why some doctors serve in rural areas: a qualitative assessment from chhattisgarh state (india) 2010

80
7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010 http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 1/80  Xbs ^ajl Dantar~ ^lryl c` _|rem Erle~7  E U|emctetcyl E~~l~~jl`t iraj Nbbettc~herb ^tetl _LVA_T Evrcm ?656 Xarkc`h ta Xarkc`h ta Xarkc`h ta Xarkc`h taerd~ e blemtbclr C`dce erd~ e blemtbclr C`dce erd~ e blemtbclr C`dce erd~ e blemtbclr C`dce 

Upload: paceminterris

Post on 04-Apr-2018

215 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 1/80

 

Xbs ^ajl Dantar~ ^lryl c` _|rem Erle~7

 E U|emctetcyl E~~l~~jl`t iraj Nbbettc~herb ^tetl

_LVA_T

Evrcm ?656

Xarkc`h taXarkc`h taXarkc`h taXarkc`h tax xx x erd~ e blemtbclr C`dceerd~ e blemtbclr C`dceerd~ e blemtbclr C`dceerd~ e blemtbclr C`dce 

Page 2: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 2/80

VBIC * @B^_N * ^B_N Nbbettc~herb

?

‒Xbs ^ajl Dantar~ ^lryl c` _|rem Erle~7 E U|emctetcyl E~~l~~jl`t iraj Nbbettc~herb ^tetl– 

Na`d|ntld os tbl C`dce` C`~tct|tl ai V|omcn Blemtb- Dlmbc "CCVBD#- tbl V|omcn Blemtb Ia|`detca`

ai C`dce "VBIC#- tbl @etca`em Blemtb ^s~tlj~ _l~a|rnl Nl`trl "@B^_N#- e`d tbl ^tetl Blemtb

_l~a|rnl Nl`trl "^B_N#- Nbbettc~herb 

^|vvartld os i|`d~ iraj tbl Emmce`nl iar Blemtb Vamcns ) ^s~tlj~ _l~lernb- Xarmd Blemtb

Arhe`cwetca`- Hl`lye e`d tbl ^tetl Blemtb _l~a|rnl Nl`trl- Nbbettc~herb

_L^LE_NB TLEJ7

CCVBD ! VBIC @B^_N ^B_N Nbbettc~herb

Dr Keocr ^blckb "Mled C`yl~tchetar# 

Oeocte _egk|jerc

Dr Er|`e Obettenberse

Dr Krc~b`e D _ea

Dr T ^|`derereje`

Dr Hercje H|vte

Dr Kejml~b Gec`

Dr Vretcobe Vete`xer

Jebl`dre Hexerl

Dr K_ E`ta`s

Tbc~ rlvart xe~ vrlverld os Keocr ^blckb xctb c`v|t iraj Vretcobe Vete`xer- Hercje H|vte e`d

Oeocte _egk|jerc. Tbl yclx~ lvrl~~ld c` tbc~ rlvart erl ~amlms tba~l ai tbl e|tbar~ e`d `at ai tblcr c`~tct|tca`~. Narrl~va`dl`nl jes ol dcrlntld ta keocr.~blckbFvbic.arh 

ENK@AXMLDHLJL@T^7 Tbc~ ~t|ds xa|md `at beyl oll` va~~coml xctba|t tbl liiart~ e`d

e~~c~te`nl ai `|jlra|~ ircl`d~ e`d e~~ancetl~ c` Nbbettc~herb e`d Dlmbc. Iarlja~t- tbe`k~ erl

d|l ta tbl ~t|ds vertcncve`t~ „ dantar~ ~lryc`h c` r|rem e`d rljatl erle~ ai lchbt dc~trcnt~ ai 

Nbbettc~herb „ iar ~verc`h tblcr yem|eoml tcjl e`d ~berc`h tblcr rljerkeoml ~tarcl~- tba|hbt~ e`d

c`~chbt~. E~~ancetl~ iraj tbl @_BJ e`d ~tetl blemtb ~lrycnl~ c` tbl lchbt ~t|ds dc~trcnt~

iencmctetld iclmd yc~ct~ e`d ennajve`cld c`yl~tchetar~ „ ta lenb ai tblj xl axl a|r hretct|dl. C`

_ecv|r- tbe`k~ erl d|l ta nammleh|l~ et tbl ^tetl Blemtb _l~a|rnl Nl`trl- Nbbettc~herb-

l~vlncemms Dr V|`c Kakba- Ycrl`dre K|jer- Blje`t Yec~b`ey e`d Vrlj Ylrje- iar tblcr yem|eoml

e~~c~te`nl et dciilrl`t ~tehl~ ai tbl ~t|ds. Jlhbe Gec`–~ enn|retl tre`~nrcvtca`~ ai tbl

c`tlryclx~ l`be`nl tbl yem|l ai tbc~ ~t|ds. Ic`emms tbl e|tbar~ tbe`k Vrai K ^rc`etb _ldds e d

Vrai ^e`ges Wadvls iar tblcr ~|vvart e`d h|cde`nl.

Page 3: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 3/80

VBIC * @B^_N * ^B_N Nbbettc~herb

>

 EO^T_ENT

Tbl hmaoem vraomlj ai tbl |`lu|em dc~trco|tca` ai tbl blemtb xarkiarnl oltxll` nctcl~ e`d

ycmmehl~- xctb ct~ ~lylrl na`~lu|l`nl~ iar tbl eyecmeocmcts e`d u|emcts ai blemtb ~lrycnl~- e`d a`

blemtb a|tnajl~ c` r|rem e`d rljatl hlahrevbcnem erle~- c~ em~a jerkld c` C`dce. _l~lernb c`ta

tbl vbl`ajl`a` ai xarkiarnl jemdc~trco|tca` be~ tsvcnemms ian|~ld a` xbs blemtb xarklr~

nbaa~l `at ta ~tes c` r|rem manetca`~. C` tbc~ u|emctetcyl rl~lernb ~t|ds- na`d|ntld c`

Nbbettc~herb ~tetl c` C`dce- xl lvmarl tbl na`ylr~l „ tbl rle~a`~ xbs ~ajl u|emcicld blemtb

xarklr~ rljec` e`d na`tc`|l ta ~lryl c` atblrxc~l |`dlr~lryld r|rem e d rljatl erle~. Tbcrts*

~lyl` c`*dlvtb c`tlryclx~ xlrl na`d|ntld xctb jldcnem vrentctca`lr~ ~lryc`h c` r|rem blemtbnerl

iencmctcl~ c lchbt dc~trcnt~ ai Nbbettc~herb- oltxll` G|`l e`d E|h|~t ?663. Dete xlrl

tbljetcnemms e`ems~ld |~c`h tbl ”irejlxark‚ evvraenb iar evvmcld u|emctetcyl rl~lernb.

Xl ia|`d tbet vrentctca`lr~– c`ctcem dlnc~ca`~ ta gac` ~lrycnl c` r|rem e`d rljatl erle~ xlrlxcdlms c`im|l`nld os hlahrevbcnem eiic`ctcl~ e`d iejcmcem e~~ancetca`~. A`nl c` ~lrycnl- tbl

vrentctca`lr~ na`ira`tld najvml edylr~l na`dctca`~ e`d ncrn|j~te`nl~- c`nm|dc`h vaar xarkc`h

e`d mcyc`h erre`hljl`t~- ma`h l~tre`hljl`t~ iraj iejcmcl~- e`d tbrlet~ ta vlr~a`em ~ln|rcts.

Tblcr dlnc~ca`~ ta rljec` c` r|rem e`d rljatl erle~ aylr vlrcad~ ai tcjl xlrl drcyl` os yercld

najoc`etca`~ ai ientar~ c`nm|dc`h hlahrevbcnem eiic`ctcl~- vlr~a`em yem|l~ ai ~lrycnl- vrail~~ca`em

c`tlrl~t~ e`d ejoctca`~- ~tra`h rlmetca`~bcv~ xctb nammleh|l~ e`d c` tbl ne~l ai na`trent|em

dantar~- tbl e`tcncvetca` ai aotec`c`h e rlh|mer va~ctca`. E jegarcts ai rl~va`dl`t~ bed bed e

r|rem |vorc`hc`h- e`d ljvbe~cwld tbl cjvarte`nl ai iejcmcercts e`d najiart c` ycmmehl l`ycra`~.

Iar xajl` dantar~- tbl avvart|`cts iar oatb ~va|~l~ ta xark e`d mcyl c` tbl ~ejl manetca`

dc~tc`ntms ljlrhld e~ e va~ctcyl ientar. ^vlncicn erle~ ai `lld cdl`tcicld os rl~va`dl`t~ c`nm|dld

cjvrayld xarkvmenl erre`hljl`t~ e`d rl~a|rnl~- olttlr ba|~c`h e`d ~nbaam~ iar tblcr nbcmdrl`-

trec`c`h e`d ~kcmm dlylmavjl`t c` erle~ xbcnb rlimlntld najj|`cts `lld~- e`d „ c` tbl ne~l ai 

na`trent|em dantar~ „ e~~|re`nl~ ai gao ~ln|rcts e`d olttlr ~emercl~.

Tbc~ ljvcrcnem ~t|ds cdl`tcicl~ kls- ~vlncicn najvmll~ ai ientar~ et tbl c`dcycd|em mlylm xbcnb ent

c` ieya|r ai rltl`tca` ai vraycdlr~ c` r|rem erle~. Ct em~a bchbmchbt~ tbl na`dctca`~ ai blemtb

xarklr~ mcyc`h c tbl~l erle~- e`d tblcr `lld~. Vme``lr~ e`d blemtb e|tbarctcl~ ne eddrl~~

nrctcnem c~~|l~ ai xarkiarnl rltl`tca` os vrail~~ca`em ld|netca` e`d rlnr|ctjl`t vamcncl~ tbet

ettrent ne`dcdetl~ jarl mcklms ta ~lryl c` r|rem erle~- os l`eomc`h e`d ljvbe~cwc`h tbl va~ctcyl

vbl`ajl`e e`d ientar~ xbcnb |`dlrmcl vrentctca`lr~– dlnc~ca`~ ta rljec`- e`d os eddrl~~c`h

tblcr ljlrhc`h `lld~ tbra|hb yercld vamcns entca`~ c`nm|dc`h cjvrayljl`t~ c` ~vlncicn e~vlnt~ ai blemtb ~s~tlj~ vlriarje`nl e`d dl~ch`.

Page 4: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 4/80

VBIC * @B^_N * ^B_N Nbbettc~herb

4

TEOML AI NA@TL@T^

EO^T_ENT ......................................................................................................................................... >

TEOML AI NA@TL@T^ .................................................................................... .................................... 4

MC^T AI ICH\_L^ ............................................................................................................................... <

MC^T AI TEOML^ ................................................................................................................................. 9

C@T_AD\NTCA@ ................................................................................................................................ 8

Oenkhra|`d ........................................................................................................................... 8

Na`nlvt|em Irejlxark ................................................................................. ..................... 56

JLTBAD^ ....................................................................................................................................... 55

^lmlntc`h Vertcncve`t~ ............................................................................... .......................... 55

Iclmdxark ............................................................................................................................ 5?

E`ems~c~ ............................................................................................................................... 5?

Ltbcnem Vrlne|tca`~ ............................................................................................................. 5>

IC@DC@H^ ........................................................................................................................................ 54

Iclmd ^lttc`h~ ...................................................................................................................... 54

Vraicml ai _l~va`dl`t~ ....................................................................................................... 58

Vlr~a`em e`d Vrail~~ca`em E`tlnldl`t~ ............................................................................. 53

Navc`h Xctb Edylr~cts ........................................................................................................ ?9

Ientar~ C`im|l`nc`h Tblcr Dlnc~ca`~ ta _ljec` .................................................................. ><

Xbet Tbls @lld7 Cjvrayc`h tbl Lvlrcl`nl ..................................................................... <2

^\JJE_S AI IC@DC@H^ ................................................................................................................ 93

^T_ETLHCN CJVMCNETCA@^ .............................................................................................................. 85

_LIL_L@NL^ ................................................................................................................................... 84

E@@LR\_L^ .................................................................................................................................... 8<

Tavcn H|cdl ......................................................................................................................... 8<

Iarj iar Aotec`c`h Na`~l`t ............................................................................................... 88

Tbljetcn Irejlxark ai E`ems~c~ ....................................................................................... 82

Tcjlmc`l ai C`tlryclx~ ........................................................................................................ 26

Page 5: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 5/80

VBIC * @B^_N * ^B_N Nbbettc~herb

<

MC^T AI ICH\_L^

Ich|rl 5 Dc~trcnt~ ai Nbbettc~herb tetl ........................................................................................... 3

Ich|rl ? Na`nlvt|em Irejlxark ................................................................................................... 56

Ich|rl > C`tlryclx~ xlrl na`d|ntld c` lchbt dc~trcnt~ .................................................................. 54

Page 6: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 6/80

VBIC * @B^_N * ^B_N Nbbettc~herb

9

MC^T AI TEOML^

Teoml 5 Dljahrevbcn- ~anca*lna`ajcn e`d blemtb vraicml ai Nbbettc~herb .................................... 3

Teoml ? Vraicml ai ~t|ds rl~va`dl`t~ ............................................................................................. 58

Teoml > Vraicml ai emm r|rem dantar~ c` Nbbettc~herb......................................................................... 58

Teoml 4 Vraicml ai emm r|rem dantar~ c` Nbbettc~herb narrl~va`dc`h ta ~t|ds l~~l`tcem nrctlrce - ..... 52

Teoml <. Kls ic`dc`h~ iraj tbl ~t|ds .............................................................................................. 93

Page 7: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 7/80

VBIC * @B^_N * ^B_N Nbbettc~herb

8

C@T_AD\NTCA@

Tbl hmaoem vraomlj ai tbl |`lu|em dc~trco|tca` ai tbl blemtb xarkiarnl oltxll` nctcl~ e`d

ycmmehl~- xctb ct~ ~lylrl na`~lu|l`nl~ iar tbl eyecmeocmcts e`d u|emcts ai blemtb ~lrycnl~- e`d a`

blemtb a|tnajl~ c` r|rem e d rljatl hlahrevbcnem erle~- c~ em~a jerkld c` C`dce. Tbc~ ~t|ds

~llk~ ta |`dlr~te`d e`d lmeoaretl tbl jc ai rle~a`~ xbs u|emcicld blemtb xarklr~ ‒~tes a`– „

xbs tbls na`tc`|l xarkc`h c` |`dlr~lryld erle~. C` dac`h ~a xl dlvert iraj tbl na`yl`tca` ai 

lvmarc`h tbl ‒`lhetcyl– vbl`ajl`a` ai rl~c~te`nl ta r|rem vmenljl`t~ e`d jchretca` exes iraj

r|rem erle~- e`d c`~tled ian|~ a` tbl ‒va~ctcyl– a|tnajl "c` blemtb vme``c`h tlrj~# ai u|emcicld

blemtb xarklr~ na`tc`|c`h ta vav|metl e`d xark c` r|rem erle~. Xl ian|~ a` jldcnem

vrentctca`lr~ c` tbc~ ~t|ds. U|emctetcyl rl~lernb jltbadamahs xe~ edavtld ta eddrl~~ tbc~

aoglntcyl- c`yamyc`h iclmd*oe~ld nammlntca` ai dete tbra|hb c`*dlvtb c`tlryclx~- e`d tbljetcn

e`ems~c~ ai tbl dete. Tbl iclmdxark xe~ na`d|ntld c` lchbt dc~trcnt~ ai Nbbettc~herb- e ~tetl xctbe ~ch`cicne`t trcoem vav|metca` ai vaar lna`ajcn ~tet|~ e`d e ~|oavtcjem dl`~cts ai u|emcicld

blemtb xarklr~

Oenkhra|`d

C`dce–~ Blemtb Xarkiarnl Nrc~c~

E blemtb xarkiarnl xbcnb c~ edlu|etl c` ~cwl- ~kcmm jc- u|emcts e`d eoml ta rlenb emm ~lntca`~ ai 

tbl vav|metca` c~ `lnl~~ers iar enbclyc`h e bchb e`d lu|cteoml naylrehl ai blemtb ~lrycnl~. C`dce`

nl`~|~ l~tcjetl~ edg|~tld iar ld|netca`em u|emcicnetca`~ rlylem tbet tbl blemtb xarklr dl`~cts

"c`nm|dc`h dantar~- `|r~l~ e`d jcdxcyl~# c~ evvracjetlms 2 vlr 56-666 vav|metca` "VBIC ?662#-

xlmm ~bart ai tbl ~|hhl~tld `arj ai ?< vlr 56-666 "XBA ?669#. E xcdl yerclts ai blemtb

xarklr~ vraycdl ~lrycnl~ c` emmavetbcn e`d C`dce` ~s~tlj~ ai jldcnc`l. Ema`h~cdl tbl vrayc~ca` ai 

emmavetbcn ~lrycnl~- vbs~cnce`~ trec`ld c` Es|rylde- Sahe- \`e`c- ^cdbe e`d Bajlavetbs-

nammlntcylms k`ax` e~ ES\^B- vraycdl blemtb nerl. Blemtb xarklr~ iraj oatb ~s~tlj~ ai 

jldcnc`l erl ljvmasld os tbl haylr`jl`t i|`dld v|omcn ~lntar e`d tbl vrcyetl ~lntar.

Tbl hlahrevbcn dc~trco|tca` ai C`dce–~ blemtb xarkiarnl c~ dc~t|roc`h. Ja~t "96,# blemtb xarklr~

erl vrl~l`t c` |roe` erle~ xblrl ?2, ai tbl vav|metca` rl~cdl~ "VBIC ?662#. Tbc~ r|rem oce~ c~

na`~c~tl`t enra~~ nedrl~ ai blemtb xarklr~; 46, ai emmavetbcn vbs~cnce`~- `|r~l~ e`d jcdxcil~-ES\^B vrentctca`lr~ e`d ?6, ai dl`tc~t~ erl vrl~l`t c` r|rem erle~. Tbc~ c~ rlimlntld c` tbl max

blemtb xarklr dl`~cts ai 55"4?# vlr 56-666 vav|metca` c` r|rem "|roe`# erle~. Enra~~ nedrl~ ai 

blemtb xarklr~ tbl dciilrl`nl~ erl jarl emerjc`h; tbl dl`~cts ai dantar~ vlr 56-666 vav|metca`

c` r|rem "|roe`# C`dce c~ > "5>#- ai `|r~l~ ?.4 "55.>#- ai jcdxcil~ 6.92 "5.4#- ai vberjenc~t~ 5.>

"4.4# e`d ES\^B vrentctca`lr~ 5 ">.4#. Tbl~l dciilrl`nl~ erl lyl` jarl ~trckc`h iar iljeml blemtb

xarklr~- vertcn|merms iljeml dantar~. Tbc~ hlahrevbcn cjoeme`nl c` tbl blemtb xarkiarnl

bejvlr~ tbl eocmcts ai r|rem vav|metca`~ ta ennl~~ u|emcts blemtb ~lrycnl~.

Page 8: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 8/80

VBIC * @B^_N * ^B_N Nbbettc~herb

2

Tbl jegarcts ai blemtb xarklr~ c` oatb tbl vrcyetl e`d v|omcn ~lntar erl vrl~l`t c` |roe` erle~.

Tbl vrcyetl ~lntar c` C`dce dajc`etl~ tbl dlmcylrs ai n|retcyl blemtb ~lrycnl~. C` oatb |roe` e`d

r|rem erle~- tbl jegarcts "86,# ai blemtb xarklr~ erl ljvmasld c` tbl vrcyetl ~lntar "VBIC ?662#.

Tbc~ c~ na`~c~tl`t enra~~ dciilrl`t blemtb xarklr nedrl~. I|rtblr- aylr 26 vlr nl`t ai tbl u|emcicld

vrcyetl vraycdlr jerklt c~ na`nl`tretld c` |roe` erle~ "XBA ?668#. Tbl menk ai u|emcicld

jldcnem vrail~~ca`em~ c` r|rem erle~ be~ rl~|mtld c` tbl jegarcts ai r|rem ba|~lbamd~ rlnlcyc`h

nerl iraj vrcyetl vraycdlr~- je`s ai xbaj erl ml~~ tbe` i|mms u|emcicld "XBA ?668#.

Tbl v|omcn ~lntar be~ jedl na`~cdlreoml liiart~ ta vmenl dantar~ e`d e yerclts ai atblr blemtb

xarklr~ c` r|rem erle~ tbra|hb ct~ ye~t `ltxark ai blemtb ~|o*nl`trl~- vrcjers e`d najj|`cts

blemtb nl`trl~ c` tbl~l erle~. Baxlylr- bchb mlylm~ ai yene`ncl~ c` tbl~l blemtb iencmctcl~ d|l ta

evvac`tld blemtb xarklr~ `at tekc`h |v va~t~- eo~l`tllc~j e`d d|em vrentcnl beyl najvrajc~ld

tbc~ liiart. Tbc~ vraomlj c~ vertcn|merms en|tl iar dantar~ et Vrcjers Blemtb Nl`trl~ "VBN~# e`d

iar ~vlncemc~t dantar~ et Najj|`cts Blemtb Nl`trl~ "NBN~#. VBN~ ~lryl e~ tbl icr~t vac`t ai 

na`tent iar n|retcyl ~lrycnl~ c` r|rem erle~ e`d beyl e nrctcnem raml c` manetc`h oe~cn blemtb ~lrycnl~

xctbc` najj|`ctcl~. A`l ~t|ds ic`d~ tbet eo~l`tllc~j eja`h vrcjers nerl xarklr~ c` C`dce c~ e~bchb e~ 46,- jekc`h ct c~ bchbl~t c` tbl xarmd "Xarmd Oe`k ?662#. Tbl~l vraomlj~ na`trco|tl ta

tbl |`rlmceocmcts ai aiicncem l~tcjetl~- e`d jes lvmec` aiicncem iecm|rl~ ta c`nrle~l emmanetca`~ ai 

iencmctcl~ e`d old~ xblrl tbls erl `lldld ja~t.

Je`s rle~a`~ beyl oll` dan|jl`tld iar xbs blemtb xarklr~ tsvcnemms nbaa~l `at ta xark c`

r|rem erle~. ^emers ljlrhl~ e~ e` cjvarte`t ientar ai e gao e`d ~tra`hms eiilnt~ tbl xcmmc`h`l~~ ta

xark c` r|rem erle~ "Nbajctw 5338; ^lr`llm~- Mc`dlmax lt em. ?668#. C` C`dce- ~tertc`h ~emercl~ iar

emmavetbcn vbs~cnce`~ c` tbl v|omcn ~lntar c~ era|`d _~. ?6-666 vlr ja`tb e`d eoa|t bemi ai tbet

iar `|r~l~. Baxlylr- tblrl c~ mcttml eddctca`em c`nl`tcyl hcyl` iar tba~l xba erl va~tld c` r|rem

erle~. Ientar~ atblr tbe` ~emers em~a vmes e` cjvarte`t raml c` tbl vrlilrl`nl ai |roe` va~ctca`~.

Iar lejvml ennl~~ ta trec`c`h- blemtb nerl e`d ld|netca` iar nbcmdrl`- vrajatca` avvart|`ctcl~-

tbl eyecmeocmcts ai lmlntrcncts- xetlr e`d ba|~c`h erl emm rle~a`~ tbet |roe` gao~ erl |~|emms

ieyarld "D|~~e|mt e`d Ire`nl~nbc`c ?669; Mc`dlmax e`d ^lr`llm~ ?669; ^lr`llm~- Mc`dlmax lt em.

?668#. C` Vekc~te`- tbl eo~l`nl ai lu|cvjl`t e`d ~|vvmcl~ xe~ e jegar dltlrrl`t iar ennlvtc`h e

r|rem va~t "Wecdc 5329#. E ~t|ds a` r|rem blemtb xarklr jatcyetca` c` Yclt`ej bchbmchbtld tbl

cjvarte`nl ai evvrlncetca` e`d ~|vvart iraj je`ehlr~ e`d nammleh|l~ e~ xlmm e~ iraj tbl

najj|`cts "Dclmlje`- N|a`h lt em. ?66>; VBIC ) Xarmd Oe`k ?662#.

Nbbettc~herb ^tetl

Nbbettc~herb xe~ neryld a|t ai tbl nl`trem C`dce` ~tetl ai Jedbse Vredl~b c` @ayljolr ?666.

Tbl ^tetl be~ e` erle ai 5-><-535 ~u. kj. xctb e vav|metca` ai ?5 jcmmca` "?665 Nl`~|~#. Tblrl

erl 59 dc~trcnt~- 549 omank~- e`d ?6->62 ycmmehl~ c` tbl ^tetl. 44, ai tbl me`d c~ iarl~tld e`d c~

bajl ta trcol~ xba na`~tct|tl a`l tbcrd ai tbl vav|metca`. Tbl eoayl ientar~ vmenl Nbbettc~herb

c` e |`cu|l va~ctca`. Tbl vbs~cnem c`eocmcts ta l`~|rl a|trlenb ~lrycnl~ ta iarl~tld erle~ na|vmld

xctb tbl vaar lna`ajcn ~tet|~ ai tbl trcoem jegarcts beyl na`~trec`ld liiart~ ta cjvrayl blemtb

e`d blemtb ~lrycnl c`dcnetar~ c` tbl ~tetl. Nbbettc~herb be~ e ~bartehl ai blemtb xarkiarnl;

Page 9: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 9/80

VBIC * @B^_N * ^B_N Nbbettc~herb

3

ennardc`h ta tbl O|mmltc` ai _|rem Blemtb ^tetc~tcn~ c` C`dce- ?66< tbl dantar*ta*vav|metca` retca c~

57>566.

@a.  Ctlj  Nbbettc~herb  C`dce 

5 Tatem vav|metca` "Nl`~|~ ?665# "c` jcmmca`# ?6.2> 56?2.95

? Tatem Ilrtcmcts _etl "^_^ ?669# >.4 ?.3

> C`ie`t Jartemcts _etl "^_^ ?668# 95 <8

4 Jetlr`em Jartemcts _etca "^_^ ?665 * ?66># >83 >65

< ^l _etca "Nl`~|~ ?665# 323 3>>

9 ^nbld|ml ne~tl vav|metca` "c` jcmmca`# ?.4? 599.94

8 ^nbld|ml trcol vav|metca` "c` jcmmca`# 9.9? 24.>>

2 Iljeml mctlrens retl "Nl`~|~ ?665# ",# <5.3 <>.8

Teoml 5 Dljahrevbcn- ~anca*lna`ajcn e`d blemtb vraicml ai Nbbettc~herb5 

Ich|rl 5 Dc~trcnt~ ai Nbbettc~herb tetl

5^a|rnl7 bttv7!!jabix.`cn.c`!@_BJ!^tetl,?6Icml~!nbbettc~herb.btj. Ennl~~ld a` 56!3!62

Page 10: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 10/80

VBIC * @B^_N * ^B_N Nbbettc~herb

56

Na`nlvt|em Irejlxark 

Vrentctca`lr~– dlnc~ca`~ ta ‒~tes a`– erl najvml- e`d c`im|l`nld yerca|~ms os vlr~a`em ientar~ e~

xlmm e~ os tblcr rlmetca`~bcv~ e`d c`tlrentca`~ xctb tbl blemtb ~s~tlj- tbl najj|`ctcl~ tbls mcyl

e`d xark c`- e`d tblcr vetcl`t~.

Ich|rl ? Na`nlvt|em Irejlxark 

E ~cjvml jadlm drexc`h iraj Vartlr e`d nammleh|l~ "?66?# xe~ vrava~ld e~ e na`nlvt|em

irejlxark ta vme` tbl rl~lernb c`~tr|jl`t~ e`d iar ~|o~lu|l`t tbljetcn e`ems~c~. Tbl

irejlxark c~ na`~tr|ntld ai ia|r aylrmevvc`h dajec`~- xctb tbl jec` ~|oglnt ai rl~lernb „ tbl

blemtb xarklr~ „ et tbl nl trl. \~c`h tbc~ irejlxark- tbl rle~a`~ xbs vrentctca`lr~ ‒~tes a`–erl lejc`ld os ~t|dsc`h tblcr ax` vlr~a`em nberentlrc~tcn~- yem|l~ e`d iarloler~- e`d em~a tblcr

rl~vlntcyl c`tlrienl~ xctb tbl blemtb ~s~tlj- xctb najj|`ctcl~- e`d xctb tblcr vetcl`t~.

Page 11: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 11/80

VBIC * @B^_N * ^B_N Nbbettc~herb

55

JLTBAD^

C`*dlvtb c`tlryclx~ "Hrocnb 5333# xlrl na`d|ntld xctb e ~lmlntca` ai jldcnem vrentctca`lr~ xbabeyl e` l~teomc~bld rlnard ai ~lrycnl c` r|rem erle~. Tbl dete iraj tbl~l c`tlryclx~ e d

dc~n|~~ca`~ xlrl e`ems~ld |~c`h tbl irejlxark evvraenb iar evvmcld u|emctetcyl rl~lernb

"_ctnbcl ) ^vl`nlr 5334#. Tbl dete xlrl ~artld c`ta ljlrhc`h tbljetcn netlharcl~ rlvrl~l`tc`h

vrentctca`lr~– lvlrcl`nl~- rle~a`~ iar ~tesc`h a`- e`d tblcr lvrl~~ld `lld~- e`d erl vrl~l`tld.

^lmlntc`h Vertcncve`t~

L~~l`tcem e`d dl~creoml nrctlrce iar tbl ~lmlntca` ai vertcncve`t~ xlrl dlmc`letld e~ iammax~7

L~~l`tcem7

*  ^lryc`h c` VBN ar NBN c` e r|rem erle iar jarl tbe` icyl sler~

A_

*  ^lryc`h c` e VBN ar NBN c` e rljatl? r|rem erle iar jarl tbe` a`l sler

Dl~creoml7

*  Emmavetbcn trec`c`h

*  Vrl~l`nl c` rljatl r|rem erle iar jarl tbe` < sler~ "jarl tbe` 56 sler~ bchbms dl~creoml#

*  ^lryc`h et vrcjers blemtb nl`trl mlylm "e~ avva~ld ta omank mlylm#

*  Iljeml

Tbl dl~creoml nrctlrce rlvrl~l`tld e na`~nca|~ vrlilrl`nl iar jarl bchbms u|emcicld dantar~ "tblcr

rltl`tca` c` r|rem erle~ olc`h jarl dl~creoml c` vme``c`h tlrj~#- tba~l xarkc`h c` vertcn|merms

rljatl erle~- e`d xctb e hrletlr ml`htb ai tcjl ~vl`t c` r|rem erle~ "~a e~ ta ennl~~ e rcnblr ~lt

ai enna|`t~ drex` iraj ma`hlr lvlrcl`nl#- e`d xajl` dantar~.

_l~va`dl`t~ xlrl cdl`tcicld v|rva~li|mms c` lenb dc~trcnt ~lmlntld iar tbl ~t|ds- oe~ld a`

c`iarjetca` iraj manem iencmctetar~ e d narraoaretld os c`~vlntc`h haylr`jl`t rlnard~. Nerl

xe~ tekl` ta l`~|rl rlvrl~l`tetca` ai oatb ~ll~- oatb netlharcl~ ai ljvmasjl`t "c.l. rlh|mer

e`d na`trent|em# e`d emm hlahrevbcnem manetca`~ xctbc` tbl ~tetl "2 dc~trcnt~ xlrl cdl`tcicld

?Tbl nrctlrce iar rljatl`l~~ erl drex` iraj aiicncem haylr`jl`t nme~~cicnetca` ai VBN~ e`d NBN~- oe~ld

a` tbl iammaxc`h na`dctca`~7

e. Dc~te`nl iraj Dc~trcnt BU 

o. Iarl~tld erle

n. Vaarms na``lntld os raed

d. Ltl`t ai beoctetca`

l. ^ch`cicne`t ~ln|rcts na`nlr`~

i. Menk ai ld|netca`em iencmctcl~

Page 12: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 12/80

VBIC * @B^_N * ^B_N Nbbettc~herb

5?

~vrled enra~~ tbl @artblr`- Nl`trem e`d ^a|tblr` wa`l~ ai tbl ~tetl# xctbc` tbl ~tetl "^cmylrje`

?664#. Vrentctca`lr~ jlltc`h ‒dl~creoml– nrctlrce xlrl cdl`tcicld vrlilrl`tcemms. E tatem ai >8

vertcncve`t~ xlrl l`mc~tld iar c`tlryclx.

Iclmdxark 

E rl~lernb tlej iraj VBIC e`d ^B_N na`d|ntld tbl rl~lernb aylr e vlrcad ai txa e`d e bemi 

ja`tb~ iraj G|ms „ ^lvtljolr ?663- c` lchbt dc~trcnt~ ai Nbbettc~herb ~tetl. Vrcar ta ljoerkc`h

a` iclmdxark rl~lernblr~ |`dlrxl`t trec`c`h c` u|emctetcyl rl~lernb jltbadamahs- c`nm|dc`h

c`tlryclx tlnb`cu|l- irejlxark e`ems~c~- e`d ltbcnem na`~cdlretca`~ c` c`tlryclxc`h e`d be`dmc`h

dete. Tavcn h|cdl~ xlrl dl~ch`ld drexc`h a` tbl dciilrl`t tbljetcn erle~ dlvcntld c` tbl

rl~lernb irejlxark "~ll Ich|rl 5#- e`d xlrl |~ld ta na`d|nt tbl c`*dlvtb c`tlryclx~. Emm

c`tlryclx~ xlrl na d|ntld xctb tbl ylroem na`~l`t ai rl~va`dl`t~. ^ll E``l|rl iar tbl tavcn

h|cdl e`d ~te`derd iarj iar aotec`c`h ylroem na`~l`t.

E~vlnt~ ai c`tlryclx tlnb`cu|l ljvbe~cwld c`nm|dld dlylmavc`h haad revvart e`d najiart- `a`*

vrlg|dcncem e`d `a`*vrlljvtcyl ~tsml- eyacdc`h dcrlntcyl ar mledc`h u|l~tca`~- c`yctc`h `erretcyl~

ai lvlrcl`nl~ e`d evvravrcetl vraoc`h "Orcttl` ?666#. Ltbcnem na`~cdlretca`~ era|`d tekc`h

na`~l`t iar c`tlryclx~- l`~|rc`h na`icdl`tcemcts ai dete- rl~vlnti|m najj|`cnetca`- ettl`tca` ta

~ancem e`d n|mt|rem `arj~- xlrl em~a hcyl` vertcn|mer na`~cdlretca` xbcml na`d|ntc`h iclmdxark.

Emm >8 rl~va`dl`t~ cdl`tcicld xlrl c`tlryclxld. C`tlryclx~ xlrl na`d|ntld c` Bc`dc e`d

rlnardld a` e dchctem jldce dlycnl xctb tbl vlrjc~~ca` ai tbl rl~va`dl`t~. Emm rlnardc`h~ xlrl

tre`~nrcold e`d tre`~metld c`ta L`hmc~b tlt a` e najv|tlr xard vranl~~c`h vrahrejjl.

E`ems~c~

Dete e`ems~c~ xe~ na`d|ntld ~cdl os ~cdl xctb nammlntca` ai tbl dete. Iar arhe`cwc`h tbl tlt|em

dete iraj tre`~nrcvt~ ai c`tlryclx~- tbl ”irejlxark‚ evvraenb iar evvmcld u|emctetcyl rl~lernb

xe~ evvmcld "_ctnbcl ) ^vl`nlr 5334#. Tbc~ evvraenb najoc`l~ c`d|ntcyl e`d dld|ntcyl

evvraenbl~- c` tbet ct vlrjct~ tbl najoc`etca` ai vrl*dltlrjc`ld tbljl~- xctb tba~l ljlrhc`h

iraj e rledc`h ai tbl dete. Tbl ~tlv~ c` tbl irejlxark evvraenb erl l`mc~tld e~ iammax~7

*  Iejcmcercwetca` xctb rex dete

*  Cdl`tcisc`h e tbljetcn irejlxark "~ll e``l|rl#- oe~ld a` vrl*dltlrjc`ld aoglntcyl~- e`d

ljlrhc`h iclmd mlylm c~~|l~

*  C`dlc`h „ os evvmsc`h tbl tbljetcn irejlxark ~s~tljetcnemms ta tbl dete.

*  Nbertc`h „ rlerre`hc`h tbl dete c`ta dc~tcmmld ~|jjercl~ ai yclx~ e`d lvlrcl`nl~.

*  Jevvc`h e`d c`tlrvrltetca` „ |~c`h tbl nbert~ ta manetl na`nlvt~- vbl`ajl`e- tsvamahcl~-

e`d e~~ancetca`~ oltxll` tbljl~.

