Journal of Global Resources
doi.org/10.46587/JGR.2020.v06i02.013

Volume 6 (02)

July 2020
Page 92-99
ISSN: 2395-3160 (Print), 2455-2445 (Online)

13
REGIONAL DISPARITY IN AVAILABILITY OF HEALTH CARE FACILITIES OF BIRBHUM
DISTRICT, WEST BENGAL: A SPATIO-TEMPORAL ANALYSIS
Mahuya Sen
Assistant Professor of Geography, Birbhum Mahavidyalaya, Suri (West Bangal) India
Email: mahuyasen74@gmail.com
Abstract: In search of a healthy prosperous life several attempts have been made throughout theworld to develop health care facilities. Since independence health standards in India have
improved considerably beside various development processes. The objective of the study is tohighlight the development gap of health care facilities of Birbhum District and to find out the healthindex of the study area to show the disparities among various blocks of the District. The study ismade from secondary data collected from the District statistical handbook of 2015. Health index ofBirbhum District, 2015 varies from 0.30 to 2.30. Disparities in health care facilities are foundamong the different blocks of the district and also from rural area to urban area of the district.
Key words: Health Care Facility, Development Processes, Health Index, Disparity
Introduction
According to the Constitution of India, the primary duties of every state are to raise the level ofnutrition, the standard of living and to improve public health. The results of better health carefacilities are reflected by a better life expectancy, low mortality and low morbidity rate with anintense health care facility. Along with various development processes, health standards in India
have improved considerably since Independence. After the Independence the planningcommission of India assigned funds for health and to improve health infrastructure, education,research and services; various innovative measures were taken for the purpose. In the first fiveyear plan (1951-56) among various preventive measures, strong steps were taken to start
primary health centers at each block headquarters. The government of India formulated a healthpolicy in 1983 to reorient the health delivery system to meet the emerging requirements of thecountry and also to build up preventive and curative health. Then in 2002, a new health policy
was formulated to face the new challenges by augmenting existing health infrastructure so thataccess to health services across the social and geographical region of the country became more
equitable (Misra, R.P.2007). In this policy, involvement of private sector in health services hasbeen given responsibility. With the concerted efforts of the government and other public- private
agencies, some of the health indicators in India have experienced impressive growth. ‘Longevity
has more than doubled since independence, infant mortality rate has fallen, malaria has been
controlled, small pox and guinea worm have been completely eradicated and leprosy and polio
are nearing elimination’. (Prasad Neeta, February 2010,). Despite these achievements, the healthcare facilities provided by India to her people are not adequate. When compared to othercountries these facilities are amongst the least adequate in the world. Even within India there ismarked disparity in the medical facilities of different regions. Some of her states enjoy aprogressive health care facility, whereas others are heavily over burdened by an ill-fed, illsheltered unhealthy population. Though some achievements were observed but the difference
among the blocks of the district and between rural and urban area has widened. To bridge thesegaps a new health policy, the National health policy, 2017 was adopted. This aimed at increasing
investment in the primary health sector. It seeks to include everyone in an integrated way tomove towards wellness. It aims at achieving universal health coverage and delivering quality
health care services to all at a reasonable cost. The present study is an attempt to reveal theblock level disparity of health care facility in the district of Birbhum, West Bengal which comprises
92nineteen blocks whose economy is mainly agricultural. To ensure equity of access to all subgroups of population a public healthcare infrastructure across India should be set up in terms ofcertain norms. According to the Govt. norm there should be one Sub-center (SC) for every 5000
population (3000 population in case of hilly and tribal areas), one Primary Health Centre (PHC)
for every 30,000 population and one Community Health Centre (or Rural Hospital) (CHC or RH)
for every 100,000 to 120,000 population. (Birbhum Human development Report, 922birbhum.pdf)
Objectives
1. The objective of the present study is to highlight the development in the health system afterindependence.
2. To find out and analyze the different indicators of the health infrastructure.
3. To show the block level disparity of health care facility in the district of Birbhum, WestBengal.
4. To find out spatial pattern of disparity in the health care facilities throughcalculating a Health Index in different blocks of Birbhum district.
5. To find out our progress to meet future health care needs.
Location of the Study Area
The District of Birbhum is located in the western part of the state of West Bengal being
surrounded by the districts of Bardhamman on South and South West, Murshidabad in the Eastand North East along with the State of Jharkhand in North and North West. The district
stretches from 23°33´30”N-23°33’45”N latitudes and 87°47’00”E-87°49’00”E longitudes.(Fig.no.
01)
Figure 01: Map showing the location of West Bengal in India, Birbhum District in West
Bengal and Sadar Town in Birbhum District

93

Figure 02: Map showing the three sub-divisions along with respective blocks of BirbhumDistrict

