difficulties in healthcare delivery in an unequal
society and its effect on the health of a society.
Dhanashri.S.Shinde (2010): has studied the “Spatial Analysis of Health Facilities in

Maharashtra‟s South Konkan Region”. The study is mainly based on secondary sources. In this
article the author discussed about the spatial distribution of various health facilities and
formulate the composite health facility index (CHFI) using the ranking coefficient method. By
this method they highlighted the glaring disparities. Finally the author concluded in the study
area the distributional pattern of medical facilities clearly reveals that only 10% of the total
population largely, concentrated in the urban areas is relatively better served, whereas over 90%
remains underserved. The accessibility and efficiency of the existing health facilities was
evaluated while making future plans for the development of health facilities in the region.
Price Water House Coopers (July 2010) , has studied the “Access to Healthcare:
Challenges and Solutions”, the author discusses about the healthcare scenario and challenges in
access. In this article he briefed about the healthcare system goals, healthcare in India and about
the government spending on healthcare, latter studies about access to healthcare is limited by
Dysfunctional physical infrastructure, lack of adequate human capital and poor healthcare
financing.
T. V. Sekher has studied the “Health Care for the rural poor: Decentralization of health services
in Karnataka, India”. The delivery of health services in India remains poor, particularly in rural
areas, due to lack of infrastructure and personnel, financial constraints, lack of awareness, poor
accountability and transparency. Though the networks of the department have spread to almost
every village, the availability and utilization of the services continue to be very poor and grossly
inadequate. The whole idea of decentralized governance is based upon some key factors like
people‟s participation, accountability, transparency and fiscal transfers. Our observations from
Karnataka indicate that placing health services system under the control of Panchayat Raj
institutions has resulted in an overall improvement in the services delivery. The health personnel
20
are found to be accountable to people and there is a significant improvement in the attendance of
doctors and paramedical staff in discharging their duties under the watchful eyes of the local
leaders. This has resulted in better functioning of PHCs and CHCs and improved utilization of
public health care facilities. Karnataka provides a good opportunity for Panchayat Raj
institutions {PRIs} to demonstrate their capability in improving the health service delivery for
the benefit of the poor. The author concluded by saying we need to wait and see how effectively
PRIs can be used as a vehicle for better health service delivery. This, to a great extent, depends
upon the cooperation, coordination and mutual trust between health bureaucracy and Panchayat
leadership.
Divya.S and Chandrashekara.B (2012), they contributed joint paper on “Assessing the
availability of Primary health care services in Chamarajanagara District using Kernel Density
Estimation”. In this paper the authors discussed the availability of Primary health care Centres in
Chamrajanagar District using Kernel Density Estimation for assessing population coverage of
health services. By using the kernel density estimation they calculated accessibility rations such
as population to Primary Health Centre and Population to Health Workforce. They find out that,
the health centres are unevenly distributed throughout the district. The article seeks to build
further multiple types of accessibility to assess population coverage of services.
AnkitaMisra,(et.al), (2005): They contributed a joint paper on “A GIS Based Analysis Of

Health Care Services In The City Of Pune”. They attempts to analysis Distribution of hospitals
and diseases using GIS, availability and utilization of healthcare facilities in Pune District. The
author Concluded that healthcare services in the district was well served but in some parts of
study area the roads are lacking in hospital services and recommended possible areas for the
setting up of new hospitals in Pune District. Shanon et al 1973 Utilization of health services has
mainly looked in terms of access, in relation to geographical distance and time. Access to health
care services is linked to the distance of the facility and also the time involved reaching there by
the ill person.
Ronald Anderson and John.F.Newman (2005)have worked on “Societal and individual

determinants of medical care utilization in the United States”, they discussed that the healthcare
utilization is emphasized by, the characteristics of the health services delivery system, changes in
21
medical technology, individual determinants of utilization. Author explained that these three
factors are specified within the context of their impact on the healthcare system.
Jonathan B. Baker &. Lin Liu (2006) “The determinants of primary health care utilization: a
comparison of three rural clinics in Southern Honduras”: The author has explained that primary
healthcare utilization is poorly understood in many parts of the developing world. This is
especially true in rural places, such as Santa Lucia, Intibucá, Honduras, where there are only 3
primary health care facilities servicing almost 12,000 people, and generally the author speaking
access to care is limited. The author mainly examines the factors that can be used to explain the
primary healthcare utilization and aims to improve the understanding of patient utilization
behaviour. A better understanding of utilization can be used by health services planner to
improve primary health care delivery in this and similar locations. The findings of this research
indicate that utilization can be explained, to a large extent, by factors relating to economic status
and walking time to clinic. This suggest a strong “distance decay” of utilization pattern based on
estimated walking time to clinics and is consistent with other rural developing world health
service research. The author has generally concluded of this research that people attending the
government-based rural health centres exhibit distinctly different spatial patterns of utilization
than do those who attend the private health clinic. Therefore, the same model should not be used
to examine both types of primary care services. This conclusion contributes to developing sound
health policy.
Albert Christopher Dhas&M.Helen Mary Jacqueline (2008) they contributed a joint

