India is witnessing rapid urbanization. As per the 2001 Census, 28.53% of the population resided in urban areas, and by 2011 Census, the figure had reached 31.16%. UNFPA estimates that by 2030, 40.76% of country's population will be urban. Unprepared for such rapid growth, the cities lack infrastructure and basic services. Nearly one-third of urban inhabitants are living in slums or slum-like conditions. NFHS-3 (2005-06) figures highlighted that nearly 100,000 babies in Indian slums die every year before their fifth birthday. Poor access to healthcare, poor nutrition and health-seeking behaviour, poor environmental conditions and high prevalence of infectious diseases contribute to the high maternal and child morbidity and mortality among the urban poor.
Our efforts in urban health
PFI entered into a partnership with USAID India in October 2009 to start a comprehensive Health of the Urban Poor (HUP) program. The program envisages the development of a responsive, functional and sustainable urban health system that provides need-based, affordable and accessible quality healthcare and improved sanitation and hygiene for the urban poor. The Government of India has formally recognized PFI-HUP as a partner for providing support to the national and state governments in NUHM implementation.
The program was initiated in eight states - Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Odisha, Rajasthan, Uttarakhand and Uttar Pradesh, and five cities - Agra, Bhubaneswar, Delhi, Jaipur and Pune. Informed by its experience and learning, the program has now scaled up its support to the state governments and urban local bodies in 20 cities for implementing the National Urban Health Mission.
The Objectives of Health of the Urban Poor program
- Provide quality technical assistance to the GOI, states and cities for effective implementation of the NUHM
City demonstration programme
The HUP city demonstration programme develops, tests, and demonstrates strategies and intervention models for urban health. This creates evidence and scope for scale-up and replication in other cities. The HUP program has developed an Urban Health Model consisting of five approaches to provide easy and equitable access to health care, facilitated by community involvement, guided by a systematic plan, coordinated by local authorities and monitored regularly.
Urban Health Model - the five approaches
HUP’s intervention at the state level involves collaboration with the departments of Health and Family Welfare, Women & Child Development, Housing & Urban Development, Public Health Engineering Department and Urban Local Bodies. It provides technical assistance in health systems strengthening, evidence based planning, convergence, public private partnerships, promotion of water, sanitation and hygiene (WASH) and strengthening the management information system.
At national level, HUP provides support to the Ministry of Health and Family Welafe in planning, review of state programme implementation plans and developing frameworks and policies for urban health. The support includes strengthening capacities, development of training modules, guidelines, and planning, monitoring and research tools. HUP state offices are evolving as technical assistance units and the city demonstration sites are being used for learning by implementers and decision makers. HUP has successfully demonstrated convergence and partnerships with the private sector for urban health.
For more: Health of the Urban Poor website