Mapping health inequality: Assessing the impact of topographic elevation on primary healthcare access in Purulia

Access to quality primary healthcare is a fundamental human right and a determinant of an equitable healthcare system which influenced by multidimensional factors, including geographical characteristics. Disparity in access to primary healthcare services increases the inequality of health status and obstructs the universal primary healthcare coverage, especially in Purulia where predominant inhabitants are from multiple tribal communities and conserving unique socio-cultural characteristics of their own. Simultaneously, Purulia comprises with the scattered hills, ridges and undulating landscape, similar to Sub-Saharan Africa which topographically hinders access to healthcare services. This study conducted in 2024 to systematically explores the complex association between topography and primary healthcare access using the ‘Framework of Access’ by Penchansky and Thomas along with geospatial mapping. Here, the Availability refers to the adequacy of infrastructural and human resources of healthcare, Accessibility denote the geographical reachability, Affordability denote the financial capability to access the healthcare services, the functional capacity of the healthcare services is accessed under Accommodation and Acceptability represent the socio-cultural compatibility. Digital Elevation Model and Pearson’s Correlation Coefficient is incorporated to delineate the topographic elevation and its association with primary healthcare access at Community Development Blocks (C.D. blocks) level. C.D. blocks characterised with higher topographic elevation have been identified with significant inequality in availability and accessibility of primary healthcare services. Deployment of mobile primary healthcare units and expansion of transport networks can reduce the disparities.