moradabad city - nuhm.upnrhm.gov.innuhm.upnrhm.gov.in/urban/pip/moradabadpip.pdf · nuhm planning...

National Urban Health Mission

Moradabad City Program Implementation Plan

National Urban Health

Mission

Prepared by District Health Officials with support from Urban Health Initiative


NATIONAL URBAN HEALTH MISSION

Program Implementation Plan

2013-14

District Health Society

Moradabad


Preamble

Census 2001 data says that 28.6 crores people live in urban areas in our country. The

urban population is estimated to increase to 35.7crores in 2011 and to 43.2 crores in 2021.

Urban growth has led to rapid increase in number of urban poor population, many of whom

live in slums and other squatter settlements. As per Census 2001, 4.26 crores people lived in

slums spread over 640 towns/ cities having population of fifty thousand or above. In the

cities with population one Lakh and above the 3.73 crores slum population is expected to

reach 6.25 crores by 20081, thus putting greater strain on the urban infrastructure which is

already overstretched2. Demographers have described the Indian scenario as the 2-3-4-5

syndrome, i.e., in the last decade, the Indian population grew at an average rate of 2%, the

urban population at 3%, mega cities at 4%, and slum populations increased at a rate of 5%.

The aim of the city health plan is to improve the health status of the urban poor

communities and other disadvantaged section of society by provision of quali ty integrated

primary health services.

The city health plan of Moradabad has been made to improve access of slum

population to health services either by providing integrated and sustainable system for

primary health or revamped public health system and encourage healthy health behavior of

the communities through intensive IEC/BCC strategies. It will also try to ensure equitable

access of slum population to quality health care through a revamped public health system.

The plan envisages to strengthen linkages between slum communities and health service

providers and to strengthen referral systems for critical cases from community and primary

health care to identified referral centers.

Dr. SanjeevYadav Sanjay Kumar, IAS

Chief Medical Officer District Magistrate

Moradabad Moradabad


Acknowledgement

The present work for the planning of National Urban Health Mission which came with maintaining hard work, dedication and perseverance. This work of planning would not

have been completed without the help and support of a number of people.

We do not have hesitation in saying that this work would not have come up without the valuable support and continuous encouragement of Shri Sanjay Kumar (IAS), District

Magistrate, Moradabad. His great confidence in team and spurred us into action.

My special regard goes to Dr. SanjeevYadav, Chief Medical Officer, Moradabad a dynamic and enthusiastic personality. He has always been a source of great encouragement

for us. The initiation and completion of this work would be substantiated only in his sincere and able guidance, expertise and precious opinion, keen attention, constructive suggestions and constant help. His critical reading of all the parts of the work has helped shape the NUHM planning in its present form.

I express my gratefulness to ShriAmit Kumar Ghosh, IAS, Mission Director, National Health Mission & Mr. ShashankVikram, IFS, Additional Mission Director, NUHM for

overreaching support and building the thoughts in our mind.

I owe my sincere gratitude to Dr. M.R. Gautam (general Manager) & Dr. UshaGangwar, (Deputy General Manager – NUHM) who have helped us immensely by providing relevant information, expert suggestions. This planning work got accomplished with their valuable support and eagerness to help.

I am privileged to have such good city team especially ShriRaghubir Singh (DPM, NRHM) &ShriSamarendraBehera, City Manager, UHI who have supported, helped, put their great efforts into planning of NUHM at city level.

I am also pleased to appreciate the precious help and motivation which I got from

my respective departments DUDA, ICDS, Nagar Palika, Education department, CMS and DTO.

Last but not the least; I would like to thanks all those people who were involved in the planning process directly or indirectly.

Dr. RanjanGautam Nodal Officer - Urban

Moradabad


Abbreviation

ANM Auxiliary Nurse Midwife

ASHA Accredited Social Health Activist AWC Aanganwari Center

AWW Aanganwari Worker BSGY BalSwasthay Guarantee Yojana

BSUP Basic Services for Urban poor

BSA Basic SikhshaAdhikari CDPO Child Development Project Officer

DH District Hsopital DWH District Women Hospital

DHS District Health Society

DUDA District Urban Development Authority ICDS Integrated Child Development Scheme

IDSMT Integrated Development of small & Medium Towns IDSP Integrated Disease Surveillance Program

