The report, “Healthcare equity in urban India”, released recently by Azim Premji University, notes the health vulnerabilities and inequalities in cities in India.
GS-II: Social Justice and Governance (Issues related to Poverty)
Dimensions of the Article:
- Highlights of the report on life expectancy of urban poor
- Causes of Urban Poverty
- Issues related to urban poor
- Way forward suggested by the report
Highlights of the report on life expectancy of urban poor
- Life expectancy among the poorest is lower by 9.1 years and 6.2 years among men and women, respectively, compared to the richest in urban areas.
- One-third of India’s people now live in urban areas, with this segment seeing a rapid growth from about 18% (1960) to 28.53% (2001) to 34% (in 2019). Close to 30% of people living in urban areas are poor.
- The report, besides finding disproportionate disease burden on the poor, also pointed to a chaotic urban health governance, where the multiplicity of healthcare providers both within and outside the government without coordination are challenges to urban health governance.
- The other key findings include a heavy financial burden on the poor, and less investment in healthcare by urban local bodies.
Causes of Urban Poverty
- The lack of infrastructure in rural areas, forces inhabitants of these regions to seek out work in India’s mega-cities.
- As more and more people make this migration, the space left to accommodate them becomes less and less.
- Urban development can’t keep up with the growing numbers of informal settlers and leads to an increase in the number of slums.
Lack of investment:
- Urban poverty is a result of the lack of opportunities and skills training for most of the working age population.
- Over the years, a shortage of adequate investment in quality education and basic services like health, sanitation, waste management and skill training has had its consequences.
- It has led to generations of malnourished, uneducated, unaware and unskilled or semi-skilled people who find it difficult to find decent paying jobs.
Lack of infrastructure in villages:
- Due to lack of basic amenities and employment options in villages people migrate to cities.
- Agriculture is barely a lucrative option in villages, so their only job option is to seek out work in the cities’ informal economies.
- Millions migrate to the cities every day to take up informal jobs such as domestic help, taxi driving, construction site work, etc.
- However, this creates overcrowding in the already packed urban infrastructure.
Issues related to urban poor
- Housing Vulnerability: Majority of urban poor generally live in low quality unhygienic areas such as slums. They have no ownership rights and entitlements. As occupants construct on the empty land, the civic body does not provide them basic amenities- therefore they have no access to individual water connection, toilets, electricity, and roads. Also, poor live in unhealthy and insanitary living conditions. According to Census 2011, 17.7% of urban population comprising 65 million people lives in slums.
- Economic Vulnerability: Irregular employment with low wages makes them more vulnerable. This restricts availability of formal credit from banks, they have no access to formal safety net programmes, and productive assets.
- Social Vulnerability: The income inequality creates divergence between lower strata of society i.e. poor and middle class. It increases social differences in education and skill development programmes.
- Personal Vulnerability: At personal level, poor are more vulnerable for getting social justice in their day-to-day work. The poor are victims of all types of injustice and violence. Particularly, low caste people and minority, especially women, children, the elderly, disabled and destitute have no access to social justice.
Way forward suggested by the report
- Strengthening community participation and governance
- Building a comprehensive and dynamic database on the health and nutrition status, including co-morbidities of the diverse, vulnerable populations
- Strengthening healthcare provisioning through the National Urban Health Mission, especially for primary healthcare services
- Putting in place policy measures to reduce the financial burden of the poor
- Establishing a better mechanism for coordinated public healthcare services and better governed private healthcare institutions.
-Source: The Hindu