Health care for urban poor
0
Shares
![](https://themirrorofsociety.com/wp-content/uploads/2020/02/2020-02-07-21-42-52-714-768x461.jpg)
![](https://themirrorofsociety.com/wp-content/uploads/2020/02/FB_IMG_1579623183273-768x525.jpg)
DR MD RAJJA
Rapid urbanization and the significant growth of the urban population have created greater demands on the urban infrastructure plus service delivery. The urban poor comprise a heterogeneous group. Most of the urban poor live in slums. A significant number are also homeless, and often on the move from one temporary shelter to another and are a high-risk group. They are the hardest to locate and are also the least visible in the urban setting.
Urban poverty is characterized by food insecurity, extremely poor living conditions and a lack of job security. Thus, the urban poor are vulnerable in multiple ways. Their dependence on the informal sector makes their income highly insecure. In the event of serious sickness it is a financial shock for the household. The lack of access to water, sanitation and safe drinking water increase their corporeal vulnerability. The health condition of the municipal poor is not very different from that of the rural poor and in some respects is still worse.
The allocation of ailments across economic classes shows that the living conditions and nutritional insecurity of the urban poor increase their vulnerability to communicable and water-borne diseases, anaemia, prevalence of reproductive health problems, under-sustenance and inadequate vaccination coverage. Despite legal provisions for public responsibility, municipalities have not been able to provide health services for the under-privileged during times of need. Problems include non-availability of health-care facilities, underutilization of existing institutions, and congestion in most of the less important and tertiary care centres.
The poor spend significant amounts on health care through short-term borrowings for health-related expenses, particularly in the case of shattering illnesses. Because of job uncertainty, lack of recognition and lack of a support system, illnesses push them into debt and further poverty.
The state is inhibited in responding fully to the local needs, and in implementing legislated positive action for the marginalized. Significant efforts are required to orient health services and financing to the desired level by targeting the poor in urban areas. The required package of health services would need to be from primary and preventive ones. In addition, it would be necessary to arrange indispensable curative care, diagnostic services and support for calamitous illnesses. Creative strategies are needed in developing public insurance and other mechanisms to protect the urban poor after the impact of financial defeat throughout illnesses.
Dr Md Rajja
Medical Doctor
Birgunj Nepal