The document analyzes determinants of doctor performance in public health systems in three states of India. It finds that all three states have significant doctor vacancies, with Jharkhand filling only 30-95 of 96-131 positions across different districts. Rajasthan has 8,162 doctor positions but 745-658 new positions per year, leaving 2,991 vacancies. Uttarakhand has 946 doctors against a sanctioned 1,922 positions. Peripheral health facilities generally lack adequate doctors, medical infrastructure and support systems. Recruitment challenges, contractual uncertainties and lack of promotions contribute to poor retention of doctors in rural areas.