Geospatial view on Maternal Healthcare

A research paper namely, ‘Timely Access to Public Health Facilities for Pregnancy Care in Tribal Gujarat: A Geospatial Analysis’ was released, examining the access to maternal healthcare facilities from a geospatial perspective 

• The paper was published in the Economic & Political Weekly, Vol. 59, 2024

Geospatial view on Maternal Healthcare: Key Highlights of the Study

• Target Group: The study focuses on Gujarat’s tribal population, constituting 14.8% of the total population, scattered across 14 districts.
  • Dahod, Banaskantha, Sabarkantha, Aravalli, Mahisagar, Bharuch, Surat, Tapi, Dang, Navsari, Valsad, Panchmahal, Chhota Udaipur, and Narmada
• Data Source: The study used GIS data, data from the National Family Health Survey and geocoded health facilities spread across districts with higher concentrations of tribal population
• Modes of Transportation: The  authors used various forms of transportation ie. a car, a motorcycle and walking to reach and understand the accessibility of healthcare centres (tertiary, secondary and primary health centres).
• Focus: To provide a visual and quantitative understanding of the distribution of healthcare facilities within tribal regions across these districts and evaluate the extent to which people can access healthcare facilities for timely maternal care through spatial analysis, mapping, and quantitative methods.

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• Findings: 
  • Average Coverage of Pregnancy Care: The paper reveals that the average coverage of pregnancy care in Gujarat’s tribal districts is 88% 
    • Approximately 80% of women receive antenatal care (ANC), and 90% give birth at healthcare facilities, and 92% receive postnatal care (PNC) for themselves and their infants. 
  • Regional Disparity: Districts in the north near Rajasthan and northwest near Madhya Pradesh are the worst performing, while the best-performing districts are in the south near Maharashtra.
    • Lower ANC coverage: Districts such as Banaskantha, Mahisagar, Sabarkantha, Dahod, and Bharuch record low levels of  ANC coverage
      • Districts  with higher overall pregnancy care rates have also witnessed a neglect of ANC, which is particularly concerning.
  • Meeting WHO Standards: Districts including Surat, Tapi, Dang, Navsari, and Valsad demonstrate better pregnancy care outcomes meeting WHO standards. 
    • The Districts of Banaskantha and Bharuch demonstrate low levels of  pregnancy care even falling below the WHO-prescribed thresholds in at least two care indicators. 
  • Geographical Constraints: Over 50% of households reside more than 25 km away from tertiary care facilities while about 30% of households live away from community healthcare centres and primary healthcare centres  limiting  women’s access to health facilities even during pregnancy-related emergencies.
    • The unavailability of health centres near the tribal hamlets results in inadequate levels of ANC and PNC care after pregnancy.
  • Population Bias: Many rural and tribal residents experience inadequate access to healthcare facilities, as resources are concentrated in urban areas to manage the growing population in smaller urban clusters.
• Recommendations of Report:
  • Ensuring Accessibility to All: To assess the geographical distribution of the health care centres to ensure that they don’t remain concentrated in specific regions and are  distributed equitably across all areas to provide timely access to healthcare during pregnancy.
  • To consider both temporal and spatial aspects of healthcare, rather than solely focusing on the traditional factors like population and socio-economic factors.
  • Adhering to Established Standards: The distribution of public health centres is expected to adhere to population norms and geographical considerations as per Indian Public Health Standards 2022
  • Focusing on making transport facilities available: Social norms and limited resources often prevent women, especially in rural areas, from using motorcycles, and there is limited public transportation available limiting their access to ANC and PNC care.
  • Policy Focus: To implement policies that establish well-equipped and affordable public healthcare centres in easily accessible locations with accessible transport options  for disadvantaged communities.

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