Development of a Position Paper on Urban Health Scenario and Its Determinants in West Bengal

Agency : Child In Need Institute (CINI)

India’s urbanization, though precipitous, is undirected, random, and opportunistic, shaped more by pressures than by policies. This has resulted in inequitable access to health services and adverse health outcomes for the urban poor. Form the literature it is evident that a little increase in decadal growth rate has been seen in urban India. According to the population projections report, out of the total population increase of 371 million during the period of 2001-2026 in the country, the share of increase in urban population is expected to be 182 million i.e., 48.78%. This unprecedented growth in population poses challenges for the city governments in providing basic services such as health, drinking water, sanitation, housing, electricity, sewerage, livelihood etc., in urban areas. Keeping these multiple problems in view, and the lack of government priorities in urban health, inadequate public health infrastructure in urban areas, varying socio-economic, environment and infrastructural conditions among vulnerable and non-vulnerable slums, increase usage of private health services by urban poor, and lack of social security mechanisms. Keeping the above scenario in view, to understand the health situation of the urban slums, a study was undertaken with an objective to develop a position paper on urban health scenario and its determinants in the state of West Bengal which advocates the need of poorest of the poor and strengthening the existing system by recommending bridging the gaps.

The current study was undertaken in 32 wards (9 wards from CINI working area and 23 from non-CINI working area) of KMC from a period of 26th December 2022 to 28th February 2023 to understand the health status of the slum dwellers consisting of both slums and street population spreading up in the city. Addition to this, stakeholders were interviewed to understand the gaps and experiences of the community were also sought through Focus Group discussions. Study findings concludes that females were more aware regarding the services as they are remaining at home always. It is also seen that health status of the community is better in area where CINI was providing services, follow ups and counselling. Private service providers’ collaboration was reported to be poor however they wish to join the system. But in the absence of clear-cut guidelines, the same is not seen. Health infrastructure and human resources, discrimination need to be eliminated if we wish to provide a better health system for the urban areas. Hence the study recommended to improve expansion of public health care, Emphasis on PPP for assuaging public health sector, Enforcement of WASH program, Training and awareness generation amongst all stakeholders, people management, community and patient centric approach, and More research on waiting time and improving quality of services.



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