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Smart Cities: UnderprivilegedCitizens and Ways Towards
Equitable Access to Services andWell-being
Siddharth AgarwalUrban Health Resource Centre, India
May 14, 2015Rotary Club MeerutChamber of Commerce, Bombay Bazaar, Meerut
Find us on facebookwww.uhrc.in
Outline
Urbanization, Health and well-being challenges What Approaches have worked, helped learn practical lessons and the‘How to do’ with relevant stakeholders:
# 1 Spatial city and Neighbourhood maps help better understand living environment # 2 Slum-Community/Women’s Groups increase demand for services [Mahila Arogya Samiti in
NUHM] # 3 Collective Social Needs Savings & Loans [Community Revolving Fund in NUHM] # 4 Gentle Negotiation: Under-served communities address determinants of urban health
across sectors, through community applications for services # 5 Youth-children groups emerging as ‘Force Gen-next’ # 6 Community’s Own Efforts when authorities do not respond # 7 Facilitating Access to Picture ID, Proof of Address and social benefits # 8 Facilitating Access to Food subsidy cards # 9 Multi-dimensional Efforts to Improve Health, Nutrition, Environment, Related Services:Through Coordination & Linkage Building – towards addressing social determinants of health
Urbanization, Health and well-being challenges What Approaches have worked, helped learn practical lessons and the‘How to do’ with relevant stakeholders:
# 1 Spatial city and Neighbourhood maps help better understand living environment # 2 Slum-Community/Women’s Groups increase demand for services [Mahila Arogya Samiti in
NUHM] # 3 Collective Social Needs Savings & Loans [Community Revolving Fund in NUHM] # 4 Gentle Negotiation: Under-served communities address determinants of urban health
across sectors, through community applications for services # 5 Youth-children groups emerging as ‘Force Gen-next’ # 6 Community’s Own Efforts when authorities do not respond # 7 Facilitating Access to Picture ID, Proof of Address and social benefits # 8 Facilitating Access to Food subsidy cards # 9 Multi-dimensional Efforts to Improve Health, Nutrition, Environment, Related Services:Through Coordination & Linkage Building – towards addressing social determinants of health
India’s Urbanizing economy: Affluence andDeprivation Juxtaposed
In India’s glittering cities opulence grows along withdeprivation and poverty 60% of Mumbai’s population lives on 8% of land [Parsuraman, S. 2007]
and contribute to economy in diverse ways, living in severe congestion In Delhi, water-supply for planned colonies is 225 lpcd (liter per capita
daily) and 50 lpcd for listed slums
Urban poor contribute substantially to India’s economicgrowth: Between 60- 90% of urban poor are involved in urban informal sector. Urban sector contributes 60% -70% of GDP
In India’s glittering cities opulence grows along withdeprivation and poverty 60% of Mumbai’s population lives on 8% of land [Parsuraman, S. 2007]
and contribute to economy in diverse ways, living in severe congestion In Delhi, water-supply for planned colonies is 225 lpcd (liter per capita
daily) and 50 lpcd for listed slums
Urban poor contribute substantially to India’s economicgrowth: Between 60- 90% of urban poor are involved in urban informal sector. Urban sector contributes 60% -70% of GDP
Parsuraman, S - http://www.karmayog.org/urbandvlp/upload/21756/Newspaper-essays_Prarsuraman.pdf. This indicateshigh density of living space for 60% living in slums, chawls, informal settlements.Population density of Greater Mumbai (area under Municipal Corporation of Greater Mumbai) estimated at 24,812(Mumbai Suburban district & Mumbai City district) persons per sq. km. as per Census 2011 .Density of Mumbai City – 43,447 per sq. km.
