International Research Journal of Social Sciences_____________________________________ ISSN 2319–3565Vol. 3(12), 15-22, December (2014) Int. Res. J. Social Sci. International Science Congress Association 15 Spatial Inequality in Health Care Infrastructure in Sundarban, West Bengal, India Dipanwita De Contractual Whole Time Teacher in Geography, Swami Niswambalananda Girls' College, Hugli, West Bengal, INDIA Available online at: www.isca.in, www.isca.me Received 8th August 2014, revised 18th September 2014, accepted 14th October 2014 Abstract Health is a fundamental human right and central to the concept of quality of life. Due to various socio-economic and political factors, there exists a widespread inequality in the distribution of health care facilities in India. The present study attempts to highlight on the existing health care infrastructure and also tries to analyse the inter-block disparities regarding health care facilities in Sundarban which is known as one of the backward region of West Bengal. To identify the regional pattern of health care infrastructure three broad categorie have identified i.e. availability of health care infrastructure, performances of public health care centres and accessibility to health care infrastructure. There is a huge shortfall in the existing number of primary health centres and manpower under the public health system in Sundarban. Nearly 70% areas of Sundarban have suffered from very poor health care infrastructure. Only six blocks viz. Canning-I, Kakdwip, Jaynagar-I, Patharpratima, Mathurapur-I and Mathurpur-II have relatively better health care facilities than rest of Sundarban. The state Government needs to adopt viable policies and programmes and take some immediate actions to improve the health care infrastructure in Sundarban. Keyword: Disparities, health care infrastructure, quality of life, shortfall, viable policies. Introduction Nobody would deny that a healthy community is the infrastructure of building an economically viable society. Sound health is the precondition for human development process to roll on smoothly, irrespective of caste, religion and region. Health is not just the absence of disease. It represents both physical and mental capability to enjoy living. Health care is a social determinant as it influenced by social policies. One of the basic objectives of eleventh five year plan is to achieve good health for people, especially the poor and the unprivileged. In view of this, the department of Health and Family Welfare has focussed its attention on improving the primary health services by channelizing adequate financial and manpower resources for making the health services more accessible and affordable to the poor people. In fact, after independence of the country, the health infrastructure of Sundarban has expanded manifold, still the physical health infrastructures are inadequate to extend quality health services to all the people. Literature review: Health is an integral part of development. The health care as a constitutive element of well-being and yet it has been one of the most neglected aspects of development in India. Just as health status is influenced by the socio-economic factors, similarly health services are shaped by the socio-economic and political factors of any region . Inequality in the distribution of health care facility is a common manifestation of these factors and a general feature of health care system in India. According to Rajeshwari and Sinha , the distribution of health care institutions in India is guided by locational preferences. Public health is nothing but, the practice of preventing disease and promoting good health within groups of people, from small communities to entire countries. In this context, an attempt is made to examine the spatial distribution of health care infrastructure in Sundarban. It is not surprising that there is a tremendous pressure on existing health care system to meet the need of vast population. Hence an assessment of available resources is imperative for proper allocation and efficient utilization of health care services. Study area: Sundarban is the southernmost part of West Bengal. It is bounded by the river Hooghly on the west, the Bay of