Mapping accessibility to oral health care in coastal India - A geospatial approach using a geographic information system (GIS)

Background: It is imperative to have a thorough assessment of the existing distribution of oral healthcare facilities and understand potential accessibility when planning for expansion of oral health services. In the present study, an attempt to measure geographic accessibility to oral healthcare, by locating the availability of dental practitioners in the coastal districts of Karnataka state, India using a geographical information system (GIS), has been made. Methods: For the study, data on public and private oral health centres were collected for the three coastal districts of Karnataka state, India. Population and income data were collected, along with geographic attributes (latitudes and longitudes) of the practitioners' addresses. Descriptive statistical analyses and dentist-to-population ratios (D:P) were calculated. Correlation between the number of clinics with population and D:P with per capita income were analyzed using Pearson's correlation coefficient. Chi-square test applied to analyze any association between D:P and urbanization. Results: Among 340 clinics, 8.5% are public and 91.5% are private clinics catering to a population of 4,704,179. Average D:P for the three coastal districts is 1:13,836. There is an uneven urban-rural distribution of dentists with lower D:P in rural areas. Rural population in four taluks have only one dentist for over a lakh population. Six taluks have only one dentist for every 50000 - 100000 population in rural areas. Six rural areas had only public centers to cater to their oral health. Conclusions: From the study, it is concluded that oral health services were concentrated in areas with higher annual income per-capita, increased urbanization and population density.