Approach # 1a: Mapping Helps Inclusionof Unlisted Slums/Clusters
SLUM NUMBER POPULATIONLISTED 102 455923UNLISTED 85 216935TOTAL 187 672858
LOCATION OF SLUMS
Meerut City
6Spatial city mapping of vulnerable clusters integral strategy of NUHM
Community groups in slums prepare maps toa) Ensure that no family is left out from lists used for housing, food subsidy,
entitlements;b) Track access to health services e.g. Immunization and ANC , HIV testing,c) Help identifying and providing services/linkage to recent migrants
Approach:1 (b)Demonstrate uses of Neighborhood Mapping
7
Approach 2: Demand side strategies
Cluster teams of Women’s Groups: Slum-Community/Women’s Groups as agents of change Cluster teams or Congress of slum women’s groups gives stronger voice
and greater negotiation power
Women’s groups are Mahila Arogya Samitis mandated in NUHM 1
1NUHM Framework for Implementation, May 2013
Network of slum-based community groups inIndore and Agra
UHRCIndore/Agra
Training, Monitoring,Supervision &
problem solving
Training, Monitoring,Supervision &
problem solving
• Project coordinator• Field coordinators
Linkage withCivic Authorities
Linkage withCivic Authorities
8 to 23 women groups in a large slum cluster 10-14 members per group 30 to 70,000 slum population per cluster team
5 Cluster teams 7-37members (1 per group)
(has office bearers, bankaccount, registered NGO)
• Grant toclusterteam
• ProgrammeMonitoring
• Grant toclusterteam
• ProgrammeMonitoring
UHRC Delhi
Approach 3: Building skills, self-reliance and confidence Collective Social Needs Savings and Loans: for Health and
related Emergency, Child Education, Starting a smallbusiness, purchasing food grains, Marriage, getting assetsback from money lenders
This approach is a mandated in NUHM as ‘revolving community fund’1
1NUHM Framework for Implementation, May 2013
Utilization of loans from Women’s Groups
Data from collective savings registers of 125 women’s groups in Agra and Indoreduring April‐13 to March‐14 shows that of the 3327 loans given:
925 loans (27.8%) for health needs, of which 550 loans served maternal‐childhealth needs, and 375 loans served other health needs
531 loans (15.96%) helped overcome challenges that interrupt or lead to drop-outin children’s education
524 loans (15.74%) helped start/expand livelihoods 424 loans (12.74%) helped store grains at harvest time, a measure to address food
insecurity during low (or no) wage-earning times 221 loans (6.64%) supported girl marriages 302 loans (9.07%) enabled repaying money‐lender debts 190 loans (5.71%) were used for grocery/kitchen expenses 210 loans (6.31%) enabled houseimprovements, land lease, toilet construction
Data from collective savings registers of 125 women’s groups in Agra and Indoreduring April‐13 to March‐14 shows that of the 3327 loans given:
925 loans (27.8%) for health needs, of which 550 loans served maternal‐childhealth needs, and 375 loans served other health needs
531 loans (15.96%) helped overcome challenges that interrupt or lead to drop-outin children’s education
524 loans (15.74%) helped start/expand livelihoods 424 loans (12.74%) helped store grains at harvest time, a measure to address food
insecurity during low (or no) wage-earning times 221 loans (6.64%) supported girl marriages 302 loans (9.07%) enabled repaying money‐lender debts 190 loans (5.71%) were used for grocery/kitchen expenses 210 loans (6.31%) enabled houseimprovements, land lease, toilet construction
Approach 4: Gentle Negotiation through CollectivePetitions, reminders (Written requests to officers ofHealth, Nutrition & Environmental Departments)
PetitionResponse of Civic
Authority
Letter in support ofpetition/request by
politician
Letter in support ofpetition/request by
politician
Approach 5: Youth-children groups emergingas ‘Force Gen-next’
With continual mentoring, motivation Youth-children groups inslums are not only improving their own lives but also contributeto their societies in tangible ways.
