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Urban health gets a look-in

Special Correspondent
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NUHM to ensure basic amenities such as safe water, sanitation for better health

Key issues of urbanisation, including poor sanitation and lack of safe drinking water, will get increased focus under the new National Urban Health Mission (NUHM), which will be rolled out in the State soon.

The first phase of NUHM will be implemented in five Corporations — Thiruvananthapuram, Kochi, Kollam, Thrissur and Kozhikode — and the 10 municipalities of Neyyattinkara, Alappuzha, Pathanamthitta, Kottayam, Thodupuzha, Manjeri, Palakkad, Kannur, Kasaragod, and Kalpetta.

In Kerala, an estimated 47.7 per cent people live in urban areas. Slum population constitutes about three per cent of the urban population. An estimated five lakh people live in urban slums.

Urban PHCs

NUHM will have an entirely new structure.

The Health Department will be working with the departments of Urban Affairs, Social Justice, and Local Self Government, with municipal bodies playing a key and complementary role at the city level.

Lack of basic amenities such as safe water and sanitation, socio-economic issues, influx of migrant labourers, and a high density of population are at the heart of health issues in urban areas.

Poor utilisation

“A prime problem is the poor utilisation of public health care services, either due to their unavailability or because most of the pubic sector facilities are either secondary/tertiary or speciality services,” Health officials told The Hindu.

“We have proposed a revival of primary health care services in urban areas through the opening of 54 new urban primary health centres (UPHCs) with evening out-patient clinics,” Health officials added.

12 UPHCs

There will be one PHC for 50-60,000 of the population with two doctors and one junior public health nurse per 10,000 population. Thiruvananthapuram Corporation will thus get 12 new urban PHCs under NUHM.

“There will be renewed focus on urban immunisation. There will be fixed-day immunisation clinics in UPHCs, outreach camps, and follow-up to ensure that children complete the immunisation schedule. This has become essential because of the influx of migrant families,” the official said.

Migrant workers

The presence of around 25 lakh migrant workers across major cities in the State has been posing problems for the Health department.

Screening of migrant workers in urban areas, and providing them with health cards are being planned because most migrant women and children require interventions in nutrition, ante-natal care, and immunisation.

Adolescent health

Adolescent health and gender issues will be another focus area under NUHM, as the socio-economic situations in urban slums often fuel issues of gender violence, discrimination, and adolescent abuse. Ward health committees will work closely with school teachers and counsellors in urban areas.

The launch of NUHM will see the induction of the Mayor, Municipal chairperson, Corporation Secretary and Health Standing Committee chairperson into the District Health Societies.

Plan and funds

“We had already submitted the Programme Implementation Plan (PIP) for National Rural Helath Mission for 2013-14 by the time NUHM had been announced by the Health Ministry.

Thus we had to prepare a fresh PIP for NUHM for the next six months, ending in March 2014. From this year, the urban health mission will be a sub-mission under the National Health Mission,” a senior Health official said.

Kerala’s PIP for NUHM had been for Rs.57.11 crore. The Union Health Ministry has sanctioned around Rs.25 crore, considering the fact that effectively, this PIP is ending in March this year. With the ministry yet to launch NUHM formally, it remains to be seen whether the State will get an opportunity to utilise this allocation by March.

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