This paper describes the spatial distribution of public healthcare centers and their services in Bidar District. As a result, the present paper aimed to identity the served and unserved area by the health centers based on their functions.

   Bidar District is a top of hill city located on the Deccan Plateau, in the northeastern part of Karnataka State in India. Bidar District lies between 17⁰ to 35¹ N to 18⁰ to 25¹ N Latitude and from 76⁰ to 42¹ E to 77⁰ to 39¹ E Longitudes. Bidar District covers an area of 5448 sq.km and accounts for 2.84% of the state’s total geographical area. It’s bordered by Nanded and Osmanabad District of Maharashtra state on the Northern side, south by Gulbarga District of Karnataka state, Latur and Osmanabad Districts of Maharashtra state, on the western side and Nizamabad and Medak districts of Andhra Pradesh State on the eastern side. Totally, Bidar District consists of five taluks, such as, Aurad, Basavakalyan, Bhalki, Bidar and Humnabad with 30 hoblies, 175 Grama Panchayaths, 7 towns 6 Municipalities and Bidar being the head quarters of the district. District consists of 621 villages, out of which 599 inhabited and 22 uninhabited villages. As per 2011 census, the population of the Bidar district is 1,703,300 of which male and female were 870,665 and 832,635 respectively.

The Existing government healthcare centres can be organized in different hierarchical order as the Health Sub Centre, Primary Health Centre including Community health care, General Hospitals and District Hospital. They are located on the basis of economic feasibility and requirement of the people. The spatial distribution of healthcare centres of Bidar District has been analyzed for all five taluks. The uneven distribution of health centres is observed even at micro level not only between the regions but within the region also depending up on the necessity of the health care centers and for the people. So far as the public healthcare centers of the Bidar district is concerned, it comprises of one District Hospital, Four General/Taluk hospitals, 57 Primary Health Centres out of that 33 are working 24x7 and 8 Community Health Centres. The distribution of Public healthcare centres as been shown in the following Table 1 and Figure 2.

   The Present hospitals system varies in size and kinds of medical care services, where one can get all types of treatments that are needed by a patient. In the study area, the existing public healthcare centers can be structured in different hierarchical order to study the optimum use of available resources in different health centers.

According to 2011 census the total population of Bidar district was 1703300. As per NRHM norms in Bidar district reveals that, the existing number of health institutions each community hospital serves 2,43,328 populations, whereas each PHC is serving to a population of 29882 persons and the Sub Centres available in the district serving the population of 6194 persons. It reveals that, the study area had less numbers of health institutions when compared to NRHM norms. The below Table 2 shows, the ratios of population and Public Health Centres in Bidar district.

   Buffer analysis has been used to show the served and un-served area for PHC’s in the study area. It has been used to identify the villages within a given buffer limit of facility. Euclidean buffer is drawn around each PHC. The villages of an area can be easily determined whether they are served or un-served. A village within the buffer was considered to have access to a facility, while those outside the buffer were assumed not to have access. In the present study the buffers are drawn from each PHC at a distance of 5 and 7 Kilometers to define different service areas, Figure 4 and Table 3 shows the illustration.

The results of served and unserved areas for PHC’s, is shown in the above table in the study area. The 67.28 percent of the population is being served within the buffer of 5 kilometers and 9.03 percent of population is being served by PHC’s. Beyond the buffer of 5 kilometers up to 7 Kilometers. The unserved area accounts the population of 23.69 percent of the total population of the study area.

However, gaps remain large in rural urban differences, exemplified by IMR estimates of 70 for rural areas and 25 for urban areas (SRS, 2015). Despite overall improvements in health indicators, inter district and regional disparities continue. The five taluks of Bidar is still facing problems like Under-nutrition in under five age children and anemia in women continue to remain unacceptably high. Women’s health, mental health and disability care are still relatively neglected. Certain preventable health problems remain more prevalent in geographical regions or among particular groups. Structural reforms as suggested by the task force on Health have to be made and more effective management practices imbued with accountability have to be introduced to ensure swift and effective local responses to Health Problems. The relatively low level of public confidence in public health services particularly at primary health centers. Lack of Credibility of services adversely affects the functioning of all programmes. Underlying reasons for implementation gaps need to be understood and addressed.