INTRODUCTION:

Good health is not only the primary requirement of well-being of people; it also enhances economic growth of the nation (Saikia, 2014). For ideal human development and proper growth of any country, development of health status is considered as one of the key ingredients. With the improvement of health status, country makes its human capital more energetic and vibrant. As per the definition of World Health Organization (WHO) health, is a "State of complete physical, mental, and social well being, and not merely the absence of disease or infirmity."

Webster stated that “the condition of being sound in body, mind or spirit, especially freedom from physical disease or pain”. According to Oxford English Dictionary “soundness of body or mind; that condition in which its functions are duly and efficiently discharged”.

Health status of a country affects its economic growth and social well being through various channels (Ghatak and Das, 2012). When health status improves, the country can produce more output with any given combination of skills, physical capital and technological knowledge with its human capital (Sen, 2001). As per the Human Development Report of UNDP, health is one of the primary components of human development. That is why World Bank has started to give more priority to health development. Even though India is accelerating its economic growth over the last two decades, it has rated poorly in human development indicators and health indicators (Baru et al., 2010, Saikia, 2014). In UNDP Human Development Index, 2017 India ranked 131 among 188 countries, which is only because of negligence of the authority, inadequate use of health care devices and unhygienic health conditions.

OBJECTIVES:

i. To find out the spatial pattern of disparity regarding the health care facility of the district.

ii. To identify the developmental strategies of health in different C.D. Blocks (both rural and municipalities) of Purba Bardhaman District.

iii. To assess the problems regarding the health conditions in different parts of the district.

iv. To recommend suggestions to mitigate these problems.

MATERIALS AND METHODS:

Data has been collected from District Statistical Handbook, 2014, Primary Census Abstract, 2011. Data has been disseminated with MS Excel 2007. Data has been processed by using IBM SPSS Statistics 25 (evaluation copy) Software. Thematic Maps has been prepared with ArcMap 10.5 (evaluation copy). The collected data has been classified, tabulated and analyzed for the purpose of the study. Choropleth technique has been utilized to represent spatial variation of health status. Statistical technique like dimension index has been implied to standardize all variables and finally to find out Health index by using four parameters, viz. Medical institution-People Ratio, Bed-Population Ratio, Doctor-Population Ratio, Family Welfare Centers and Sub centers-Population Ratio, which ultimately represents the C.D. Block wise distribution of rural health status of Purba Bardhaman district excluding municipal areas.

Fig.1: Dimension Index

Source: UNDP Human development Report, 2002

1. Medical institution-People Ratio (MPR):

Medical institution-People Ratio includes number of hospitals, rural hospitals, block primary health centers, primary health centers, and other departments of government of West Bengal including state government undertaking, local bodies, and government of India including central government undertaking and N.G.O / private bodies (Nursing Homes) per thousand populations.

2. Bed-Population Ratio (BPR):

Number of beds in medical institutions per thousand populations.

3. Doctor-Population Ratio (DPR):

Number of doctors in hospitals per thousand populations.

4. Family Welfare Centers and Sub centers-Population Ratio (SPR):

Dimension Index:

Before the Health Index itself is calculated, an index is essential to be created for each parameter.

Therefore, dimension index of each variable can be calculated. Minimum and maximum values are selected for each underlying indicator (Fig.1). Performance in each dimension is expressed as a value ranging between 0 and 1 by applying the following general formula:

(Actual Value – Minimum Value)

Dimension Index =------------------------------------------- (i),

(Maximum Value-Minimum Value)

(Human Development Report, 2002)

Without proper health infrastructure it is not possible to deliver health services to the people. The totality of health infrastructure includes not only governmental entities but also non-governmental entities that provide health services to the people (Sayanti, 2014). Therefore, preparation of health index is very much essential to deficit location and its reason behind it. Health index is constructed to show the spatial pattern of health infrastructure as a weighted average of various components (Lakshmi and Sahoo, 2013).The Health Index can be calculated with the following equation of these parameters-

HI = ¼ (MPR+BPR+DPR+SPR). (ii), (Ghatak and Das, 2012)

Study Area:

The Purba bardhaman district is the part of the state of West Bengal, India. It is located between the 22°56ʹ00”N–23°51ʹ00ʺN latitude and 87°26ʹ00ʺE–88°25ʹ00ʺE longitude, covering an area of 5416 km² and it contains 23 Community Development (C.D.) blocks and 6 municipalities. This district is bound by the Paschim Bardhaman in the west, Birbhum District in the north-west, Murshidabad in the north and Nadia District in the east. In the south-east and south-west side of this district Hugli and Bankura districts are located respectively. Geographically this district is a transitional zone between the Jharkhand plateau which constitutes a portion of peninsular shield in the west and Ganga-Brahamaputra alluvial plain in the north and east.

RESULTS AND DISCUSSION:

Development of health care facility in Purba Bardhaman district:

Purba Bardhaman is one of the affluent districts of West Bengal for the agriculture practice. This district is also known as rice bowl of India for its supreme production. But from the point of view of health care facility the district is very far from the level of excellence. Spatial analysis of health infrastructures will represent the status of health of Purba Bardhaman district.