Bengal on the south, Ichamati-Kalindi-Raimangal rivers on the east and the Dampler-Hodges line on the north. In this Ganga Plain delta building process is still very active. This active delta has a network of tidal channels, river creeks and numerous islands. The climate of the area is characterised by an oppressive hot summer, high humidity all through the year and well distributed rainfall during the monsoon season. Figure1 represents location of the study area. The total land area measures about 9629 sq.km, of which, nearly 48% area is inhabited whereas the rest is reserved forest. In 2011 the total recorded population in this region was 4426259. The mainstay of economy is agriculture, primarily Paddy cultivation. The region is characterised by developmental constraints in terms of rapidly growing population, lack of appropriate transportation, modern energy services, adequate health care delivery and education. International Research Journal of Social Sciences___________________________________________________ ISSN 2319–3565Vol. 3(12), 15-22, December (2014) Int. Res. J. Social Sci.International Science Congress Association 16 Objectives: i.To highlight the existing infrastructure available for health care services in Sundarban. ii. To show the inter-block variations in health care facilities in the study area. iii. To find out the regional pattern in the distribution of health care infrastructure of Sundarban. Figure-1 Location Map of Sundarban International Research Journal of Social Sciences___________________________________________________ ISSN 2319–3565Vol. 3(12), 15-22, December (2014) Int. Res. J. Social Sci.International Science Congress Association 17 Material and Methods The present research work is entirely based on secondary sources of data collected from Provisional Census Abstract, 2011 and Bureau of Applied Economics and Statistics, Government of West Bengal, for the year 2011. Infrastructure can be measured either in terms of investment towards a particular service or in terms of physical quantity of the services available to the end users. In the present study twelve indicators of physical infrastructure services have considered to construct the Healthcare Infrastructure Index for Sundarban. Table 1 shows the selected indicators of health care infrastructure. These are grouped in following three categories under different heads: i. Availability of health care facilities. ii. Performances of public health care centres. iii. Accessibility to health care facilities. Table-1 Selected indicators of Health care Infrastructure of Sundarban Availability of health care infrastructure X 1 Doctor-population Ratio X 2 Population served per Primary Health Centre (PHC) X 3 Population served per sub-centre X 4 Number of Medical institutions per 1,00,000 population X 5 Number of beds per 10,000 population Performances of public health care centres 6 Percentage of indoor patients to total indoor patients of Sundarban X 7 Percentage of outdoor patients to total outdoor patients of Sundarban X 8 Percentage of immunization to total immunization of Sundarban X 9 Percentage of institutional delivery to total institutional delivery of Sundarban. Accessibility to Health care infrastructure 10 Number of Medical institutions per 100 sq. km. X 11 Number of sub-centres per 100 square kilometres. X 12 Percentage of villages with nearest PHC within 5 km ( If not available within the village) Source Computed by author In the present work community development blocks have been taken as the unit of the study. The detailed methodology for preparing Healthcare Infrastructure Index (HII) runs as follow: X- minX ijij I=ij maxX- minX ijij Iij is the infrastructure indicator for the jth block with respect to th variable and Xij represents the value of the ith infrastructural development indicator in jth block, minj Xij and maxj Xij are the minimum and maximum values of  respectively. However, if Xijis negatively associated with the status of infrastructural development, former equation can be written as: - X ij ijI=ij maxX- minX ijij maxTo identify the overall development regarding health care infrastructure, Healthcare Infrastructure Index (HII) have been computed. This is done by taking