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HUP Newsletter Urban Health Observer January 2012 |
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HUP Newsletter
URBAN HEALTH OBSERVER
VOL.-1, JANUARY 2012
Flagship Program on Urban Health ……..Striving to make a difference in lives of urban poor
Our newsletter “Urban Health Observer” is an attempt
to bring to you information on the key initiatives and
challenges on Urban Health in India and highlight the
Health of the Urban Poor (HUP) Program’s role in
addressing those challenges and supporting the
government’s initiatives on the Urban Health issues in
the country.
HUP has been working very closely with the Ministry
of Health and Family Welfare, Govt. of India on
creating a favorable policy environment on Urban
Health and securing long term commitment for
improving the health status of the urban poor.
We hope this newsletter would be a useful tool to
share the strategies, initiatives, innovations and
achievements of HUP Program in the arena of Urban
Health. This newsletter will be a monthly publication.
We hope you will enjoy reading it.
From the HUP team
In this edition:
About HUP Program
Growing Urbanization in India- Are we ready for
the challenge?
Consultation Workshop on NUHM- A big stride
Highlights of GOI efforts on Urban Health
USAID-Investing in Urban Health
since 2002
HUP-The journey so far
Dear Readers,
It gives me immense pleasure to present the first edition of
Health of the Urban Poor (HUP) Newsletter. This newsletter has
been put together by HUP team and I take this opportunity to
congratulate them. The HUP program started in October 2009
and Population Foundation of India is proud to have been
selected as the primary recipient with the support of consortium
partners. The HUP program has been approved by the Ministry
of Health & Family Welfare and provides technical assistance to
Empowered Action Group (EAG) states in the area of Urban
Health and health determinants. HUP also implements City
Demonstration Projects in 5 cities across India. HUP has
developed as a comprehensive project in Urban Health and is
positioned around the proposed National Urban Health
Mission in general and Urban Health in particular.
This issue of the news letter gives an account of some of the work
that HUP has been doing. I am sharing HUP’s work with you
and invite you to critique our work and provide your valuable
suggestions. Please do write in any way or feel free to contact us.
Here’s wishing the HUP Team a very great future ahead.
Poonam Muttreja
Executive Director
Population Foundation of India
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HUP Newsletter
URBAN HEALTH OBSERVER Flagship
Program
on
Urban
Health
……..Striving
to
make
a
difference
in
VOL.-1, JANUARY 2012
lives of urban poor
Health of the Urban Poor (HUP) Program
Objective 1
Provide quality
technical
assistance to the
GoI, states and
cities for
effective
implementation
of the National
Urban Health
Mission (NUHM)
Objective 2
Expand
partnerships in
Urban Health
including
engaging the
commercial
sector in PPP
activities
Objective 3
Promote the
convergence of
different GoI
Urban Health
and
development
efforts
Objective 4
Strengthen
urban planning
initiatives by the
state through
evidence-based
city-level
demonstration
and learning
efforts
Improved Health Status of the Urban Poor
About HUP Program:
Vision:
A responsive, functional, and sustainable health
system that provides need based, affordable and
accessible quality health care, improved water,
sanitation and hygiene for urban poor in eight states.
Jaipur
Delhi
Agra
Pune
Bhubaneswar
States:
Bihar
Chhattisgarh
Jharkhand
Madhya Pradesh
Odisha
Rajasthan
Uttar Pradesh
Uttarakhand
Growing Urbanization in India: Are we ready for the
challenge?
Goal:
To improve the health status of the urban poor in the
urban locations by adopting effective and efficient
sustainable strategic intervention approaches
adopting the principle of convergence of the various
development programs.
Geographical Spread:
Eight States: Madhya Pradesh, Chhattisgarh,
Rajasthan, Bihar, Jharkhand, Uttar Pradesh,
Uttarakhand and Odisha.
