Health Care Providers In India Research Articles

Awareness, Attitude, and Current Practices Toward Influenza Vaccination Among Physicians in India: A Multicenter, Cross-Sectional Study.

Background: Although annual influenza vaccination is recommended for healthcare providers (HCPs), vaccination rate among HCPs in India is generally low. This cross-sectional survey was conducted to evaluate physicians' awareness, attitude, and current practices toward influenza vaccination in high-risk groups in India.Methods: The survey was performed in June–July 2020, wherein consulting physicians, pulmonologists, diabetologists, obstetricians/gynecologists, or cardiologists across 14 cities completed a 39-item questionnaire consisting of 3 sections, one each on awareness, attitude, and practice patterns. Descriptive statistics were used to summarize the study results. Statistical analysis was performed for comparison of subgroups by physician specialty, city of practice (metro/non-metro), and zone of practice (north/south/east/west). Level of statistical significance was set at p < 0.05.Results: In all, 780 physicians completed the survey. Of these, 3.97, 53.08, and 42.95% had high, medium, and low level of awareness about influenza/influenza vaccination, respectively. Statistically significant (p < 0.05) between-group differences were found by physician specialty and zone of practice. In terms of attitude toward vaccination of high-risk group subjects, only 0.9% physicians were “extremely concerned,” while the majority (92.56%) were “quite concerned” and 6.54% were a “little concerned,” with no reported significant differences between different subgroups. With regard to practice patterns, 82.82% of physicians offered influenza vaccines to their patients, 32.69% vaccinated 10–25% of patients per month, and 38.85% required and offered the vaccine to their office staff. Physicians' reasons for not prescribing influenza vaccines to patients included fear of side effects (16.54%), cost (15.64%), lack of awareness about availability (15.38%), absence of belief that it is beneficial (14.36%), history of side effects (13.46%), and patients' fear of needles (11.28%).Conclusion: These findings suggest the need to implement educational strategies among physicians to enhance their awareness about influenza vaccination and improve their attitudes and current practices toward influenza vaccination especially in high-risk groups in India.

Age and Reasons for First Dental Visit in a Tertiary Care Hospital in South India

Abstract Background: Early visit to the dentist with an aim of prevention has been advocated universally, but the timing for seeking dental treatment differs among different countries. Aim: This study aimed to determine the timing and reasons for the first dental visit among children attending the dental clinic in a tertiary care hospital in Tamil Nadu, South India. Methods: This hospital-based study reviewed the dental records of children who had visited the dental clinic from January 1, 2019 to December 31, 2019. All those between 0 and 10 years of age and visiting a dentist for the first time were included in the study. The continuous variables were analyzed using mean and standard deviation. The categorical variables were calculated using Chi-square, Fisher's exact test, and two-proportion test. Results: We reviewed the dental records of 1005 children (60% boys and 40% girls). The most frequent age for the first dental visit was between 5 and 6 years. The most common reasons for visits to the dental clinic were pain (23.8%) and dental caries (16.6%). Only 3.8% of children had their first dental visit by 1 year of age and primarily for therapeutic purposes. Dental caries and traumatic injuries were more frequent in children below the age of 3 years. Conclusion: The present study found pain as the most frequent reason for the visit, but there was a delay in first dental visits among children. This study suggests effective oral health policies for children and a need to change the perception and practices among the dental professionals in the region. Timing of the first dental visit of a child can help us to determine the quality of dental care a child receives. Delayed dental visit among children in this study indicates the ineffective oral health policies and the gap that exists between the pediatric health-care providers in India.

Exploring quality of life among head-and-neck cancer patients in Western India using European organization for research and treatment of cancer questionnaires.

Head-and-neck cancers (HNCs) are one of the major public health problems for both patients and the health-care providers in India. The clinical manifestations of HNC and its treatment can lead to negative effects on the quality of life (QoL) of the patient. The study is aimed to explore the QoL using the European Organization for Research and Treatment of Cancer (EORTC) QoL questionnaires among HNC patients in Western part of India. A cross-sectional prospective study was conducted among 400 HNC patients attending the tertiary cancer center. The QoL was assessed by using the EORTC core questionnaire (EORTC QLQ-C30) and EORTC head- and neck-specific questionnaire (EORTC QLQ-H and N35). The data were explored using means, standard deviation, medians, ranges, and proportions. All the 400 patients had completed the questionnaire having a compliance rate of 100%. There was no missing data at the item level for the EORTC QLQ-C30 questionnaire. While the missing items for EORTC QLQ-H and N35 were: problems while swallowing food, problems with teeth, and sexuality. The mean functional score ranged from 74.22 to 93.49 for EORTC QLQ-C30. The mean symptoms score was found in the range from 3.25 to 81.50 for EORTC QLQ-H and N35. Both questionnaires were comprehensive and well accepted by the patients. These questionnaires provided the information-related disease-specific QoL data, which otherwise is often missed. Health-care providers should not only focus on the clinical effects of treatment but also on QoL issues because it will improve overall patient care and survival.

