Healthcare Equity In Urban India

The urban part of the country now comprises a total of 30% of the poor population. According to the census of India conducted in 2011, the urban population of India has seen a growth from 18% in 1960 to 34% in 2019. But the provisions for healthcare services have not been able to match this growth. All the sectors of the healthcare system should be looked after, but the primary sector should be promoted first in order to work for the public good. 

India’s Healthcare Conditions

• The healthcare system of India has been facing quite a lot of issues. Low number of institutions and lack of human resources contribute to the main health issues of urban India. 
• The Indian healthcare system consists of a three-tier system.
  • Primary health care is provided to the rural population by the Indian Public Health Standards. Community health centre, sub centre, and primary health centre provides healthcare to the rural population. Secondary health care is provided through district hospitals. 
  • Tertiary care is provided through super speciality hospitals at regional and Central level institutions. 

Public Health Sector 

• The National Health Mission provides an emergency response and health systems preparedness package. Financial and technical support is extended to the states and Union Territories to strengthen the public healthcare system. 

• The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana was launched in 2018 as the largest government health insurance scheme. It’s a centrally sponsored scheme.

• The Pradhan Mantri Swasthya Suraksha Yojana was announced in 2003 to correct the regional imbalances and provide affordable healthcare services and also extend facilities for quality medical education in the country.

Factors Affecting Healthcare Services In India-

The main health issue of urban India are: 

• Disease burden on the poor 
• Unorganised urban healthcare governance
• Financial burden faced by the poor 
• Less Investment in healthcare by urban local bodies. 

Scope for Improvement

• Promoting community participation and governance in urban India. 
• Building a database on the health and nutrition status of the country. 
• Strengthening healthcare provisions with the help of National Urban Health Mission. 
• Reducing the financial burden of the poor, and introducing better governed private healthcare facilities. 

Equity Issues In Healthcare

There is a challenge of imbalance of resource allocation and lack of physical access to high-quality health care services. There is also inadequate human resource for healthcare. 

Equity issues in healthcare also include healthcare expenditures that are high due to inflation and behaviour factors also affect the affordability of healthcare facilities in India. There are inequalities when it comes to access to healthcare facilities due to differences in socio-economic status, geography, and gender. 

Equity metrics should be used to monitor, assess and strategically plan investment in the healthcare facilities to tackle the equity issues in healthcare. A refined equity-focused process should be developed to influence decision making in health reforms. Specific responsibilities should be redefined and key factors should be held accountable to achieve equity in healthcare in India. With the implementation of these principles will ensure more equitable healthcare for India’s population. 

The Main Health Issues Of Urban India

The National Urban Health Mission that was launched in 2013 provides a mechanism to deal with the main health issues of urban India by putting focus on the urban poor. The urban population is facing a challenge to deal with vector-borne diseases, non communicable diseases, air pollution, respiratory infections, road traffic incidents, and injuries. 

The social welfare, women and child development, road transport and highways, school education and sanitation sectors should contribute with the healthcare sectors to deal with these issues. Infectious diseases like COVID-19, dengue, diarrhoea are spread due to poor and overcrowded environments. 

Unhealthy housing, poor sanitation and waste management systems contribute to the spread of such diseases. The migrants and the poor population living in urban areas are clustered in the most deprived and environmentally degraded spaces with less mobility, work and educational opportunities. These lead to the main health issues of urban India. 

Barriers To Healthcare Access In Urban Areas 

Patient complexity, limitation of resources, access to the services, training constraints and avoidance of care by the patient are some of the barriers to healthcare access in urban areas. 

Other barriers include transportation, geographical location, organisational barriers, availability of services and health infrastructure. There are also financial barriers to healthcare access in urban areas as the government spending on healthcare facilities is the least among other sectors. 

Report On Healthcare Equity In Urban India 

The report on ‘Healthcare Equity In Urban India’ conducts research on vulnerabilities and inequalities of healthcare systems in India. It covers the availability and accessibility of healthcare facilities. Cost of healthcare facilities and possibilities of services to be introduced in the future are also explored. 

The report collects data after interacting with organisations in cities and towns across Surat, Lucknow, Delhi, and Mumbai. The National Family Health Surveys analysis, the census of India and the inputs of state-level healthcare facilities also helped with the findings of the report. 

Conclusion 

Rapid urbanisation has led to the poor living conditions of the low income groups in urban cities. They live in environmentally degraded areas that are overcrowded and have no access to safe water and sanitation facilities. The healthcare equity in urban India studies the health vulnerabilities and inequalities in the urban cities. It also covers the availability, accessibility and cost of healthcare facilities in India. The report on healthcare equity in India was released by the Azim Premji University.