The state of Himachal Pradesh covers an area of almost 55,673 square km., and has less than one per cent of India's population. Nearly half of the population (42%) lives below the poverty line. The crude birth rate, death rate and infant mortality rates are 28.4, 8.9 and 75 respectively. Corresponding rates for India are 29.3, 9.8 and 80. In general, the social, economic and demographic profiles of Himachal Pradesh indicate that conditions are in fact better than those prevailing in, for example, the four large northern states. Despite these better than average conditions, several constraints remain. These include the rugged terrain, sparsely populated and scattered villages and inaccessibility of services. In addition, community participation has been largely absent, mother and child health services have not been adequately linked with family planning, awareness and practice of immunisation and disease management are poor, personnel are inadequately trained, and information and education activities are limited and not sufficiently integrated with cultural conditions. Management information systems also lack dependability.
The overall objective of the envisaged project was to achieve the goals of the national policy of "Health for all by the year 2000". The immediate objectives were to improve service delivery, to increase the demand for health and family welfare services; and to improve programme management. Three members of an appraisal mission were tasked to: determine the project area(s) and analyse the health situation analyse demographic data, the socio-economic status of women, and gender specific and age specific literacy rates analyse the health sector, including health policy, management and organisation, health service infrastructure, maintenance systems, drugs and supplies, health management information systems, staff requirements and training needs, information, education a assess health sector financing determine project objectives, target groups, the structure of the project and executing institutions, cost and financing