IHL Individual House Level IMR Infant Mortality rate

KFA Key Focus Area

LHV Lady Health Visitor LT Lab Technician

MAS MahilaArogyaSamiti MMR Maternal Mortality rate

NHM National Health Mission

NPP Nagar PalikaParishad

NPSP National Polio Surveillance Program

NRHM National Rural Health Mission NUHM National Urban Health Mission

OD Open Drainage

UA Urban Agglomeration

UCHC Urban Community Health Center UFWC Urban Family Welfare Center

UHI Urban Health Initiative

UHP Urban Health Post

SAM Severely Acute Malnourishment


Table of Content

Preamble

2

Acknowledgement

3

Abbreviation

4

City Profile

6-9

Table 1: Demographic Profile

10

Table 2: Morbidity status of the city

11

Table 3: Listing & Mapping of slums

12-18

Color map of Moradabad city with slum layers

19

Table 4: Overview of existing public health facilities

20-23

Key issues

24-25

Strategies, activities and work plan under NUHM

26-27

City Programme Management Arrangement

28

Voucher Scheme 29-34

Voucher Scheme Budget 35-39

City level targets & indicators

40-41

City Profile


Name of the City – Moradabad

Status of the city – District Headquarter

Moradabad is one of the important cities in Uttar Pradesh, well known for its brass industry. It was established under the reign of Mughal Emperor Akbar as the head office of

ChaupalaPargana. Later on it was named Moradabad after the name of Mughal Emperor Shah Jahan’s son MuradBux, and this name still persists.

Fig 1: Moradabad Location Map

Moradabad city is situated in western U.P. between 28°21´ to 28°16´ Latitude

North and 78° 4´ to 79 Longitude East. It is bounded on the north by Bijnor

district, on the south by Budaun district, on the east by Rampur district

and on the west by JyotibaPhule Nagar district. Moradabad is well connected by road and rail from the rest of India. It is situated 167 km from Delhi, connected to it by the National Highway 24. It is also Divisional Headquarters of Northern Railways, on

Howrah and Amritsar main line. Ramganga river flows in the north east

and Ganga river in south west of the city. Being situated on the main railway line and National Highway, Moradabad city has attracted industrial and commercial development as the raw material or manufactured goods can easily be transported. Moradabad is on the route from Delhi to many popular hill stations in the state of Uttarakhand (like Nainital, Ranikhet, Almoraetc) and Jim Corbett National Park (Tiger Reserve).

Table 1:District level indicators, Moradabad

Population – District* 3322461 persons

Urban population-District* 1573623 persons

City Population (Municipality) 887871 Persons

Slum population-City 430159 persons

AverageLiteracy Rate 57 %

Decadal Growth Rate 25.22% Source: Census 2011

Sites of tourist interest in Moradabad include the fort overhanging the river bank, built by

Rustam Khan, and the fine Jama Masjid or great mosque (1631). It is famous for itsbrass handicraft items which are exported to countries like USA, Britain, Canada, Germany and


the Middle East. It is believed that the brassware industry originated from Moradabad and

spread to the rest of the country.

Moradabad has a hot climate for most of the year. The average summer temperatures range from 25º C to 46º C, May and June being the hottest months. The

monsoon extends from July-September, bringing an average rainfall of 967 mm. Winters last from November to February-March. Cold waves from the Himalayan region make the winters in Moradabad very chilly. Temperatures fall as low as 3º to 4º C at the peak of winter. City Institutional Structure

Moradabad city is the district headquarters and also houses the divisional administrative headquarters of the division consisting of Moradabad and neighboring 4 districts. The total area covered by Moradabad Municipal Corporation is 2,285 sq km while the total area of Moradabad district is 3,807 sq km.

Moradabad district has 12 urban local bodies (ULBs) which include 1 Municipal

Corporation of Moradabad city, 5 Municipal Boards (Nagar Palika) which are Chandausi, Sambhal, Bilari, Bahjoi and Thukurdwara Nagar Palika, and 6 Municipal Councils (Nagar Panchayats) which are Umari Kala, Kanth, BhojpurDharampur, Kundarki, Sirsi and Narauli. The functions of these urban local bodies include providing for water supply, education, hospitals, roads, market places, street lighting, drainage, fire brigades and record of birth and deaths.

Moradabad Development Authority (MDA) includes Moradabad and neighbouring Rampur district in its area of functioning. For planned development and growth in U.P., the

State town planning and development act was enacted in 1973 that declared Moradabad city as a development area. The city of Moradabad was constituted on 29.03.1981. MDA is

headed by the Chairman and Commissioner, Moradabad division who is supported by the Vice Chairman and Secretary. The other chief officers under him include the Chief Engineer/

In charge of Engineering, Chief Planner/ In charge of Planning and Chief Accounts Officer/ In charge of Accounts.

Demographic & Social Profile The total population of Moradabad city (Municipal Corporation) in year 2011 stood

at 887,871 persons, of which constitute 52% male population and 48% female population. The decennial growth rate (2001-2011) of 25.22%which is more than the national growth

rate. The overall sex ratio of Moradabad city is 912 females per thousand males.

Vulnerable Population

The total slum population of Moradabad city as per 2011 census was 430159, which was 48.44% of total city population. Total number of households was 86031 and the


average household size was 5. As per DUDA, the latest BPL estimates were available for

1996, since no BPL survey has been undertaken after that year. The total BPL population in 1996 numbered 342,950 and total number of BPL households was 68,590.

