New Delhi: The government’s ambitious health mission for the urban poor will yet again fail to see the light of day anytime soon.
The National Urban Health Mission (NUHM), the urban counterpart of the National Rural Health Mission, was to have been launched in the current fiscal (2009-10) with an initial allocation of Rs50 crore in the budget last year.
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However, numerous changes in the programme’s model have led to a further delay in its launch.
“This year no proposal has been sent for allocation of funds for the NUHM in the Budget. The Rs50 crore from last year will lapse and can be used in other projects,” a health ministry official involved in the budgetary process said on condition of anonymity.
Another official said that though NUHM has received in-principle approval from the Planning Commission, the commission suggested the ministry study similar models in other countries before approaching the cabinet.
“Based on this, there will be changes in NUHM. The one basic debate that is there is that health is wider than just medical care. It is good to target the poor who need medical care, but with outbreaks like dengue, chikungunya and H1N1, one cannot ignore the public health challenges,” said Amarjeet Sinha, joint secretary (NRHM), health ministry.
He added that public health issues and challenges such as water, sanitation and environment will have to be a part of an urban initiative.
The ministry is also trying to decide on the issue of composition of the healthcare system in terms of public and private sector participation. One option being explored is to buy hospitalized care from private hospitals and the other is to also have basic primary healthcare in public system to play the countervailing role both in terms of quality of healthcare and cost.
“So, we need to see what component should be purchasing and what should be provisioning of care. There are some who feel that there are more options for purchasing medicalized care in urban area, but that doesn’t take away the fact that you still need primary healthcare,” said Sinha.
While fund allocation for both NUHM and NRHM may overlap once it is launched, Sinha said NUHM is likely to be launched in the next fiscal (2010-11). Union health minister Ghulam Nabi Azad had announced in his joining speech last year that NUHM was one of the top priorities for this government. However, since then, major changes in the programme have led to a delay in its launch.
Health secretary K. Sujatha Rao though is a little more cautious on the NUHM launch date. “The designing of NUHM is yet to be done and a lot of survey needs to be done. This may take up (to) a year. So, approvals (for the mission) may be later in this year or next,” said Rao. She added that currently the ministry is in the process of getting data and briefings on the components of the mission are still taking place.
NUHM aims to cover India’s 210.7 million urban residents with a special focus on the 62.5 million poor people who live in slums.
The total budget for this scheme was pegged at Rs6,207.84 crore.