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DISTRIBUTION OF HEALTH CARE FACILITIES IN BARAN DISTRICT (RAJASTHAN)
Saniya Khan1 and Alok Chauhan2
Research Scholar, 2Assistant Professor of Geography,
Department of Geography, Vardhman Mahaveer Open University, Kota (Raj.), India
Email: alokres@gmail.com
1

How to cite this paper:
Khan Saniya, Chauhan Alok
(2023) Distribution of HealthCare Facilities in Baran
District (Rajasthan), Journalof Global Resources, Vol.
09 (02)
DOI:
10.46587/JGR.2023.v09i02.010

Received: 31 March 2023
Reviewed: 30 May 2023
Final Accepted: 18 June 2023

Abstract: Health is fundamental aspect to the national
progress in any sphere. Due to various socio-economic andpolitical factors, there exists a widespread inequality in the
distribution of health care facilities in India. The study area
Baran district is an outgrowth of Madhya Pradesh's uplands,
which are a portion of the Malwa plateau. It consists primarilyof low hills and undulating plains. It is the part of South-east
region of Rajasthan known as Hadoti. The main objective of
this paper is to analyses the spatial variation of health carefacilities in the district. The present study is based on
statistical data regarding the distribution of different types ofhealth care facilities and family welfare facilities at district
hospital, community health centres (CHCs), and primary
health centres (PHCs) and Sub-centres. The present study
reveals that health care facilities are not equally distributed in
all the tehsils of the district. The study also reflects a huge
gap across tehsil level in terms of population distribution ofhealth care facilities.
Key words: Health Care Facilities, Rajasthan, Baran, PHCs
and CHCs.

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Introduction
Health is an essential component for the development of human resource and the quality oflife. According to the World Health Organisation, “Health is a state of complete physical,
mental, and social well-being and not merely the absence of disease or infirmity.” Health - amajor form of human capital is an important determinant of human development in terms ofhigh life expectancy and healthy life. India has made significant progress in improving healthcare facilities but basic health care services still have not reached to the rural masses, nomatter how much progress is achieved in the urban and semi-urban areas. In the backdrop ofthis, the present study is an attempt to analyse the distribution pattern of health care facilities
in Baran district. Though healthcare facilities in India have undergone a change at an
unprecedented scale, yet substantial proportion of the population is unable to receive evenminimally adequate healthcare at needed time. Unequal distribution of healthcare facilities,
low income and high cost of medical care are major constraints in accessibility andaffordability of healthcare facilities (Bhandari and Dutta, 2007; Datar et al, 2007).
In order to know the distribution pattern of health care facilities in any region, it ispertinent to first assess the distribution of health care facilities in spatiotemporal perspective. It
has now become essential to analyse the availability of health care facilities in the study area
in terms of suggested norms of Indian health care policy (Rai et al, 2023). It will also help inproviding proper health services to the rural population and framing strategy for national
distribution of health care facilities and its proper utilization among the population (Nemet andBailey, 2000; Patil et al, 2002; Rai et al, 2012). Health care facilities of Baran district are basedon primarily modern allopathic system of treatment. To assess the distribution pattern ofhealth care facilities, data has been collected from District Statistical Handbook and fromoffice of the chief medical and health officer of Baran district. Present study shows the tehsil
wise distribution of health care facilities, namely Allopathic, PHCs, CHCs, and Sub-Centres,
Ayurvedic, Homeopathic and Unani health centres during 2021-22.
Study Area
The study area is located between 24˚24' to 25˚26’ N latitude and 76˚12' to 77˚26’ E longitude.
It is located in Rajasthan's south-eastern region and is bordered by the states of Madhya
Pradesh on its east, south, and south-east, the Rajasthan districts of Kota and Jhalawar on its
north and west, and the state of Rajasthan's Madhya Pradesh on its south and west. In the
Baran district, there are eight tehsil headquarters- Mangrol, Anta, Baran, Atru, Chhabra,
Chhipabarod, Kishanganj, and Shahbad. Baran district is ranked 26th in terms of population
density and 19th in terms of area in Rajasthan state. There are 1221 villages in the Baran
district- 1114 of them are inhabited, while 107 are uninhabited. The district has a total
population of 12, 22,755 as per the 2011 Census and 14, 66,276 in 2021(Projected).
Population density of Baran district was 175 persons per sq. km in 2011 and increased to 210
persons per sq. km in 2021 (Projected). The percent of Scheduled Castes and Scheduled
Tribes in the Baran district is 18.1 and 22.6 respectively whereas the corresponding figures for
the State are 17.8 and 13.5. The major tribal group in Baran district of Rajasthan is Sahariya.
Sahariya is the fourth most populous tribe in Rajasthan. Sahariya is the only Particularly
Vulnerable Tribal Groups (PVTG) of Rajasthan inhabiting Baran district of Rajasthan. A large
share (97 %) of this PVTG inhabits in Kishanganj and Shahbad tehsil of Baran District.

