Scheme expected to bring the urban poor within its purview
The Centre is in the process of finalising the National Urban Health Mission (NUHM) to provide better healthcare facilities to urban slumdwellers. The ambitious Rs.33,000-crore scheme is expected to bring within its purview domestic helps, vegetable vendors, vulnerable populations such as migrants, rag-pickers and street children.
The Mission, aimed to “correct structural imbalances” in the public health system in urban areas, including that of infrastructure and human resource, will focus on urban slumdwellers who get the benefit of neither routine immunisation nor programmes to control vector-borne diseases like malaria, dengue and tuberculosis. Reproductive and child health will also be brought under the Mission. It will cover all cities with a population of more than one lakh.
According to the 2001 census, almost 4.26 crore people lived in slums in 640 cities and towns having a population of 50,000 and more. In the cities with a population of one lakh and above, a 3.73-crore slum population was expected to reach 6.25 crore by 2008, putting greater strain on infrastructure.
However, despite proximity to facilities, access to healthcare is severely restricted for the urban poor due to the inadequacy of public health delivery system and lack of resources.
The under-five mortality among the urban poor is 72.7, significantly higher than the urban average of 51.9.
Several health indicators among the urban poor are worse than those in the rural areas. More than 46 per cent of the urban poor children are underweight and almost 60 per cent are left out of the immunisation net. Once in place, the seven-year NUHM will seek to reduce the infant mortality rate to 30 per 1,000 live births and maternal mortality rate to 100 per 1,00,000 live births by 2015.
The Mission will have four components — outreach services, primary urban health centres, referral services and emergency medical services. The plan is to have one outreach session in every slum every month and setting up 4,214 public urban health centres. The government is also looking at the possibility of providing individual health security cards for individuals or a family.
Other diseases, which the Mission intends to target, are malaria, kala-azar, dengue, filaria, cataract, leprosy and tuberculosis. Each municipal corporation, municipality and notified area committee will be a unit of planning under the Mission.
While for the first two years the Centre and the State will share the burden in the ratio of 85:15, from the third year (2012-13) onwards, urban local bodies will have to share 10 per cent of the cost, as per the draft.