Tblrl xe~ e` ljvbe~c~ a` ltrentc`h |`dlrmsc`h cjvmcnetca`~ e`d jle`c`h~ xbcnb rl~va`dl`t~

e~nrcold ta tblcr lvlrcl`nl~- retblr tbe` ta aylrtms ~tetld yclx~ e`d rbltarcn. ^vlncem ettl`tca`

xe~ vecd ta `ateoml yercetca`~ e`d dcylrhl`nl~ c` vlr~vlntcyl~ oltxll` dciilrl`t rl~va`dl`t~.

Page 13: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 13/80

VBIC * @B^_N * ^B_N Nbbettc~herb

5>

Txa e`ems~t~ nadld tbl dete e~ vlr tbl tbljetcn irejlxark- e`d tblcr nbacnl~ c` ettenbc`h

nadl~ ta tbl tlt xlrl najverld e`d ~te`derdcwld- ta cjvrayl tbl rlmceocmcts ai c`tlrvrltetca`~

iraj tbl dete "Jes~ e`d Vavl ?666#.

Tbljetcnemms netlharcwld ic`dc`h~ erl vrl~l`tld xbcnb c`narvaretl vettlr`c`h e`d yercetca`~ c`

rl~va`~l~. Xl beyl em~a ltrentld rljerkeoml `erretcyl~ xbcnb cmm|~tretl ~vlncicn vranl~~l~ e`d

mcil lvlrcl`nl~ ai tbl rl~va`dl`t~.

Ltbcnem Vrlne|tca`~

Vrcar ta c`tlryclx~- rl~va`dl`t~ xlrl c`iarjld ai tbl aoglntcyl~ ai tbl ~t|ds e`d bax tbl

nammlntld c`iarjetca` xa|md ol |~ld. _l~va`dl`t~ xlrl em~a c`iarjld ai tbl v|rva~l ai tbl

~t|ds e`d tbet tbl dete xa|md ol trletld c` e na`icdl`tcem je``lr. Ylroem na`~l`t xe~ aotec`ld

iar c`tlryclx~ e`d iar rlnardc`h tbl c`tlryclx. Emm rlnardc`h~ xlrl ~tarld c` e mankeoml na`tec`lr

xctb rl~trcntld ennl~~. Emm dchctem dete xlrl be`dmld c` najv|tlr vrahrejjl~ c` l`nrsvtld

iarjet xctb rl~trcntld ennl~~. Nerl be~ oll` tekl` ta l`~|rl e`a`sjcts ai emm c`dcycd|em~ nctld

c` tbc~ rlvart- os xctbbamdc`h tblcr `ejl~ e`d tba~l ai tax`~- ycmmehl~ e`d c`~tct|tca`~ xbcnb

jes beyl mld ta tblcr cdl`tcicnetca`.

Page 14: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 14/80

VBIC * @B^_N * ^B_N Nbbettc~herb

54

IC@DC@H^

Iclmd ^lttc`h~

Tbl ~t|ds naylrld 54 NBN~ e`d ?> VBN~ manetld c` rljatl e`d r|rem erle~ enra~~ lchbt dc~trcnt~

c` tbl ~tetl ai Nbbettc~herb. Emm tbl blemtbnerl nl`trl~ ~lmlntld xlrl dc~te`t iraj tbl dc~trcnt

bledu|ertlr~ e`d vaarms na``lntld os e`s iarj ai v|omcn tre`~vart. Xbcml ~ajl ai tbl NBN~

xlrl edlu|etlms mc`kld os raed~- rlenbc`h tbl VBN~ xe~ aitl` e vraomlj e~ tbls xlrl manetld

dllv c` tbl r|rem c`tlrcar~ |~|emms xctb |`veyld raed~. C` je`s ne~l~- tbl jec` jle`~ ai v|omcn

tre`~vart xlrl gllv~- aylrnraxdld xctb vlavml e`d ax`ld os c`dcycd|em~ rl~cdc`h c` tbl erle.

Blemtbnerl xarklr~ va~tld c` tbl~l manetca`~ hl`lremms rlms a` tblcr vrcyetlms ax`ld ylbcnml~

e`d ~ajltcjl~ ejo|me`nl~ "ci tblrl c~ a`l c` tbl blemtbnerl nl`trl# iar treylmmc`h ta omank ar

dc~trcnt blemtbnerl nl`trl~ xbl` nemmld iar jlltc`h~ ar atblr xark rlmetld yc~ct~.

Ich|rl > C`tlryclx~ xlrl na d|ntld c` lchbt dc~trcnt~

D|l ta vaar raed mc`kehl~ c` ~ajl vmenl~- ~ajl VBN~ erl n|t aii iraj tbl rl~t ai tbl ~tetl

d|rc`h tbl rec`s ~le~a` ne|~c`h na`~cdlreoml dciicn|mtcl~ iar jldcnem ~|vvmcl~- vetcl`t rlilrrem-e`d aitl` cjvldl blemtb xarklr~– xllkms ar decms najj|tl~. Ennl~~ ta irl~b vrad|nl c~ em~a

~lylrlms mcjctld c tbl~l tcjl~. Je`s ai tbl blemtbnerl nl`trl~ yc~ctld menkld oe~cn iencmctcl~ ai 

xetlr ~|vvms- lmlntrcncts e`d lu|cvjl`t „ tbc~ c~ dc~n|~~ld i|rtblr c` tbl oads ai tbl rlvart. C`

vmenl~ xblrl edlu|etl lu|cvjl`t c~ eyecmeoml- irlu|l`t lmlntrcncts a|tehl~ vrlyl`t ct~

|tcmcwetca`. Oer e ilx c`~te`nl~- mcyc`h u|ertlr~ vraycdld os e|tbarctcl~ erl c` dcmevcdetld

na`dctca` e`d c` ja~t c`~te`nl~ vrentctca`lr~ erre`hl tblcr ax` ennajjadetca` os rl`tc`h

vrcyetl ba|~l~. Je`s ai tbl dantar~ c`tlryclxld mcyl ema`l- najvlmmld os menk ai vravlr ba|~c`h

Page 15: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 15/80

VBIC * @B^_N * ^B_N Nbbettc~herb

5<

e`d ld|netca`em iencmctcl~ iar tblcr nbcmdrl`- ta ~l`d tblcr iejcmcl~ ta tax ~ e`d nctcl~. Menk ai 

eyl`|l~ iar ~anclts e`d l`tlrtec`jl`t erl evverl`t c` je`s c`~te`nl~- e`d illmc`h~ ai ~ancem

c~ametca` e`d ma`lmc`l~~ erl najja`. E`clts e`d dlvrl~~ca` xlrl em~a rlvartld eja`h ~ajl

vrentctca`lr~ e`d blemtb xarklr~- na|vmld xctb tbl ettl`de`t vraomlj~ ai emnabamc~j.

Tbl ~t|ds tlej bed ta treylm iar ma`h ba|r~ ta rlenb tbl~l manetca`~- tbra|hb ye~t ~trltnbl~ ai 

iclmd~ e`d ~ajltcjl~ dl`~lms iarl~tld erle~. Tbl tlej xe~ ennajve`cld os manem blemtb aiicncem~

ar blemtb xarklr~ xba xlrl xlmm enu|ec`tld xctb tbl tlrrec` e`d tbl manetca` ai tbl blemtbnerl

nl`trl~. D|rc`h tbl yc~ct~- tbl tlej irlu|l`tms nejl enra~~ ~lntca`~ ai raed~ xbcnb bed oll`

dl~trasld "e`d rlnl`tms rlvecrld# os me`djc`l~ rlvartldms vme`tld os c`~|rhl`t~- e` c`dcnetar ai 

tbl l`ycra`jl`t ai ycaml`nl e d jcmctercwetca` c je`s vert~ ai tbl ~tetl. Iar e `|jolr ai 

dantar~ e`d blemtb nerl xarklr~ va~tld c` erle~ eiilntld os c`~|rhl`ns- vlr~a`em ~eilts c~ e

jegar na`nlr` e`d ne|~l ai e`clts. _l~va`dl`t~ e`d ~t|ds iencmctetar~ rlvartld ~lylrem

c`~te`nl~ ai ycaml`t nme~bl~ oltxll` c`~|rhl`t~- ~ln|rcts iarnl~ e d na|`tlr c`~|rhl`t~. C` a`l

c`~te`nl- tbl tlej blerd ai tbl ann|rrl`nl ai e` erjld ettenk rl~|mtc`h c` tbl dletb ai ~lylrem

vamcnl aiicnlr~- e ilx des~ eitlr yc~ctc`h tbl manetca`. Veredacnemms- je s vert~ ja~t eiilntld os

~trcil xlrl em~a ai lnlvtca`em ~nl`cn ole|ts- xctb tblcr m|~b hrll` me`d~nevl~ e`d iarl~t e`dja|`tec` yc~te~.

Vedds iclmd~ c` e ~a|tblr` dc~trcnt

Page 16: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 16/80

VBIC * @B^_N * ^B_N Nbbettc~herb

59

E vrcjers blemtb nl`trl> 

E` |`veyld raed mledc`h ta e VBN

Yc~te iraj e najj|`cts blemtb nl`trl

>Vbatahrevb~ erl `at `lnl~~ercms ai manetca`~ xblrl c`tlryclx~ taak vmenl

Page 17: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 17/80

VBIC * @B^_N * ^B_N Nbbettc~herb

58

Vraicml ai _l~va`dl`t~

Teoml ? vraicml~ tbl >8 rl~va`dl`t~ c` tbl ~t|ds- oe~ld a` dciilrl`t nberentlrc~tcn~. Dltecm~ ai 

tbl ~lmlntca` vranl~~ e`d verejltlr~- c`nm|dc`h l~~l`tcem e`d dl~creoml nrctlrce erl dl~nrcold a`

vehl 55. Tbl lyl`t|em ~lmlntca` c~ xlchbtld os a|r vrlilrl`tcem cdl`tcicnetca` ai emmavetbcndantar~- dantar~ c` rljatl manetca`~- tba~l xctb jarl lvlrcl`nl- VBN dantar~ e`d xajl`.

^l4 

Jeml >> "23,#

Iljeml 4 "55,#

Ljvmasjl`t ~tet|~_lh|mer ?< "92,#

Na`trent|em 5? ">?,#

^s~tlj ai Jldcnc`lEmmavetbs >5 "24,#

ES\^B 9 "59,#

U|emcicnetca` "dlhrll#Jldcnem hred|etl >5 "24,#

Jldcnem va~thred|etl 9 "59,#

Sler~ ai ~lrycnl

5 * < 5? ">?,#

9 * 56 3 "?4,#

0 56 59 "4>,#

XarkvmenlVBN ?> "9?,#

NBN 54 ">2,#

Teoml ? Vraicml ai ~t|ds rl~va`dl`t~

"@ : >8#

Eitlr tbl ~t|ds xe~ najvmltld- xl |`dlrtaak e` c`~vlntca` ai haylr`jl`t rlnard~.

Nbbettc~herb be~ 5-?>8 dantar~ xarkc`h c` r|rem manetca`~ enra~~ tbl ~tetl "896 c` VBN~ e`d 488

c` NBN~#. Tbls erl vraicmld c` Teoml > olmax. Et tbl tcjl tbl c`tlryclx~ xlrl na`d|ntld- emm

ES\^B dantar~ c` tbl ~tetl xlrl l`hehld a` na`trent|em tlrj~.

^lJeml 322 "26,# 

Iljeml ?43 "?6,# 

Ljvmasjl`t ~tet|~_lh|mer 2<5 "93,# 

Na`trent|em >29 ">5,# 

^s~tlj ai Jldcnc`lEmmavetbs 392 "82,# 

ES\^B ?93 "??,# 

Sler~ ai ~lrycnl

= 5 ?>5 "53,# 

5 * < 963 "43,# 

0 < >38 ">?,# 

XarkvmenlVBN 896 "95,# 

NBN 488 ">3,# 

Teoml > Vraicml ai emm r|rem dantar~ c` Nbbettc~herb

"@ : 5?>8#

4Tbl vrlilrl`nl iar rl~va`dl`t~ xctb ma`hlr d|retca`~ ai ~lrycnl c` rljatl manetca`~ na`imcntld xctb e`d

mcjctld tbl `|jolr ai xajl` dantar~ c` tbl lyl`t|em ~lmlntca`- ~c`nl ylrs ilx xajl` dantar~ ilmm c` tbc~

netlhars.

Page 18: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 18/80

VBIC * @B^_N * ^B_N Nbbettc~herb

52

E nma~lr c`~vlntca` ai tbl rlnard~ em~a rlylemld tbet 9?< jldcnem vrentctca`lr~ c` Nbbettc~herb

narrl~va`dld ta a|r l~~l`tcem nrctlrce ai e jc`cj|j ai icyl sler~ ~lrycnl c` e r|rem ~lttc`h A_ a`l

sler–~ ~lrycnl c` e rljatl ~lttc`h. Tbl~l dantar~ beyl em~a oll` vraicmld olmax- c` Teoml 4.

^lJeml <?9 "24,# 

Iljeml 33 "59,# 

Ljvmasjl`t ~tet|~_lh|mer >45 "<<,# 

Na`trent|em ?24 "4<,# 

^s~tlj ai Jldcnc`lEmmavetbs >8> "96,# 

ES\^B ?<? "46,# 

Sler~ ai ~lrycnl5 * < >89 "96,# 

0 < ?43 "46,# 

XarkvmenlVBN 465 "94,# 

NBN ??4 ">9,# 

Teoml 4 Vraicml ai em m r|rem dantar~ c` Nbbettc~herb narrl~va`dc`h ta ~t|ds l~~l`tcem nrctlrce<-9

 

"@ : 9?<#

Et tbl tcjl ai iclmdxark- tbl rlnard~ rlylemld tbet <?9 "24,# ai tbl~l 9?< vrail~~ca`em~ xlrl

jeml- >45 "<<,# xlrl rlh|mer ljvmasll~ "xctb tbl rljec`dlr olc`h na`trent|em ljvmasll~#- e`d

>8> "96,# xlrl u|emcicld c` emmavetbcn "Xl~tlr`# jldcnc`l. Emm ?<? ES\^B*trec`ld vbs~cnce`~

xlrl ljvmasld a` na`trent|em tlrj~- tb|~ iarjc`h tbl jegarcts "23,# ai emm na`trent|em dantar~

c` tbl ~lmlntca` |`cylr~l. Ia|r b|`drld "94,# ai tbl~l dantar~ xlrl ljvmasld c` vrcjers blemtb

nl`trl~- e`d tbl rl~t c` omank*mlylm iencmctcl~ "najj|`cts blemtb nl`trl~#.

<Tbl~l aiicncem ich|rl~ jes `at rlimlnt ent|em hra|`d vrl~l`nl ai dantar~- ~c`nl tbls da `at enna|`t iar

eo~l`tllc~j9

Tbl vraicml ai ~t|ds vertcncve`t~ "Teoml ?# yercl~ iraj tbet ai tbc~ mc~tc`h- ~c`nl dl~creoml nrctlrce xlrl em~a

evvmcld xbcml ~lmlntc`h rl~va`dl`t~ "~ll vehl 8#

Page 19: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 19/80

VBIC * @B^_N * ^B_N Nbbettc~herb

53

Vlr~a`em e`d Vrail~~ca`em E`tlnldl`t~ 

\vorc`hc`h e`d iejcms oenkhra|`d 

E ~ch`cicne`t jegarcts ai tbl dantar~ c` tbc~ ~t|ds bed bed e r|rem |vorc`hc`h ">4!>8#- e`d e

`|jolr ai tblj nctld b|joml olhc``c`h~ e`d berd~bcv7

Iejcms oenkhra|`d xe~ `atbc`h hrlet iraj tbl olhc``c`h… ~trechbtexes

iraj tbl oattaj xl beyl najl ta tbl tav "Emmavetbcn dantar- na`trent|em-

56 sler~ c` r|rem e`d rljatl erle~- jeml# 

Xl beyl emxes~ ~tesld c` ycmmehl~ e`d ic`e`ncemms em~a xl erl `at mckl tbet

tbet xl beyl oll` ora|hbt |v `cnlms… xl beyl ~tesld c` ~tr|hhml…

"Emmavetbcn dantar- na`trent|em- 5< sler~ c` r|rem e`d rljatl erle~- jeml# 

C ej iraj e ~cjvml e`d ardc`ers iejcms. Js ietblr xe~ e  vetxerc  "me`d

rlnard~ nmlrk#. Js ld|netca` xe~ ja~tms c` rljatl erle~. C dcd js bchb~nbaam iraj "`ejl xctbblmd „ tax` xlmm k`ax` e~ c`~|rhl`t ~tra`hbamd#* e

@eemctl erle "lyl`# c` 532> "Emmavetbcn dantar e`d ~vlncemc~t- rlh|mer- 8 

sler~ c` r|rem e`d rljatl erle~- jeml# 

Et mle~t icyl rl~va`dl`t~ cdl`tcicld tblj~lmyl~ e~ olc`h ltb`cnemms trcoem- e`d beyc`h najj|`cts

eiicmcetca`~ ta trcoem hra|v~. ^ajl rl~va`dl`t~ cdl`tcicld tblj~lmyl~ e~ olma`hc`h ta cjjchre t

najj|`ctcl~ archc`emms iraj e `lchboa|rc`h ~tetl. _l~va`dl`t~– verl`tem e`d e`nl~trem

ann|vetca`~ re`hld iraj ierjc`h ta yerca|~ iarj~ ai haylr`jl`t ~lrycnl- e`d ld|netca`.

E ilx "54!>8# xlrl oar` ar ora|hbt |v c` tbl ~ejl dc~trcnt ar rlhca` ai tblcr vrl~l`t beoctetca`-

xblrle~ c` atblr c`~te`nl~- tbls xlrl iraj tax`~ e`d "|~|emms# ycmmehl~ c` atblr dc~trcnt~ ai 

Nbbettc~herb "58!>8#- e`d anne~ca`emms iraj `lchboa|rc`h ~tetl~ "9!>8#. ^lyl`tll` ai tbl >8

rl~va`dl`t~ rlvartld mcyc`h ier exes iraj tblcr verl`tem bajl~- aitl` eoml ta yc~ct tblj a`ms

c`irlu|l`tms.

Na`g|hem mcil

E jegarcts ai rl~va`dl`t~ xlrl jerrcld et tbl tcjl ai c`tlryclx ">4!>8#- aitl` xctb nbcmdrl`. E~

je`s e~ 54 ai tbl~l >4 rl~va`dl`t~ rlvartld mcyc`h evert iraj tblcr na`g|hem iejcmcl~. C` ~ajl

ai tbl~l c`~te`nl~- tbl ~va|~l~ e`d nbcmdrl` xlrl manetld c` vracjetl tax`~- xctb

avvart|`ctcl~ ta yc~ct tblj a` xllkl`d~ ar a`nl e ja`tb.

Js iejcms c~ c` "e `leros tax`#. Js xcil c~ e tlenblr c` tbl ld|netca`

dlvertjl`t. C beyl e a`l e`d e bemi sler amd hcrm c` tbl ba|~l. C ~tes blrl

"c` tbl ycmmehl# iraj Ja`des ta ^et|rdes. C ha a|t ta tbl iejcms a`

^et|rdes. A`l des xcmm beyl ta ol hcyl` ta tbl iejcms. "Emmavetbcn dantar-

rlh|mer- 9 sler~ c` r|rem e`d rljatl erle~- jeml# 

Page 20: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 20/80

VBIC * @B^_N * ^B_N Nbbettc~herb

?6

Baxlylr ~ajl rl~va`dl`t~ em~a rlvartld tbet tblcr ~va|~l e`d nbcmdrl` xlrl manetld c` e

dc~te`t vert ai tbl ~tetl ar c` e`atblr ~tetl xctb mcjctld avvart|`ctcl~ ta jllt. Tsvcnem rle~a`~

iar ~lveretca` c`nm|dld tbl eo~l`nl ai iencmctcl~ iar nbcmdrl`–~ ld|netca` c` vmenl~ ai xark- e`d

ljvmasjl`t avvart|`ctcl~ iar b|~oe`d e`d xcil c` ~lveretl manetca`~.

Ci C kllv tblj blrl tbl` bc~ "~a`–~# ld|netca` xcmm ol eiilntld. Xblrl tbls

"xcil e`d ~a`# mcyl c~ u|ctl ier iraj blrl. ?<6*>66 kj. ^ajltcjl~ ct c~ 4*<

ja`tb~ oliarl C ~ll tblj… et tcjl~ ci C hlt e` avvart|`cts tbl` C ha jarl

aitl`… "Emmavetbcn dantar- rlh|mer- aylr ?6 sler~ c` rljatl erle~- jeml# 

Ai tbl ia|r iljeml rl~va`dl`t~ c` tbl ~lmlntca`- tbrll xlrl jerrcld * lenb ai tblj mcyc`h xctb

tblcr b|~oe`d~ e`d nbcmdrl` * e`d tbl ia|rtb xe~ ~c`hml.

L`tlrc`h tbl jldcnem vrail~~ca`

Gac`c`h tbl jldcnem vrail~~ca` ljlrhld e~ e jegar mcil*lyl`t iar ~lylrem rl~va`dl`t~. Tbl ja~t

nrctcnem jajl`t c` tbc~ vranl~~- e~ rlna|`tld os rl~va`dl`t~- xe~ ai hec`c`h edjc~~ca` ta e

jldcnem nammlhl. L`trs c`ta e JOO^ dlhrll na|r~l xe~ xcdlms yem|ld aylr ES\^B jldcnem

dlhrll na|r~l~ "OEJ^- OBJ^ e d atblr~#. ^ajl rl~va`dl`t~ rlvartld rlvletld ettljvt~ ta

hec` edjc~~ca` ta tbl JOO^ dlhrll na|r~l. A`l OEJ^ hred|etl rlna|`tld c` dltecm bax bl bed

vrlverld ta najjct ~|cncdl eitlr iecmc`h ta enbclyl tbl rlu|c~ctl jerk~ iar JOO^- o|t xe~

vrlyl`tld os bc~ ircl`d~ e`d tbl` vlr~|edld ta tekl |v tbl OEJ^ na|r~l.

_l~va`dl`t~ xlrl c`im|l`nld os tblcr ~comc`h~ e`d vllr~ ~t|dsc`h iar vrl*jldcnem lejc`etca`~-

e`d os n|mt|rl~ ai enedljcn enbclyljl`t e`d e~vcretca` c` tblcr rl~vlntcyl iejcmcl~ e`d

najj|`ctcl~.

C hat c`~vcrld os js ~l`car~ "et ~nbaam. Tblrl xlrl 4*< ai tblj e`d C em~a

taak tbl ~|oglnt~ tbls xlrl dac`h. C tba|hbt tbet tbls beyl em~a hcyl` VJT

"vrl*jldcnem tl~t#- C xcmm em~a hcyl. Tbc~ xe~ tbl tbc`kc`h. C`ctcemms C bed `at

tba|hbt ai olc`h e dantar e`d ~lryl tbl vlavml. C hat c`~vcrld os tbl

~l`car~. "Emmavetbcn dantar- rlh|mer- 3 sler~ c` rljatl erle- jeml# 

D|rc`h js nbcmdbaad C dcd `at lyl` k`ax xbet VJT "vrl*jldcnem tl~t# xe~.

Xbl` C ve~~ld 55tb "~te`derd# js ircl`d xe~ icmmc`h tbl iarj * C e~kld bcj

xbet c~ VJT1 Tbls tamd jl tbet sa| olnajl e dantar os dac`h tbc~ ~a

lyl` C tba|hbt mlt~ icmm ct |v. C bed ~vl`t ~ajl _~. 56*5< "a` tbl iarj#. E`d

C heyl tbl lej xctba|t e`s vrlveretca - xctba|t ~t|dsc`h. Xl xlrl ia|r

ai |~ xba ~et c` tbl lej. Ai |~- tbl a`l xba jedl jl icmm tbl iarj e`d C

nmlerld ct- tbl atblr txa ircl`d~ dcd `at. O|t tbet ircl`d xba nmlerld VJT

iecmld bc~ icr~t sler. Lyl` `ax xbl` bl jllt~ jl c` "e `leros tax`#… vaar

ilmmax c~ r|``c`h e hranlrs ~tarl `ax. "Emmavetbcn dantar- rlh|mer- 55 sler~

c` rljatl erle~- jeml# 

Page 21: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 21/80

VBIC * @B^_N * ^B_N Nbbettc~herb

?5

Xbl` C xe~ ~t|dsc`h- et tbet tcjl tblrl xe~ e mat ai nrewl iar tbl ”~ncl`nl‚

~|oglnt c` rlmetca` ta atblr ~|oglnt~… xbltblr ert~ ar najjlrnl ^a c` js

vlr~a`em ne~l- tbl ~|oglnt tbet C nba~l C nba~l ct omc`dms- tbc`kc`h tbet ct be~

e mat ai nrewl- e`d em~a… xl ~ba|md ~es ct c~ rl~vlntld...~a hac`h xctb tbc~

tba|hbt C nba~l ~ncl`nl e`d ~t|dcld. ^trechbtexes eitlr tbl icr~t sler C xe~

~lmlntld c` tbl VJT. "Emmavetbcn dantar- na`trent|em- 56 sler~ c` r|rem e`d 

rljatl erle~- jeml# 

Verl`tem ejoctca`~ iar tblcr nbcmdrl` xlrl em~a irlu|l`tms nctld e~ e dltlrjc`e`t iar l`tlrc`h

jldcnem ~t|dcl~.

Js ietblr xe`tld jl ta olnajl e` l`hc`llr e`d js jatblr xe`tld jl

ta olnajl e dantar… ~c`nl xl xlrl ~jemm ~a xl dcd `at tbc`k j|nb eoa|t

olnajc`h e dantar ar l`hc`llr. C` tbl olhc``c`h C vrlverld js~lmi iar

l`hc`llrc`h a`ms… tbl` js jatblr ~ecd tbet tblrl c~ `atbc`h c` tbc~….mcil ai 

e` l`hc`llr c~ `at e~ j|nb e~ tbet ai e dantar…~a tbl` C mlit ct e`d taak

ocamahs "e~ e` avtca`em ~|oglnt e`d vrl*jldcnem rlu|crljl`t# e`d ~t|dclde`d olnejl e dantar "Emmavetbcn dantar- rlh|mer- 55 sler~ c` rljatl erle~-

jeml# 

C` jarl tbe` a`l c`~te`nl- vrentctca`lr~ rlna|`tld nrctcnem nbcmdbaad lvlrcl`nl~ „ ~ajltcjl~

tbl dletb ar c`icrjcts ai e verl`t iraj e vrlyl`teoml ar trleteoml ne|~l „ xbcnb mld tblj ta

v|r~|l nerllr~ c` jldcnc`l.

Js jatblr xe~ a`nl octtl` blrl c` be`d- e`d a`nl a` iaat- xl trcld ta hlt

blr blemld tbra|hb  gbed*vbaa`k  "xctnbnreit# o|t `atbc`h xarkld… Js

ietblr xe~ va~tld ~ajlxblrl lm~l. C bed ta tekl nerl ai js ba|~l- |~ld ta

maak eitlr js jatblr- |~ld ta naak iaad et bajl os js~lmi… tblrl xe~ `a

a`l lm~l et js vmenl- `a |`nml*e|`ts `a a`l ct xe~ `at e gac`t iejcms. Iraj

tbet des ct nejl ta js jc`d * C xe~ c` nme~~ ~c * tbet C beyl ta olnajl e

dantar. "Emmavetbcn dantar- rlh|mer- 52 sler~ c` rljatl erle~- jeml# 

Js ietblr lvcrld d|l ta jemerce. Js ietblr xe~ c` tbl crrchetca`

dlvertjl`t. Bl bed ta ha ta tbl iclmd. Tblrl xe~ e vba`l iraj tbl bajl

tbet ietblr c~ ~|iilrc`h e~ ~|nb. Dantar~ tamd jl tbet sa|r ietblr ve~~ld

exes d|l ta jemerce… tbl` em~a C tba|hbt tbet `a a`l ~ba|md dcl ai 

jemerce. Ct c~ e vrlyl`teoml dc~le~l. Tbc~ c~ tbl rle~a` C nejl c`ta tbc~.

Atblrxc~l C bed nba~l` edjc`c~tretca` iar js~lmi. "Emmavetbcn dantar-rlh|mer- 9 sler~ c` r|rem e`d rljatl erle~- jeml# 

C` js dc~trcnt tblrl c~ e ycmmehl…tblrl xe~ tbc~ meds…c` Nbbettc~herbc tbls

~ecd tbet ~bl bed ~ajl nbbaat kc ocjerc  "na`tehca|~ dc~le~l# e`d ~bl

lvcrld... e`d `aoads xe~ rleds ta vcnk blr |v. C |~ld ta ol rlemms ~nerld

xbl`lylr e`sa`l dcld- C xa|md `at lyl` najl a|t ai js ba|~l… o|t tblrl

C vcnkld blr |v … tbc~ heyl jl ~trl`htb…. Iraj tbl` C jedl e nbacnl iar

Page 22: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 22/80

VBIC * @B^_N * ^B_N Nbbettc~herb

??

tbl jldcnem mc`l. "Emmavetbcn dantar- na`trent|em- 52 sler~ c` rljatl erle~-

jeml# 

Cdlem~ ai ~lrycnl e`d na`trco|tca` ta ~anclts xlrl em~a nctld os ~ajl rl~va`dl`t~ e~ e rle~a` iar

l`tlrc`h tbl vrail~~ca`.

C taak edjc~~ca` tbc`kc`h tbet C ~ba|md da ~ajltbc`h… C` xbcnb xes C xcmm

ol eoml ta ~lryl tbl vlavml. Tblrl erl yerca|~ xes~ ta ler` ja`ls…o|t c`

jldcnem sa| beyl oatb… haylr`jl`t c~ hcyc`h tbl ja`ls e`d ~cdl os ~cdl

xl erl em~a ~lryc`h tbl vlavml. "Emmavetbcn dantar- na`trent|em- 5< sler~ c`

r|rem e`d rljatl erle~- jeml# 

C |~ld ta tbc`k tbet C ej hac`h c`ta tbl mc`l ai ~ancem ~lrycnl- ta ~lryl tbl

vetcl`t~; ct–~ e haad dlld… lyl` tades tbet bamd~ tr|l. "Emmavetbcn dantar 

e`d ~vlncemc~t- na`trent|em- 59 sler~ c` rljatl erle~- jeml# 

Ja~t ai tbl rl~va`dl`t~ ">5!>8# c` tbc~ ~lmlntca` xlrl JOO^ hred|etl~- e`d tbl rljec`c`h ~cxlrl OEJ^ hred|etl~. ^c rl~va`dl`t~ bed va~thred|etl dlhrll~ "JD ar J^# ai ~vlncemcwetca`.

Iar je`s- jldcnem ld|netca` c`yamyld rlmanetc`h tljvarercms ta tax`~ ier exes iraj tblcr

iejcmcl~. Emm tbl rl~va`dl`t~ bed ettl`dld jldcnem nammlhl c` tbl ~ejl ar `lchboa|rc h ~tetl~.

_l~va`dl`t tsvcnemms ~vakl mcttml ai tblcr lvlrcl`nl~ c` jldcnem nammlhl- atblr tbe` tbet ct xe~ e

vlrcad ai berd ~t|ds e`d- c` ~ajl c`~te`nl~- ~tr|hhml ta najvltl enedljcnemms.

Najc`h ta xark c` r|rem e`d rljatl erle~

Eitlr tblcr lvlrcl`nl~ ai hec`c`h l`tre`nl ta jldcnem nammlhl- tbl `lt nrctcnem nerllr ~tlv iar

ja~t vrentctca`lr~ xe~ cdl`tcisc`h avvart|`ctcl~ iar xark. Eja`h tba~l c` rlh|mer gao~- e`|jolr bed ~tertld xark e~ na`trent|em ljvmasll~ e`d bed metlr oll` |vhredld ta rlh|mer

~tet|~. ^lylrem bed xarkld c` atblr manetca`~ c`nm|dc`h c` haylr`jl`t ~lrycnl c` atblr tax`~-

ycmmehl~ e`d c` tbl vrcyetl ~lntar- vrcar ta gac`c`h xark c` tblcr vrl~l`t manetca`~.

Je`s rl~va`dl`t~ vlrnlcyld tbet tblcr vrl~l`nl c` tblcr rl~vlntcyl manetca`~ xe~ `at ai tblcr

nbaa~c`h * tbls xlrl ~cjvms e~~ch`ld tblrl os tbl haylr`jl`t–~ vmenljl`t vranl~~.

C` tbl olhc``c`h ct xe~ at haad et emm…ct xe~ g|~t e ycmmehl. Xbl` sa|

~t|ds c` tbl nammlhl tbl` ct c~ dciilrl`t… sa| tbc`k tbet sa| xcmm xark et e

haad vmenl… xbl` C nejl a|t ai tblrl tbl` "C xe~ vmenld c`# tbc~ VBN c` e

ycmmehl% Eitlr tbet C tba|hbt AK mlt–~ trs a|t tbc~ VBN gao. "Emmavetbcn dantar-

rlh|mer- 4 sler~ c` r|rem e`d rljatl erle~- jeml# 

Nbacnl1 Nbacnl g|~t jle`~ tbet e vlr~a` trcl~ ta maak iar ~ajlvmenl haad…

xblrl et mle~t sa| hlt e haad l`ycra`jl`t ta mcyl c`. Eitlr gac`c`h

"haylr`jl`t ~lrycnl#- os tbl ardlr~ ai tbl nammlntar C xe~ va~tld blrl-

~c`nl tblrl xe~ `a dantar blrl. "Emmavetbcn dantar- rlh|mer- ?.< sler~ c`

r|rem e`d rljatl erle~- jeml# 

Page 23: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 23/80

VBIC * @B^_N * ^B_N Nbbettc~herb

?>

Eitlr C xe~ hcyl` js icr~t va~tc`h- C nejl ta k`ax tbet ct xe~ tbl ja~t

oenkxerd vmenl. Eitlr najc`h ct xe~ `at va~~coml ta hlt a|t iar e`atblr 8

sler~. Xbl` C ic`emms na|md hlt a|t tbl` ct xe~ mckl ‚ee~jee` ~l `ckml e|r 

kbegaar vl etkl‚ "a|t ai tbl irsc`h ve` c`ta tbl icrl#… ~a C hat a|t ai tblrl

e`d hat ~t|nk blrl iar ?2 sler~. Xba xa|md mckl ta ha ta vraomljetcn

vmenl~ * tbet vlr~a` be~ ta ol taa cdlemc~tcn- mckl 566, ba`l~ts e`d

He`dbce`. @arjem vlavml mckl |~ xa|md a ms mckl ta ha ta e vmenl xbcnb be~

ilxlr vraomlj~… xblrl tblrl c~ ja`ls. ^a ct xe~ os nbe`nl tbet xl nejl

blrl * xl dcd `at xc~b ta najl blrl. "Emmavetbcn dantar- rlh|mer- ?2 sler~ c`

r|rem e`d rljatl erle~- jeml# 

^ajl rl~va`dl`t~ ta|nbld a` tbl emmlhld raml ai `lvatc~j e`d c` ~ajl c`~te`nl~ entcyl

narr|vtca` c` tbl emmanetca` ai va~tc`h~- ~|hhl~tc`h tbet rljatl e`d ml~~ vrlilrrld manetca`~

xlrl e~~ch`ld ta tba~l xba dcd `at beyl vlr~a`em ar vln|`cers c`im|l`nl ta oler a` e|tbarctcl~.

A` tbl atblr be`d- e `|jolr ai vrentctca`lr~ bed em~a entcylms ~a|hbt ta xark c` tbl erle ai tblcr vrl~l`t manetca`~- "iar e yerclts ai rle~a`~ xbcnb erl a|tmc`ld olmax#- e`d c` ~ajl

c`~te`nl~ c`dcnetld tbet tbl e|tbarctcl~ bed oll` rl~va`~cyl ta tblcr rl~vlntcyl ~ct|etca`~.

Hlahrevbcnem e`d ltb`cn "trcoem# eiic`ctcl~ xlrl nctld os e `|jolr ai vrentctca`lr~ 

Iraj tbl olhc``c`h- C tba|hbt tbet C xcmm ha ta js bajl vmenl e`d da

~lrycnl… ~a xbl` xl xlrl na|`~lmmld "os haylr`jl`t vmenljl`t

e|tbarctcl~# tbls e~kld iar js nbacnl „ C heyl `ejl~ ai tbrll vmenl~ e`d C

hat js icr~t nbacnl "Emmavetbcn dantar- rlh|mer- ?.< sler~ c` r|rem e`d rljatl

erle~- jeml# 

C hat tbl vmenl ai js nbacnl. _chbt `ax tbc~ erle c~ ic`l "~eil iraj c`~|rhl`t

entcycts#… e`d "tbl va~ctca`# xe~ em~a yene`t iraj u|ctl ~ajl tcjl… C

olma`h ta ~|nb e iejcms… olne|~l C ej e trcoem ~a C ic`d ct ic`l ta xark c` e

trcoem erle "Emmavetbcn dantar- rlh|mer- 2 sler~ c` rljatl erle- jeml# 

Yem|l~ ai ~lrycnl e`d tbl cjvarte`nl ai e ~ancem rlt|r` iraj haylr`jl`t*i|`dld jldcnem

ld|netca` xlrl em~a nctld os e ilx dantar~- e~ e jatcyetc`h ientar iar gac`c`h e va~ctca` c` e r|rem

ar oenkxerd erle.

