ISRJ_FORMA new - Indian Streams Research Journal

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ISSN No : 2230-7850

International MultidisciplinaryResearch Journal

Indian Streams

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Executive EditorAshok Yakkaldevi

Editor-in-ChiefH.N.Jagtap

Vol 7 Issue 3 April 2017

Mohammad HailatDept. of Mathematical Sciences, University of South Carolina Aiken

Abdullah SabbaghEngineering Studies, Sydney

Ecaterina PatrascuSpiru Haret University, Bucharest

Loredana BoscaSpiru Haret University, Romania

Fabricio Moraes de AlmeidaFederal University of Rondonia, Brazil

George - Calin SERITANFaculty of Philosophy and Socio-Political Sciences Al. I. Cuza University, Iasi

Hasan BaktirEnglish Language and Literature Department, Kayseri

Ghayoor Abbas ChotanaDept of Chemistry, Lahore University of Management Sciences[PK]

Anna Maria ConstantinoviciAL. I. Cuza University, Romania

Ilie Pintea,Spiru Haret University, Romania

Xiaohua YangPhD, USA

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Kamani PereraRegional Center For Strategic Studies, Sri Lanka

Janaki SinnasamyLibrarian, University of Malaya

Romona MihailaSpiru Haret University, Romania

Delia SerbescuSpiru Haret University, Bucharest, Romania

Anurag MisraDBS College, Kanpur

Titus PopPhD, Partium Christian University, Oradea,Romania

Pratap Vyamktrao NaikwadeASP College Devrukh,Ratnagiri,MS India

R. R. PatilHead Geology Department Solapur University,Solapur

Rama BhosalePrin. and Jt. Director Higher Education, Panvel

Salve R. N.Department of Sociology, Shivaji University,Kolhapur

Govind P. ShindeBharati Vidyapeeth School of Distance Education Center, Navi Mumbai

Chakane Sanjay DnyaneshwarArts, Science & Commerce College, Indapur, Pune

Awadhesh Kumar ShirotriyaSecretary,Play India Play,Meerut(U.P.)

Iresh SwamiEx - VC. Solapur University, Solapur

N.S. DhaygudeEx. Prin. Dayanand College, Solapur

Narendra KaduJt. Director Higher Education, Pune

K. M. BhandarkarPraful Patel College of Education, Gondia

Sonal SinghVikram University, Ujjain

G. P. PatankarS. D. M. Degree College, Honavar, Karnataka

Maj. S. Bakhtiar ChoudharyDirector,Hyderabad AP India.

S.Parvathi DeviPh.D.-University of Allahabad

Sonal Singh,Vikram University, Ujjain

Rajendra ShendgeDirector, B.C.U.D. Solapur University, Solapur

R. R. YalikarDirector Managment Institute, Solapur

Umesh RajderkarHead Humanities & Social Science YCMOU,Nashik

S. R. PandyaHead Education Dept. Mumbai University, Mumbai

Alka Darshan ShrivastavaShaskiya Snatkottar Mahavidyalaya, Dhar

Rahul Shriram SudkeDevi Ahilya Vishwavidyalaya, Indore

S.KANNANAnnamalai University,TN

Satish Kumar KalhotraMaulana Azad National Urdu University

Editorial Board

International Advisory Board

Welcome to ISRJISSN No.2230-7850

Indian Streams Research Journal is a multidisciplinary research journal, published monthly in English, Hindi & Marathi Language. All research papers submitted to the journal will be double - blind peer reviewed referred by members of the editorial board.Readers will include investigator in universities, research institutes government and industry with research interest in the general subjects.

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Mr. Dikonda Govardhan KrushanahariProfessor and Researcher ,Rayat shikshan sanstha’s, Rajarshi Chhatrapati Shahu College, Kolhapur.

