After years of wait, India is all set to have a health programme for its nine crore urban poor. The Expenditure Finance Committee (EFC) on Tuesday cleared the Union health ministry’s blue print of a National Urban Health Mission (NUHM). The ministry will soon take the Rs 22,000-crore proposal to the Cabinet. Nearly 75% of this budget will be funded by the Centre. NUHM will be launched in 779 cities or towns that have a population of 50,000 or more along with seven mega cities — Mumbai, New Delhi, Kolkata, Chennai, Bangalore, Hyderabad and Ahmedabad. Contrary to popular belief, the health standards of the urban poor in most cases are worse than their rural counterparts.
More than two million births occur annually among the urban poor, and the health indicators in this group are poor. Around 56% deliveries among the urban poor take place at home. The under-5 mortality among urban poor at 72.7% is significantly higher than the urban average of 51.9%. Nearly 60% urban poor children do not receive complete immunization compared to 58% in rural areas, 47.1% urban poor children less than three are underweight as compared to 45% in rural areas and 59% of women (15-49 age group) are anemic as compared to 57% in rural India.
Over 285 million urban people in India account for 28% of the country’s total population. It is expected to increase to 33% by 2026. According to projections, out of the total population increase of 371 million during 2001-26, the share of increase in the urban population is expected to be 182 million, who suffer from serious health problems. A health ministry official said, “The Centre has pledged around Rs 17,000 crore for NUHM. Every state will soon start mapping their existing infrastructure to fill the gaps so that smooth health services are made available to the poor. It will be a city-specific plan. The primary health centres will carry out preventive, clinical and curative services. We envisage keeping the PHC near these slums open from 12 noon to 8 pm so that poor don’t miss their wages and can come to a PHC for treatment after work. The PHCs will carry out diagnostics, OPDs, antenatal care, immunization rounds with a referral linkage to a satellite hospital.”
NUHM also got the backing from President Pranab Mukherjee, who as the then finance minister in his Budget speech on March 16, had said, “NUHM is being launched to encompass the primary healthcare needs of people in urban areas.” The NUHM will ensure health services for all urban dwellers — urban poor population, living in listed and unlisted slums besides all other vulnerable population such as homeless, rag-pickers, street children, rickshaw-pullers and other temporary migrants.
“Lack of economic resources inhibiting or restricting their access to private facilities, illegal status, poor environmental condition, overcrowding and pollution has contributed to their poor health status,” a Planning Commission report said. “Conservative estimates show that 38 crore people are living in urban areas, and it is projected to increase to 54 crore by 2050. This unprecedented urbanization brings with it influx of migrants, rapid growth of populations, expansion of the city boundaries and a concomitant rise in slum populations and urban poverty,” it added.
At the primary care level, one urban primary health centre will be established for every 50,000 population. An urban social health activist will be posted for every 200-500 households, and a mahila arogya samiti will be established for every 50-100 households, which will be provided an annual united grant of Rs 5,000 per year. NUHM’s launch is being constantly deferred since 2008.
News source: TimesofIndia