C gac`ld blrl olne|~l ai js ietblr... Bl em~a heyl ~lrycnl blrl… bl bed

~ll` tbl xbaml ai "tbl dc~trcnt „ `ejl xctbblmd# ~a bl ~ecd sa| erl `lldldjarl tblrl. Bl bed ~ecd et mle~t < sler~ o|t C bed jedl e terhlt ai 56

sler~- `ax tbc~ c~ js >rd sler. "Emmavetbcn dantar- rlh|mer- 55 sler~ c`

rljatl erle~- jeml# 

C nba~l ct "tbl va~tc`h# a` js ax`… C ilmt tbet C ~ba|md… xbetlylr

ld|netca` C beyl tekl`- tbl haylr`jl`t be~ ~vl`t a` jl C ej u|emcicld

l`a|hb tbet C na|md xark c` js ax` `|r~c`h bajl ar e`s atblr och ba~vctem

Page 24: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 24/80

VBIC * @B^_N * ^B_N Nbbettc~herb

?4

o|t C ilmt tbet ~c`nl C beyl tekl` iraj tbl haylr`jl`t ~a C rlt|r` ta tbl

haylr`jl`t em~a. Em~a ta tbl najj|`cts ta xbcnb C olma`h * C beyl tekl`

iraj tbl ~anclts ~a C xcmm beyl ta rlt|r` ct. ^a ta rlt|r` xbet C taak iraj

tbl haylr`jl`t e`d ~anclts C gac`ld e haylr`jl`t gao e`d C ej xarkc`h c`

tbl trcoem erle iar js vlavml "Emmavetbcn dantar e`d ~vlncemc~t- rlh|mer- 2

sler~ c` r|rem e`d rljatl erle~- jeml# 

E ilx rl~va`dl`t~ c`dcnetld tbet tbls bed gac`ld haylr`jl`t gao~ c` r|rem erle~ d|l ta vamcncl~

mc`kc`h na`d|nt ai r|rem ~lrycnl xctb lmchcocmcts iar ar vrlilrl`tcem edjc~~ca` ta va~thred|etl

dlhrll na|r~l~.

C ~bcitld blrl mleyc`h e vrcyetl vrentcnl xartb "_~.# >6-666 * 46-666. Js

vrentcnl xe~ ylrs haad c` "e `leros tax`# e`d C mlit tbet vrentcnl ta ol

blrl. Tbl rle~a` xe~ tbet xctb tbl kcd~ e`d tekc`h nerl ai tbl ba|~l C

na|md `at ~t|ds. ^a iar tbc~ rle~a` a`ms C gac`ld haylr`jl`t gao tbet ci C ej

c` haylr`jl`t tbl` haylr`jl`t xcmm hlt a|r VH da`l… tbc~ xe~ tbl

jatcyetca`. "ES\^B dantar- na`trent|em- 9 sler~ c` rljatl erle- jeml# 

A`l rl~va`dl`t rlna|`tld tbl edye`tehl~ ai  hrletlr e|ta`ajs c` nerc`h iar vetcl`t~ e`d tbl

eocmcts ta |tcmcwl bc~ vrail~~ca`em ~kcmm~ olttlr e~ e rle~a` tbet jatcyetld bcj ta jayl iraj e ncts

ba~vctem ta e ycmmehl VBN.

C mlit nl`trem ~lrycnl e`d nejl blrl… C xe~ tblrl iar > sler~. Aylr tblrl ct

xe~ mckl sa| beyl ta da xbetlylr c~ ~lt os tbl haylr`jl`t… mckl

verenltejam- or|il` "co|vrail`#- evert iraj tbet sa| ne`–t da e`stbc`h

lm~l iar e`soads sa| g|~t hcyl tblj ~ajl e`emhl~cn e`d ~l`d tblj aii- ~a

emm tbc~ C dcd `at l`gas- ~a tbet–~ xbs C mlit ct. Blrl * xbetlylr rl~a|rnl~ sa|

beyl- xbetlylr k`axmldhl sa| beyl- sa| ne` |~l. Sa| ne` da e mat iar tbl

vetcl`t. Iar tbet rle~a` C mlit ct e`d nejl. "Emmavetbcn dantar- rlh|mer- 52

sler~ c` r|rem e`d rljatl erle~- jeml# 

A`l iljeml vrentctca`lr rlna|`tld bax tbl vracjcts ai tbl dantar–~ bajl e`d ~va|~l–~ vmenl

ai xark- iejcms na``lntca`~ c` tbl blemtb dlvertjl`t e`d blr xcmmc`h`l~~ ta xark c` e r|rem erle-

lenb vmesld e raml c` blr dlnc~ca` ta tekl |v e va~ctca` c` e rljatl a|tva~t.

Js vravlr bajl c~ c` tbl nama`s ?< kj iraj blrl. Eitlr ve~~c`h tbl V^N

"v|omcn ~lrycnl~ najjc~~ca` lejc`etca`#- C xe~ hcyl` tbc~ va~tc`h. ^ll- `a

a`l xe`t~ ta najl blrl. Iar tbl V^N em~a ct c~ e vraomlj "ta ic`d ~ajla`l#tbet xcmm najl blrl. Tbl naardc`etar tbl`- "`ejl ai e blemtb aiicncem#- xl

em~a bed iejcms rlmetca`~ xctb tblj. Xbl` tbl mc~t nejl a|t bl k`lx tbet

tbc~ VBN c~ ?< kj exes e`d ci `aoads lm~l- tbl` ~bl xcmm gac` e`d ha tblrl.

Ci ~ajla`l lm~l c~ hcyl` tbl` tbet vlr~a` xcmm `at gac`. Jes ol tbls xlrl

tbc`kc`h tbc~ olne|~l ai xbcnb C hat ct. " Emmavetbcn dantar- rlh|mer- 4 sler~

c` rljatl erle- iljeml#

Page 25: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 25/80

VBIC * @B^_N * ^B_N Nbbettc~herb

?<

Tbc~ enna|`t lvctajcwl~ bax najoc`etca`~ ai ientar~ xlrl irlu|l`tms rl~va`~coml iar dantar~–

c`ctcem vmenljl`t e`d najjl`nljl`t ai xark c` r|rem vrcjers blemtb ~s~tlj~.

Page 26: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 26/80

VBIC * @B^_N * ^B_N Nbbettc~herb

?9

Navc`h Xctb Edylr~cts

^lylrl na`~trec`t~ c` xarkc`h na`dctca`~ xlrl lycdl`t c` ~ajl c`~te`nl~- e`d ~lylrem

rl~va`dl`t~ em~a rlvartld beyc`h ta navl xctb ~bartehl~ ai xetlr- lmlntrcncts- ~venl e`d

~|vvmcl~. Vraomlj~ c` treylmmc`h ta vaarms ennl~~coml iclmd a|tva~t~ xlrl irlu|l`tms rlvartld.

Tblrl xe~ e` lvcdljcn ai he~tral`tlrctc~ blrl * lylrsa`l xe~ c` tbl ~ejl

na`dctca` e`d xl dcd `at beyl ~venl. Tblrl c~ `a ba~vctem o|cmdc`h- e`d emm

tbc~ "lc~tc`h iencmcts# c~ amd ~tsml- mckl c` tbl ja`~aa`~ ct mlek~. Xbl` tblrl

erl taa je`s vetcl`t~ xl beyl vraomlj~ e~ ta xblrl ta kllv tblj „ ~a

lylrstbc`h xe~ icmmld xctb yajctc`h e`d ielnl~. O|t xl trletld tblj.

"Emmavetbcn dantar- rlh|mer- ?4 sler~ c` r|rem e`d rljatl erle~- jeml# 

Lmlntrcncts c~ e vraomlj blrl. Ct xa|md ol tblrl iar txa des~ tbl` xcmm ha iar

tbl l`tcrl `chbt. Ct c~ e tljvarers na``lntca`. Tbrll vbe~l na``lntca` bed

najl o|t ct na|md `at ol c`~temmld d|l ta ~ajl vraomlj~. Tblrl c~ em~a e

vraomlj ai xetlr e~ tblrl c~ a tev. C beyl ljvmasld e vrcyetl vla` ta icmmxetlr e`d jekl iaad "Emmavetbcn dantar- rlh|mer- 3 sler~ c` rljatl erle-

jeml# 

C |~ld ta ha iar tbl dlmcylrs c` e oaet….C da`–t lyl` k`ax bax ta

~xcj#…tbl rcylr xe~ c` ~vetl e`d c` tbet ~ct|etca` xl |~ld ta tekl aii a|r

nmatbl~ e`d ~ct c` a|r |`dlrnmatbl~ c` e ~jemm oaet- e`d ha… tblrl c~ e mat ai 

dlje`d "iar jldcnem nerl# ~cr- tbet sa| j|~t najl ar lm~l tbl l`tcrl ycmmehl

xcmm najl ta tekl sa|… "Emmavetbcn dantar- rlh|mer- 52 sler~ c` rljatl

erle~- jeml# 

Tblrl xlrl ~lylrem enna|`t~ ai dantar~- `|r~l~ e`d ~|vvart ~teii xarkc`h aylrtcjl- ~berc`h

d|tcl~ e`d ~ajltcjl~ dcycdc`h tblcr tcjl enra~~ txa ar jarl iencmctcl~ c` dciilrl`t manetca`~- ta

aylrnajl vlr~a``lm ~bartehl~. ^lylrem rl~va`dl`t~ rlvartld edevtc`h e`d jekc h imlcoml |~l

ai eyecmeoml rl~a|rnl~ ta eddrl~~ manem blemtbnerl lld~. Irlu|l`tms tbc~ c yamyld jekc`h

vlr~a`em lvl`dct|rl~.

C beyl ta maak eitlr ? vmenl~…~a ci C beyl ha`l tblrl e`d tbls nemm jl iar

~ajltbc`h cjvarte`t tbl` C beyl ta r|` blrl „ ct–~ eoa|t ?6 kj~ „ C ha os

"jatar#ockl. "C`y7 e`d tbl ja`ls iar vltram dal~ tbl haylr`jl`t hcyl

ja`ls1# _7 xl ha a` a|r ax`. Atblrxc~l xl xa|md `at ol eoml ta da ct.

"Emmavetbcn dantar- rlh|mer- 2 sler~ c` rljatl erle- jeml# 

Evert iraj tbl vetcl`t~ C beyl ta maak eitlr tbl emm ycmmehl~ c` tbl omank…

tblrl xe~ e ne~l ai dlmcylrs- >6 kj exes iraj tbl omank bledu|ertlr- tbls

bed `aoads c` tblcr bajl. ^bl nemmld xbl` ~bl xe~ ?66kj exes iraj blr

bajl- tbet tblrl c~ `aoads et js bajl e`d C ej c` meoa|r vec` e`d tblrl

c~ `a erre`hljl`t eyecmeoml c` tbl ycmmehl * ~a tbl` xl ~l`t a|r

edjc`c~tretcyl gllv ta blr bajl e`d hat blr edjcttld ta ba~vctem e`d tbl`

Page 27: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 27/80

VBIC * @B^_N * ^B_N Nbbettc~herb

?8

xl rlilrrld blr ta "tbl dc~trcnt bledu|ertlr~#. A|r gllv taak blr tblrl.

"Emmavetbcn dantar- rlh|mer- 59 sler~ c` r|rem e`d rljatl erle~- jeml# 

Ct–~ `at tbet a`ms tbl dantar xba c~ a` ljlrhl`ns d|ts xcmm da tbl

ljlrhl`ns. Lyl` ci ct c~ `at sa|r d|ts sa| beyl ta da. Tblrl erl ~teii 

~bartehl~… C` ~jemm vmenl~ sa| beyl vlr~a`em rlmetca`~bcv~ xctb lylrsa`l…

Sa| ne``at tlmm tblj (`a–. ^a sa| beyl ta ~ll tblj * lyl` ci sa| erl ~mllvs-

lyl` ci sa| erl tcrld… lyl` ci ct c~ jcddml ai tbl `chbt. "Emmavetbcn dantar 

e`d ~vlncemc~t- rlh|mer- 4 sler~ c` r|rem erle- iljeml# 

Xl da `at beyl iclmd ~|vlryc~ar~. ^c`nl ~|vlryc~ar~ erl `at tblrl tbl` tblcr

rl~va`~cocmcts c~ hcyl` ta tbl vlr~a` xba c~ lvlrcl`nld c` tbet iclmd. Xl

beyl ta xark xctb ~|o~tct|tl~. Xl arhe`cwl tbc`h~ ennardc`h ta tbl

je`vaxlr xl beyl e`d da tbl xark. "Emmavetbcn dantar- rlh|mer- aylr ?6

sler~ c` rljatl erle~- jeml# 

Vraomlj~ ai  ennl~~ e`d najj|`cnetca` xlrl vertcn|merms jerkld c` jarl rljatl erle~. Ena`trent|em dantar ~lryc`h c` e VBN c` e vertcn|merms rljatl manetca` c` e iarl~tld yemmls

rlna|`tld bax bc~ nammleh|l~ e`d bl navld xctba|t i|`ntca`em jatar*trenk~ e`d tlmlvba`l

najj|`cnetca`.

C` js iclmd "erle#- ~|rylsc`h c~ ylrs dciicn|mt * c` tbl rec`~- emm tbl jarl ~a.

Tblrl c~ e rcylr; a`l ~lntca` c~ enra~~ tbl rcylr- ~a d|rc`h imaad~ ct c~ dciicn|mt

ta ha tblrl. Tbl oaet~ erl ylrs ~jemm * ~cttc`h c` tblj c~ dciicn|mt e`d C da`–t

k`ax bax ta ~xcj. A|t ai iler C da`–t ha- ~a a|r iclmd xarklr~- C tlmm tblj

ta je`ehl. Tbl atblr txa ~lntca`~- yc~ctc`h tblj c~ ylrs dciicn|mt * sa| beyl

ta ha xemkc`h j|nb ai tbl xes. Tblrl c~ a`l vac`t xbcnb c~ emja~t 5?6 kj

exes. ^a tblrl C beyl ~|rylsld a`ms a`nl olne|~l C da`–t beyl js ax`

"jatar#ockl „ ia|r xbllmlr~ ne –t ha tblrl. ^a txa des~ hac`h- txa des~

najc`h * ta da tbl ra|`d "ES\^B dantar- na`trent|em- > sler~ c` rljatl

erle~- jeml# 

Tlmlvba`l najj|`cnetca` c~ `at tblrl et emm. Tblrl c~ `atbc`h- `a me`dmc`l-

`a "jaocml# `ltxark naylrehl. Sa| beyl ta ha aylr tbl hbet "bcmm# ta hlt e

~ch`em- atblrxc~l sa| ne`–t hlt e`s jl~~ehl~. Tbl ycmmehl tec je` jayl~

eoa|t e`d bl be~ e jaocml vba`l- ~a xl na`yls jl~~ehl~ "ta tbl `lerl~t

omank ba~vctem- e`d ta iejcms# tbra|hb bcj e`d tbl` tbls mleyl e jl~~ehl

xctb bcj- xbcnb xl hlt os lyl`c`h. E~~|jl tblrl c~ e najvmcnetld dlmcylrs* rlilrrc`h c~ ylrs dciicn|mt. Tbl tec~ blrl mleyl et 2 c` tbl jar`c`h e`d

tbls najl et < c` tbl lyl`c`h a`ms- ~a iraj 2 ej ta < vj tblrl erl `a

jle`~ "ai najj|`cnetca` ar tre`~vart# blrl. ^a ci xl rlilr e ne~l tbl`

tbet vlr~a` xa|md kllv ~cttc`h blrl c` ira`t ai |~. Ci xl ha a|t~cdl "aylr

tbl bcmm# ta nemm ~ajla`l- tbls da`–t najl olne|~l ct tekl~ tblj ? ba|r~

"iraj tbl `lerl~t tax`# „ xl beyl ta xect tcmm <. C` oltxll` tbls heyl e`

ejo|me`nl iar blrl o|t tbet na|md `at nmcjo "|v tbl bcmm# ta tbl raed. ^a ci 

Page 28: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 28/80

VBIC * @B^_N * ^B_N Nbbettc~herb

?2

tbl vetcl`t c~ rlemms cmm- ci ct c~ e dlmcylrs ne~l- tbl`… "ES\^B dantar-

na`trent|em- > sler~ c` rljatl erle~- jeml# 

Vraomlj~ xctb rl~cdl`tcem iencmctcl~ xlrl xcdlms rlvartld- xctb dantar~ iarnld ta tekl |v vrcyetl

ennajjadetca`~ ar mcyl c` vaarms jec`tec`ld ar c`edlu|etl haylr`jl`t iencmctcl~.

C ne`–t hlt js iejcms blrl. Tblrl erl `a iencmctcl~. C`ire~tr|nt|rl c~ wlra- emm

atblr iencmctcl~ erl wlra. Tbc~ c~ e rljatl vmenl. Ct c~ a`l–~ haad m|nk ci tblrl

c~ lmlntrcncts. Tblrl c~ e mat ai vraomlj ai xetlr. Emm xetlr ~a|rnl~ mckl tev-

oarlxlmm erl e iecm. Sa| beyl ta ardlr xetlr iar _~ 56 e mctrl. @axedes~-

olne|~l ai "e haylr`jl`t ~nbljl#- ~c`nl vlavml hlt rcnl c` _~ ? vlr kh- tbl

vlr~a` xba iltnbl~ xetlr c~ em~a `at eyecmeoml. "Emmavetbcn dantar- rlh|mer-

9 sler~ c` r|rem e`d rljatl erle~- jeml# 

Tblrl erl `a vravlr u|ertlr~ blrl… sa| ne` ~ll tbl ~ct|etca` sa|r~lmi…

lylrs sler C ~vl`d et mle~t _~. 4666 mesc`h vamstbl`l "xetlrvraai ~blltc`h

ta vrlyl`t mlekehl# "Emmavetbcn dantar- rlh|mer- 55 sler~ c` rljatl erle~-

jeml# 

Tblrl erl je`s ai |~ "dantar~# xba erl mcyc`h c` rl`tld ba|~l~… iar

oetbc`h tbls erl hac`h a|t~cdl- hac`h ta tbl rcylr… ~a emm tbc~ c~ `at rchbt… Ci 

sa| erl je`ehc`h e VBN ar ba~vctem- sa| ~ba|md ~tes `ler tbl ba~vctem sa|

~ba|md beyl u|ertlr~ c` tbl vrljc~l~- e mcttml exes iraj najja` vlavml

"Emmavetbcn dantar- rlh|mer- 52 sler~ c` r|rem e`d rljatl erle~- jeml# 

TACMC@H C@ AO^N\_CTS

Dantar~– ir|~tretca`~ iraj tbl e`a`sjcts ai xarkc`h c` rljatl erle~ e`d iraj tbl menk

ai evvrlncetca` e`d rlnah`ctca` ai tblcr na`trco|tca`~ xlrl lvrl~~ld lmau|l`tms os

tbc~ Omank Jldcnem Aiicnlr iraj e` |`dlrdlylmavld dc~trcnt7

"Dantar~# xarkc`h c` haad vmenl~ mckl ECCJ^ e`d ^eiderg|`h

"ba~vctem~ c` Dlmbc#- tblcr xark hlt~ bchbmchbtld. Xl mler`

tbet ~ajl dantar be~ rlnlcyld Vedje~brc. C ej ~esc`h ~ajl

octtlr tbc`h~. C ej xarkc`h blrl; ci C dcl c` e ome~t ar js be`d 

hlt~ irent|rld tbl` C ej `at hac`h ta hlt e`s Vedje~brc. Xl

erl `at hlttc`h tba~l herme`d~- tba~l imaxlr~- ar hamd jldem~.

Xl erl a`ms ~lryc`h tbl vetcl`t~. Ci C ej ~etc~icld et tbet mlylm 

tbl` ct~ ic`l. Atblrxc~l ci C ej hac`h ta te js orec`~ os olc`h|`~etc~icld tbl` `aoads c~ hac`h ta ma~l o|t jl. Xl

|`dlr~te`d lylrstbc`h- lvlrcl`nl ct o|t ne``at ~es ct. Xba

da xl ~es ct ta1 Xa|md C ~es emm tbc~ ta tbl vaar trcoem~ xba

tblj~lmyl~ da`–t |`dlr~te`d j|nb. Xa|md C ~es tbc~ ta tba~l

narr|vt edjc`c~tretar~1  "Emmavetbcn dantar e`d ~vlncemc~t-

na`trent|em- 59 sler~ c` rljatl erle~- jeml# 

Page 29: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 29/80

VBIC * @B^_N * ^B_N Nbbettc~herb

?3

Ma`h ~lveretca`~ iraj iejcmcl~- e najja` na`~lu|l`nl ai olc`h manetld c` rljatl e`d

c`ennl~~coml erle~- xlrl aitl` e ne|~l ai dc~trl~~. Vraomlj~ ai ~lveretca` iraj iejcmcl~ xlrl

rlvartld jarl irlu|l`tms os na`trent|em dantar~- xba bed ml~~ nbacnl c` dltlrjc`c`h tblcr

manetca`~- e`d mcjctld vlrjcttld mleyl ai eo~l`nl. E ilx dantar~ c dcnetld dc~t|roe`nl~ c`

~va|~em rlmetca`~ e`d l~tre`hljl`t~- na`~lu|l`t ta tbl vraomlj ai ~lveretca`.

Tbl ~ct|etca` c~ ~|nb tbet jatblr*ietblr erl c` "e `lchboa|rc`h ~tetl#.

Ietblr c~ 26 sler~ ai ehl e`d Jatblr c~ 8< * xl beyl mlit tblj oatb tblrl

e`d xl erl ~cttc`h blrl... tbet–~ tbl xes js mcil be~ t|r`ld a|t.

"C`yl~tchetar7 da sa| jc~~ tblj1# Tbc~ sa| xcmm rlemcwl xbl` ct bevvl`~ ta

sa| [octtlrmsZ. Des oliarl sl~tlrdes js jatblr ilmm dax` [~tert~ nrsc`hZ

e`d C na|md`–t ha… et tbl ehl ai 8< xbet xcmm bevvl`- ~bl dal~`–t let

e`stbc`h… [nrcl~ berdlrZ… xl da`–t hlt e mleyl iraj xark. A`ms ta ler` e

mcyc`h- C beyl mlit olbc`d js 26 sler amd ietblr ta mcyl c` tbc~ g|`hml xblrl

`a a`l xcmm mcyl. Xl da`–t hlt mleyl… xl nemm tblj- l`u|crl- tbls tlmm |~

”~a`- C ilmm dax`‚- C ~es ”Jatblr- tekl tbc~ jldcnc`l‚- e`d xl ha aii ta

~mllv… ~a da`–t e~k jl eoa|t js iejcms [~ao~Z. "ES\^B dantar-na`trent|em- ?.< sler~ c` rljatl erle- jeml# 

Xl erl mcyc`h 966*866 Kj~ exes iraj a|r iejcms e`d rlmetcyl~.

Haylr`jl`t hcyl~ |~ 52 des~ ne~|em mleyl a`ms "c` e sler#. Ci ~ajltbc`h

haad ar oed bevvl`~ c` a|r iejcms tbl`… ci sa| treylm 966 kj ct xcmm tekl >

des~ ta ha e`d > des~ ta najl. E`d C xcmm ~tes iar et mle~t ?*> des~. ^a a|t

ai 52 des~- 56 des~ erl ha`l mckl tbc~. "ES\^B dantar- na`trent|em- 9 sler~

c` rljatl erle- jeml# 

Xbl` ~ajltcjl~ xl hlt e bamcdes- C ha "ta yc~ct xcil e`d nbcmd c` tbl ncts# „

ilxlr tbe` a`nl e ja`tb- e`d je`s tcjl~ lyl` tbet c~ `at va~~coml.

Olne|~l ai tbc~ sl~ iejcms rlmetca`~ erl e mcttml… tbls da hlt e mcttml |v~lt...

"Tbls e~k# ‒xbet c~ tblrl- tbet sa| erl mcyc`h tblrl ~a ier exes1– Iraj js

~cdl- C mckl ct blrl… Ci xl bed tbl ~nbaam~ e`d lylrstbc`h lm~l xe~ olttlr-

tbl` C xa|md beyl hat tbl iejcms blrl…o|t ct–~ mckl…..js verl`t~ jedl jl

~t|ds e`d jedl jl e dantar- ~a a|r kcd~ ~ba|md em~a olnajl ~ajltbc`h...

tbet c~ xbs C beyl klvt tblj c` "tbl ncts# "Emmavetbcn dantar- rlh|mer- 55

sler~ c` rljatl erle~- jeml# 

Lra~ca` ai vrail~~ca`em ~kcmm~ e`d na`icdl`nl xe~ e najja`ms rlvartld vraomlj- e~ aitl`

ettrco|tld os rl~va`dl`t~ ta atblr~ ai tblcr enu|ec`te`nl- e~ ta tblj~lmyl~. Irlu|l`tms tbc~ xe~mc`kld ta mcjctetca`~ ai rl~a|rnl~ "nmc`cnem iencmctcl~ e`d lu|cvjl`t# ta vrentcnl e bchb ~te`derd ai 

jldcnc`l- e`d tbl menk ai avvart|`cts iar i|rtblr enedljcn dlylmavjl`t.

^ncl`nl c~ jayc`h iarxerd e`d xl erl mehhc`h olbc`d… c` ~ajl ljlrhl`ns

ci tblrl c~ ~ajl nrctcnem dc~le~l- C da`–t k`ax- tbl` C e~k e`atblr dantar. Ci 

bl k`ax~ tbl` ct–~ AK ar lm~l C beyl ta maak |v oaak~ * e`d oaak~ erl `at

blrl xctb |~. Ci xl bed e mcorers- tbl` xl na|md rlilr ta ct. ^ajltcjl~ xl

Page 30: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 30/80

VBIC * @B^_N * ^B_N Nbbettc~herb

>6

beyl ta trec` tbl~l vlavml `|r~l~ e`d xarklr~ a` dc~le~l~… ~a xbetlylr c~

a|r k`axmldhl xl ne` a`ms hcyl tbet j|nb "ES\^B dantar- na`trent|em- >

sler~ c` rljatl erle~- jeml# 

Tblrl erl `a erre`hljl`t~ iar R*res~- `a erre`hljl`t iar omaad tl~t~.

Olne|~l ai Gllye` Dllv "|`tcld i|`d~ ~nbljl#- tblrl c~ e teoml e`d nbecr-

oliarl tbc~ lyl` teoml nbecr xe~ `at tblrl. Xl beyl edevtld ta tbc~

l`ycra`jl`t * C beyl iarhattl` tbl jltbad ai dceh`a~c~ ai dc~le~l blrl... Ci 

tblrl c~ e`s rlarcl`tetca` na|r~l C xa|md mckl ta da ct- e`d hlt `lx ir|ct~ ai 

k`axmldhl. O|t blrl tbl ~ct|etca` c~ ~|nb tbet lyl` xbet xl beyl da`l

"~t|dcld c` jldcnem nammlhl# be~ ha`l. "ES\^B dantar- na`trent|em- 9 sler~

c` rljatl erle- jeml# 

Xl da`–t beyl tbl oe~cn lu|cvjl`t iar ra|tc`l c`yl~tchetca` mckl |rle-

nrletc`c`l- ~|nb ra|tc`l c`yl~tchetca`~ erl `at va~~coml. Ci C ej `at eoml ta

vravlrms c`yl~tchetl e vetcl`t tbl` bax xcmm C ol eoml ta hcyl bcj vravlr

trletjl`t1 A`nl e >6 old ba~vctem c~ jedl tblrl ~ba|md ol e` R*resjenbc`l- a`l ~a`ahrevbs- a`l ~vlncemc~t. Emm tbl~l iencmctcl~ erl `at blrl.

Xl erl `at eoml ta ~lryl a|r vetcl`t~ mckl xl xe`t ta. "Emmavetbcn dantar 

e`d ~vlncemc~t- na`trent|em- 59 sler~ c` rljatl erle~- jeml# 

Dantar~ navld xctb tbl vra~vlnt ai dlnmc`c`h ~kcmm~ c` dciilrl`t xes~. Xbcml ~ajl na`nldld

ettrctca` ai k`axmldhl e`d c`tlmmlnt|em ilrya|r- atblr~- na`ylr~lms- cjjlr~ld tblj~lmyl~ dllvms

c` ~t|dca|~ v|r~|ct~ e`d ennl`t|etld tblcr jldcnem vrail~~ca`em cdl`tctcl~- ta na|`tlr c~ametca`

e`d menk ai enedljcn lva~|rl.

C ej e dantar ~a C olmclyl tbet xbetlylr C beyl ~t|dcld C beyl ta jec`tec`

tbet e`d `at mlt ct ha ar iarhlt. "Emmavetbcn dantar- na`trent|em- 52 sler~ c`

rljatl erle~- jeml# 

Najvmcnetc`h tbl dantar~– na`nlr`~ era|`d e` lradc`h k`axmldhl oe~l xe~ tbl vraomljetcn

c`tlrienl xctb emtlr`etcyl k`axmldhl ~s~tlj~ e`d vlrnlvtca`~ ai blemtb tbet xlrl ~|o~nrcold

ta os manem vav|metca`~.

Je`s "vetcl`t~# vrlilr gbed*vbaa`k "xctnbnreit# Xl trcld tbet tbc~ ~ba|md

~tav o|t ct xe~ dciicn|mt ta da ~a. ^a xl tamd tblj tbet sa| da gbed*vbaa`k

o|t tekl a|r teomlt e~ xlmm. Je`s vlavml beyl edevtld ta tbet. Tbls

|`dlr~te`d tbet jemerce ne`–t ol trletld xctb gbed*vbaa`k a`ms. Tbls kllva|r jldcnc`l~ e~ xlmm. "Emmavetbcn dantar- rlh|mer- aylr ?6 sler~ c` rljatl

erle~- jeml# 

Xl kllv a` nemmc`h tbl jlltc`h ai tbl~l "tredctca`em blemlr# vlavml ta

jekl tblj |`dlr~te`d. O|t dcd `at hlt e`s rl~|mt. O|t tbls beyl e bamd a`

tbl najj|`cts * ci tbls beyl e ~es c` tbl najj|`cts tbls xcmm `at g|~t mlt

ha ai ct. Em~a ci tbl vlavml olmclyl c` ~ajltbc`h tbl` tbls xcmm at g|~t ~tav

Page 31: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 31/80

VBIC * @B^_N * ^B_N Nbbettc~herb

>5

olmclyc`h c` tba~l tbc`h~ emm ai e ~|ddl`. "Emmavetbcn dantar e`d ~vlncemc~t-

rlh|mer- 8 sler~ c` r|rem e`d rljatl erle~- jeml# 

Iar ES\^B u|emcicld dantar~ c` na`trent|em va~ctca`~- tbl lvlrcl`nl ai vrl~nrcoc`h emmavetbcn

jldcnc`l~ c` haylr`jl`t nmc`cn~ xe~ ~ajltcjl~ vraomljetcn. Nammleh|l~ xctb emmavetbcn dlhrll~

xcdlms dcd `at vlrnlcyl tblcr najvltl`nl ta ol et ver- e`d dcd `at tr|~t tblj xctb emm e~vlnt~ ai 

jldcnem je`ehljl`t. ES\^B dantar~ dcd `at beyl avvart|`ctcl~ ta v|r~|l ar l`be`nl tblcr

~kcmm~ e`d k`axmldhl c` tblcr ax` ~s~tlj~ ai jldcnc`l.

^c`nl xl erl c` tbl "Es|ryldcn# vrail~~ca`- xl emxes~ illm haad ta hcyl

v|rl Es|ryldcn trletjl`t. O|t sa| ~ll- c` Es|rylde- sa| da `at beyl

jldcnc`l~ iar cjjldcetl rl~|mt~. Tbl jldcnc`l~ beyl `at oll` cjvrayld.

Ct be~ bevvl`ld o|t `at tbet j|nb. O|t c` Emmavetbs ct c~ cjvrayc`h revcdms.

E`d xl beyl ta "hcyl emmavetbcn trletjl`t# ~c`nl xl beyl oll` va~tld c`

haylr`jl`t iencmctcl~. "ES\^B dantar- na`trent|em- > sler~ c` rljatl erle~-

 iljeml# 

Tbl tbrlet ai ncycm ~trcil c~ vlrye~cyl c` je`s vert~ ai c`tlrcar Nbbettc~herb. C`~|rhl`t hra|v~

xlrl xcdlms ilerld „ tbls xlrl tsvcnemms rlilrrld ta c` b|~bld ta`l~ e~ tba~l ”iraj c`~cdl‚

"Bc`dc7 ”e`der xeml‚- e rlilrl`nl ta tblcr dxlmmc`h c` nejv~ dllv c`~cdl tbl iarl~t~ xbcnb naylr

merhl trent~ ai r|rem Nbbettc~herb#. Baxlylr tblrl c~ em~a e ~tra`h vrl~l`nl ai na|`tlr*c`~|rhl`t

hra|v~ e`d erjld iarnl~ ai tbl haylr`jl`t c` tbl~l rlhca`~ „ e`d tbl~l- ema`h xctb c`~|rhl`ns-

rlvrl~l`t e nammlntcyl na`tlt ai jcmcters vrl~l`nl e`d ~trcil c` tbl mcyl~ ai ycmmehlr~- e`d tbl

c`~ln|rctcl~ lvlrcl`nld os blemtb vlr~a``lm.

E orcdhl dl~trasld os c`~|rhl`t~8 

8Vbatahrevb~ erl `at `lnl~~ercms ai manetca`~ xblrl c`tlryclx~ taak vmenl

Page 32: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 32/80

VBIC * @B^_N * ^B_N Nbbettc~herb

>?

E `|jolr ai dantar~ ~ecd tbet xbcml tbls xlrl hl`lremms vlrjcttld ta ~tes e`d vrentcnl c`

c`~|rhl`t*dajc`etld erle~ e`d rerlms ~|oglntld ta dcrlnt vlr~a`em berj- tbls xlrl em~a ~|oglnt

ta tbl ber~b |`xrcttl` r|ml~ cjva~ld os jcmcte`t~. Tbls xlrl xcdlms mcjctld c` tblcr jayljl`t~

os tbl iler ai olc`h ne|hbt c`- ar mlit ~tre`dld os- c`ncdl`t~ ai ycaml`t na`imcnt; e`d em~a ai 

nevt|rl e`d v|`c~bjl`t ci tbls yl`t|rld c`ta ”rl~trcntld‚ erle~ xbcml a` iclmd yc~ct~. C`~|rhl`t~

xlrl em~a xcdlms rlvartld ta ol rl~va`~coml iar rl~trcntc`h ennl~~ e`d najj|`cnetca`~ c`

rljatl erle~. Tlmlvba`l mc`l~ e`d jaocml ~ch em taxlr~ xlrl `at vlrjcttld ta ol lrlntld- e d

raed~ xlrl jc`ld e`d raed*jekc`h lu|cvjl`t o|r`t e`d ye`demcwld xblrl tbls xa|md beyl mld

ta c`nrle~ld ennl~~ ta rljatl erle~ na`trammld os c`~|rhl`t~- ennardc`h ta enna|`t~ ai ~lylrem

rl~va`dl`t~. ^lylrem rl~va`dl`t~ nctld c`~te`nl~ ai jcmcte`t~ tekc`h va~~l~~ca` ai merhl

u|e`tctcl~ ai jldcnem ~|vvmcl~ e`d jldcnc`l~ iar tblcr ax` |~l; e`d ~ajl ai olc`h ra|~ld iraj

tblcr bajl~ e`d tekl` et h|`vac`t c`ta iarl~t nejv~ ta trlet cmm e`d c`g|rld jljolr~ ai tbl

c`~|rhl`t hra|v~. Tblrl xlrl `|jlra|~ najvlmmc`h enna|`t~ ai tbl~l l`na|`tlr~; baxlylr-

irlu|l`tms tbl rl~va`dl`t~ vrlilrrld tbet tbl~l ~tes aii tbl rlnard.