Table 2: Urban Slums in Moradabad: At A Glance

Indicators

Numbers

Total Slum Population

430,159

Average Household Size

5

Total Number of Households

86031

Total BPL Population

3,42,950

Total Number of BPL Households

68,590

Source: DUDA Report 2013 and UHI program survey report 2012, Moradabad

The slum identification has been done by DUDA in 1996 and as per their estimates it

is 60. UNICEF is also undertaking project on Protecting Child Rights in Moradabad and they are also using the same DUDA list. No vulnerability assessment of the city has been reportedly undertaken by any agency in Moradabad.

Moradabad housing and urban planning department looks after the housing needs

of the city, including affordable housing for the poor. It is governed by Housing and Urban Planning Department of Uttar Pradesh that ensures planned development of urban areas

and creates an enabling environment to provide affordable housing throughout the state. The department is supported by AwasBandhu. To care for different functions, it has further

sub departments and authorities such as UP Housing & Development board, Regulated Area, Special Area Development Authorities, Development Authorities, Town & Country

Planning Department and U.P. SahakariAwasSangh. The Town & Country Planning Department is supported by SambhagiyaNiyojanKhand, Traffic & Transportation Appraisal

Unit, NCR Planning Cell, I.D.S.M.T. Scheme, Physical Survey Division and SingrauliNiyojan Unit. Health System and Infrastructure

Moradabad has both public and private health services, including health centres by

religious and charitable institutions. There are several government as well as private hospitals and nursing homes, besides individual private practitioners.

Table 3: Distribution of Health Facilities

Type of Facilities Number


Government Health Facilities

First Tier (Primary Health Care Facilities)

Urban Health Post 13

Urban RCH Health Post 13

Second Tier Facilities

District / Joint Hospital 1

District Women Hospital 1

Post-Partum Centre 3

Medical / Dental College 2

ESIDispensaries 2

Defence 1

Private Health Facilities

Private for Profit 101

Maternity /Nursing Homes 40

Abortion/NSV Providers 40

DMPA Providers 34 Source: Office of Chief Medical Officer; Department of Health and Family Welfare 2012;

First tier facilities

At the first tier, the city has 13 urban health posts. In addition there are 13 urban

RCH health posts, focusing on reproductive and child healthcare services. Second Tier Facilities

In Moradabad, there are two Government–run secondary / tertiary level hospitals, including one exclusively for women. Besides, there are also 3 postpartum centres. There are two dental colleges as well.

Economic Base Moradabad city’s economy is based primarily on small scale and cottage industries,

commerce and trade, which include sugar mills and a distillery, pulp & paper, pharmaceutical and chemical industries. Over 15,000 small scale industry units are spread

all over the district, with greater concentration in the urban areas, especiallyMoradabad&Sambhal. Moradabad is famous for brass metal handicrafts. A good

number of artisans are also engaged in home manufacturing of horn and bone handicraft articles in Sambhal.

During Mughal period Moradabad was a major centre for minting silver and copper coins as currency. Other immigrating artisans from Benaras, Lucknow, Agra and Jalesar formed the

current cluster of brassware industry in Moradabad. The brassware industry saw the blooming period in early 19th century when the British took the art to foreign markets. In

1980s various other products like EPNS, iron sheet metal ware, glass ware and aluminum artworks were also introduced to the art industry of Moradabad. New technologies like


electroplating, lacquering, powder coating etc. also found their way to the industry.

Moradabad is among the 90 Minority Concentration Districts (MCDs) 3 in the country. The district has been identified as backward with unacceptably low levels of either socio-

economic or amenities indicators or both and they are in urgent need of focused attention. Table 1: Demographic Profile

Total Population of city (in lakhs) 887871 Source: Census 2011

Slum Population (in lakhs) 432500 Source: UHI & Health Department, NPSP

Slum Population as percentage of urban population

48.44% Source: City Population

Number of Notified Slums 60 Source: DUDA

Number of slums not notified 28 Source: UHI

No. of Slum Households 86031 Source: UHI &NPSP

No. of slums covered under slum improvement programme (BSUP,IDSMT,etc.)

NA

Number of slums where households have individual water connections*

NA

Number of slums connected to sewerage network* NIL

Number of slums having a Primary school 88 Source: BSA Office

No. of slums having AWC 88 Source: Urban CDPO Office

No. of slums having primary health care facility 75 Source: Health Department

Demographic profile of Moradabad city reveals that a total population of 887871 people is

existing in the city. As per the source and program implementation of NPSP and UHI, a total number of 430159 slumsreside in notified and non -notified slum areas with a total house

hold of 86031. The slum population ration in comparison to city population is 48.44%. As per the DUDA and others like UHI and NPSP states that a 88 slums are existing in the city

with 60 notified and 28 non-notified slums. During an individual consultation with Municipality Corporation, it came into fact that there is no authentic source or figure

available for slum improvement, slums connected to individual water connections and slums connected to sewerage network. A meeting with ICDS provided the information on presence of AWCs across all the slums including notified and non-notified slums and a total number of AWCs covering the whole city is 651. There are 75 slums which are catered by different health facilities like urban revamping centers, urban RCH centers and district level

facilities. The actual situation and scenario of the population and other facilities data can be gathered and authenticated once the urban ASHA selection starts and baseline survey done

across the city.