ISSN: 2230-7850 Volume - 7 | Issue - 3 | aPRIL - 2017

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Indian Streams Research Journal

URBAN HEALTH CARE INFRASTRUCTURE FACILITIES IN KOLHAPUR DISTRICT (MAHARASHTRA) : A GEOGRAPHICAL ANALYSIS

1

ABSTRACTealth care is the basic requirement of people, which isgenerally provided by the Government Hin each country all over the world. Health care

infrastuctutre is the basic requirement of the people which improves the capacity or potentionlity of human being and when any community in a region is healthy it augements the productivity hence improve the economy of the individual as well as the community in aregion or country.It is the basic requirement which have to provided by the government in a region or country for the maintance of the health. The health is influenced by a large number of factors, such as adequate water and food availability and acessiblity,

1 2 3K. C.Ramotra , Maruti T. Hajare and Yuvraj S. Mote1Professor, Department of Geography, Shivaji University, Kolhapur.

2Associate Professor, S.B. KhadeMahavidyalaya, Koparde, Kolhapur.3Assistant Professor, Baba NaikMahavidyalaya, Kokrud, Sangli.

housing, basic sanitations, healthy lifestyles, hospitals, and health manpower, (i.e. Doctors, Nurses coundition, supporting staff etc). These are the basic indices of present paper for measuring of health care infrastructural development in Kolhapur district, the areaundertaken for the present study. The present paper is based on primary as well as secondary data.The primary data collected with intensive field workcondectedin 2014 and the secondare data from District Statistical Abstract of Kolhapur, 2001, 2011 and 2015.The Doctor-population,nurse-populations,bed-population ratios etc. have been calculated and composite index isconstructed and depicted on the map to identifythe areas lagging behind.All this aids in comprehension of overall health care status in Kolhapur district. It is found that urban centres are highly facilited with health care infrastructer in comparison to ruralareas. Larger the size of urban centre better the medical facilities. It is also found that for83.56% of 202667 householdshealth care infrastructure was available in urban Kolhapur.Karveer tehsil is being the headquarters and urban centre having high level of health care infrastructure and Gadhingaljis identified as the most lagging tehsil in 2001, which should be priortised in making the provision of minimum required health care infrastructure for maintenance of people’s good health status for boosting the overall economiy and living standard.

Urban Health, Health Care Facilities, Infrastructure.

The geographical environment play important role of human health. Among the several disciplines which study the health of the people in one form or another, Geography is one. There are a number of geographical factors, which influence and sometimes even detrmine the health and reproductive capacity of living beings including man (Misra, 1970). Health is a common theme in the most cultures. In fact health has been viewed as an "absence of disease" and if one was free from any kind of disease, then the person was

KEYWORDS-

INTRODUCTION :

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URBAN HEALTH CARE INFRASTRUCTURE FACILITIES IN KOLHAPUR DISTRICT (MAHARASHTRA)....

considered healthy; many more dimensions have also been suggested and that is spiritual, emotional, vocational and politically healthy. Health is not perceived the same way by all members of communities including various professional groups (e.g. biomedical, ecological, psycho-social and holistic) giving rise to confusion about the concept of health (Park, 2011).

The widely accepted definition of health is that given by world health organization WHO (1948) "Health is a state of complete physically mental and social well-being and not merely an absence of disease or infirmity". In recently this statement has been amplified to include the ability to lead a "socially and economically productive life of human.

Health care facilities in the present day scenario of LPG form basic need of the mankind. Several efforts on the part of government have been taken since pre-independence period. However, while the many geographical pockets have been enjoying fair level of the health care facilities, some areas are still far away from the reach of these facilities even after six and half decades of Independence. Such a situation necessitated to take insight into the health care facilities and development in urban area of Kolhapur district during 2001 and 2011.

The present paper intends to exmine the state of urban health care infrastructure facilities in Kolhapur district during the last decade of 2001-11.

