Bringing Policy Focus to Urban Health in India: Lessons for Developing Countries

Introduction: Even in 2005, when urbanization had been recognized, Government of India launched its flagship health-initiative for rural areas entitled National Rural Health Mission. One-third of urban population lives in poverty, deserving focus for health needs.

Methods and Intervention: To bring greater attention to urban poor the following approach was undertaken: (i) review of government documents to identify policies helpful to the cause which served as leverage points, (ii) disaggregation of urban DHS data, (iii) few, simple, compelling messages to policymakers, media, (iv) bringing together diverse stakeholders to support agenda and engage with civil-servants, (v) use of city maps with listed and unlisted poverty-clusters and health facilities plotted to visualize deprivation, (vi) documentation within government system (minutes-of-meetings, letters from city/state/national official to call meeting to discuss the subject) is crucial, (vii) study tours to model programs and need-based support for operationalizing institutional mechanisms and community action to propel urban health agenda and (viii) remaining flexible and responsive to the policy formulation system is critical.  

 

Impact and lessons learned: Improved focus on health of urban-poor can be generated by using disaggregated DHS data and appreciating positive features and opportunities of existing health policies; demonstrating evidenced based consultative programming in diverse cities; identifying champions within system, facilitating their initiatives; ensuring involvement of senior officials at critical junctures; facilitating regular official documentation within Government system; remaining flexible, supportive and responsive.

 

Conclusions: These approaches resulted in increased attention to Urban Health evidenced through: recommendations of a national government task force, increased budgetary allocation to Urban Health, National Slum Health Project Guidelines, publication of India-DHS official urban health report based on data for eight large cities, a dedicated National Urban Health Mission drafted.

Key words: metrics, urban slums, India, policy