‘Up to 30% of Bengaluru’s poorest quintile seek private healthcare services’

Azim Premji University releases report on ‘Health Care Equity in Urban India’

In the light of disproportionate health vulnerabilities being suffered by the urban poor in India, Azim Premji University (APU) released a report, ‘Health Care Equity in Urban India’, in collaboration with 17 regional NGOs to combat the problem.

“The report explores understanding of health vulnerabilities of urban poor, availability, accessibility and cost of healthcare facilities, and possibilities in future-proofing services in the next decade,” said APU in a statement on November 19.

Calling for significant investments in scaling up healthcare facilities and infrastructure in cities, the report found that there is a disproportionate disease burden on the poor, chaotic urban health governance, financial burden on the poor, and urban local bodies are less invested in healthcare.

To address these issues, the university and NGOs called for strengthening community participation and governance, building a comprehensive and dynamic database on the health and nutrition status, strengthening healthcare provisioning through the National Urban Health Mission, and policy measures to reduce financial burden on the poor.

Among other findings, the report noted that life expectancy among the poorest in urban areas, when compared with the richest, was lower by 9.1 years in case of men and 6.2 years for women.

Cost-wise, the report observed that evidence from Bengaluru showed that 30% of even the poorest quintile seek healthcare from private sources. Since there is a 10-fold difference in cost between public and private facilities, it significantly adds to their financial burden.


“Urban healthcare has received relatively less research and policy attention. This report is an important contribution that enhances our understanding of the health vulnerabilities of the urban poor, unpacks the health system governance challenges in different cities and towns, and provides a road map for how to reimagine our urban health systems,” said APU professor Arima Mishra.

The varsity and NGOs pointed out that the 74th constitutional amendment, 1992 mandated a central role for urban local bodies to be invested in healthcare, but that is hardly visible, except for some pockets in Bengaluru, Mumbai and Thiruvananthapuram.

“The very purpose of APU is to contribute to a just, equitable, humane and sustainable society. The pandemic has brought to the fore the tremendous inequities in healthcare for disadvantaged sections in rural and urban India. This comprehensive report on healthcare in urban India highlights key gaps in the health system that lead to inadequate health access for the urban poor,” said Richa Govil, Director, School of Development, APU.

The report drew insights from data collected through detailed interactions with civil society organisations across Mumbai, Bengaluru, Surat, Lucknow, Guwahati, Ranchi, and Delhi.

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Sagar Biswas

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