Off the map
by Siddharth Agarwal, executive director of the Urban Health Resource Centre
July 20, 2009 – Indian Express
The urban poor, although one of the most disadvantaged sections of the country, is also among the hardest to target for government. While the new government, as visible in the recent Budget, has paid some attention to enhancing services and attempted to increase the provision of facilities for the urban poor, the success of all these social welfare schemes will hinge on what Finance Minister Pranab Mukherjee highlighted in his speech as a challenge: “re-energising government and improving delivery mechanisms.” This is doubly problematic when it comes to our cities.
India has been rapidly urbanising; the urban poor, who number 100 million, are the fastest growing segment of India’s population. Living mostly in temporary (and hence frequently undocumented) settlements, they lack access to water supply, sanitation and healthcare services. The poor living standards and suboptimal healthcare is reflected in high child mortality rates — one in 14 children do not live to see their fifth birthday, according to the 2005-06 National Family Health Survey.
Several of the newly-announced social welfare schemes have the potential to positively impact living conditions of the urban poor. The Jawaharlal Nehru National Urban Renewal Mission, for example, has set aside — under the heading “Basic Services for the Urban Poor” — an allocation for housing and amenities of Rs 3,973 crore, including the provision for Rajiv Awas Yojana announced recently. The problem this will take on is vast: there is currently a shortage of 2.6 crore housing units in cities, almost all of which is for low- income groups. It will be critical to ensure that these provisions reach the most disadvantaged city dwellers.
Initiatives towards food security and the increase in outlay — by 17 per cent — for the National Rural Health Mission may not be directly targeted at the urban poor. A specific allocation was not announced, for example, for the National Urban Health Mission. Our cities will continue to hope that the government’s commitment to launching the NUHM will be turned into action. (Almost the entire increase in health outlays has been focused on rural areas.)
But the question is: will increased spending alone be enough? While the government has certainly upped the spending on schemes for marginalised populations their implementation — as has been signalled by several within government — will need a sense of purpose, urgency, capacity and efficiency if optimal outcomes are to be obtained. And this will be particularly true when the needs of the urban poor are taken into account. Why? Because the temporary nature of many settlements of the urban poor means they fall into the cracks in any government programme.
Nearly 49 per cent of slums in India are unlisted, according to National Sample Survey Organisation data. It would be necessary, therefore, to extend all essential services to unidentified sections of urban poor by mapping unlisted and hidden slum clusters, and other temporary settlements. Any effective, speedy and honest implementation of policies will require efficient management, convergence and coordination among all departments at national, state and city levels, to reach vulnerable communities.
Then there is the question of manpower. Whether or not there are enough well-trained people to administer programmes for the vulnerable in urban areas is a matter of serious concern. When designing the propagation mechanism of welfare schemes, care should be taken to expeditiously recruit a reasonable number of people with expertise from outside; and training or re-training personnel in government departments on the provisions of the new schemes, with a special focus on how policy provisions can reach the most disadvantaged, should not be forgotten either.
Finally, government alone cannot do everything. State intervention can be made more effective by force-multipliers from outside. Several successfully implemented interventions have shown that the involvement of civil society in planning, delivery, progress review and addressing operational bottlenecks can enhance accountability of well-intentioned policy initiatives. Their efficiency and reach would also improve. Strengthening community level partnerships by building sustainable community-based organisations in slum clusters, to improve their institutional and financial capacity, should be a priority; that will enhance demand for and utilisation of the planned programmes.
The government has said it is concerned about the well-being of the least-privileged sections of society. The rest of us must ensure the translation of words into action.