Why do some health care providers disrespect and abuse women during childbirth in India?

BackgroundDisrespect and abuse during childbirth can result in fear of childbirth. Consequently, women may be discouraged to seek care, increasing the likelihood for women to choose elective cesarean section in order to avoid humiliation, postnatal depression and even maternal mortality. This study investigates the causes underlying mistreatment of women during childbirth by health care providers in India, where evidence of disrespect and abuse has been reported. MethodsQualitative research was undertaken involving 34 in-depth interviews with midwifery and nursing leaders from India who represent administration, advocacy, education, regulation, research and service provision at state and national levels. Data are analysed thematically with NVivo12. The analysis added value by bringing an international perspective from interviews with midwifery leaders from Switzerland and the United Kingdom. FindingsThe factors leading to disrespect and abuse of women relate to characteristics of both women and their midwives. Relevant woman-related attributes include her age, gender, physical appearance and education, extending to the social environment including her social status, family support, culture of abuse, myths around childbirth and sex-based discrimination. Midwife-related factors include gender, workload, medical hierarchy, bullying and powerlessness. DiscussionThe intersectionality of factors associated with mistreatment during childbirth operate at individual, infrastructural, social and policy levels for both the women and nurse-midwives, and these factors could exacerbate existing gender-based inequalities. Maternal health policies should address the complex interplay of these factors to ensure a positive birthing experience for women in India. ConclusionMaternal health interventions could improve by integrating women-centred protocols and monitoring measures to ensure respectful and dignified care during childbirth.

Peripartum Safety: Time to Act

Peripartum safety refers to the safe care of women throughout the antenatal, intranatal, and postnatal periods.Approximately 15% of all childbearing women are likely to develop life-threatening complications. Indiaand Nigeria accounted for one-third of global maternal deaths at the country level. Recognizing the need,the United States has initiated a Maternal safety Bundle. On a par with, The Government of India introducedvarious programs to reduce maternal deaths. Though the country made most of its progress, MMR stateperformances are varied in their extremes and failed to achieve the targeted goal. High maternal mortalityis associated with medical, socio-economic, and health care system problems are evidenced. The shortfallof skilled health care providers in India hampers progress towards achieving universal health coverage. Thecurrent situation calls for more sensitization and sustainable efforts for integration and institutionalizationof health system monitoring to achieve the target of Sustainable Developmental Goals. Studies need togerminate to tackle the health care insufficiencies of pregnant women and enhance the quality of care.

An Assessment of Awareness, Preparedness and Availability of Personal Protective Equipment among Frontline Healthcare Providers in India during the COVID-19 Pandemic

