To meet the health service demands of the increasing population in quality and quantity and to effectively address health concerns of the urban poor, the Ministry of Health and Family Welfare, Government of India had proposed to launch the National Urban Health Mission (NUHM) for the duration of the 11th Five Year Plan (2008-2012).
In view of the proposed mission, the Ahmedabad Municipal Corporation (AMC) felt the need to upgrade facilities available at its urban health centres and provide second tier facilities like community health centres. The newly merged areas and some of AMC’s earlier wards require additional sub-centres to help AMC effectively provide health out-reach services to its population. UMC was approached by AMC to prepare a proposal for the project.
The organizations involved in the proposal narrowed down on various aspects of urban health care to be addressed under the project. There was need to review the existing urban health infrastructure and identify the gaps between the existing and proposed health infrastructure; a detailed report which would concentrate on required physical resources for the project and upgradation of the urban health facilities in the entire AMC jurisdiction. There was requirement for a detailed report that would give details of the manpower required in development as per the project, a sample design of the urban health centers, community health centers and sub centers and indepth knowledge on the measures to improve quality of health infrastructure like health information systems and also training and capacity building workshops for health officials. Finance resources for the proposed project were also worked out.
UMC worked hands on with AMC health staff to identify required data on the existing urban health infrastructure and to collect data regarding spatial distribution of health facilities and slums across Ahmedabad. UMC staff visited AMC’s existing UHCs and CHCs to understand their functioning and understand the requirements for upgrading facilities. UMC developed a methodology which involved meetings and interviews with health staff including medical officers, pharmacists, lab technicians, multi-purpose workers (MPW) etc. Separate SWOT analysis was conducted with medical health workers and with pharmacists, lab technicians and MPWs. UMC with assistance of AMC staff, identified slum pockets and communities on the base map of Ahmedabad and also marked existing health facilities provided by the AMC. These maps were later transferred to a GIS environment to analyze the accessibility of health facilities by slum dwellers. This assisted in locating newer health facilities as proposed under the NUHM. UMC also has prepared model layouts for the new proposed health centres for the AMC. A detailed phase-wise budget and a proposal was prepared for the AMC for submission to Government of India under the NUHM.