The Kolhapur district is located in the southern most part of Maharashtra state and has latitudinal extent of 150 43' North to 17010' North and longitudinal extent of 730 40' East to 74042' East an area of 7747 sq.km and population of 3874015 as per the 2011 census. The area undertaken for the present study is Kolhapur district that comprises twelve tehsils viz. (1) Shahuwadi (2) Panhala (3) Hatkanagale (4) Shirol (5)Karvir (6) Gaganbavda (7) Radhanagari (8) Kagal (9) Bhudargad (10) Ajra (11) Gadhinglaj and (12)Chandgad.

Present paper is based on primary as well as secondary sources of data. Primary data collected by conducting the intensive field work and secondary sources of data collected from the records of PHC, RH, DHO and DSO of Kolhapur district, and records of Municipal Corporation of Kolhapur. The data have also been collected from the District Census Handbook, District Gazetteers, Vital Statistics Office of Pune, Socio-economic Abstract, and Town and Village Drectory of Kolhapur District.

The work load factors deal with, bed- population ratio (BPR), doctor- population ratio (DPR) and nurse-population ratio (NPR). All these indices are made by doing calculations as per the norms suggested by the Bhore Committee (1946) and the above said ratios have been calculated by consideringMcGlashan’s formula and the work load factors have taken man-pawor and oxleray health care ficilitiesfrom the tehsils of the Kolhapur district during 2001 to 2011. This formula shows the hospital work load based on bed- population, doctor- population and nurse- population in the Kolhapur district.

Population served in ‘00’ Work load = __________________________

General use of patient’s beds

The above formula is used for computing bed- hospital, doctors- population and nurse-population ratios for the years 2001 and 2011. The standard ratios are hereby considered as per the Bhore committee norms. The committee has suggested that for every 1000 persons there shoulde a bed, for every 2500 persons one doctor, and for every 500 persons one nurse is required. The calculated ratios are compared with the ratios givenby in

OBJECTIVE

STUDY AREA

DATA BASE AND METHODOLOGY

The following formula given by McGlashan (1966) employed for computing the work load:

Volume - 7 | Issue - 3 | APRIL - 2017

2Available online at www.lbp.world

the Bhore Committee Report so as to examinethe adequacy of health facilities at tehsillevel in Kolhapur district. The tehsils have been given ranks on the basis of health care services available in tehsils of the Kolhapur district. Health care resources include such as physicions, nurses and native doctors (Meade, 2010). For measuring the status of tehsil’s health care facilities, development index has been calculated using Kundu’s (1979) normalization method.The following infrastructure indiceslike hospital, specialized hospital i.e. Cancer and T. B, clinics, maternity home, PHC and sub-PHC have been considered for this purpose.

Health care infrastructure facilities are essentially needed for maintenance of people’s the health in a given region or country. For example, hospital, specialized hospital i.e. cancer, tuberculosis, clinics, maternity home, primary health centre, sub-primary health centre, etc., all are important for maintenance of health and development of a region or country. Broadly speaking development constitutes the elements, like economic growth, infrastructure and social development. Development is not merely an exercise of growth activities but means and includes social justice and economic growth. The status of health is an internal part of social development. The spatial variation in health services or infrastructure is an indicator indicating the unequal social development in a region or country. Naturally development of a region needs, among other things the identification of areas or regions lagging behind and its improvement (Ghosh, 2010). The spatial variation in health care infrastructure in a country has to be minimised by providing more allocations for the lagging and backward areas.

Source: Socio-economic Review and District Statistical Abstract of Kolhapur District, 2001

It is found that on an average overall urban health care facility index of study area was 3.41 in 2001. The Karvir tehsil (4.68) is identified with high development and Shiroltehsil(2.14) is identified as the most lagging tehsil in the study area. The tehsils such as Karvir (4.68), Shahuwadi (4.35), Bhudargad (3.88), Ajra (3.71) and Gaganbavda (3.61) having health care facilities above the average. The tehsils viz. Shirol (2.14), Chandgad (2.94), Gadhinglaj (2.96), Panhala (3.09), Radhanagari (3.19), Kagal (3.21) and Hatkanangale (3.23) are identified with below average.

In 2001, there were as many as 7 tehsils i. e. 58.33% of the 12 tehsils in Kolhapur district are comparatively backword due to inadequate infrastructure which can affect the health of the people.