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Objectives
The main objectives of the present study are as follow:i.
To evaluate the existing infrastructure for health care services in Baran district.
ii.
To assess the inter-tehsil variations in health care facilities in the study area.
iii.
To find out the regional pattern in the distribution of health care infrastructure of Baran
district.
Database and Methodology
The present study is based on secondary data, the Statistical Handbook of Baran district
2022 providing data regarding the availability of different types of health care facilities at
District hospital, CHCs, PHCs and Subcentres. Other data related with health care facilities
were obtained from Chief Medical Health Officer (CMHO) office of Baran District. The ratios
are calculated by the help of absolute figure of different health care facilities in tehsils as per
Lakh population of Baran district. The data regarding the population of 2011 is obtained from
District Census Handbook while projected population data were used to calculate thepopulation in 2021.
Results and Discussion
Sound health infrastructure ensures efficient and effective utilization of essential publichealthcare services. The totality of the public healthcare infrastructure includes all
governmental and non-governmental entities that provide public healthcare services to thepeople. A total of 75 Primary Health Centres (PHC), 272 Sub-Centres (SC), one district
hospital, 14 Community Health Centres (CHC), and one T.B. clinic make up the public healthinstitutions of the Baran district. In addition, there are 61 Ayurvedic hospitals/dispensaries, six
Homeopathic hospitals/dispensaries and three Unani hospitals/dispensaries for the public's
medical needs (Table 01). Health care facilities are not distributed evenly across district (Table1). Even at a tehsil level, the unequal distribution of health facilities can be seen, both
between and within tehsils, depending on the need for medical facilities and patient access.
Table 01: Distribution of Health Care Facilities in Baran District 2021
District
CHCs/ PHCs
Sub
Ayurvedic Homeopathic
HospitalSubcentre
DH
Mangrol
1
5
19
3
0
Anta
3
7
31
9
0
Baran
1
8
27
8
1
Atru
2
9
49
11
1
Kishanganj
2
8
42
8
2
Chhabra1
831
61
Chhipabarod
2
2
32
10
0
Shahbad
3
3
41
6
1
Total
1
14
50
272
61
6
Tehsil

Unani

0
0
1
0
0
2
0
0
3

Source: CMHO Office Baran, 2022

Among all the eight tehsils of the district Anta and Shahbad tehsils have highest
number of CHCs. While considering PHCs it was observed that Atru tehsils (9) has thehighest number of PHCs, followed by Baran (8), Kishanganj (8), Chhabra (8), Anta (7), andMangrol (5). Low numbers of PHCs are located in Chhipabarod (2) and Shahbad (3) Tehsils.
The figures make it evident that the central west portion of the district has the highest
concentration of health centres, while the northern and north-eastern tehsils of the district
have the lower concentration (Figure 01).

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Figure 01: Health Care Facilities, 2021

The number of SCs is highest in Atru (49) tehsil followed by Kishanganj (42) and
Shahbad (41) While Mangrol (19) tehsil has the lowest number of Sub-Centres. The
distribution of homeopathic hospitals/dispensaries is mainly concentrated in Kishanganj (2),Baran (1), Atru (1), Chhabra (1) and Shahbad (1) tehsils. Anta and Chhipabarod tehsils do nothave any homeopathic health care centre. Maximum number of Ayurvedic health centre foundin Atru (11) followed by Chhipabarod (10) tehsils. Out of the total three Unani hospitals twoare located in Chhabra and one in Baran tehsil.
Distribution of villages Based on Distance from Health Care Facilities
India's rural and urban populations have vastly different levels of access to healthcare. Rural
folks have significantly fewer options than city dwellers, who can choose from public or private
providers. With sub-centres operating at the local level, India has a very extensive publichealth network. The primary health clinics and the community are connected by the healthsub-centres, which are primarily staffed by barefoot health workers (Barik and Thorat, 2015).
One of the most crucial factors in determining the effectiveness of healthcare service delivery
and the accessibility of the public to a particular health centre is the average population
served by the facility. Given that population norms are the foundation for all criteria used toestablish a health centre, its significance is clear. Additionally, it can be claimed that there is anegative correlation between a health centre’s population coverage and its accessibility to thegeneral public; the greater the population coverage, the lower the accessibility (Taqi et al,2017). Here accessibility to healthcare centres has been analysed with the distance (up to 10km) at the tehsil levels (Table 02).
In the district, 8.47 percent of the total villages have a community health centre (CHC)
within less than 05 kms, while 32.31 percent of the villages have a CHC within a distance of
5–10 kms. However, 59.2 percent of the total villages have poor accessibility, with a CHC at a
distance of more than 10 kms. Anta Tehsil tops the list of villages with relatively highaccessibility, with 14.44 percent of its villages having a CHC within 05 kms, followed by88