paper on “Trends in Health Status and Infrastructural Support in Tamil Nadu”. In this article the
author analysis the health status in Tamil Nadu and to highlight the major issues on it. The health
scenario of Tamil Nadu was examined, based on certain selected health indicators and the extent
of health infrastructure available in the state and its utilization were discussed. The author
concluded that though the study area seems to have performed better compared to all India
average in demographic and several health indicators. But the demographic indicators and vital
statistics indicate very high of Tamil Nadu in term of health performance, there are several areas
in which improvements are possible. Particularly, Infant mortality and maternal mortality rates
could be brought down further and major diseases could be controlled and reduced further.
22
Dalal K &Dawad S (2009):have worked on “Non-utilization of public healthcare facilities:
examining the reasons through a national study of women in India”. The study mainly based on
Secondary data. In this article the authors examine women’s opinion about their reasons for the
no utilization of appropriate public healthcare facilities according to categories of their
healthcare seeking in India. The authors explain that the majority of Indian families do not use
public healthcare facilities mainly because of inconvenient and poor quality. So, he concludes
that the redistribution of public healthcare facilities will help address established of rural
disadvantages. So, improved the quality of care is necessary steps to reducing maternal mortality
and poverty.
Wan and Soifer (1974): “Determinants of Physician utilization- A Casual Analysis”, has
discussed the most important factors related to health service utilization are the need for care
(illness level) average cost per visit, health insurance coverage and age. Other variables either
have an indirect or negligible effect.
Milly Katana (2005): has made an intensive study on “Utilization of Formal Healthcare
services and Associated factors in Uganda: A Case study of Luweero District”, he argued that the
level of utilization of health care service in Uganda remains very low. The low level negatively
affects the quality of life of many Ugandans who remains outside the healthcare delivery system.
The descriptive cross-sectional study was carried out to establish the level of utilization of health
care services among the district, to determine the factors promote or hinder use of health care
services in the formal health care system. The author also carried out the study related to
establish the types of health facilities through which people got care. The findings of this
research indicate to support both district health planners, health managers at the central level, to
design better strategies that will improve utilization rates of health care services.
Trish Prosser (2007): have worked on “Utilization of Health and Medical services: factors
influencing health care seeking behaviour and unmet health needs in rural areas of Kenya”. The
author studied that factors which influence the use of health and medical services, specifically
health care seeking behaviour in the study area. The study was conducted in three geographically
area of Kenya: one coastal, one semi-arid, and one within the Lake Victoria basin, by using
questionnaire to achieve demographic and socio-economic data, as well as information relating
23
to the activities of people. Multivariate analyses are used in this study. The current study also
highlighted the importance of access issues to health care seeking. These factors involved costs
associated with seeking treatment, distance and the time taken to travel to health care facilities.
The author finds out that many people would not use hospitals or health centres or other types of
formal care, even though they would prefer to, because there was some access issue, either with
the time taken to travel the distance or the type of facility that was closest.
Ateeque Ahmad, (et.al) (2009): have worked on “Micro Regional Planning of Health
Facilities in Bulandshahr District”: In this article the author discusses about the distribution
pattern of health facilities, and levels of development of educational facilities, to devise a micro
regional plan for better access of health facilities in Bulandshahr District of U.P. This study is
mainly based on secondary sources of data. A diagnostic planning has been proposed based on
qualitative and quantitative methods are used in this article to achieve the goal of attaining
balanced regional development. The author by keeping in view the number of facilities existing
in 2001, he proposed the number of health facilities for 2021 to achieve the balanced standard of
functional level for growing population.
Roger Strasser (2003): “Rural health around the world: challenges and solutions”. In this
article the author has discussed that the major challenges facing rural health around the world, he
reviewed the problems, he attempted to analysis that the immense challenges are taken for
improving the health of people of rural and remote areas of the world and initiated a specific
action plan are taken like, The Global initiative on rural health plan. The health for all rural
people is too achieved through the concentrated efforts of both international and national
working peoples like doctors, nurses, and other health workers in rural areas around the world to
give “Health for All Rural People” it focused world attention on rural health and marked the
beginning of a new era for improving the health and well-being of people in rural and remote
areas of the world.
Hilary Graham and Micheal.P.Kelly (2004):“Health Inequalities: Concepts, frameworks

and policy” in this article author tried to highlight some of the conceptual issues relating to
socio-economic inequalities in health. The first section discusses how people have been
classified in the UK and how, using the traditional measures to socio-economic position, the
24
challenge of health inequalities is being addressed. The second section focuses on
„determinants‟, a core term in the drive to reduce health inequalities and discusses the difference
between determinants of health and determinants of inequalities in health. The distinction
between the idea of health disadvantage, health gaps and health gradients is explored in the third
section. The paper therefore makes explicit some of the key terms used in the debates about
health inequalities to help inform the process of policy development.
AnujBariar, (et.al), (2004): In their paper on “Development of GIS Based Spatial Data
Infrastructure for Micro-Level Planning”. In this article they focus on the development of spatial
data infrastructure at village level for a part of Allahabad district of Uttar Pradesh state under
GIS environment. They made an analysis of the Allahabad district infrastructure facilities using
GIS, it is helpful in the planning and development of rural infrastructure specially healthcare
facilities. Finally, they have finded by observing the maps that there is a urgent need for setting
up more schools and enhancing health services in the shankargarh block of Allahabad district. A
GIS based spatial data infrastructure has been developed for a part of Allahabad District in the
present work for planners and decision maker for making more informed decisions. These will
useful to administration and resource mobilization as well as help in decision-making for micro
level planning.
25
CHAPTER 3 - RESEARCH METHODOLOGY
3.1 Introduction
The methodology used to conduct research is mentioned in this chapter. It helps in developing
plan to proceed to conduct the research. This chapter also tells about Research Question,
Population and Sample to be surveyed, method of data collection and Questionnaire design to be
used for the study.
The purpose of this study is to get the answers about Healthcare Services in Rural area and
Farmer Health. The type of research is descriptive type since it explores and describes variables’
relationship, the way they occur without manipulating them. The descriptive study is aimed at
obtaining information can be subjected to analysis, extraction of patterns and drawing of
comparisons for clarification purposes and provision of making decisions platforms.
3.2 Research Question