MCYC@H XCTB YCAML@NL

Xbcml tblrl xlrl `a rlvart~ ai dcrlnt vlr~a`em berj ta dantar~- tbls xlrl `at

cjj|`l ta tbl de`hlr~ ai manem vamctcn~ ai na`imcnt- e`d xlrl aitl` lva~ld icr~t

be`d ta c`ncdl`t~ ai ~trcil. A`l dantar `erretld bax bl xe~ enna~tld a`l rec`s

`chbt os e hra|v ai c`~|rhl`t~ e`d jedl ta ~ct tbra|hb e iarl~t na|rt xctb ycmmehlr~

trcld iar ent~ ai ~ldctca`7

5<*?6 vlavml ~|rra|`dld |~ e`d vac`tld h|`~ et |~ e`d 

~tertld e~kc`h ”iraj xblrl beyl sa| najl- xba erlsa|1‚ tblrl xe~ tbc~ oas xba mcyl~ olbc`d a|r ba~vctem- bl

xe~ tblrl e`d tamd tblj ”bl c~ tbl `lx Dantar- c`

haylr`jl`t ba~vctem… be~ najl 8*2 ja`tb~ eha‚ ~a tbls 

~ecd ”AK- tekl bcj tekl bcj‚ C "trcld ta vratl~t# o|t tbls 

c`~c~tld ”@a ^ebeo- najl ta tbl jlltc`h‚. ^a tbls taak |~

e`d xl ~tesld xctb tblj tbet `chbt |`tcm 4 ej. Tbls dcd 

xbet tbls da xctb tbl ycmmehlr~ * u|l~tca` tblj e`d olet 

tblj |v. Tblrl xe~ e ycmmehlr- tbls olet bcj ~a j|nb tbet 

bl dcld „ xbet ne` C ~es- bl dcld c` ira`t ai a|r lsl~ * c`

 ira`t ai oatb tbl dantar~. Xbl` tba~l vlavml xlrl e mcttml

exes tbl` bl ~ecd ta |~ ”Dantar ^ebeo vmle~l hcyl jl e`

c`glntca`- ct–~ b|rtc`h ylrs oedms‚ C hat ~a ~nerld- c` ~|nb e

~ct|etca` bax da sa| hcyl c`glntca`1 C tamd bcj ”C ne`–t hcyl

c`glntca` tcmm tbl~l vlavml mleyl- najl metlr‚ O|t tbl`...

"ES\^B dantar- na`trent|em- > sler~ c` rljatl erle- jeml#

Page 33: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 33/80

VBIC * @B^_N * ^B_N Nbbettc~herb

>>

Najja` edjc`c~tretcyl vraomlj~ ai haylr`jl`t ~lrycnl taa xlrl aitl` jeh`cicld c` rljatl

erle~. ^ajl ai tbl~l c`nm|dld metl vesjl`t~ ai ~emercl~- c`eocmcts ta aotec` vrajatca`~ ar

tre`~ilr~ ta atblr manetca`~- e`d edg|~tc`h ta manem ~s~tljcn e`d ~ancltem vamctcn~.

Tcmm e sler eha xl na|md `at lyl` tekl a|t a|r ~emers lyl`. Tbl ocmm xa|md

ol jedl blrl- tbl` tbl nbcli jldcnem aiicnlr "et dc~trcnt BU# xa|md

na|`tlr~ch` ct- tbl` tbet ocmm |~ld ta ol ~|ojcttld c` tbl trle~|rs- tbl` ct

|~ld ta najl c` tbl oe`k- tbl` iraj oe`k xl |~ld ta hlt tbl vesjl`t.

O|dhlt~ tbet ~ba|md ol tblrl- tba~l erl ~tcmm `at eyecmeoml ta |~ * tbl

o|dhlt~ iar vltram e`d emm erl ~tcmm `at edlu|etlms eyecmeoml. Tblrl ~ba|md

ol o|dhlt~ iar tbc`h~ mckl na`tc`hl`ncl~- lvl`dct|rl e`d emm- lyl` treylm

emmaxe`nl. Iar edjc`c~tretcyl na`tram tbl i|mm*imldhld rchbt~ tbet ~ba|md ol

tblrl iar tbc~ mlylm- lyl` tbls erl `at tblrl … "edjc`c~tretcyl na`tram c~

xctb# aiicnlr~ ~cttc`h et tbl dc~trcnt * dc~trcnt blemtb aiicnlr e`d nbcli jldcnem

aiicnlr "Emmavetbcn dantar- rlh|mer- ?2 sler~ c` r|rem e`d rljatl erle~-

jeml# 

Maak et tbc~ irent|rl c` js erj iraj drcyc`h e jatarnsnml... ner~ da`–t rlenb

tba~l erle~. Tbc~ c~ a`l tsvl ai ~enrcicnl * vbs~cnem. Ci C da`–t beyl tbc~ be`d

tbl` bax xcmm C xark1 ^lna`dms- C ~ba|md ol hcyl` iencmctcl~ a`ms tbl` xa|md

C ol eoml ta xark- o|t xctb js ax` ylbcnml C bed ta ~vl`d a` js ax` vltram

e`d dcl~lm ta da iclmd xark- ~a C ej em~a ~enrcicnc`h ic`e`ncemms. Tbcrdms- js

iejcms hlt~ e`hrs7 ‒xbl` atblr vlavml erl `at xarkc`h tbl` xbs erl sa|

dac`h ct- xbs beyl sa| tekl` tbl o|rdl` ai dlylmavc`h tbc~

erle1–"Emmavetbcn dantar e`d ~vlncemc~t- na`trent|em- 59 sler~ c` rljatl

erle~- jeml# 

Na`trent|em dantar~ rlvartld e dc~tc`nt ~lt ai na`nlr`~- rlmetld ta c`~ln|rctcl~ ai ljvmasjl`t

e`d e xcdl~vrled vlrnlvtca` ai tblcr c`ilrcarcts c` rlmetca` ta rlh|mer dantar~.

Oenk xbl` JV xe~ a`l ~tetl- Nbbettc~herb bed `at oll` iarjld- C gac`ld

a` na`trent. E`d C ej ~tcmm a` na`trent- C beyl `at oll` jedl rlh|mer ~a emm

tbc~ eiilnt~ sa| jl`temms. Xl erl hcyc`h ~a j|nb- ~tesc`h c` ycmmehl~- tbl

haylr`jl`t ~ba|md et mle~t jekl |~ rlh|mer... E`d C ej ~tcmm c` tbl VBN…

Tba~l xba beyl oll` js g|`car~ iar < sler~ erl `ax ~cttc`h a` js bled "c`

~|vlrcar va~ctca`~#- e d xl erl ~tcmm blrl. 55*5? sler~ xl beyl ~lryld c`

tbl r|rem erle ~ajl ol`lict ~ba|md ol hcyl`; c`~tled sa| erl hcyc`h ol`lict~

ta tbl `lx rlnr|ct~ "Emmavetbcn dantar- na`trent|em- 5< sler~ c` r|rem e`d rljatl erle~- jeml# 

^ajl vlavml ora|hbt e meds c` e o|mmank*nert. Tbls tamd jl tbet ~bl xe~

dled… tblrl xe~ e ims o|wwc`h aylr blr. Tbl` C nblnkld blr v|m~l- e`d ct

xe~ tblrl- ylrs xlek. C` tbet ba~vctem- xl dcd `at beyl erre`hljl`t~ iar

lmlntrcncts ~a- olne|~l ai menk ai mchbt- C ~ecd tbet ct c~ olttlr ta je`ehl tbl

~ct|etca` a|t~cdl c` tbl nert. ^a- xl heyl blr et mle~t 56 oattml~ ai CY im|cd

Page 34: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 34/80

VBIC * @B^_N * ^B_N Nbbettc~herb

>4

c` tbl nert- e`d ~bl cjvrayld. Tbl mledlr~ ai tbl ycmmehl xlrl ~esc`h tbet

tbl dantar xcmm kcmm blr „ c` xc`tlr- bl c~ hcyc`h im|cd ta e vetcl`t c` tbl

jcddml ai tbl raed… tbls ~ecd tbet tbc~ tljvarers dantar c~ `at haad- xbet

xcmm bl da1 C beyl blerd tbc~ xctb js ax` ler~. C maakld eitlr blr iar tbl

`lt tbrll des~ e`d tades ~bl c~ emcyl. "ES\^B dantar- na`trent|em- 9 sler~

c` rljatl erle- jeml# 

^\JJE_S7 NAVC@H XCTB EDYL_^CTS 

Vrentctca`lr~ manetld c` r|rem e`d rljatl Nbbettc~herb xlrl na`ira`tld xctb e najvml re`hl ai edylr~l ncrn|j~te`nl~ e`d vbl`ajl`e. ^ajl ai tbl~l erl |`cu|l ta rljatl manetca`~ "ennl~~

e`d najj|`cnetca`- ~lveretca` iraj iejcmcl~- ncycm ~trcil- n|mt|rem na`imcnt~#- xbcml c` atblr

c`~te`nl~ tbl~l dantar~– treyecm~ rlimlntld e` ejvmcicld ylr~ca` ai tba~l ienld os atblr~ c` v|omcn

~lrycnl ~lntar~ "c`ire~tr|nt|rl e`d ba|~c`h- xarkc`h na`dctca`~- |`~|vvartcyl vrajatca` e`d

tre`~ilr vamcncl~- o|rle|nretcn raedomank~- ennl~~ ta trec`c`h e`d na`tc`|ld ld|netca`#.

Tbl dantar~ navld xctb- e`d xlrl eiilntld os- tbl~l ncrn|j~te`nl~ c` dciilrl`t xes~. Edylr~cts

jes beyl c` je`s c`~te`nl~ mld ta e dlnmc`l c` vrail~~ca`em ~te`derd~ e`d na`icdl`nl- e`d c`

~ajl c`~te`nl~ os tbl dlrlmcntca` ai oe~cn rl~va`~cocmctcl~. C` atblr c`~te`nl~ dantar~ rl~va`dld

os edevtc`h- c``ayetc`h- vratlntc`h tblcr vrail~~ca`em cdl`tctcl~- ba`c`h tblcr ~kcmm~ e`d tecmarc`h

tblj ta tblcr ~ct|etca`~. Nmlerms na`trent|em dantar~ xlrl eiilntld jarl ~lylrlms os na`nlr`~ ai 

 gao c`~ln|rcts e`d vaarms ~|vvartcyl xarkc`h e`d edjc`c~tretcyl rlmetca`~bcv~ tbe` dantar~ c`

rlh|mer ljvmas.

Page 35: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 35/80

VBIC * @B^_N * ^B_N Nbbettc~herb

><

Ientar~ C`im|l`nc`h Tblcr Dlnc~ca`~ ta _ljec` 

^lmi e`d Iejcms 

E re`hl ai vlr~a`em e`d iejcmcem ientar~ ljlrhld c` ~ajl rl~va`dl`t~– enna|`t~ e~ ientar~

ieya|rc`h ~tesc`h a` ta ~lryl c` haylr`jl`t iencmctcl~ c` r|rem e`d rljatl erle~. Vlr~a`em yem|l~

ai ~lrycnl ta tbl vaar e`d ~lmiml~~`l~~ xlrl em~a lvrl~~ld os je`s rl~va`dl`t~ e~ olc`h

cjvarte`t jatcyetc`h ientar~.

C ej ylrs ~etc~icld. C ej ylrs bevvs. Sa| beyl blmvld vaar vlavml blrl- ~a

`et|remms e vlr~a` xa|md ~tes vmle~ld- bevvs. Tbl lvlrcl`nl c~ ole|tci|m

e`d lnctc`h * tbls da `at beyl j|nb ja`ls e`d a`l illm~ haad xarkc`h

eja`h~t ~|nb vlavml. C tbc`k ct–~ ylrs nbemml`hc`h‚ "Emmavetbcn dantar-

na`trent|em. 56 sler~ c` rljatl erle~- jeml# 

Vetcl`t~ xcmm najl ta sa| b|`hrs e`d `ekld- xctba|t ja`ls * xl g|~t tbc`k

tbet Had be~ hcyl` |~ e` avvart|`cts ~a jesol xl beyl oll` oar` ta da~ancem ~lrycnl a`ms "~jemm me|hb#. ^a ct hal~ a`. C ej ylrs ~etc~icld * olne|~l

C olma`h ta e vaar iejcms- ~a C ic`d ct ic`l. "ES\^B dantar- na`trent|em- >

sler~ c` rljatl erle- jeml# 

Blrl xl xark iar a`ms tba~l vlavml iar xbaj `aoads xark~. C` e xes xl

erl xarkc`h iar tbl haylr`jl`t e`d em~a dac`h ycrt|a|~ xark " v|`se ke

keej# os xarkc`h iar tba~l iar xbaj `a a`l xark~. "Emmavetbcn dantar e`d 

~vlncemc~t- rlh|mer- 2 sler~ c` r|rem e`d rljatl erle~- jeml# 

Atblr~ rljerkld a` tbl vlr~a`em i|micmjl`t e`d tbl illmc`h ai  ~lmi*xartb e`d |~li|m`l~~ ai 

vrentcnc`h c` atblrxc~l |`dlr~lryld erle~.

Je`s vlavml "dantar~# nejl oliarl jl o|t tbls mlit. Tbls berdms |~ld ta

ol blrl iar a`l `chbt c` e xllk. C tba|hbt tblrl c~ e `lld iar blemtb nerl

iencmctcl~ blrl e`d ct ~ba|md ol vraycdld ta tblj xctb ~ajl jarl c`tlrl~t.

Vlavml erl bevvs xctb js ~lrycnl~ e`d C em~a ~tes jatcyetld xctb tblcr

rl~va`~l. "Emmavetbcn dantar- rlh|mer- 3 sler~ c` rljatl erle- jeml# 

^c`nl C beyl oll` dac`h tbc~ gao- C illm txa tbc`h~. A`l c~ tbet C ne` mleyl ct

e`d gac` vrcyetl "vrentcnl#- beyl js ax` nmc`cn- ax` nbejolr- beyl e haad

vrentcnl. Ci C mleyl iraj blrl- C xcmm ler` e mat jarl tbe` tbc~. O|t "tbl~lna`d illmc`h c~ tbet ci# C xe`t ta na`tc`|l tbc~ olne|~l ci lylrsoads xcmm

mleyl tbl haylr`jl`t gao tbl` xbet xcmm bevvl` ta tbl haylr`jl`t

ba~vctem1 "Emmavetbcn dantar e`d ~vlncemc~t- rlh|mer- ?6 sler~ c` r|rem e`d 

rljatl erle~- jeml# 

Page 36: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 36/80

VBIC * @B^_N * ^B_N Nbbettc~herb

>9

C tba|hbt tbet ci emm tbl vlavml kllv r|``c`h iraj tbl ycmmehl tbl` tbl

~ct|etca` xcmm `lylr cjvrayl. "Emmavetbcn dantar- rlh|mer- 59 sler~ c` r|rem 

e`d rljatl erle~- jeml# 

^ajl rl~va`dl`t~ ~vlncicnemms nctld iejcmcem yem|l~ e~ olc`h c`~tr|jl`tem c` tblcr na`tc`|etca` ai 

~lrycnl.

"Eitlr C u|emcicld# C xarkld c` e`d era|`d "e jegar ncts# c` `|r~c`h bajl~.

Eitlr tbet js ietblr ~ecd tbet sa| trs "xarkc`h# iar ~ajltcjl c` "e rljatl

dc~trcnt#. ^a C nejl e`d mler`t e mat * xl |~ld ta xemk 5<*?6 kj~ ta rljatl

erle~... ^a tbl olhc``c`h xe~ iraj js ietblr * C nejl olne|~l ai tbet- o|t

metlr C ~tertld mckc`h ct blrl. Vlenli|m vlavml mcyl blrl e`d ci sa| da e mcttml

iar tblj- tbls trlet sa| mckl iejcms. Bl "ietblr# bed ~ecd et mle~t < sler~

o|t C bed jedl e terhlt ai 56 sler~. @ax tbc~ c~ js >rd sler- "xbltblr C#

hlt a|t iraj blrl ar `at tbet–~ e dciilrl`t tbc`h o|t C mckl ct blrl.

"Emmavetbcn dantar- rlh|mer- 55 sler~ c` rljatl erle~- jeml# 

C ej iraj e ylrs ~jemm ycmmehl * C `lylr bed ~|nb e xc~b c` js blert- mckl C

`lylr bed e`s xc~bl~ tbet C xcmm rlenb tbc~ ~tehl. O|t js verl`t~ xarkld

berd ta jekl jl e dantar e`d xbl` C rlt|r`ld- C ~tertld ~lryc`h ~anclts

a`ms. "Emmavetbcn dantar e`d ~vlncemc~t- rlh|mer- 2 sler~ c` r|rem e`d rljatl

erle~- jeml# 

C` ~ajl c`~te`nl~- ~lrycnl yem|l~ xlrl jerkld os aylrt rlmchca~cts- xctb tbl rl~va`dl`t~ mc`kc`h

nerc`h iar tbl vaar et `a na~t- ta vlriarjc`h e rlmchca|~ ~lrycnl. A`l r|rem Omank Jldcnem Aiicnlr

rljerkld tbet ”ct c~ rlmchca|~ xark- o|t sa| ne` ler` ja`ls et tbl ~ejl tcjl.‚ "Emmavetbcn

dantar e`d ~vlncemc~t- rlh|mer- 2 sler~ c` r|rem e`d rljatl erle~- jeml# 

_chbt iraj tbl olhc``c`h C beyl oll` rlmchca|~…beyl bed c`nmc`etca`

taxerd~ ”obektc‚ "dlyatca`#. Sa| j|~t beyl blerd ai "tbl `ejl ai e ~ec`t#

‒^TE@D \V E@D OL NA\@TLD–

E iljeml na`trent|em dantar dl~nrcold blr vrlilrl`nl iar e gao xctb rc~k e`d bchbv|rva~l. ^lryc`h c` rljatl ycaml`nl*eiimcntld erle~ xe~ ~|nb e` avvart|`cts- ~bl ~ecd7

C xe~ drex` ta dac`h e gao tbet C ej aomchetld ta da- tbet C

beyl ta ~te`d |v e`d ol na|`tld. Tbls xlrl `at bevvs et 

bajl „ tbls ~ecd ‒ct–~ e @eemctl erle- tblrl c~ ~a j|nb ichbtc`h

tblrl- lylrsdes ct c~ c` tbl TY–... "O|t C ~ecd# xblrlylr a`l c~-

a`l be~ ta dcl ~a ci C beyl ta dcl C xcmm * xbltblr blrl ar tblrl%

"ES\^B dantar- na`trent|em- > sler~ c` rljatl erle~- iljeml#

Page 37: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 37/80

VBIC * @B^_N * ^B_N Nbbettc~herb

>8

 „ C beyl tbl ~ejl `ejl. ^a tblrl xe~ ~ajl c`im|l`nl tblrl tbet bl taak

tbl vetb ai vlenl * ~a olne|~l C ej bc~ `ejl~ekl C xc~b C ne` ol 6.5, e~

|~li|m ta ~ajla`l. "Emmavetbcn dantar- na`trent|em- 52 sler~ c` rljatl

erle~- jeml# 

C ej e mcttml ~vcrct|em. Ct–~ mckl * Had be~ hcyl` |~ jldcnem vrail~~ca` e`d xl

erl eoml ta hcyl e mat ai blmv- ~a ct–~ haad "Emmavetbcn dantar- na`trent|em. 56

sler~ c` rljatl erle~- jeml# 

Atblr rlmlye`t vlr~a`emcts trect~ c`nm|dc`h c`nevencts ar dc~te~tl iar najjlrncem l`tlrvrc~l- ar e

vrlilrl`nl iar tbl mcil~tsml ai rlh|mer ~lrycnl- vertcn|merms e~~ancetld xctb dantar~– dlnc~ca`~ ta

rlirec` iraj ~xctnbc`h ta vrcyetl vrentcnl.

Xbetlylr C hlt C tl`d ta ol bevvs c tbet. C `lylr tbc`k c` tlrj~ ai „ ‒C hat

_~ 566 tades ~a "C ~ba|md hlt# _~ ?66 tajarrax–. C beyl ~ll` je`s vlavml

xba dl~crl jarl- o|t jl- lyl` ci C hlt _~ <6- C illm bevvs... C xcmm `at da

"vrcyetl# vrentcnl. Xbet c~ tbl vac`t c` ler`c h ~a j|nb ja`ls- sa| xcmm`at tekl ct xctb sa| "olsa`d tbl hreyl#. C ej e` le~cms ~etc~icld tsvl ai 

vlr~a` * ci C hlt ct- ct–~ haad- ci `at- lyl` tbl`. Ct c~ emm ietl. C da`–t tbc`k

j|nb eoa|t ct * g|~t mlt ct ha. "Emmavetbcn dantar- rlh|mer- 55 sler~ c` rljatl

erle~- jeml# 

C` vrcyetl "vrentcnl# C xe~ beyc`h tbc~ vraomlj tbet C na|md `at e~k iar

ja`ls. Mckl ci C ~ll e vaar vlr~a` tbl` „ ~es ct c~ najc`h ta 5<6 r|vll~ „ C

|~ld ta tbc`k- bl c~ vaar bax xcmm C e~k iar 5<6 r|vll~- ~a hcyl xbetlylr sa|

xe`t ta hcyl. ^a bl xa|md hcyl 566 r|vll~. E`d ~ajla`l lm~l xa|md

najl e`d ~es ‒^cr C em~a da`–t beyl ja`ls– „ mckl tbc~ C ma~t e mat ai ja`ls- 5

* 5.< mekb r|vll~. ^a C tba|hbt- mlt jl ha "c`ta haylr`jl`t ~lrycnl# „ et

mle~t C xcmm hlt "_~.# 5<666 c` e ja`tb "~jcml~#. Ct c~ js xlek`l~~. "ES\^B

dantar- na`trent|em- > sler~ c` rljatl erle~- jeml# 

C` vrcyetl "vrentcnl# sa| beyl ta xark jarl- e`d c` haylr`jl`t ~lrycnl ct c~

e` le~s mcil. „ da ~lrycnl- da icr~t nme~~ d|ts e`d xetnb tbl "nrcnklt# jetnb

e`d ct–~ aylr. Ja~t vlavml da`–t najl c` ~lrycnl * tbls da vrcyetl. O|t C

mckld ct tbc~ xes a`ms "Emmavetbcn dantar- rlh|mer- ?< sler~ c` rljatl erle~-

jeml# 

Tbl mahc~tcn~ ai rec~c`h iejcmcl~ c` rljatl erle~ xlrl `at emxes~ ~trechbtiarxerd iarvrentctca`lr~- e`d irlu|l`tms vrehjetcn retblr tbe` cdlamahcnem ientar~ dcntetld tblcr rle~a`c`h.

Ai tbl~l vrehjetcn lmljl`t~- tbl eyecmeocmcts ai  haad ~nbaam~ iar tblcr nbcmdrl` ljlrhld e~ e

dajc`e`t ientar c`im|l`nc`h tblcr ~tesc`h a` c` e vertcn|mer manetca`.

Olne|~l ai tbl vm|~ vac`t ai iencmctcl~ ai tbl nbcmdrl`–~ ld|netca` C ej blrl

e~ ~|nb- e`d `at ~a |`bevvs. Iar tbl tcjl olc`h ct c~ emrchbt iar jl- olne|~l

oatb tbl nbcmdrl` erl c` na`yl`t ~nbaam~. Lyl` tbl dantar~ era|`d xcmm ~l`d

Page 38: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 38/80

VBIC * @B^_N * ^B_N Nbbettc~herb

>2

tblcr nbcmdrl` ta na`yl`t ~nbaam~. "Emmavetbcn dantar- na`trent|em- 52 sler~

c` rljatl erle~- jeml# 

Tblrl erl dc~n|~~ca`~ c` tbl iejcms o|t tbls da`–t beyl e`s aoglntca`~ xctb

ct- olne|~l tbl kcd~ erl ~t|dsc`h c` haad ~nbaam~ e`d xbetlylr atblr

na`yl`cl`nl~ ~ba|md ol eyecmeoml erl olc`h vraycdld. ^a tbet–~ xbs tblrl c~

`a aoglntca` tbet ‒sa| erl ~tesc`h c` e ycmmehl– ar e`stbc`h. Ct–~ `at 566,

o|t ~nbaam iar tbl nbcmdrl`- e`d atblr na`yl`cl`nl~ iar a|r mcil~tsml- xl erl

hlttc`h tblj blrl. Tbet–~ xbs xl da`–t xe`t ta jchretl taxerd~ tbl ncts

e`stcjl ~aa`. "Emmavetbcn dantar- na`trent|em- 56 sler~ c` r|rem e`d rljatl

erle~- jeml# 

Tbl hrletl~t ol`lict ai ~tesc`h blrl xe~ tbet xl na|md ld|netl tbl

nbcmdrl` blrl vravlrms. A`l be~ ha`l ta jldcnem nammlhl e`d tbl atblr ta

l`hc`llrc`h nammlhl. C illm tbc~ vlenl tbet js kcd~ erl ~t|dsc`h xlmm. Tbc~ c~

js vlenl "Emmavetbcn dantar- rlh|mer- ?4 sler~ c` r|rem e`d rljatl erle~-

jeml# 

C |~ld ta najj|tl xllkms iraj "e `leros ncts# 566kj~ iraj blrl. Iar tbl

me~t ? sler~ tbl erle be~ oll` ylrs eiilntld os @eemctl~- ~a tbet c~ xbs C

jayld js iejcms blrl "iraj tbl ncts ta tbl ycmmehl#. C xe~ oarld ai mcyc h

ema`l em~a. C beyl a`l de|hbtlr- tbc~ sler ~bl c~ c` Nme~~ ?- ~bl t|r`ld 9

sler~ amd. Tblrl c~ e` L`hmc~b Jldc|j ^nbaam `leros- ~a ~bl hal~ tblrl. C

beyl ta ~lt |v js iejcms- e`d js de|hbtlr- xl beyl ta ~bax tblj e xes

em~a- xbet c~ tbl xes ai mcil "Emmavetbcn dantar- na`trent|em. 56 sler~ c`

rljatl erle~- jeml# 

Tbl bevvl`~te`nl ai  oatb ~va|~l~ xarkc`h c` tbl ~ejl ar edgenl`t manetca`~- e`d tb|~

l`eomc`h tblcr mcyc`h tahltblr- xe~ em~a rlvartld ta ol e ientar ieya|rc`h ~tesc`h a`- os je`s

rl~va`dl`t~.

Js Jr~. C~ em~a va~tld blrl. ^c`nl oatb ai |~ erl tahltblr ~a ct c~ `at ai 

j|nb vraomlj. Ci xl xa|md beyl ta ha et dciilrl`t vmenl~ tbl` tblrl xa|md

beyl oll` e vraomlj. "Emmavetbcn dantar- rlh|mer- ?.< sler~ c` r|rem e`d 

rljatl erle~- jeml# 

Xl da tbc`k tbet xl ~ba|md hlt a|r~lmyl~ tre`~ilrrld o|t iar hlttc`h e

tre`~ilr ct xcmm tekl tcjl. Js xcil em~a tlenbl~ c e hcrm~– vrcjers ~nbaam.Tbl` js ~a` c~ ~t|dsc`h c` ~nbaam. ^a jedej- xl beyl ta tbc`k eoa|t emm

tbl~l tbc`h~. "Emmavetbcn dantar- rlh|mer- 58 sler~ c` r|rem e`d rljatl

erle~- jeml# 

C` vertcn|mer- xajl` dantar~ rlvartld ic`dc`h xark c` manetca`~ na`~lu|l`t ta tblcr b|~oe`d~

emrleds beyc`h cdl`tcicld xarkc`h avvart|`ctcl~ tblrl.

Page 39: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 39/80

VBIC * @B^_N * ^B_N Nbbettc~herb

>3

C hat jerrcld blrl- e`d b|~oe`d c~ iraj blrl ct~lmi ~a lyl` C nejl blrl.

^|nb avvart|`ctcl~ erl ylrs rerl oatb b|~oe`d*xcil ~tesc`h tahltblr-

`arjemms a`ms a`l hlt~ e va~ctca`. Bl c~ c` tbl ~ejl ba~vctem; bl c~ e dantar

"Emmavetbcn dantar e`d ~vlncemc~t- rlh|mer- 4 sler~ c` r|rem erle- iljeml# 

C beyl e ba|~l e`d C ne`–t ha ~ajlxblrl lm~l mleyc`h tbl ba|~l olbc`d…

Js b|~oe`d c~ blrl- bl be~ bc~ ax` o|~c`l~~ " Emmavetbcn dantar- rlh|mer- 4

sler~ c` rljatl erle- iljeml#

Js Jr. c~ em~a blrl- c` e gao- ~a tblrl c~ `at j|nb vraomlj. Olne|~l js

Jr.–~ u|ertlr c~ `leros ~a xl hlt ta ~tes tahltblr "Emmavetbcn dantar-

rlh|mer- < sler~ c` r|rem e`d rljatl erle~- iljeml# 

Tbl ~|oglnt ai tbl c`nl`tcyl ai vrcyetl vrentcnl c` haylr`jl`t ~lrycnl era~l anne~ca`emms c` tbl

c`tlryclx~. _lh|mer ljvmasll~ erl vlrjcttld ta vrentcnl vrcyetlms iar ill~ a|t~cdl dl~ch`etld

xarkc`h ba|r~- c` Nbbettc~herb. E~ je`s e~ 5? ai tbl >8 rl~va`dl`t~ c`dcnetld tbet vrcyetl

vrentcnl ~|vvmljl`tld tblcr rl~vlntcyl c`najl. Xbcml c` merhlr ~lttmljl`t~- tblrl xe~ e` entcyldlje`d e`d jerklt iar vecd ~lrycnl~- ja~t vrentctca`lr~ rlvartld tbet e jegarcts ai tblcr

vetcl`t~ xlrl c`neveoml ai vesc`h iar ~lrycnl~. L~vlncemms c` jarl rljatl erle~- vrcyetl vrentcnl

xe~ hl`lremms `at na`~cdlrld yceoml ar vraicteoml. Aylremm- avvart|`cts iar vrcyetl vrentcnl xe~

`at e vrajc`l`t ientar ieya|rc`h ~tesc`h a`.

E vetcl`t xcmm najl ta sa| b|`hrs e`d `ekld- xbet <6 r|vll~ xcmm sa| e~k

iraj bcj1 "ES\^B dantar- na`trent|em- > sler~ c` rljatl erle- jeml# 

Vesc`h nevencts c~ `at tblrl. Tcmm tbrll dchct ich|rl ct c~ ic`l o|t ci ct rlenbl~ e

ia|r dchct ich|rl tbl` ct c~ `at va~~coml iar bcj ta ves xctba|t tekc`h e mae`

ar ~lmmc`h ~ajltbc`h. "Emmavetbcn dantar- rlh|mer- 59 sler~ c` r|rem e`d 

rljatl erle~- jeml# 

E~ emrleds `atld a` vehl ??- e `|jolr ai rl~va`dl`t~ dcd `at illm tbet tblcr c`ctcem dlnc~ca`~ ta

 gac` vrentcnl c` r|rem erle~ xlrl ai tblcr ax` nbacnl. Tblrl xlrl atblr ientar~ et vmes „ ic`e`ncem

`lld~ e`d aomchetca`~- na|vmld xctb ~|oglntca` ta haylr`jl`t vmenljl`t vranl~~l~- e`d

avvart|`ctcl~ iar bchblr ~t|ds. _ljerkeoms- c` tbc~ na`tlt- e `|jolr ai vrentctca`lr~ rlna|`tld

bax tbls enbclyld e dlhrll ai najiart- e`d olnejl enn|~tajld aylr tcjl ta mcil e`d xark c`

tbl ycmmehl~.

C` tbl olhc``c`h ct xe~ `at haad et emm… sa| tbc`k tbet sa| xcmm xark et ehaad vmenl... "o|t C xe~ vmenld c`# tbc~ VBN c` e ycmmehl% Eitlr tbet C tba|hbt

AK mlt–~ trs a|t tbc~ VBN gao. ^maxms C edg|~tld. C ~tertld illmc`h e ~l`~l ai 

a`l`l~~ xctb tbl vlavml "Emmavetbcn dantar- rlh|mer- 4 sler~ c` r|rem e`d 

rljatl erle~- jeml# 

Xbl` C gac`ld * iraj "e `leros ncts#- C nejl os o|~ ta tbl omank. Xbl` C

rlenbld- C tba|hbt ‒c~ tbc~ e omank "ba~vctem#1– * tblrl c~ `a ba|~l- `a daar-

Page 40: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 40/80

VBIC * @B^_N * ^B_N Nbbettc~herb

46

ct~ ljvts. AK- Ci tbc~ c~ xbet xe~ xrcttl` c` js ietl tbl` ic`l. Metlr ct ilmt

ak „ C hat c`trad|nld ta e na|vml ai vlavml- C xl`t ta tbl iclmd. "Emmavetbcn

dantar- rlh|mer- aylr ?6 sler~ c` rljatl erle~- jeml# 

C` tbl olhc``c`h ct xe~ e mcttml add. Ct xe~ dciicn|mt ta |`dlr~te`d tbl

me`h|ehl. Xl |~ld ta jekl a|r vla` ~ct ol~cdl |~ e`d tre`~metl * tbc~ xes

xl |~ld ta trlet. @ax xl |`dlr~te`d tblcr me`h|ehl- xl ne`–t ~vlek o|t

xl |`dlr~te`d "ES\^B dantar- na`trent|em- > sler~ c` rljatl erle~- jeml# 

E~ emrleds rlvartld- dantar~ bed irlu|l`t e`d ~ajltcjl~ bewerda|~ c`tlrentca`~ xctb c`~|rhl`t

hra|v~- xcdlms rlherdld e~ e dltlrrl`t iar vrentcnc`h c` rljatl erle~. Baxlylr- ~ajl

rl~va`dl`t~ em~a rlvartld a` vlr~a`em vranl~~l~ ai ennmcjetcwetca` ta tblcr v|rvartldms

de`hlra|~ ~trcil*eiimcntld l`ycra`jl`t~. Tcjl ~vl`t e`d rlmetca`~bcv~ dlylmavld ~lryc`h manem

najj|`ctcl~ ~ajltcjl~ mld ta e dcjc`c~bjl`t ai tbl tbrlet ai ycaml`nl- e~ c`ctcemms vlrnlcyld.

Tbls xlrl `at bevvs et bajl „ tbls ~ecd ‒ct–~ e @eemctl erle- tblrl c~ ~a

j|nb ichbtc`h tblrl- lylrsdes ct c~ c` tbl TY–... ~a et icr~t tbls xlrlvrlyl`tc`h jl- o|t metlr C na`yc`nld tblj. E`d `ax C ~ll tbet blrl- ct c~

`at tbet j|nb ai e vraomlj. C` tbl olhc``c`h ct xe~ ylrs ~tre`hl * C |~ld ta

nemm |v bajl lylrs lyl`c`h e`d ~es ‒tekl jl exes iraj blrl– "~jcml~#.

Tbl` hred|emms sa| tbc`k tbet sa| beyl ta ~tes blrl a`ms- xblrl lm~l xcmm

sa| ha1 ^a mckl tbet ~maxms sa| edg|~t "ES\^B dantar- na`trent|em- > sler~

c` rljatl erle~- iljeml# 

Ct c~ ~ecd tbet ct c~ e @eemctl erle e`d emm- o|t C beyl `lylr ienld e`s ~|nb

vraomlj. Ct–~ `at tbet C beyl`–t jlt tblj * xl da jllt tblj. Tbls a`ms

xe`t trletjl`t; tbls da`–t beyl e`s atblr dlje`d~. Tbls erl em~a `arjem

b|je` olc`h~ mckl |~. Xbet bevvl`~ oltxll` tblj e`d tbl vamcnl c~ e

dciilrl`t jettlr. A|r rlmetca`~ xctb tblj beyl oll` haad. A|r rlmetca ~

xctb tbl vamcnl beyl em~a oll` haad. Xl erl tbl vlavml xba hcyl blmv. Ci 

xl xcmm ltl`d blmv tbl` xba xcmm berj |~1 @a a`l xcmm. Vlavml "atblr

vrentctca`lr~# ~ba|md najl blrl „ |`ml~~ tbls najl bax xcmm tbls k`ax1

"Emmavetbcn dantar- rlh|mer- 55 sler~ c` rljatl erle~- jeml# 

Tbl me~t rl~va`dl`t–~ ~tetljl`t rlimlnt~ a` tbl cjvarte`nl ai dlylmavc`h rlmetca`~bcv~ e`d tr|~t

xctb najj|`ctcl~- e`d em~a a` tbl vrcycmlhld va~ctca` ai tbl manem vrentctca`lr- eoml ta l`hehl

vrail~~ca`emms xctb ~ln|rcts iarnl~ e`d c`~|rhl`t~ emckl.