Shahbad (10.74 %). With only 4.84 percent of CHC within a 05 kms radius, Chhabra Tehsil isthe most inaccessible in terms of CHC.
Table 02: Distribution of CHCs, PHCs, SCs According to their Relative Distance from
Villages across Tehsils
CHC

TehsilAnta
Mangrol
Baran
Atru
ShahbadKishanganj
ChhabraChhipabarod
Total

<5KM
14.44
12.1
6.66
5.7
10.74
5.25
4.84
8.04
8.47

5-10km
51.32
49.66
37.78
20
14.12
23.15
26.88
35.63
32.31

PHC
>10km
34.21
38.24
55.55
74.28
75.14
71.58
68.28
56.32
59.2

<5km
30.25
27.62
21.11
12.85
26.37
17.36
13.08
17.82
20.80

5-10km
56.58
58.23
55.55
32.86
25.79
37.9
44
36.78
43.46

SC
>10km
13.16
14.15
23.33
53.57
47.8
44.73
42.86
45.4
35.62

<5km
59.21
56.48
45.55
49.99
47.12
53.72
60.93
21.96
49.37

5-10km
34.21
31.23
32.22
20
23
35.1
29.69
25.43
28.86

>10km
6.58
12.29
22.22
22.14
29.84
11.17
9.9
10.98
15.64

Source: Calculated by Authors, 2021

Primary Health Centres (PHCs) are located within 5 kms of 20.80 percent of thevillages and there are 43.46 percent of the villages have PHC within 10 kms distance. 35.62
percent of the total villages have inadequate accessibility since their nearest PHC is located at
the distance of more than 10 kms. Anta Tehsil tops the list of villages with relatively highaccessibility, with 30.25 percent of its villages having a PHC within 5 kilometres, followed by
Shahbad (26.37 %). Only 12.85 percent of the settlements have nearest PHC at the distanceof in less than 5 kms thus making it the most inaccessible in terms of PHC. More than half
(53.37 %) of the total villages in Atru tehsil have the nearest PHC at a distance of more than
10 kms. Only Anta tehsil has the better availability of PHCs as there are only 13.16 percent of
the total villages have the nearest PHC at a distance of more than 10 kms.
Analyzing the distributional pattern of SCs is highly significant as sub-centres arethought to be crucial in maintaining the health of the population, particularly for women andchildren in rural areas. It is satisfactory that almost half (49.37 %) of the total villages in the
district have the nearest SC at the distance of less than 5 kms. More than half of the totalvillages in Chhabra (60.93 %) and Kishanganj (53.72 %) tehsils have the nearest SC at the
distance of less than 5 kms while Chhipabarod tahsil has only 21.96 percent villages in thiscategory. Only 15.64 percent of the total villages have the nearest SC at the distance of morethan 10 kms.
Density of Healthcare Facilities across Tehsils
Access to healthcare has been shown to be significantly influenced by geographic
considerations. Although they have a significant impact on how each person uses healthcare,
supply-side factors cannot account for geographic disparities. The inequalities may also be
influenced by variations in other parameters, such as the cost and responsiveness of services(Mulyanto et al, 2020) The density of density of health care facilities per 100 sq. km. ispresented in table 03. It is clear from the table that there is less than one (0.98) health carefacility available in 100 sq. km. of area. This figure is not satisfactory more specifically for the
district which has a large proportion of tribal population. The availability of beds and doctors is
also poor in the district. Availability of merely two doctors in 100 sq. km. of area is a serious
concern for policy and decision makers. Tribal dominant tehsils Kishanganj and Shahbad are
lagging far behind in terms of availability of health care facilities in per 100 sq. km. area.