How much the villagers of “Gonda,Satna and Motihari” Village of Uttar Pradesh,Madhya
Pradesh and Bihar respectively arebenefited from the services in rural area and farmer health
with respect to their education.
The questions are tested by looking various factors such as education, family size, population,
gender ratio,Age, Government schemes and financial conditions of villagers.
3.3. Factors and Sample

The following factors were considered while doing the research-
(1). Population.
(2). Gender
(3). Age
(4). Higher class
(5). Middle class
26
(6). Lower class
(7). Education
3.3.1 Target factors

Target factors include Population of villagers of Gonda,Satna and Motihari which is in Uttar
Pradesh , Madhya Pradesh and Bihar respectively.
It includes Gender i.e., the total numbers of male and female in all those villages.
It includes Age i.e., the different age group (children, young, old) villagers in that village.
It includes the different categories of class such as higher class (rich), middle class (neither rich
nor poor) and lower class (poor).
It also includes the total educated or uneducated villagers of the village.
3.3.2 Sampling Technique

Simple random sampling in field survey, snow ball sampling and social media is the technique
used for completion of project and getting a general view on our topic. Due to pandemic
situation we also float the questionnaire in online mode like – WhatsApp, Facebook, Google
forms and Instagram. Primary data was collected from respondents via Google Forms which
were circulated through various social networking sites.
3.4 Sample Size

The sample size for this survey is taken to be 98 for general public and 40 for doctors, belonging
to various age groups, gender and having different educational qualification. The size taken
completely reflects the total of people living in villages.
3.5 Questionnaire Design

An extensive literature survey was carried out to develop the construct for the study in the form
of questionnaire. It focuses on obtaining information relating to demographic factors as age,
gender, educational qualification which were asked through nominal questions in Sections.
27
Thiswill help us to identify whether by changing the statement, the respondent’s response
remains consistent, the meaning of the statement being unchanged.
Questionnaire has been designed after considering the following points-
(a) Various problems faced by villagers in day-to-day life.
(b) Education level of the villagers.
(c) Government schemes and subsidies whether reaching to them or not.
(d) Knowledge about government schemes.
(e) Government infra structure is sufficient for villagers or not.
3.6 Data Collection

Responses to various questions from questionnaire were recorded by means of Google Forms
which was circulated through social networking sites and the responses of 98 general people and
40 for doctor were recorded.
28
CHAPTER 4: DATA ANALYSIS AND FINDINGS
4.1 Data from general public

QUESTION NO. 1
GENDER
Frequency Percent Valid Percent Cumulative

Percent
VALID Male 57 58.16% 58.16% 58.16%
Female 41 41.84% 41.84% 100%
Total 98 100% 100%
Gender Distribution
Female
42% Male
Female
Male
58%
Table 1:Gender Distribution

Figure 1: Gender Distribution
FINDINGS:
29
Around 58.16% of the general public respondents were male and 41.84% of the respondents
Age Distribution
Frequency Percent Valid Cumulative
Percent Percent
Below 20 17 17.35% 17.35% 17.35%
years
Between 21 47 47.96% 47.96% 65.31%
VALID to 40 years
Between 41 19 19.39% 19.39% 84.7%
to 60 years
Above 60 15 15.3% 15.3% 100%
years
Total 98 100% 100%
were female in the survey.
QUESTION 2
Table 2: Age distribution of the respondents from general public

Figure 2: Age Distribution of the general public respondents
FINDINGS:
Most of the respondents were in the age group of between 21 to 40 years around 47.96% while
19.39% were in the age group of between 40 to 60 years and 17.35% were in age group of below
20 years and 15.3% were in the age group of Above 60 years.
Age Distribution
Above 60 years, Below 20 years,
15% 17%
Below 20 years
Between 41 to 60 Between 21 to 40 years
years, 20% Between 41 to 60 years
Above 60 years
30
Between 21 to 40
years, 48%
QUESTION 3
Table 3: Annual income distribution of the respondents
Annual Income of the respondents

Groups of Annual Frequency Percent Valid Cumulative
income Percent Percent
VALID Below 1 lakh 28 28.57% 28.57% 28.57%
Between 1 lakh to 23 23.47% 23.47% 52.04%

5 Lakh
Above 5 lakhs 14 14.29% 14.29% 66.33%
Not want to 33 33.67% 33.67% 100%

disclose
Total 98 100% 100%
Annual Income Distribution
Below 1 lakh, 28.0,

Not want to 29%
disclose, 33, 34% Below 1 lakh
Between 1 lakh to 5 Lakh
Above 5 lakhs
Not want to disclose
Above 5 lakhs, 14, Between 1 lakh to 5

