This paper summarizes empirical findingsfrom recent World Bank financed analysis on the use ofhealth services by the poor in India (Mahal et al 2000) andsome additional analysis conducted with the same data. Threefactors motivate the choice of approach taken here and inthe background paper. First, the size of the population, thediversity within India, and the unique governance structureprovide an opportunity for comparative analysis to supportlearning about equity in health service use. This led toanalysis below the national level where state-levelcomparisons are used. This paper and the analytical worksupporting the findings summarized in it are part of a setof studies intended to provide information for public andprofessional discussion around the shape of India'sfuture health system. Other studies included private healthsector analysis, consumer protection in the health sector,health insurance, pharmaceutical sector analysis, andanalysis of the quality of health services. The underlyingpurpose is to find ways to improve health outcomes in India,particularly for the poor, and to develop sustainable healthsystems and financing to achieve better health outcomes. Thewhole effort originated out of a longstanding dialoguebetween the Government of India and the World Bank. A briefdescription of the data and methodology is presented in thenext section. A summary of national- level findings isprovided and state-level findings are also discussed. Adiscussion of the relevance of the findings, including studylimitations, is presented in the final section.
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