AROUND 18 per cent of people in low-income slums are moving from above poverty line to below it,reveals a new study on the health of urban poor by International Institute of Population Sciences (IIPS),Mumbai.
The study,which covered Pune,Bhubaneswar and Jaipur,attributes this to the fact that a large majority of the urban poor is opting for expensive private health services,leading to massive out-of-the-pocket expenditure.
The study showed a similar trend in child immunisation. A substantial proportion of children aged 12-23 months nearly 50 per cent in Pune,41 per cent in Bhubaneswar and 21 per cent in Jaipur were vaccinated at private health facilities,it said.
Among those who gave birth to babies in 2009,2010 and 2011,we found 76 per cent in Bhubaneswar,50 per cent in Jaipur and 53 per cent in Pune opted for public health facilities. Among the urban poor,32 per cent in Pune,37 per cent in Bhubaneswar and 40 per cent in Jaipur did not avail public health services. The reasons are multiple, said S K Singh,who headed the study.
He said the findings showed people were not convinced of the quality of services at public health facilities.
Another reason is limited access to public health facilities on city outskirts.
The public sector urban health delivery system,especially for the poor,has been limited in its reach and constrained due to social exclusion of slums,weak social fabrics and lack of coordination among stakeholders, Singh said.
He said during our study,a certain mindset of municipal officials emerged,that is,if they extend water,electricity and health facilities to those living on city outskirts,rail lines,etc,these people might start believing they are part of the city and start demanding housing or rehabilitation.
The study reveals though below-poverty-line people are entitled to a monetary health benefit of Rs 1,400,such provisions have failed to encourage them to avail public health services.
The paper shows 21 per cent in Bhubaneswar,38 per cent in Jaipur and 39 per cent in Pune did not opt for such provisions and instead went to private health facilities.
We found that only one family member in 21 per cent of households in Bhubaneswar,20 per cent in Jaipur and 30 per cent in Pune had a health or insurance cover. Among the urban poor,merely 12 per cent in Pune and 11 per cent households each in Bhubaneswar and Jaipur have health insurance, said Singh.
The IIPS team that conducted the study mooted public-private partnership to strengthen the healthcare system. It said tertiary healthcare could be covered by insurance companies and a health cess imposed on individuals with an annual income of Rs 20 lakh and more.
If we dont take urgent steps to strengthen healthcare facilities,India will not be able to meet the minimum development goals, said Singh.