Page 41: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 41/80

VBIC * @B^_N * ^B_N Nbbettc~herb

45

^\JJE_S7 ^LMI E@D IEJCMS  

E re`hl ai vlr~a`em e`d iejcmcem ientar~ xlrl c`im|l`tcem c` dltlrjc`c`h dantar~– dlnc~ca`~ ta

rljec` c` r|rem ~lrycnl. Vlr~a`em yem|l~ „ c`nm|dc`h ~lrycnl arcl`tetca`~ "aitl` c`im|l`nld os

iejcms |vorc`hc`h#- ~vcrct|em mle`c`h~- dc~c`nmc`etca` iar vrcyetl vrentcnl; e`d vrehjetcn ientar~

~|nb e~ ~nbaamc`h iar tblcr nbcmdrl` e`d tbl avvart|`cts iar oatb ~va|~l~ ta xark e`d mcyl c` tbl

~ejl manetca`- ljlrhld e~ vrajc l`t ientar~. @ateoms- xbcml je`s dantar~ xlrl c`ctcemms

rl~c~te`t ta tblcr r|rem vmenljl`t~- tbls xcdlms rlvartld edg|~tc`h e`d olnajc`h enn|~tajld ta

ycmmehl mcil aylr tcjl. ^ajl em~a dlljvbe~cwld tbl ~|vva~ld tbrlet ai c`~|rhl`t ycaml`nl iar

dantar~ mcyc`h c` na`imcnt erle~.

Page 42: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 42/80

VBIC * @B^_N * ^B_N Nbbettc~herb

4?

Najj|`cts e`d Ltb`cncts 

Ct be~ emrleds oll` ao~lryld tbet hlahrevbcnem e`d ltb`cn mc`kehl~ xlrl c`~tr|jl`tem c` dantar~

c`ctcemms ~llkc`h xark c` r|rem manetca`~ "vehl ??#. Hlahrevbcnem eiic`ctcl~ "|`dlrmc`ld os e

najoc`etca` ai ientar~ rlmetc`h ta |vorc`hc`h- najj|`cts e`d n|mt|rl# xlrl em~a tbl ja~t xcdlms

nctld e`d eiicrjetcyl jatcyetca` tbet dantar~ e~~ancetld xctb tblcr dlnc~ca`~ ta rljec` c` evertcn|mer r|rem manetca`. E ~ch`cicne`t `|jolr ai dantar~ "52!>8# rlvartld tbet tbls bed

vrlilrrld ta ~tes e`d xark c` vmenl~ xblrl tbls bed oll` ora|hbt |v; xblrl jljolr~ ai tblcr

iejcmcl~ ar najj|`ctcl~ rl~cdld; e`d xba~l me`h|ehl~ e`d n|mt|rl tbls xlrl iejcmcer xctb.

Xl xcmm xark. Vlavml iraj "`ejl ai rljatl dc~trcnt# xcmm xark c` "`ejl ai 

rljatl dc~trcnt#. Vlavml iraj "e ml~~ rljatl dc~trcnt# ar "e`atblr ml~~

rljatl dc~trcnt# jes najl. O|t xl erl xarkc`h blrl iar je s sler~- *

xbet vraomlj xcmm xl beyl1 Xbet vraomlj * `at lyl` me`h|ehl vraomlj. C

lyl` k`ax Ha`dc "trcoem me`h|ehl#. Tblrl c~ `a vraomlj. "Emmavetbcn

dantar- rlh|mer- 52 sler~ c` rljatl erle~- jeml# 

C mckl ct blrl a`ms. Olne|~l xl erl iraj "`ejl ai rljatl dc~trcnt# tbet c~

xbs xl da `at ienl j|nb vraomlj c` ~tesc`h blrl. Mckl ci ~ajla`l najl~

iraj a|t~cdl tbl` tbls ic`d ct dciicn|mt- mckl ‒bax xcmm C mcyl js mcil blrl– tbc~

tsvl ai vraomlj. O|t xl ienl `a vraomlj olne|~l xl ~tes c` tbl ycmmehl

e`d xl erl iraj tbl ycmmehl ~a `a vraomlj~ et emm. Xl erl mcyc`h le~cms.

"Emmavetbcn dantar- rlh|mer- ?< sler~ c` rljatl erle~- jeml# 

C olma`h ta tbc~ vmenl. Js iejcms c~ blrl ~c`nl C da`–t k`ax xbl`. Tbls

"vlavml# k`ax jl e`d `ax tbls illm tbet tbls ~ba|md najl ta tbl ba~vctem.

Oliarl tbet tbls xlrl g|~t na`~|mtc`h tbl _JV- vlavml xba ha daar ta daar

iar trletjl`t. ^a tbls beyl ~tertld ta najl `ax... Vetcl`t~ najvmec` c`

Nbbettc~herbc xbcnb C |`dlr~te`d ylrs xlmm. E`d tblcr atblr me`h|ehl

Ha`dc- ct xe~ em~a |~ld c` a|r ba|~l os js hre`djatblr- ~a C ne`–t ~vlek ct

o|t ne` |`dlr~te`d ct ta ~ajl ltl`t. "Emmavetbcn dantar- rlh|mer- 4 sler~ c`

rljatl erle- iljeml# 

Js jetlr`em bajl c~ blrl. C beyl oll` ~tesc`h blrl ~c`nl nbcmdbaad ~a C

k`ax tbl~l vlavml ~c`nl nbcmdbaad e`d tbls k`ax jl ~c`nl tbl` taa…..~a C

|~ld ta najl e`d ha ~c`nl nbcmdbaad. Tbls k`ax tbet C ej iraj tbet

iejcms * tbls k`ax jl oatb xes~ * jldcnem em~a e`d vlr~a`em em~a.

"Emmavetbcn dantar- rlh|mer- ?.< sler~ c` r|rem e`d rljatl erle~- jeml# 

Ent|emms- C beyl hrax` |v blrl a`ms. Js ietblr–~ gao xe~ c` tbl

haylr`jl`t `leros- ~a C beyl ~t|dcld iraj blrl a`ms. Ct |~ld ta ol ylrs

`cnl * `ax ct be~ olnajl ylrs ~l`~ctcyl o|t atblrxc~l a|r "`ejl~ ai txa

ycmmehl~# xlrl ylrs ~eil. ^a C beyl oll` ~llc`h ct iraj tbl olhc``c`h xbet

c~ blrl e`d xbet `at. ^a ~c`nl olhc``c`h a`ms C xe~ ia`d ai tbl vmenl- e`d

xe`tld tbet C da ~ajltbc`h dciilrl`t iar tbl vlavml- hcyl "~lrycnl~# xbcnb

Page 43: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 43/80

VBIC * @B^_N * ^B_N Nbbettc~herb

4>

vlavml erl eoml ta hlt le~cms. "Emmavetbcn dantar- rlh|mer- < sler~ c` r|rem 

e`d rljatl erle~- iljeml# 

C` ~ajl c`~te`nl~- ‒olc`h e manem– xe~ `at tbl dltlrjc`c`h ientar- o|t a`ms na`trco|tars c` tbl

dlnc~ca` ta ~tes a`; ~ajltcjl~ d|l ta eo~l`nl ai avvart|`cts lm~lxblrl "e~ c` tbl ne~l ai tbc~

jeml JA xctb 53 sler~ ai lvlrcl`nl#

C trcld ylrs berd ta hlt js~lmi rlmclyld. O|t C dcd`–t ~|nnlld- olne|~l "`ejl

ai ycmmehl# c~ ~|nb e vmenl tbet `a dantar hal~… ~a olc`h e manem C tba|hbt

`ax `atbc`h c~ ta ol da`l- "C ~ba|md# g|~t ~tes blrl "Emmavetbcn dantar-

rlh|mer- 53 sler~ c` r|rem e`d rljatl erle~- jeml# 

_lmetcyl vracjcts ta verl`t~ e`d atblr iejcms jljolr~ xe~ ~tetld ta ol cjvarte`t os ~ajl

rl~va`dl`t~. Ehlc`h verl`t~ aitl` bed blemtb vraomlj~ xbcnb `lldld ta ol eddrl~~ld- e`d

tbls xlrl em~a eoml ta vraycdl ~|vvart c` rec~c`h nbcmdrl`.

C ej rleds ta xark et tbl ycmmehl a`ms. Js iejcms c~ em~a iraj blrl1 Js xcil

c~ iraj era|`d "e `leros ycmmehl# * ct j|~t ol era|`d 5?*5> kj- tbet–~

xblrl js c`*mex~– bajl c~. C da`–t beyl e`s vme`~ ta jchretl ta tbl ncts.

"Emmavetbcn dantar- na`trent|em- 56 sler~ c` r|rem e`d rljatl erle~- jeml# 

Js jatblr*ietblr ~tes c` tbl ycmmehl * xl beyl a|r ierjc`h tblrl. Ct~ 5<6kj iraj blrl e`d C ha lylrs ?*4 ja`tb~. Ct dal~`–t illm mckl xl erl ier

exes iraj tblj. Xl erl eoml ta najj|`cnetl. Ci tbls ~es tbet xl beyl

~ajl blemtb vraomlj ar ~ajltbc`h- xl tekl a|t tbl ylbcnml e`d ha. Ct

tekl~ 4 ba|r~. "Emmavetbcn dantar e`d ~vlncemc~t- rlh|mer- 2 sler~ c` r|rem e`d 

rljatl erle~- jeml# 

‒^L@D JL TA TBL VMENL C NEJL I_AJ–

A`l dantar rlna|`tld bax bl tcrld ai xarkc`h c` e ncts c` e dc~trcnt ier exes iraj bc~

bajl- vrlilrrc`h e tre`~ilr ta a`l ai tbl rljatl~t ycmmehl~ c` bc~ bajl dc~trcnt.

C hat tcrld ai ct "xarkc`h c` tbl ncts# ~a C ~tavvld hac`h a` js 

d|ts. Tbl` a`nl tbl Nbcli Jc`c~tlr nejl nma~l ta a|r ba~vctem-

tblrl xe~ ~ajl vrahrejjl „ ~a C xl`t tblrl e`d C

najvmec`ld. C e~kld tblj ta ~l`d jl ta tbl vmenl xblrl C

nejl iraj. Eitlr 5< des~- C hat e` ardlr e`d C nejl blrl. C

xe~ rlemms bevvs ta najl blrl iraj tblrl. "Emmavetbcn dantar-

rlh|mer- 55 sler~ c` rljatl erle~- jeml#

Page 44: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 44/80

VBIC * @B^_N * ^B_N Nbbettc~herb

44

Ci C tbc`k eoa|t tbl nbcmdrl`- xl beyl e gac`t iejcms e`d tblcr hre`dverl`t~

erl tblrl. Js nbcmdrl` erl ~tesc`h xctb tbl hre`dverl`t~ najiarteoms. C

mleyl tblj tblrl aitl`. Tbls em~a ~t|ds c` "tbl ycmmehl xblrl tbl

hre`dverl`t~ mcyl#. " Emmavetbcn dantar- rlh|mer- 4 sler~ c` rljatl erle-

 iljeml#

C bed avvart|`ctcl~ * C xe~ hlttc`h e xlmm*vesc`h gao c` Dlmbc- o|t C dcd `at

ha. Olne|~l C beyl oll` ~tesc`h exes iraj js bajl- e`d js iamk~ xlrl

~esc`h7 ‒bax je`s sler~ xcmm sa| ~tes exes1– ^a C tba|hbt ta avt iar e

`leros vmenl. "C tba|hbt# xcmm ~tes xctbc` 566*?66 kj * et mle~t tblrl xcmm ol

irlu|l`t yc~ct~ ta js vmenl. Tblrl erl ~ajl iejcms vraomlj~ em~a ~a C vrlilr

`at ta ol taa ier exes. "Emmavetbcn dantar- rlh|mer- ?.< sler~ c` r|rem e`d 

rljatl erle~- jeml# 

Atblr rl~va`dl`t~ xba dcd `at ~vlncicnemms beyl iarloler~ c` tbl manetca`~ c` xbcnb tbls xlrl

va~tld o|t bed bed e r|rem |vorc`hc`h em~a nctld e vrlilrl`nl iar r|rem gao~. _|rem |vorc`hc`h-

iejcmcercts xctb ycmmehl mcil e`d xctb e~~ancetld yem|l~ ai ~cjvmcncts e`d iartct|dl xlrl tbl klsientar~ nctld c` tbl~l enna|`t~. 

Vlavml iraj jcddml nme~~- xba erl iraj nctcl~ * tbls da`–t mckl ct blrl. Xl

beyl emxes~ ~tesld c` ycmmehl~ e`d ic`e`ncemms em~a ct–~ `at tbet xl beyl

oll` ora|hbt |v `cnlms * xl beyl ~tesld c` ~tr|hhml. Xl mckl ct c` ~tr|hhml-

tblrl c~ `a vraomlj c` tbet. "Emmavetbcn dantar- na`trent|em- 5< sler~ c`

r|rem e`d rljatl erle~- jeml# 

Xbs da xl xe`t ta ha ta e ncts1 "Olne|~l# xl illm tbet tblrl erl haad

iencmctcl~- haad ja`ls e`d ci ja`ls c~ tblrl lylrstbc`h c~ tblrl. O|t c`

ycmmehl tblrl c~ `a ja`ls- o|t ~tcmm sa| ne` hlt vlenl… ci sa| erl xarkc`h

iar vlavml c` ycmmehl~ tbls xcmm tbe`k sa| e`d hcyl sa| rlherd~ iraj tblcr

blert. Tbls xcmm hcyl sa| jarl rl~vlnt. Ci tbl vlr~a` hlt rl~vlnt bc~

liicncl`ns e`d l`lrhs c`nrle~l~. "Emmavetbcn dantar e`d ~vlncemc~t- rlh|mer- 8 

sler~ c` r|rem e`d rljatl erle~- jeml# 

Js vlr~a`em illmc`h c~ tbet ci sa| beyl oll` oar` c` e ycmmehl sa| xcmm `at

tekl tcjl c` ~lttmc h dax` blrl. O|t ci tblrl c~ ~ajla`l oar` e d rec~ld c`

e ncts e`d ci e~kld ta mcyl e ycmmehl tbl` tbls jchbt `at ol eoml ta. Tba~l

xba najl iraj a|t~cdl- eitlr maakc`h et tbl l`ycra`jl`t blrl- tbls `at ol

eoml ta edg|~t. "Emmavetbcn dantar- na`trent|em- 52 sler~ c` rljatl erle~-

jeml# 

Ct xe~ emrleds c` js blert tbet C xcmm mcyl c` e ~jemm vmenl a`ms e`d xark.

Olne|~l js oenkhra|`d xe~ `at ~|nb- tbet C xa|md beyl edg|~tld c` e och

vmenl. C` ylrs och nctcl~- xbet tbls ~es- tbl mcil~tsml- C xa|md`–t ol eoml ta

edg|~t c` ct. Tbc~ vmenl xe~ iejcmcer ta jl- ~a C ilmt tbet ct c~ ~|cteoml iar jl.

Page 45: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 45/80

VBIC * @B^_N * ^B_N Nbbettc~herb

4<

E`d ~c`nl tbl` "me|hbc`hms# ct be~ na`tc`|ld blrl. "Emmavetbcn dantar-

na`trent|em- 56 sler~ c` r|rem e`d rljatl erle~- jeml# 

Js ba|~l c~ 5 kcmajltlr exes… e`d e~ ier e~ ~tesc`h c` tbl ycmmehl c~

na`nlr`ld- C ej iraj e ycmmehl- C beyl oll` oar` e`d ora|hbt |v c` tbl

ycmmehl- e`d ~a C da `at ienl e vraomlj. "Emmavetbcn dantar- rlh|mer- 59 sler~

c` r|rem e`d rljatl erle~- jeml# 

^ajl rl~va`dl`t~ ~vlncicnemms rlilrrld ta e` ltb`cn "|~|emms trcoem# cdl`tcts e~ olc`h e

dltlrjc`e`t c` tblcr dlnc~ca`~ ta rljec` e`d ~lryl vertcn|mer najj|`ctcl~. 

C` js trcoem rlhca` `a atblr vlr~a` xe`t~ ta xark ~a C xcmm a`ms xark iar js

vlavml. Vlavml r|` exes iraj tbc~ vmenl „ ct c~ e ylrs trcoem erle- tblrl erl

e mat ai iarl~t~. O|t C ej js~lmi e trcoem- ~a "C tba|hbt# xba xcmm xark c` a|r

erle1 Xl a`ms xcmm beyl ta xark c` a|r erle "Emmavetbcn dantar e`d 

~vlncemc~t- rlh|mer- 2 sler~ c` r|rem e`d rljatl erle~- jeml# 

C ej em~a e` ^T "^nbld|mld Trcol# e`d C ej ~lryc`h tbl ^T vlavml blrl- ~a C

ic`d ct haad "ES\^B dantar- na`trent|em- > sler~ c` rljatl erle- jeml# 

Iraj tbl olhc``c`h C olma`h ta ~|nb e iejcms….`ax olne|~l C ej e trcoem ~a

C ic`d ct ic`l ta xark c` e trcoem erle. "Emmavetbcn dantar- rlh|mer- 2 sler~ c`

rljatl erle- jeml# 

Ltb`cn eiic`ctcl~ xlrl `at a`ms rl~trcntld ta trcoem ar ne~tl cdl`tcts. C` et mle~t a`l c`~te`nl- e

rl~va`dl`t xctb Ol`hemc verl`tehl c`dcnetld tbet bl bed vrlilrl`tcemms nba~l` e manetca` xbcnb

bed merhl Ol`hemc*~vlekc h ~lttmljl`t~. C` atblr c`~te`nl~- dantar~ jes `at beyl archc`emms beyl

bed e r|rem |vorc`hc`h ar vrlyca|~ najj|`cts mc`k~ c` tblcr vmenl ai xark- o|t bed dlylmavld

nma~l mc`k~ e`d rlmetca`~bcv~ xctb tbl manem najj|`ctcl~ aylr tcjl. Tbc~ ~l`~l ai olma`hc`h ta

manem najj|`ctcl~ xe~ nctld os ~ajl e~ e rle~a` iar ~tesc`h a`.

C mckld tbl vmenl; blrl ct–~ `at mckl tbl ncts mcil- `a ichbtc`h e`d emm. Vlenli|m

vlavml mcyl blrl e`d ci sa| da e mcttml iar tblj- tbls trlet sa| mckl iejcms.

Tbls tr|~t sa| e`d ci tbls beyl e`s vraomlj tbls najl ta sa| ~esc`h tbet

sa| erl a|r lmdlr~. "Emmavetbcn dantar- rlh|mer- 55 sler~ c` rljatl erle~-

jeml# 

A`nl C xe~ tre`~ilrrld- lylrsa`l xl`t a` e ~trckl- tbls ~|rra|`dld tbl

jc`c~tlr- ne|~ld e vraomlj. Olne|~l tbl tbc`h c~ tbet c` rljatl erle~

dantar~ da`–t xe`t ta ~tes. @ax ml`htb ai js ~lrycnl c~ hlttc`h aylr. C beyl

~lttmld blrl. C beyl ~vl`t ~a je`s sler~ c` tbc~ dc~trcnt tbet `ax ct c~

dciicn|mt iar jl ta ha ta e dciilrl`t dc~trcnt. C` e `lx vmenl xl jchbt k`ax

vlavml o|t xba xcmm k ax |~. O|t c` e` amd vmenl- aylr blrl- lylrsoads

k`ax~ jl. Lyl` ci e vamctcnce` hal~ os jarl vlavml xcmm k`ax jl "me|hb#

olne|~l xl erl tbl a`l~ xba ha iar "iclmd xark# nejvech`~ „ xbltblr ct c~

Page 46: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 46/80

VBIC * @B^_N * ^B_N Nbbettc~herb

49

v|m~l vamca ar najj|`cts cjj|`cwetca . Xl erl tbl vlavml xba v|t |v

tbl nejv~. "Emmavetbcn dantar e`d ~vlncemc~t- rlh|mer- ?< sler~ c` r|rem e`d 

rljatl erle~- jeml# 

Emm tbl vlavml k`ax jl os ienl e`d `ejl. Tbls em~a k`ax js iejcms c` tbl

~ejl xes. Tbls kllv najc`h. Tblrl c~ `a och vrcyetl vrentctca`lr tbet tbls

ne` ha hlt trletld tblrl. Tbls beyl ta najl blrl. Tbls k`ax jl xlmm. Ct c~

e ~jemm vmenl. Blrl- emm vlavml k`ax a`l e`atblr os ienl- os `ejl.

"Emmavetbcn dantar- rlh|mer- 9 sler~ c` r|rem e`d rljatl erle~- jeml# 

_l~va`dl`t~ xlrl em~a e~kld eoa|t tblcr rlmetca`~bcv~ xctb manem haylr`jl`t e`d ncycm

edjc`c~tretar~. Tbl~l xlrl rlvartld ta ol yerceoml- e`d xctb e ilx lnlvtca`~ xlrl tsvcnemms

va~ctcyl o|t |`rljerkeoml. Iraj ja~t enna|`t~- ct evvlerld tbet manem edjc`c~tretar~

naavlretca` xe~ |~|emms ~amcnctld xbl` ~vlncicn lyl`t~ `lldld ta ol arhe`cwld ~|nb e~ blemtb

nejv~ ar cjj|`cwetca` drcyl~. Tblrl xlrl em~a yerceoml rlvart~ eoa|t tblcr l`hehljl`t

ltl`dc`h ta tbl vme``c`h e`d arhe`cwetca` ai rlh|mer blemtb ~lrycnl~- ~|nb e~ tbra|hb tbl

Gllye` Dllv ^ejctcl~.2 

C beyl ~|nb haad c`tlrentca`~ xctb tblj "Ve`nbeset# tbet g|~t a` c`iarjc`h

tblj tbet C `lld emm tbl ~xllvlr~ tbc~ ^|`des- tbls ~l`d… C beyl hat haad

~|vvart iraj lylrsa`l ~a ier * iraj tbl ^DJ tblrl be~ oll` `a vraomlj.

Haad ~|vvart iraj "dc~trcnt aiicncem~#- iraj atblr~. "Emmavetbcn dantar e`d 

~vlncemc~t- rlh|mer- ?< sler~ c` r|rem e`d rljatl erle~- jeml# 

Tblrl erl tcjl~ xbl` ~ajla`l iraj tbl Ve`nbeset najl~ ta ~es tbet tbls

beyl ta arhe`cwl e blemtb nejv ar e dc~eocmcts nejv. Tbls em~a naavlretl e

mat c` V|m~l Vamca. "Emmavetbcn dantar- rlh|mer- aylr ?6 sler~ c` rljatl erle~-

jeml# 

Nammlntar ~lt |v e ylrs `cnl vrahrej * bl hat e ”Ve`nb ^ejjlme`‚ da`l. C`

tbl Ve`nb ^ejjlme` ct xe~ mckl sa| tlmm tblj eoa|t tbl cjvarte`nl ai 

V|m~l Vamca- xbet c~ ct- xbs ~ba|md tbl nbcmdrl` drc`k ct "tbl arem yennc`l#

e`d bax da sa| ~eyl tblj ~a tbet c` tbl i|t|rl ct ne` ol vrlyl`tld

"Emmavetbcn dantar- na`trent|em. 56 sler~ c` rljatl erle~- jeml# 

Tblrl c~ i|mm ~|vvart; xl beyl jlltc`h~ ai Gllye` Dllv ^ejctc. Xl nemm

vlavml iraj emm hra|v~. Tbl bled ai  eher vemcke- tlb~cmdeer - iraj VXD xl

nemm vlavml- iraj emm dlvertjl`t~. Xl em~a edyc~l tbl vlavml- tbet tblrl c~e ^ejctc iarjld ~a ci e`sa`l be~ e`s vraomlj ar ~|hhl~tca` a` bax tbl

ba~vctem c~ ta ol r|`- xbalylr xe`t~ ta hcyl edycnl- tbls ne` najl. ^a c`

oltxll` "^ejctc jlltc`h~# em~a- xl temk e mat xctb tblj. "Emmavetbcn dantar-

rlh|mer- < sler~ c` r|rem e`d rljatl erle~- iljeml# 

2E vrahrejjl iar tbl |tcmcwetca` ai |~lr i|`d~ ta dlylmav iencmctcl~ manemms- e`d l`be`nl najj|`cts

enna|`teocmcts. Em~a k`ax` e~ _ahc Kemse` ^ejctcl~

Page 47: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 47/80

VBIC * @B^_N * ^B_N Nbbettc~herb

48

^erve`nb- rlemms ~vlekc`h- erl `at c`tlrl~tld c "blemtb c~~|l~#. Tbls erl

jarl c`tlrl~tld c` vlriarjc`h ncycm xark „ raed~- o|cmdc`h~. "Emmavetbcn

dantar e`d ~vlncemc~t- rlh|mer- ?< sler~ c` r|rem e`d rljatl erle~- jeml# 

Aylremm baxlylr- tblrl xe~ mcttml ta ~|hhl~t tbet dantar~– rlmetca`~bcv~ xctb manem edjc`c~tretar~

bed e ~s~tljetcn liilnt „ lctblr `lhetcyl ar va~ctcyl „ a` dantar~– dlnc~ca`~ ta rljec` c` ~lrycnl

c` tbl ycmmehl~.

^\JJE_S7 NAJJ\@CTS E@D LTB@CNCTS  

Najj|`cts eiic`ctcl~ xlrl eja`h tbl kls jatcyetca`em ientar~ xbcnb na`trco|tld ta dantar~–

dlnc~ca`~ ta na`tc`|l manemms. Hlahrevbcnem mc`kehl~ ai |vorc`hc`h e d n|mt|rl- e`d nma~l`l~~ taiejcmcl~ e`d iarloler~ xlrl nctld e~ va~ctcyl rle~a`~ xbs dantar~ bed ~vlncicnemms nba~l` ta

xark c` r|rem- lyl` rljatl manetca`~- tr|jvc`h `lhetcyl ientar~ ~|nb e~ c`ennl~~cocmcts e`d vaar

iencmctcl~. E r|rem |vorc`hc`h e`d ~vlncicn ltb`cn "l.h. trcoem cdl`tctcl~# xlrl em~a rlvartld ta ol

cjvarte`t os ~ajl. Tbl cjvarte`nl ai ~ve`~ ai tcjl ~vl`t xarkc`h xctbc manem najj|`ctcl~-

e`d tbl rl~|mte`t dlylmavjl`t ai najj|`cts illmc`h- k`axmldhl ai manem xes~ e`d tredctca`~

e`d ~l`~l ai olma`hc`h em~a ne``at ol |`dlrl~tcjetld.

Page 48: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 48/80

Page 49: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 49/80

VBIC * @B^_N * ^B_N Nbbettc~herb

43

"vetcl`t# olmclyl~ c` sa|- tajarrax tblrl xcmm ol 56 e`d tbl des eitlr tblrl

xcmm ol 566. "Emmavetbcn dantar- na`trent|em- 52 sler~ c` rljatl erle~- jeml# 

Tbl haylr`jl`t evvac`tld jl- ~a C ~tesld blrl. C ~tesld e`d ~lryld tbl

vlavml. C xl`t e`d temkld ta tbl vlavml e`d ~ecd tbet C beyl oll`

evvac`tld blrl e~ dantar. O|t vlavml ~ecd `a- xl k`ax tbet tblrl c~ `a

trletjl`t- e`s txa teomlt~ erl hcyl` e`d xl erl ~l`t oenk. ^a C xl`t daar

ta daar c` ycmmehl e`d C tamd tblj –C ej e `lx dantar * sa| xcmm hlt hm|na~l

e`d c`glntca`~ ci sa| `lld- e`d sa| xcmm hlt edjcttld c` ba~vctem–- ~a tbc~

xes C na`yc`nld tbl vlavml. E vetcl`t xlmierl e~~ancetca` xe~ iarjld * C

xarkld tblrl xctb `ajc`em nberhl~ ai _~. ? a`ms e`d xctbc` ~c ja`tb~ tbl

i|`d~ c`nrle~ld ~lylrem*iamd. "ES\^B dantar- na`trent|em- 9 sler~ c` rljatl

erle- jeml# 

C icr~t ~tertld blemtb nejv~ c` tbl ycmmehl~ * mckl tcmm 5- sa| xark c` tbl

ba~vctem- tbl` et ? xl mleyl iar tbl ycmmehl~. Xl |~ld ta jekl e vme` „

xbl` xl xcmm ha c xbcnb ycmmehl- ~lntca` xc~l. C` bcmms erle~ js terhlt xe~jarl xblrl tblrl xe~ jarl vaar vlavml * ~a tbc~ xes- > des~ c` xllk >*4

tcjl~ xl ~tertld dac`h nejv~. E`d d|rc`h dc~le~l~ "a|torlek# tcjl * ltre

liiart~. Em~a xl |~ld ta l`na|rehl vlavml ta najl ta tbl ba~vctem tbet

najl sa| xcmm hlt jldcnc`l~ e`d xl xcmm hcyl oattml "c.y. im|cd# em~a ar

xbetlylr tbc`h~ tbls `lld- ~a xbl` xl klvt dac`h tbc~- vlavml ~tertld

beyc`h tr|~t. Ct taak e mat ai tcjl ta da emm tbc~ "Emmavetbcn dantar- rlh|mer-

52 sler~ c` r|rem e`d rljatl erle~- jeml# 

Sl~ C dcd nejv~ iar neterent * tblrl xlrl jarl tbe` 566 ne~l~ a`nl ~a C

taak erre`hld tbet tbl ycmmehl ~anclts xa|md jekl lylrstbc`h irll ai na~t.

Xl dcd emm tbl rl~t * hlttc`h tbl vetcl`t~- erre`hc`h iar ylbcnml~- tekc`h nerl

ai tbl vetcl`t~ e`d emm tbet. "Emmavetbcn dantar- rlh|mer- ?4 sler~ c` r|rem e`d 

rljatl erle~- jeml# 

C beyl trletld ~ajltbc`h mckl <66 ta 866 ne~l~ ai mlvra~s. Ci xl hlt "tbl

vetcl`t# c` tbl lerms ~tehl~- ct c~ ic`l- xl trlet tblj- e`d ci bl be~ najl ta

|~ rlemms metl tbl` * ci ~ajloads dal~ `at beyl e ic`hlr- ar e mcjo * tbl` xl

da`etl nmatbl~- ~bal~- tbra|hb tbl Mlvra~s Jc~~ca`. ^a tbls "tbl vetcl`t~#

rlemms mckl |~- e`d ~es tbet xl erl ~lryc`h tblj. Tba~l vetcl`t~ rljljolr

tbet ci Dantar ^ebeo xe~ `at tblrl xl xa|md `at beyl hat emm tbc~. Lermclr

dantar~ beyl najl e`d ha`l o|t xl xlrl tbl a`l~ ta ves ~a j|nbettl`tca` ta mlvra~s ne~l~. "Emmavetbcn dantar- na`trent|em- 52 sler~ c`

rljatl erle~- jeml# 

Page 50: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 50/80

VBIC * @B^_N * ^B_N Nbbettc~herb

<6

Eja`h ~lmlntld rl~va`dl`t~- tbl ejoctca` ta vrahrl~~ ta bchblr va~ctca`~ c` tbl haylr`jl`t

v|omcn blemtb ~s~tlj~ xe~ e jatcyetc`h ientar.

Os Had–~ hrenl ci C xcmm da js VH. eitlr tbet ennardc`h ta tbl ^tetl vamcns- e

haylr`jl`t dantar ne` dlncdl ci bl xe`t~ ta ha c` tbl edjc`c~tretcyl iclmd

ar atblrxc~l * jldcnem. C illm tbet C xcmm ol eoml ta hcyl olttlr ~lrycnl c` tbl

edjc`c~tretcyl tlej. Lctblr OJA ar NJA * a`l ~ba|md beyl k`axmldhl

eoa|t tbl vrahrejjl. Tbl `|jolr ai `etca`em vrahrejjl~ tbet erl

r|``c`h- tbl lvcdljcn~- a`l ~ba|md beyl dltecmld k`axmldhl. C tbc`k C~ba|md ha c` iar e OJA c` i|t|rl eitlr C ej vrajatld. C ne` hcyl e haad

rl~|mt e~ e OJA. "Emmavetbcn dantar- rlh|mer- 9 sler~ c` r|rem e`d rljatl

erle~- jeml# 

Iar je`s dantar~- vertcn|merms tba~l c` tbl jarl rljatl erle~- tblrl xe~ `a aoyca|~ ~lveretca`

oltxll` xark e`d bajl mcil. Xarkvmenl~ xlrl em~a eyl`|l~ iar ~|vvart e`d ~ancem c`tlrentca`-

e`d tbls ~berc`h mcyc`h u|ertlr~- ve~tcjl~ e`d vrlann|vetca`~ xctb na*xarklr~- aitl` edg|~tc`h

V_AIL^^CA@EM I\MICMJL@T

Xbcml dantar~ dcd najvmec` eoa|t tbl lra~ca` ai tblcr k`axmldhl e`d tbl menk ai 

ld|netca`em avvart|`ctcl~- slt- ~ncl`tcicn c`tlrl~t e`d vrail~~ca`em i|micmjl`t xe~

jerkld eja`h ~lylrem ai tbl rl~va`dl`t~. Tbl irlu|l`tms nrctcnem `et|rl ai cmm`l~~c` vaar e`d |`dlr~lryld erle~- e`d tbl avvart|`ctcl~ ta enbclyl ~ch`cicne`t

jldcnem a|tnajl~ xe~ nblrc~bld.

Tbl mcil*~eyc`h tbet xl beyl da`l- mckl emja~t xbl` tbl

 vlr~a` xe~ dsc`h * et tbl orc`k ai dletb- xl beyl ~eyld 

tblj. Je`s ai tblj * ~ajl ockl enncdl`t ne~l~- jemerce-

~`ekl octl * sa| hlt jarl ~etc~ientca` eitlr hcyc`h ~|nb

~lrycnl. Oe~cnemms C ej e dantar; C mckl dantar~– xark a`ms.

"Emmavetbcn dantar- rlh|mer- ?2 sler~ c` r|rem e`d rljatl

erle~- jeml#

Mckl e ~|vlr ~vlncemc~t c~ ~eyc`h mcil os rljayc`h orec`

t|ja|r~- C ej xarkc`h et tbl ~ejl mlylm os trletc`h

nlrlorem jemerce- jl`c`hctc~ vetcl`t~. Tblrl c~ `a

dciilrl`nl c` tbl xark. Ct xa|md a`ms ol js jl`temcts tbet 

C ej `at e ~|vlr ~vlncemc~t vmenld c` ~ajl och vmenl „ ~a C

da`–t beyl ner~ e`d atblr iencmctcl~. Atblrxc~l js jatcyl

ai ~lryc`h c~ olc`h i|micmmld blrl. Ci tblrl c~ e vetcl`t ai 

dcerrbale e`d ds~l`tlrs e`d tbl vetcl`t c~ c` jartem 

~tetl- ci bc~ mcil c~ ~eyld tbl` ct be~ tbl ~ejl yem|l e~

tba~l c` ~ajl och vmenl. Tbc~ c~ xbet C olmclyl. "Emmavetbcn

dantar e`d ~vlncemc~t- na`trent|em- 59 sler~ c` rljatl

erle~- jeml#

Page 51: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 51/80

VBIC * @B^_N * ^B_N Nbbettc~herb

<5

xctb lu|e`cjcts. Xbcml tblrl xlrl c`~te`nl~ ai c`tlrvlr~a`em dciilrl`nl~- haad vlr~a`em e`d

xarkc`h rlmetca`~bcv~ xctb nammleh|l~ xlrl e ~a|rnl ai ~trl`htb e`d ~|~tl`e`nl.

C beyl haad rlmetca`~ xctb emm ~teii jljolr~… ~ll ci xl erl haad tbl` a|r

~teii c~ haad. Ci C ej xra`h js ~teii jljolr~ xcmm em~a ol xra`h. Tbc~ c~

~|nb e vmenl tbet evert iraj tblj tblrl c~ `a iejcms * ~a xl ~berl a|r

bevvc`l~~ e`d ~arrax~ e`d tbls ~berl tblcr~ xctb |~. C ~namd tblj em~a ci 

tbls da ~ajltbc`h xra`h- o|t C da `at ~namd tblj c` ira`t ai tbl vetcl`t~.

O|t xbl` vetcl`t hal~ C tlmm tblj tbet tbls ~ba|md `at beyl da`l tbc~.

"ES\^B dantar- na`trent|em- 9 sler~ c` rljatl erle- jeml# 

C beyl klvt tbl ba~vctem ~teii mckl e iejcms- ~a xbetlylr xark C hcyl ta tblj-

tbls da ct. Iar c`~te`nl- ci C hcyl ~ajl atblr xark ta tbl ^c~tlr "`|r~l#- ~bl

hl`lremms dal~ ct iar jl olne|~l emm ai |~ beyl ta da tbl xark tahltblr.