Table 2: Morbidity Status of the city


SL. NO. Name of Disease/ cause of morbidity (e.g. COPD, trauma, cardiovascular disease etc.)

Number of cases admitted in 2012-13

1 Injuries and Trauma 1161 2 Self-inflicted injuries/suicide 148

3 Cardiovascular Disease 798

4 Cancer (Breast cancer) 0 5 Cancer (cervical cancer) 0

6 Cancer (other types) 9 7 Mental health and depression 2

8 Chronic Obstructive Pulmonary Disease (COPD) 1788

9 Malaria 27 10 Dengue 0

11 Infectious fever (like H1N1, avian influenza, etc.) 0 12 TB 1606

13 MDR TB 0

14 Diarrhea and gastroenteritis 2761

15 Jaundice/Hepatitis 632

16 Skin diseases 7 17 Severely Acute Malnourishment (SAM) 0

18 Iron deficiency disorder 1734 19 Others 3823

The above table reflects the morbidity status of the city Moradabad. The data source

for this profile is IDSP and District hospital which is treated as the most authentic source. Apart from that, a district health indicator is shown below to analyses more about the health status of the city/district and also it will help us for a better planning and quality service delivery.

District Health Indicators Total Urban Source Infant Mortality Rate 65 67 AHS 2010-11

Under five Mortality Rate 82 78 AHS 2010-11

Maternal Mortality Ratio 339 AHS 2010-11 Total fertility Rate 3.2 UHI & MLE

Full Immunization (Percentage)


Table 3: Listing & Mapping of Slums

A detailed mapping of the listed and unlisted slums, vulnerable populations as well as public health facilities catering to the slums is done for Moradabad city in the following format.

Sl.no.

Ward no.

Name of the slum

Population

Quality of housing(Kutcha, Pucca& Mixed)

Quality of sanitation

Status of water supply (Piped, Hand pumps, open wells, none)

Location and distance of nearest AWC

Location and distance of nearest Primary School

Location and distance of nearest Primary Health Centre/UHP/UFWC

1 40 DiptySbKamandir

3717 Mixed

81.6% of the total population uses safety tank toilets. 1% of the total HH uses open space and 18% of the total HH using dry

More than 80% of the slum population uses Hand pumps as water supply and remaining population uses supply waters

DiptySbKamandir Kanya PS, KatgharSubhadra

MCU Katghar

2 40 KudaGhar 1146

Mixed KudaGhar KatgharPaschi

m MCU Katghar

3 32 Kamla Nagar 506 Mixed Kamla Nagar KatgharPurvi MCU Katghar

4 32 Prabhat market 2145 Mixed Prabhat market KatgharPurvi MCU Katghar

5 40

SiyalKout 528 Mixed

SiyalKout Kanya PS, KatgharSubhadra

MCU Katghar

6 14 Gulabbadi 5097 Mixed Gulabbadi KatgharPurvi MCU Katghar

7 35 SinghmanHazari 2219 Mixed SinghmanHazari Katghar West MCU Katghar

8 19

DehriGhat 704 Mixed

DehriGhat Kanya PS, KatgharSubhadra

UHP PeetalBasti

9 18 Veer Shah Hazari 2929

Mixed Veer Shah Hazari KatgharPaschi

m MCU Katghar

10 18 Mahbullaganj 4785 Mixed Mahbullaganj KatgharPurvi MCU Katghar


11 18

Katghar Beech 885 Mixed

toilet (manual scavengers) or flusing in open drains. (Source : with support of sanitation consultant, UNICEF)

