TOI : Health scheme for urban poor on the cards : Nov 7,2007

Mumbai: Your housemaid or the neighbourhood dhobi may soon have a tailor-made health scheme for their needs. Titled the National Urban Health Mission, it is the city-equivalent of the village-centric National Rural Health Mission, the pet project of Union health minister Anbumani Ramadoss.

    “The NRHM was launched on April 12, 2005, but it did not include the urban poor. It was only in June that a task force was set up to study the feasibility of the National Urban Health Mission,’’ said Nandita Kapadia-Kundu, additional director of the IHMP (Institute of Health Management, Pachod), who was a member of the task force.

    Unfortunately, the draft policy submitted to the Centre six

months ago has still not come up for consideration.

    There is no denying a need for an urban health mission. According to Delhi-based Sidharth Agarwal, whose Urban Health Resource Centre has been advocating for the urban mission, “There are 100 million urban poor in India. Even at a conservative estimate, there are 2 million births every year in these pockets.’’ Statistics show that 1.1 million of these children are born at homes despite the perception that urban centres have enough hospitals. “This underlines the need for doing something for the urban poor,’’ says Agarwal.

    On Tuesday, Kapadia-Kundu unveiled, for the first time, a few salient features of the proposed mission. It envisages an urban ASHA (Accredited Social Health Activists) who would act as a volunteer for a population of 1,500 to 2,000 persons, a focus on health of vulnerable groups such as unauthorised slumdwellers, street children and commercial sex workers and work towards integrating health and health-related departments such as women and child or water and sanitation in cities.

    Health activists, under the aegis of the Jan Swasthya Abhiyan (JSA) on Tuesday, discussed its various highlights, providing suggestions on how to implement the scheme. JSA’s Anant Phadke pointed out that the urban mission should also focus on new diseases such as arthritis, depression, diabetes, etc. “At present, we only have the RCH II (Reproductive and Child Health II) scheme which doesn’t look beyond reproductive health aspects,’’ he said.

    Speakers at the meet, however, admitted that Mumbai’s public health network —starting with health posts and dispensaries leading up to superspeciality hospitals—was comprehensive. “Mumbai seems like a different planet in some aspects of public health, but it is plagued by complaints of staff shortage and inadequate infrastructure,’’ said activists. Refuting the charges, a BMC official said these were “sporadic complaints.’’

    Phadke felt that the urban health mission should have a different approach towards metropolises like Mumbai and Pune as against the non-metro cities of Ahmednagar, Nanded, etc.

    According to Dr P Doke, who is the director general of health services (DGHS), an urban health mission is the need of the hour. In fact, Maharashtra, which has the largest slum population in India, had lobbied for it. “Nearly 42% of our population is urban and it is increasing at a fast rate. The need for an urban mission was felt as the NRHM would otherwise cater to only a small percentage of people in our state,’’ he said.

    VILLAGE WELFARE

    The NRHM was rolled out in the state by health minister Vimal Mundada in 2005. Since then, the state has set up ‘health, sanitation and nutrition committees’ in 24,000 villages, each given a budget of Rs 10,000 per year. These committees are empowered to carry out any health-related activity at the village level, be it buying particular medicines for patients from chemists or paying ambulance charges for emergency patients. They have also set up ‘Rugn Kalyan Samitis’ at nearly 60% of district and sub-district hospitals for support equipment.

Publication:Times of India Mumbai; Date:Nov 7, 2007; Section:Times City; Page Number:11