Background Across the world as millions of people stayed at home to reduce the transmission of severe acute respiratory syndrome coronavirus 2 COVID-19 health-care providers braved all odds and did the exact opposite. Though health workers are expected to save the lives of people however concerns related to the awareness preparedness of hospital settings and availability or shortage of PPE kits surfaced and probably put healthcare workers at risk while carrying out their duties. An unforeseen shortage of PPE was evidenced across India during the peak of the pandemic in mid 2020. The media reported that many healthcare providers including nurses became infected and some of them even lost their lives. Hence the safety and protection of healthcare providers while at work assumes great significance.Objectives The study aimed to evaluate the awareness and preparedness regarding PPE and protocols for the same among frontline healthcare providers in India during theCOVID-19 pandemic and also explore the need and availability status of PPE kits for frontline health workers across India.Methodology This cross-sectional study included a total of 65 healthcare providers who were actively treating COVID-19 patients across hospitals in India during the middle of 2020. After obtaining informed consent respondents were invited to answer an online questionnaire-based survey on the awareness knowledge and availability of PPE and recommended PPE practices related to COVID-19 infection in healthcare settings. Out of the 87 providers reached out to only 65 of them answered the questionnaire in its entirety reflecting a response rate of 74.71. A purposive convenient sampling method was used for data collection. Statistical analysis was performed and descriptive statistics are presented.Results The overall awareness among all categories of frontline healthcare workers was found to be adequate. Approximately 49 of the respondents had never used PPE during their clinical duties and as high as 60 of the respondents reported that they were not being provided appropriate PPE routinely. However most of the respondents were aware that PPE can help protect them from COVID-19 infection. Nearly 51 of the respondents used the N95 respirator mask during clinical duties following by 44.62 using triple layered medical mask and 4.62 of them using cloth masks. Interestingly only 47.69 of the respondents were confident about having been demonstrated the appropriate method to wear the PPE and the precautions to be followed therein. As high as 95 of the respondents were interested to receive guidelines andor trainings to help understand the right method to use and dispose the PPE. Concerningly only 24.62 of the respondents confirmed positively that they had been provided with appropriate PPE kits during their clinical duties 23.08 of them said they probably received the PPE while 20 of them were unsure of either.Conclusion The findings lead us to believe that there have been some gaps and potential risk for frontline healthcare workers. In terms of awareness availability and training received regarding the use of PPE by frontline health workers much more needs to be done and there is a need to constantly monitor the implementation of PPE regimen in all healthcare facilities. Healthcare professionals in lower and middle income countries such as India may face more difficulties than those from other countries with a high proportion of respondents reporting that they did not have the necessary resources to care for patients with COVID-19. It is very important that technical and logistical difficulties should be addressed in the event of a future outbreak as they have a negative impact on healthcare workers. Most of the respondents as high as 85 have the willingness and interest to receive training to understand the proper method to use and dispose PPE. It is important for authorities to provide an efficient supply chain up-to-date protocols and pertinent lucid information. This study has highlighted some areas that need to be improved for dealing with future waves of the COVID-19 pandemic and other potential future pandemics and epidemics especially in a low resource developing country context

Replacement Blood Donation Denials in Children: A Cross-sectional Study

Introduction: Developing countries like India still depend on Replacement Donors (RD) for their blood requirements. Healthcare providers in India often face Replacement Blood Donation (RBD) denials in children especially in rural areas. Aim: To find reasons for RBD denials in children. Materials and Methods: A cross-sectional study was done over six months at a tertiary care centre located in rural part of Northern India. Children requiring Blood Transfusion (BT) whose parents refused RBD were included in the study. Children were divided into three groups based on their age and data on various parameters were collected. Observation parameters included sex, birth order, number of siblings, disease for which admitted, duration between admission and need for transfusion, indication for transfusion, decision maker in the family, resistance to decision of denial by any other member of family, parental education, socio-economic status and reasons for denial. Data were analysed using SPSS software (Statistical Package for the Social Sciences, version 17.0, SPSS Inc, Chicago, Ill, USA). The p-values were computed for categorical variables using Chi-square (χ2) test. A p-value of less than 0.05 was considered statistically significant. Results: Out of 356 children requiring BT, parents and relatives of 130 children (36.51%) refused RBD. Of these 130 children, 84 were females and 46 were males with male-female ratio of 1:1.8. Females were more likely to be denied RBD (p-value=0.001). Of these 130 children, only 77 could be included in the study because of various reasons. Age of the study group ranged between 2 days to 15 years. Denials were significantly higher (p-value=0.0032) in children with 3rd or higher birth order. Little benefit in terms of life expectancy was the commonest reason for denials in neonates and was found statistically significant (p-value=0.00368). Fear of donation was the most common reason for denial in all the groups combined (38.9%). Considering themselves ineligible and religious beliefs were the other reasons for denials. Conclusion: RBD denial in children is common in India. Misconceptions, Illiteracy, poverty, sex discrimination and false beliefs are major contributory factors for denial.

Continuing Education for Prehospital Healthcare Providers in India - A Novel Course and Concept.

