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Urban Health

Centre mulls NRHM clone for urban poor (The Pioneer-10 August 2010)

Union Health Ministry is mulling over a proposal to launch a National Urban Health Mission
(NUHM), on the lines of National Rural Health Mission (NRHM), to cater to the requirements of
urban poor in all the 640 cities across the country by facilitating “equitable access to available
health facilities.”

The estimates for the proposed NUHM (2010-11 to 2016-17) are approximately `25,000 crore
for Centre, `5,000 crore for the State Governments and `3,000 crore for urban local bodies. The
ratio of funding between the Centre and the States will be 85-15 for the mission.

For emergency medical services alone, a one-time provision of `20 crore for metros, `10 crore
for cities with 10 lakh-plus population and `5 crore for other cities with one lakh-plus population
for upgradation/strengthening of trauma, cardiac and other emergency care facilities in identified
Government hospitals will be provided under the mission. The estimated cost of emergency
medical services in seven metros at the rate of `20 crore, 28 cities with over 10 lakh population at
`10 crore and 395 other cities with 1 lakh-plus population at `5 crore will be `2,395 crore.

A draft framework for implementation of NUHM says the intent is to develop a „communitised‟
model (neither public nor private) of healthcare wherein community organisations will be
provided with the resources to buy services that they need.

The NRHM and NUHM will be two sub-missions of a larger National Health Mission. The
NUHM will leverage the institutional structures of NRHM for administration and
operationalisation of the mission, the planning process for which will be started in all municipal
corporations, municipalities, notified area committees and town panchayats in the current
financial year, according to the draft report.

The NUHM focus, says the draft, will be on alleviating the distress of the urban poor in seeking
quality health services and will cover urban poor population, living in listed and unlisted slums,
vulnerable sections including homeless, ragpickers, streetchildren, rickshaw-pullers, construction
and brick and lime kiln-workers, sex workers and other temporary migrants. It will be based on a
detailed GIS mapping and household surveys.

According to UN projections, if urbanisation in India continues at the present rate, then 46 per
cent of the total population will be in urban regions of India by 2030. Rapid urbanisation will put
greater strain on the urban infrastructure, which is already overstretched.