The distribution of public healthcare facilities varies not only in rural and urban areas but also within rural and urban areas. Public Healthcare centers are providing health services to the people for promoting good health for all, but it depends on accessibility of healthcare centers. Therefore, Availability of the health centers are primarily effect on utilize of healthcare facilities. The Hunsur taluk had 4 hoblis encompasses 95 public health centers, which includes One Taluk Hospital, 21 Primary Healthcare centers,73 Health sub centers and 1 mobile health units. The Hobliwise distribution of Public healthcare centres and Ratios of Population has been shown in (Table 1 and Figure 2).

Figure 2

As per Government of India, National Rural Health Mission (NRHM), the public health institutions in rural areas are to be upgraded from its present level of a set of standards called Indian Public Health Standards (IPHS). According to NRHM policy the population norms for the provision of Sub-Centres, PHC’s and Community Health Centres in plain areas are suggested 5000, 30,000, 1, 20,000 people respectively, where as in the Hilly/Tribal regions it is 3,000, 20,000, 80,000 respectively. The (Table 1) shows the Hobliwise Distribution of Public HealthCare Centers and Ratios of Health Centers to the population. In the study area, 2, 82,963 populations are served by One Taluk Hospital, 21 Primary Health Centers and 73 Health Sub Centers. The Community Health Centre is not located in Hunsur taluks, as the city has got general hospital, which can cover all the facilities of community health centre.

The High concentration of PHCs are located in Hanagodu Hobli (8), serving the population ratio of 1:8397, followed by Bilikere hobli (6), serving the population ratio of 1: 11432. The lowest concentration of PHC’s is located in Gavadagere Hobli (4) and Hunsur Hoblis (3) with serving population ratio is 1:10275 and 1:35365 respectively. PHC’s it acts as a referral unit for 6 Sub-Centres, it reveals that, the each PHC is serving to a population ratio of 1:13474 persons. The highest and lowest numbers of Sub Centers are located in Hunsur Hobli (21) and Bilikere Hoblis (20) with serving population ratio of 1:5052 and 1: 3429 respectively. Followed by Hanagodu Hobli (17) with serving population ratio of 1:3951 and the lowest concentration of HSC’s is located in Gavadeagere hobli (15) with serving population ratio is 1:2740, it reveals that, the each HSC’s is serving to a population ratio of 1:3876 persons. Though it shows there is regional imbalance in the distribution of Public healthcare centres among hoblis of the Hunsur taluk.

As per National Rural Health Mission (NRHM) highlights the healthcare facilities available at different levels namely, Primary and Sub health centers levels in terms of health services, workforce and infrasturucture facilities. The Responsibility of healthcare centers is in two folds, providing skilled medical staff in the healthcare centers and Realization of Millnnimum Developed Goals of improving healthcare facilities to reduce the different kinds of diseases. By primary survey and observation in context of availability of workforce and health infrastructure facilities of 21 Primary Health Centers and 73 Health Sub Centers of the study area are discussed here. In this survey availability of health workforce and health infrastructure like weighing machine, Blood Pressure instrument, steam sterilizer, labour room, wards, OPD, laboratory facility and with their own building, having public utilities like (electricity, drinking water, vehicle and toilets) are included to identify the shortcoming of physical infrastructure facilities with regards to recommended norms have been discussed under the following subheads.

The below (Table 2) shows the of availability of health workforce and health infrastructure facilties of PHCs of the study area are discussed here. In this survey availability of workforce like doctors, nurse, Asha and infrastructure facilities like beds wards, Equipments etc., are included.

The Primary Health Centres are the first contact point of medical persons with the community. It acts as a referral unit for 6 Sub-Centres and refers out cases to CHC and higher order public hospitals located at taluk and district level. But, CHCs are not available in the study area. However, as the population density in the country is not uniform, the number of PHCs would depend upon the case load ⁶. The PHC essential of health workforce is one medical officer, 3 staff nurses, one paramedical and four other staffs. The above (Table 2) shows that, Hobliwise distribution of health workforce of the PHC’s and ratio’s of Health Services to the Population. Among the 4 hoblis in that high concentration of Health Workforce Observed in Bilikere hobli having (5) Doctors serving the population at the ratio of 1:13718, (5) Nurse with 1:13718, and (52) Asha worker with 1:1319 ratio. Followed by Hanagodu Hobli (6) Doctors serving the population at the ratio of 1:11196, (3) Nurse with 1:22392 and (49) Asha worker with 1:1370 ratios. Respectively, Hunsur hobli having (3) Doctors serving the population at the ratio of 1:35365, (4) Nurse with 1:26523 and (30) Asha workers with 1:3536 ratio. The lowest concentration of Health workforce observed in Gavadagere hobli consists with (3) Doctors serving the population at the ratio of 1:13699, (2) Nurse with 1:20549 and (34) Asha workers with 1:1209 ratio respectively. It can be observe in the above (Table 2), though there is high population but the availability of Health workforce are less according to IPHS norms.

