National Urban Health Mission

National Urban Health Mission
Name	National Urban Health Mission
Formation	2013
Type	Public health initiative
Area served	India
Parent organization	Ministry of Health and Family Welfare (India)

National Urban Health Mission The National Urban Health Mission was an initiative launched to improve urban primary health care across Indian metropolitan and municipal areas, coordinating with Ministry of Health and Family Welfare (India), NITI Aayog, State Health Departments of India, Municipal Corporation of Delhi, Brihanmumbai Municipal Corporation, and Kolkata Municipal Corporation stakeholders. It aimed to integrate with existing schemes such as National Rural Health Mission, Janani Suraksha Yojana, Ayushman Bharat, Mission Indradhanush, and National Vector Borne Disease Control Programme to reduce urban health inequities, maternal and child mortality, and communicable disease burden.

Background and Objectives

The mission emerged amid policy discussions involving Planning Commission (India), World Health Organization, United Nations Children's Fund, Public Health Foundation of India, World Bank, and urban local bodies after studies by Indian Council of Medical Research and Centre for Policy Research highlighted gaps in slum health, migrant health, and noncommunicable disease care. Core objectives included strengthening Urban Primary Health Centers, expanding coverage for vulnerable populations in slums of Mumbai, Kolkata, Chennai, and Bangalore, improving access to maternal health and neonatal care services, and establishing linkages with tertiary hospitals like All India Institute of Medical Sciences and Postgraduate Institute of Medical Education and Research for referrals.

Implementation and Structure

Implementation relied on coordination among Ministry of Health and Family Welfare (India), State Health Societies, Municipal Corporations, Urban Local Bodies, National Health Mission architecture, and partner NGOs such as Society for Nutrition, Education and Health Action and ActionAid. The structure emphasized creation of Urban Primary Health Centers and appointment of cadres including Urban Community Health Workers, Medical Officers from Indian Medical Association networks, and linkages to District Health Societies. Technical support came from institutions like Public Health Foundation of India, All India Institute of Hygiene and Public Health, and international partners such as USAID and UK Department for International Development. Governance arrangements referenced frameworks from National Health Policy 2017, Constitution of India decentralization provisions, and municipal health plans developed under Smart Cities Mission convergence.

Programs and Services

Services covered maternal and child health interventions found in Janani Suraksha Yojana and Integrated Management of Neonatal and Childhood Illness packages, routine immunization in line with Universal Immunization Programme, antenatal care, family planning similar to Family Planning Programme (India), noncommunicable disease screening aligning with NPCDCS, tuberculosis case finding consistent with Revised National Tuberculosis Control Programme, and vector control efforts from National Vector Borne Disease Control Programme. Urban outreach targeted migrants and informal workers in Dharavi, Nizamuddin, and other informal settlements through partnerships with National Urban Livelihoods Mission implementers and civil society groups like Kutch Mahila Vikas Sangathan and Pratham. Linkages to telemedicine pilots, emergency referral systems with National Ambulance Services (India), and health management information supported integration with e-Sanjivani and state health information systems.

Funding and Resource Allocation

Financing combined central grants administered via Ministry of Health and Family Welfare (India), state match funding channels through State Finance Commissions, and municipal budgets from Municipal Corporations supplemented by international donor contributions from World Bank and Bill & Melinda Gates Foundation. Resource allocation aimed to follow norms similar to National Health Mission per capita formulas, with special provisions for high-density urban slums in Mumbai, Kolkata, Hyderabad, and Ahmedabad. Human resources were funded via contractual arrangements reflecting precedents from National Rural Health Mission and accreditation incentives tied to National Accreditation Board for Hospitals & Healthcare Providers standards.

Monitoring, Evaluation, and Impact

Monitoring used indicators from National Family Health Survey rounds, routine data from Health Management Information System (India), and evaluation studies by Indian Council of Medical Research, Centre for Social Medicine and Community Health, and independent evaluators like World Bank consultants. Impact assessments measured changes in institutional delivery rates, immunization coverage, infant mortality rate as reported by Sample Registration System, tuberculosis notification rates, and control of dengue and malaria outbreaks. Evidence indicated variable outcomes across states such as Kerala, Tamil Nadu, Maharashtra, and Bihar; successful cities reported improved service utilization while others showed persistence of access gaps noted in reports by Comptroller and Auditor General of India and civil society audits.

Challenges and Criticisms

Criticisms cited fragmentation between State Health Departments and Municipal Corporations, insufficient urban human resources despite recruitment drives, funding shortfalls compared with National Health Mission rural allocations, and limited integration with social determinants addressed by Ministry of Housing and Urban Affairs and Ministry of Labour and Employment. Operational challenges included weak data interoperability with Aadhaar-linked systems, coordination issues with private healthcare providers and pharmaceutical supply chains, and concerns raised by public health researchers at All India Institute of Medical Sciences and Tata Institute of Social Sciences about equity for migrants and informal workers. Policy commentators in outlets aligned with Economic Survey of India analyses recommended stronger municipal financing reforms via 14th Finance Commission-style arrangements and deeper engagement with community organizations.

Category:Health programmes in India