Chronicles from Central India: An Atlas of Rural Health


In rural and tribal India, nearly all diseases are prevalent in much higher numbers and more complex forms than in urban parts of the country. This is because people in rural areas are adversely located on several socio-economic determinants of health, including availability of food, environmental stress, distance from healthcare facilities and access to education. The work of the Jan Swasthya Sahyog (JSS; Health Support Group), the authors write, “has taught us that disease is the biological embodiment of deprivation.”

The JSS is a collective of health professionals from the country's leading institutions; the group’s services-based programme is over a decade old. It covers more than 1.5 million people across 2,500 villages in northwestern Chhattisgarh (“arguably the country’s epicentre of underdevelopment”) and southeastern Madhya Pradesh, where, they write, “We have observed and tried to manage massive levels of hunger, malnutrition, resultant illnesses and much avoidable mortality.”

This report examines "the political economy of the ailments of the rural and tribal poor in India." It documents disease patterns among rural populations and investigates the political and economic policies that impact sociocultural practices. Together, these create a regime of structural violence that most severely impacts the rural poor. The report uses official data and other studies along with patients’ narratives, picture stories, blog notes and disease maps to create an account that is important for "anyone concerned with human development and …greater equity and justice."


  1. Around 2 million people in India, according to official estimates, get malaria every year, and about 700 die from it. The World Health Organisation estimates there are 15 million cases of malaria in India annually, and 20,000 deaths every year.

  2. Quoting the Million Death Survey, this report states that there are at least 45,000 fatal snakebites every year in India. These numbers were highest in Uttar Pradesh (8,700), Andhra Pradesh (5,200), and Bihar (4,500).

  3. Eclampsia is a condition marked by new-onset, generalised tonic-colonic seizures in a woman with preeclampsia. Maternal mortality rates of 0 to 14 per cent have been reported in pregnancies complicated by eclampsia. One study states that eclampsia accounts for almost 43 per cent of total maternal deaths.

  4. Maternal mortality rates are higher in Assam, Uttar Pradesh, Madhya Pradesh, Chhattisgarh, Bihar and Rajasthan, and the least in Kerala and Tamil Nadu.

  5. The reported deaths from cervical cancer every year in India are around 67,500. It is second among the major causes of death for women aged 15-44. Estimates suggest a 79 per cent increase by 2025. There are about 100,000 new cases of cancer of the cervix in India every year.

  6. 'Sugar ki bimari' is poorly understood in India, the new 'diabetic capital of the world'. It is slowly destroying the lives of more than 70 million people across the country.

  7. As many as 2.6 million Indians suffer from tuberculosis. Over 55 per cent of TB patients in India are moderately or severely malnourished, and the co-epidemic of tuberculosis and under-nutrition is a major public health hazard.

  8. India has less than 1,500 neurophysicians for a population of 12 million people living with epilepsy.

  9. Around 37 per cent of Indian women have experienced some form of abuse by their husbands – pushing, slapping, hair-pulling, punching, kicking, choking and  burning. The actual figure could be much higher. Domestic violence is a public health problem of epidemic proportions all over the world.

  10. About 30 lakh workers in India are at a high risk of exposure to silica. Rajasthan, Gujarat, Madhya Pradesh, Haryana, Delhi and Karnataka are among the worst-affected states. The victims are mostly poor migrant workers.

  11. An estimated 42 million Indians, mainly women, suffer from thyroid disorders.

  12. India has the highest prevalence of clinical and sub-clinical vitamin A deficiency among other South Asian countries: 31-57 per cent of preschool children and 5 per cent of pregnant women manifest signs and symptoms.

  13. Oral cancer is the most common cancer among men in India, which accounts for about 40 per cent of the world's oral cancer cases.

  14. In India, suicide by poisoning is recorded as the main cause for 40 per cent of reported suicides.

  15. In Chhattisgarh, the rate of suicides was 21 per 1 lakh population as against the national average of 11, according to a 2013 report of the National Crime Records Bureau.

    Focus and Factoids by Divya Jain.

    PARI Library's health archive project is part of an initiative supported by the Azim Premji University to develop a free-access repository of health-related reports relevant to rural India.


Jan Swasthya Sahyog, Chhattisgarh


Jan Swasthya Sahyog, Chhattisgarh


11 Sep, 2016