The essential physical infrastructure facilities at PHCs should have 6 beds, with adult weighing machine, Blood Pressure instrument, steam sterilizer, labour room, wards, OPD, laboratory facility and with their own building, having public utilities like (electricity, drinking water, vehicle and toilets). The Table 3 shows that, Hobliwise distribution of health Infrastructure facilities available at PHC’s and ratio’s of Health Services to the Population. Among the 4 hoblis in that high concentration of Health Infrastructure Observed in Hanagodu hobli having 8 PHCs with (41) Beds serving the population at the ratio of 1:1638, (6) Wards, 11 weighing machine and 11 Bp Monitor, one Wheel Chair, one Trolley and one functional vehicle is available. All the 4 PHCs possess own building, steam sterilizer, labour room, wards, OPD, laboratory facilities, one functional vehicle and public utilities like (electricity, drinking water, and toilets) are in working condition. Remaining 4 PHCs are rented building and the infrastructure facilities were not in good condition. Followed by Bilikere Hobli having 6 PHCs with (36) Beds serving the population at the ratio of 1:1905, (6) Wards, 5 weighing machine and 9 Bp Monitor among them 2 Bp Monitor is not in working condition. In Bilikere hobli among 6 PHCs 4 PHCs possess own building remaining 2 are rented building, wards, OPD, facilities and public utilities are not in working condition and one functional Vehicle, one wheel chair is available. Respectively, Gavadagere hobli consists of 4 PHCs with (22) Beds serving the population at the ratio of 1:1868 (2) Wards, 5 weighing machine 5 Bp Monitor, one wheel chair, one trolley and one functional vehicle is available. Among 4 PHCs, 2 PHCs possess own building another 2 Rented building, steam sterilizer, labour room, wards, OPD, laboratory facilities, one functional vehicle, and public utilities like (electricity, drinking water) are in working condition in 2 PHCs only. The health infrastructure of Hunsur hobli consists with 3 PHCs with (14) Beds serving the population at the ratio of 1:7578 (1) Wards, 6 weighing machine, 10 Bp Monitor and two functional vehicle available. Among 3 PHCs 2 PHCs possess own building, another one Rented building, steam sterilizer, labour room, wards, OPD, laboratory facilities, two functional vehicle, and public utilities like (electricity, drinking water and toilets) are in working condition in 2 PHCs only. It can be observe in the above (Table 3), though there is high population in the study area but the availability of Health Infrastructure facilities are less according to IPHS norms.

Health sub-centres are basic or pre-primary health and medical care service centres at the grassroots level. The staffs of the unit are managed by a male health worker and an auxiliary nurse and mid-waves in each sub-centre to provide curative health/medical services and join the national programmes. The work of these staff members consists of house to house visits for collecting vital statistics of all families and to communicate the health related programmes under the direction of medical officers of the concerned primary health centre-unit. In addition to that they give the treatment for minor ailments, health education in respect of common communicable diseases, family welfare, immunization, vaccination etc. with adequate field staff. These sub-centres are expected to show progress in each month in programmes that are envisaged by each sub-centre. Totally, Study area comprises 73 Health Sub Centre among them 22 HSCs have their own building and remaining they are functioning under rented building. On an average 24.71 percent sub-centers are running in their own building, while 75.29 Percent are running under rented building. In the study area, Most of the Sub-centers have depend on bore well but some of that is not working in the places like Hirekyanahalli, Karimuddanahalli, Doddahejjur and Thattekere; other sub-centers have hand pump for water supply. Totally, 60% of the sub-centers have hand pump, 20% of the sub-centers depend on well and remaining 10 % sub-centers do not have water supply in their premises, So they want to travel for water. All Sub-Centers do not have telephone connection, electric facilities and water supply only 60% of sub-centers have electricity connection, telephone and water supply.

Nearest Neighbour Techniques: The Spatial distributions of health centers are unevenly distributed in the study area. In the present study Nearest Neighbour Technique has been used to observe how these health centers are distributed in Hunsur Taluk. The ‘Nearest Neighbour method, was firstly developed by two botanists, Clark and evens 1954, they have used this techniques to measures the pattern of incidence of different species of plants in a region. Later on, geographers have widely used this technique in order to study the distributional pattern of the places and other phenomena in different geographical regions of the world. As a result, this technique has been used in research to study the Geographical distribution of health centers in the study area. The following formula is as:

Rn=2d¯nA

   Where: Rn = The description of the distribution

   n = The number of points (Health Centers) in the study area

By using this formula, Rn values for Four Hoblies of the taluks have been calculated.

Table 4

Sl. No	Hoblis	Rn Value	Pattern
1	Bilikere	1:8536	Randomly Distributed
2	Hunsur	1:2838
3	Gavadagere	1:7761
4	Hanagodu	1:1745
Total		1.1929

Source: Compiled by Author

The Nearest Neighbour analysis statistics for all four hoblies of Hunsur taluk were derived from the distance between nearest health centers. The Rn Value of the study area is 1.1929, it shows that these health centers are randomly distributed, these can be observed in the Map no 3. Since south western part of the taluk is forest region, So a large proportion of the residents have to travel a long way to access the health care facilities.