14% Lakh, 23, 23%
Figure 3: Annual income Distribution of the Respondents
FINDINGS:
Most of the respondents does not want to disclose their annual income around 33.67% while around
28.57% of the respondent’s annual income was below 1 Lakh and 23.47% respondents’ annual income
was between 1 lakh to 5 lakh and 14.29% were of the annual income of above 5 lakhs.
31
QUESTION 4:
Have you ever been to a rural healthcare facility?
Table 4: Responses on the rural healthcare centre visit
Responses Frequency Percent Valid Percent Cumulative

percent
Yes 63 64.29 64.29 64.29

No 35 35.71 35.71 100%
Total 98 100% 100%
Visiting a rural healthcare facilty

Reponse
NO No, 35
YES Yes, 63
0 10 20 30 40 50 60 70
Total number of respones
Figure 4: Responses on visiting rural healthcare facility
FINDINGS:
Around 64.29% of the responses were Yes, which means 63 people out of 98 have visited to a
rural healthcare centre and 35.71% of the response were No, which means 35 out of 98 people
have not yet been to a rural healthcare centre.
32
QUESTION 5: Where do you go for the treatment of any disease?

Percent
Nearest healthcare 33 33.68% 33.68% 33.68
centre
Healthcare centre 34 34.69% 34.69% 68.37
in the city
Treating oneself 15 15.3% 15.3% 83.67
by home remedies
Using black 00 00 00 83.67
magic/superstition
I trust my immune 16 16.33% 16.33% 100%
system
Total 98 100% 100%
Table 5: Responses on any sickness or disease from the public
Response to sickness
40
35
30
25
20
15
10
0
Nearest healthcare Healthcare centre in Treating oneself by Using black I trust my immune
centre the city home remedies magic/superstition system
Figure 5:Response to sickness
FINDINGS:
Most of the respondents visit the healthcare centre in the city around 34.69%, closely followed
by the nearest healthcare centre around 33.68%, while others either treat themselves by home
remedies which is approximately 15.3% or they thrust their immune system that it can fight by
itself which is 16.33%, while no one believes in any kind of superstition to cure the sickness.
33
QUESTION 6
Are the medicines available whenever you go for the treatment?
Table 6: Responses on the availability of medicines

Percent
Yes, Regularly 45 45.92% 45.92% 45.92%

Sometimes 29 29.6% 29.6% 75.52%
Available
Rarely available 23 23.47% 23.47% 98.99%
Never available 1 1.01% 1.01% 100%
Total 98 100% 100%
Availability of Medicines
Never available, 1,
1%
Rarely available,
23, 23%
Yes, Regularly
Sometimes Available
Yes, Regularly, 45,
46% Rarely available
Never available
Sometimes
Available, 29, 30%
Figure 6: Availability of the medicines in the healthcare centre
FINDINGS:
Most the respondents, around 45.92% said that the medicines are regularly available in the
healthcare centre, 29.6% said that it is sometimes available while 23.47% responds that the
medicines are rarely available and only 1.01% said that it is never available.
34
QUESTION 7
Are female doctors available in the healthcare centre?
Table 7: Availability of female doctors

Percent
Yes 58 59.18% 59.18% 59.18%

Yes, but 25 25.51% 25.51% 84.69
periodically
No 15 15.31% 15.31% 100%

Total 98 100% 100%
AVAILABILITY OF FEMALE DOCTORS

TOTAL NO. OF RESPONES
Yes, 58
Yes, but periodically,

25
No, 15
AVAILABILTY OF FEMALE DOCTOR
Figure 7: Availability of the female doctors
FINDINGS:
Around 59.18% the responses of the general public is Yes on the availability of the female
doctor while 25.51% Reponses were yes the doctors are available but only periodically and
remaining 15.31% said that female doctors were not available in the healthcare centre.
35
QUESTION 8
How much is the average time doctors are available in the healthcare centre regularly?
Table 8: Average time spent by doctors

Percent
2 to 4 hours 36 36.73% 36.73% 36.73
4 to 8 hours 38 38.78% 38.78% 75.51
Available but 20 20.4% 20.4% 95.91
not daily
Rarely available 4 4.09% 4.09% 100%
Total 98 100% 100%
Availability of Doctors
total no. of respones
, 4 to 8 hours, 38
, 2 to 4 hours, 36
, Available but not

daily, 20
, Rarely available, 4
Availability
Figure 8: Average time spent by doctors
FINDINGS:
Most of the doctors are available from 4 to 8 hours in the healthcare centre around 38.78%,
closely followed by the group of 2 to 4 hours which is around 36.73%, while 20.4% said that
20.4% doctors are available but not daily and 4.09% of the response said that doctors are rarely
available in the healthcare centre.
36
QUESTION 9
Are menstruation cycle products like sanitary napkins available in the healthcare centre?
Table 9: Availability of period products

Valid
Yes 53 54.08% 54.08% 54.08%

No 45 45.92% 45.92% 100%
Total 98 100% 100%
AVAILABILITY OF PERIOD HEALTHCARE PRODUCTS
No, 45
RESPONSE
Yes, 53
TOTAL NO. OF RESPONSES
Figure 9: Availability of period products
FINDINGS:
Most responses around 54.08% said that the menstruation products sanitary napkin or pads and
others are available in the healthcare centre while 45.92% said that it is not available in the
healthcare centre.
37
QUESTION 10
Is there sufficient facility of ambulance and blood bottles?
Table10: Facilityofambulanceandbloodbottles

