Estimating spatial accessibility of public primary health care precisely . ”

According to the Alma-Ata Declaration of 1978 Primary Health Care (PHC1) was described as the “...the first level of contact ...with the national health system bringing health care as close as possible...”. Forty years later in 2018 this study estimates the spatial accessibility of public primary health care precisely at granular village level. Primary Health Care (PHC) in India is provided thru the Primary Health Centers (PHC2) and attached Sub Centers (SC). Spatial accessibility provides a summary measure of two important and related components of access firstly the volume of services provided and secondly the proximity of services provided relative to the location of the population. Anecdotes exist in our country that PHC2’s and attached SC’s are few in number, are not optimally distributed and hence do not provide universal coverage. In the district of Nalgonda, Telangana the study team sourced geo coordinates data of all 566 villages, 257 SC’s from ground level health care professionals by requesting them to share geo tagged images. The study team visited all 32 PHC’s to source geo About the Author: Mrs. Priyadarsini Suresh Ms.Priyadarsini Suresh is a PhD candidate at DST Health Informatics Rapid Design Lab @ PHFI-Indian Institute of Public Health – Hyderabad. Her research area is studying temporal and spatial influences on the virtual diffusion of health promotion information. She is an expert health care statistician, videographer, video editor and original digital health promotion video content creator. E mail ID: priyadarsini.suresh@iiphh.org Contact: +91 9701095968 PHFI Indian Institute of Public Health – Hyderabad Plot No 1, ANV Arcade, Amar Coop Society, Kavuri Hills, Madhapur,, Hyderabad – 500 033, India www.phfi.org ; www.acscir.res.in Phone: 91 -40-4900 6000 Ext: 6056 : 91 -40-4900 6056 Direct 19th Esri India User Conference 2018 Page 2 of 8 coordinates. The data was analyzed using ArcGIS spatial analyst software module. The total population of new Nalgonda district in 2016 was 1618416. As per IPHS standards the district should have 32 PHC’s which was present. However they were not optimally distributed Figure 1; there were 5 clusters where two or more PHC’s were found in close spatial proximity. Figure 2 shows universal coverage with the 20 kilometer catchment access area using two methods: Euclidean and travel distance. As per IPHS standards SC’s should be present within 3 km access distance of villages. Figure 3 shows all villages and sub centers spatially plotted. A 3 kms Euclidean catchment access area ring was generated around them. 25% or 142 villages were found to be out of catchment area. When the same area was arrived based on travel distance, 225 villages or 39.7% of the total villages were found to be outside catchment access area. This study shows that spatial visualization and optimization methods can help in designing universal health care coverage and go beyond anecdotal thoughts 19th Esri India User Conference 2018 Page 3 of 8 (Word Limit of the Paper should not be more than 3000 Words = 7/8 Pages)