Katghar Beech Kanya PS, KatgharSubhadra

MCU Katghar

12 18

HoliKaMaidan 482 Mixed

HoliKaMaidan Kanya PS, KatgharSubhadra

MCU Katghar

13 40 Udpura 1198 Mixed Udpura Udpura PS MCU Katghar

14 40 Pachpeda 221 Mixed Pachpeda KatgharPurvi MCU Katghar

15 18 Choti Mandi-1 742

Mixed Choti Mandi-1 KatgharPaschi

m MCU Katghar

16 18 Choti Mandi-2 643

Mixed Choti Mandi-2 KatgharPaschi

m MCU Katghar

17 60

Maqbara-2 4500 Mixed

Maqbara-2 Kanya PS Maqbara

MCU Katghar

18 54 KatarShaheed 4000

Mixed KatarShaheed

JHS KatarSheed RCH Warsi Nagar

19 48 Peer Zada 7291

Mixed Peer Zada Kanya PS

Maqbara RCH Warsi Nagar

20 54 ShekhAlaUddin 822

Mixed ShekhAlaUddin Kanya PS


21 55 Barwalan 17909

Mixed Barwalan

Barwalan PS RCH Warsi Nagar

22 70

Mughal Pura 4570 Mixed

Mughal Pura Kanya PS, Mughalpura

RCH Warsi Nagar

23 43 Jama Masjid 3370

Mixed Jama Masjid Kanya PS,

Mughalpura RCH Warsi Nagar

24 43 Warsi Nagar 12478

Mixed Warsi Nagar Kanya PS,

Mughalpura RCH Warsi Nagar

25 52

GhuinyanBagh 5450 Mixed

GhuinyanBagh GuiyanBagh PS

RCH Warsi Nagar

26 60 Darziyan 625

Mixed Darziyan

GariKhana RCH GadiKhana


27 59 DargahAbadi 3154

Mixed DargahAbadi

GariKhana RCH GadiKhana

28 60 Maqbara-1 4074

Mixed Maqbara-1 Kanya PS


29 24

ChakkarkiMilak 11470 Mixed

ChakkarkiMilak Kanya PS MilakMukkarbpur

CPH

30 9 Bangla Gaun 15451 Mixed Bangla Gaun Bangla Gaon PS DWH

31 61

MukarrabPur 14246 Mixed

MukarrabPur Kanya PS MilakMukkarbpur

CPH

32 67 Miyan Colony 4459

Mixed Miyan Colony Rehmat Nagar

PS UHP Miyan Colony

33 67 Azad Nagar 6336

Mixed Azad Nagar Rehmat Nagar

PS UHPMiyan Colony

34 31

Khwaja Nagar 7201 Mixed

Khwaja Nagar Rehmat Nagar PS

RCH Karula

35 65 Tamil Basti 493

Kutcha Tamil basti Rehmat Nagar

PS RCH Karula

36 25

RahmatnagarGali no-8

3323 Mixed

RahmatnagarGali no-8

Rehmat Nagar PS

RCH Karula

37 19

Govind Nagar 12592 Mixed

Govind Nagar Dehri

UHP PeetalNagri

38 45

KachiBasti 2075 Mixed

KachiBasti Dehri

UHP PeetalNagri

39 45

Nand Colony 2024 Mixed

Nand Colony Dehri

UHP PeetalNagri

40 10 KashiramnagarYojna

6145 Mixed

KashiramnagarYojna KhushalPur

DWH

41 11 Adarsh Colony 2861

Mixed Adarsh Colony Adarsh Nagar

PS DWH

42 11 Habudabasti 450 Kutcha Habudabasti PAC PS DWH


43 10 Sirkoi 3092 Mixed Sirkoi Kanya PS PAC DWH

44 10 Bhood 2449

Mixed Bhood Kanya PS PAC

UHP Faqeerpura

45 11

FaqeerPura 1320 Mixed

FaqeerPura Kanya PS PAC UHP Faqeerpura

46 4 Ambedkar Nagar 2210

Mixed Ambedkar Nagar

BhogpurMithoni

UHP Faqeerpura

47 19 DehriGaun

3191 Mixed

DehriGaun Dehri PS UHP PeetalNagri

48

MiyaBadi 11380 Mixed

MiyaBadi

Rehmat Nagar PS

49 15 Kazipura 12995

Mixed Kazipur Kazipura PS

RCH Nawabpura

50 12 Maunather 12800 Mixed Maunather Maunather PS

51 31 Dhimeri 4000

Mixed Dhimeri Dheemri PS

RCH Miyan Colony

52 Meerpur 4115

Mixed Meerpur

Kanya P.S. Majhola RC Majhola

53 1 Shahpur 4400

Mixed Shahpur

Shah PurTigri PS

54 Lodhipur 4910

Mixed Lodhipur

LodhipurJawahar Nagar PS

55 10

Vishanpur/Bhimathor 3515

Mixed Vishanpur/Bhimathor Bhimather PS

56 26 Surajnagar 12395 Mixed Surajnagar Dheri UHP PitalBasti

57 Khushhalpur 9015 Mixed Khushhalpur KhushalPur PS RCH Majhola

58 Jayantipur 9115 Mixed Jayantipur Jayantipur PS CPH, Karula

59 Govendpur 8430 Mixed Govendpur KalyanPur

60 3 Panditnagla 8910 Mixed Panditnagla PanditNagla PS