a simple average of the chosen indicators. It may be algebraically expressed as: n ij i=1 I HII= N  Where, N represents total number of selected indicators for healthcare infrastructure and HIIj denotes the health care infrastructure Index for jth block. The high values of HIIj indicate high level of development and vice versa. Results and Discussion Health infrastructure is the resources needed to deliver the essential public services to the people. Sound health infrastructure ensures efficient and effective utilization of essential public health services. The totality of the public health infrastructure includes all governmental and non-governmental entities that provide public health services to the people. Availability of health care facilities: The doctor-population ratio is perhaps the most important factor affecting the health care facility in an area. Sundarban is lagging behind far in terms of availability of doctors and also there is huge variation in population served per doctor. In 2010-11, population served per doctor in Kakdwip was 7621 while for Harora it was 53600. Table 4 depicts the overall scenario regarding doctor-population ratio in the study area which is frustrating enough. Since independence India adopted the process of planning all round development of the country including raising the standard of living of the people. In such programmes one of the programmes was that of establishment of Primary Health Centres with three sub-centres and four to six beds per Primary Health Centre in community development block. Primary Health Centres (PHCs) are the most important peripheral health service institutions. Unfortunately, not a single block has been found where less than 30,000 persons are served by one PHC. In contrast, there are four blocks namely, Canning-I and II, Kakdwip and Jaynagar-I where population served per PHC is more than four times than the existing norm. Out of nineteen blocks there are seventeen blocks where the average number of people served by one PHC is more than 50,000 Table 2 reflects International Research Journal of Social Sciences___________________________________________________ ISSN 2319–3565Vol. 3(12), 15-22, December (2014) Int. Res. J. Social Sci.International Science Congress Association 18 very poor condition of the supply side of health care system in the Sundarban. Table–2 Population-PHC Ratio in the Blocks of Sundarban (2010-11) Size of population served per PHC Name of the Blocks 30,000 or less 30,000- 50,000 Hinjaiganj,Namkhana 50,000-70,000 Hasanabad, Sandeshkhali-I, Kultali 70,000-90,000 Harora, Sandeshkhali-II, Basanti, Gosaba, Sagar, Patharpratima, Jaynagar-II, Mathurpur-II 90,000 or more Mathurpur-I, Canning-I and II, Jaynagar-I,Kakdwip , Minakhan Note: The national norm is one PHC for every 30,000 population in plain areas and for 20,000 population in tribal, hilly and backward areas. Source: Computed from District Statistical Handbook of North and South 24 Paraganas, 2011. In Sandeshkhali-I and II, Gosaba, Namkhana and Mathurpur-II, one sub-centre provides services 4000 to 5000 persons which is much higher than the existing norm of 3000 population. However it is evident from table 3 that there are three blocks which are close to the norm of its provision. The average population served by one sub-centre in Sundarban is 5321. Table–3Population-Sub-centre Ratio in the Blocks of Sundarban (2010-11) Size of population served per Sub-centre Name of the Blocks 5000 or less Sandeshkhali-I and II, Gosaba, Namkhana and Mathurpur-II 5000-6000 Basanti, Sagar, Patharpratima, Jaynagar-I and II, Mathurpur-I, Canning-I and II, Kakdwip , Minakhan, Hinjaiganj, Kultali 6000-7000 Hasanabad 7000 or more Harora, Note The national norm is one sub-centre for every 5000 population in plain areas and for 3000 population in tribal, hilly and backward areas. Source Computed from District Statistical Handbook of North and South 24 Paraganas, 2011 In the present analysis medical institutions include medical colleges, district and sub-divisional hospitals, rural hospitals, PHCs, private medical institutions and those run by NGOs etc. It does not include sub-centres as they provide only minor health care facilities. The availability of