Urban health has become one of the most important health concerns of the ensuing decade, across India and internationally, due to the high pace of urbanisation. Along with the severity, the urban health care system in India needs special attention.
It is well acknowledged that urban inhabitants are more vulnerable. It is especially slum dwellers who are poorer than average. They have unstable finances and are more likely to fall into poverty due to medical expenses. The urban poor are more susceptible than those living in the countryside since.
They live and work in a harsh and dangerous metropolitan environment. Sometimes they stay as ‘illegal’ inhabitants of the urban realm. The disaggregated statistics for urban poor paint a bleaker image than for rural regions. Here we mentioned the facts shared by experts analysing the history and current state of urban health resource centres.
The policies of the urban health system
Urban regions were supposed to receive more than three-fourths of the funding for medical care throughout the initial years of the Five-year Plan. But the emphasis remained on curative services and disregarded preventive, primitive, and rehabilitative health services. The bulk of beds and other facilities are in cities under the Second Five-Year Plan.
The government recognized in the Fifth Plan that the rural sectors had suffered while the urban healthcare structure had grown. The Alma Ata Declaration significantly impacted the Sixth Plan, which advocated a community-based approach to addressing population healthcare needs.
Cities were developing industrially to witness the creation of shantytowns and slums that were home to villagers who had migrated to cities in pursuit of better possibilities. The concern for urban healthcare is the lack of urban health resource centres and total reliance on tertiary and secondary treatments, even for minor diseases.
It identified the necessity of improving urban health indicators by offering primary healthcare services, particularly in slums, where they were worse than in many rural and tribal areas of India. Healthcare systems then started offering referral links at higher levels. This was especially important in slums, where the situations were worse than in many other urban and rural areas of India.
The infrastructure of the urban healthcare system
There are now 871 health posts spread over several states and UTs, and many are not operating very efficiently. Urban Local Bodies are playing a significant role by establishing dispensaries or Health Centres to support the health department’s efforts in delivering basic healthcare services to the urban people. But most of this initiative’s participants are bigger Municipal Corporations in major cities.
As part of IPP V, 479 UPHCs, 85 Nursing Homes, and 244 sub-centres were built in Mumbai and Chennai with funding from the World Bank. As part of IPP VIII, comparable medical facilities were built in Delhi, Bengaluru, Hyderabad, and Kolkata. Thus, the India Population Project developed urban health facilities in major cities. Although the projects have ended, municipal organisations and governments continue to use the infrastructure to provide health services.
The Role of NGOs
Community-based organisations and non-government organisations (NGOs) have provided contributions by providing direct services, empowering local communities, raising awareness of health issues, and advocating with the government because the government’s efforts to address urban health needs are insufficient.
Current challenges in the urban health systems
While infectious illnesses like tuberculosis (TB), malaria, and dengue continue to spread unabatedly, the frequency of non-communicable diseases is rising, placing a double burden of morbidity on the urban population. As a result, urban health systems must cover a wide range of health requirements of the urban poor, including those caused by infectious illnesses, non-communicable illnesses, pregnancy and RCH needs. It should also cover other urban-specific health burdens, including mental health, traffic accidents, and injuries.
People who live in metropolitan settings are also significantly more vulnerable to natural and man-made calamities. This includes floods, internal migration and displacement, occupational illnesses, and diseases linked to air pollution. To appropriately treat such a vast spectrum of health demands, a wide variety of human, material, and financial resources are required.
States must be flexible and innovative in their design of the urban health care system in India to successfully implement the better healthcare Mission. The unique health requirements of the at-risk populations should also accompany this.
Urban healthcare is a difficult area of health promotion that requires unconventional thinking. Apart from implementation and administrative difficulties, the hardest thing is that the vast majority of illnesses are brought on by ailments that fall beyond the scope of the healthcare system. While the medical department has to keep experimenting and adopting new ideas, other social policy areas also require significant improvements.