61 45 kalyanpur 7400 Mixed kalyanpur KalyanPur PS

62 62

MaanpurNarayanpur 3455

Mixed MaanpurNarayanpur

MannpurNarayanpur PS RCH Majhola


63 13 Majholi 3280

Mixed Majholi

Kanya PS Manjholi RCH Majhola

64 2 Laakdi 5000

Mixed Laakdi

Laakdi PS, Lakdi 2 PS RCH Majhola

65 Dakka 5000 Mixed Dakka Dakka PS RC HMajhola

66 34 Nawabpura 5000

Mixed Nawabpur

Kanya PS Nawabpura

RCH Nawabpura

67 14 Indira colony 10000 Mixed Indira colony Dheri

68 27 Daulatbagh 1340 Mixed Daulatbagh Bangla Gaon PS RC Kisroul

69 26 Prakash Nagar 1285 Mixed Prakash Nagar KhushalPur PS RCH Majhola

70 17 BudhiVihar 1420 Mixed BudhiVihar Manjhola RC Majhola

71 SonakpurBalmiki 1795

Mixed SonapurBalmiki

Kanya PS Harthala RC Harthala

72 46 Bhadaura 2110 Mixed Bhadaura Bhadura PS RC Harthala

73 Fazipur 10000 Mixed Fazipur FazalPur PS

74 44 Chao keeBasti 2595

Mixed Chao keeBasti

Kanya P.S. LalBagh RC Majhola

75 Church Majhola 940

Mixed Church Majhola

Kanya P.S. Majhola RC Majhola

76 MilakMajhola 2285 Mixed MilakMajhola Majhola RC Majhola

77 Ramtalaya 29455 Mixed Ramtalaya Line Par RC Majhola

78 6 NayagaonHarthala 4135

Mixed NayagaonHarthala

Kanya PS Harthala RC Harthala

79 21 Makhinyabasti 2150 Mixed Makhinyabasti Bangla Gaon PS

80 30

Gyanikibasti 2490 Mixed

Gyanikibast

Kanya P.S. LalBagh RC Majhola

81 Chidiyatola 3315 Mixed Chidiyatola Bangla Gaon PS RC Majhola

82 40

Sitapuri 1330 Mixed

Sitapuri

Rehmat Nagar PS RC karula

83 40 Dahrgkanta( Sambhalchaurah 2135

Mixed Dahrgkanta( Sambhalchaurah Man Pur RC Majhola


a) a)

84 LakshamanpuriLinepaar 7225

Mixed LakshamanpuriLinepaar Line Par PS RC Majhola

85 Saraikishanlal 1125 Mixed Saraikishanlal Kanya P.S. Ganj

86 51 Lalabagh 1565

Mixed Lalabagh

Kanya PS Lalbagh

RCH KanoonGoyan

87 Kundanpur 5735

Mixed Kundanpur

Kanya PS, Kundanpur

88 NayagaonAmbedkarnagar 3032

Mixed NayagaonAmbedkarnagar

Kanya P.S. Harthala CPH

Total 430,155

This information’s has been identified and taken from various sources such as NPSP, Health Department, DUDA and UHI. Also

to triangulate, we have cross checked the information’s. The AWC presence in the slums was supported by ICDS department and the health department has supported with presence of primary health facilities. The education department has supported with data which indicates presence of primary or upper primary schools in the slums where children go for their schooling.


Colour map indicating the location of the slums base layers


Table 4: Overview of existing public health facilities

Sl. No.

Name & type of facility (DH, Maternity Home, CHC, other ref. hospital UFWC, UHP PHC, Dispensary etc.)

Managing Authority (Municipal Council, State Health Department, facilities functioning on PPP basis)

Location of Health facility

Population covered by the facility

Services provided

Human Resource

s available – list

type and number

of HR available

i.e. ANM, LT, SN, MOs, Specialis

ts etc.

No. and type of

equipment

available: X-ray

machine, USG,

autoclave etc.

1

District Hospital (Male)

State Health Department

Civil Lines 3322461 Emergency Services, CeasearianServices,BloodBank,BurnUnit,Pathology,USG, NSV Services

MO-33,Staff Nurse-32, LT-4,Other-63

1 USG Machine,4- Autoclave

2

District Female Hospital


Civil Lines 3322461 Emergency Services, Ceasearian& Normal Delivery Services,Pathology,SNCU

