Sun. Mar 3rd, 2024
Public Health in Urban Informal Settlements

The Informal settlements are faced with numerous challenges, including poverty, a lack of socio-economic resources, and a lack of legal ties and support from the municipal governments. This leads to an increased risk for the residents and exacerbates health inequalities, resulting in a lack of access to basic amenities.

Urbanization in India has also had serious consequences for public health. Nearly one billion people are estimated to live in slums without access to basic necessities. The percentage of the population residing in urban areas in India has increased over the years, from 11.4% in 1901 to 28.53% in 2001 and 31% in 2011 (Census, 2011) and is expected to rise by 46% in 2030. The congested areas, shanty towns, and slums are giving rise to diseases such as diarrhoea and malaria.

To address these issues, the Government of India (GOI) introduced the National Urban Health Mission (NUHM). The NUHM offers a comprehensive framework for implementing policies and techniques that support the infrastructural needs of the urban poor. The policy aims to increase access to healthcare for migrant labourers, coolies, and other types of migrants who are often deprived of basic healthcare facilities and services. In addition, policies such as the Jawaharlal Nehru National Urban Renewal Mission (JNNURM), ICDS, and other related schemes help in improving citizens’ access to basic amenities such as housing, sanitation, and water.

The goal of the NUHM is to provide universal access to equitable, affordable, and quality healthcare services to urban slum dwellers and vulnerable sections. However, the implementation of the policy has faced several challenges, such as difficulties in finding space to set up urban primary healthcare centres in slum areas (National Urban Health Mission (NUHM), Swaniti Initiative, 2014). The formation of Mahila Arogya Samitis has also proven to be a challenge as it is difficult to mobilize the migrant population into the program and empower them.

To improve the NUHM policy and its implementation, the following recommendations are made:

(i) Improving public service delivery by making it transparent and time-bound, by focusing on designing the agencies effectively and creating a balance between independence and accountability.

(ii) Adopting a Public-Private Partnership (PPP) model for service delivery, to build better infrastructures such as roads, safe water supply and electricity.

(iii) Capacity building in the administration, to ensure better delivery of services by staffing hospitals with competent and domain-expert personnel.

(iv) Better coordination and access to information to enable better policy analysis, as asymmetric information between the government and academia/think tanks or civil society can hinder policymaking.

(v) The health departments should introduce innovative reforms to address the problems, including social protection for migrant people, enforcement of environmental and public health sector regulations, a focus on prevention and promotion, and partnerships with non-profit organizations. The policy’s achievements should be evaluated every five years to ensure its targets are being met.

In conclusion, the NUHM policy is a step in the right direction towards inclusive urban healthcare, but its implementation faces challenges. The government, with the help of Urban Local Bodies (ULBs), should focus on the informal settlements by providing attention to these areas, which often fall outside the legal standing and are socially excluded. The efficiency of the NUHM could be improved through.

By Sanjida

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