Methodology
The study is based on block level secondary data available from the District Statistical
Handbook of Birbhum, 2011. It is a quantitative analysis. Here four related parameters of healthcare have been taken into consideration to calculate the Health Index from which to analyze thespatial variation of health care facilities in the study area. The parameters are:
 Health center Density /10 sq. km.,
 Number of beds/1000 populations, Number of doctors /1000 populations, Number of family welfare centers / 1000 populations
Health Index is calculated on the basis of the above indicators. The Health Index is thesimple arithmetical average of the above four parameters. HI = ¼(1+2+3+4). (Roy, Debasish,2013) Relevant maps are prepared on the basis of health parameters and health indices andanalysis is done on them.
Scarcity and Disparity in Health Infrastructures in the Study Area
Birbhum district has three subdivisions namely Rampurhat, Suri and Bolpur Sub-divisions. The
population density varies significantly across the different blocks of the Birbhum district. Theblocks in the Rampurhat have the highest population density and the highest aggregate
population in the district in comparison with the blocks of the other two sub divisions. But inRampurhat the physical infrastructure of public health care institutions and health care personnel
appear to be substantially insufficient compared with the health care resources supplied to theless populated blocks in the district. According to 2011 data there are 838
94hospital beds and 72 doctors in Rampur hat, where as there are 1543 hospital beds and 82
doctors positioned in Suri Sadar s which has the second highest aggregate population but thelowest population density in the district. Because of these unequal distributions of health careinstitutions the quality of health care services is below standard. Since population and the total
number of health care institutions vary widely across different blocks of the district, the ratio
between the population and the number of health care institutions is an indicator to analyze
block level disparity in health care infrastructure.
Each block of the district should be served by more than 5 PHCs under the existing
national norms instead of the present average per block, which is just above 3 per block. In
regional terms, the largest shortfall in the number of PHCs is observed in the populous Nalhati-I
block followed by Murarai-I in Rampur hat and Bolpur-Sriniketan and Nanoor blocks in Bolpur
sub-division. Nalhati-I block requires 5 additional PHCs and other aforesaid blocks require
another 4 PHCs under the existing norm. On the other hand, the corresponding gaps are among
the lowest in Mayureshwar-II, Md. Bazar, Sainthia, Rajnagar, Suri-II and Labhpur. Each of theseblocks requires one additional PHC following the norm. It is observed from fig. no. 3 that thepopulation density is highest in the northern most blocks namely Muraroi 1 & 2 and northeastern blocks namely Nalhati 2, Rampurhat 2 and followed by the south eastern blocks such as
Mayureswar 2 and Labpur. The lowest population density is found in the western most blocks
namely Rajnagar, Khoyrasole and Dubrajpur.
Figure 03: Map showing population density of Birbhum District, 201195

Figure 04: Distribution and number of Beds and Doctors, Birbhum District, 2011

Spatial distribution of number of beds and doctors of the study area are found from thefig. no. 4. The number of doctors and beds are very scanty in most of the blocks of the district.
But in three blocks namely Rampurhat I, Dubrajpur and Bolpur- Sriniketan total number ofbeds are more in number. Obviously Birbhum needs more doctors and beds to raise its doctorpopulation ratio to meet up the huge population pressure.
Figure 05: Health Index of Bibhum District, 201596

