Hardly Smart About Urban Health Care

Context: Despite the renewed policy focus on cities, the pandemic has exposed the weaknesses in handling a public emergency in urban areas.

Challenges in Urban Health care during a pandemic:

• Urban crisis: Indian cities are not only facing a public health crisis but also a larger emergency of economic issues and livelihoods.

• Slow implementation: Many of the projects undertaken under the ‘Smart Cities Mission’ are behind schedule.

• According to the Ministry of Housing and Urban Affairs, of the 5,151 smart city projects, only 1,638 projects have been completed. 

• Lack of focus on public health: 

• Only 69 of over 5,000 projects undertaken under the Smart Cities Mission were focused on health infrastructure. 
• Lack of decentralisation: Despite public health as one of the functions that are to be devolved to the municipalities (12th schedule of the Constitution).

• Lack of capacity: Urban local bodies continue to be financially and administratively weak and heavily understaffed. 

• High level of vacancy: of Accredited Social Health Activist (ASHA) workers in urban areas, especially in COVID-19 hotspot cities such as Mumbai.

Way Forward: 

• Prioritising urban development: Under Smart cities mission, investing in programmes that improve the health and livelihoods of residents.
• Strengthening existing programmes such as the National Urban Livelihoods Mission and National Urban Health Mission to solve the health challenges in urban areas.
• Decentralised political and administrative systems with strong local governments and high investment in local public health care.
• Job creation: Introduction of a national urban employment guarantee programme that assures jobs for urban residents and strengthens the capacities of urban local bodies.