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Urbanization and health challenges: need to fast track launch of the national urban health mission.

Yadav K, Nikhil S, Pandav CS - Indian J Community Med (2011)

View Article: PubMed Central - PubMed

Affiliation: Centre for Community Medicine, Old OT Block, AIIMS, New Delhi, India.

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The urban population growth in India represents the 2-3-4-5 syndrome: in the last decade India grew at an average annual growth rate of two percent, urban India grew at three percent, mega cities at four percent, and the slum population rose by five to six percent... When it comes to the history of urban civilization, let us for a moment go back in time to 6000 years ago, to the ancient urban civilization of India — the Indus valley Civilization and the cities of Mohenjo-Daro and Harappa... The existing capacity of the sewerage system in Delhi is grossly inadequate, as only about 55 percent of the population is covered under an organized sewerage system and about 15 percent under on-site sanitation systems... The rest of the population does not have proper access to sanitation facilities... A re-analysis of the third National Family Health Survey showed that one in 10 children born in the slums did not live to see their fifth birthday; only 40 percent of the slum children received all the recommended vaccinations; of the 2.25 million births each year among the urban poor, more than half were at home; 54 percent of the children under five years were stunted; and 47 per cent were underweight... One in ten children in slums did not live to see their fifth birthday... As per NFHS 3, 24 percent of the urban women are overweight / obese as compared to only seven percent of the women in rural areas... The public sector urban health delivery system, especially for the poor, has so far been sporadic, far from adequate, and limited in its reach Although urban areas have a greater number of doctors per a thousand population as compared to rural areas (80 percent of the doctors serve in urban areas) and do not face the transport bottleneck as compared to rural areas, yet doctors are functionally inaccessible to a majority of the urban poor population... The National Urban Health Mission (NUHM) was the much awaited initiative, ensuring quality health care to the urban poor, but it has become a casualty of bureaucratic logjam and inter-ministry turf issues... The NUHM aimed to improve the health status of the urban poor, particularly the slum dwellers and the other disadvantaged sections, by facilitating equitable access to quality health care through a revamped public health system... To start with, 300 medical colleges can be entrusted with running these mobile health vans, with Departments of Community Medicine as the focal points... Such a step will benefit both stakeholders... The urban slum population will benefit by getting access to quality health care facilities at their door step, and the medical colleges will get an excellent avenue to train medical students and nursing students in the unique setting of urban slums... The urban environment overlays the natural environment, raising issues of sustainable use and protection of land, water, air, and soil... The management of this human-natural interface has a significant effect on the health of urban dwellers.

No MeSH data available.


Summary of study carried out by centre for community medicine titled
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Mentions: The public sector urban health delivery system, especially for the poor, has so far been sporadic, far from adequate, and limited in its reach Although urban areas have a greater number of doctors per a thousand population as compared to rural areas (80 percent of the doctors serve in urban areas) and do not face the transport bottleneck as compared to rural areas, yet doctors are functionally inaccessible to a majority of the urban poor population.(12) Cost, timings, distance, attitude of health providers, and other factors put the secondary care and private sector facilities out of reach of most of the poor urban residents. When the urban poor access private facilities, the significant cost incurred leads to severe debt. Other factors contributing to the inadequate reach of services are illegality, social exclusion of slums, hidden slum pockets, weak social fabric, lack of coordination among various stakeholders, and neglected political consciousness. All the above-mentioned factors lead to a rapid proliferation of what is called an ‘informal private health sector’ in urban slums. This sector is dominated by practitioners who are either untrained in any system of medicine or trained in one system and practice another or those who are less than qualified. The findings of a study conducted by the Center for Community Medicine, All India Institute of Medical Sciences, on the role of private practitioners in urban slums, highlights the grim picture.(13) (Excerpts in Box 1). With the exponential growth of population, there is pressure on an already unresponsive public sector. Moreover, the undeterred growth of the private sector without appropriate regulations means that the poor and the vulnerable are rendered even more vulnerable. Choices that the urban poor make for health care have implications not only for the individuals treated, but also for disease transmission and the development of drug resistance. With recent outbreaks of dengue, Chikungunya, and HINI influenza one cannot and should not ignore the public health challenges of the dismal health status of the urban poor. For these communicable diseases, all the population is at risk, irrespective of the socioeconomic status.


