Health Atlas prepared by NATMO can help in proper planning and formulation of strategies to provide better health services at the regional level consisting of villages, blocks and districts
While preparing the National Atlas of India containing 300 plates in 8 volumes – two plates were prepared on Health and Disease of the country. One Map India – Health (see Delhi Plate at cover page) represented the strength of hospital beds in different places of the country along with a chart showing the total number of doctors and nurses in different states and another Map India – Diseases represented prevalence and death rate of four diseases particularly Cholera, Tuberculosis, Leprosy and cancer at the state level. In the year 1991 a special map on India -Mortality and Communicable Diseases (fig. 1) was published on the occasion of the International Seminar on Health care planning in the developing world under the angle of 100 commissions on Health and Development. While preparing National Atlas of India -abridged edition, a revised plate of India- Health was published in 1995, showing district-wise bed, population ratio and state-wise doctor population ratio of the country. In the ninth plan, a health and disease atlas of India was also proposed in which one part is subjected to deal with the aspects of health services only and one map in this part was allocated to services to disabled persons. On the eve of the International Day for disabled on December 3, 1995, it was decided to prepare the map entitled India-services to disabled (fig. 2) on priority basis on the advice of TIFAC group of the Department of Science and Technology. At the same time, National Atlas and Thematic Mapping Organisation (NATMO) got in touch with the Ali Yavar Jung Institute for hearing handicapped, particularly its Director, Dr. Rekha Roy. The outline of this was discussed with her, and the final draft map was also shown to her before undertaking its printing. Available data base was a directory of institutional working for disabled in India published in 1995 by National information Centre on Disability and Rehabilitation under the Ministry of Social Welfare, Government of India. Based on the directory, six categories of handicaps namely- (a) Locomotor handicap, (b) Hearing handicap, (c) Visual handicap, (d) Mentally handicap, (e) Cerebral palsy and (f) Leprosy cured were analysed district -wise, along with a number of service-types provided in all the districts of the country as per available data. The types of services for different categories of disabled persons are divided in six groups i.e. (a) Therapeutic/Counseling, (b) School/Educational, (c) Vocational Training, (d) Sheltered Home/Placement, (e) Manpower development and (f) Assistive devices. All the data compiled and analysed at the district level has been represented in various districts on the map of India (scale 1:6 million) with the help of hexagons. In each triangle of hexagons, all six categories of handicaps as mentioned above are shown clockwise and the number of service-types available for them are shown by different colours.
The list of different types of service as listed above is mentioned in the reference box. Due to lack of space, details of different types of services available in different districts for different categories of handicaps could not be shown and that would be possible only if there is any project undertaken at a large scale mapping of the aspect specially on 1: 1 million scale maps. Other than a number of services available at the district level, the ratio of disabled persons per service unit at the state level is also shown with the help of choropleth method. Data of total disabled persons per service unit at the state level is also shown with the help of choropleth method. Data of total disabled persons in the different states is taken from NSS, 47th round-1991 and the number of total service units working for disabled in each state is compiled from the directory of institutions working for the disabled in India. After representing the data on the map it is evident that the minimum ratio of 5,000 disabled persons per service-unit is seen in four southern states namely Maharashtra, Karnataka, Tamil Nadu and Kerala followed by 5,000-9,000 disabled persons per service-unit in Rajasthan, Gujarat, Orissa and West Bengal. In Andhra Pradesh and Himachal Pradesh, the ratio of disabled persons per service-unit varies from 9,001to13,000 while in Madhya Pradesh, Uttar Pradesh, Punjab and Haryana it is 13,001 to 17,000 per service-unit. The maximum ratio of 17,000 disabled persons per service-unit is found in Bihar, Sikkim and North-Eastern states. Due to non-availability of data / information, we do not have a complete picture of Jammu and Kashmir and Arunachal Pradesh. While comparing the number of services available to different kinds of disabled persons at the district level, it is evident from the map that these are mostly state headquarters where the maximum number of services exist. It is also evident from the map that most of the district of Tamil Nadu, Kerala, Maharashtra and West Bengal are seen having better services along with a very few districts of Gujarat, Rajasthan, Haryana, Uttar Pradesh and Orissa. In most of other districts either availability of services is very poor or there is no information on data available for them. Data representation on the map clearly indicates that there is enough scope of further data representation as there are more than two hundred districts still left over without any data or information. Based on proper and real data representation at the micro level, we can review our present position and situation regarding rendering of services to disabled persons for the entire country. Such maps can help us in proper planning and formulation of strategies to provide better health services at the regional level consisting of villages, blocks and districts.