Tbl` tblrl erl des~ xbl` C da`–t beyl j|nb blmv- tbl` C da tbl drl~~c`h- C

r|` tbl AVD- maak eitlr tbl vetcl`t~ e~ xlmm * C da emm xark ema`l… C beyl

tamd tbl l`tcrl ~teii tbet tbls ~ba|md xark. Lylrsoads da xbet tbls erlrl~va`~coml iar. Najl a` tcjl- ha a` tcjl. C da`–t ~es tbet C ej sa|r

~l`car- C ej sa|r g|`car. C ej dac`h js xark- sa| da sa|r~. Lylrsa`l xark~

nardcemms. "ES\^B dantar- na`trent|em- ?.< sler~ c` rljatl erle- jeml# 

Tblrl c~ e "jljolr ai# ~teii xba c~ ic`c~bc`h a` ?6tb ai tbc~ ja`tb. ^a xl

erl emm illmc`h oed tbet bl c~ hac`h. Sa| ~ll ct c~ mckl e iejcms * g|~t < ~teii 

erl tblrl * ? dantar~- _JE- vberjenc~t e`d xerd oas- ~a iejcms*~tsml xl

erl ettenbld ta lenb atblr. Xl illm mckl ~ajla`l iraj a|r bajl c~

mleyc`h. Xl erl emm illmc`h ylrs oed "ES\^B dantar- na`trent|em- > sler~ c`

rljatl erle~- jeml# 

Js xarkc`h naavlretca` c~ ic`l xctb emm. Tblrl erl e ilx xba erl drc`klr~ *

tblrl erl emxes~ 5*? vlavml mckl tbet. Tbls jes `at olbeyl ylrs xlmm et

tcjl~. Tbls da `at xark xctba|t e ~namdc`h. Tbl` bl xark~ ic`l. _l~t- emm c~

ic`l. Tbls da xbetlylr C e~k tblj. "Emmavetbcn dantar- rlh|mer- 9 sler~ c`

r|rem e`d rljatl erle~- jeml# 

Tbl raml ai ~|vvartcyl ~|vlryc~ar~ e`d vllr~ xe~ em~a nctld os ~ajl c` nrletc`h e va~ctcyl

xarkc`h l`ycra`jl`t et iencmcts mlylm.

Tbl atblr ~l`car dantar~ xba erl blrl * tbls erl blrl iraj oliarl |~ * ~a

xl kllv a` dc~n|~~c`h xctb tblj e`d tekl ~|hhl~tca`~ iraj tblj- kllv

hlttc`h ~|vvart… ci c` ~ajl dlnc~ca`- xl erl ienc`h ~ajl vraomlj xctb e`s

dc~le~l xl ne` na`~|mt xctb tbl ~l`car dantar. Em~a iar tbl atblr tbc`h~

em~a mckl xl `lld tbc~ ar tbet xl kllv a` na`~|mtc`h… Tbls erl blmvi|m- tbl

OJA e`d NJA naavlretl xctb |~ i|mms. "Emmavetbcn dantar- rlh|mer- ?.<

sler~ c` r|rem e`d rljatl erle~- jeml# 

Page 52: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 52/80

VBIC * @B^_N * ^B_N Nbbettc~herb

<?

A|r OJA c~ tbl ol~t * bl ~|vvart~ iar lylrstbc`h. Xl cjjldcetlms nemm

OJA ^ebeo tbet ^cr tbc~ c~ tbl vraomlj * ~a ci ct c~ c` bc~ be`d~ tbl` bl blmv~

cjjldcetlms…ci `at tbl` xl nemm tbl NJA ar xl na`tent tbl ~erve`nb e`d

rl~t ai tbl vlavml c` tbl ycmmehl >6

A|r OJA ^ebeo c~ e ylrs `cnl je`…ct~ a`ms olne|~l ai bcj tbet C xarkc`h

ar lm~l C xa|md beyl re` exes ma`h oenk "ES\^B dantar- na`trent|em- >

sler~ c` rljatl erle- jeml# 

^ln|rcts e`d vrl~tchl eiiardld os e haylr`jl`t gao xe~ rlvartld ta ol cjvarte`t os ~ajl ai 

tbl rl~va`dl`t~- emtba|hb os ~ajl enna|`t~- tbl vrl~tchl e~~ancetld xctb hayt gao~ bed xe`ld

c` rlnl`t sler~.

Tbc~ c~ e haylr`jl`t gao- ~a tl`~ca`- ic e`ncem tl`~ca` c~ ml~~. C` vrcyetl

"vrentcnl# xl bed ta tekl tl`~ca` * tbl xbaml des xl bed ta raej eoa|t *

sa| bed ta hcyl daar ta daar ~lrycnl. "ES\^B dantar- na`trent|em- > sler~ c`

rljatl erle~- jeml# 

Ct c~ haylr`jl`t ~lrycnl- ~a sa| beyl ~teocmcts c` mcil. C` e "vrcyetl# `|r~c`h

bajl sa| ne``at beyl tbc~ "ES\^B dantar- na`trent|em- > sler~ c` rljatl

erle~- iljeml# 

C` haylr`jl`t xl em~a hlt atblr ol`lict~ * mckl xl hlt trec`c`h iar bchblr

~t|dcl~. Xl hlt k`axmldhl- xl jllt e mat ai och dantar~ * tblrl erl

ol`lict~ "ES\^B dantar- na`trent|em- > sler~ c` rljatl erle~- jeml# 

Tbls "iejcms# erl ylrs bevvs tbet C ej e dantar „ ci tblrl c~ ~ajl xark c`

xbcnb C ne` blmv tbls da najl ta jl- e`d C illm bevvs eoa|t ct. Ct illm~

haad xbl` ~ajloads c` tbl iejcms c~ c` e bchb va~t. "Emmavetbcn dantar-

rlh|mer- 55 sler~ c` rljatl erle~- jeml# 

C` a|r tcjl- c` 5336- tbet tcjl tblrl xe~ `a ~|nb nrewl iar vrcyetl gao~.

Tbl`- haylr`jl`t gao xe~ na`~cdlrld tbl ol~t. C bed e va~thred|etl

dlhrll- e`d C hat e haylr`jl`t gao "Emmavetbcn dantar e`d ~vlncemc~t-

rlh|mer- ?6 sler~ c` r|rem e`d rljatl erle~- jeml# 

Nmlerms rlh|mer gao~ xlrl ~a|hbt eitlr os na`trent|em ljvmasll~- xctb tbl~l ientar~ c` jc`d- e`d

tbl e`tcncvetca` ai aotec`c`h e rlh|mer gao ci tbls na`tc`|ld c` ~lrycnl ljlrhld e~ e ~ch`cicne`t

jatcyetc`h ientar iar na`trent|em dantar~.

Js Jr~. ~tes~ a|t~cdl- nbcmdrl` e`d emm mcyl a|t~cdl ~a C tbc`k mleyl ct- xbs

oatblr g|~t iar 5<666 r|vll~ * tbc~ j|nb C ne` ler` tblrl "c` vrcyetl

vrentcnl c` tax # em~a. O|t olne|~l C ~ll ~ajl va~~cocmctcl~- ~a C tbc`k tbet

c` e sler ar txa C jchbt hlt rlh|mer- tbl` C ne` hlt js Jr~ blrl a`ms. Xl

beyl hat e~~|re`nl * xl xl`t a` ~trckl e`d tbls ~ecd ”c` ?*> ja`tb~ xl

Page 53: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 53/80

VBIC * @B^_N * ^B_N Nbbettc~herb

<>

xcmm da ~ajltbc`h eoa|t sa| vlavml‚ E~~|re`nl beyl oll` hcyl` os tbl NJ

* bl ~ecd ”nma~l tbl ~trckl e`d xark‚ olne|~l tbls xlrl najvlmmld * tbl

rec`s ~le~a` bed ~tertld e`d dc~le~l~ bed ~tertld ta ~vrled "ES\^B

dantar- na`trent|em- > sler~ c` rljatl erle- jeml# 

Ct xe~ e` |`iart|`etl ao~lryetca` baxlylr tbet dlmes~ e`d crrlh|merctcl~ c` vmenljl`t~ e`d

tre`~ilr~ jes em~a beyl oll` e` cjvarte`t ientar iar dantar~– na`tc`|c`h ta xark c` tblcr

vrl~l`t manetca`~. E `|jolr ai dantar~ xlrl dc~~etc~icld xctb tblcr rl~vlntcyl va~tc`h~- e`d bed

~a|hbt tre`~ilr~ lm~lxblrl. Baxlylr tbls rljec`ld xblrl tbls xlrl- d|l ta |`rl~va`~cyl`l~~

ta tblcr rlu|l~t~ e`d tblcr ax` ic`e`ncem najv|m~ca`~ xbcnb vrlyl`tld tblj iraj rc~kc`h

~llkc`h `lx eyl`|l~ ai xark.

^c`nl sa| erl e~kc`h- C xcmm tlmm tbet xbl` C bed najl blrl C bed tba|hbt

tbet C xcmm ~tes iar ? sler~ e`d tbl` xcmm ic`d ~ajltbc`h `ler js ba|~l. C

bed ~l`t c` tbl rlu|l~t me~t sler o|t tbls bed hcyl` jl e vmenl i|rtblr

exes `ler "e`atblr dc~trcnt#. C dcd `at tekl tbet e`d tba|hbt tbet xcmm evvms

ehec` `lt sler. "Emmavetbcn dantar- rlh|mer- 3 sler~ c` rljatl erle- jeml# 

Eitlr va~t hred|etca`- txcnl C beyl emja~t mlit. Sa| na|md ~es tbet C na|md

`at mleyl xbl` C trcld ta ha a|t o|t iecmld… iraj tbl ve~t 9 sler~- < sler~-

8 sler~ C beyl bed e menk ai na`icdl`nl. "Emmavetbcn dantar e`d ~vlncemc~t-

rlh|mer- ?< sler~ c` r|rem e`d rljatl erle~- jeml# 

C tba|hbt ai tekc`h e tre`~ilr lermclr. O|t ci e rlmclylr "rlvmenljl`t# xcmm `at

najl tbl` sa| xcmm `at ol rlmclyld * tbet–~ xbet tbls ~ecd. E`d c` ?665 C

dcd e tre`~ilr * o|t et tbet tcjl em~a tbls dcd `at hlt e rlmclylr- ~a tbls

xlrl `at rleds ta mlt jl ha. ?*> tcjl~ C heyl e` evvmcnetca` ~esc`h rlmclyl

jl o|t tbls dcd `at da ~a. Tbl` C dcd `at trs ehec`. "Emmavetbcn dantar-

rlh|mer- 53 sler~ c` r|rem e`d rljatl erle~- jeml# 

C trcld- C hat e tre`~ilr em~a. O|t metlr tblrl xe~ ~ajl vraomlj xctb tbl

rlmclylr- ~a C dcd `at hlt rlmclyld iraj blrl. Bl dcd `at najl ta rlmclyl jl-

~esc`h tbet ct–~ e oenkxerd erle. "Emmavetbcn dantar- rlh|mer- ?4 sler~ c`

r|rem e`d rljatl erle~- jeml# 

C trs lylrs sler iar e nbe`hl ai va~tc`h. Blrl `aoads xe`t~ ta najl. Tbls

~es- hlt e rlmclylr. E rlmclylr * iraj xblrl da C hlt a`l1 "Emmavetbcn dantar-

rlh|mer- 52 sler~ c` r|rem e`d rljatl erle~- jeml# 

Tbl NJA ~ecd tbet c` e ilx ja`tb~ bl xcmm orc`h jl ta "e `leros ncts# o|t

tbl` bl rltcrld. Tbl` C ~tavvld trsc`h. @ax iar bax je`s jarl des~

xa|md C xe`t ta ~tes blrl1 C beyl ~vl`t 8 sler~ blrl. Et tbl ja~t C xe`t ta

~tes e`atblr sler blrl. "Emmavetbcn dantar e`d ~vlncemc~t- rlh|mer- 8 sler~ c`

r|rem e`d rljatl erle~- jeml# 

Page 54: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 54/80

VBIC * @B^_N * ^B_N Nbbettc~herb

<4

^\JJE_S7 TBL XA_KVMENL E@D TBL ‒^S^TLJ– 

Xark ~etc~ientca` xe~ yerceoml eja`h tbl rl~va`dl`t~- xctb ~ajl rlvartc`h bchb mlylm~ ai 

vlr~a`em ~etc~ientca` iraj vraycdc`h des ta des nerl- e`d em~a iraj edye`nc`h v|omcn blemtb

vrahrejjl~ e`d ~trl`htbl`c`h lc~tc`h ~lrycnl~. E `|jolr ai dantar~ em~a vac`tld ta tbl

avvart|`cts iar vrail~~ca`em hraxtb e`d i|micmjl`t- c` |`dlr*rl~a|rnld erle~- c` tbl na`tlt ai 

tbl irlu|l`t `lld iar ~lrycnl~ ai e nrctcnem e`d bchb cjvent `et|rl. C` tbl eo~l`nl ai atblr ~ancem

eyl`|l~ e`d ~lveretca`~ iraj iejcmcl~ e`d najj|`ctcl~ iar dantar~ c` rljatl erle~- tbl ~tra`h

rlmetca`~ dlylmavld xctb na*xarklr~- vllr~ e`d ~|vlryc~ar~- xlrl cjvarte`t c` cjvrayc`h tbl

lvlrcl`nl. @ateoms- ~c`nl ja~t na`trent|em dantar~ erl vmenld c` rljatl erle~- tbc~ ic`dc`h xe~

jarl najja` eja`h tblj. Tbl ~ln|rcts ai rlh|mer haylr`jl`t gao~ xe~ e `ateoml jatcyetc`h

ientar iar na`trent|em dantar~. \`rl~va`~cyl edjc c~tretcyl ~s~tlj~ em~a vmesld e raml c`

dantar~ `at olc`h eoml ta enbclyl tre`~ilr~ ta atblr manetca`~.

Page 55: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 55/80

VBIC * @B^_N * ^B_N Nbbettc~herb

<<

_lmetca`~ xctb Vetcl`t~

Xbcml ja~t ai tbl dantar~ rlvartld haad rlmetca`~ xctb manem najj|`ctcl~- tblrl xlrl em~a

c`~te`nl~ ai nma~l e`d ltl`dld rlmetca`~bcv~ xctb vertcn|mer vetcl`t~.

C xa|md mckl ta ~berl js lvlrcl`nl xctb a`l vetcl`t. Tbls ~baxld tblcr

nbcmd c` dc~trcnt ba~vctem * tbl dantar xratl tbl jldcnc`l > des~ * 4 des~- bl

dcd `at hlt xlmm- tbl` bl ora|hbt tbl nbcmd ta jl. C heyl ~sjvtajetcn

jldcnc`l ta bcj e d tbl nbcmd hat ic`l. Bl ~es~ tbet dc~trcnt ba~vctem xe~

`at eoml ta n|rl e`d Dantar ^ebeo dcd ct. Tades em~a bl hlt~ tbl nbcmd ta jl

a`ms. Bl ~es~ Dantar ^ebeo C xcmm ~bax a`ms ta sa|. ^a tbl ljatca`em

na``lntca` c~ tblrl "Emmavetbcn dantar- rlh|mer- 4 sler~ c` r|rem e`d rljatl

erle~- jeml# 

C` mlvra~s ci xl hat "tbl vetcl`t# c` tbl lerms ~tehl~- ct c~ ic`l…e`d ci ct be~

najl ta |~ rlemms metl tbl`…ci ~ajloads dal~ `at beyl e ic`hlr- ar e mcjo-tbl` xl da`etl nmatbl~- ~bal~- tbra|hb tbl Mlvra~s Jc~~ca`. ^a tbls "tbl

vetcl`t~# rlemms mckl |~- e`d ~es tbet xl erl ~lryc`h tblj. Tba~l vetcl`t~

rljljolr tbet ci Dantar ‒~ebeo– xe~ `at tblrl ‒xl xa|md `at beyl hat emm

tbc~–. Lermclr dantar~ beyl najl e`d ha`l- o|t xl xlrl tbl a`l~ ta ves ~a

j|nb ettl`tca` ta mlvra~s ne~l~. ^a tbls rljljolr |~ e`d eitlr tbls erl

n|rld tbls rl~vlnt |~. Mckl lyl` iar TO- tbra|hb tbl jldc|j ai DAT^ C

beyl trletld e mat ai ne~l~. ^a mckl lyl` iar tblj tblrl trletjl`t

na`tc`|l~ iraj 3 ta 5? ja`tb~. Tbls najl e`d ha e`d kllv jlltc`h- e`d

hrllt |~ ‒`eje~tl–* ~a e rlmetca`~bcv c~ iarjld "Emmavetbcn dantar-

na`trent|em- 52 sler~ c` rljatl erle~- jeml# 

Sl~ tblrl erl je`s ~|nb- tbls najl ta jl a`ms. Ci C ej `at tblrl tbl` tbls

xect iar jl tbet xbl` xcmm dantar ~ebeo najl… C beyl oll` blrl iar ?5

sler~. Tblrl xe~ e nbcmd xctb `lvbratcn ~s`drajl * tbl kcd j|~t ol 2*56

sler~ amd. Ct~ e ylrs vec`i|m mcil. C ~ex e`d dceh`a~ld bcj. C heyl

trletjl`t e`d bl |~ld ta hlt AK- e`d bl klvt najc`h ta jl… `ax eitlr

55 sler~ bl c~ AK- bl be~ hrax` c`ta e sa|`h je`. Bc~ ietblr em~a najl~ *

tbls tekl js `ejl- e`d tbls rlilr atblr vlavml ta jl em~a "Emmavetbcn

dantar- rlh|mer- ?2 sler~ c` r|rem e`d rljatl erle~- jeml# 

Tblrl c~ e xaje` xba xe~ `at beyc`h jl`~l~ iar e ma`h tcjl- ~a Cvrl~nrcold e jldcnc`l e`d `ax ~bl c~ beyc`h blr jl`~l~. ^bl c~ ylrs bevvs

`ax. Xbl`lylr ~bl xa|md beyl blr vlrcad~ ~bl xa|md najl e`d tlmm jl

tbet ”^cr- tbc~ ja`tb C bed js jl`~l~‚. ^ajltcjl~ ~bl mleyl~ je`hal~ et

js bajl iar tbl nbcmdrl`. ^a tblrl erl ~|nb ne~l~ * e rlmetca`~bcv c~

l~teomc~bld. "ES\^B dantar- na`trent|em- ?.< sler~ c` rljatl erle- jeml# 

Page 56: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 56/80

VBIC * @B^_N * ^B_N Nbbettc~herb

<9

E najj|`cts blemtb nl`trl3 

^ajl rl~va`dl`t~ ~vakl ai tbl cjvarte`nl ai edevteocmcts ta tbl dciilrl`t `lld~ ai vetcl`t~ c`

rljatl erle~.

Tbls da`–t |`dlr~te`d e`stbc`h ~a ct c~ a|r gao ta jekl tblj |`dlr~te`d.

@ax ci xl lvmec` ta tblj ennardc`h ta tblcr ax` |`dlr~te`dc`h- a`ms tbl`

ct~ AK- ci xl lvmec` mckl sa| xa|md c` _ecv|r tbl` tbls xcmm `at |`dlr~te`d

e`stbc`h. ^a xl beyl ta ~bevl a|r~lmyl~ ennardc`h ta tblcr l`ycra`jl`t.

"Emmavetbcn dantar- rlh|mer- 55 sler~ c` rljatl erle~- jeml# 

Vlavml xe`t tbet ci tbls beyl najl ta e dantar ~a tbl` tbls da`–t beyl tbl

`lld ta ha e`sxblrl lm~l… tbls da`–t ~ll bax j|nb bl k`ax~- tbls xe`t

tbl olbeyca|r ai tbl dantar ~ba|md ol haad. Ci sa|r olbeyca|r c~ haad tbls

hcyl e mat ai mayl… Js lvlrcl`nl be~ oll` ylrs haad "Emmavetbcn dantar-

rlh|mer- 55 sler~ c` rljatl erle~- jeml# 

Ct–~ e ~jemm vmenl. Ilx vlavml ~tes blrl e`d tblrl c~ g|~t a`l dantar *

aoyca|~ms emm tbl vetcl`t~ najl blrl a`ms. Mckl vrlh`e`ns ne~l~ * ci tbls

beyl e`s atblr ecmjl`t tbls ~tcmm najl ta jl a`ms. Xctb ~|nb vetcl`t~ sa|iarj e rlmetca`~bcv eoayl tbl `arjem ‒vetcl`t e`d dantar– "Emmavetbcn

dantar e`d ~vlncemc~t- rlh|mer- 4 sler~ c` r|rem erle- iljeml# 

3Vbatahrevb~ erl `at `lnl~~ercms ai manetca`~ xblrl c`tlryclx~ taak vmenl

Page 57: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 57/80

VBIC * @B^_N * ^B_N Nbbettc~herb

<8

^\JJE_S7 _LMETCA@^BCV^ XCTB VETCL@T^

E `|jolr ai dantar~ ~vakl ai ~tra`h rlmetca`~bcv~ xctb tblcr vetcl`t~- o|t tblrl xe~ mcttml

c`dcnetca` tbet tbl~l cjventld dcrlntms a` tblcr dlnc~ca`~ ta rljec` c` r|rem erle~.

Page 58: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 58/80

VBIC * @B^_N * ^B_N Nbbettc~herb

<2

Xbet Tbls @lld7 Cjvrayc`h tbl Lvlrcl`nl 

Eja`h na`trent|em dantar~- bchblr ves*~neml~ xlrl e irlu|l`tms lvrl~~ld `lld- xctb e

jegarcts ai tblj nmecjc`h tbet tblcr najvl`~etca` e`d tbl tlrj~ ai tblcr na`trent~ xlrl

vrabcoctcyl. E `|jolr ai rl~va`dl`t~ rlvartld bax tblcr ~emercl~ bed `at oll` c nrle~ld tajetnb tbl rc~c`h vrcnl~ ai najjadctcl~ e`d ~lrycnl~.

Tbls erl hcyc`h jl 5<-666 vlr ja`tb xbcnb c~ `atbc`h. Xbl` C gac`ld blrl-

rcnl xe~ _~ 55 vlr kh. @ax- bax ne` sa| je`ehl c` 5<-6661 Xbl` xl

|~ld ta ha ta _ecv|r tbl ierl xe~ _~ <6- tades ct c~ _~ ><6 e`d a|r ~emers c~

tbl ~ejl. A|r lna`ajcn na`dctca` be~ oll` dc~t|rold oedms * tades ci a|r

nbcmdrl` iemm cmm xbet xcmm xl da c` _~ 5<-6661 ^emers c~ `at haad. "ES\^B

dantar- na`trent|em- 9 sler~ c` rljatl erle- jeml# 

Eitlr Nbbettc~herb xe~ iarjld * iraj _~. 2666- ct ~trechbtexes olnejl _~.

5<-666. Xbl` ct olnejl _~. 5<666!* C xe~ rlmclyld tbet e haad l`a|hb ves

~neml be~ najl. ^a xbet ci C ej a` na`trent oe~c~- ct–~ ak. Js xark xcmm r|`

~jaatbms. O|t e~ tcjl c~ ve~~c`h os- tades–~ va~ctca` c~ ~|nb tbet e vrcjers

~nbaam tlenblr c~ ler`c`h eoayl 5<-666 e`d xl erl ~tcmm xarkc`h iar tbl

~ejl. ^a `ax iar tbl iejcms ar ta jec`tec` tbl mcil~tsml- xblrl xcmm sa| hlt

tbl ja`ls iraj1 ^a sa| xcmm beyl ta "da vrcyetl# vrentcnl. O|t tbl na`trent

~es~ tbet `a kc`d ai vrcyetl vrentcnl c~ emmaxld "me|hb~#. "Emmavetbcn dantar-

na`trent|em- 56 sler~ c` r|rem e`d rljatl erle~- jeml# 

Xbl` xl ~tertld blrl- xl xlrl hlttc`h 2666- o|t `ax ct c~ 5<666. Eitlr

~a je`s sler~ ct c~ ~tcmm 5<666. C` 2666- mcyc`h xe~ dciicn|mt * tbl` ct hat

5<666 e`d ct ilmt e mcttml haad. O|t xctb tbl lna`ajcn ~ct|etca` `ax- 5<666

c~ maakc`h lu|em ta tbet 2666 „ ct ~llj~ tblrl c~ `a dciilrl`nl. E`d vlavml

olmax |~ beyl ~|vlr~ldld |~ * mckl e xarklr c~ hlttc`h ?6666. ^a xl erl

illmc`h e mcttml mlt dax`. "ES\^B dantar- na`trent|em- > sler~ c` rljatl

erle~- jeml# 

_ljerkeoms ilx rlh|mer dantar~ "?!?<# lvrl~~ld dc~~etc~ientca` xctb tblcr n|rrl`t ~emercl~.

Baxlylr- e `|jolr ai rl~va`dl`t~ yacnld tbl avc`ca` tbet hrletlr najvl`~etca` iar dantar~

xarkc`h c` rljatl erle~ xa|md e~~c~t c` tblcr rltl`tca` dantar~ c` rljatl erle~.

Dantar~ xba erl xarkc`h c` tbl~l rljatl erle~ * tbls erl ent|emms dac`h eieya|r. Xl ~es tbet ‚sa| erl e haylr`jl`t ~lrye`t sa| erl `at dac`h e`s

ieya|r‚ o|t ct–~ `at rlemms mckl tbet * ci tbls erl mcyc`h 86 kj~ c`~cdl tbl

 g|`hml tbl` tbl dantar c~ ylrs yem|eoml ta tbl vlavml mcyc`h tblrl „ bl c~

dac`h e ieya|r ta tbl ~s~tlj. E`d e~ c`nl`tcyl- ci e dantar c~ mcyc`h 86 kj~

exes iraj e`s vmenl tbl` xbet ne` sa| hcyl1 Ja`ls * Xbet lm~l ne` sa|

hcyl1 "Emmavetbcn dantar e`d ~vlncemc~t- rlh|mer- 2 sler~ c` r|rem e`d rljatl

erle~- jeml# 

Page 59: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 59/80

VBIC * @B^_N * ^B_N Nbbettc~herb

<3

Hcyl tbl dantar~ ~ajl c`nl`tcyl ~a tbet et mle~t tbls ~tes blrl olne|~l ai 

tbl m|rl. Ci sa| da `at hcyl tbet- e`d ~es tbet sa| beyl ta ha ta ycmmehl~ *

xbs xcmm tbet vlr~a` ha1 "Emmavetbcn dantar- rlh|mer- ?.< sler~ c` r|rem e`d 

rljatl erle~- jeml# 

^emers ~ba|md ol c`nrle~ld ennardc`h ta tbl ycmmehl manetca`. Tatemms c`tlrcar

* ~emers ~ba|md ol 5 mekb; ml~~ c`tlrcar * <6- 666; ncts * >6-666. Tbc~ c~ ylrs

cjvarte`t. "Emmavetbcn dantar e`d ~vlncemc~t- rlh|mer- ?6 sler~ c` r|rem e`d 

rljatl erle~- jeml# 

Tbl ~ln|rcts ai e rlh|mer gao xe~ em~a e xcdlms e`d ~tra`hms lvrl~~ld `lld eja`h na`trent|em 

dantar~. Je`s ai tblj bed gac`ld tblcr n|rrl`t na`trent|em va~ctca`~- oe~ld a` e~~|re nl~ ar

lvlntetca`~ ai na`ylr~ca` ta e rlh|mer va~ctca` eitlr e vlrcad ai tcjl. Tbl |`nlrtec`tcl~ ai 

na`trent ljvmasjl`t xlrl jeh`cicld c` tbl ne~l ai ES\^B dantar~- ~c`nl tblrl erl `a rlh|mer

 gao~ lerjerkld iar `a`*emmavetbcn vrentctca`lr~.

C xe`t ta ~ll js~lmi vrahrl~~c`h o|t olne|~l ct c~ c` tbl be`d~ ai Had ~a C

da`–t k`ax ci ct xcmm bevvl` ar `at. C illm tblrl ne` ol ~ajl vrahrl~~ ci xl

~tcnk blrl o|t blrl- ct jchbt em~a bevvl` tbet xl mleyl e`d ha. Js Jr~

~tes~ a|t~cdl- nbcmdrl` e`d emm mcyl a|t~cdl- ~a ~ajltcjl~ C tbc`k ”mleyl ct-

 g|~t iar 5<666 r|vll~...‚ o|t olne|~l C ~ll ~ajl va~~cocmctcl~ ~a C tbc`k tbet

c` e sler ar txa C jchbt hlt rlh|mer tbl` C ne` orc`h js Jr~ blrl. "ES\^B

dantar- na`trent|em- > sler~ c` rljatl erle- jeml# 

C ej c` e` ed ban gao. Xbl` C ha ta tbl oe`k iar e mae` tbls ~es sa| xcmm ol

t|r`ld a|t eitlr a`l sler ~a bax xcmm sa| ves oenk tbl mae`. Ci sa| xcmm

mleyl tbl gao e`d ha xblrl xcmm xl ~lernb iar sa|1 Os tbc~ ed ban gao tbl

haylr`jl`t c~ hlttc`h ct~ xark da`l- o|t a|r va~ctca` c~ hlttc`h vaarlr.

"ES\^B dantar- na`trent|em- 9 sler~ c` rljatl erle- jeml# 

Tbl iarlja~t tbc`h c~ tbet a|r gao c~ `at ~ln|rl. Tbl ~xard c~ be`hc`h *

tbet c~ tbl tsvl ai gao xl beyl. Xl erl |`dlr na`trent e`d xbl` tbl

emmavetbcn dantar~ xcmm najl tbl` xl xl xcmm ic`d tbet xl erl `at `lldld.

^a xl beyl `a nlrtec`ts blrl. Emmavetbcn dantar~ beyl e rlh|mer va~t blrl

~a ct–~ ic`l iar tblj "ES\^B dantar- na`trent|em- > sler~ c` rljatl erle~-

 iljeml# 

C` na`trent ~lrycnl sa| ne`–t tbc`k j|nb * @ayljolr xcmm najl `ax- tbl`

xl xcmm najl ta k`ax ci tbc~ ~lrycnl xcmm rljec` ar `at. Ci tblrl c~ e

vlrje`l`t ~lrycnl tbl` e vlr~a` tbc`k~ eoa|t tbl i|t|rl em~a * xbet xcmm

a`l da ar `at da. O|t c` e na`trent gao * C beyl a`l de|hbtlr * sa| ne`–t

vme` xbltblr sa| xcmm beyl e ~lrycnl ar `at- ar xcmm ol eoml ta eiiard e

~lna`d nbcmd ar `at. Sa| `lylr k`ax xbet tbl i|t|rl bamd~. "ES\^B

dantar- na`trent|em- ?.< sler~ c` rljatl erle- jeml# 

Page 60: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 60/80

VBIC * @B^_N * ^B_N Nbbettc~herb

96

Tbl `lld iar jarl tre`~verl`t e`d retca`em  vranld|rl~ iar vrajatca` e`d tre`~ilr xlrl

bchbmchbtld os ~lylrem rl~va`dl`t~.

C beyl oll` xarkc`h ~c`nl ?6 sler~- e`d ~a ier C beyl bed `a vrajatca`~ et

emm * C g|~t kllv ~cttc`h era|`d. @at e ~c`hml vrajatca`- `a c`nrljl`t- `a

tcjlmc`l* ct–~ oll` ?6 sler~. Tba~l xba beyl g|~t ic`c~bld vraoetca`

vlrcad~ beyl rlnlcyld c`nrljl`t~. Tblrl erl je`s ~|nb ne~l~ * tblrl c~ a`l

xba c~ js ?4 sler~ ~l`car- lyl` bl be~ `at rlnlcyld e`s vrajatca`. Tblrl

c~ tbc~ dantar c` "e`atblr dc~trcnt# xba c~ 56 sler~ js g|`car * bl be~ oll`

vrajatld. Blrl ct be~ `atbc`h ta da xctb g|`car ar ~l`car. Tblrl c~ `a

”C^^\L E ^CJVML MLTTL_‚

^ajl na`trent|em dantar~ rlvartld beyc`h ~lryld a` na`trent iar e` c`ardc`etl

vlrcad ai tcjl- rlvartldms d|l ta maavbaml~ e`d tlnb`cnemctcl~ xbcnb na|md ol beyloll` rledcms rlntcicld os tbl llrnc~l ai vamctcnem xcmm os edjc`c~tretar~.

Xbl` C gac`ld a` na`trent- emm ai JV xe~ a`l ~tetl. Tbl

dcyc~ca` ai Nbbettc~herb bevvl`ld metlr c` ?66?- e`d js 

 va~ctca` c~ ~tcmm na`trent|em. Xl erl hcyc`h ~a j|nb-

~tesc`h c` ycmmehl~ „ tbl haylr`jl`t ~ba|md et mle~t tbc`k 

~a j|nb tbet tbls jekl |~ rlh|mer. C beyl oll` xarkc`h

 iar 5? sler~. "Emmavetbcn dantar- na`trent|em- 5< sler~ c`

r|rem e`d rljatl erle~- jeml# 

C beyl xc~bld ct "hlttc`h e rlh|mer va~ctca`# o|t xbet ne`

xl da eoa|t ct1 Ct c~ c` tbl be`d~ ai tbl haylr`jl`t.Xbl` C gac`ld ~lrycnl C xe~ txa sler~ aylr*ehl. E`d `ax 

tl` sler~ metlr xbl` e`atblr ra|`d ai ~lmlntca`~ iar 

rlh|mer ~lrycnl c~ tekc`h vmenl- C ej aylr*ehl ehec`. ^a

`ax C beyl ~tavvld bavc`h. "Emmavetbcn dantar-

na`trent|em- 56 sler~ c` rljatl erle~- jeml#

Xl gac`ld blrl xbl` Nbbettc~herb xe~ `at iarjld * tbl`

tbc~ xe~ c` Jedbse Vredl~b. ^a tbl Blemtb jc`c~tlr et 

tbet tcjl- iar "txa |`dlrdlylmavld dc~trcnt~# bl

c`trad|nld e ~vlncem xarkiarnl netlhars. E`d tbet c~ ~tcmm 

tbl ne~l „ ~a xl beyl oll` blrl iar jarl tbe` 5< sler~-

o|t a` a|r rlnard ct c~ xrcttl` tbet xl erl ed ban. Tbc`k eoa|t xbet erl hac`h tbra|hb. A` a`l be`d sa| lvlnt 

|~ ta ~lryl sa| e`d xbl` aiicncem maavbaml~ najl |v tbl`

sa| ne`–t lyl` c~~|l e ~cjvml mlttlr. "Emmavetbcn dantar

e`d ~vlncemc~t- na`trent|em- 59 sler~ c` rljatl erle~-

jeml#

Page 61: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 61/80

VBIC * @B^_N * ^B_N Nbbettc~herb

95

rlvrl~l`tetca` ai ~|nb hrclye`nl~ * C da ct a` js ax` o|t ct–~ `at blerd.

Tbl rlyclx xe~ da`l me~t sler os tbl dcrlntaretl o|t tcmm detl tbl

"edjc`c~tretar# be~ `at oll` eoml ta hlt tbl vevlr. Iraj blrl- xbetlylr

vevlr hal~ ta tbl "edjc`c~tretar# kllv~ msc`h c` tbl tre~b et tbl

dcrlntaretl. Tbl "edjc`c~tretar# ~es~ tbet bl dcd `at rlnlcyl e`s ~|nb vevlr

e`d "~l`car edjc`c~tretar# ~es~ tbet bl dal~ `at k`ax e`stbc`h. "Emmavetbcn

dantar e`d ~vlncemc~t- rlh|mer- ?6 sler~ c` r|rem e`d rljatl erle~- jeml# 

_lu|l~t tbl haylr`jl`t ta jekl e jlnbe`c~j iar vrajatca`. Xbl` C

beyl hcyl` ~lrycnl et tbc~ mlylm iar ~a ma`h tbl` sa| ~ba|md em~a hcyl

avvart|`cts et |vvlr mlylm * et dc~trcnt mlylm "Emmavetbcn dantar- rlh|mer- ?2

sler~ c` r|rem e`d rljatl erle~- jeml# 

Tbl Haylr`jl`t- `a jettlr bax je`s r|ml~ ct jekl~- "ct# ne``at iammax.