STATUS OF HEALTH CARE INFRASTRUCTURE FACILITIES, 2001-11

Table 1Distribution of Health Care Infrastructure Facilities in Kolhapur District, 2001

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Sr. No.

Tehsil Health care infrastructure facilities per 100,000 population-2001 Composite index

1 2 3 4 5 6 7 8

Hospital Specialized hospitals –Cancer & T.B.

Clinics Maternity home

PHC Sub-PHC

Score value

Ranks

1 Karvir 0.97 0.45 1.63 1.00 0.35 0.28 4.68 1 2 Shahuwadi 0.82 0.00 0.58 0.00 1.62 1.33 4.35 2 3 Bhudargad 0.68 0.00 0.71 0.00 1.23 1.26 3.88 3 4 Ajra 1.20 0.00 0.00 0.00 1.17 1.34 3.71 4

5 Gaganbavda 0.00 0.00 0.00 0.00 2.20 1.41 3.61 5 6 Hatkanangale 0.79 0.27 0.13 1.22 0.44 0.38 3.23 6 7 Kagal 0.58 0.00 1.12 0.00 0.72 0.79 3.21 7 8 Radhanagari 0.86 0.00 0.00 0.00 1.15 1.18 3.19 8 9 Panhala 1.22 0.00 0.00 0.00 0.89 0.98 3.09 9 10 Gadhinglaj 0.67 0.00 0.48 0.00 0.82 1.99 2.96 10 11 Chandgad 0.80 0.00 0.00 0.00 0.98 1.08 2.94 11 12 Shirol 0.32 0.00 0.57 0.00 0.69 0.56 2.14 12 District Total 0.81 0.36 0.74 1.11 1.02 0.96 3.41 -



Table 2Distribution of Health Care Infrastructure Facilities in Kolhapur District, 2011

Source: Socio-economic Review and District Statistical Abstract of Kolhapur District, 2011.

A health care infrastructure facility per 100,000 population has been computed for the year 2011.Kundu’s normalization method has been used for constructingthe indications for this propose composite index are considered as hospital, specialized hospital i.e. Cancer and T. B, clinics, maternity home, PHC and sub-PHC. It is noticed that on an average overall urban health care facility index of study area was 4.71 in 2011.

Gaganbavda tehsil (7.92) is identified with high and Shirol (2.73) with lowest level of development in the study area. The tehsils viz. Ajra (4.73), Bhudargad (4.83), Hatkanangale (4.90), Radhanagari (5.35), Karvir (5.40), Shahuwadi (5.87) and Gaganbavda (7.92) are above the average index in health care infrastructure facilities and the remaining five tehsils in Kolapure district such as Shirol (2.73), Chandgad (3.06), Panhala (3.35), Kagal (4.01) and Gadhinglaj (4.38) are below the average.

4


Sr. No.

Tehsil Health care infrastructure facilities per 100,000 population-2011

Composite index

Hospital Specialized hospital –Cancer& T.B.

Clinics Maternity home

PHC Sub-PHC

Score value

Ranks

1 Gaganbavda 4.10 00 00 00 2.00 1.82 7.92 1 2 Shahuwadi 0.77 00 2.26 00 1.54 1.30 5.87 2 3 Karvir 0.83 0.39 2.63 0.86 0.38 0.31 5.40 3 4 Radhanagari 1.47 00 1.57 00 1.07 1.24 5.35 4 5 Hatkanangale 0.72 0.25 2.08 1.09 0.39 0.37 4.90 5 6 Bhudargad 0.97 00 1.38 00 1.18 1.30 4.83 6 7 Ajra 1.22 00 0.87 00 1.18 1.46 4.73 7 8 Gadhinglaj 1.29 00 1.38 00 0.70 1.01 4.38 8 9 Kagal 1.05 00 1.52 00 0.64 0.80 4.01 9 10 Panhala 1.13 00 0.40 00 0.82 1.00 3.35 10 11 Chandgad 0.77 00 00 00 1.14 1.15 3.06 11 12 Shirol 0.75 00 0.80 00 0.63 0.55 2.73 12 District Total 1.25 0.32 1.48 0.97 0.97 1.02 4.71 -