MO-15,Staff Nurse-22, LT-3,Other-13

1 USG Machine,5- Autoclave 1 X-Ray Machine

3 Revamping Health Post Harthala


Harthala 50000 Approx

Emergency Services, ,Pathology,USG, Female Sterlization Services

MO-7,Staff Nurse-17,

1-X-Ray Machine, 2- Autoclave


LT-0,Other-53

not Working

4

Revamping Health Post Mukkarmpur


Mukkarmpur

50000 Approx

OPD Services, Counseling, Vaccination,FP Services

MO-1, Staff Nurse-1,ANM-1,Other-1

Weighing Machine-1, Stethoscope-1,BP Instrument-1

5

Revamping Health Post Majhola


Kajhola 50000 Approx




6

Revamping Health Post Kisrol


Kisrol 50000 Approx




7

Revamping Health Post KanoonGoyan


KanoonGoyan

50000 Approx




8

MCU Katghar State Health Department

Katghar 50000 Approx





9

Revamping Health Post Adarsh Nagar


Adarsh Nagar

50000 Approx




10

Revamping Health Post Karulla


Karulla 50000 Approx




11

Revamping Health Post Town Hall


Town Hall, AD office Campus

50000 Approx




12

Revamping Health Post KanjariSarai


KanjariSarai 50000 Approx




13 Revamping Health Post Kothiwal Nagar


Kothiwal Nagar

50000 Approx




14 Revamping Health Post Gadikhana


Gadikhana 50000 Approx

OPD Services, Counseling, Vaccination,FP Services MO-1, Staff Nurse-

Weighing Machine-1, Stethoscop


1,ANM-1,Other-1

e-1,BP Instrument-1

15

UHP Kashiram Nagar


Kashiram Nagar

50000 Approx




16

UHP PitalBasti Under NRHM

PitalBasti 50000 Approx




17

UHP Fakeerpura

Under NRHM

Fakeerpura 50000 Approx




18

UHP Nawabpura

Under NRHM

Nawabpura 50000 Approx




19

UHP Miyan Colony

Under NRHM

Miyan Colony

50000 Approx





20

UHP Warsi Nagar

Under NRHM

Warsi Nagar 50000 Approx




21

UHP KarullaRahmat Nagar

Under NRHM

Rahmat Nagar, Karulla

50000 Approx




22

UHP JatavBasti Bangla Gaon

Under NRHM

JatavBasti, banglaGaon

50000 Approx




23

UHP Chao Ki BastiChidiyaTola

Under NRHM

ChidiyaTola, ChaokiBasti

50000 Approx




24

UHP Barwalan Under NRHM

Barwalan 50000 Approx




25 UHP Lalbagh

Under NRHM

Lalbagh 50000 Approx

OPD Services, Counseling, Vaccination,FP Services MO-1, Staff Nurse-

Weighing Machine-1, Stethoscop


1,ANM-1,Other-1

e-1,BP Instrument-1

26

UHP Indra Colony, Gulabwari

Under NRHM

Indra Colony, Gulabwari

50000 Approx




27

UHP Majhola Under NRHM

Majhola 50000 Approx




28

CPH Under NRHM

Kanth Road 3322461 OPD Services, Counseling, Vaccination,FP Services



The above table reveals all types of health facilities such as district level hospitals including male and female, urban heal th

posts supported by state govt. and NRHM. It also reflects the quantity of population catered by these facilities and the type of services available in each facility. This table also reflects the human resources present in all the facilities in addition to the equipment’s used for quality service delivery. Apart from these, there is also a large gap in demand and supply side of the quality service delivery. Most of these urban health posts are partially equipped with trained providers to cater services regularly. Also comparing to the demand side, as there is no or less outreach activities are conducted to generate demand among the urban poor to make accessibility to these facilities. NUHM initiation will lead a vital role in fulfilling the demand as well as the supply side by conducting outreach activities at community level there by equipping and upgrading the facilities as UPHC at community level across the city to cater quality service delivery.


2. Key Issues

Based on the above tables and facts, the planning team had identified various

key issues as far as delivery of health care is concerned with specific focus on urban poor. They are-

Maternal Health:Pregnancy and child birth are the leading causes of death, disease and disability among women of reproductive age. Lack of antenatal care is an important risk factor for maternal health which is contributed largely due to inaccessibility of health facilities in the urban areas. Also, the availability of Front-Line Workers (FLWs) is very low in the urban slums as compared to the rural areas where ASHAs are the lead volunteers of the client-outreach activities. The Reproductive and Child Health Program recommends that as part of antenatal care, pregnant women should be provided with at least three antenatal check-ups, two doses of tetanus toxoid vaccine and iron and folic acid supplementation for at least three months during pregnancy. However, the urban

areas are comparatively low indicators of maternal health than rural areas and this need to be focused in increasing the indicators by delivering quality services. Childhood morbidity and health services:Moradabad district is always common in facing outbreaks of polio and Vaccine Preventable Diseases which are more common in urban slums owing to high population density and continuous incoming of a new pool of infective agents with the immigrating population. Although vaccines have been developed for this deadly disease, yet their reach to children in urban slums is a major area of concern. Also, there is high drop-out and left-out rates of immunization among

urban poor households as compared to the urban average and rural areas. This is mainly due to the weak birth registration system particularly for the urban slums. Many of the

births particularly home deliveries in the urban slums remain unregistered. This is compounded by inaccessibility of health facilities for the urban slum population and lack

of FLWs for providing the required information.