Promoting Hygiene,Hand-washing
Youth petitions to civic authoritiesfor streets, garbage cleaning
Cleaner DrainsBefore After
During 2013-2014: 100,000 slum population benefited (Agra + Indore) fromcleaning of drains
Electricity Connection
During 2013-2014: 12000 slum population benefited (Agra + Indore) fromelectricity connections
Before After
Improvement of Slum Pathways, Sewer
During 2013-2014: 50,000 slum population benefited (Agra + Indore) from roads paved
Improvement of Slum Pathways, Lanes
During 2013-2014: 40,000 slum population benefited (Agra + Indore)from roads paved
Water Tanker Installation
During 2013-2014: 37000 slum population benefited (Indore & Agra)from water supply
Approach # 6: Community’s Own EffortsCommunity Contributes to build, re-build vital bridge
in Banganga Area, Indore
BeforeOct’11 Oct’11 Aug’12 Oct’12
Elevating House Plinth to prevent rain-waterentering house
Rain water enters houseRain water enters house
Rain water does not enter elevatedhouseElevating House Plinth
Approach # 7
Perseverant Efforts to enableGovernment Picture ID, Proof ofAddress, Certificate of Birth Date
Perseverant Efforts to enableGovernment Picture ID, Proof ofAddress, Certificate of Birth Date
Women showing their UID-Aadhaar CardsPicture ID & Proof of Address
During Apr 13 – Mar 14: 8000 persons benefited from proof of address and PhotoID
Approach # 8Efforts towards TranslatingMandate into Reality: FoodSubsidy Cards and Social BenefitSchemes
Approach # 8Efforts towards TranslatingMandate into Reality: FoodSubsidy Cards and Social BenefitSchemes
Dept. WCDICDS, Girl Child Benefit,
Others
Health DeptANC, Immunization
JSY,Other services
PoliticiansVoice, support for
applications
Municipal Corprn/JNNUR-
Roads, drains,water., toilet, tenure,
housing
Federation ofWomen’s Groups
Approach #9: Multi-dimensional Efforts to ImproveHealth and Related Services Through Coordination &Linkage Building
Dist. Magistrate’s OfficeSocial Assistance ProgramsOld Age & Widow Pension
Food Subsidy BPL,APL Cards
Labour DeptDomestic worker
registration
PoliticiansVoice, support for
applications
Municipal Corprn/JNNUR-
Roads, drains,water., toilet, tenure,
housing
OthersVoter ID, Adhar,
Domicile Certificate,caste Certificate
UHRCIndore/ Agra
Gender empowerment enhancescaring capacity of woman and family
Through women’s groups, gender equationis positively improved at family andsociety level
Women’s enhanced access to resourcesand greater capacity to take timely care ofthemselves, children, and the family helpsthe family and community
Through women’s groups, gender equationis positively improved at family andsociety level
Women’s enhanced access to resourcesand greater capacity to take timely care ofthemselves, children, and the family helpsthe family and community
Empowered Assertive Women TakeAction…….
Women wielding bamboos against alcoholism vending points, gambling joints
….and no boundaries can stopthese empowered women
Women’s group members at the HindustanTimes Social Innovators Conclave, 2014
Vociferous women organise a ‘Jan Jagran’ Rally
“There are ought to be something very specialabout the boundary conditions of the universe,and what can be more special than that thereis no boundary.” – Stephen Hawking
Functioning,AccountableSystem for
Urban Health,Nutrition and
Well-beingLong Lever of :a) Complementary skills, Knowledge,Experiencea) Commitment , Motivationb) Understanding of problemsc) Accountability, responsibility
With Hope and ConfidenceWith Hope and Confidence
33
Functioning,AccountableSystem for
Urban Health,Nutrition and
Well-beingLong Lever of :a) Complementary skills, Knowledge,Experiencea) Commitment , Motivationb) Understanding of problemsc) Accountability, responsibility
“A small body of determined spirits fired by an“A small body of determined spirits fired by anunquenchable faith in their mission, can alter theunquenchable faith in their mission, can alter thecourse of history”course of history” -- MohandasMohandas KaramchandKaramchand GandhiGandhi
www.uhrc.in ; [email protected]
Social Orgnaisations,Professionals, Govt.Managers, Public &Private
Sectors, slum CBOs,Civil Society