HEALTHCARE ACCESSIBILITY IN PRIMARY HEALTH CENTERS OF EAST KHASI HILLS DISTRICT, MEGHALAYA: SPATIAL ANALYTICAL APPROACH

Primary Health Centres (PHCs) form the foundation of rural healthcare delivery by providing essential preventive, curative, maternal and child healthcare services. However, the effectiveness of PHCs depends not only on their availability but also on their spatial distribution, accessibility, infrastructure capacity and ability to meet population demands. The present study assesses the spatial distribution, accessibility and service adequacy of Primary Health Centres in East Khasi Hills District, Meghalaya, using Geographic Information System (GIS), Nearest Neighbour Analysis (NNA), field survey and Z-score statistical techniques. A total of 22 PHCs were mapped to examine their spatial distribution pattern, while five representative PHCs, namely Smit, Jongksha, Wahsherkhmut, Laitryngew and Pomlum, were selected for detailed accessibility and service adequacy assessment. A field survey of 100 respondents was conducted to examine healthcare accessibility characteristics, including travel time, travel distance, mode of transportation and perception of PHC accessibility. The findings indicate that 91% of respondents consider PHCs accessible, while 52% reach healthcare facilities within 15–30 minutes. However, 42% of respondents travel more than 5 km to access PHC services, highlighting geographical accessibility constraints in remote mountainous areas. The Nearest Neighbour Analysis produced an Rn value of 1.2, indicating a random spatial distribution pattern of PHCs across the district. The Z-score analysis based on healthcare indicators such as doctors, ANMs, staff nurses, supporting staff, laboratory technicians, inpatient services, outpatient attendance, population served, villages covered and bed availability reveals significant variations in service adequacy among PHCs. Pomlum PHC demonstrates comparatively better performance, followed by Smit and Jongksha PHCs, whereas Wahsherkhmut and Laitryngew PHCs require improvements in healthcare manpower and infrastructure. The study highlights the importance of GIS-based healthcare planning in identifying spatial inequalities and improving equitable healthcare accessibility and service delivery in mountainous regions.