Quality of care is low across provider types in India

Low quality of care is one of the most significant challenges for Odisha’s health system. Ours was the first study to assess the quality of care from both patient and provider perspectives at a state level. We found poor clinical competence among providers to diagnose and treat common conditions, poor patient safety culture in public sector hospitals, and low levels of patient satisfaction, especially among vulnerable groups. Only 2.2 percent of outpatient care providers knew the correct treatment for common conditions, including illnesses like TB, diarrhea, and pre-eclampsia, which have been national priorities for decades. All providers across public and private sectors prescribed incorrect and unnecessary treatments. Only 10 percent of public hospital staff have ever reported adverse events and medical errors, which are critical for improving patient safety; the corresponding rate in developed nations is 45 percent. These worrisome findings raise the question: are people getting value for their money spent?


58.0 percent

Percent of cases diagnosed correctly.

2.2 percent

Percent of providers who advised correct treatment

40.3 percent

Percent of providers who prescribed only unnecessary medications, and no correct treatment

Data from our survey of public and private providers in Odisha, India using clinical vignettes to measure diagnostic and treatment competence of five common conditions. Source: Kalita A, Bose B, L Woskie, Dilip D, & Yip W (2021). Quality of primary care in India: an assessment of clinical effectiveness among public and private sector providers in Odisha, India. India Health Systems Project Working Paper. USA: Harvard T.H. Chan School of Public Health.