medical institutions is measured in terms of number of medical institutions per 1, 00,000 population. It is highest in Mathurpur-II (5.0) followed by kakdwip (3.9). Canning-II is the most poorly served block where 1, 00,000 persons are served by less than one medical institution. Population served per bed is an important indicator of health indicator. Total number of available beds in Sundarban is 1296 (2011). On an average, one bed served 3415 person in a year during 2010 - 11. The availability of beds in medical institutions is measured in terms of beds per 10,000 population. In Sundarban, it is highest in Kakdwip and lowest in Hasanabad. Table 4 highlights that there are twelve block where number of beds serving 10,000 persons is less than just three. So, it is quite evident that regarding population-bed ratio, the circumstances of study area is miserable. Performance of hospitals, PHCs and sub-centres: To measure the performances of public health care system, we have identified four indicators which are illustrated in Table1. The performance of any health care unit can be denoted by the relative population pressure in the concerned unit. The numerical figures regarding performances of public healthcare centres are expressed in terms of the percentage. The clinical attendance of patients and the use of medical facilities is another important indicator which reflects the utilization of public health services. The clinical attendance of patients has been analysed in terms of indoor and outdoor patients. In case of the treatment of indoor and outdoor patients, Canning-I and Kakdwip have able to manage a satisfactory position. Both blocks have served more than 32 percentages of indoor patients to total indoor patients of Sundarban. Canning- I have still contributed a good effort to serve the outdoor patients and Jaynagar-II also plays major role in this context. In respect of indoor and outdoor admission of patients Hasanabad stands in lowest position. Women throughout the world play critical role in economic growth and development and their contribution have an impact on households, communities and national economies. Poor health has repercussion not only for women but also their families. Women in poor heath are more likely to give birth to low weight infants. They also are less likely to be able to provide food and adequate care for their children. One important indicator of safe motherhood at the district level is the extent of institutional delivery. In respect of institutional delivery Horoa, Kakdwip, Canning-I, Jaynagar-I have achieved a considerable success in recent years. Though, the overall performance of Sundarban is far behind the target of 100% institutional delivery. Moreover, there are substantial variations in the extent of institutional delivery across the blocks. In Sundarban, the block Kakdwip occupies first rank with 13.4% institutional delivery to total institutional delivery of Sundarban, while Hasanabad is in lowest position with only 1.2% institutional delivery to total institutional delivery of the study area. International Research Journal of Social Sciences___________________________________________________ ISSN 2319–3565Vol. 3(12), 15-22, December (2014) Int. Res. J. Social Sci.International Science Congress Association 19 Immunization programme aims to reduce mortality and morbidity due to vaccine preventable diseases. Since ancient era emphasis has been given to the preventive aspect of health and it is well known that the prevention is better than cure. Universal Immunization Programme (UIP) was launched in India 1985 to control diseases like measles, diphtheria, and tetanus and childhood tuberculosis10. The analysis reveals wide differences in level and distribution of childhood immunization within blocks of Sundarban. In immunizing the child, favourable achievement is observed in Canning-I and Basanti block. Other good performing blocks are Canning II, Patharpratima and Hinjalganj found to be worst performing block. Accessibility of health care infrastructure: The provision of accessibility to health facility can ensure better health condition of the inhabitants. Table 5 reveals that Jaynagar-I ranks first with relatively high number of medical institutions per100 sq.km. Here one medical institution serves 16 sq.km. Canning-I and Mathurpur-II occupy second and third positions respectively where one medical institution serves 20.87 sq.km and 20. 