Community Driven and Managed Slum Well-Being Programme in Agra City, India

Ali, Naushad

Introduction: Agra is a rapidly growing, industrialized and tourism-dominated city of Uttar Pradesh, India’s largest State. Agra city has 1.7 million population, with nearly 50% urban poor. Aimed at improving healthcare access in 60 slums (2,00,000 slum population), a consultation-based program started in 2005 involving government Departments, municipal corporation, civil-society organizations and slum communities. Community enablement and empowerment are key strategies.

Intervention: Women’s health groups (each comprising 10-15 active women) were formed and strengthened to generate demand for civic services, serve as a community resource and link with service providers. Across 60 slums, sixty women groups have been networked into four federations. Each Federation has 10-15 women’s’ groups. Each group is represented in the federation by 1-2 democratically elected representative(s). Three federations are registered with Government of India as formal civil society organizations.

Results: In six years, there have been improvements in health service access, information dissemination and healthy behaviour adoption in the intervention area. Federations coordinate with various stakeholders to facilitate access of urban poor families to entitlements like ration-cards, write applications for - health services, water-supply, cleaning of drains and also mentor/monitor their women groups. Federations receive modest grants to conduct above-mentioned activities. An independent rapid survey in 2009 showed 70% children were completely immunized in intervention area versus 28% in non-intervention area.

Potential Value: Programme focusing on community capacity building towards self-reliance has reaped gains in health-behaviour adoption, equitable service access and has built social infrastructure which serves as support systems for deprived urban populations. Lessons from this programme in “communitization” have been included in Government of India’s National Urban Health Mission, Slum Improvement Programme and Urban Health Programmes of two States.