The recent report released by Azim Premji University, in collaboration with 17 regional NGOs across India, highlights the disparity in life expectancy between the poorest and the richest in urban areas. The study found a difference of 9.1 years for men and 6.2 years for women among the lowest and highest income groups.
Exploring Health Inequalities in Urban India
The report investigates health vulnerabilities and disparities in Indian cities, examining factors such as the availability, accessibility, and cost of healthcare facilities. It also looks into future-proofing services over the next ten years. Figures from the report reveal that one-third of India’s population is now urbanized, seeing a steep upturn from 18% in 1960 to 34% in 2019. Around 30% of people living in these urban areas are poor.
Challenges of Urban Health Governance
Findings from the study illustrate a chaotic picture of urban health governance, with a lack of coordination among a myriad of healthcare providers both within and outside government sectors. This chaos places a disproportionate disease burden on impoverished individuals and families, creating significant challenges to the governance of urban health.
The Financial Impact on Low-Income Groups
Low income residents in urban areas experience a substantial financial burden and limited investment in healthcare by urban local bodies. The report stresses the importance of policy measures to alleviate this financial burden and suggests strengthening community participation and governance as potential solutions.
Suggested Measures
The report proposes building comprehensive and dynamic databases to monitor the health and nutrition status of vulnerable populations, including those with co-morbidities. It emphasizes the need for improvements in healthcare provision via the National Urban Health Mission, particularly for primary healthcare services. Additionally, it recommends better mechanisms to coordinate public healthcare services and improve governance of private healthcare institutions.
India’s Healthcare System: A Snapshot
India’s healthcare system, currently battling an array of issues including a shortage of institutions and inadequate human resources, operates under a three-tier structure. Primary, secondary, and tertiary care services form this system’s backbone. While all three levels need attention, the report underlines the necessity for targeted efforts to bolster primary health care.
Public Health Sector Initiatives
The National Health Mission (NHM) provides Emergency Response and Health Systems Preparedness Packages, offering technical and financial support to States/UTs to enhance the public healthcare system. The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY), launched on 23rd September 2018, is the world’s largest government-funded health assurance/insurance scheme. The Pradhan Mantri Swasthya Suraksha Yojana (PMSSY), initiated in 2003, aims to correct regional imbalances in the provision of affordable/reliable tertiary healthcare services and augment quality medical education facilities.
The Covid-19 pandemic has underscored the importance of a robust and adequately resourced healthcare system. Addressing these challenges now will provide significant benefits to the most vulnerable and ensure critical services are accessible to urban dwellers across all income groups.