Tbls ~ba|md ~es /ct–~ oll` ~a je`s sler~ ~c`nl bc~ va~t hred|etca` ~a bl

~ba|md ol ~lttmld c` dc~trcnt/. O|t tbls da`–t da tbet. C ej e ~vlncemc~t iar ~a

je`s sler~- o|t ~tcmm blrl. C beyl ~tesld a` blrl- xcmms*`cmms. "Emmavetbcndantar e`d ~vlncemc~t- rlh|mer- ?< sler~ c` r|rem e`d rljatl erle~- jeml# 

Ci e dantar hlt~ va~tld c` e rljatl erle tbl` tblrl c~ `a ~|nb vamcns tbet

tbet vaar vlr~a` xa|md hlt tre`~ilrrld eitlr < „ 56 sler~. Tbl vaar h|s

kllv~ ehc`h e`d na`tc`|l~ ta ~tes c` tbl ycmmehl. @aoads xe`t~ ta ~tes

tblrl iarlylr. Ct c~ mckl xbl` e oas "sa|`h dantar# najl~ iar e gao bc~

nbcmdrl` erl ~jemm ar bl c~ `at jerrcld. Tbl` os tbl tcjl bc~ kcd~ erl 4*<

sler~ amd bl ~ba|md hlt tre`~ilrrld olne|~l ai tbl nbcmdrl`–~ ld|netca`. Ci 

bl c~ |`jerrcld bl ne` ~tes e`sxblrl. O|t xbl` bl `lld~ ~nbaam~ e`d emm

era|`d tbl` a`l `lld~ e nbe hl ai vmenl. Tbl haylr`jl`t ~ba|md beyl e

nmler vamcns. "Emmavetbcn dantar e`d ~vlncemc~t- rlh|mer- ?6 sler~ c` r|rem e`d 

rljatl erle~- jeml# 

C beyl oll` xarkc`h blrl iar 59 sler~. Ci xl ha os haylr`jl`t `arj~ tbl`

eitlr < sler~ ai d|ts c` e trcoem erle C ~ba|md beyl oll` tre`~ilrrld ta

e`atblr ml~~ rljatl vmenl * o|t emm tbl~l tbc`h~ erl `at va~~coml. C da`–t

xe`t ta omejl tbl haylr`jl`t o|t tbc~ c~ e ient tbet xctba|t jekc`h e mat

ai vlr~a`em liiart~- tblrl xcmm ol `a tre`~ilr. "Emmavetbcn dantar e`d 

~vlncemc~t- na`trent|em- 59 sler~ c` rljatl erle~- jeml# 

.

Dlicncl`t b|je` rl~a|rnl~- evert iraj tbl vraomlj~ tbls nrletl iraj e vme``lr–~ vlr~vlntcyl-

beyl tblcr ja~t cjjldcetl cjvent a` tbl xarkc`h mcyl~ ai tbl vraycdlr~ xba na`tc`|l ta xark c`

|`dlr~lryld erle~. Tbl `lld iar eddrl~~c`h ~bartehl~ c` vlr~a``lm os icmmc`h lc~tc`h yene`ncl~

xe~ yacnld os e jegarcts ">?!>8# ai rl~va`dl`t~.

^ll- C ~ba|md edjct blr "e vetcl`t ~te`dc`h `leros# * ~bl be~ jemerce. ^bl

be~ oll` trletld txcnl vrlyca|~ms. @ax ci C edjct blr c` tbl ba~vctem- C

jchbt mler` tbet tblrl c~ e nejv ar tbet C beyl ta r|` ta a`l ai tbl VBN~

Page 62: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 62/80

VBIC * @B^_N * ^B_N Nbbettc~herb

9?

"xblrl tblrl erl `a atblr emmavetbcn dantar~#. E`d tblrl c~ `a ~teii 

"`|r~l~# blrl. Tbc~ c~ xbs C da`–t edjct vetcl`t~. C kllv tblj c` AVD iar ?*

> ba|r~ xbl` C ej ~cttc`h- tbl` C e~k tbl vetcl`t ta najl ehec` tbl `lt des

ar des eitlr `lt- o|t C ne`–t e~k tblj ta ~tes aylr`chbt. "Emmavetbcn dantar-

rlh|mer- 55 sler~ c` rljatl erle~- jeml# 

Tblrl c~ R*_es o|t tbl tlnb`cnce` c~ `at tblrl ~a ct c~ `at avlretca`em… Tbl

xarkmaed be~ em~a c`nrle~ld- xctb jl e`d "e nammleh|l# xbet be~ bevvl`ld

tbet C beyl ta maak eitlr e l`tcrl VBN e`d e NBN. "Tbl nammleh|l# be~ txa

VBN~ * "`ejl~ ai VBN~#. Olne|~l ai tbl xarkmaed C illm |`~|rl. C tbc k tbet

ci C hlt a`l blmvc`h be`d tbl` C xcmm ol eoml ta da ct. " Emmavetbcn dantar-

rlh|mer- 4 sler~ c` rljatl erle- iljeml#

Tblrl c~ a`l `|r~l e`d e xerd oas- ~a ct–~ ylrs dciicn|mt ta je`ehl xctb g|~t

? vlavml. C ej a`l dantar e`d C ej maakc`h eitlr ? VBN~ xbl` tblrl ~ba|md

ol 4 "dantar~ maakc`h eitlr ? VBN~#. C bed ~l`t e xrcttl` rlu|l~t o|t tblrl

be~ oll` `a va~tc`h tcmm `ax. C beyl ~l`t ct txcnl… "Emmavetbcn dantar-rlh|mer- 2 sler~ c` rljatl erle- jeml# 

Nmle`lr~ erl tbl ochhl~t vraomlj iar tbl ba~vctem * xl a`ms bed a`l

~xllvlr. Tbl` iraj Gllye` Dllv ^ejctc xl taak e vert tcjl ~xllvlr.

Lyl` tbet xe~ `at l`a|hb * ~a xl beyl klvt bcj i|mm tcjl `ax "Emmavetbcn

dantar- rlh|mer- 52 sler~ c` r|rem e`d rljatl erle~- jeml# 

Tbl `lld iar cjvrayc`h tbl u|emcts e`d rlh|mercts ai jldcnem ~|vvmcl~ e`d  vrayc~ca` ai olttlr 

xarkvmenl c`ire~tr|nt|rl xe~ em~a ~tetld xcdlms- ta cjvrayl xarkc`h na`dctca`~ e`d l`be`nl

vrail~~ca`em ~etc~ientca`.

^BA_T*^TEIILD E@D AYL_O\_DL@LD

Lc~tc`h vlr~a``lm erl aylro|rdl`ld e`d ~te`d ta ol`lict hrletms ci yene`ncl~ erl icmmld

Iar e vav|metca` ai 86-666 xl erl g|~t txa JOO^ dantar~. Xl

beyl ta da va~t jartlj~- JMN~- AVD- ~|rhlrs e`d aiicncem 

xark em~a. Xl em~a beyl ta tekl nerl ai tbl ardlr~ iraj

Dlmbc- _ecv|r e`d "dc~trcnt bledu|ertlr~#. Bax xl je`ehl emm 

tbl~l tbc`h~ c~ ~ajltbc`h a`ms xl ne` |`dlr~te`d. Iar tbl

~ekl ai b|je`cts * lyl` xl erl b|je`~ * xl em~a beyl iejcms 

aomchetca`~. Xl erl `at eoml ta i|micm a|r aiicncem 

rl~va`~cocmctcl~- e`d a|r iejcms mcil c~ ienc`h dciicn|mtcl~ taa.

"Emmavetbcn dantar e`d ~vlncemc~t- na`trent|em- 59 sler~ c`

rljatl erle~- jeml#

Page 63: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 63/80

VBIC * @B^_N * ^B_N Nbbettc~herb

9>

Tblrl c~ ~bartehl ai jetlrcem~- e`d ct c~ ai ylrs oed u|emcts. Xl hlt a`ms

5!56tb ai tbl rlu|crld jetlrcem~ iar lylrstbc`h. CY im|cd „ xbltblr C temk ta

tbl NJA- tbl nammlntar- ar hcyl c` xrctc`h „ xbetlylr im|cd najl~ me~t~ a`ms

e xllk. Iar Ge`e`c ^|rek~be Sage`e * ct c~ `at e~ cjvarte`t ta c`nrle~l

c`~tct|tca`em dlmcylrcl~ e~ ct c~ ta vraycdl iencmctcl~ c` tbl c`~tct|tca`. Xl

`lld et mle~t <66*966 ~src`hl~ iar 5<6 dlmcylrcl~. ?66 e`tcocatcn~. Medcl~

najl e`d mcl dax` c` meoa|r raaj * tbl r|oolr ~bllt c~ `lylr nbe`hld. <6

dlmcylrcl~ tekl vmenl a` tbl ~ejl ~bllt. Iar tbl ve~t ?6 sler~ C kllv

blerc`h tbc~ * tblrl c~ `a dlmcylrs teoml- `a ~src`hl- `a ~te`d ar drcv- `a

ved~ ar natta`. Ci xl |~l a`l ~|ntca` t|ol iar a`l nbcmd xl ~ba|md `at ol

|~c`h tbl ~ejl iar emm tbl dlmcylrld oeocl~. Ci ~ajla`l c~ dsc`h ai vec` xl

~ba|md `at |~l |~ld ~src`hl~. Tbls hcyl <6 hmayl~ iar tbl ja`tb- tbet taa

|`~tlrcmcwld- e`d a`l be~ ta xe~b ct lylrs tcjl e`d tbl` |~l ct. Tblrl erl

`a omaad oe`k~. Tblrl c~ g|~t a`l c` tbl dc~trcnt xbcnb be~ 4 oattml~ ai 

omaad. Ci xl da`–t hcyl omaad tbl` vetcl`t~ dcl lylrs des. Et NBN mlylm ci 

omaad c~ `at hcyl`- tbl` je`s vetcl`t~ xcmm dcl. Da xrctl emm ai tbc~ dax` „ci ~ajltbc`h xcmm bevvl` os sa|r xrctc`h ct- tbl` da xrctl ct. "Emmavetbcn

dantar e`d ~vlncemc~t- rlh|mer- ?6 sler~ c` r|rem e`d rljatl erle~- jeml# 

AT c~ `at i|`ntca`em- olne|~l tblrl c~ `a ~tlrcmcwetca` evveret|~ e`d ashl`

nsmc`dlr~. ^lna`dms tblrl c~ e vraomlj ai lmlntrcncts blrl. Xctba|t

lmlntrcncts ct c~ dciicn|mt ta da ~|rhlrs. Ci tbl ~|ntca` jenbc l dal~ `at

i|`ntca`- e`d ci tblrl c~ `a vravlr ~tlrcmcwetca`- bax ne` xl r|` ct1

"Emmavetbcn dantar e`d ~vlncemc~t- rlh|mer- 8 sler~ c` r|rem e`d rljatl erle~-

jeml# 

Xbl` xl erl dac`h nel~erle` ~lntca`- ja~t ai tbl tbc`h~ xl beyl ta

erre`hl a` a|r ax`. E~ ~|nb haylr`jl`t c~ `at eoml ta ~|vvms emm tbl

tbc`h~ ta tbl vlrcvblrcl~ mckl tbl dr|h~ e`d lu|cvjl`t * tblrl erl je`s

tbc`h~ xbcnb xl beyl ta ardlr vlr~a`emms. "Emmavetbcn dantar e`d ~vlncemc~t-

rlh|mer- 4 sler~ c` r|rem erle- iljeml# 

C` ?5 vmenl~ tblrl c~ `a ~|o nl`trl * ~a xbet ~ba|md tbl ^c~tlr "E@J# da1

^ba|md ~bl avl` tbl ~|onl`trl et ~ajloads(~ vmenl1 Ic a`l raaj iar

dlmcylrcl~- xctb vme~tcn a` tav1 "Emmavetbcn dantar e`d ~vlncemc~t- rlh|mer- ?<

sler~ c` r|rem e`d rljatl erle~- jeml# 

Olc`h e OJA C ~ba|md ol hlttc`h e ylbcnml ta xark a` iclmd a`ms tbl` xcmm C

ol eoml ta naylr xbaml iclmd ai 86-666 vlavml * ylbcnml- dcl~lm- drcylr- tbl~l

erl vltts tbc`h~ tbet ~ba|md `at `lld ta ol ~ecd. O|t- lyl` ta da tbet C beyl

ta jekl mat~ ai liiart~ e`d dl~vctl tba~l C beyl`–t rlnlcyld tblj. C beyl ta

|~l js ax` ylbcnml e`d ~vl`d a` js ax` vltram e`d dcl~lm ta da iclmd

xark "Emmavetbcn dantar e`d ~vlncemc~t- na`trent|em- 59 sler~ c` rljatl

erle~- jeml# 

Page 64: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 64/80

VBIC * @B^_N * ^B_N Nbbettc~herb

94

Xbcml je`s bed ettljvtld ta rec~l c~~|l~ ai vlr~a``lm e`d jetlrcem ~bartehl~ xctb tblcr

~|vlryc~ar~- xctb yersc`h ~|nnl~~- ~ajl rlherdld ct ta ol e i|tcml llrnc~l.

Ct c~ |`mcklms tbet ~ajla`l xcmm gac`. Vlavml najl- ~ll tbl vmenl e`d ha… ci C

dc~n|~~ emm tbl~l tbc`h~ "~bartehl~ ai ~teii e`d jetlrcem~# xctb bcj "tbl

NJA# tbl` ct–~ e xe~tl ai tcjl iar jl e~ xlmm e~ bcj. Tblrliarl C da `at da

ct. Tbl AVD c~ taa bleys iar jl- C xe`t e`atblr dantar- o|t bl bcj~lmi dal~

`at beyl a`l- bax xcmm bl hcyl iar jl1 " Emmavetbcn dantar- rlh|mer- 4 sler~

c` rljatl erle- iljeml#

@ax blrl xl `lld jldcnc`l o|t da`–t beyl ct… C dcd dc~n|~~ tbc~ NJA

~ebco e`d bl c~ ‒sl~- sl~- sl~–- o|t tbl` metlr `atbc`h. C jle`- sa| erl hcyc`h

najv|tlr~ lylrsxblrl….e`d tblrl erl iencmctcl~ ai jaocml vba`l~ * ci sa|

xe`t ta da ~a j|nb tbl` xbs da`–t sa| hcyl ct ta jl1 Jldcnc`l~ da`–t ha

xe~tl et js AVD. ^a tblrl c~ e vraomlj tbet C da`–t beyl jldcnc`l~ e`d

tbl` xbet ~ba|md C ~es ta tbl vetcl`t1 "Emmavetbcn dantar- na`trent|em- 52sler~ c` rljatl erle~- jeml# 

Hrletlr avvart|`cts iar trec`c`h e`d ~kcmm dlylmavjl`t xe~ e`atblr lvmcnctms lvrl~~ld `lld

ai e `|jolr ai rl~va`dl`t~.

Ci tbl haylr`jl`t ne` hlt tbl dantar~ xba erl va~tld c` tbl vlrcvblrcl~ ta

vamc~b tblcr ~kcmm~ a`nl c` e sler ar ~a… E rlirl~blr na|r~l „ xl j|~t ol

hcyl` e nbe`nl ta da ~ajltbc`h mckl tbet. ^a tbet lyl` xl erl ol`lictld

e`d xl da `at iarhlt xbetlylr xl beyl ~t|dcld. "Emmavetbcn dantar e`d 

~vlncemc~t- rlh|mer- 4 sler~ c` r|rem erle- iljeml# 

C beyl ta rlilr a|t je`s ne~l~. Xl ~ba|md ol hcyl` e rlirl~blr na|r~l et

mle~t lylrs ? sler~- e`d xl ~ba|md em~a ol hcyl` JD "va~thred|etl dlhrll#

trec`c`h- ar et mle~t e dcvmaje. Olne|~l xl mcyl c` rljatl erle~- ci tbls

jekl |~ c`ta ~vlncemc~t~ e`d hlt |~ ta da JD tbl` tbl vlavml xcmm ol

ol`lict. Ne~l~ tbet xl l`d |v rlilrrc`h xa|md tbl` ol tekl` nerl ai.

"Emmavetbcn dantar- rlh|mer- 55 sler~ c` rljatl erle~- jeml# 

Sl~- ci tbls trec` jl c` artbavldcn~- "C# xcmm dlic`ctlms ha. Tbls ~ba|md

arhe`cwl trec`c`h~ txcnl e ja`tb% "me|hb~# Em~a iar o|r` ne~l~ „ xl erl `at

eoml ta je`ehl ~|nb ne~l~ xlmm. Tbl tbcrd c~ jetlr`em blemtb. Xl erl emmjeml dantar~. C`ctcemms tbls da `at vrlilr |~ * tblrl erl ~ajl rl~lryetca`~

c` tbl najj|`cts- o|t xbl` tblrl c~ e mat ai vraomlj tbl` tbls da `at

tbc`k jeml ar iljeml dantar „ tbc~ xa|md ol ja~t ol`licncem. "Emmavetbcn

dantar- na`trent|em- 52 sler~ c` rljatl erle~- jeml# 

Page 65: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 65/80

VBIC * @B^_N * ^B_N Nbbettc~herb

9<

Tbl `lld iar olttlr mcyc`h e`d ba|~c`h erre`hljl`t~ xe~  najja`ms rlvartld enra~~ emm

netlharcl~ ai rl~va`dl`t~. Na~t~ ai rlvecr~ c` dcmevcdetld ba|~c`h xlrl aitl` oar`l vlr~a`emms-

e`d ~berc`h ai mcyc`h u|ertlr~ xe~ najja`vmenl. ^ajl rl~va`dl`t~ najvmec`ld eoa|t tbl

c`dch`cts ai mcyc`h ennajjadetca`~ xbcnb tbls ilmt dcd `at olict tblcr vrail~~ca`em ~tet|~.

Hcyl e ilx ejl`ctcl~ ta tbl dantar~. Tbls ~ba|md jekl u|ertlr~ iar

dantar~- `at mckl e vrcjers ~nbaam je~tlr * tblrl erl je`s xba erl mcyc`h c`rl`tld ba|~l~ „ ta oetbl- tbls erl hac`h a|t~cdl ta tbl rcylr. ^a emm tbc~ c~

`at rchbt. Ci sa| erl na`~tr|ntc`h e VBN ~ajlxblrl tbl` ema`h xctb tbet

sa| ~ba|md jekl u|ertlr~ * e mcttml exes iraj tbl najja` vlavml. Emm

tbl~l ennajjadetca`~ erl `at ~a haad „ rlvecr~ erl aitl` `lldld- e`d xl

beyl ta da ct a|r~lmyl~. Tbl haylr`jl`t a`ms vraycdl~ tbl xemm e`d tbl

raai * ci e`stbc`h be~ ta ol cjvrayld- xl beyl ta da ct. "Emmavetbcn dantar-

rlh|mer- 52 sler~ c` r|rem e`d rljatl erle~- jeml# 

‒JS VETCL@T^ ^BA\MD NAJL TA JL IC_^T–

Tblrl xe~ e vertcn|mer dlje`d iar `lld~*~vlncicn nmc`cnem ~kcmm~ dlylmavjl`t 

eja`h rl~va`dl`t~- c` erle~ xbcnb rlimlntld tblcr iclmd lvlrcl`nl~- e`d xbcnb

xa|md l`be`nl tblcr rl~va`~l ta najj|`cts `lld~.

Ci C ej hcyl` jarl trec`c`h c` be`dmc`h TO tbl` C xcmm mckl ct 

olne|~l C beyl ~ll` ne~l~ ylrs nma~lms- C beyl ~ll`

 vetcl`t~ dsc`h ~a C illm mckl C xe`t ta ol eoml ta da

~ajltbc`h eoa|t ct. Tbl ochhl~t tbc`h c~ tbet vetcl`t~

da`–t najl blrl aitl` * tbls ha ta "e `leros omank 

bledu|ertlr~ xctb vrcyetl dantar~#. ^a ct b|rt~ „ C illm 

tbet xbl` C ej ~cttc`h blrl tbl` js vetcl`t~ ~ba|md najl

ta jl et mle~t tbl icr~t tcjl. E`d C illm tbet ci C xe~ eoml ta

tlmm vlavml jarl eoa|t DAT^ e`d TO nerl tbl` jesol tbl

na`dctca` xa|md `at beyl oll` ~|nb. "ES\^B dantar-na`trent|em- ?.< sler~ c` rljatl erle- jeml#

Je`s e tcjl xl erl c` tbl iclmd e`d tbl na`dctca` c~ ~|nb

tbet xl illm xl da`–t beyl l`a|hb ~kcmm~. L~vlncemms c`

~|rhlrs e`d ao~tltrcn~ * xl xe`t ta trlet- o|t xl da`–t 

beyl tbl e|tbarcwetca`. ^a ct xa|md ol haad ta hlt ~ajl

trec`c`h. Iraj tbl olhc``c`h C beyl bed e` c`tlrl~t c`

~|rhlrs- o|t lyl` ci xl xe`t ta da xl erl |`eoml ta * ~a

tbc~ c~ tbl a`ms tbc`h mlit  "Emmavetbcn dantar- rlh|mer- 52

sler~ c` r|rem e`d rljatl erle~- jeml#

Page 66: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 66/80

VBIC * @B^_N * ^B_N Nbbettc~herb

99

Tbl ~lna`d dantar xba c~ blrl c~ ~tesc`h xctb jl- c` js u|ertlr~. ^ajl

xark be~ oll` da`l c` js u|ertlr- o|t c` bc~ vert- `atbc`h j|nb be~ oll`

da`l56

* ~a bl c~ ~tesc`h xctb jl a`ms. "Emmavetbcn dantar- rlh|mer- 53 sler~

c` r|rem e`d rljatl erle~- jeml# 

Dantar~ da `at xe`t ta najl ta tbl ycmmehl- o|t xbs1 Icr~t tbc`h c~ tbet

ennajjadetca`~ blrl erl c`edlu|etl. Iar tbl ve~t ? º sler~- C xe~ ~tesc`h

c` rl`tld u|ertlr~ * js u|ertlr~ beyl g|~t oll` na`~tr|ntld. Ci e JOO^

dantar c~ gac`c`h blrl e`d bl ~ll~ tbet ci tblrl c~ `a iencmcts iar bcj ta mcyl-

tbl` bax xcmm bl illm1 C dcd `at beyl e raaj ta ~tes c` iar > sler~. O|t at

lylrsoads xa|md beyl tbl ~ejl ettct|dl. Olne|~l C ej rec~ld c` e ycmmehl

xl da `at tekl tcjl ta edg|~t o|t ci ~ajla`l iraj tbl jltra~ ar haad ncts

tbl` bax xcmm bl edg|~t1 "Emmavetbcn dantar- rlh|mer- ?.< sler~ c` r|rem e`d 

rljatl erle~- jeml# 

^a xl beyl ta ~tes tahltblr- beyl ta ~berl. C taak tbc~ raaj c` tbl ba~vctem

"iencmcts# o|cmdc h a`ms. Ct c~ ent|emms e ~|o*nl`trl o|cmdc`h * a`l raaj e`d

kctnbl`. ^a > vlavml mcyl c` a`l raaj * ? dantar~ e`d a`l vberjenc~t. Iar

~tesc`h- ~ajl olttlr erre`hljl`t~ ~ba|md dlic`ctlms ol jedl. "ES\^B

dantar- na`trent|em- > sler~ c` rljatl erle~- jeml# 

Tbl `lld iar u|emcts ld|netca` iar tblcr nbcmdrl` xe~ xcdlms e`d ljvbetcnemms nctld os

rl~va`dl`t~ "?8!>8#- enra~~ emm hra|v~ e d netlharcl~. E `|jolr ai dantar~ c` ylrs rljatl

rlvartld tbet tbls xlrl bevvs ta rljec` vrcjercms olne|~l tblrl xlrl haad ~nbaam~ c` tbl

ycnc`cts. C` atblr c`~te`nl~- tba~l xba xlrl atblrxc~l na`tl`t xctb r|rem xark rlvartld tbet

olttlr ~nbaam~ xlrl tbl a`ms rle~a` xbcnb xa|md beyl mld tblj ta jchretl ta nctcl~.

C xe`t ta hcyl js nbcmdrl` e haad ld|netca`- ~a c` js ncrn|j~te`nl~ C beyl

ta kllv tblj c` _ecv|r. C da`–t k`ax bax je`s sler~ ct xcmm tekl iar e haad

~nbaam ta avl` blrl. "Emmavetbcn dantar- rlh|mer- 55 sler~ c` rljatl erle~-

jeml# 

Ct c~ tbl jec` rle~a` * ci e dantar gac`~ blrl tbl` tblrl c~ `a iencmcts iar

xetlr e`d lmlntrcncts- tblrl erl `a dantar~– u|ertlr~- o|t tbl ochhl~t

vraomlj c~ tbet tbet tbls ne`–t hcyl tblcr nbcmdrl` lyl` vrcjers ld|netca`.

^a ennardc`h ta tbl tcjl~- bc~ nbcmdrl` xcmm meh olbc`d. ^a olne|~l ai tbc~

`aoads xe`t~ ta gac` blrl. Et omank mlylm et mle~t tblrl ~ba|md ol e ~nbaam

iar nbcmdrl` * iraj tblrl- dantar~ ne` ha decms ta tblcr VBN~. Tbc~ xes tblrl

xcmm ol jarl dantar~ iar r|rem ~lrycnl. "Emmavetbcn dantar e`d ~vlncemc~t-

rlh|mer- 2 sler~ c` r|rem e`d rljatl erle~- jeml# 

56Tbl ~lna`d dantar–~ emmanetld raaj xe~ c` e ~tetl ai vertcem dl~tr|ntca`- xctb txa xemm~ e`d vert ai tbl

raai jc~~c`h

Page 67: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 67/80

VBIC * @B^_N * ^B_N Nbbettc~herb

98

Tblrl erl `a ~nbaam~ blrl „ tblrl erl haylr`jl`t ~nbaam~ o|t `a tlenblr~.

^nbaam~ erl c` e oed na`dctca` * tblrl c~ e bchb ~nbaam o|t tblrl c~ a`ms a`l

tlenblr * ne` sa| cjehc`l iraj vrcjers ta bchb ~nbaam a`ms a`l tlenblr%

"ES\^B dantar- na`trent|em- > sler~ c` rljatl erle- jeml# 

Olne|~l C ej e VH c` jldcnc`l- lyl` C beyl e dl~crl tbet- mckl tba~l nbcmdrl`

xba erl hac`h ta haad ~nbaam~ e`d beyl haad vmenl~ ta ha ta iraj tblrl-

~cjcmerms a|r nbcmdrl` xa|md em~a ettec` e haad va~ctca`. O|t xl erl `at

lyl` eoml ta hcyl a|r nbcmdrl` haad ld|netca`- tbl ja~t oe~cn tbc`h.

"Emmavetbcn dantar e`d ~vlncemc~t- na`trent|em- 59 sler~ c` rljatl erle~-

jeml# 

@ax iar a|r nbcmdrl` ld|netca` c~ `at va~~coml blrl. Tbl haylr`jl`t

~ba|md jekl ~|nb e vme` xblrl a|r nbcmdrl` ne` ~t|ds c` e jadlr` ~nbaam.

Ci tbls dcd tbet- tbl` xl xa|md beyl oll` tl`~ca`*irll tades. E`d tbl

~lrycnl xl erl dac`h iar tbl haylr`jl`t xa|md ol da`l xctb c`tlrl~t.

"ES\^B dantar- na`trent|em- 9 sler~ c` rljatl erle- jeml# 

Hraxc`h na`nlr`~ c` tbl xekl ai c`nrle~c`h ncycm ycaml`nl e`d c`~|rhl`ns erl ~|jjld |v c` tbc~

iljeml dantar–~ enna|`t. Tbl `lld iar e~~|re`nl ai  vlr~a`em ~ln|rcts c~ nmlerms cjvarte`t iar

dantar~ c` nlrtec` ycaml`nl*eiimcntld erle~.

^tesc`h blrl be~ rlemms olnajl dciicn|mt. Des os des- tbl na`dctca` c~

dltlrcaretc`h. Tbl @eemctl vraomlj be~ c`nrle~ld. Xbl` C bed c`ctcemms

najl blrl ct xe~ `at tbet oed. O|t c` me~t <*9 ja`tb~ ct be~ hat xar~l.

Emtba|hb tbls da `at tra|oml |~ e mat o|t sa| `lylr k`ax xbet tra|oml xl

jes me`d |v c`. Tbet c~ xbs C illm tbet ct c~ olttlr ta ha iraj blrl. Tbls

rlnl`tms o|r`t e tr|nk `ler tbl E@J–~ ba|~l. Ct c~ `at ylrs ~eil c` tbl

ycmmehl. Xl illm eirecd. " Emmavetbcn dantar- rlh|mer- 4 sler~ c` rljatl erle-

 iljeml#

Tbl va~tc`h c~ ic`l blrl. Tblrl c~ `a vraomlj e~ ~|nb- tblrl c~ `a rlem

vraomlj iraj @eem~ blrl- o|t ~tcmm ci tblrl c~ e ~a|`d ai e h|`~bat- tbl`

jc`d dal~ hlt dc~t|rold. L~vlncemms et `chbt ci ct ~llj~ tbet tblrl c~

~ajltbc`h bevvl`c`h e`d ~ajla`l c~ evvraenbc`h- ct jekl~ jl e`ca|~.

"Emmavetbcn dantar- rlh|mer- 59 sler~ c` r|rem e`d rljatl erle~- jeml# 

Page 68: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 68/80

VBIC * @B^_N * ^B_N Nbbettc~herb

92

^\JJE_S7 XBET TBLS @LLD

Tbl rl~va`dl`t~– lvrl~~ca`~ ai tblcr `lld~ „ rlimlntc`h vlrnlvtca`~ ai nbe`hl~ xbcnb xa|md

cjvrayl tblcr lvlrcl`nl~ ai xarkc`h c` r|rem e`d rljatl erle~ „ l`najve~~ld e re`hl ai 

rliarj~ e`d cjvrayljl`t~. Olttlr ~emercl~ e`d gao ~ln|rcts xlrl ljvbetcnemms ~tetld os

na`trent|em dantar~- xbcml tbl l`tcrl nra~~ ~lntca` ai dantar~ ljvbe~cwld tbl cjvarte`nl ai 

jarl retca`em tre`~ilr e`d vrajatca` vranld|rl~- icmmc`h ai blemtb xarklr yene`ncl~- e`d

cjvrayljl`t~ c` jetlrcem~ e`d iencmctcl~. Jarl avvart|`cts iar `lld~*oe~ld ~kcmm~ trec`c`h e`d

olttlr ba|~c`h em~a ia|`d ~ch`cicne`t jl`tca`. ^ancem `lld~ yacnld c`nm|dld "ja~t vrajc`l`tms#

olttlr ~nbaamc`h iar tblcr nbcmdrl`- e`d e~~|re`nl ai vlr~a`em ~ln|rcts.

Page 69: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 69/80

VBIC * @B^_N * ^B_N Nbbettc~herb

93

^\JJE_S AI IC@DC@H^

E ~s`av~c~ ai kls ao~lryetca`~ c~ vrl~l`tld c` Teoml < olmax.

JEGA_55

JC@A_5?

 _le~a`~ iar

Gac`c`h

*  Hlahrevbcnem e`d ltb`cn "trcoem# eiic`ctcl~

*  Vlr~a`em yem|l~ ai ~lrycnl

*  Ic`e`ncem najv|m~ca`~

*  C`d|nljl`t~ ai vrlilrl`tcem

edjc~~ca` ta bchblr ld|netca` 

Ientar~

Ieya|rc`h

^tesc`h A`

*  Hlahrevbcnem eiic`ctcl~

*  _|rem |vorc`hc`h

*  Ltb`cn "trcoem# eiic`ctcl~

*  Eyecmeocmcts ai haad ~nbaam~ c` tbl rlhca`

*  Vlr~a`em yem|l~ ai ~lrycnl

*  Vrail~~ca`em c`tlrl~t e`d ejoctca`

*  ^tra`h rlmetca`~bcv~ xctb nammleh|l~

*  E`tcncvetca` ai ~ln|rcts ai rlh|mer gao "N#

*  Avvart|`cts iar oatb ~va|~l~ ta xarke`d mcyl c` tbl ~ejl manetca` "I#

*  ^vcrct|em e`d rlmchca|~ mle`c`h~

*  Dc~c`nmc`etca` iar vrcyetl vrentcnl

*  Ic`e`ncem najv|m~ca`~

*  Hlttc`h enn|~tajld ta r|rem mcil

*  Nma~l`l~~ ta verl`t~ e`d iejcms

*  Iejcmcercts ! iejcmcercwetca` xctb

ycmmehl mcil

*  Haad rlmetca`~ xctb manem

najj|`ctcl~*  ^etc~ientca` e`d i|micmjl`t

*  Haad rlmetca`~ xctb ~|vlryc~ar~ 

@lld~

Lvrl~~ld

*  E~~|re`nl ai gao ~ln|rcts "N#

*  Cjvrayld xarkvmenl erre`hljl`t~ e`d

rl~a|rnl~

*  Haad ~nbaam~ iar nbcmdrl`

*  Olttlr ba|~c`h

*  @lld~*~vlncicn trec`c`h e`d ~kcmm

dlylmavjl`t

*  Olttlr ~emercl~ "N#

*  Jarl retca`em vrajatca`~ e`d

tre`~ilr~

*  E~~|re`nl ai vlr~a`em ~ln|rcts

Teoml <. Kls ic`dc`h~ iraj tbl ~t|ds

"N7 ~vlncicn ta na`trent|em dantar~- I : ~vlncicn ta iljeml dantar~#

Vrentctca`lr~– c`ctcem dlnc~ca`~ ta gac` ~lrycnl c` r|rem e`d rljatl erle~ xlrl aitl` c`im|l`nld os

vrcar iejcmcem e`d najj|`cts mc`kehl~ xctb tbl vmenl "dc~trcnt ar rlhca`# c` u|l~tca`. C` atblr

c`~te`nl~ tbl dlnc~ca` ta gac` xe~ aitl` e|tajetcn ar |`jldctetld „ tbls xlrl ~cjvms va~tld

tblrl os tbl ~tetl blemtb edjc`c~tretca`.

A`nl c` ~lrycnl- dantar~ `at a`ms ienld edylr~l ltlr`em ncrn|j~te`nl~ o|t em~a ~tr|hhml xctb

jeh`cicnetca`~ ai tbl hl`lrcn vraomlj~ ai haylr`jl`t blemtb ~s~tlj~. Tbl~l na`dctca`~ lyakl

e jc ai rl~va`~l~ eja`h dantar~- ~ajl rlylmmc`h c` tbl lvlrcl`nl e`d ic`dc`h avvart|`ctcl~ c`

tbl nbemml`hl ai edylr~cts- e`d atblr~ na`ira`tc`h e` lradc`h k`axmldhl oe~l e`d dlnmc`l c`

vrail~~ca`em na`icdl`nl e`d neveocmctcl~.

Tbl dantar~– dlnc~ca`~ ta rljec` c` r|rem e`d rljatl erle~ aylr vlrcad~ ai tcjl xlrl drcyl` os e

jarl najvml ~lt ai ientar~ rlimlntc`h vlr~a`em u|emctcl~- najj|`cts mc`kehl~ e`d ~s~tljcn

ientar~ e`d c`im|l`nl~. Nrctcnemms najoc`etca`~ ai rle~a`~ xlrl e~ cjvarte`t e~ dc~nrltl ientar~

c` c`im|l`nc`h tbl dlnc~ca`~ ai tbl vrentctca`lr~ ta rljec`. Mcil vranl~~l~- vrail~~ca`em c`tlrl~t~

55Vrajc`l`t tbljl~ „ lmcnctld xcdlms e`d!ar ljvbetcnemms lvrl~~ld

5?Ml~~ vrajc`l`t tbljl~ „ lmcnctld eja`h ar lvrl~~ld os ilxlr rl~va`dl`t~

Page 70: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 70/80

VBIC * @B^_N * ^B_N Nbbettc~herb

86

e`d ejoctca`~ e`d rlmetca`~bcv~ o|cmt aylr vlrcad~ ai tcjl c`im|l`nld tbl dantar~– dlnc~ca`~ ta

~tes a`.

_l~va`dl`t~– yclx~ xlrl em~a ne`ye~~ld a` xbet tbls `lldld ta cjvrayl tblcr lvlrcl`nl~ ai 

xarkc`h e`d mcyc`h c` rljatl e`d r|rem erle~- xbcnb naylrld e ~vlntr|j ai vatl`tcem rliarj~ e`d

cjvrayljl`t~ era|`d c`~tct|tca`em vranld|rl~- rldrl~~c`h rl~a|rnl hev~- e`d gao ~eilts.

Tbl vrail~~ca`em c`~ln|rctcl~ ai na`trent|em dantar~ ~lt tblj evert c` ~ajl rl~vlnt~ „ oatb ai 

ientar~ ieya|rc`h ~tesc`h a` e`d tblcr ~tetld `lld~.

Page 71: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 71/80

VBIC * @B^_N * ^B_N Nbbettc~herb

85

^T_ETLHCN CJVMCNETCA@^

Ai emm ienlt~ ai e` liilntcyl blemtb ~lrycnl- tbl vrl~l`nl ai blemtb xarklr~ c~ tbl ja~ti|`dejl`tem rlu|crljl`t. Tbl ~|nnl~~i|m cjvmljl`tetca` ai blemtb nerl vme`~ rlu|crl~ nma~l

ettl`tca`- `at g|~t ta tbl `lld~ ai l`d*|~lr~ ai nerl o|t em~a ta ira`tmc`l vraycdlr~ ai blemtb

nerl- tblcr e`tlnldl`t~- tbl ncrn|j~te`nl~ c` xbcnb tbls mcyl e`d dc~nberhl tblcr d|tcl~- tbl xlo

ai c`tlrentca`~ xbcnb dlic`l tblcr raml~ c` blemtb ~s~tlj~ e`d ~ancltcl~- e`d tblcr c`tlrl~t~-

e~vcretca`~ e`d `lld~ "^blckb e`d Hlarhl ?656#.

