
Nearly one-third of India’s urban population live in slums, informal settings or sidewalk tents, which are characterised by overcrowding, poor hygiene, sanitation, absence of proper civic services and fuelled by basic health infrastructure and healthcare service delivery.
Main issues that require attention if health services for the urban poor are to be improved and made more accessible are while inadequate health facilities maybe partly responsible for the poor health status of slum dwellers the answer does not lie in simply providing more services. Although it is extremely important to invest in more services like reorienting and sensitising doctors, additional beds in government hospitals, well equipped dispensaries and maternity clinics near slums and settlements inhabited by the poorer sections; focus needs to be on accepting and understanding that although medical facilities for the urban poor are both inadequate and the poor have limited access, the poor can avail of the same in cities that are not available to them in the villages; and a demand for such services must be identified and this demand must be fulfilled keeping in mind the felt needs of the poor.
Optimal urban governance helps the health sector, in promoting and planning for hygienic living conditions; building inclusive cities that are accessible and making cities resilient to emergencies like epidemics. A synergy between the urban local bodies, state and central government is needed to engage on quality research to generate and systematise knowledge to address many existing information gaps.
The inequities of health disaggregated by intra-urban area; the effectiveness of proactive approaches to deal with health inequity in cities; and the importance of involving all citizens in the decisions that affect their habitat and their health is crucial. Also, it is imperative to maintain this momentum of creating clean, green and healthy cities to live in.
Urban health advocates should identify successful models to be shared as menus of policy options and models of good practice. Improvement in public health infrastructure, schemes for reaching out to the urban poor, facilitation of development of community’s negotiation capacity for increasing demand for maternal and child health services and improved access to health care are necessary. It is therefore imperative that urban health receives due attention and is accompanied by coordinated actions from all stakeholders and more importantly, a strong political commitment for addressing the growing problems of the urban poor.










