The Geographer 1 Vol. 62, No. 2, July 2015 Analysis of Health Care Facilities in Narayanpur Block, Mirzapur District Uttar Pradesh Shikha Singh* and M.B.Singh** Abstract This paper aims to attempt the study of availability, accessibility and infrastructure of public health care facilities in Narayanpur block. It also tries to find out the gap between existing public health care facilities and normative requirement of public health care facilities as set by the government of India. The Narayanpur block is situated in Mirzapur district of Uttar Pradesh. It has 2,12,560 persons as per 2011 census. With regards to allopathic health care facilities the study area possesses one Community Health Center, five Primary Health Centers, and twenty seven Sub-Centers. Among them some of the health centers are suffering from acute shortage of staffs and infrastructure. Key words: Health care, Community health center, Primary health centers, Sub-centers and Facilities Introduction To study the availability and accessibility of Healthy population is the boon for any society health care facilities or country. The phrase ‘health is wealth’ proves it. To analyze the infrastructure of health care Health is a basic aspect of human resource. Health facilities is influenced by many factors such as nutrition, To assess the gap between existing public housing condition, sanitation, healthy lifestyle, health care institutions and the normative protection against environmental hazards and requirement of health care institutions as set by communicable diseases etc. For better health the Government of India every individual in a society tries to take care of such influencing factors, which come under health Database and Methodology care. Health care determines the life expectancy The present study is based on both primary at birth, which uses to calculate human and secondary data. The primary data regarding development index. Medical care (‘service infrastructure in CHC, PHC and Sub-Center have provided by professionals for the purpose of been gathered from January to May in 2012. The promoting, maintaining, monitoring or restoring secondary data is collected from CMO Office, health’) is subset of the health care. Health care Mirzapur and District Statistical Handbook of facilities are the institutions that provide medical Mirzapur district for 2012. An attempt is made to care. India acts as the welfare state; it is deal with availability of allopathic health care responsibility of the government to provide facilities (including institutions, sub-centers, medical care to its people without any partiality. doctors, beds, paramedical staffs and other staffs) as per 1,00,000 population. Objectives To find the detail account of the government owned The Study Area health care facilities in Narayanpur block, Mirzapur Narayanpur block is situated in Mirzapur district, following objectives have been undertaken: district of Uttar Pradesh. The longitudinal extent * Research Scholar, ** Professor & Former Head, Department of Geography, Banaras Hindu University, Varanasi, Email: [email protected], [email protected] The Geographer 2 Vol. 62, No. 2, July 2015 is 82º 48' E to 83º 5' E and latitudinal extent is 25º for 230.53 sq.km. The total population of the 0' N to 25º 14' N. There are 213 revenue villages study area is 2,12,560 among them 1,10,997 are (188 inhabited villages, 25 uninhabited villages) males and 1,01,563 are females as per 2011 and 13 nyay panchayats. It’s total area accounts census. Location of Narayanpur Block Fig.1 Availability and Accessibility of Health Care sub-centers (SCs) are the lower unit. A sub-center Facilities is serving on every 5,000 population in plain area The health care infrastructure in rural areas (on every 30,000 population in hilly and tribal has been developed as a three tier system. The areas). The primary health centers (PHCs) are the The Geographer 3 Vol. 62, No. 2, July 2015 Source: CMO Office, Mirzapur, 2012. Fig.2 second lower unit. A primary health centre is In Narayanpur block there exists one CHC, serving on every 30,000 population in plain area five PHCs and twenty seven Sub-Centers. The (on every 20,000 population in hilly and tribal community health centre is located at Chachery areas). The community health centers (CHCs) are Mod (in Pirallipur village) while primary health higher unit, which also act as a referral unit for centers are situated in Chunar town (it does not the PHCs. A community health center is serving come under any nyay panchayat), Pachewara on every 1, 20,000 population in plain area (on village, Dharammerpur village, Terhua village and every 80,000 population in hilly and tribal areas). Adalhat bazaar. This shows that out of 13 nyay The Geographer 4 Vol. 62, No. 2, July 