Situation Analysis on Urban Health Equity in Nepal

Background Since 2007 majority of population in the world today lives in urban areas. By 2030 six out of every ten people will be city dwellers and which is predicted to grow seven out of every ten people by the year 2050. The... [ view full abstract ]

Background
Since 2007 majority of population in the world today lives in urban areas. By 2030 six out of every ten people will be city dwellers and which is predicted to grow seven out of every ten people by the year 2050. The common health & social challenges in urban areas include; overcrowding, air pollution, rising level of risk factors, urban life style leading physical inactivity and harmful use of alcohol, tobacco and triple threats by infectious diseases, non communicable diseases and injuries, road traffic accident & violence.
Nepal
More than 17% people of the live in urban area, which is predicted to grow 50% of total population by the year 2035. The urban poor comprise 25% of the total urban population in which the slum population is 61.% and squatters are 7%. Total Fertility Rate in urban among women from the lowest wealth quintile 4.7 compared to women from the highest wealth quintile 1.3. The median age of marriage among women in the 20 - 49 years age group in the lowest wealth quintile found 17 years. Only 18% of women from the lowest wealth quintile received antenatal care against 84 % from the overall urban population.
The urban poor are not getting health services due to low priority. The roles and responsibility of the stakeholders is unclear and has not owned quality essential health care service to urban poor. Increasing burden of preventable diseases, changed urban life style and high drop out rates of TB cases are the challenges.
Conclusion
To ensure health and social equity in urban areas needs to develop and strengthen healthy public policy. The roles and responsibilities of key stakeholders should be clearly defined. The quality of services and referral mechanism should be improved along with development of updated Urban Health Management Information System.