Healthcare Accessibility in East Khasi Hills, Meghalaya, India: Age, Gender, and Socioeconomic Barriers to Primary Health Centre Access

Abstract

Aims: This study investigates the travel patterns of males and females across different age groups, modes of transport, and socio-economic factors influencing access to Primary Health Centres (PHCs) in the rugged terrain of East Khasi Hills District, Meghalaya. Study Design: A cross-sectional survey of 106 respondents from five PHCs was conducted, supplemented with secondary demographic information. Methodology: GIS-based buffer and overlay analyses were employed to map age- and sex-wise travel patterns and service coverage areas. Descriptive and cross-tabulated statistics were used to examine socio-economic disparities in healthcare access. Results: The median travel distance to PHCs was 6.8 km (IQR: 4.2–11.5). Female respondents reported 15% longer travel distances compared to males. Patient satisfaction scores varied across PHCs, ranging from 68% in Mawkynrew to 90% in MawlaiMawroh. Socio-economic variables, particularly income, education, and household size, significantly influenced healthcare-seeking behaviour. Remote villages with poor road infrastructure and limited transport options faced longer travel times and reduced service satisfaction, while urbanised areas with better connectivity showed higher accessibility and greater satisfaction. Conclusion: The findings underscore the urgent need for infrastructural improvements, decentralisation of PHCs, and targeted interventions to reduce inequities in healthcare access in the district. These results provide valuable insights for policymakers and planners seeking to strengthen rural health systems in hilly and underserved regions.