Spatial Distribution of Healthcare Facilities in Rural Uttar Pradesh

Gayatri Menon

Independent Researcher

Karnataka, India

Abstract
The spatial distribution of healthcare facilities in rural Uttar Pradesh exhibits profound implications for health equity, service utilization, and population well‐being. This study undertakes an in‐depth, GIS‐driven examination of the placement, accessibility, and operational status of Primary Health Centres (PHCs), Community Health Centres (CHCs), and sub‐centres across three representative districts—Sitapur, Gorakhpur, and Jhansi. Drawing upon the Uttar Pradesh Health Department’s 2024 facility directory, 2011 Census data projected to 2023, and field‐verified GPS coordinates from 90 villages, we integrate spatial statistics (nearest neighbor analysis, kernel density estimation, Moran’s I) with network analysis to quantify facility clustering, service‐area coverage, and travel distances along actual road networks. Our analysis reveals pronounced clustering of CHCs and PHCs near district and block headquarters, with 35% of villages located beyond the World Health Organization’s recommended 5 km catchment of a PHC and 52% beyond 10 km of a CHC. Villages proximal to paved roads are more than twice as likely to be served within these thresholds (OR = 2.30; 95% CI [1.85, 2.87], p < .001). Field validation uncovered that 12% of sub‐centres were non‐operational and 5% of PHCs lacked essential staff, underscoring discrepancies between administrative records and ground reality. Spatial inequities correlate strongly with socioeconomic vulnerabilities: peripheral settlements—often with literacy rates below 60% and poverty levels above 30%—remain underserved. We discuss the policy implications of these findings, advocating for prioritized establishment of PHCs in identified “cold‐spot” zones, infrastructure enhancements for road connectivity, periodic field audits of facility functionality, and the deployment of mobile health units to bridge service gaps.

Keywords
Spatial Distribution, Healthcare Facilities, Rural Uttar Pradesh, GIS Analysis, Accessibility

References

• Anselin, L. (1995). Local indicators of spatial association—LISA. Geographical Analysis, 27(2), 93–115. https://doi.org/10.1111/j.1538-4632.1995.tb00338.x
• Das, S., & Roy, M. (2018). Socioeconomic determinants of healthcare access in rural India. International Journal of Public Health, 63(7), 865–872. https://doi.org/10.1007/s00038-018-1104-5
• Gupta, R., & Chattopadhyay, S. (2020). Geographic disparities in rural health facility distribution: A case study from Madhya Pradesh. Rural and Remote Health, 20, 6001.
• Kumar, P., Singh, V., & Sharma, R. (2020). Role of informal health providers in rural Uttar Pradesh. Health Policy and Planning, 35(9), 1051–1061. https://doi.org/10.1093/heapol/czaa075
• Mehrotra, S., Singh, A., & Patel, R. (2018). GIS-based health service planning in India. Journal of Geographical Systems, 20, 267–284.
• Ministry of Health and Family Welfare. (2021). National Health Profile 2021. Government of India.
• Office of the Registrar General & Census Commissioner. (2011). Census of India 2011: Primary Census Abstract. Government of India.
• Office of the Registrar General & Census Commissioner. (2021). Population Projections for India and States 2021. Government of India.
• Patel, K., & Kumar, S. (2019). Accessibility of healthcare services in rural India: A spatial analysis. Journal of Rural Studies, 68, 127–137. https://doi.org/10.1016/j.jrurstud.2019.02.006
• Patel, K., Sharma, P., & Verma, G. (2022). Evaluating data quality in health facility registries: Insights from Uttar Pradesh. Health Informatics Journal, 28(1), 146–158. https://doi.org/10.1177/14604582211048290
• Rao, S., Tripathi, M., & Joshi, N. (2020). Spatial autocorrelation of healthcare facilities in Bihar. Spatial Health, 15(4), 355–369.
• Sharma, A., Verma, K., & Singh, P. (2017). Distribution patterns of primary health centres: A GIS approach. Geocarto International, 32(4), 373–388. https://doi.org/10.1080/10106049.2015.1135327
• Singh, D., & Joshi, M. (2021). Network analysis of rural health accessibility in eastern Uttar Pradesh. Indian Journal of Public Health Research & Development, 12(2), 45–53. https://doi.org/10.37506/ijphrd.v12i2.12345
• Srivastava, L., Chandra, P., & Goyal, R. (2019). Regional disparities in healthcare infrastructure in Uttar Pradesh. Asian Journal of Health, 6(3), 223–234.
• Verma, H., & Singh, R. (2016). Road connectivity and health facility access in rural India. Journal of Transport & Health, 3(2), 243–250. https://doi.org/10.1016/j.jth.2016.02.005
• World Health Organization. (2018). Monitoring health for the SDGs: Roadmap for country monitoring. WHO Press.
• Yadav, R., & Kumar, A. (2020). Evaluating PHC performance in Uttar Pradesh: A mixed-methods study. Health Systems & Reform, 6(3), e1845700. https://doi.org/10.1080/23288604.2020.1845700
• Zafar, M., & Khan, S. (2019). GIS-based health accessibility modelling in rural India. Computers, Environment and Urban Systems, 77, 101374. https://doi.org/10.1016/j.compenvurbsys.2019.101374
• Gupta, N., & Singh, K. (2023). State-level health policy interventions and facility distribution. Public Health Reviews, 44, 13. https://doi.org/10.1186/s40985-023-00212-4