From the fig. no. 5 overall Health Index determined for different blocks of Birbhum district isvery poor. According to Health index of 2011 the blocks of Birbhum District can be divided into
three categories:
1. Less developed Blocks: Blocks with index value below 0.250 are ‘less developed.’ Among
19 blocks 15 blocks are in the lowest level of health index. There are Nalhati-I, Nalhati-II,Murarai-I, Murarai-II, Mayureswar-I, Mayureswar-II, Rampurhat-II, Mohammad Bazar,Sainthia, Rajnagar, Suri-II, Khoyrasole, Labhpur, Nanoor, Illambazar.
2. Moderately Developed Blocks: Blocks with index value between 0.251-0.500 are‘Moderately Developed Blocks.’ Bolpur-Sriniketan and Suri I have the moderate level ofhealth Index.
3. Developed Blocks: Blocks with index value 0.501 are ‘developed.’ Only Dubrajpur andRampurhat I lie in this group.
In various blocks of Birbhum district public health care infrastructure consists of 1 district
hospital located at the district headquarter, 2 Sub-divisional hospitals situated in 2 subdivisions, 4
Rural Hospitals (RH) which are better equipped than the BPHCs and located at blockheadquarters, 15 Block Primary Health Centres (BPHCs) located at the headquarters of theBlocks and 58 Primary Health Centers (PHCs). So the headquarters are getting more facilities
than the rest of the district. These health infrastructures should be decentralized.
Conclusion
The recent scenario of health infrastructure is highly un-satisfactory. The presence of healthpersonnel is often much less than required by the prescribed norms. The health plan must be
based on the needs and demands of the target group and the constraints of resources. The newhealth policy 2002 and the national health policy 2017 are trying to mitigate the problems. The
period of policy should be more frequent so that the problems can be monitored quickly. In thepolicy priority should be given to the quality services and more accessible health institutions inrural areas The District is a poor performer in the health dimension. The accessibility of healthcare facilities is very poor in the study area. Disparities in health care facilities are found among
the blocks of the districts and also from rural area to urban area of the district. But over the years
the district has seen improvement in the health index. In 2009 health index of Birbhum districtvaries from 0.02 to 0.10 (Roy, Debasish, 2013) whereas in 2015 it is slightly higher i.e. from 0.30
to 2.30. It is vital to address gaps between what exists and what is desired. Clinical services areto be provided in underserved areas and mobile clinics can be arranged in remote places. The
Government of India spends only 1.60 percent of its GDP as public expenditure on healthaccording to the budget estimate for the year 2020. This is very low compared to other countries.
The United States spends the most i.e. 18 percent of its GDP on public health. More money
should be spent on public health care because the healthy people are the valuable asset of oursociety.
References
1. District Statistical Handbook, 2011, Govt. of W.B., Bureau of applied economics & statistics,
Dept. Of planning, statistics & programme monitoring, pp-18-19
2. Prasad, Neeta February, (2010). Chief editor of Kurukshetra, A Journal of RuralDevelopment, Vol.58,No.4,p-2
3. Misra, R.P. (2007). Geography of health, concept publishing company, New Delhi. pp 433- 447
4. Roy, Debasish (2013) status of human development in the district of Birbhum at block level in
Sociology and Anthropology 1(2). 104-110, 2013, Horizon Research Publishing. Pp-104- 106,http://www.hrpub.org DOI: 10.13189/sa.2013.010209
5. Status of Rural Health Care And The Hidden Disparity: A Study Of Birbhum District, West
Bengal, www.iosrjournals.org 14
6. Wbplan.gov.in, DHDR_Birbhum, chatper - 3 Health and health care in Human Development
Report Birbhum page -39 -41
7. www.isca.in
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Annexure 01#. Name of the Blocks
No. ofof Birbhum District Hospitals

No. ofRuralHospitals1. Nalhati I1
2. Nalhati Ii
0
3. Murarai I1
4. Murarai Ii
1
5. Mayureswar I1
6. Mayureswar Ii
1
7. Rampurhat I10
8. Rampurhat Ii
1
9. Mahammad Bazar
1
10. Saithia
1
11. Dubrajpur
11
12. Rajnagar
1
13. Siuri I
10
14. Siuri Ii
1
15. Khoyrasol
1
16. Bolpur- Sriniketan
1
17. Labpur
1
18. Nanoor
1
19. Illambazar
1
Total
415
Source: District Statistical Handbook, 2011 (Birbhum)

Block primary
HealthCentresPrimary
healthCentres010000100000
100
10
00
4322423434
542223353258

Other dept. ofgovt. of WB
Including state
govt. undertaking

Govt. of India
including central
govt. undertaking

112

1

398

2

N.G.O.
/Privatebodies

Total

Total
no. ofbeds

Total no.
of Doctors

100
000
1000
10
100
60
1
1
12

5
3
3
53474657343
4
116
5492

71
3183
52
3152355
60
64
47368
3180
31
37310
64
48
64
1879

43
5866335758643526776154

Annexure 02#Name of the Blocks

1. Nalhati I
2. Nalhati Ii
3. Murarai I
4. Murarai Ii
5. Mayureswa R I
6. Mayureswa R Ii
7. Rampurhat I
8. Rampurhat Ii
9. Mahammad Bazar
10. Saithia
11. Dubrajpur
12. Rajnagar
13. Siuri I
14. Siuri Ii
15. Khoyrasol
16. Bolpur-Sriniketan
17. Labpur
18. Nanoor
19. Illambazar

Area in sq. km. Total
249.71109.15
175.51
185.33224.83156.57287.63181.55315.64304.39344.88221.47154.65135.81
272.19334.58267.98311.83261.54

533
534
74657
34
3
4
116
54

Health Centres/10 sq. km.
0.20020.27490.17090.26980.13340.25550.24340.22030.19010.16430.20300.13550.25860.22090.14700.32880.22390.16030.1529No. of beds
/1000 populations
0.3466
0.24260.43500.23420.19400.4073
1.88390.31940.38890.24062.02830.39750.71830.35470.24141.53050.31700.21950.379499

No. of doctors/1000 populations
0.01950.02350.02620.03600.03760.04700.17510.02660.04250.02560.04410.07690.03590.03430.03260.12840.03470.03200.0356

No. of family welfare
Centres/1000 populations
0.00490.00780.00520.00450.00630.00780.00530.00530.00610.00510.00550.01280.00900.01140.00650.00490.00500.00460.0059HealthIndex, 2011
0.57130.54870.63740.54450.37130.71762.30770.57170.62760.43562.28080.62281.02180.62130.4275
1.99250.58050.41650.5738