Five Cities: Jaipur, Pune, Bhubaneswar, Delhi and Agra
Consortium Partners:
Prime: Population Foundation of India,
Sub-recipients: Plan-India (www.planindia.org),
IIHMR-Jaipur (www.iihmr.org) and Bhoruka Charitable
Trust (www.bctngo.org)
Technical Support: Care-India (www.careindia.org),
CEDPA (www.cedpaindia.org), Micro Insurance
Academy (www.mia.org) and IIPS-Mumbai
(www.iipsindia.org)
Key Stakeholders:
National Level: Ministry of Health and Family Welfare
(MoHFW), Ministry of Housing and Urban Poverty
Alleviation (MoHUPA), Ministry of Urban Development
(MoUD), Ministry of Women and Child Development (WCD)
State Level: Department of Health and Family Welfare
(DoHFW), Department of Women Child Development
(WCD), Public Health Engineering Department (PHED),
Department of Housing and Urban Development (DHUD)
City Level: Urban Local Bodies (ULBs)
India has been witnessing rapid urbanization in the
recent decades. Share of urban population in India has
grown from 17.3% in 1951 to 31.2% in 2011.
As per Census 2011, around 358 million people live in
urban areas of the country, which is expected to rise to
535 million by 2026. Urban growth has led to rapid
increase in number of urban poor population, which
rose from 18.7 % of the total urban population in 1973-
74 to 26.8 % in 2004-05 (as per Ministry of Housing &
Urban Poverty Alleviation, Government of India);
many of whom live in slums and other squatter
settlements. Also, 41% of the urban poor are
concentrated in the eight poorer states in India (known
as EAG – Empowered Action Group states).
In order to tackle the urban infrastructure and
governance issues, the Govt. of India launched the
Jawahar Lal Nehru Urban Renewal Mission (JnNURM)
in the year 2005, but in order to effectively address the
health concerns of the urban poor population, the
National Urban Health Mission (NUHM) has been long
awaited. National Rural Health Mission (NRHM) has
improved the health care infrastructure and the health
status of the rural population but the urban areas still
continue to be neglected because of limited resource
allocation under Urban RCH component of NRHM.
With Govt. of India’s vision of entitlement of every
citizen to essential primary, secondary and tertiary
health care services, a lot needs to be done for the
urban poor and vulnerable sections whose health care
indicators are worse than the rural population. So, as of
now the vision of “Universal Health Coverage by
2022”seems to be a distant dream.
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HUP Newsletter
URBAN HEALTH OBSERVER Urbanization
in
India
Flagship Program
1951-2026
on
Urban
Health
……..Striving
to
make
a
difference
in
VOL.-1, JANUARY 2012
lives of urban poor
600
100
535
90
500
433
80
70
358
400
60
285
50
300
38.2
40
32.3
23.3
25.7
27.8
30.0
30
100
17.3
18.0
19.9
20
10
0
1951
1961
1971
1981
1991
2001
2011
2021
0
2026
India has been urbanizing rapidly in recent decades. It is estimated that the urban poplation will nearly double to reach 535 mission by 2026
Source: Technical group on Population Projection, RGI, 2006
Consultation Workshop on National Urban Health Mission- A big stride:
A day long workshop was jointly organized by the Ministries of Govt. of India (a) Health and Family Welfare, (b)
Urban Development and (c) Housing and Urban Poverty Alleviation on 23rd July 2010 in Delhi for consultation on
the proposed NUHM and possible convergence points amongst the JNNURM and proposed NUHM for the
improvement amongst the urban poor and decipher scopes and challenges to address it. The consultation was
attended by key personnel of all three ministries –Ms. K Sujatha Rao, Secretary, MoHFW, Ms. Kiran Dhingra,
Secretary, MoHUPA, Sh. P.K. Pradhan, AS & MD (NRHM), MoHFW, Sh. P K Mohanty, AS & MD (JNNURM), MoHUPA.
The meeting was facilitated by Shri Amarjeet Sinha, Joint Secretary, MoHFW and was supported by HUP Program,
which was the secretariat for the workshop. The workshop provided immensely rich inputs into the proposed
NUHM, both in terms of identifying relevant issues to be addressed as well as best practices that could be
incorporated into NUHM framework for better program implementation. Some of the key recommendations
included- Integration of efforts of Health and Urban Development Departments, need to address non- health
determinants like water and sanitation, role of public-private partnerships in improving reach of services to the
vulnerable population, enhancing community participation and building capacity of Govt. frontline health workers.
Highlights of GOI Efforts on Urban Health:
Supporting public (health) infrastructure in urban
areas:
This supports public health facilities mainly in larger
and metropolitan cities, which includes 1,083 Family
Welfare Centers; 871 Health Posts; 479 Urban Health
Posts; 85 Maternity Homes and 244 Sub Centers.