67 sq.km respectively. In all other blocks the number of medical institutions per 100 sq.km is less than four and in Sandeshkhali-II and Canning-II the number is reduced to 1.5 per 100 sq.km and 0.9 per 100 sq.km. Though sub centres are provide only minor health care facilities but it is very important to the rural poor. Jaynagar-I has higher accessibility to sub-centre as it located here at 2.6 sq.km apart from each other, while 10sq.km is the highest spacing has recorded in Namkhana. In our country provision for comprehensive health care starts from the PHCs. In case of the accessibility of PHC within 5 km from village, the situation is satisfactory in Minakhan, Sandeshkhali-II, Hinjalganj, Patharpratima and Mathurpur-I where more than 25% villages have greater accessibility to PHCs. The numbers of PHCs have to be increased substantially in Jaynagar-II and Mathurpur-II. Kendall’s Coefficient of Concordance (W) to study the degree of association among parameters: Kendall’s coefficient of concordance (W) has been used to determine the degree of association among several parameters (k), of 19 blocks (N) of Sundarban. Value of Kendall’s coefficient of concordance (W) is 0.2479. As, N (i.e. number of objects) is larger than 7, value of chi-square (has been procured to determine the significance of W. Table value of 2 at 5% level for (N-1= 19-1=18) 18 degrees of freedom is 28.869 but the calculated value of is 53.546 and this is considerably higher than the table value. Twelve sets of ranking of selected parameters are calculated which is elaborated in table 5. This rejects the null hypothesis that twelve sets of ranking of selected parameters are independent and accepts the alternative hypothesis of significance agreement of twelve sets of ranking. Table–4Health care infrastructures and Health care Infrastructure Index (HII) of Sundarban Blocks of Sundarban Availability of health care Infrastructure Performances of public health care centres Accessibility to healthcare centres x 1 x 2 x 3 x 4 x 5 x 6 x 7 x 8 x 9 x 10 x 11 x 12 Haroa 53600 71467 7393 1.4 1.3 5.0 4.7 8.0 4.9 2.0 19.0 12.2 Minakhan 28441 99542 5105 1.5 2.1 3.0 4.9 4.5 4.4 1.9 24.6 30.7 Hasnabad 22585 67754 6159 2.0 0.9 0.9 0.9 1.2 5.0 2.6 21.6 18.9 Hingalganj 34909 43636 5455 2.3 1.4 1.7 1.1 1.6 2.9 1.7 13.4 27.3 Sandeshkhali-I 41116 54822 4699 1.8 1.4 2.2 5.5 7.4 3.5 1.6 19.2 6.7 Sandeshkhali-II 32195 80488 4599 1.9 2.2 1.6 1.5 2.2 3.3 1.5 17.7 45.8 Canning-I 12189 304724 5442 3.0 3.9 17.0 16.5 11.2 8.0 4.8 29.8 4.9 Canning-II 42087 126262 5612 0.8 1.6 2.2 4.5 1.6 7.1 0.9 20.9 6.8 Basanti 30611 84179 5345 2.4 2.3 2.3 2.3 2.1 8.0 2.0 15.6 24.6 Gosaba 49320 82199 4835 1.6 2.1 2.1 4.6 1.7 4.3 1.3 17.2 4.9 Kakdwip 7621 140982 5222 3.9 7.0 15.7 6.4 13.4 5.8 4.4 21.4 9.5 Namkhana 14064 36566 4941 3.8 3.9 5.1 1.1 3.6 3.8 1.9 10.0 18.9 Sagar 17670 70679 5049 2.4 3.9 6.7 6.2 6.7 4.5 1.8 14.9 16.5 Patharpratima 22122 82956 5105 3.6 3.0 3.4 6.0 5.4 7.7 2.5 13.4 33.3 Jaynagar-I 20242 131576 5263 3.0 2.7 5.6 6.2 9.5 5.6 6.1 38.2 18.0 Jaynagar-II 25216 84055 5365 2.0 2.3 4.7 8.8 3.3 6.4 2.7 25.2 1.7 Kultali 22905 57263 5327 3.1 2.7 5.2 9.2 3.6 5.7 2.3 14.0 7.7 Mathurapur-I 16259 97552 5273 2.1 4.2 6.8 6.9 5.5 4.1 2.7 25.1 28.4 Mathurapur-II 9202 73613 4908 5.0 5.2 8.9 2.7 7.5 5.0 4.8 19.8 1.7 Source: Computed by author. International Research Journal of Social Sciences___________________________________________________ ISSN 2319–3565Vol. 3(12), 15-22, December (2014) Int. Res. J. Social Sci.International Science Congress Association 20 Table-5Block wise Rank for Health care Infrastructure in Sundarban Blocks of Sundarban x x x x x x x x x x10 x11 x12 Haroa 19 7 19 18 18 9 11 4 11 10 11 11 Minakhan 12 15 7.5 17 13.5 12 10 10 13 12.5 5 3 Hasnabad 9 5 18 12.5 19 19 19 19 9.5 7 6 7.5 Hingalganj 15 2 16 10 16 17 17.5 17.5 19 15 17.5 5 Sandeshkhali-I 16 3 2 15 17 14.5 9 6 17 16 10 15 Sandeshkhali-II 14 9 1 14 11.5 18 16 14 18 17 12 1 Canning-I 3 19 15 6.5 5.5 1 1 2 1.5 2.5 2 16.5 Canning-II 17 16 17 19 15 14.5 13 17.5 