Medical institution-People Ratio (MPR):

Medical institution-people ratio depicts the number of medical institutions per thousand populations. It is one of the vital parameter among the four parameters. Because, if the number of medical institutions are enough to the requirement of the population size, people of the region will be provided immediate service and the status of the health of that particular region will definitely increase.

With the spatial analysis of medical institutions it can be understood that there is a wide disparity between C.D. blocks. Raina-I and Raina-II has more number of medical institutions having dimension index value 0.089 and 0.075. Aushgram-I, Aushgram-II, Bhatar, Galsi-I, Burdwan-II, Jamalpur, Kalna-II occupied second place. Ketugram-II, Katwa-I, Katwa-II, Purbasthali, Mangolekote, Manteswar, Memari-II, Khandosh got third position in the dimension index and rest of the C.D. Blocks has very low amount of medical institutions (Fig.3 )

Fig. 3 Spatial distribution of medical institution

Fig. 4 Spatial distribution of number of beds

Bed-Population Ratio (BPR):

With the help of this ratio number of beds in medical institutions per thousand populations can be represented. Without enough number of beds it is quite difficult to assure proper treatment. Jamalpur, Memari-I, C.D. Blocks stands in good position having dimension index of 0.035, 0.038. Aushgram-I, Aushgram-II, Galsi-I, Mangolekote, Bhatar, Raina-I, Raina-II, Kalna-II C.D. Blocks stands in second position in terms of Bed-Population Ratio. Rest of blocks except Burdwan-I and Burdwan-II occupied in third position in bed population ratio (dimension index). In Burdwan-I and Burdwan-II C.D. blocks rural health facilities has been neglected because of the emergence of urban health care units (Fig.4).

Fig. 5: Spatial distribution of number of doctors

Fig. 6: Spatial distribution of number of family

welfare centers and sub-centers

Doctor-Population Ratio (DPR):

Doctors are the backbone of health care system. Therefore, appropriate number of doctor is very much essential.

In Aushgram-I, Aushgram-II, Memari-I, Raina-II C.D. Blocks has satisfactory amount of doctors in respect to the population. Galsi-I, Bhatar, Mangolkote, Katwa-I, Raina-I, Memari-II, Kalna- II occupied second position. Rest of the C.D. block has very worst condition in Doctor- Population Ratio (Fig.5).

Family Welfare Centers and Sub centers-Population Ratio (SPR):

This ratio explains number of public and private family wale fare centers and sub-centers per thousand populations. Sub-centre provides health care services to the community at the grass-root level. As Family Welfare Centers and sub-centers are the first contact point with the community in terms of health, the success of any nation would depend largely on well functioning sub-centers providing services of acceptable standard to the people. Performance of Galsi-II Aushgram-I is quite good. Galsi-I, Bhatar, Mongolekote, Ketugram-I, Ketugram-II, Katwa-I, Katwa-II, Memari-I, Kalna-II, Jamalpur, Raina-I C.D. Blocks stands in second position. Aushgram-II, Kandaghosh, Raina-II, Burdwan-II, Manteswar, Memari-II occupied third position. Kalna-I, Purbasthali-I, Purbasthali-II, Burdwan-I has extreme bad condition (Fig. 6).

Spatial distribution of health status based on Health Index:

Calculation of health index has been done with the above mentioned formula (ii) with the four parameters (Table1). With the help of the Health Index map spatial distribution of health infrastructure throughout the Purba Bardhaman district can be analyzed.

Fig. 7 reveals the fact that Aushgram-I, Galsi-II C.D. Blocks are comparatively more developed blocks having health index value 0.269 and 0.262. Raina-I, Raina-II, Jamalpur, Kalna-II, Galsi-I, Bhatar, Mangolkote, Ketugram-II C.D. Blocks can be described as developed blocks. Katwa-I, Katwa-II, Manteswar, Memari-I, Memari-II, Burdwan-II, Khandaghosh, Aushgram-II and Ketugram-I C.D. blocks got its status as moderately developed blocks. Burdwan-I, Kalna-I, Purbasthali-I, Purbasthali-II C.D. blocks found in less developed blocks category. But overall senario is not satisfactory in this district. In present conte local administration and government should take immidiate iniciatives to increase the number of medical institution, number of beds in medical institution, number of doctors and number of family welfare centers and sub-centers.