BackgroundEmergency medical services (EMS) in India face enormous challenges in providing care to a geographically expansive and diverse patient population. Over the last decade, the public–private-partnership GVK EMRI (Emergency Management and Research Institute) has trained over 100,000 emergency medical technicians (EMTs), with greater than 21,000 currently practicing, to address this critical gap in the healthcare workforce. With the rapid development and expansion of EMS, certain aspects of specialty development have lagged behind, including continuing education requirements. To date, there have been no substantial continuing education EMT skills and training efforts. We report lessons learned during development and implementation of a continuing education course (CEC) for EMTs in India.MethodsFrom 2014 to 2017, we employed an iterative process to design and launch a novel CEC focused on five core emergency competency areas (medicine and cardiology, obstetrics, trauma, pediatrics, and leadership and communication). Indian EMT instructors and providers partnered in design and content, and instructors were trained to independently deliver the CEC. Many challenges had to be overcome: scale (>21,000 EMTs), standardization (highly variable skill levels among providers and instructors), culture (educational emphasis on rote memorization rather than practical application), and translation (22 major languages and a few hundred local dialects spoken nationwide).Lessons LearnedDuring the assessment and development phases, we identified five key strategies for success: (1) use icon-based video instruction to ensure consistent quality and allow voice-over for easy translation; (2) incorporate workbooks during didactic videos and (3) employ low-cost simulation and case discussions to emphasize active learning; (4) focus on non-technical skills; (5) integrate a formal training-of-trainers prior to delivery of materials.ConclusionThese key strategies can be combined with innovation and flexibility to address unique challenges of language, system resources, and cultural differences when developing impactful continuing educational initiatives in bourgeoning prehospital care systems in low- and middle-income countries.

Tort of Medical Negligence in India

Indians, of late, have risen to the challenge of healthcare and increased their efforts to provide healthcare facilities to their underprivileged compatriots. This is primarily being done through NGOs and other organizations many of which are funded by the Government. One of the most popular ways to do so have been establishment of health centres which provide the poor with free of cost health services. As we know, instances of malpractice and negligence, unfortunately, have penetrated into every known field and medical field is no exception to this. The usual legal cases of medical negligence are usually covered under the Consumer Protection Act, 1986 but not the cases of negligence and malpractice in the above mentioned health camps because the poor beneficiaries don’t qualify as “consumers” since they haven’t paid any sort of consideration for the services they availed. This research paper seeks to bring to light the role of NGOs and social activists as primary and secondary health care providers in India, unearth their underlying issues but at the same time, lends a special eye to the instances of medical negligence in their camps. The paper in its quest to do so, tries to answer few questions like whether those poor people have any remedy and if yes, then how can they avail it? And whether there is need for procedural guidelines and policy considerations to safeguard the rights of poor and save them from the vicious legal cycle of this country?

Reducing HIV stigma among healthcare providers in India using a partly tablet-administered intervention: the DriSti trial

ABSTRACTHIV stigma has long been recognized as a significant barrier in the worldwide fight against HIV. Across cultures, stigma has been shown to cause psychological distress and act as a barrier to engagement in care. Health professionals can serve as a crucial source of HIV stigma, with drivers that include fears and transmission misconceptions and pre-existing negative attitudes towards marginalized groups. To increase their impact, stigma reduction interventions need to be scalable and sustainable as well as adaptable to different cultural contexts. The DriSti intervention was designed to meet these needs through an easily adaptable, mostly tablet-administered, interactive intervention delivered to ward staff (n = 1,557) and nursing students (n = 1,625) in 62 Indian institutions, using a cRCT design, with wait-list controls. Six-month outcome analyses, showed significant reductions in misconceptions (p < .001) and worry about acquiring HIV at work (p < .001). Intervention participants also reported significantly greater reductions in endorsement of coercive policies (p < .001) and in the number of situations in which they intended to discriminate against PLWH (p < .001) than control participants. This brief, scaleable intervention could be adapted for similar populations in the region, using different mHealth platforms and thus has important implications for current global stigma reduction initiatives and training curricula.

Tort of Medical Negligence in Pro Bono Cases

Indians, of late, have risen to the challenge of healthcare and increased their efforts to provide healthcare facilities to their underprivileged compatriots. This is primarily being done through NGOs and other organizations many of which are funded by the Government. One of the most popular ways to do so have been establishment of health centers which provide the poor with free of cost health services. As we know, instances of malpractice and negligence, unfortunately, have penetrated into every known field and medical field is no exception to this. The usual legal cases of medical negligence are usually covered under the Consumer Protection Act, 1986 but not the cases of negligence and malpractice in the above mentioned health camps because the poor beneficiaries don’t qualify as “consumers” since they haven’t paid any sort of consideration for the services they availed. This research paper seeks to bring to light the role of NGOs and social activists as primary and secondary health care providers in India, unearth their underlying issues but at the same time, lends a special eye to the instances of medical negligence in their camps. The paper in its quest to do so, tries to answer few questions like whether those poor people have any remedy and if yes, then how can they avail it? And whether there is need for procedural guidelines and policy considerations to safeguard the rights of poor and save them from the vicious legal cycle of this country?

