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India has historically been called a rural economy but has witnessed fast-paced urbanisation in the last few decades. Currently, one-third of our population is urban. It is projected that by 2030, 46% of our population will be living in cities. Urban areas are characterised by high economic activity, diversity of livelihood opportunities and infrastructural development. Migrants are drawn to urban areas for employment opportunities and to establish a better life for themselves and their families. 

 

Challenges faced by communities in urban areas: Most individuals and families living in urban areas face multiple and overlapping vulnerabilities. The vulnerabilities faced by urban people come from:  

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  • 1. Residential vulnerability: Slum or slum-like habitations face the insecurity of tenure and are unserved or under-served with basic public services like sanitation, clean drinking water and drainage.  

  • 2. Occupational vulnerability: Urban residents working in the informal sector, daily wage labourers, factory workers working without adequate safety equipment, sanitation workers without adequate protective equipment and bonded labour are occupationally vulnerable.  

  • 3. Social vulnerability: Hinders access to resources such as health services, education and access to government schemes/ programmes because of societal discrimination. Widows, transgenders, the elderly, the disabled and those belonging to scheduled castes and tribes face discrimination because of their disadvantaged social status.  

 

Social and systemic barriers to accessing public healthcare services in urban areas:  

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  • 1. Limited availability of government primary healthcare services: Primary healthcare facilities in urban areas are limited in number. Urban residents have access to ‘larger’ or secondary/ tertiary hospitals (even for minor ailments) and private sector providers, paying heavily out of their pockets.  

  • 2. Overcrowding in public hospitals: Patients are forced to procure products and diagnostic services from other private providers due to lengthy waiting times.  

  • 3. Inconvenient timings: As most public health services open in the morning hours, consulting a doctor may mean the loss of a day’s wage for the poor. The alternative is to go to private doctors during evening hours. 

 

Community mobilisation strategies for urban areas: Key strategies for community mobilisation in urban areas to facilitate improved case-finding, testing and treatment are given below.

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  • 1. Peer outreach at TB testing and treatment sites: Peer educators will be linked with TB service providers. These can be peers from a targeted intervention or HIV care and support programmes. Community or peer-led measures will penetrate better and facilitate Intensified Case Finding (ICF).   

  • 2. Mobile unit with the display of Information, Education and Communication (IEC) materials along with a facility for sputum collection and transportation.

  • 3. Safe virtual or physical spaces (for example telephone hotlines, or drop-in centres) to seek information and referrals for care and support for TB treatment. Weekly/ fortnightly awareness sessions, testing days and follow-up testing days for TB can be organised in coordination with District TB Officers (DTOs). 

  • 4. Involvement of Community-based Organisations (CBOs)/ civil societies

 

Various departments/programs which play a role in community mobilisation in urban areas: 

 

 

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Editable-1620-Community mobilization strategies-Urban areas.pptx (56.3 KB)

 

 

Assessment 

  

 
 
 
 
 
 

  

 Question     
 
 
 
 

Answer   

1     
 
 
 
 

Answer 2     
 
 
 
 

Answer 3     
 
 
 
 

Answer 4     
 
 
 
 

Correct answer     
 
 
 
 

Correct explanation     
 
 
 
 

Collaboration of National TB Elimination Programme (NTEP) and National Urban Health Mission (NUHM) is to develop strategies to address urban TB. 
 
 

 False  
 
 

 True  
 
 

    
 
 

    
 
 

 2  
 
 

National Urban Health Mission integrates vertical health programs in its services. It makes special efforts to make its services accessible by the urban marginalized population through its location, service delivery, outreach and making its service providers sensitive to the needs of its target population. 

 

 

 

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