Table: 1 Parameters to prepare health index

C.D. Block	No. of Medical Institution Per Thousand Population	Dimension Index	No. of Bed Per Thousand Population	Dimension Index	No. of Doctor Per Thousand Population	Dimension Index	Family welfare Centers Per Thousand Population	Dimension Index	Health Index
Ausgram-I	0.034	0.058	0.293	0.026	0.050	0.031	0.176	0.959	0.269
Ausgram-II	0.033	0.057	0.258	0.022	0.046	0.029	0.133	0.722	0.208
Bhatar	0.034	0.060	0.319	0.029	0.038	0.024	0.144	0.787	0.225
Burdwan-I	0.014	0.000	0.083	0.000	0.019	0.012	0.111	0.606	0.154
Burdwan-II	0.033	0.056	0.105	0.003	0.026	0.016	0.137	0.748	0.206
Galsi-I	0.032	0.053	0.283	0.025	0.037	0.023	0.144	0.785	0.222
Galsi-II	0.020	0.019	0.197	0.014	0.020	0.013	0.183	1.000	0.262
Jamalpur	0.030	0.048	0.368	0.036	0.030	0.019	0.143	0.778	0.220
Kalna-I	0.019	0.016	0.174	0.011	0.019	0.012	0.106	0.579	0.155
Kalna-II	0.030	0.047	0.239	0.019	0.042	0.026	0.155	0.847	0.235
Katwa-I	0.023	0.027	0.162	0.010	0.035	0.022	0.144	0.787	0.211
Katwa-II	0.022	0.024	0.183	0.012	0.029	0.018	0.146	0.797	0.213
Ketugram-I	0.018	0.013	0.169	0.011	0.030	0.019	0.145	0.791	0.208
Ketugram-II	0.025	0.034	0.211	0.016	0.025	0.016	0.152	0.828	0.223
Khandaghosh	0.021	0.021	0.153	0.009	0.021	0.013	0.137	0.749	0.198
Memari-I	0.018	0.013	0.394	0.039	0.046	0.028	0.142	0.774	0.213
Memari-II	0.027	0.038	0.213	0.016	0.033	0.021	0.140	0.762	0.209
Mongalkote	0.023	0.026	0.308	0.028	0.038	0.024	0.144	0.787	0.216
Monteswar	0.021	0.021	0.198	0.014	0.021	0.013	0.135	0.735	0.196
Purbasthali-I	0.019	0.016	0.213	0.016	0.019	0.012	0.111	0.606	0.162
Purbasthali-II	0.024	0.028	0.174	0.011	0.024	0.015	0.122	0.667	0.180
Raina-I	0.044	0.090	0.282	0.025	0.033	0.021	0.144	0.783	0.230
Raina-II	0.040	0.076	0.258	0.022	0.053	0.033	0.139	0.756	0.222

Source of the data: District Statistical Handbook, Bardhaman 2014

Calculated by authors

Fig. 7: Spatial distribution of health facilities based on health index

CONCLUSION:

A healthy socio-econmic region can only be possible when good health infrustructure will be available in the concerned region. This kind of study is very much effective in the present era of pollution, global warming and other environmental degradations which badly affect human health both directly or indirectly. Therefore, managerial steps must be taken by the government and non-government organizations to awar people about the procedure to maintain hygenic health condition. Purba Bardhamn district is a growing district in terms of agriculture, so, major part of the district contains rural areas. The result of this articles depicts that urban areas of the district is more concious about health than the rural areas. So, government must look after about the health condition of the rural areas so that rural people can also enjoy and a healthy long life.

AKNOWLEDGEMENTS:

The authors are thankful to the Department of Planning, Statistics and Programme Monitoring for all the facilities made available and availed for the work as a researcher. Our deepest gratitude goes to Dr. Gopal Chandra Debnath, retired Professor, Department of Geography, Visva-Bharati, Santiniketan who guided us throughout the study and his wise counselling and encouragement to complete this article. We express our sincere and heartfull thanks to Dr. Niladri Das for technical support.

REFERENCES:

1. Ghatak S and Das PP. Status of Rural Health Care and the Hidden Disparity: A Study of Birbhum District, West Bengal, India. IOSR Journal of Humanities and Social Science (JHSS). 3.2; 2012: 13-18.

2. Poddar S. A Study of Spatial Variation of Women Health Status in Hugli District of West Bengal, India. International Research Journal of Social Sciences. 3(11); 2014: 20-26.

3. Saikia D. Health care infrastructure in the rural areas of north-east india: current status and future challenges. Journal of Economic & Social Development. Vol. - X, No. 1; 2014: Available from https://www.researchgate.net/publication/265511171

4. Lakshmi TS and Sahoo D. Health Infrastructure and Health Indicators: The Case of Andhra Pradesh, India. IOSR Journal Of Humanities And Social Science (IOSR-JHSS). 6.6; 2013: 22-29.

5. Sen A. Many Faces of Gender Inequality. The New Republic, India. 2001.

6. District Statistical Handbook of Bardhaman, 2014. Available from http://www.wbpspm.gov.in/publications/District%20Statistical%20Handbook

7. Baru, R., A. Acharya, S. Acharya, A.K. Shiva Kumar and K. Nagaraj. Inequities in Access to Health Services in India: Caste, Class and Region. Economic and Political Weekly. 45.38; 2010: 49-58.

Received on 07.08.2018 Modified on 10.09.2018

Res. J. Humanities and Social Sciences. 2018; 9(4): 875-880.

DOI: 10.5958/2321-5828.2018.00146.8