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Table 03: Density of Health Care Facilities per 100 sq. km.
TehsilInstitution
Anta
1.62
Mangrol
1.41
Baran
1.27
Atru
1.29
Kishanganj
0.69
Shahbad
0.40
Chhabra1.12
Chhipabarod
0.48
Total
0.98
Source: Calculated by Authors, 2021

Beds
28.71
21.23
7.61
15.82
10.69
10.07
18.45
8.64
14.28

Doctors
3.97
2.45
1.58
2.24
1.67
1.77
2.61
1.44
2.18

Paramedical Staff
15.78
12.43
8.09
7.67
4.19
4.76
8.72
4.80
7.71

Other Staff
6.72
4.27
2.69
2.95
2.02
2.04
4.36
2.52
3.32

Availability of Healthcare Facilities
In many nations, observers are beginning to wonder whether the public's requirements andexpectations can be met by the health systems there. To address these issues, two major
strategies have been put forth. The first involves giving health systems more resources on the
grounds that the issues are brought on by a lack of resources to deal with an ageing
population, rising public expectations, and technological advancements. The second strategy
focuses on improvements to the way health systems are set up and how services aredelivered, and it advises making better use of the resources that are already available(Lamarche et al, 2011). Therefore, it is necessary to analyse the availability of healthcare
facilities on the basis of population. The availability of healthcare facilities, such as the numberof medical institutions, beds, doctors, paramedical staff, and other staff per 100,000
population has been presented in Table 4.
Table 04: Health Care Facility Per Lakh Population 2021
TehsilInstitution
Anta
7.6
Mangrol
5.4
Baran
6.7
Atru
5.9
Kishanganj
4.8
Shahbad3.4
Chhabra6.04
Chhipabarod
1.88
Total
5.19
Source: Calculated by Authors, 2021

Beds
134
112
40.50
72
73.94
84.01
99.34
33.97
76.82

Doctor
18.54
14.32
8.43
10.22
11.60
14.76
14.09
5.66
83.3

Paramedical Staff
73.68
65.02
43.03
34.96
29
39.74
46.99
18.88
40.89

Other Staff
31.37
28.42
14.34
13.44
14.01
17.03
23.5
9.91
17.66

Institution per Lakh Population: An average of 5.19 institutions are located in the district forevery one lakh people. The distribution of medical facilities varies noticeably within the district.
It is clear from Table 4 that in 2021 Anta tehsil has the highest number of institutions per lakh
population. The availability of institutions in Kishanganj, Shahbad, and Chhipabarod tehsils is
lower than the district average.
Beds per Lakh Population: The total number of beds available in all the health careinstitutions was 1158 in 2021. It is a crucial health indicator that guarantees the availability ofindoor clinical space in the event of a serious illness or emergency. There exists a large
variation in terms of availability of beds. In the district there are only 76.82 beds are available
for per lakh population. Anta tehsil has the highest (134) availability of beds while
Chhipabarod has the lowest (33.97).
Doctors per Lakh Population: It serves as an example of a quantitative evaluation of the
population's reliance on hospital doctors. Doctors are the cornerstone of any region's

90healthcare system since without an adequate number of doctors, any sort of medical
infrastructure is completely useless. A better standard of medical care is more likely to beobtained when the doctors are adequate. When considering the number of doctors per lakh ofthe population, the district average is 83.3 with the highest in Anta and the lowest in
Chhipabarod tehsils.
Paramedical Staff per Lakh Population: The district's paramedical staff average in 2021
was 40.89. The availability of paramedical personnel in Anta (73.68) is found highest. When
compared to the district average, anta, Baran, and Chhabra tehsils have better availability ofparamedical staff.
Other Staff per Lakh Population: The other employees at the healthcare facilities include thesweeper, attendant, clerk, gatekeeper, etc., who are involved in non-medical tasks. The
district has 17.66 other staff members per lakh population. Anta (31.37) tehsil has the highest
availability of other employees.
Conclusion
It has been found in the study that there exists a significant variation in terms of availability ofhealth care facilities in Baran district. The tehsils located in the close proximity of district
headquarter, i.e., Baran and Anta have better health care infrastructure. Health careinfrastructure is very poor in tribal dominated Kishnganj and Shahbad tehsils. In remaining
tehsils, the figures are also not satisfactory. Overall condition of health infrastructure is notsatisfactory in the context of rural areas of Baran district. Study reveals that the availability andaccessibility of health care is significantly heterogeneous. Beside this, availability of trained
manpower, beds, number of doctors and para-medical staff in different health centres is not
sufficient to serve the present population. A suitable mechanism should also be developedwith people’s participation for effective management of health care facilities. Health careprogrammes are to be made more effective by community participation to increase the ratio of
the beneficiaries.
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