Fig. 1

URBAN CENTRE-WISE HEALTH CARE FACILITIES The health of an individual is closely related to the various geographical factors. There are various sub-

disciplines, which study the health of an individual and society. Geography is one of them. Geographical factors are more influencing thatdetermine the health of an individual and the community as well (Hajare, 1996). The urban health care is an essential part of the controlling, maintaining, preventive and eradication programmes of diseases. India has a national health policy, for the existing hospital-based and disease-oriented health care model has provided health benefits mainly to the urban elite. Approximately 80 per cent of health care facilities are concentrated in urban areas. But the urban areas there is an uneven distribution of health care facilities, such as hospitals, doctors, nurses, beds, staffs (K. Park, 2011) are very much uneven and causing the regional imbalance at tehsil level in the district.

In India, Bhore Committee (1946) has suggested norms for the human health care, which has introduced tehsil-wise health care facilities in the district. But after the Bhore Committee, as many as 9 have been formed all over India for the health care planning, such as Mudaliarin 1962, Chadahin 1963, Mukerji in 1965 and in 1968, Jungawallain 1967, Kartar Singh in 1971, Shrivastavin 1975, Rural Health Scheme in 1977 and Health for All 2000

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Volume - 7 | Issue - 3 | APRIL - 2017 URBAN HEALTH CARE INFRASTRUCTURE FACILITIES IN KOLHAPUR DISTRICT (MAHARASHTRA)....


A.D. All above mentioned committees have accepted the Bhore Committee’s norms without change.

Source: Field work, 2014.However, we have collected urban centre-wise manpower and health care data/ information in

Kolhapur district by pilot survey in the year 2014. Manpower is one of the important components of health care infrastructures. The term 'manpower' includes here both professional and auxiliary health care norms from different angles. In the present paper the norms given by the Bhore Committee have been slightly modified by us i.e. one hospital, doctor, nurse, bed and one clerical staff required per one thousand population.

Table 3 revealed that the highest hospital-population ratio in Kolhapur city in 2014was 4.50 hospitals for every one thousand population and the lowest ratio was found in Panhala and Ichalkaranji urban centres during the same year. It is further found that Panhala tehsil is identified with 0.76 hospitals and 0.89 in Ichalkaranji for every one thousand population. Panhala is a famous hill station known all over India. So, it is not permissible to construct new hospital building or to purchase the land. Therefore, the hospital-population ratio is very low in Panhala urban centre.

In the remaining six urban centres viz. Pethvadgaon, Jaysingpur, Kurundwad, Kagal, Murgud and Ajra are found below mean level of hospital-population ratio. The Malkapur and Gadhinglaj urban centres have notable hospital-population ratio, which is 3.74 hospitals for every one thousand population in Malkapur urban and 2.91 hospitals in Gadhinglaj urban centres.

The highest doctor-population ratio in the Kolhapur city was 3.01 doctors per 1000 population. Kolhapur city being district headquarters is having good educational facilities and job opportunities. Therefore, most of the doctors prefer to start their practice in Kolhapur city. As a result the doctor-population ratio is high in the city.

The lowest doctor-population ratio is found in Ajra and Ichalkaranji city, where 1.02 doctors and 1.04 doctors are available respectively for every one thousand population. The Malkapur and Gadhinglaj urban centres were having notable doctor-population ratio as compared to other urban centres in the district. Pethvadgaon, Jaysingpur, Kurundwad, Kagal, Murgud urban centres have average level but Panhala and Ichalkaranji urban centres are below mean level of doctor population ratio.The availability of doctor is as low as 1.27 for every one thousand population in Panhala and 1.04 in Ichalkaranji.

