New Delhi: In a clear misuse of Government subsidies in the health sector, the well-off people are enjoying its fruits, depriving the poor who have the first right on them, a World Bank study has said.

"The richest 20 per cent capture about 33 per cent of the subsidies meant for the poor while the 20 per cent of the poorest could use only 10 per cent of the services. The subsidies are primarily made as the poor could not afford health care services," according to the report "Health Policy Research in South Asia" compiled by the World Bank.

The report, which was released today (Jan 7, 2004), is a compilation of researches done by local people in South Asian countries.

India was among the top five countries which offer poor health services in public sector. Other four countries being the conflicted ones could not offer quality services, leading author and health economist at the World Bank International Abdo Yazbeck said.

Factors such as the country spends very little on the health sector, people being unaware about the facilities offered in the Government hospitals and illiteracy contribute a lot in the poor health scenario, the report said.

On inviting researches done by local people to compile the report, Yazbeck said, "Locally managed research are more relevant to the local policymakers and are likely to be more closely linked to politically feasible reforms and policies."

The book also talks of "large inequalities" in health outcomes within the country. Kerala offers quality health services in public sector with limited resources while Bihar trails far behind, the report said.