The broad relationship between the extent and pattern of sickness in a south Indian rural community, attendance at the Area Health Centre (AHC) and service rendered to the sick at the centre were studied by National Tuberculosis Institute (NTI), Bangalore. The objectives were to study (i) point prevalence of symptoms of all kinds and their pattern (ii) attendance at the AHC and the pattern of symptoms among them: and (iii) number of visits for each spell of sickness, by nature of symptom, laboratory tests offered, and referral to better equipped health institutions. A 30,000 population served by the Bettahalasur Primary Health Centre (PHC) which is 20 km. away from Bangalore city was chosen. The selection of villages was done by random sample so that about 1000 persons from each of 5 field health workers' area was available for symptoms questioning. The out patients at the PHC were questioned for symptoms by the PHC medical officer in a manner exactly similar to that for the community by the trained NTI para medical staff. The answers given by patients were recorded by NTI staff both at the centre and at the community. On revisits made for the same spell of sickness, the interval in days from the first visit, any laboratory tests done and reference to better equipped institutions were also recorded.

The point prevalence of sickness in the area was 9.5%; cough, pain and fever, in that order were the three cardinal symptoms that accounted for 68% of the total sickness in the community. Only 1.3% of the sick, at any point of time, had attended the AHC but the attendance by the sick persons residing in the village where the health centre is located was 9.2%. The composition of the out patients attendance was significantly different from that of the sick in the community in respect of age, sex and symptoms. Thus, women and the elderly persons who also constitute a major reservoir of tuberculosis, tended to disregard their symptoms while younger persons in the productive age group had availed the health centre facilities more freely. Among symptoms, cough was the most ignored. Of the total out patients, 71% had attended only once, 18% twice and 11% three times or more for any particular episode of sickness. Only 7 9% were offered laboratory examination and an insignificant number were referred to better equipped health institutions.