4 19 8 14 Basanti 13 13 13 8.5 10 13 15 15 1.5 11 14 6 Gosaba 18 10 3 16 13.5 16 12 16 14 18 13 16.5 Kakdwip 1 18 9 2 1 2 5 1 6 4 7 12 Namkhana 4 1 5 3 4 8 17.5 11.5 16 12.5 19 7.5 Sagar 6 6 6 8.5 5.5 5 6.5 7 12 14 15 10 Patharpratima 8 11 7.5 4 7 11 8 9 3 8 17.5 2 Jaynagar-I 7 17 10 6.5 8.5 6 6.5 3 8 1 1 9 Jaynagar-II 11 12 14 12.5 11.5 10 3 13 5 5.5 3 18.5 Kultali 10 4 12 5 8.5 7 2 11.5 7 9 16 13 Mathurapur-I 5 14 11 11 3 4 4 8 15 5.5 4 4 Mathurapur-II 2 8 4 1 2 3 14 5 9.5 2.5 9 18.5 Source: Computed by author. Overall scenario of health care infrastructure in Sundarban: After a detail analysis of the aforesaid parameters, Health care Infrastructure Index (HII) for each community development blocks have been worked out to perceive the status of health care facilities in different blocks of Sundarban. Table-6 represents the Health care Infrastructure Index (HII) for Sundarban.This would enable us to identify the gaps in infrastructure development in healthcare facilities at the inter block level in Sundarban and also help to make suggestions for appropriate policy interventions for achieving balanced infrastructure development in this area. There is a wide range of regional variations in levels of health care development among the blocks of Sundarban. So far, Kakdwip with the Composite Index 0.685 is at best position in providing health care services to its common people. It is followed by Canning-I, Jaynagar-I, Mathurpur-II having the rank of 2nd, 3rd and 4th respectively. On the contrary, the conditions of Canning-II, Haroa and Gosaba are very poor in health care services. The situation of Gosaba in health care services is really alarming. Table-7 portrays the overall scenario regarding health care infrastructure of Sundarban. Table6 Health care Infrastructure Index (HII) in SundarbanSl. No. Blocks of Sundarban Health care Infrastructure Index(HII) Rank 1 Haroa 0.274 18 2 Minakhan 0.401 12 3 Hasnabad 0.319 15 4 Hingalganj 0.289 16 5 Sandeshkhali-I 0.339 14 6 Sandeshkhali-II 0.368 13 7 Canning-I 0.663 2 8 Canning-II 0.278 17 9 Basanti 0.404 11 10 Gosaba 0.271 19 11 Kakdwip 0.685 1 12 Namkhana 0.432 9 13 Sagar 0.460 7 14 Patharpratima 0.521 5 15 Jaynagar-I 0.597 3 16 Jaynagar-II 0.430 10 17 Kultali 0.439 8 18 Mathurapur-I 0.501 6 19 Mathurapur-II 0.588 4 Source Computed by author. International Research Journal of Social Sciences___________________________________________________ ISSN 2319–3565Vol. 3(12), 15-22, December (2014) Int. Res. J. Social Sci.International Science Congress Association 21 Table-7 Levels of Development in Health care Infrastructure in Sundarban Levels of Healthcare Infrastructure Indices Number of Blocks Name of the Blocks Very High �0.6 2 (10.5) Canning-I, Kakdwip High 0.5 to 0.6 4 (21) Jaynagar-I, Patharpratima, Mathurapur-I, Mathurapur-II Medium 0.4 to 0.5 6 (31.7) Namkhana, Basanti, Sagar, Jaynagar-II, Kultali, Minakhan Low 0.3 to 0.4 3 (15.8) , Hasanabad, Sandeshkhali-I and II Very Low 0.3 4 (21) Hinjaiganj, , Canning-II, Haroa, Gosaba Note: Figures in parenthesis indicate % to total number of blocks. Source: Compiled by author. Figure-2Health Care Infrastructure Index (HII) of SundarbanThis level of variation in health care infrastructure may be arranged into five grades i.e. very high (above 0.6), high (0.5 to 0.6), moderate (0.4 to 0.5), low (0.3 to 0.4) and very low (below 0.3). Table 7 and Figure 2 depict the imbalances in the level of International Research Journal of Social Sciences___________________________________________________ ISSN 2319–3565Vol. 3(12), 15-22, December (2014) Int. Res. J. Social Sci.International Science Congress Association 22 health care infrastructural development in Sundarban. In this region, two blocks (10.5%) have able to achieve relatively advantageous position and just four blocks (Jaynagar-I, Patharpratima, Mathurapur-I, Mathurapur-II) have performed well in health care infrastructure. Out of nineteen blocks of Sunarban seven blocks (36.8%) reflect low level of heath care infrastructure. The Sundarban is geographically a remote area, criss-crossed by the rivers. Poor transport and communication network, lack of conventional electricity supply and scarcity of potable water are major problem of this