Strengthening Urban Health for Advancing Universal Health Coverage in India

In 2011, nearly 31 per cent of Indian population lived in urban areas and this proportion was rapidly growing. In parallel, the disease epidemiology in India, as a whole, was changing, with non-communicable diseases (NCDs) contributing to nearly two-thirds of total disease burden stressing the already overburdened health systems in Indian states. Contrary to common perceptions, the health outcomes of the urban poor in India are not any better and at times worse than those of the rural population. The challenges in urban health are well known-poor infrastructure, uncoordinated and fragmented health service delivery, suboptimal financing, insufficient coordination amongst multiple agencies, migrant population, shortage of human resources, high level of inequalities and inequities, etc. In recent years, with the recognition that replication of what is being done in rural areas may not be sufficient to address challenges in urban settings, unique solutions to urban health have been identified. This article summarizes the key health challenges and proposes a few solutions to address urban health challenges and improved health outcomes in urban agglomerations. The authors argue that progress towards universal health coverage in India would be partial unless sustained and harmonized initiatives are done to improve health situation in urban India.