Tbc~ u|emctetcyl rl~lernb ~t|ds lvmarl~ e vbl`ajl`a` xbcnb ~ba|md c` cdlem tlrj~ ol e  iect 

ennajvmc  „ tbl vrl~l`nl ai blemtb xarklr~ c` blemtb nerl iencmctcl~ „ o|t xbcnb c` tbl |`iart|`etl 

rlemcts ai r|rem blemtb ~s~tlj~- c~ aitl` rerlr tbe` tblcr eo~l`nl. C` ct~ lvmaretca` ai tbl xark

e`d mcyl~ ai u|emcicld vrentctca`lr~ xba na`tc`|l ta rljec` c` ~lrycnl c` rljatl r|rem manetca`~ ai 

Nbbettc~herb ~tetl- tbl ~t|ds sclmd~ ic`dc`h~ xbcnb erl ai ~tretlhcn rlmlye`nl c` Nbbettc~herb e`d

C`dce` blemtb vamcns na`tlt~- e`d em~a na`tec` cjvarte`t hmaoem ml~~a`~ iar ~tretlhcl~ ta rltec`

u|emcicld blemtb xarklr~ c` r|rem e`d rljatl erle~.

Hlahrevbcnem e`d ltb`cn eiic`ctcl~- e`d e r|rem |vorc`hc`h- evvler ta ol dajc`e`t ientar~

ieya|rc`h dantar~– dlnc~ca`~ ta gac e`d em~a ta rljec` c` ~lrycnl c` r|rem manetca`~. Tbc~ ic`dc`h

~|vvart~ tbl dlvmasjl`t ai vamcncl~ ~|nb e~ eiicrjetcyl entca` iar l`trs c`ta jldcnem ld|netca`

iar dantar~ archc`etc`h iraj |`dlr~lryld erle~- e`d em~a vatl`tcemms  iar ne`dcdetl~ xctb trcoem

ltb`cncts.  E`atblr vatl`tcem ~tretlhcn dcrlntca` ~|hhl~tld os tbc~ ic`dc`h c~ tbl dlnl`tremcwetca`

ai jldcnem trec`c`h7 tbl c`~tct|tca` ai jldcnem nammlhl~ c` r|rem e`d rljatl erle~- ta l`eoml

jldcnem e~vcre`t~ xctb e r|rem |vorc`hc`h ta trec` e`d gac` xark c` tblcr vrlilrrld vmenl~ ai rl~cdl`nl. Ennmcjetcwetca` ta r|rem mcil em~a ljlrhld e~ e` cjvarte`t ientar ieya|rc`h dantar~–

dlnc~ca`~ ta rljec`- xbcnb em~a |`dlr~narl~ tbl cjvarte`nl ai r|rem jldcnem ld|netca .

Xbcml tbl `lld iar e` eo~am|tl c`nrle~l c` ves*~neml~ dcd `at ljlrhl e~ e ~tra`h tbljl eja`h

tbc~ ~lmlntca` ai rl~va`dl`t~- tbc~ ~ba|md `at ol c`tlrvrltld ta jle` tbet tbl c~~|l ai lna`ajcn

rlt|r`~ c~ c`~ch`cicne t. Tbl cjvarte`nl ai rlh|mer rlj|`lretca` e`d ai ettl`de`t ol`lict~ ta

haylr`jl`t ~lrye`t~ ~|nb e~ olttlr ba|~c`h e`d ld|netca`em avvart|`ctcl~ iar nbcmdrl` ne``at

ol aylr~tetld. I|rtblrjarl- e hredld ~emers ~neml oe~ld a` rljatl`l~~ e`d dciicn|mts ai 

tlrrec`- e`d hrletlr ol`lict~ "vl`~ca`~- ba|~c`h- irll ld|netca` iar nbcmdrl`# ta dantar~ ~lryc`h

c` dciicn|mt erle~ na|md ol ai vertcn|mer |tcmcts- vertcn|merms c` tbl na`tlt ai tbl xer*mckl

ncrn|j~te`nl~ c` vert~ ai tbl ~tetl- tbl cjvmcnct rc~k~ ta vlr~a`em ~ln|rcts e`d ~ancem c~ametca`.

^vlncem liiart~ ne` ol |`dlrtekl` os tbl ~tetl ta e~~c~t dantar~– ~va|~l~ c` ic`dc`h ljvmasjl`t

c` tbl ~ejl erle~- e`d c` iencmctetc`h edjc~~ca` ta bchb u|emcts ~nbaam~ xctb oaerdc`h

erre`hljl`t~ iar tblcr nbcmdrl`. Yam|`tercms cjvmljl`tld ratetca` vamcncl~- xctb tbl avtca` ai 

mcjctc`h tbl tcjl ~vl`t c` e vertcn|merms dciicn|mt erle- jes em~a blmv ta cjvrayl |vtekl ai rljatl

va~tc`h~.

Page 72: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 72/80

VBIC * @B^_N * ^B_N Nbbettc~herb

8?

Tbl ~tra`h vlr~a`em yem|l~ e`d vrail~~ca`em c`tlrl~t~ lyc`nld os e `|jolr ai rl~va`dl`t~ olmcl

tbl vav|mer jstb~ tbet dantar~ rljec` c` r|rem erle~ a`ms a|t ai najv|m~ca`- e`d tbet

haylr`jl`t ~lrycnl c~ xcdlms na`~cdlrld c`ilrcar ta vrcyetl vrentcnl. C` ~vctl ai ~ch`cicne t

na`nlr`~ aylr tbl u|emcts ai xarkc`h l`ycra`jl`t~- rlh|mer haylr`jl`t ~lrycnl xe~ xcdlms

rlherdld os rl~va`dl`t~ e~ e ~teoml nerllr avtca`- e`d e va~ctcyl avvart|`cts ta na`trco|tl ta

tbl oraedlr ~ancem haad. ^|o~te`tcyl c`tlryl`tca`~ ecjld et o|cmdc`h a` tbl~l va~ctcyl

na`nlvtca`~ os rec~c`h tbl ennlvteocmcts ai ljvmasjl`t c` r|rem blemtb ~lrycnl~- e~ xlmm e~ tbl

cjehl ai haylr`jl`t blemtb ~lrycnl~ eja`h r|rem najj|`ctcl~ jes xlmm ~lryl ta ettrent jarl

`lx rlnr|ct~ e`d ecd c` rltl`tca` ai jarl u|emcicld xarklr~.

Icr~t e`d iarlja~t- tbl vraicml ai haylr`jl`t blemtb nerl ne` ol l`be`nld os vraycdc`h olttlr

xarkc`h na`dctca`~ iar blemtb xarklr~ „ c`nm|dc`h olttlr c`ire~tr|nt|rl- jetlrcem~ e`d- cra`cnemms-

jarl je`vaxlr. Tbl vrl~l`nl ai edlu|etl `|jolr~ ai ~teii c` blemtb iencmctcl~ cjvrayl~ tbl

xarkc`h lvlrcl`nl iar tba~l emrleds c` ~tetca`- nrletc`h e va~ctcyl nsnml7 jarl je`vaxlr

cjvrayl~ xarkc`h na`dctca`~ xbcnb c` t|r` ettrent~ jarl je`vaxlr ! ecd~ c` rltl`tca`.

@|rt|re`nl ai dantar~– vrail~~ca`em c`tlrl~t~ e`d ejoctca`~- e`d ~tljjc`h tbl lra~ca` ai 

vrail~~ca`em ~kcmm~  c~ e`atblr nrctcnem ~tlv c` rec~c`h tbl ~ancem vraicml ai haylr`jl`t ~lrycnl~.Avvart|`ctcl~ ta l`be`nl ~kcmm~ e`d enedljcn lva~|rl c` erle~ xbcnb rlimlnt najj|`cts

`lld~ ent ta i|rtblr dantar~– vrail~~ca`em c`tlrl~t~ e`d ne` rld|nl vraomlj~ ai c`tlmmlnt|em

ettrctca` e`d c~ametca` „ dantar~ vertcn|merms ljvbe~c~ld tbl `lld iar rlirl~blr nmc`cnem ~kcmm~

trec`c`h c` erle~ ~|nb e~ ljlrhl`ns e`d enncdl`t nerl- ao~tltrcn~ e`d jetlr`em blemtb-

t|olrn|ma~c~ e`d jemerce nerl. Lmlntra`cn najj|`cnetca` a` jldcnem ~|oglnt~ xctb vllr~ e`d

~vlncemc~t~ tbra|hb ycdla e`d tlmlna`ilrl`nc`h c`tlrienl~ be~ olnajl va~~coml- e`d na|md blmv c`

na|`tlrc`h tbl vrail~~ca`em c~ametca` e`d ~kcmm ettrctca` lvlrcl`nld os r|rem dantar~. Tbl

c`trad|ntca` ai va~thred|etl ~vlncemc~t dlhrll~ c` r|rem jldcnc`l e`d vrcjers nerl c~ e`atblr

c`tlryl`tca` tbet ne` ent ta l`be`nl tbl ennlvteocmcts e`d ~tet|~ ai r|rem vrentcnl.

Em~a ylrs ~ch`cicne`tms- dantar~ ~llk enna|`teocmcts e`d rl~vlnt iraj tblcr ljvmaslr~. _etca`em

e`d tre`~verl`t vranld|rl~ iar vmenljl`t- tre`~ilr- vrajatca` e`d |vhredetca` iraj

na`trent|em ta rlh|mer ~lrycnl~ ne` emm vmes e raml c` jekc`h r|rem haylr`jl`t ~lrycnl e jarl

ettrentcyl vrava~ctca`. Me~tms- na~jltcn hl~t|rl~ erl `at xctba|t tblcr vrehjetcn cjvarte`nl. Ct

c~ e` |`iart|`etl najjl`ters tbet c` ~ajl ncrnml~- r|rem va~tc`h~ xlrl rlherdld e~ ‒v|`c~bjl`t

va~tc`h~– ar e~ me~t rl~art~ iar tba~l xctba|t tbl vlr~a`em na``lntca`~ ar l`trlvrl`l|rcem

c`ctcetcyl ta ic`d xark c` nctcl~. Ier*rljayld iraj tbc~ cjehl ai tbl |`~|nnl~~i|m a|tne~t- ~ajl

dantar~ e~~lrtld tblcr ax` ~lmi*vlrnlvtca`~ e~ blral~ e`d ira`tclr ~amdclr~ c` dlil`nl ai tba~l

ja~t c` `lld. Tbl haem ai hrletlr rltl`tca` jes xlmm ol ~lryld ci e|tbarctcl~ xlrl ta ~berl e`d

vrajatl tbc~ vlrnlvtca`- e`d najjl`nl ta ennard iarjem rlnah`ctca` e`d rlxerd iar ~lrycnl~

|`dlr dciicn|mt na`dctca`~ ta blemtb xarklr~ xctb evvravrcetl nrldl`tcem~ e`d bc~tarcl~ ai r|rem~lrycnl. E|tbarctcl~ ne` em~a e~~c~t c` o|cmdc`h va~ctcyl e`d l`eomc`h xarkc`h l`ycra`jl`t~

tbra|hb na`tlt ~vlncicn venkehl~ ai entcyctcl~ „ c`nm|dc`h ~|vvartcyl ~|vlryc~ca`- ta|r

vrahrejjl~- e`d ~ncl`tcicn lyl`t~. Arhe`cwld iar|j~ e`d anne~ca`~ iar c`tlrjc`hmc h xctb ~ancem

e`d vrail~~ca`em vllr~ e`d xctb manem najj|`ctcl~ ne` em~a l`hl`dlr ~tra`hlr vlrnlvtca`~ ai 

evvrlncetca` e`d rlnah`ctca`.

Page 73: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 73/80

VBIC * @B^_N * ^B_N Nbbettc~herb

8>

Tbl ic`dc`h~ ai tbc~ ~t|ds- ljlrhc`h tbra|hb e ~s~tljetcn- rchara|~- rlimlcyl e`d xlmm*yemcdetld

rl~lernb vranl~~- erl `lylrtblml~~ ai e ~|oglntcyl `et|rl. Xbcml tbl e|tbar~ olmclyl tbet tbls

beyl ~ch`cicne`t yem|l c` c`iarjc`h ~tretlhcn dcrlntca`~- tbls erl `at c`tl`dld ta rlvrl~l`t e`

cjjldcetl om|lvrc`t iar vamcns nbe`hl- "xbcnb c~ `lnl~~ercms na`tlt*~vlncicn- ~|oglnt ta tbl

vrlyecmc`h oeme`nl ai blemtb ~lntar vrcarctcl~ e`d ta na`~cdlretca`~ ai avlretca`em ile~cocmcts-

vamctcnem yceocmcts e`d na~t#. Bax tbl~l ic`dc`h~ ne` ~lryl c~ 5# e~ e` c`ilrl`tcem oe~c~ iar ~tretlhcn

dcrlntca`~ xbcnb dl~lryl ta ol iclmd*tl~tld iar cjvent e`d evvravrcetl`l~~- e`d ?# ta bchbmchbt

~vlncicn ~s~tljcn l`be`nljl`t~ xbcnb jes ecd c` cjvrayld rltl`tca` ai tbl u|emcicld v|omcn

blemtb xarkiarnl- manemms- `etca`emms e`d hmaoemms. Kls vatl`tcem ~tretlhcn cjvmcnetca`~ xbcnb ne`

ol c`ilrrld iraj tbc~ ~t|ds erl ~|jjerc~ld e~ iammax~7

*  L~teomc~bjl`t ai jarl jldcnem trec`c`h c`~tct|tl~ c` r|rem e`d rljatl erle~*  ^tretlhcl~ vrajatc`h eiicrjetcyl entca` iar l`trs c`ta jldcnem ld|netca` iar dantar~

iraj |`dlr~lryld erle~- e`d ai trcoem ltb`cncts

*  L`be`nld e`d e~~|rld haylr`jl`t ljvmasll ol`lict~- `ateoms u|emcts ba|~c`h e`d

nbcmdrl`–~ ld|netca`

*  C`trad|ntca` ai hredld ~emers ~neml~ oe~ld a` rljatl`l~~ e`d dciicn|mts ai tlrrec`- e`d

l`be`nld venkehl~ ai ol`lict~ ta dantar~ ~lryc`h c` dciicn|mt erle~

*  C`trad|ntca` e`d cjvmljl`tetca` ai yam|`ters ratetca` vamcncl~- xctb tbl avtca` ta mcjct

tbl eja|`t ai tcjl ~vl`t c` vertcn|merms dciicn|mt erle~

*  ^trc`hl`t cjvmljl`tetca` ai ~te`derd~ iar xarkc`h na`dctca`~ „ c`nm|dc`h edlu|ens ai 

c`ire~tr|nt|rl- jetlrcem~ e`d je`vaxlr

*  E|hjl`tc`h c`*~lrycnl trec`c`h avvart|`ctcl~ ta nma~lms rlimlnt najj|`cts e`d trec`ll

`lld~

*  Jle~|rl~ ta l`be`nl retca`emcts e`d tre`~verl`ns ai vranld|rl~ iar vmenljl`t- tre`~ilr

e`d vrajatca`

*  C`~tct|tca` ai iarjem rlnah`ctca` e`d rlxerd~ iar ~lrycnl~ |`dlr dciicn|mt na`dctca`~

^|jjers7 ~tretlhcn cjvmcnetca`~

Page 74: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 74/80

VBIC * @B^_N * ^B_N Nbbettc~herb

84

_LIL_L@NL^

5.  Orcttl`- @.- ?666. U|emctetcyl C`tlryclx~. C` N. Vavl ) @. Jes~- ld~. U|emctetcyl _l~lernb c`

Blemtb Nerl. Omenkxlmm V|omc~bc`h Mtd.- vv. 5?*?5.

?.  Nbajctw- K. J. "5338#. /Xbet da dantar~ xe`t1 Dlylmavc`h C`nl`tcyl~ iar Dantar~ ta ^lryl c`

C`da`l~ce(~ _|rem e`d _ljatl Erle~./

>.  Dclmlje`- J.- V. N|a`h- lt em. "?66>#. /Cdl`tcisc`h ientar~ iar gao jatcyetca` ai r|rem blemtb

xarklr~ c` @artb Yclt @ej./ B|j _l~a|rnl Blemtb 5"5#7 56*56.

4.  D|~~e|mt- H. e`d J. N. Ire`nl~nbc`c "?669#. /@at l`a|hb tblrl- taa je`s blrl7 |`dlr~te`dc`h

hlahrevbcnem cjoeme`nl~ c` tbl dc~trco|tca` ai tbl blemtb xarkiarnl./ B|j _l~a|rnl Blemtb 47

5?*5?.

<.  Hrocnb- N.- 5333. U|emctetcyl rl~lernb c` blemtb7 e` c`trad|ntca`- Ma`da`7 ^ehl.

9.  Mc`dlmax- J. e`d V. ^lr`llm~ "?669#. /Tbl vlriarje`nl ai blemtb xarklr~ c` Ltbcavce7 rl~|mt~

iraj u|emctetcyl rl~lernb./ ^an ^nc Jld 9?"3#7 ???<*??><.8.  Jes~- @. ) Vavl- N.- 5333. U|emcts c` u|emctetcyl rl~lernb. C` N. Vavl ) @. Jes~- ld~. U|emctetcyl

_l~lernb c` Blemtb Nerl. Ma`da`7 OJG oaak~- vv. 2?*56?.

2.  VBIC ) Xarmd Oe`k "?662#. Nerllr Vrlilrl`nl~ ai Jldcnem e`d @|r~c`h ^t|dl`t~ c` \tter Vredl~b

* E U|emctetcyl E`ems~c~- V|omcn Blemtb Ia|`detca` ai C`dce ) Tbl Xarmd Oe`k- @lx Dlmbc.

3.  VBIC "?662#. Tbl ^cwl- Najva~ctca` e`d Dc~trco|tca` ai C`dce(~ Blemtb Xarkiarnl- V|omcn Blemtb

Ia|`detca` ai C`dce.

56. Vavl- N. ) Jes~- @.- ?666. U|emctetcyl jltbad~ c` blemtb rl~lernb. C` U|emctetcyl rl~lernb c`

blemtb nerl. Ma`da`7 OJG V|omc~bc`h Hra|v.

55. Vartlr- G.D.B. lt em.- ?66?. Ml~~a`~ c` c`tlhretca` * avlretca`~ rl~lernb c` e` C`dce` mlvra~s @HA.

Mlvra~s _lyclx - 8>"?#- 548*<3.

5?. _ctnbcl- G. ) ^vl`nlr- M.- 5334. U|emctetcyl Dete E`ems~c~ iar Evvmcld Vamcns _l~lernb. C` E.

Orsje` ) _. O|rhl~~- ld~.  E`emswc`h U|emctetcyl Dete- Ma`da`; @lx Sark7 _a|tmldhl- vv. 58>*

34.

5>. ^lr`llm~- V.- J. Mc`dlmax- lt em. "?668#. /Iar v|omcn ~lrycnl ar ja`ls7 |`dlr~te`dc`h

hlahrevbcnem cjoeme`nl~ c` tbl blemtb xarkiarnl./ Blemtb Vamcns Vme`. ??">#7 5?2*5>2.

54. ^blckb- K. ) Hlarhl- E.- ?656; C`dce–~ blemtb vraycdlr~ „ dcylr~l ira`tclr~- dc~veretl iart|`l~. C`

K. ^blckb ) E. Hlarhl- ld~. Blemtb Vraycdlr~ c` C`dce7 A` tbl Ira`tmc`l~ ai Nbe`hl - @lx Dlmbc7

_a|tmldhl- vv. 5*54

5<. ^cmylrje`- D.- ?664. U|emctetcyl _l~lernb7 Tblars- Jltbad e`d Vrentcnl- ^ehl V|omcnetca`~ C`n.

59. XBA "?669#. Xarkc`h tahltblr iar blemtb. Tbl Xarmd Blemtb _lvart. Hl`lye- Tbl Xarmd Blemtb

Arhe`cwetca`.58. XBA "?668#. @at L`a|hb Blrl... Taa Je`s Tblrl * Blemtb Xarkiarnl c` C`dce. @lx Dlmbc- Xarmd

Blemtb Arhe`cwetca`- Na|`trs Aiicnl iar C`dce.

52. Xarmd Oe`k "?662#. Hmaoem Ja`ctarc`h _lvart ?662 * JHD~ e`d tbl L`ycra`jl`t. Xe~bc`hta`

DN- Tbl Xarmd Oe`k.

53. Wecdc- ^. E. "5329#. /Xbs jldcnem ~t|dl`t~ xcmm `at vrentcnl c` r|rem erle~7 lycdl`nl iraj e

~|ryls./ ^an ^nc Jld ??"<#7 <?8*<>>.

Page 75: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 75/80

VBIC * @B^_N * ^B_N Nbbettc~herb

8<

 E@@LR\_L^

Tavcn H|cdl

TAVCN H\CDL

C`trad|nl ~lmi e`d l`hehl rl~va`dl`t 

Vraycdl c`iarjetca` a` tbl ~t|ds e`d aoglntcyl~- na`icdl`tcemcts e`d i|rtblr c`iarjetca` e~

dltecmld c` tbl na`~l`t iarj

Tekl c`iarjld na`~l`t iar c`tlryclx e`d iar rlnardc`h tbl c`tlryclx 

^xctnb a` rlnardlr 

Najjl`nl tbl c`tlryclx

TAVCN^

5.  Ld|netca`em- vrail~~ca`em e`d ~ancem bc~tars

?.  Na`tlt ai gac`c`h tblcr rl~vlntcyl vrail~~ca`

>.  Lvlrcl`nl~ ai xarkc`h c` tblcr vrl~l`t manetca`

4.  Lvlrcl`nl~ ai xarkc`h c` atblr manetca`~- ci e`s

<.  ^ancem haem~ e`d ejoctca`~

9.  Vrail~~ca`em haem~ e`d ejoctca`~

8.  _ljct ai jldcnem d|tcl~ e`d entcyctcl~

2.  Tsvl~ ai vetcl`t~ „ jldcnem vraicml~

3.  Tsvl~ ai vetcl`t~ „ ~ancem e`d lna`ajcn vraicml~

56.  C`tlrentca`~ xctb vetcl`t~- rljerkeoml ar ma`h*~te`dc`h e~~ancetca`~ ci e`s

55.  Iejcmcem oa`d~- lvlrcl`nl ai hlahrevbcnem dc~te`nc`h iraj iejcms- ci ~a

5?.  Najj|`cts oa`d~- lvlrcl`nl ai hlahrevbcnem dc~te`nc`h iraj najj|`cts- ci ~a

5>.  C`tlrentca`~ xctb najj|`cts mledlr~- ~ancem jayljl`t~- vamctcnem entar~

54.  Lvlrcl`nl~ ai xarkc`h erre`hljl`t~

5<.  Lvlrcl`nl~ ai rlj|`lretca` erre`hljl`t~

59.  C`tlrentca`~ xctb na*xarklr~- ~|vlryc~ar~- rlilrrem |`ct~- atblr blemtb ~s~tlj entar~

58.  Lvlrcl`nl~ ai avvart|`ctcl~ iar vlr~a`em dlylmavjl`t ! nevencts*o|cmdc`h

52.  Lvlrcl`nl ai nbe`hl~ e`d rliarj~ c` xarkc`h erre`hljl`t~ ar rlj|`lretca`- ci e`s

53.  Lvlrcl`nl~ ai najvltc`h avvart|`ctcl~ lm~lxblrl

Aotec` ! rlna`icrj tbl iammaxc`h dltecm~

*  I|mm ejl ai rl~va`dl`t QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ

*  Dl~ch`etca` ai rl~va`dl`tQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ

*  I|mm u|emcicnetca`~ QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ

*  Tatem d|retca` ai lvlrcl`nl QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ

*  D|retca` ai lvlrcl`nl c` r|rem ! rljatl r|rem erle QQQQQQQQQQQQQQQQQQ

Page 76: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 76/80

VBIC * @B^_N * ^B_N Nbbettc~herb

89

Vac`t~ ta rljljolr xbcml na`d|ntc`h c`tlryclx7

*  Tekl tcjl ta o|cmd revvart e`d najiart

*  Naylr emm tbl tavcn~ nerli|mms- e~ tbl c`tlryclx vranlld~ emtba|hb `at `lnl~~ercms c` ~lu|l`tcem ardlr

*  L`na|rehl dltecmld `erretcyl~ ai lvlrcl`nl~- vraol nerli|mms ta l`na|rehl * `at c`tlrr|vt * `erretcyl~

*  Ian|~ a` lvlrcl`nl~ ai ~vlncicn lyl`t~ e`d vbl`ajl`e- `at a` bsvatbltcnem ar eo~trent lejvml~

*  L`na|rehl rl~va`dl`t~ ta vraycdl lvme`etca`~ ai tblcr lvlrcl`nl~- retblr tbe` avc`ca`~ xbcnb erl `at mc`kld

ta ~vlncicn lvlrcl`nl~

*  Vraol evvravrcetlms- c`trad|nl `lx tavcn~ `et|remms c` tbl na|r~l ai na`ylr~etca`

*  Eyacd mledc`h u|l~tca`~- da `at vrl*ljvt rl~va`~l~

*  Emxes~ ol rl~vlnti|m- edavt e `l|trem ta`l e`d na`~nca|~ms eyacd lvrl~~c`h g|dhjl`t- lyl` ci sa| da `at ehrll

xctb tbl rl~va`dl`t

Page 77: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 77/80

VBIC * @B^_N * ^B_N Nbbettc~herb

88

Iarj iar Aotec`c`h Na`~l`t 

Na`~l`t Vranl~~ e`d Iarj

C`iarjetca` ta ol na`ylsld ta tbl blemtb xarklr vrcar ta aotec`c`h na`~l`t7

Xl erl dac`h e rl~lernb ~t|ds lvmarc`h tbl lvlrcl`nl~ e`d ncrn|j~te`nl~ ai u|emcicld blemtb xarklr~

xba beyl xarkld iar e ma`h tcjl c` r|rem e`d rljatl erle~.

Tbc~ ~t|ds c~ olc`h na`d|ntld os tbl V|omcn Blemtb Ia|`detca` ai C`dce- @etca`em Blemtb ^s~tlj~ _l~a|rnl

Nl`tlr ai tbl Jc`c~trs ai Blemtb e`d Iejcms Xlmierl- Haylr`jl`t ai C`dce e`d Nbbettc~herb ^tetl Blemtb

^s~tlj~ _l~a|rnl Nl`tlr- Haylr`jl`t ai Nbbettc~herb.

Xl erl bavc`h ta temk xctb sa| iar eoa|t >6 jc`|tl~ ta a`l ba|r. Vmle~l temk ta |~ irllms e`d ire`kms e`d

mlt |~ k`ax ci tblrl erl e`s c~~|l~ xl orc`h |v tbet sa| da `at xe`t ta dc~n|~~. Et e`s tcjl- sa| jes

tlrjc`etl e` c`tlryclx ar rlu|l~t tbet c`tlryclx dete ol rljayld iraj tbl ~t|ds.

Sa|r vertcncvetca` c` tbc~ ~t|ds- e`d emm rlnard~ eoa|t sa|r vertcncvetca`- rljec` na`icdl`tcem. Emm dete xcmm ol

~tarld c` ~ln|rl manetca`~ e`d eyecmeoml a`ms ta ~t|ds vlr~a``lm. @a`l ai tbl c`iarjetca` aotec`ld xcmm ol

cdl`tcicld xctb sa|- ar sa|r vmenl ai xark.

Ci sa| beyl e`s u|l~tca`~ `ax C xcmm e`~xlr tblj- e`d ci sa| beyl u|l~tca`~ metlr sa| ne` na`tent |~

^tetljl`t ai vlr~a` edjc`c~tlrc`h na`~l`t

C beyl i|mms lvmec`ld ta QQQQQQQQQQQQQQQQQQQQQQQQQQQQ tbl na`tlt- v|rva~l- vranld|rl~ e`d rc~k~ tbet

erl c`yamyld c` tbl eoayl*dl~nrcold ~t|ds. C beyl tekl` irll e`d c`iarjld na`~l`t iraj bcj!blr ta

vertcncvetl c` tbl c`tlryclx- xctba|t ~|hhl~tca` ar nalrnca`. C beyl e`~xlrld emm u|l~tca`~ ta tbl ol~t ai js

eocmcts.

 QQQQQQQQQQQ QQQQQQQQQQQQQQQQQQQQQQQQQQQQ QQQQQQQQQQQQQQQQQQQQQQQ

Detl ^ch`et|rl "Vlr~a` Edjc`c~tlrc`h Na`~l`t# @ejl

Xct`l~~ld os7

 QQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQQ QQQQQQQQQQQQQQQQQQQQQQQ

^ch`et|rl "Xct`l~~# @ejl

Page 78: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 78/80

VBIC * @B^_N * ^B_N Nbbettc~herb

82

Tbljetcn Irejlxark ai E`ems~c~

^|vlriejcms Nadl Iejcms Nadl`ejl Dlic`ctca`7 ^lhjl`t ai tlt xbcnb dl~nrcol~7 

OENKH_A\@D Vlr~a`em e`tlnldl`t~ OQIEJ Vlr~a`em iejcms bc~tars

OQNAJ Bc~tars ai najj|`cts eiic`cts "ltb`cn ! mc`h|c~tcn !

rlmchca|~#

OQMAN Vmenl ai |vorc`hc`h ar ld|netca`

OQLD\ Vlr~a`em bc~tars ai ld|netca` e`d u|emcicnetca`~

OQV_AI Ncrn|j~te`nl~ ai l`tlrc`h jldcnem vrail~~ca`

OQATBXK Vrlyca|~ xark lvlrcl`nl atblr tbe` c` vrl~l`t manetca`

OQGAC@ Ncrn|j~te`nl~ ai gac`c`h xark c` vrl~l`t manetca`

IENTA_^ Ientar~ ieya|rc`h ~tesc`h a` „ vlr~a`em 

IQVL_YEM Vlr~a`em yem|l~ xctb olerc`h a` lvlrcl`nl ai ~tesc`h a`

IQENN\^T Vranl~~ ai hlttc`h enn|~tajld ta mcyc`h e`d xarkc`h c`

vrl~l`t manetca`IQIEJ_LM _lmetca`~bcv~ xctb iejcms xctb olerc`h a` lvlrcl`nl ai 

~tesc`h a`

IQ_LMCH _lmchca|~ c`nmc`etca`~ xctb olerc`h a` lvlrcl`nl ai 

~tesc`h a`

IQ^VA\^L ^va|~l*rlmetld ientar~ xctb olerc`h a` lvlrcl`nl ai 

~tesc`h a`

IQVV Avvart|`cts iar vrcyetl vrentcnl c` vrl~l`t manetca`

Ientar~ ieya|rc`h ~tesc`h a` „ najj|`cts 

IQLTB Ltb`cn eiic`ctcl~ xctb olerc`h a` lvlrcl`nl ai ~tesc`h a`

IQHLAH Hlahrevbcnem eiic`ctcl~ xctb olerc`h a` lvlrcl`nl ai 

~tesc`h a`

IQHAY_LM _lmetca`~bcv~ xctb haylr`jl`t entar~ "manem ~lmi*hayt-dc~t edjc`c~tretca`- atblr# xctb olerc`h a` lvlrcl`nl ai 

~tesc`h a`

IQVAM_LM _lmetca`~bcv~ xctb vamctcnem jayljl`t~ ar entar~

"c`nm|dc`h c`~|rhl`t e`d na|`tlrc`~|rhl`t hra|v~# xctb

olerc`h a` lvlrcl`nl ai ~tesc`h a`

IQNAJJ_LM _lmetca`~bcv~ xctb manem najj|`ctcl~ xctb olerc`h a`

lvlrcl`nl ai ~tesc`h a`

Ientar~ ieya|rc`h ~tesc`h a` „ blemtb ~s~tlj

IQNAM_LM _lmetca`~bcv~ xctb xarkvmenl nammleh|l~ xctb olerc`h a`

lvlrcl`nl ai ~tesc`h a`

IQ^\V_LM _lmetca`~bcv~ xctb ~|vlryc~ar~ ar ~|vlrcar~ xctb olerc`h

a` lvlrcl`nl ai ~tesc`h a`IQGAO^LN Gao ~ln|rcts e~ e ientar olerc`h a` lvlrcl`nl ai ~tesc`h

a`

IQXA_KYEM Yem|etca` ai xark7 l`gasjl`t- ~etc~ientca` e`d nbemml`hl

ai xark- cdlem~ ai vrail~~ca`em ~lrycnl ar vrail~~ca`em

cdl`tcts

IQNAJV\M Najv|m~ca` ta rljec` c` vrl~l`t manetca`

IQV_L^T Vrl~tchl "ai haylr`jl`t gao- eja`h vllr~ e`d

nammleh|l~- ltn.# e~ e ientar olerc`h a` lvlrcl`nl ai 

~tesc`h a`

Page 79: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 79/80

VBIC * @B^_N * ^B_N Nbbettc~herb

83

Ientar~ ieya|rc`h ~tesc`h a` „ vetcl`t~

IQVET_LM _lmetca`~bcv~ xctb vetcl`t~ xctb olerc`h a` lvlrcl`nl ai 

~tesc`h a`

@LLD^ @lld~ xbcnb xa|md l`be`nl lvlrcl`nl ai ~tesc`h a`

@Q^EM\V ^ch`cicne`nl ai c`nrle~l c` ~emers

@QNBCMDLD ^ch`cicne`nl ai ld|netca`em avvart|`ctcl~ iar nbcmdrl`

@QENED ^ch`cicne`nl ai avvart|`ctcl~ iar enedljcn lva~|rl e`d

dlylmavjl`t

@QVLL_ ^ch`cicne`nl ai avvart|`ctcl~ iar vllr c`tlrentca`~

@QVL_^LN ^ch`cicne`nl ai olttlr vlr~a`em ~ln|rcts

@QGAO^LN ^ch`cicne`nl ai gao ~teocmcts e`d ~ln|rcts "jec`ms iar

na`trent|em ljvmasll~#

@QV_AJ ^ch`cicne`nl ai jarl retca`em vranld|rl~ e`d vamcncl~ iar

vrajatca`

@QT_E@^ ^ch`cicne`nl ai jarl retca`em vranld|rl~ e`d vamcncl~ iar

tre`~ilr e`d vmenljl`t

@Q^TEII ^ch`cicne`nl ai narrlntc`h ~bartehl~ ai ~|vvart ~teii ar

nammleh|l~

@QJET ^ch`cicne`nl ai narrlntc`h ~bartehl~ ai lu|cvjl`t e`d

jetlrcem~ e`d cjvrayc`h xarkc`h na`dctca`~

@QBA\^ ^ch`cicne`nl ai olttlr rl~cdl`tcem erre`hljl`t~

@QENK ^ch`cicne`nl ai olttlr enk`axmldhljl`t e`d rlnah`ctca`

ai na`trco|tca`

@Q^\VL_ ^ch`cicne`nl ai olttlr ~|vlryc~ars ~|vvart e`d h|cde`nl

@Q^AN ^ch`cicne`nl ai cjvrayld ~ancem mcil e`d mlc~|rl iencmctcl~

@E__ETCYL^ Lvlrcl`tcem `erretcyl~

@E_QN_CTLR Nrctcnem lvlrcl`nl~ xbcnb vraycdl e` c`~chbt c`ta tbl

c`dcycd|em lvlrcl`nl ai mcyc`h e`d xarkc`h c`

@E_QNAV Lvlrcl`nl e`d jlnbe`c~j~ ai navc`h xctb vlr~a`em e`d

ncrn|j~te`tcem vraomlj~ ai mcyc`h e`d xarkc`h c` tbl

vrl~l`t manetca`

Page 80: Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

7/30/2019 Why Some Doctors Serve in Rural Areas: A Qualitative Assessment from Chhattisgarh State (India) 2010

http://slidepdf.com/reader/full/why-some-doctors-serve-in-rural-areas-a-qualitative-assessment-from-chhattisgarh 80/80

VBIC * @B^_N * ^B_N Nbbettc~herb

Tcjlmc`l ai C`tlryclx~

^. @a. Detl Dc~trcnt Iencmcts c` xbcnb c`tlryclx na`d|ntld

565.68.63 5

NBN

? VBN>

6?.68.63 ?

VBN

4 VBN

< VBN

9

6>.68.63 >

VBN

8 VBN

2 VBN

3

68.62.63 4

NBN

56 VBN

55 NBN

5? NBN

5> NBN

54 NBN

5<62.62.63

<

VBN

59 VBN

58 VBN

52

62.62.639

VBN

53 VBN

?6 NBN

?5 VBN

??

56.62.638

VBN

?> VBN

?4 VBN

?< VBN

?9 NBN

?8 NBN

?2 NBN

?3

5?.62.63

2

NBN

>6 VBN

>5 VBN

>? NBN

>>

5>.62.63

NBN

>4 VBN

>< VBN

>9 VBN

>8 VBN