region along with natural calamity like cyclones and storm surges. Apart from the indifferent attitude of the government, the above mentioned problems are associated with poor development of health care infrastructure in this region11. Conclusion Health and nutrition are intimately and intricately connected12.It must be noted that only institutions do not constitute a compressive health care system but it includes certain other elements, like the system of nutrition, provision of uncontaminated drinking water and healthy living environment13. The present study only focuses on the infrastructural facilities of health care system of Sundarban. Nevertheless, this study provides valuable information on recent health care situation of Sundarban. It focuses on the extreme shortages of health care institutions and manpower in the public health system. As majority of people in Sundarban depend on public health care system, the most important thing is to recruit the required number of doctors and staffs in the public health institutions. Government should open up new teaching hospitals to increase the number of doctors. It may be useful to encourage the non-allopathic system of medicine as large number of people, particularly in rural areas, depends on traditional system of medicine14. The ongoing efforts of the government to build up private-public partnership and involve the panchayats more effectively in the participatory management of health services are expected to ensure better health care services. References 1.Dreze J. And Sen A., India Development and Participation, Oxford University Press, New Delhi, (2005) 2.Baru R., Acharya A., Acharya S., Shiva Kumar A.K. And Nagraj K., Inequalities in Access to Health Services in India: Caste, Class and Region, Economic and political Weekly, 65(38), (2010)3.Rajeshwari and Sinha S., Spatial Inequalities in the development of Public Health Care Facilities in Rural Haryana, India: Health Care Patterns and Planning edited by Akhtar R., A P H Publishing Corporation, New Delhli, (2004) 4.Pradad B.A., Occupational Health Problems of Woman Migrant Workers in Thogamalai, Karur District, Tamil Nadu, India, Int. Res. J. Social Sci., 2(4), 7-15, (2013), Retrieved, August 5, 2014, from http://www.isca.in/IJSS/ 5.Provisional Population Tables, Census of India (2011)6.Shahi G., Post-Independence Health Facilities in India: An Evaluation, Geog. Perspective, 5(2), 26-32, (1991) 7.Aich M., Mahzebin M., Fahriasubarna N. and Hassan A., A Study on Socio-Economic Condition and Nutritional Profile of Women Workers in Shrimp and Agriculture Sectors in Selected Two Districts of Bangladesh, Int. Res. J. Social Sci., 3(3), 15-21, (2014), Retrieved, August 5, 2014, from http://www.isca.in/IJSS/ 8.Sunilkumar, Kamalapur M. and Reddy S., Women Health in India: An Analysis, Int. Res. J. Social Sci., 2(10), 11-15, (2013) Retrieved, August 5, 2014, from http://www.isca.in/IJSS/9.Trivedi R., Adhikari P., Singh S., Singh S. P., Sharma V., Mishra A. And Goyal A., Prevalence of Practices of Preventive Health Care Measure and its Causes among Medical Professionals of Shyam Shah Medical College, Rewa, India, Int. Res. J. Social Sci., 3(6), 17-22, (2014), Retrieved, August 5, 2014, from http://www.isca.in/IJSS/ 10.District Human Development Report of Retrieved, August 5, from http://www.isca.in/IJSS/South 24 Paraganas, Retrieved, July 30, 2014, from http://www.wbplan.gov.in/HumanDev/DHDR/24%20pgsSouth/Chapter%2001%20FINAL-1.pdf, (2009) 11.Shabnam S., Spatial Inequality in Health Care Infrastructure in West Bengal, Indian J. of Reg. Sci., 34(2), 26-34, (2012) 12. Jackson A.A., Human Nutrition in Medical Practice: The Training of Doctors, Proceedings of Nutrition Society, 60, 257-263, (2001) cited by Somannavar M.S., Proposal for Incorporation of Nutrition Science in First Year Undergraduate Medical Curriculum in India, Int. Res. J. Social Sci., 1(2), 60-62, (2012), Retrieved, August 5, 2014, from http://www.isca.in/IJSS/ 13.Choubey K., Health Care Delivery in Madhya Pradesh, India: Health Care Patterns and Planning edited by Akhtar R., A P H Publishing Corporation, New Delhi, (2008) 14.Soman K., Rural Health Care in West Bengal, Eco. and Pol. Weekly, 37(26), 2562-2564, (2002)