Valid
Yes 33 33.67% 33.67% 33.67%

No 65 66.33% 66.33% 100%
Total 98 100% 100%
Availability of ambulance and blood bottles
No Series 1, No, 65
reponses
Yes Series 1, Yes, 33
0 10 20 30 40 50 60 70
total no. of reponses
Figure 10: Facility of ambulance and blood bottles
FINDINGS:
Around 66.33% respondents said that the ambulance and blood bottle service is not available in
their healthcare facility while 33.67% respondents said that the ambulance and blood bottle
service is available.
38
QUESTION 11
How many instances of medical negligence or wrongful diagnosis have been in the healthcare unit?
Table 11:Instances of medical negligence

Percent
Below 10 45 45.92% 45.92% 45.92%

11 to 25 39 39.8% 39.8% 85.72%
25 to 50 12 12.24% 12.24% 97.96%
Above 50 2 2.04% 2.04% 100%
Total 98 100% 100%
Negligence of the hospital
2%
12%
Below 10
11 to 25
46%
25 to 50
40% Above 50
Figure 11: Instances of medical negligence in the hospital
FINDINGS:
It is been observed from the data that around 45.92% of responses for hospital negligence cases
is below 10 while around 39.8% responses were for the group between 11 to 25 and 12.24%
39
were for the group of 26 to 50 cases and only 2.04%of the responses for the hospitals the
negligence case is above.
QUESTION 12
How is doctor- patient confidentiality clause followed in the healthcare unit?
Table 12:Complying doctor patient confidentiality clause

Percent
Not followed at 10 10.2 10.2 10.2
all
Poorly followed 33 33.67 33.67 43.87
Somewhat 51 52.04 52.04 95.91

followed
Excellent as per 4 4.09 4.09 100%

law
Total 98 100% 100%
Doctor patient confidentiality rule

60
50
total no. of responses
40
30
51
20
33
10
10
0
4
not followed at all poorly followed somewhat followed excellent, as per the law
Comply of the rule
Figure 12: Complying doctor patient confidentiality clause
FINDINGS:
40
According to respondent’s data, doctor patient confidentiality rule is somewhat followed in the
organization around 52.04%, whereas 33.67% says that it is poorly followed and 10.2% says that
it is not followed at all while only 4.09% says that it is followed excellently as per the rule of
law.
QUESTION 13
Rate thecleanness of the equipment, machines before use –
Table 13: cleanness of the equipment & machines

Percent
Bad, not clean 8 8.16% 8.16% 8.16%

Poorly 43 43.88% 43.88% 52.04%
Nice, can be used 43 43.88% 43.88% 95,92%
Very good, fully 4 4.08% 4.08% 100%

sanitized
Total 98 100% 100%
Cleanness of the healthcare equipment

4 8
Bad, not clean

Poorly
Nice, can be used
43 very good, fully sanitized
43
Figure 13:cleanness of the equipment & machines
FINDINGS:
41
Around 43.88% pf the respondents from the general public says that the equipment’s are poorly
clean or they are nice and can be taken into use while 8.16$ says that they are very bad, they are
not clean and only 4.08% says that they are cleaned properly and are fully sanitized.
QUESTION 14
Do you think more improvement is needed in the healthcare centre?
Table 14:improvement needed in the healthcare centre

Percent
Yes, 29 29.6 29.6 29.6%
infrastructure can
be improved
Yes, in the 37 37.75 37.75 67.35%
availability and
specialization of
doctors
Yes, in 26 26.53 26.53 93.88
medicines and
other equipment
No, I am 6 6.12 6.12 100%
satisfied.
Total 98 100% 100%
Improvement needed in the healthcare facility
No, I am satisfied. 6
Yes, in medicines and other equipment 26
Yes, in the availability and specialization of doctors 37
Yes, infrastructure can be improved 29
0 5 10 15 20 25 30 35 40
Figure 14: Improvement needed in the healthcare centre
FINDINGS:
42
Around 37.75% respondents think that availability and specialization of the doctors needs to be
improved followed by infrastructure which is around 29.6% which is closely preceded by need to
improve in medicines and equipment’s and only 6% of the respondents says that they are
satisfied,
QUESTION 15
Are the COVID-19 patients get treated in the rural healthcare facility?
Table 15: Treatment of COVID-19 Patients

Valid
Yes, they get 24 24.49% 24.49% 24.49%

treatment in the
local hospital
No, they get 74 75.51% 75.51% 100%
transferred to the
city hospital
Total 98 100% 100%
covid - 19 test treatment

80
70
60
Total no. of responses
50
40
74
30
20
24
10
0
Yes, they get treatment in the local hospital No, they get transferred to the city hospital
treatment
Figure 15: Treatment of COVID-19 Patients
FINDINGS:
43
As per the data, it can be concluded that 75.51% of people get transferred to the city hospital for
the treatment of COVID-19 -19 while 24.49% says that they get the treatment in their local
healthcare facility.
QUESTION 16
Do the doctors and staff use mask, sanitizers and also maintain the social distance?
Table 16: use of mask, sanitizers and social distancing

Valid
Yes 54 55.1 55.1 55.1

No 44 44.9 44.9 100%
Total 98 100% 100%
USE OF MASK AND SANITIZER

TOTAL NO. OF RESPONSES
Series 1, Yes, 54
Series 1, No, 44
USE OF MASK AND SANITIZER
Figure 16: use of mask, sanitizers and social distancing
FINDINGS:
According to the data 55.1% of the staff and the doctors use mask and sanitizer while 44.9% of
the staff and doctors do not use mask and sanitizer.
44
4.2 Data from the doctors of rural healthcare centre
QUESTION 1
Table 17: State wise distribution
NAME OF THE STATE

