Report of the Health Survey and Development Committee: Vol. I


The Health Survey and Development Committee was appointed by the Government of India in October 1943 to make a broad survey of health conditions and services in British India. Its chairman was Joseph William Bhore, an Indian Civil Service officer.

The Committee recommended the integration of curative and preventive medicine at all levels, the development of primary health care centres, and major changes in medical education. Volume I of the Committee's four-volume report draws a picture of the state of public health in India and the organisation of health services.

In December 1941, Japan’s entry into the Second World War had adverse effects on India. Thus, the statistical and other information in this report was limited to the year 1941 and the preceding 10 years.


  1. The report states that an assessment of the state of the public health should be based on information about victims of disease, people who do not show signs of sickness but are mentally and physically restricted, and those in good health. But data regarding positive health, it says, was more difficult to find than that related to sickness and mortality, so the statistics in this report were confined to ill health and death.

  2. It was estimated that there were 200,000 maternal (or maternity-related) deaths every year. Between 1932 and 1941, the average number of deaths (due to dysentery, cholera, smallpox, plague, fevers and respiratory diseases) per year in British India (excluding Burma) was 6,201,434. Of the fevers, most people died of malaria. Of respiratory diseases, tuberculosis was the bigger killer.

  3. In Bengal, the ratio of doctors to the population was three and a half times more in urban than in rural areas. In Sind, the doctor to population ratio in urban centres was about 49 times that in rural areas.

  4. The total number of sanitary or health inspectors employed was about 3,000, while it was estimated that the number required would be close to 12,000.

  5. The Sarda Act, which came into force on April 1, 1930, made the minimum age for marriage for girls 14 years. This, according to the report, was too low because it put the strain of maternity on a growing girl.

  6. Of the 7,441 medical institutions in the provinces, only 566 or 7.6 per cent were maintained wholly by private agencies. Of the remaining 6,875 institutions, 94.5 per cent were run on public funds (provincial and those of local bodies), while the remaining 5.5 per cent received grants-in-aid from such funds. Thus, the share of public revenue in providing medical relief and services was very high.

  7. In 1936, nearly half the districts and three-quarters of the municipalities had no qualified health officers. Between 1935 and 1944, the number of full-time health officers (medicine graduates with a public health qualification) in larger municipalities increased only by six, and the number of licentiates (health officers with a certificate of competence) in smaller municipalities went up by 18.

  8. In 1935, only 45 women vaccinators were employed in rural areas and 37 in urban areas. Between 1935 and 1943-1944, the number of these women workers rose to 75 in rural areas and to 44 in urban centres – a total increase of 37. In many parts of the country, only a woman vaccinator could get access to homes and mix freely with other women.

  9. Insufficiency of specific foods was associated with conditions then known as “deficiency diseases." These included beri, which was fairly common among adults and infants in the Northern Circars division of the Madras Presidency; keratomalacia, a common cause of permanent blindness in south India; osteomalacia and rickets in certain parts of north India; and goitre in some areas in the Himalayan and sub-Himalayan regions.

  10. In predominantly agricultural countries like India, the report says, the infection rate of tuberculosis varied from 21-34 per cent in rural regions to 80-90 per cent in urban and industrial areas.

  11. The incidence of cholera varied from province to province; it was high in Madras, Bengal, Bihar and the Central Provinces and lower in Orissa and the United Provinces.

  12. The first known leprosy asylum was established in Calcutta early in the 19th century. In later years, numerous other institutions were established by missionaries, local authorities and private benefactors.

  13. The percentage of urban and rural population served by “protected water supplies” was 6.6 in Madras, 7.3 in Bengal, 4.1 in the United Provinces and 9 in the North-West Frontier Province.

    Focus and Factoids by Vedika Inamdar.

    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.


Health Survey and Development Committee


Manager of Publications, Government of India, Delhi


18 Dec, 1945