Table 3Urban Centre-wise Health Care Facilities in Kolhapur District, 2014

Hospital-Population Ratio

Doctor-Population Ratio

6


Sr. No.

Urban Centres Urban Health Care Facilities per 1000 Populations Hospital Doctor Nurse Bed Other

Staff 1 Malkapur 3.74 2.80 1.68 3.97 2.99 2 Panhala 0.74 1.27 0.89 4.34 2.55 3 Pethvadgaon 1.91 2.14 1.16 5.06 1.75 4 Jaysingpur 1.13 2.28 0.76 7.93 1.58 5 Ichalkaranji 0.89 1.04 0.99 2.25 1.19 6 Kurundwad 1.47 2.01 2.09 4.55 1.92 7 Kolhapur 4.50 3.01 8.89 5.22 6.10 8 Kagal 1.72 2.37 5.77 2.40 2.81 9 Murgud 1.69 2.05 1.43 3.75 1.87 10 Ajra 1.09 1.02 0.98 2.05 1.03 11 Gadhinglaj 2.91 2.83 8.72 3.20 4.19 Total 21.81 22.32 33.36 44.72 29.98 Mean 1.98 2.07 3.03 4.06 2.81 SD 1.22 1.32 3.17 1.68 1.81 CV 61.61 63.76 140.62 41.37 64.41



Nurse-Population Ratio

Bed-Population Ratio

Staff-population Ratio

TEHSIL-WISE STATUS OF URBAN HEALTH CARE FACILITIES

The nurse-population ratio in Kolhapur city (8.89) and Gadhinglaj urban area (8.72), per thousand people in 2014 (Table 3) was relatively high. The lowest nurse- population ratio was found in Jaysingpur, Ichalkaranji and Ajra urban centres. Out of that Ichalkaranji city is well known notonly in Maharashtra state but also in India as a whole because of its power-loom and cotton industries. Hence, majority people have migrated from all over Maharashtra and Karnataka to Ichalkaranji city, for seeking labour work and employment in cotton industry. Ultimately, population growth is very fast. So, nurse-population ratio is reduced for every per thousand population. Kagal and Kurundwad urban centres were having notable nurse-population ratio during 2014. The remaining urban centres are below average. The standard deviation is higher than the mean level. It means that there is high variation of nurse-population ratio.

Table 3indicates that the Panhala, Pethvadgaon, Jaysingpur, Kurundwad urban areas have bed-population ratio higher than the other urban areas of Kolhapur district in the year 2014. The bed population ratio is in Ichalkaranji city, Kagal and Murgud urban areas was relatively very low. There are 2.25 nurses per thousand persons in Ichalkaranji, 2.40 in Kagal and 2.05 in Ajra urban centres in 2014. Remaining urban centre’s having average level of nurse-population ratio in Kolhapur district.

The staff-population ratio means the clerical staff in hospital. It is available in particular urban area, which provides medical services to the surrounding area. The highest staff-population ratio occurred in Kolhapur city and Gadhinglaj urban area.

It is found that 6.10 staff for every one thousand population in Kolhapur city and 4.19 in Gadhinglaj urban centre in year of 2014. Malkapur, Kagal and Panhala urban centres have notable staff-population ratio, which is available 2.99 in Malkapur, 2.81 in Kagal and 2.55 in Panhala urban centres per thousand population.

Health is the most important factors of humanbeings on which the processes and rate of whole developments depends. In urban areas different health facilities are available but what type of health facilities like hospitals, doctors, nurse, beds, staff, etc. are in existence. In view of this, it neccssitates to look into the state of health infrastructure. Therefore, here attempt is made to compute the status of health care facilities in urban area in the study area. Prof. Kundu’s normalization method is used for calculation purpose. The percentage of tap water, electricity, bathroom, toilet, hospital, doctor, nurse, bed and other assistingstaff are considred here as indicators for computing composite index.

