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Health care means the maintenance of human health by the means of prevention of diseases. At the same time it also emphasizes on the diagnosis, treatment, recovery of both the physical and mental impairments in people. State of physical, mental and social wellbeing is known as health. Good health results in a better quality of life. Economic growth leads people to live better and longer. Longer life expectancy encourages larger investments in human capital, which in turn accelerates the per capita income. Health service is an indicator of social development. The study on health care facilities of a region is a far more fruitful exercise towards planning for development.

Purba Medinipur district, located to the southern part of West Bengal, has better health care facilities as compared to the other districts of West Bengal or other states of India. This district has quite a handful number of hospitals, block primary health centres, primary health centres and nursing homes. The number of beds for patients in various medical institutions and the number of doctors present in the district also remain higher. However, it has been found that a slight regional imbalance in the health care sector is present in the district. On further analysis, all the 25 blocks and 5 municipalities have been grouped into surplus and deficit areas based on the availability of various medical services. The study reveals a significant amount of disparity in the distribution of health services in Purba Medinipur district. This type of disparity create regional imbalances and hinders the all round development of an area. Proper planning is required for equal distribution of medical facilities and health services.

Objectives of this paper are to study-

1. Spatio-temporal variation of different health care facilities of Purba Medinipur district

2. Spatial variation of health services among different blocks and municipalities of the district

3. The regional disparity in health care sector of the district.

Goulet (1971) highlighted three basic components in development: (i) life sustenance, (ii) self esteem and (iii) freedom. The basic needs concept was initiated in the 70s by the World Bank which aims for housing, clothing, food and minimal education for all. Hence, development means to elevate poverty and at the same time provide basic needs, to promote a social order where none is oppressed, nor is there an oppressor.

Economic growth leads people to live longer and better and enjoy good health. According to World Health Organisation (WHO), health care facilities are hospitals, primary health care entres, isolation camps, burn patient units, feeding centres and others. Health services are considered as one of the most important criteria of human development index. Good health results in a better quality of life. Higher income leads to better health and sanitation but better health and sanitation also leads to higher income because of increased productivity and labour force participation.

The study is based on the secondary data collected from the District Census Handbook, Census of India, 2011 and from the office of Deputy Chief Medical Officer of Health, Purba medinipur. The district and block-wise data for health services (hospitals, rural hospitals, block primary health centre, primary health centres and nursing homes) have been collected, tabulated and mapped.  Data on Universal Immunization Programmes for various years have also been collected. Number of people served by various health facilities have been calculated and mapped.

Location of The Study Area

The district of Purba Medinipur is situated between 210 38’ north and 220 30’ north latitude, and 870 27’ east and 880 11’ east longitudes.  The youngest district emerged on 1st January, 2002 from former undivided Midnapore. This newly created 19th district has an area of 4295 square kilometers (District Statistical Handbook, 2005) and has a population of about 5095875 (2011 census) with a density of 1028 persons per square kilometer. The district comprises of 4 subdivisions, 21 police stations and 25 Community Development Blocks and 5 Municipalities, with the district headquarter at Tamluk – the much known Tamralipta port of the Gupta Age.

Source: NATMO and Census of India, 2011 
Fig. 1

Health care facilities

Medical facilities available in the district of Purba Medinipur have been shown in Table-1. It is seen that the number of hospitals, rural hospitals, block primary health centres and primary health centres in the district remained the same from 2010 to 2014, although, there was a little increase in the number of nursing homes during this year. The numbers of nursing homes have been decreased from 177 in 2013 to 132 in 2014. This is because some nursing homes have not got renewal license certificate from the health department of West Bengal as they could not fulfill the criteria set by the government.

In all these medical centres the total number of beds has grown from 3416 to 3486 which accounts only 2.1 percent growth in these five years. Total number of doctors available in the

district increased from 258 in 2010 to 295 in 2014. Therefore, it may be said that the medical facilities in the study area are not satisfactory according to the present population scenario.

Table-2. Achievement of Universal Immunization Programme In The District Of Purba Medinipur, 2009-10 to 2013-14

YEAR	NUMBER OF CASES
	TT	DPT	POLIO	BCG	MEASLES
2009-10	78035	86755	84408	89338	82654
2010-11	83315	81993	83454	91489	81537
2011-12	88058	86201	70179	91795	82180
2012-13	83200	85164	78116	87735	84723
2013-14	82988	82445	88355	88430	80232
Note : TT = Tetanus Toxoid     DPT = Diphtheria Pertussis Tetanus BCG = Bacille Calmette Guerin

Source: Deputy C.M.O.H. - III, Purba Medinpur, 2014

Various Immunization Programmes help in the development of a region. Table-2 shows that from 2009-10 to 2013-14 quite a good number of populations was covered under TT, DPT, Polio, BCG and Measles immunizing programme. As more and more industries are coming up, with the increase in literacy level and consciousness of the mass population, the usefulness of various types of immunization has been realized and this in turn is improving the quality of life.

Fig. 4 depicts the scenario of the district wise available medical facilities at Block and Municipal level. The municipalities are provided with government hospitals which are known as Sadar Hospital. All the blocks have rural hospitals and primary health centres, set up by the government of West Bengal. It is interesting to note that only Ramnagar-I Block (Table-3) is provided with two government hospitals; one of which is located at the favourite tourist spot at Digha. These hospitals are equipped with good medicinal facilities and provide free treatment to the people. Huge number of nursing homes is located in the municipalities. Tamluk, being the district headquarters has the maximum number of nursing homes which cater to the medicare facilities to the people who come from the surrounding rural areas to the town for better treatment. Contai Municipality has the maximum number of doctors and Haldia Municipality has the maximum number of hospital beds for patients. The scenario is quite dissatisfying. More healthcare facilities are available in the northeastern part of the district while the western part and the interior are lagging behind.

Table-4. Number of Persons Per Medical Centre In Purba Medinipur District, 2014.

Source:  District Census Hand Book, Midnapore, 2011, Dy. C.M.O.H. - II, Purba Medinipur, Super / Director of the respective hospitals, 2014 and calculated by the author

Fig. 5 shows the number of persons per medical centres in the study area. It is a fact that more the number of populations per medical institution less are the level of development in that region. It is surprising to see that 2000 people are treated in a single medical institution only in Tamluk and Egra Municipalities. Each hospital serves quite a high number of patients in Contai and Haldia Municipalities. The condition is worse in rest of the two Municipalities where around 15000 people and above is treated by a single medical institution.

The study reveals the regional disparity in the distribution of health care facilities in Purba Medinipur district. This type of disparity creates regional imbalances in the development of a district. Proper planning is required for equal distribution of health care services. Various facilities should be given in the deficit areas. As population is increasing at a manifold rate, it should also be kept in mind while extending medical help. Public consciousness and health education is required at every level. Women education in this respect will usher in a brighter prospect.

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