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The third tier of government can bolster urban health


The third tier of government can bolster urban health
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Nina Badgaiyan,
Anurag Kumar
A greater role for local bodies can boost urban healthcare but administrative challenges need to be addressed
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The covid pandemic put a spotlight on an often-neglected component of India’s health system: urban public health and healthcare. The crowding in our cities makes them natural targets, but our urban health problem runs deeper.
In the past, governments have focused on rural health, and rightly so. Expenditures under the National Health Mission (NHM), India’s primary public health and healthcare delivery vehicle, make this apparent. Union government expenditure on urban areas was ₹850 crore in 2019-20, compared to nearly ₹30,000 crore for rural. However, with rapid urban population growth, a lack of government primary and preventive health infrastructure in urban India poses a challenge. Against a norm-based target of 9,072 urban primary health centres (UPHCs), only 5,190 are operational. Further, most states do not have urban sub-centres (SCs), people’s first point of access for healthcare services. There are only 3,000 urban SCs compared to over 150,000 in rural areas.

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