7



Table 4Tehsil-wise Urban Health Care Facilities in Kolhapur District, 2001

HEALTH CARE INFRASTRUCTURE AND DISEASES MORBIDITY RATE

Source: 1) District, Census Handbook of Kolhapur District. 2) Socio-economic Review and District Statistical Abstract of Kolhapur District, 2001.

It is found that on an average overall urban health care facility index of study area was (9.27) in 2001. Karvir tehsil (10.56) is identified with high development in terms of health care infrastructure and Gadhinglaj (3.79) with low level of development in the study area. The tehsils such as Karvir (10.56), Shahuwadi (9.27) and Shirol (7.48) are above the average and Kagal (7.27), Hatkangale (5.66), Ajra (5.48), Panhala (5.44) and Gadhinglaj (3.79) tehsils are below the average. Gaganbavda, Radhanagari, Bhudargad and Chandgad tehsils have no urban population; these tehsils are entirely rural. The tehsils like Karvir highly industrialized and urbanized, hence, the health index is high.

It is found that in areas which are rural, hilly and remote having comparatively far less health care infrastructure like hospital, health centre, rural hospital, doctor, nurses and pharmaceutical shops but having large number of patients in hilly and remote areas. Moreover the literacy rate and per capita income are less as compared to advance urban centres district as well as tehsils headquarters. In this context the relationship between general morbidity of people and health care infrastructure in Kolhapur district was (r = 0.636) significant at 5% level. It is proved here that the areas which are hilly and remote with less health care infrastructure and other necessary and basic facilities, people in such areas as and when fall sick they have to cover a long distance for the treatment. Therefore, such areas should be provided necessary health care infrastructure facilities to reduce the general morbidity as well as the death rate and to bring the basic structure of essentially required health care infrastructure.

8


Sr. No

Tehsils Percentage of households having different health care facilities

Health care facilities per 100,000 population

Composite index

Tab Water

Electricity

Bathroom

Toilet Drainage

Hospital

Doctor

Nurse

Bed Other Staff

Score Value

Ranks

1 Shahuwadi 1.16 1.17 1.11 0.91 1.15 0.38 0.58 0.16 2.41 0.24 9.27 2 2 Panhala 0.97 1.20 0.71 0.53 1.08 0.07 0.12 0.08 0.43 0.25 5.44 7 3 Hatkanangal

e 1.18 1.12 0.96 0.46 0.99 0.28 0.32 0.21 073 0.37 5.66 5

4 Shirol 1.18 1.11 0.96 0.64 1.02 0.26 0.43 0.28 1.25 0.35 7.48 3 5 Karvir 1.20 1.16 1.13 0.83 1.03 0.65 0.41 0.70 2.64 0.81 10.56 1 6 Gaganbavda - - - - - - - - - - - - 7 Radhanagari - - - - - - - - - - - - 8 Kagal 1.19 1.14 0.99 0.51 1.03 0.17 0.23 0.58 1.15 0.28 7.27 4 9 Bhudargad - - - - - - - - - - - - 10 Ajra 0.70 1.18 1.18 0.87 0.86 0.10 0.20 0.09 0.20 0.10 5.48 6 11 Gadhinglaj 1.15 1.15 1.07 0.80 1.04 0.19 0.28 0.87 2.03 0.42 3.79 8 12 Chandgad - - - - - - - - - - - -

District 1.18 1.15 1.06 0.69 1.02 1.15 0.29 0.80 1.53 0.40 9.27 - Mean 89.6 94.7

0 83.00 57.10 84.00 19.44 2.93 8.00 15.24 3.98

Mean of the Mean

81.68 9.91



Table 5Kolhapur District

Relationship between Health Care Infrastructure in Hilly Areas and Diseases Morbidity Rate, 2015

CONCLUSION

REFERENCES

Source: Socio-Economic Abstract, Kolhapur District, 2015. It is generally found that areas which are well equipped with neccssary health care facilities and having healthy living environment having high level of overall productivity and income which further boosts the development.