Urbanization and health challenges: need to fast track launch of the national urban health mission.

Yadav K, Nikhil S, Pandav CS - Indian J Community Med (2011)

Summary of study carried out by centre for community medicine titled
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3104700&req=5

B1: Summary of study carried out by centre for community medicine titled
Mentions: The public sector urban health delivery system, especially for the poor, has so far been sporadic, far from adequate, and limited in its reach Although urban areas have a greater number of doctors per a thousand population as compared to rural areas (80 percent of the doctors serve in urban areas) and do not face the transport bottleneck as compared to rural areas, yet doctors are functionally inaccessible to a majority of the urban poor population.(12) Cost, timings, distance, attitude of health providers, and other factors put the secondary care and private sector facilities out of reach of most of the poor urban residents. When the urban poor access private facilities, the significant cost incurred leads to severe debt. Other factors contributing to the inadequate reach of services are illegality, social exclusion of slums, hidden slum pockets, weak social fabric, lack of coordination among various stakeholders, and neglected political consciousness. All the above-mentioned factors lead to a rapid proliferation of what is called an ‘informal private health sector’ in urban slums. This sector is dominated by practitioners who are either untrained in any system of medicine or trained in one system and practice another or those who are less than qualified. The findings of a study conducted by the Center for Community Medicine, All India Institute of Medical Sciences, on the role of private practitioners in urban slums, highlights the grim picture.(13) (Excerpts in Box 1). With the exponential growth of population, there is pressure on an already unresponsive public sector. Moreover, the undeterred growth of the private sector without appropriate regulations means that the poor and the vulnerable are rendered even more vulnerable. Choices that the urban poor make for health care have implications not only for the individuals treated, but also for disease transmission and the development of drug resistance. With recent outbreaks of dengue, Chikungunya, and HINI influenza one cannot and should not ignore the public health challenges of the dismal health status of the urban poor. For these communicable diseases, all the population is at risk, irrespective of the socioeconomic status.

View Article: PubMed Central - PubMed

Affiliation: Centre for Community Medicine, Old OT Block, AIIMS, New Delhi, India.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

The urban population growth in India represents the 2-3-4-5 syndrome: in the last decade India grew at an average annual growth rate of two percent, urban India grew at three percent, mega cities at four percent, and the slum population rose by five to six percent... When it comes to the history of urban civilization, let us for a moment go back in time to 6000 years ago, to the ancient urban civilization of India — the Indus valley Civilization and the cities of Mohenjo-Daro and Harappa... The existing capacity of the sewerage system in Delhi is grossly inadequate, as only about 55 percent of the population is covered under an organized sewerage system and about 15 percent under on-site sanitation systems... The rest of the population does not have proper access to sanitation facilities... A re-analysis of the third National Family Health Survey showed that one in 10 children born in the slums did not live to see their fifth birthday; only 40 percent of the slum children received all the recommended vaccinations; of the 2.25 million births each year among the urban poor, more than half were at home; 54 percent of the children under five years were stunted; and 47 per cent were underweight... One in ten children in slums did not live to see their fifth birthday... As per NFHS 3, 24 percent of the urban women are overweight / obese as compared to only seven percent of the women in rural areas... The public sector urban health delivery system, especially for the poor, has so far been sporadic, far from adequate, and limited in its reach Although urban areas have a greater number of doctors per a thousand population as compared to rural areas (80 percent of the doctors serve in urban areas) and do not face the transport bottleneck as compared to rural areas, yet doctors are functionally inaccessible to a majority of the urban poor population... The National Urban Health Mission (NUHM) was the much awaited initiative, ensuring quality health care to the urban poor, but it has become a casualty of bureaucratic logjam and inter-ministry turf issues... The NUHM aimed to improve the health status of the urban poor, particularly the slum dwellers and the other disadvantaged sections, by facilitating equitable access to quality health care through a revamped public health system... To start with, 300 medical colleges can be entrusted with running these mobile health vans, with Departments of Community Medicine as the focal points... Such a step will benefit both stakeholders... The urban slum population will benefit by getting access to quality health care facilities at their door step, and the medical colleges will get an excellent avenue to train medical students and nursing students in the unique setting of urban slums... The urban environment overlays the natural environment, raising issues of sustainable use and protection of land, water, air, and soil... The management of this human-natural interface has a significant effect on the health of urban dwellers.

No MeSH data available.