States Frequency Percent Valid Percent Cumulative
Percent
Madhya Pradesh 13 32.5% 32.5% 32.5%
Uttar Pradesh 13 32.5% 32.5% 65%
Bihar 14 35% 35% 100%
Total 40 100% 100%
State -wise distribution
Madhya Pradesh
Madhya Pradesh,
Bihar, 14, 35% 13, 32% Uttar Pradesh
Bihar
Uttar Pradesh, 13,

33%
Figure 17: State wise distribution
FINDINGS:
45
Data has been collected with the help of google drive link and the distribution of questionnaires,
in which around 35% of the doctors are from Bihar state while 32.5% were from Madhya
Pradesh and Uttar Pradesh.
QUESTION 2
Is the number of staff adequate in the rural hospital?
Table 18: No, of staff

Percent
Yes 8 20% 20% 20%
No 32 80% 80% 100%
Total 40 100% 100%
Adequacy of the staff in hospital
No, 32
responses
Yes, 8
Figure 18: No. of staff
FINDINGS:
Around 80% of the respondents from the doctors of rural area said that the staff in the hospital is
not adequate while the remaining 20% believes that it is adequate.
46
QUESTION 3
On average how many patients visit weekly –
Table 19: No. of patients visit in a week

Percent
More than 5 2 5% 5% 5%
Between 6 to 10 6 15% 15% 20%
Between 11 to 20 15 37.5% 37.5% 57.5%
More than 21 17 42.5% 42.5% 100%
Total 40 100% 100%
Paitents visit in a week

More than 5 , 2,
5%
Between 6 to 10,
6, 15%
More than 5
Between 6 to 10
More than 21, 17,
43% Between 11 to 20
More than 21
Between 11 to
20, 15, 37%
Figure 19: No. of patients visit in a week
FINDINGS:
47
Around 42.5% of the responses were for the group of more than 21 patients followed by between
11 to 20 groups with 37.5% while 6% response said between 6 to 10 and only 2% responses said
that more than 5 patients visit the hospital in a week.
QUESTION 4
How do rate the condition of the testing and diagnostic equipment’s available in the hospital?
Table 20: Condition of the testing and diagnostics equipment’s

Percent
very bad 2 5% 5% 5%
somewhat bad 19 47.5% 47.5% 52.5%
neither bad nor 13 32.5% 32.5% 85%
good
somewhat good 4 10% 10% 95%
very good 2 5% 5% 100%
Total 40 100% 100%
Quality Of Medical Equipments

20
Figu
18 re
16 20:
14 Cond
ition
12
of the
10 testin
19
8 g and
6 13 diag
nosti
4
cs
2 4 equip
2 2
0 ment
very bad somewhat bad neither bad nor somewhat good very good ’s
good
Quality FIN
DIN
GS:
48
Most of the response that around 47.5% said that the equipment’s used in the hospital were of
somewhat bad quality followed by 32.5% saying that it is neither bad nor good, while 10%
believes that equipment’s are of somewhat good quality and the remaining responses were
divided among very bad quality or very good quality.
QUESTION 5
Approximately how many percentages of patients you refer to get a diagnosis in the city
hospital?
Table 21: Refer patient to city hospital

Percent
Below 10% 6 15% 15% 15%

Between 11% to 9 22.5% 22.5% 37.5
25%
Between 26% to 15 37.5% 37.5% 75%
50%
More than 50% 10 25% 25% 100%
Total 40 100% 100%
Refer paitents to the city hospital
6, 15%
10, 25% Below 10%
Between 11% to 25%
Between 26% to 50%
9, 22%
More than 50%
15, 38%
Figure 21: Refer patient to city hospital
FINDINGS:
49
Around 37.5% of the responses said that between 26% to 50% of the patient refer to go to the
city hospital followed by group of between 11% to 25% patients which is 22.5%, while
approximately 25% of the responses were of more than 50% and only 15% responses said that
they refer below 10% patients to the city hospital.
QUESTION 6
What health related problems do the famer usually have come to get the treatment of?
Table 22: Farmers health problems

Percent
Skin disease 6 15% 15% 15%
Arthritis 9 22.5% 22.5% 37.5%
Respiratory 4 10% 10% 47.5%
problem
Injuries / 15 37.5% 37.5% 85%
accidents caused
during farming
Others 6 15% 15% 100%
Total 40 100% 100%
Diseases & sickness faced by the farmers
Skin disease
6, 15% 6, 15%
Arthritis
Respiratory problem
9, 22%
Injuries / accidents caused during
farming
15, 38%
Others
4, 10%
50
Figure 22: disease and sickness faced by the farmer:
FINDINGS:Around 37.5% responses indicate that problem most faced by the rural people is the
injuries or accidents caused during farming followed by arthritis by 22.5% while 15% each were
the problems faced by the farmer is skin disease or any other diseases or sickness and 10% face
respiratory problem.
QUESTION 7
Are you satisfied with the quality of medicines available in the hospital?
Table 23: Quality of medicines

