The objective of primary health care is to provide basic health services at the door steps of rural people through a network of Sub-Centres (SCs), Primary Health Centres (PHCs), Additional Primary Health Centres (APHCs) and Referral Hospitals (RHs). The major components of primary health care are (i) health education to the community, (ii) maternal, child health and family welfare, (iii) curative services, (iv) maintenance of demographic services (v) prevention and control of local epidemics and (vi) implementation of national health programmes. This performance audit of Rural Health Services in Bihar covering the period 1999-2004 revealed that Rural health care units failed to provide basic minimum services and bring about improvement in referral linkages. The health care services in rural areas of the State were grossly inadequate. Shortage of medical officers and paramedical staff ranged upto 95 per cent. There were huge shortages of health care units compared to the GOI norms. Infrastructural facilities such as buildings, drinking water, electricity, labour room facilities, equipment and diagnostic facilities were lacking in most of the health units.