Share of community participation component in inequality of primary healthcare in West Bengal, India

This study aims to measure the inequality of designated six domains of Primary Healthcare System in West Bengal with special emphasis on Community Participation Domain.

To estimate the domain specific share of inequality in Primary Healthcare System, Modified Gini, is used to identify inequality in six domains that exists across the spatial region. The value of Inequality in Overall Deprivation ranges from -1 to +1. Fifty one indicators were used to estimate the domain that contributes most in overall inequality in Primary Healthcare System. Further disaggregation is done of the indicators of Community Participation domain to understand which factors contribute most to the inequality.

The overall inequality of Primary Healthcare System in West Bengal is 0.47. Out of the selected six domains, community participation domain shows the highest share of inequality, that is, 22.92%. The deprivation or inequality in community participation domain has a significant correlation with child death. The indicators, Citizens Charter (13.61) and Participation in Village Health Plan (13.21) have the highest share in inequality within Community Participation Domain in West Bengal. Case Study of Onda Block and Khargram Block shows the severe disparity in share of inequality by this domain. Community Participation domain shares inequality of 8.49 in the primary healthcare system in Onda Block whereas it is as high as 43.45 in Khargram Block.

The State is concerned about meeting the targets of Universal Immunisation and other goals. Hence, community participation and its possible benefits in health outcome remain oblivious. Neglect of this domain leads to a higher share in overall inequality.