World trauma education: hemorrhage control training for healthcare providers in India

BackgroundHemorrhage remains a major cause of death around the world. Eighty percent of trauma patients in India do not receive medical care within the first hour. The etiology of these...

Dental quackery in India: an insight on malpractices and measures to tackle them.

Quackery in dentistry has been a problem for decades. It arises when there are inadequate numbers of competent and trained practitioners or when their charges appear prohibitive to a segment of the population. Poorly educated people often become gullible prey to quacks who perform dental treatment, which is often harmful to patients. It is time to take measures to stop such unethical practices. The purpose of this paper is to highlight the various causes of growing dental quackery in India, the possible measures to prevent it and the malpractices being carried out by quacks. It will also propose a classification of oral healthcare providers in India.

Is prevention and control of cervix cancer a priority amongst future health care providers in India?

Is prevention and control of cervix cancer a priority amongst future health care providers in India?

Regulation of Private Health Care Providers in India: Current Status, Future Directions

In the current context of more expansive role for private sector in health systems, especially in universal health coverage (UHC), its regulation has gained importance in health policy discourse. This article provides an overview of the existing regulatory mechanisms and their implementation in India, the enormity of the regulatory challenges raised by the nature of the private health care sector here and the available alternatives.

Informal healthcare providers in India: Illegal and indispensable

The corresponding author who served in Supaul district of Bihar state of India as an Acute Flaccid Paralysis(AFP) Surveillance Medical Officer(SMO) with the World Health Organisation between May 2011 and July 2013,observed that the district had a preponderance of quackery. A look at the public healthcare system in the district with a population of 2.2 million shows just why this situation exists. According to the latest data available on government websites, the shortfall of Health Sub Centres, Primary Health Centres and Community Health Centres in Supaul district is an astonishing 58%,87% and 88% respectively. These numbers are not significantly different from the numbers for the rest of the state of Bihar. There is no evidence of any political will to tackle this shocking shortfall. The Bihar government has actually reduced the allocation to health for the financial year 2017-18 to Rs.7001.52 crore from Rs.8234.70 crore in 2016-17.Estimates say 70 to 80 percent of healthcare providers in India are informal providers. This ratio can go upto 30 informal providers for every public sector doctor in certain rural areas. Upto 75 percent of primary care visits in rural areas can be to an informal provider. If we must have equitable access to healthcare in India,it would be imperative to involve these informal providers.

Contextual ambidexterity and innovation in healthcare in India: the role of HRM

PurposeThe purpose of this paper is to examine innovation in the resource-constrained context of India’s healthcare industry. It is argued that the process of innovation in addressing healthcare management challenges in such a context occurs through organisational ambidexterity and that human resource management (HRM) plays an important role.Design/methodology/approachA qualitative research methodology is applied to explore the role of HR practices in facilitating contextual ambidexterity and subsequent innovations in healthcare in India. The unit of analysis is the “case” of healthcare providers in India and in-depth interview and documentary data in two case sites are analysed to reveal the role of HRM in facilitating contextual ambidexterity and innovation. Data analysis was undertaken first at a within-case and then at a cross-case analysis level using interpretive manual coding based on how the data explained the role of HRM in delivering innovative outcomes and supporting organisational ambidexterity.FindingsThe authors found evidence of the use of sets of high-involvement HRM practices for exploration of new ideas and efficiency-driven HRM practices for creating contextual ambidexterity in the case organisations. Further, managerial/leadership style was found to play an important role in creating cultures of trust, openness, risk-taking and employee empowerment, supported by an appropriate mix of intrinsic and extrinsic rewards. Finally, training was also reported as being central to creating an ambidextrous context for delivering on various innovations in these healthcare providers.Originality/valueThis study represents an exploration of innovation in the context of India’s healthcare sector through intersecting literatures of ambidexterity, innovation and HRM practices. In light of the emerging economy research context, an important empirical contribution is palpable. Moreover, through a study design which included collecting data from multiple informants on the role of human resources in facilitating innovative outcomes, the authors reveal the role of HR-related initiatives, beyond formal HR practices in creating contextual ambidexterity. This study also reveals the degree to which contextual idiosyncrasies enhance our understanding of the role of HR in facilitating innovation in emerging economies.

