This document summarizes research on health and safety management practices in the construction industry in Gujarat, India. It finds that construction work is hazardous and small-to-medium enterprises (SMEs) dominate the industry in Gujarat. The document reviews literature on factors affecting safety performance and identifies barriers to effective health and safety management in Gujarat's construction SMEs. These include a lack of safety training and awareness among workers, inadequate safety policies and monitoring, and failure to integrate health and safety training. The document concludes more focus on safety is needed from the industry and recommends owners take a more active role in safety management.