Geospatial Accessibility to Primary and Community Health Centres in India
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Background
Studies have found that accessibility to public healthcare in India is poor. However, data on geographic access to primary and secondary public health facilities in terms of travel time and geographical scope are limited. Our study estimates the travel times and the proportion of the population with timely geographic access to primary health centres (PHCs) and community health centres (CHCs) in India.
Methods
PHC and CHC locations were taken from the Geographic Information System (GIS) dataset of the Pradhan Mantri Gram Sadak Yojana (PMGSY) 2021. Motorized and walking travel-time friction surface rasters were taken from the Malaria Atlas Project 2020. Using these, we examined the densities, travel times, and Access Population Coverage (APC) for PHCs and CHCs in India up to the district level.
Results
In 2021, India had 23.22 PHCs and 3.07 CHCs per million people. Median PHC travel time was 79.53 minutes (walking) and 16.77 minutes (motorised transport); rural: 79.9 and 17.16 minutes, urban: 60.77 and 6.99 minutes. CHC travel time was 227.53 minutes (walking) and 36.23 minutes (motorised transport); rural: 228.36 and 36.80 minutes, urban: 173.65 and 18.26 minutes. PHC APCs for walking were: 18.69% (overall), 20.51% (rural), 13.81% (urban); and for motorised transport were 97.97% (overall), 97.36% (rural), 99.73% (urban). CHC APCs for walking were 10.89% (overall): 11.58% (rural), 9.05% (urban); and for motorised transport were 98.88% (overall), 98.62% (rural), 99.06% (urban).
Conclusion
Our study found marked heterogeneity in geographic access across Indian states/UTs and districts. Geographic access by walking was better in rural India, and was better in urban India by motorised transport.
