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Coming soon: Medical plan for urban poor

April 8, 2012

A health programme to take care of India’s nine crore urban poor is all set to become a reality.

The Union health ministry has sought time from the Expenditure Finance Committee (EFC) to present the final blue print of the National Urban Health Mission (NUHM) that will be rolled out by the middle of this year.

Union health secretary P K Pradhan said the ministry is waiting to hear from secretary of the expenditure department.

“Once the EFC clears the proposal, we will take it to the Cabinet. Urban health will be taken up as a thrust area in the 12th Plan that will be rolled out soon,” Pradhan said.

NUHM also got the backing from finance minister Pranab Mukherjee, who during his Budget speech on March 16, had said, “NUHM is being launched to encompass the primary healthcare needs of people in urban areas.”

Contrary to popular belief, the health standards of the urban poor in most cases are worse than their rural counterparts.

According to the report of the Planning Commission’s working group, headed by former health secretary K Chandramouli, on the National Rural Health Mission (NRHM) for the 12th Plan, “There are more than 2 million births annually among the urban poor and the health indicators in this group are poor.” The group says around 56% deliveries among the urban poor take place at home. The under-5 mortality at 72.7 among urban poor is significantly higher than urban average of 51.9.

About 60% urban poor children do not receive complete immunization compared to 58% in rural areas, 47.1 % urban poor children less than three are under-weight as compared to 45% in rural areas and 59% of the woman (15-49 age group) are anemic as compared to 57% in rural India.

“The invisibility of the urban poor has contributed to their exclusion from the public healthcare system till now,” the group says.

NUHM will be launched in 779 cities/towns that have a population of 50,000 or more along with seven mega cities – Mumbai, New Delhi, Kolkata, Chennai, Bengaluru, Hyderabad and Ahmedabad.

The group says “NUHM would be launched and kept as a separate entity in the 12th Plan. NUHM and NRHM could be merged in the 13th Plan.”

The NUHM will ensure health services for all urban dwellers – urban poor population, living in listed, 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/restricting their access to private facilities, Illegal status, poor environmental condition, overcrowding and environmental pollution has further contributed to their poor health status. Further, no systematic investments and efforts have been made to improve health care in urban areas,” the report added. Conservative estimates show that 38 crore people are living in urban areas, and it is projected to increase to 54 crore by 2050,” the report cited.

It added, “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.”

As per NSSO estimates, urban poverty has risen from 15% in 1970s to 25% in 2004-05. The Planning Commission has estimated that 8 crore of the urban population is poor.

So what’s the plan under the NUHM? At the primary care level, one Urban Primary Health Centre (U-PHC) will be established for every 50,000 population. An Urban Social Health Activist (USHA) will be posted for every 200-500 households, and a Mahila Arogya Samiti (MAS) will be established for every 50-100 households. The MAS will be provided an annual united grant of Rs 5,000 per year.

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Categories: Public Health
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