Percent
Yes 15 37.5% 37.5% 37.5%
No 25 62.5% 62.5% 100%
Total 40 100% 100%
Quality of medicines
No No, 25
satisfaction
Yes Yes, 15
0 5 10 15 20 25 30
Total no. responses
51
Figure 23: Quality of medicines
FINDINGS:
Around 62.5% of the responses from the respondent said they are not satisfied with the quality of
the medicines while the remaining 37.5% respondents said that they are satisfied with the quality
of the medicines available in the rural healthcare facility.
QUESTION 8
How much percent of the rural population take the benefit of the schemes provided by the
government of India?
Table 24:benefit of the schemes provided by the government of India

Percent
Below 15% 11 27.5% 27.5% 27.5%
Between 16% to 15 37.5% 37.5% 65%

30%
Between 31% to 14 35% 35% 100%
60%
Above 61% 00 00 00 100%
Total 40 100% 100%
52
S CH E M E S P RO V I DE D B Y TH E G O V E RN M E N T
Benefit Schemes by the
government, Between Benefit Schemes by the
16% to 30%, 15 government, Between
31% to 60%, 14
government, Below 15%,
TOTAL NO. RESPONSES
11

government, Above 61%,
0
BELOW 15% BETWEEN 16% TO BETWEEN 31% TO ABOVE 61%

30% 60%
PERCENTAGES
Figure 24: benefit of the schemes provided by the government of India
FINDINGS:
Around 37.5% of the respondents said that between 16% to 30% of the rural population take the
benefit of the schemes provided by the government, followed by between 31% to 60% which is
35% and about 27.5% of the responses said below 15% of the rural population take the benefit of
government health related schemes.
QUESTION 9
What health issues women face generally in the rural areas?
53
Table 25: Health issues faced by the women

Percent
Malnutrition 7 17.5% 17.5% 17.5%
Problems during 13 32.5% 32.5% 50%
or after
pregnancy
Problem in their 13 32.5% 32.5% 82.5%
menstruation
cycle
Hypertension 5 12.5% 12.5% 95%
Others 2 5% 5% 100%
Total 40 100% 100%
Problems faced by women
Malnutrition
2, 5%
5, 13% 7, 17% Problems during or after
pregnancy
Problem in their menstruation
cycle
Hypertension
13, 33% 13, 32%
Others
Figure 25: health problems faced by the women
FINDINGS:
Most of the responses indicate that is around 32.5% were the problems faced by the women
during or after their pregnancy and also as well as in their menstruation cycle and 17%
respondents said that problems faced by the women was malnutrition and 13% said it is
hypertension and 5% were the others problems faced by the women.
QUESTION 10
What is the ratio of male and female patients?
54
Table 26: Gender Ratio

Percent
Male are more 26 65% 65% 65%
than female
Male are less 4 10% 10% 75%
than female
Male and 10 25% 25% 100%
female are
equal
Total 40 100% 100%
MALE-FEMALE RATIO
Male and
female are 10
equal
Male are
less than 4
female
Male are
more than 26
female
0 5 10 15 20 25 30
Figure 26:Ratio of male and female patients
FINDINGS:
Around 65% of the respondents said that male patients are more than female while 25% said that
male and female patient are in equal ratio and 10% said that female patients are more than male
patients.
QUESTION 11
What is level of knowledge the rural population concede regarding sex education?
55
Table 27: Knowledge regarding sex education

Percent
No Knowledge 12 30% 30% 30%
Little 19 47.5% 47.5% 77.5%
knowledge
average 6 15% 15% 92.5%
knowledge
Sufficient 0 0% 0% 92.5%
knowledge
Proper 3 7.5% 7.5% 100%
knowledge
Total 40 100% 100%
20
Knowledge on Sex - Education
18
16
14
total no. responses
12
10
0
No Knowledge Little knowledge average knowledge Sufficient Proper knowledge
knowledge
Figure 27: sex education knowledge
FINDINGS:
Around 47.5% of the respondents said that the knowledge of sex education is little among the
people of rural areas and about 30% of those said that people of no knowledge, 15% responses
said that people have average knowledge and 7.5% have the proper knowledge.
QUESTION 12
56
How much percentage of the people in the area are aware and indulge in safe sex and use
contraceptives?
Table 28: Awareness regarding safe sex

Percent
Below 10 % 12 30% 30% 30%
Between 11% to 19 47.5% 47.5% 77.5%

25%
Between 26% to 3 7.5% 7.5% 85%
50%
Above 51% 6 15% 15% 100%
Total 40 100% 100%
Awareness regarding safe sex

19
12
Below 10 % Between 11% to 25% Between 26% to 50% Above 51%
Figure 28: Awareness regarding safe sex
FINDINGS:
Around 47.5% of the respondents said that between 11% to 25% people indulge in safe sex
followed by below 10% which was the response of 30% people, while 15% respondents said that
51% indulge in safe sex and 7.5% said that between 26% to 50% indulge in the activity.
57
QUESTION 13
Is there proper availability of period products like pads and pain killers like ibuprofen?
Responses Frequency Percent Valid Percent Cumulative Tab

Percent le
29:
Just on demand 12 30% 30% 30% Ava
ilabi
Very low 12 30% 30% 60% lity
of
Average 6 15% 15% 75% peri
od
Sufficient 4 10% 10% 85% pro
duct
No 6 15% 15% 100% s
Total 40 100% 100% Figu
re
Availability of period products

No
Sufficient
Response
Average
Very low
Just on demand
0 2 4 6 8 10 12 14
29: Availability of period products
FINDINGS:
According to 30% of the respondents’ period products are very less available and available just
on demand while 15% respondents said that they are not available or they have an average stock
of period products and only 10% of the respondents said that the products are sufficient.
58
QUESTION 14
Did the healthcare facility have the availability of Covid-19 testing?
Table 30: Availability of Covid-19 testing