It is inferred that health care infrastructure essential for increasing the capacity of human being and at the same time the better health is related with high productivity of a region. It is found that Karvir tehsil was highly advance in terms of health care infrastructure in 2001. The study has identified 7 tehsilslagging behind in health care facility, these are Panhala, Hatkanangale, Shirol, Kagal, Radhanagri, Gadhingalaj and Chandgad, it means nearly 60 percent area is relatively less developed. In 2011, the improvement in health care facility in Kolhapur district has improved significantly. In 2001, only Karvir tehsil was well developed in terms of medical /health care infrastructure, but in 2011 it jumped to 6 tehsils i. e. Shahuwadi, Karvir, Hatkanagale, Gaganbavda, Radhanagri and Bhudargad. Three tehsils of Panhala, Shirol in the Northern part and in the Southern part of the district remain less developed as compaired to other tehsils. It is hereby suggested that the infrastructure facilities should be extended to these three less developed tehsils i. e. Panhala, Shirol and Chandgad so as to improve the quality of life of the people. The composite index based on indices tap water, electricity, bathroom, toilet drainage in the household and hospitals, doctors, nurses, beds and other staffs as a health care facilities in 2001 has shown that the Karvirtehsil being the major urban centre and headquarter in it shows the highly developed tehsil, which is closed followed by Shahuwadi. The moust lagging behind tehsil was Gadhingalj in terms these health care facilities. As per our field work conducted in 2014 has shown that the hospital are more available in all urban centres, but Kolhapur urban centre is identified highly advance followed by Malkapur. Doctors, nurses, beds and other supporting staff are alsohighly concentreted in Kolhapur, Gadhinglaj and Kagal urban centres. Gadhingalj has improved his position after 2001. Gaganbavda has improved due to provision of big rural hospital in this area. It is suggested that which are less developed areas government should provide at list minimum require health care facilities to these areas to improve the overall health coditions of the people.

1. Census of India,2001 :Maharastra,District Census Handbook of Kolhapur Series-28, Publishing of the Indian Administrative Services, Directorate of Census Operations, Maharashtra, Mumbai, pp. 23-25.2. Census of India,2011 : Administrative Atlas Maharashtra, Publishing of the Indian Administrative Services, Directorate of Census Operations, Maharashtra, Mumbai Vol. 11, pp. 757 -780. 3. Ghosh, A. (2010): Disparity in Health Services in PaschimMedinipur, West Bengal. A Geographical Review of

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Sr. No Tehsils in Hilly Areas

Relationship between Health Care Infrastructure in Hilly Area and Diseases Morbidity Rate. Health care infrastructure facilities in Hilly Area per lac population

Diseases morbidity rate per lac populations.

1 Shahuwadi 05.97 59.36 2 Panhala 3.35 40.80 3 Karvir 5.40 43.80 4 Gaganbavda 7.92 190.66 5 Radhanagari 5.35 53.22 6 Bhudargad 4.83 113.38 7 Ajra 4.75 107.76 8 Chandgad 3.00 70.55 District 32.65 679.53 r Value 0.636 t Value 2.604



India Vol. 2, P. 162-168.4. Hajare, Maruti (1996): Geographical Analysis of Diseases and Health care Facilities in Urban Areas of Kolhapur District, Unpublished M. Phil, Dissertation, Submitted to Shivaji University, Kolhapur.5. Kundu, Amitabh (1979): Measurement of Urban Processes: A Study in Regionalization, Popular Prakashan, Mumbai.6. McGlashan, N. D. (1966): Medical Geography Techniques and Field Studies, Published by Methuen and Co-Ltd, 11 New Fetter Lane, BC4 (London), pp. 50, 94.7. Misra, R. P. (2007): Geography of Health: A Treatise on Geography of Life and Death in India, Concept Publication Company, A/15-16, Commercial Block, Mohan Garden, New Delhi-110059 (India), pp. 451- 464.8. Park, K. (2011): A Textbook of Preventive and Social Medicine, “Publication by m/s BanarsidasBhanot, 1167, Perm Nagar, Nagpur Road, Jabalpur.(India) pp.812-814 and 837.

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