SECTION 4: THE EXISTANCE OF THE TERM BIMAROU SECTION 4.

1: LITERATURE REVIEW Bimaru was an acronym coined by the economic analyst Ashish Bose in the mid 1980s by taking the first letter of four northern Indian states: Bihar, Madhya Pradesh, Rajasthan and Uttar Pradesh. Bimaru has resemblance to the Hindi word BIMAR which means sick. This term was used to describe the bad state of the economy in the above mentioned backward states. Later Orissa was included in this group thus making the acronym resulting in BIMAROU. CHARACTESRISTCS OF BIMAROU STATES Low agricultural productivity Low state Gross Domestic Product Poor standard of living High Below Poverty Line population High Infant and Maternal Mortality Massive density of population Poor Public Health Care Delivery System BIHAR The state of Bihar lags far below the national average and remains well behind other states. Some of the parameters of backwardness in Bihar are per hectare productivity in agriculture, industrial output, and dependence of people on the secondary and tertiary economic sectors, employment scenario, per capita income. The state has the lowest per capita net domestic product and lowest level of public health services among all the Indian states. The acute health situation in Bihar is only understood when National Family Health Survey uses nutrition based indicators to explain the health status of Bihar. The proportion of children suffering from Anaemia in Bihar is 78%, for women it is 67.4%, for men it is 34.3% which is much above the National Averages. The nutrition standards in Bihar are also very poor. The work of health delivery systems is also limited in Bihar .The immunization programmes like BCG, DPT & Polio lack universal coverage in Bihar. The work of National Rural Health Mission is also marginal in this state.

MADHYA PRADESH Madhya Pradesh (M.P.) presents a spectacle of under-development and wide-spread poverty along with tremendous potential for development, manifesting a case of missed opportunities for development. There are big gaps in the availability of health services and requirements. There are considerable back-logs in areas like literacy, levels of nutrition, drinking water supply, basic health and poverty. Infant Mortality is very high compared to the National Average. Irrigation facilities are inadequate. There has been decline in the growth of irrigation potential created by government sources and also in the utilization ratio of potential created, mainly due to poor allocations to this sector, poor maintenance of irrigation works and inadequate farm activities by the cultivators. A large number of

irrigation projects of earlier plans have spilled over to subsequent plans due to lack of allocations. In spite of the best of efforts on behalf of the Government institutions, the people of the state are not satisfied though the government expenditure increased in absolute terms. On the other hand, there are serious questions about the economic access and quality of health care in private sector, particularly in the rural areas. The problem is compounded as government does not have effective monitoring, surveillance or control function with regard to private health care. RAJASTHAN The scenario in Rajasthan indicates that one out of every five urban dwellers is poor. The real health conditions and service coverage among this section of the population is masked by the urban average figures. The state had inadequate functional coordination among stakeholders (like health, ICDS, urban local bodies, water supply, sanitation, slum development, public distribution system, private health service providers etc).Urban health infrastructure and services in order to increase access of primary health care services to the urban poor was quite poor. ORISSA This is one such state in India which is stained with poor socioeconomic status of the inhabitants. Lower income, poor housing facility, lack of education and discrimination are some of the factors that contribute to the poor living standard including poor health status of the people in the state. The Death Rates in Orissa is highest in the country as a whole that is at least 2 points below the National Death Rate. Within first one month of birth or during

neonatal period, the mortality rate is highest as compared to postneonatal period .Besides such high infant mortality, the Underfive Mortality Rate in this state is also accounted to be very high which stands at 90.6 under five deaths per 1000 live births. The Nutritional Status says almost half of the children under five in Orissa are stunted or chronically malnourished and under weight. The people of Orissa experience a large number of disasters about 40 major disasters in 50 years that adversely affect health and development of this state. UTTAR PRADESH This state is considered to be the most populous state in India but here 45000 children die before they reach to their first birthday, this is all due to the socio-economic condition of the family. Here the CDR (Crude Death Rate) and IMR (Infant Mortality Rate) is quite high than any other state in the Nation which represents that the poor people here cannot afford the medical cost in Uttar Pradesh. Thus in this state the low level of income affect the intake of food, frequent infection, hard physical labour, etc which finally causes poor child health. Here the Infant and Child Mortality rates are quite high than the national average. It has also been found lack of willingness of the AGANWADI and ANC in improving the child health.