Geospatial Accessibility to Primary and Community Health Centres in India

BackgroundAccessibility to public healthcare in India is poor. Data on access to public health facilities in terms of travel time and geographical scope are limited. MethodsPrimary health centre (PHC) and community health centre (CHC) locations were taken from the Geographic Information System dataset of the Pradhan Mantri Gram Sadak Yojana 2021. Motorized and walking travel-time friction surface rasters were taken from the Malaria Atlas Project 2020. We examined the densities, travel times, and Access Population Coverage (APC) for PHCs and CHCs in India up to the district level. For walking APCs, we used a 30-minute time threshold for PHCs and a 60-minute threshold for CHCs. For motorized APCs, we used a 60-minute threshold for PHCs and a 120-minute threshold for CHCs. ResultsIn 2021, India had 23.22 PHCs and 3.07 CHCs per million people. Median PHC travel time was 79.53 (walking) and 16.77 minutes (motorised transport). CHC travel time was 227.53 (walking) and 36.23 minutes (motorised transport). PHC APCs for walking and motorised transport were 18.69% and 97.97%, respectively. CHC APCs for walking and motorised transport were 10.89% and 98.88%, respectively. Wide variations were seen in rural-urban analysis. ConclusionOur study found marked heterogeneity in timely geographic access, with access by walking being better in rural India and by motorised transport being better in urban India.