Health seeking behaviour in four Indian States

Project Details

This study aims to provide an understanding of health seeking behaviour in two States with low levels of health system development: Odisha and Uttar Pradesh; and two with higher levels of health system development: Maharashtra and Punjab.

The study sheds light on the questions of out-of-pocket spending, catastrophic health expenditure and distress financing, and treatment pathways in four states of India - Odisha, Uttar Pradesh (UP), Maharashtra and Punjab. The rationale for this is to better understand the differences between health seeking behaviour in more and less developed health systems at the State level in India, and to sharpen hypotheses about the evolution of health seeking behaviour as health systems develop effectively. The study provides valuable insights for health system interventions yet to be introduced, that seek to strengthen elements such as public primary care.

Using multiple methods the study delves into the following questions:

  • What factors are associated with (a) the decision to use medical care and (b) the choice among available medical providers?
  • What are the health expenditure consequences of both decisions, and with respect to Catastrophic and Impoverishing Health Expenditures?
  • What are the earnings (wages and other sources of income of households) consequences of both decisions?
  • What are the patterns of resort (what are the common pathways between providers and provider type including primary and higher levels; public and private; qualified and unqualified) in relation to a chronic condition common among adults, an acute condition common among children, and gynaecological problems among women?


Professor Barbara McPake  
Professor Sumit Kane  - Primary contact
Professor Ajay Mahal


National Council for Applied Economic Research (NCAER)
The Population Council


Bill and Melinda Gates Foundation

Research Publications