Geographical health inequalities in India: the impact of the COVID-19 pandemic on healthcare access and healthcare inequality
Authors: Jayaprakash Parvathi , Majumdar Rupsa , Ingole Somnath 
Published: November 2024

PurposeWith an emphasis on spatial health disparities, this study examines how COVID-19 has affected healthcare access and inequality in India. The study developed the Healthcare Access Index (HAI) and Healthcare Inequality Index (HII) to assess the pandemic’s effects on healthcare. The study addresses spatial health disparities in healthcare access and inequality, filling gaps in the literature. The final aim of the study is to offer policy suggestions to lessen healthcare inequities in India, particularly in the context of COVID-19.Design/methodology/approachThe study incorporates secondary data from publicly accessible databases such as the National Family Health Survey, Niti-Ayog and Indian Census databases and employs a quantitative research design. The impact of the COVID-19 pandemic on healthcare access and healthcare inequality in India is examined using the HAI and the HII. The five dimensions of healthcare access – availability, accessibility, accommodation, cost and acceptability – were used in developing the HAI. The study uses a panel data analysis methodology to examine the HAI and HII scores for 19 states over the pre-COVID-19 (2015) and post-COVID-19 (2020) periods. In order to investigate the connection between healthcare access, healthcare inequality and the COVID-19 pandemic, the analysis employs statistical tests such as descriptive statistics, correlation analysis, factor analysis and visualization analysis.FindingsAccording to the study, COVID-19 impacted healthcare access and inequality in India, with notable regional inequalities between states. The pandemic has increased healthcare disparities by widening the gap between states with high and low HII ratings. Healthcare access is closely tied to healthcare inequality, with lower levels of access being associated with more significant levels of inequality. The report advises governmental initiatives to lessen healthcare disparities in India, such as raising healthcare spending, strengthening healthcare services in underperforming states and enhancing healthcare infrastructure.Practical implicationsFor Indian healthcare authorities and practitioners, the study has significant ramifications. In light of the COVID-19 pandemic, there has been a main focus on addressing geographic gaps in healthcare access and inequality. The report suggests upgrading transportation infrastructure, lowering out-of-pocket costs, increasing health insurance coverage and enhancing healthcare infrastructure and services in underperforming states. The HAI and the HII are tools that policymakers can use to identify states needing immediate attention and appropriately spend resources. These doable recommendations provide a framework for lowering healthcare disparities in India and enhancing healthcare outcomes for all communities.Originality/valueThe study’s originality resides in establishing the HAI and HII indices, using panel data analysis and assessing healthcare inequality regarding geographic disparities. Policy choices targeted at lowering healthcare disparities and enhancing healthcare outcomes for all people in India can be informed by the study’s practical consequences.