Urban Health Program of India : Progress , Issues and Challenges

The urban population of Indian sub-continent will reach to 880 million by 2025, of which India will experience a phenomenal growth. Indian slum population has already touched 17.4% of total urban population. The inadequacy of... [ view full abstract ]

The urban population of Indian sub-continent will reach to 880 million by 2025, of which India will experience a phenomenal growth. Indian slum population has already touched 17.4% of total urban population. The inadequacy of basic services including health, is a major public health challenge for its city population, particularly the disadvantaged sections who live in slums and other vulnerable pockets. Keeping in mind the current need and future demand, the government of India has introduced the National Urban Health Mission (NUHM-2013). This path-breaking system strengthening program focuses on reaching out to the urban poor and marginalized by facilitating uniform and equitable access to quality healthcare services with the active involvement of the Urban Local Bodies (ULBs).

The components of NUHM are community engagement, capacity building, addressing health and health determinants, innovations, information technology (IT) enabled surveillance, behavior change communication and convergence. The program is intending to cover all cities of India with 50 thousand and above population.

On 1st May 2016, the NUHM program will be completing 3rd year of program implementation with a very mixed response and a varied pace. The program is still facing initial roll out issues such as slow progress of planning, delay in recruitment of all kind of cadres specially front line workers. The institutional arrangements are not fully functional across the states so as different program management units placed at state, districts or the city level to oversee the implementation activities. Till date the total expenditure of NUHM budget is just 32% of the total budget.

The current paper critically examines various aspects of the NUHM components, its progress and factors, both proximal and distal which are slowing down the pace of the implementation against the backdrop of system, process, and policy and planning.

Key Words: Governance; Urban Health Policy