Advancing universal health coverage in South Asian cities: a framework

Adams, Aubrey Manack; Nambiar, Devaki; Siddiqi, Sameen; Alam, Bushra Binte; Reddy, Srinath

doi:10.1136/bmj.k4905

Cited by 9 publications

(6 citation statements)

References 27 publications

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“…Yet, even this component of the formal in major Asian countries is not factored into most of health systems research or design, either in the Primary Health Care of 1978 or in Universal Health Coverage of the 2000s or the international slogan for attaining the Sustainable Development Goals (48). Even those advocating for addressing the Social Determinants of Health as part of UHC for South Asian cities do not seem to envisage plural forms of health care as a relevant component (49). In contrast, Cuba, a country well-recognised for the large number of doctors it produces and its well-developed modern health services, is, some may think paradoxically, also a pioneer in the scientific research and use of Homeopathy as well as teaching of herbal medicine to school children (50).…”

Section: Discussionmentioning

confidence: 99%

Health Implications of Diverse Visions of Urban Spaces: Bridging the Formal-Informal Divide

Priya

Singh

Das

2019

Front. Public Health

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In the past 200 years, urban spaces have been imagined as neatly laid out, well-planned, sanitised and civilised places of dense human habitation with regulated economic activity, where political power, financial capital, the frontiers of knowledge and technology thrive. This has been the urban planners dream, even while it does not reflect the full reality, whether of cities in the LMICs or the HICs. In the face of such homogenising visions arising from Euro-American models, formal urban systems fail to provide adequately for residents' needs, who then carve out their own resources and processes for meeting them, largely within the domain of urban “informality.” While large part of literature presents urban informality as reflected in the slum, others have shown how it is found in relation to all classes ( 1 ). The concept of informality has largely been applied to the core dimensions of economic life of the city. Applied to people's “ways of life,” intermingling of the formal and informal becomes distinctly evident in everyday practices in locations such as the peri-urban, and in activities such as health care. This paper opens up the sphere of health care for urban planning that has, in recent decades, left it largely untouched. It uses data from a rapid assessment of health seeking behaviour of three socioeconomic groups—the middle class, slum-dwellers, and homeless— in Delhi, the capital city of India. The findings, relevant beyond the specific location, reveal that people of all sections resort to myriad informal arrangements for their health care, challenging the dominant connotation of the formal-informal denoting a legitimate-illegitimate dichotomy. This provides potential directions to bridge the formal-informal divide, to re-configure urban planning towards more sustainable futures with plural visions of land use and urban greening for healthier urban conditions and for health care provisioning. The analysis posits that, besides the economic and political relations shaping the formal and informal, the politics of knowledge must be factored in if the informal has to be adequately understood for building sustainable futures.

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Section: Discussionmentioning

confidence: 99%

Health Implications of Diverse Visions of Urban Spaces: Bridging the Formal-Informal Divide

Priya

Singh

Das

2019

Front. Public Health

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“…To our knowledge, this is the first study conducted on health care-seeking migrants, a subgroup that needs to be included in urban health policymaking. This population is among those at risk of poor health and impoverishment from health care seeking, a major barrier to the attainment of universal health coverage identified in literature (Adams et al, 2018). There is more toward ensuring universal access to health care to include health care-seeking migrants, but research with them is an important first step.…”

Section: Notementioning

confidence: 99%

Understanding the Experiences of Health Care–Seeking Migrants in Delhi: Trajectories and Challenges

Mathew

Nambiar

2020

Qual Health Res

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Many studies have reported on issues of accessibility and quality of health care among the different vulnerable subgroups in urban locations. To date, no study has been done on the challenges faced by health care–seeking migrants (those traveling to cities for health reasons). This qualitative study used in-depth interviews and nonparticipant observation to examine the health problems, health care–seeking trajectories, and challenges faced by health care–seeking migrants in Delhi, India. Participants described long courses of health care seeking, typically from the district to the state capital to the national capital. There were variegated paths to health care seeking characterized by delays in service utilization, progression of disease, and cost escalation. The challenge relating to the delay in receiving health care was exacerbated by the residency status of health care–seeking migrants. In conclusion, health-related migration is associated with shared but also unique barriers to health care seeking. India’s urban health care reform agenda needs to cater to the needs of this population.

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“…To illustrate, 104 million tribal people live in India alone8 and are subject to enormous disparities in terms of political voice, essential health services, and health and nutrition indicators 39. The poor and disempowered are not just restricted to rural and remote populations, but in the case of the slums of mega-cities, are often outside the remit of public services 1011…”

Section: Health Disparities In South Asiamentioning

confidence: 99%

Rethinking community based strategies to tackle health inequities in South Asia

Bhutta

Bang²,

Afsana

et al. 2018

BMJ

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Advancing universal health coverage in South Asian cities: a framework

Abstract: Alayne Adams and colleagues propose a framework that emphasises actions on urban health governance and the social determinants of health to achieve universal health coverage in South Asian cities

Cited by 9 publications

References 27 publications

Health Implications of Diverse Visions of Urban Spaces: Bridging the Formal-Informal Divide

Health Implications of Diverse Visions of Urban Spaces: Bridging the Formal-Informal Divide

Understanding the Experiences of Health Care–Seeking Migrants in Delhi: Trajectories and Challenges

Rethinking community based strategies to tackle health inequities in South Asia

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