Supporting primary health care in urban areas,
especially in smaller cities and district headquarters
(Urban RCH program)
Recruitment and training of link workers in urban
slums
Strengthening of Urban Health Posts/Centers
Service provisioning through health posts/centers
in outreach/camp mode
PPP initiatives in urban areas
Public health initiatives in urban areas (Urban
Malaria scheme)
This includes vector control measures using
Temephos, Bti (WP and 12 AS), biological control, and
spraying of pyrethrum extract in and around every
malaria and dengue positive household.
National Urban Health Mission
The Government of India has announced its intention
to launch a national program focusing on Urban
Health in the 12th Five-Year Plan period. It would
include 779 cities each covering more than 50,000
population, with provisions for a Urban Primary
Health Center for every 50,000 population; a link
worker for every 200-500 households; and women’s
health groups for every 50-100 households.
USAID - Investing in Urban Health since 2002:
USAID India’s Vision for Urban Health:
Health system in India capacitated to deliver health
impact in priority areas.
Strategy:
USAID’s strategy to address the urban poor health
challenges is to build capacity of Indian institutions
through the provision of technical assistance to work
with city, state and national governments to
understand the issues and develop plans to solve the
problems. Another important facet of the strategy is
to leverage considerable government resources.
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HUP Newsletter
URBAN HEALTH OBSERVER PhaseI(2002
– 2004):
Flagship Program on Urban
Environmental Health Program
Health
……..Striving
to
make
a
difference
in
VOL.-1, JANUARY 2012
lives of urban poor
Formative stage
Focus was on identification and realization of Urban Shifting focus on Urban Health issues by creating
Health issues and challenges
evidences
Phase II (2005 - 2009): Extended Urban Health
Program
Process of Urban Health Planning defined and
shared with various stakeholders including Govt.
Phase III (2009 – 2013): Health of the Urban Poor
(HUP) Program
System strengthening
Advocacy for greater resource leverage
HUP-The journey so far:
Technical Assistance:
HUP facilitated convergence efforts among three different ministries- Ministry of Health and Family Welfare
(MOHFW), Ministry of Housing and Urban Poverty Alleviation (MOHUPA) and Ministry of Urban Development
(MOUD) through national consultation workshop held on 23rd July, 2010 for the proposed NUHM.
Facilitated strategic discussion on community engagement process under proposed NUHM on 16th November,
2010.
State Program Implementation Plans (PIPs) 2011-12 for all 35 states and UTs were reviewed by HUP to strengthen
the Urban RCH component.
Strategic shift (from ULB centered approach to Health Dept. centered approach) has been reflected in the NUHM
implementation framework after the consultation workshop organised by HUP at Lucknow on 1st April ,2011.
HUP has been a part of the Working Group for formulation of Implementation Framework and Expenditure
Finance Committee (EFC) note on National Urban Health Mission under the leadership of Joint Secretary (Policy).
Public Private Partnerships:
HUP program conducted a study of existing PPP models in Urban Health. The study findings throw light on the
systems and processes that work as enablers for successful implementation of PPP models.
Opportunities for leveraging resources from the corporate and private sector being explored.
Convergence:
In a follow up of the consultation workshop at the national level, HUP Odisha also facilitated convergence among
the three key departments in the state wherein a roadmap was developed for improving health of the urban poor
population in the state.
City Demonstration:
Demonstration sites set up in 5 cities covering around 5.6 lakh slum population to experiment the approaches of
the proposed NUHM with the help of 11 implementing partner NGOs.
City Maps which would be useful as planning tools prepared.
Baseline survey completed in 3 cities- Pune, Jaipur and Bhubaneswar.
Disease Burden study conducted in Pune, Jaipur and Bhubaneswar to understand the treatment seeking
behavior and generate information on community risk pooling/ health insurance.
For more information please contact
Health of the Urban Poor (HUP) Program
Population Foundation of India | B-28, Qutab Institutional Area, New Delhi-110016 | Tel: 91-11-43894166, Fax: 91-11-43894199
E-mal: info_hup@populationfoundation.in | website at www.populationfoundation.in
Disclaimer: This newsletter is made possible by the support of the American people through the United States Agency for International Development (USAID).
The contents are the responsibility of Population Foundation of India and do not necessarily reflect the views of USAID or the United States Government.