2015 Table 1: Nyay Panchayat wise Density of Sub-Centers (2011) Nyay panchayat Area Total Sub- Density Density per (km2) population centers per 10 10,000 km2 Area Population Adhawar 19.81 14233 3 1.51 2.11 Ghatam pur 14.13 13930 1 0.71 0.72 Garauri* 15.95 21615 2 1.25 0.93 Kolana 23.39 15827 3 1.28 1.90 Terhua 14.27 22197 3 2.10 1.35 Pachewara 19.42 17589 2 1.03 1.14 Deoria 24.49 22614 2 0.82 0.88 Niyamatpur Kalan 8.39 9182 2 2.38 2.18 Jalalpur Maidan 24.57 21662 2 0.81 0.92 Dhaurahara 22.05 8625 2 0.91 2.32 Bagahi 17.27 11430 2 1.16 1.75 Chandapur 9.92 7808 2 2.02 2.56 Sherpur 16.87 25848 1 0.59 0.39 Narayanpur block* 230.53 212560 27 1.17 1.27 Source: Self computed. Note: *Including Garauri Census Town. Source: Table 1. Fig.3 panchayats, nine have no PHC in their nyay efficiency, the availability of sub-centers per panchayat. The location of health centers is given 10,000 population and 10 km2 area has been in fig.2. For ascertaining the accessibility and calculated and presented in Table 1. The highest The Geographer 5 Vol. 62, No. 2, July 2015 density of sub-centers in context of area has been Infrastructure of Health Care Facilities found in Niyamatpur Kalan (2.38) while the Government of India’s bulletin on Rural Health lowest density is found in Sherpur (0.59) followed Statistics, Ministry of Health and Family Welfare, by Ghatampur (0.71), Jalalpur Maidan (0.81), New Delhi, 2012 highlights the health care Devoria (0.82) and Dhaurahara (0.91) nyay- facilities available at different levels namely CHC, panchayats. In this regard 4 nyay panchayats PHC and SC levels in terms of health services, staffs showed low density, 5 nyay panchayats marked and infrastructures. The analyses of personal survey in medium density and remaining 3 recorded high context of availability of staffs, health infrastructural density. Highest density of sub-centers in terms facilities and equipments/stocks of 1 CHC, 5 PHCs of 10,000 population accounts for 2.56 in and 27 sub-centers of the study area are discussed. In Chandapur and the lowest is recorded in Sherpur this survey availability of staffs and buildings, doctor’s (0.39) followed by Ghatampur (0.72), Deoria residence, supply of water and electricity, telephone (0.88), Jalalpur Maidan (0.92), Garauri (0.93). In and vehicles are included. The shortcomings of physical this regard 5 nyay panchayats showed low density, facilities with regards to recommended norms have 4 nyay panchayats marked medium density and been described under following sub heads at three levels remaining 4 recorded high density. of public health system. Table 2: Staff Position at Primary Health Centres PHCs Medical Officers Pharmacist Lady Health Health worker Laboratory Male Female Visitor / Male Female Technician supervisor (ANM) Chunar 2 1 - 6 10 5 1 Dharammerpur 2 - 1 - - 1 - Pachewara 2 - - - 1 1 - Narayanpur 2 - 1 - 1 1 1 Adalhat 2 - 1 - 1 1 1 Source: Based on personal survey, 2012. Availability of Staffs at Community Health presently endowed with five medical specialists Center (one physician, one pediatrician, one The CHC is recommended to serve 1, 20,000 anesthesiologist, two obstetrician / population but as on 2011 census, it is serving 2, gynecologist), five staff nurses and twenty seven 12,560 population of the study area. The Indian paramedical (twenty three RTI / STI specialist, one Medical Health Standards (IMHS) guidelines for pharmacist, one laboratory technician, two female CHC, revised 2012 said about manpower that, health worker / ANM), thirteen other staffs. The CHC has essential five medical specialists i.e. general surgeon and general duty doctor’s posts general surgeon, physician, paediatrician, were vacant on the day of survey. X-ray technician anaesthetist, obstetrician / gynecologist; four post is also vacant and there is shortage of staff general duty officers i.e. one dental surgeon, one nurses. These all hamper the performance of CHC. medical officers-AYUSH, two general duty medical officers supported by ten staff nurses, Availability of Staffs at Primary Health eleven paramedical and thirteen other staffs. Centers IMHS also says that if patient load increases, then The PHCs are the first contact point of number of General Duty Doctors may be medical persons with the community. The Indian increased. The CHC acts as the referral hospital Medical Health Standards (IMHS) guidelines for for the PHCs. The CHC of the study area is PHC, revised 2012 categorized the PHC into two. The Geographer 6 Vol. 62, No. 2, July 2015 These are Type A and Type B PHCs. Type A PHC staffs of Type B SCs are two ANMs, one male health with loaded less than 20 delivery in a month and worker and the sanitation services are outsourced Type B PHC with loaded 20 or more than 20 through full time basis.