Percent
Yes 19 47.5% 47.5% 47.5%
No 21 52.5% 52.5% 100%
Total 40 100% 100%
COVID-19 TESTING
No 21
Yes 19
18 18.5 19 19.5 20 20.5 21 21.5

Yes No
Figure 30: Availability of Covid-19 testing
FINDINGS:
Around 52.5% of the respondents said that there is no COVID-19 testing in the area while 47.5%
said that COVID-19 Testing is available in the rural healthcare facility.
59
CHAPTER 5 - CONCLUSION
In our research we found out that the number of people visiting the healthcare centres is just
average and the medicines are not always available in correct doses so that is something to be
taken care of. The availability of female doctors was satisfactory, average time of doctor’s
availability was fair and surely could be better. Availability of period products like sanitary
napkins was good, so that is something to be happy about. Blood bottles and ambulances were
not available as per demand so more measures need to be taken by the government in this area so
that the emergency needs of the population are satisfied without much delay which will in turn
save precious lives. It was found that the services were not completely negligence free so we
definitely need to minimize the negligence and provide right kind of assistances and aids through
qualified professionals and top-quality medicines and equipment’s.
The most important thing to be taken care of is the doctor patient confidentiality rule as it isn’t
followed in prescribed manner so more trainings and counselling need to be given regarding the
same to the doctors. The cleanliness of the medical equipment’s was either average or poor so
we need to make sure that proper norms are followed to maintain the cleanliness of the
equipment’s. The people felt that improvement was needed in the availability of the doctors
during working hours and of the doctors with proper specialisations. More people felt that the
infrastructure of the rural healthcare centres can be improved further and medicines and other
medical equipment’s should be more easily available.
The medical staff was not complete so more recruitments should be done to maintain proper
availability of the staff in the rural healthcare centres. The quality of medicines was not found to
be correct, so better medicines need to be made available. We see that most of the farmers face
injuries during farming so our first aid should be perfect to deal with such accidents. Further we
saw that the percentage of people who indulge in safe sex is just average so more people need to
be given sex education in rural area.
Hence, we can be very sure that if above mentioned recommendations are followed then the rural
healthcare centres will get more durable and the services provided will be more robust. In this
60
way we will see that a greater number of people will get attracted towards these rural healthcare
centres and the number of patients getting referred to the city hospitals will decrease.
61
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Rural Survey (Research Based)

“Healthcare scenario in Rural India”

A project report submitted in partial fulfilment

the requirements for the degree

Master of Business Administration (MBA)

School of Management Studies

Table 1:Gender Distribution ...................................................................................................... 29

Figure 1: Gender Distribution ................................................................................................................ 29

Date: 05/01/2021 Utkarsh Sharma (2020MB39)

under my supervision and guidance.

'Rural research survey on Healthcare scenario of Rural India'.

people who helped us to complete this project successfully.

Utkarsh Sharma (2020Mb39)

Shubhi Jain (2020MB36)

Saurabh Kumar (2020MB35)

Pragati Singh (2020MB26

1.1 Rural healthcare structure in India

1.1.1 Sub Centres (SCs)

1.1.2 Primary Health Centre (PHC)

As per minimum requirement, a PHC is to be manned by a medical officer supported by 14

1.1.3 Community Health Centre (CHCs)

The following data is based on Rural Health Statistics 2018-19.

ANM/Health Worker (Female )& Health

1 Andhra Pradesh 107

2 Arunachal Pradesh 108

9 Himachal Pradesh 1856

10 Jammu & Kashmir 824

14 Madhya Pradesh 5871

24 Tamil Nadu 6499

28 Uttar Pradesh 10749

33 Daman & Diu *

All India/ Total 58,473

*: There is a Surplus of ANM / Health Worker (Female)some of States/UTs

4 Bihar * * 1610 1541 543

5 Chhattisgarh * 454 114 313 *

7 Gujarat 582 * 75 188 *

11 Jharkhand * * 244 239 205

12 Karnataka 1740 70 413 909 *

15 Maharashtra * * 619 1101 800

20 Odisha 470 453 95 1229 777

22 Rajasthan 608 287 1596 961 *

24 Tamil Nadu 306 * 581 1235 *

25 Telangana 1134 * 323 293 *

27 Uttarakhand 122 * 57 242 196

28 Uttar Pradesh 403 380 1599 3172 3560

29 West Bengal 2797 * 123 850 *

33 Daman & Diu 4 1 0 0 *

34 Delhi 1025 * * 298 489

All India/Total 12823 1933 8979 15875 7569

1 Andhra Pradesh 403 62 127 36 64 *

2 Arunachal Pradesh 248 11 46 17 0 *

4 Bihar 518 * 149 98 * 716

7 Gujarat 1351 * 184 52 21 46

9 Himachal Pradesh 371 * 67 15 57 432

Jammu & Kashmi

11 Jharkhand 640 * 118 * * 106

12 Karnataka 343 196 40 * 24 339

13 Kerala 876 * 229 * 211 233

14 Madhya Pradesh 1191 31 96 * * *

15 Maharashtra 778 175 243 * * *

20 Odisha 1258 * 317 * * 552

22 Rajasthan 1885 * 229 87 87 *