Knowledge &amp; Attitude of Medical Students towards Ayurveda, Yoga, Unani, Siddha and Homeopathy (AYUSH)

Introduction: Amalgamation of AYUSH (Ayurveda, Yoga, Unani, Siddha& Homeopathy) with allopathy medicine is a practicable solution for scarcity of health care providers in India. In this regard Government of India has recently mainstreamed AYUSH in rural area by in cooperating it in National Rural Health Mission (NRHM). But the scope of this incorporation will be subjective to the acceptance of AYUSH by allopathic practitioners. Objective: To assess the knowledge and attitude of allopathic health care professionals (undergraduates, postgraduates and interns) towards AYUSH system of medicine. Material and Method: This was a cross-sectional study conducted in medical students of a college in Karnataka, India. Questionnaire was used and data was analyzed using SPSS 16.ver. Results: Out of 131 medical students 49% were males and 51% were females. Only 49.6% of them could expand AYUSH completely and 61% knew that AYUSH was included under NRHM. Attitude of the allopathic practitioners was positive towards AYUSH. 72.5% of them welcomed the Government move of mainstreaming AYUSH in primary health care delivery under NHM in rural areas. Conclusion: Majority of the medical students had positive attitude towards AYUSH and welcome the step of government to include them in NHM.

The Challenges and Recommendations for Gestational Diabetes Mellitus Care in India: A Review.

Gestational diabetes mellitus (GDM) is a primary concern in India affecting approximately five million women each year. Existing literature indicate that prediabetes and diabetes affect approximately six million births in India alone, of which 90% are due to GDM. Studies reveal that there is no consensus among physicians and health-care providers in India regarding management of GDM prepartum and postpartum despite available guidelines. Also, there is no consensus among physicians as to when a woman should undergo oral glucose tolerance test after delivery. This clearly shows that management of GDM is challenging and controversial in India due to conflicting guidelines and treatment protocols, despite availability of straightforward protocols for screening and management. Also, a collaborative approach remains a key for GDM management, as patient compliance and proper educational interventions promote better pregnancy outcomes. Management of GDM plays a pivotal role, as women with GDM have an increased chance of developing diabetes mellitus 5–10 years after pregnancy. Also, children born in GDM pregnancies face an increased risk for obesity and type 2 diabetes. The cornerstone for the management of GDM is glycemic control and quality nutritional intake. GDM management is complex in India, and existing challenges are multifactorial. However, there are little published data outlining these challenges. This review gives an account of some of the key challenges from self-management and health-care provider perspective. The recommendations in this review provide insights for building a more structured model for GDM care in India. This research has several practical applications. First, it points out to reaching a consensus on approaches for screening, diagnosis, and treatment of care across clinical practices in the nation that can aid in overcoming certain challenges observed. Second, it highlights the importance to build capacities and capabilities, especially in resource-limited settings. Health education among pregnant women remains a priority to resolve issues related to self-management. More broadly, further research, specifically qualitative is vital to determine forthcoming challenges with respect to patients, caregivers, providers, and policy makers and to provide solutions fitted to practice setting and demographic background.

Examining the changing health care seeking behavior in the era of health sector reforms in India: evidences from the National Sample Surveys 2004 & 2014

BackgroundHealth policy formulations in India have witnessed a shift from a reactive approach to a more proactive approach over the last decade. It is therefore important to understand the effectiveness of recent national health policies (such as the National Rural Health Mission and the National Urban Health Mission) in addressing the varied needs of the heterogeneous population of India.MethodsWe use datasets from the National Sample Surveys carried out in 2004 and 2014 to understand the change in the health seeking behavior as a result of these policies. The choice of health care facilities and the associated expenditures are compared through descriptive analyses. A multinomial logistic regression is used to identify the significant parameters which contribute towards the share of health care providers in India. The health status of two economically disparate Indian states (Bihar and Kerala) are also compared through specific metrics of performance.ResultsIt is seen that due to increased availability of facilities in close proximity, both rural and urban residents prefer to avail of those facilities which will result in minimization of transportation cost. The effectiveness of national health policies is found to vary on a regional scale. Literacy and health status have a strong correlation, thereby reinforcing that Bihar still lags far behind Kerala in terms of access to equitable health care.ConclusionTherefore, a hierarchical system, incorporating medical pluralism and tailor-made policies targeted at diverse health care demands, needs to be put in place to achieve Goal 3 of the Sustainable Development Goals as decreed by the United Nations, i.e., “health for all”.