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Present Strengths and Future Plans

Discussion with B&M Gates Foundation

April29, 2008
Urban Health Resource Centre, India

UHRC Vision & Mission

Vision An urban India where every resident enjoys optimal health and well-being, realizes her/his full potential and contributes to the nations growth and development Mission To bring about sustainable improvement in the health of the urban poor by influencing policies and programmers and empowering the community.

UHRC Program Approach

Influencing National and State Policy and Program and other Stakeholders
Emerging Area: Training, Education

City TA cum Demonstration & Learning Programs

INDORE AGRA Meerut, Delhi

National and State Level Technical Assistance

U.P., M.P., Bihar, UA, Jharkhand, Rajasthan, Maharashtra

Research, Knowledge Management and Advocacy

UH Conference Symposia Publications and Reports Website

Development of a viable, capable, independent organization

Current Policy Scenario

GOI has taken a decision to soon launch a National UH Mission with an allocation of about 8,600 crores (2.15 b USD) over 4 years
Keen interest from States for initiating programs for urban poor

JNNURM (BSUP) and IHSDP are two large programs for improving basic services to the urban poor ICDS programme is also speedily expanding reach in urban slums 74th Constitutional amendment stresses on greater role of Urban Local Bodies in health and related matters

Key Strengths/Accomplishments

Current UHRC Role in National Policy

UHRC provides technical support for design and roll-out of NUHM
Joint MOHFW-UHRC visits to States
Evidences strategies and programme documentation informed NUHM

Alluded to as Nodal Technical Agency for Urban Health for GOI UHRC acted as secretariat for National Urban Health Task Force (2006) at the directive from the Prime Ministers office. Task Force recommend NUHM Frequent questions in National Parliament (Jan 07-April 08) on health and well being of the urban poor, some quoting UHRCs evidence. UHRC assisting MOHFW in responding to questions Urban Health Guidelines issued by Govt of India, Feb 2004 Supported design of urban component of RCH II

Facilitated sample urban health proposals of four cities

City Programs Provide Learning for Policy, Program, Research City programs serve as demonstration and learning sites
Inequity and social exclusion addressed by inclusion of unlisted / hidden slums in city health plans Tools to identify & map unlisted and vulnerable slums, facilities developed Strategies for empowering improvement demonstrated slum communities for health

Study tours by government, non-government program managers (100 officers representing programs of >20 cities) Program managers, leaders from demonstration and learning sites share experiences at State and National levels Program research conducted and used for hygiene improvement, immunization tracking and exclusion related research.

Research, Knowledge Management and Advocacy National and state level urban poor specific data informed policy and programmes Repository of Urban Health Literature Collaboration with academic/professional resulted in greater attention to the issue Comprehensive urban health website attracts 60,000 hits per month Enhanced attention on the issue through conference, workshop, symposia & media

Mr. Prassana Hota, Secretary to the Ministry of Health and Family Welfare, Govt. of India, acknowledged the role of UHRC in furthering the urban health agenda in a message to UHRC website :

Technical assistance given to the GOI and State Governments has provided the right momentum for formulating policies and programmes for improving health of the urban poor.. I am confident that UHRC will continue its technical assistance efforts and its crusade for furthering urban health with dedication, commitment and a collaborative spirit.

Long Term Plan for Next 10 years

Policy Support and Tech Assistance for NUHM

Developing Policy Guidelines [e.g. Training of USHAs (Slum-level Volunteers) for different aspects] Data and Research support for better informed policy and programmes Technical Assistance for Convergence with other programmes for increased efficiency of resources Develop model methodology and instrument for city level baseline surveys Guidelines for spatial mapping of slums for city level planning

Envisaged Policy Advocacy Role for JNNURM and ICDS Advocate for greater JNNURM (BSUP) investment on water, sanitation and hygiene. Foster greater convergence at different levels with health.

Advocate with ICDS,BSUP and IHSDP to reach all urban poor habitations including unlisted slums
Advocate for stronger synergies at community level Advocate for greater role and capacity of Urban Local Bodies in view of 74th Amendment.

Envisaged TA Role at State Level for NUHM

Support Implementation of NUHM
Development of PIPs Capacity Building through workshops/study tours. Support in Developing UH Division / Cell

Catalytic Inputs for operationalizing mandated strategies Support evolving operational convergence mechanisms Development of Curriculum for Training of USHAs. Research and Data support

Envisaged TA Role at City Level for NUHM

Capacity building through hands-on support for city level planning and implementing NUHM strategies Assistance in establishing City Project Management Units Technical Assistance to operationalize convergence mechanisms Demonstration and learning of deployment and training of USHA Technical Support to evaluate program approaches including water, sanitation and hygiene. City Programs serve as demonstration and learning sites

Envisaged focus of Demonstration & Learning Programs Computerized /technology based HMIS
GIS to show health data in select area

Use of communication tech. (cell phone, PCO) for expanding reach and effective referral Model for Smart Card for PPP with doctors or private hospitals Community level health system to negotiate with public and private providers for RH services Ward based planning and implementation with focus on improving urban governance Community Health Insurance

Long-term Business/sustainability plan:

Broaden donor base
National International Corporate Houses

Build Corpus fund Arogya basti fund Purchase/build UHRC offices Establish Urban Health Training Institute

Broadening scope over time

South East Asia Urban Health Resource Centre International Conference on Urban Health in Developing Countries with an MNCRH focus Asia UH Network

Expand breadth of the UHRC programme responsiveness beyond MNCHN services

Research, Knowledge Management and advocacy

Expand and strengthen website: add UH Developing Countries portal; UH-Asia/SEA portal Collaborative State of UH Reports for SEA countries Articles series with developing country focus

Training and Education

Training programs, Courses, modules for State/Dist/NGO officers; collaboration with TERI Educational function on Urban Health
Summer/field placements of Masters and PhD students, from Indian and International Universities

15 month UH Internship for young PG pass-outs

Providing field site and mentoring to PhD students for their dissertation

Classes at Indian and International (JHU, GWU, SITVermont) universities

Exchange programme with leading universities

Management System
Decision making/institutional structure: Core Team, sub-committees Governing Board Advisory Board Financial management system: Concurrent audit Annual/statutory audit Financial Policy in place Regular efforts on Institutional sustainability plan Grants and Contract mechanism in place HR System (Ernst & Young) Recruitment system Performance Management system Resource Mobilization Team Staff capacity building policy in place Admin policies in place

With Hope and Confidence

Accountable, Effective Urban Health System

Long Lever of : a) Commitment , Motivation b) Knowledge, Experience c) Proximity to problems d) Accountability, responsibility

A small body of determined spirits fired by an unquenchable faith in their mission, can alter the course of history

Socially Committed, passionate Development Professionals with, Civil Society, Govt., slum communities

- Mohandas Karamchand Gandhi