Usage of Family Planning: High population growth rate in urban areas is not only because of rapid in-migration but also because of large families and the limited use of

family planning or contraceptive methods especially among the urban poor. Addressing

the high fertility and low use of family planning methods is not only important from the view point of reducing the rapid growth of population but also to reduce high parity and

closely spaced births which have a significant bearing on maternal and child health. The Total Fertility Rate among urban population is 3.2 which isat higher side. If we look into

the urban poor, the total fertility rate is 4.7 which are much higher than the district average. Though knowledge about methods of family planning is high but only 44.2%

Percent of urban population is using any modern method. The total unmet need for family planning in urban area is 41.2 % in comparison to unmet need of the district is 37%.


Environmental Health factors:The health status of the slum community is further

accounted by the poor climatic or environmental conditions in which they reside. Access to safe drinking water and quality sanitary means of excreta disposal are basic human

rights and forma an indispensable components of primary health care services. Inadequate sanitation, poor hygiene and water result not only in more sickness and

death but also in higher health costs, lower worker productivity and lower school enrollment and retention rates. The poor in urban areas bear a disproportionately higher burden of the non-availability of water as well as its poor quality. Majority of the urban slum households derive their drinking water either from hand pumps or public taps. Increased coordination and convergence of departments in-charge of water supply, sanitation and slum improvements with the health department is a pre-requiste for improving the health conditions of slum dwellers. Lack in Health facilities:In Moradabad urban areas, itdoes not have a wide network of primary health care services unlike rural areas. The rapid growth of urban population

has also rendered the already limited health facilities more inadequate to serve the needs of the urban poor. As a result some slum settlements are entirely uncovered by health services and the quality of services in others is seriously compromised.


3. Strategies, Activities and Work plan Under NUHM

The strategies will be designed in line with the guidelines provided by the NUHM

and to start with the minimum plans to make sure that planning’s made and implemented as per the norms and that has resulted to quality output as desired. Also it

has been taken into consideration that all planning made is participatory rolled out at community level which will ensure its progress in a wide range. The following strategies are carried out as- Creation of Service delivery infrastructure: As per the guideline, it has mentioned at every 50,000 population will be catered by UPHC to deliver quality health services. Moradabad city is proposing 18 UPHCs in accordance to the total population of 887871 people in the city. All the UPHCs will be upgraded or newly identified as per the baseline survey conducted by NUHM plan. Once the survey results are collated, it will lead to take appropriate decisions for stepping to location and placement of UPHC. Besides

that, the budget part includes all human resources which make sure that UPHCs are fully functional. Also plan for drug and consumables in required number is made allocations to provide un-interrupted services to urban poor. The planning team has also focused on strengthening the urban health posts to UPHCs and henceforth these facilities will be more active in provisioning services. Outreach: Outreach services will be provided through female health workers or ANMs who will be headquartered at UPHCs. Keeping this in view and population standard’s, Moradabad city plan has proposed 78 ANMs in the budget part of all total 88. Though

the existing 10 ANMS are already doing outreach activities and rest will be hired in the financial year after the fund flow is regular. All 88 ANMs will be engaged to provide

preventive and promotive health care services to households through routine outreach sessions. They will also focus on providing health services to children by covering all

government schools and anganwadi centers and schools located in the slums. During the sessions, they will screen birth defects, diseases, disability and deficiency and

accordingly follow up actions would be initiated.

Targeted interventions for slum population and the urban poor: MahilaArogyaSamiti will

act as community based peer education group in slums who will involve in community mobilization, monitoring and referral with focus on preventive care, facilitating access to

identified facilities and management of grants received. In this context, Moradabad city plan is proposing formation of 230 MAS in the current financial year.

Once these MAS groups are formed, the city plan has also provisioned capacity

building and orientation to enhance the skills and exposure to the members of MAS. A total number of 230 MAS group members (8-10 members in each MAS) will be trained for mobilization, sanitation and hygiene and emergency healthcare needs.


As per the requirement and according to the city total population, 230 ASHA

workers are proposed in the budget. These ASHA workers would serve as an effective and demand generating link between the health facility and the urban slums population

Each ASHA workers will serve to a population of 1000-2500 based on spatial consideration.

Each ANM will focus on conducting 4 number of UHND which will count to 528

UHNDs in the financial year. Apart from 2 number of outreach camps will conducted in 34 slums which are densely populated and hard to reach.

Public Private Partnerships: In view of presence of larger number of private (for profit

and not for profit) health service providers in urban areas, public – private partnerships

particularly with not for profit service providers will be encouraged. NUHM will also

support innovations in public health to address city and population specific needs.

However, clear and monitorable Service Level Agreements (SLAs) need to be developed

for engagement with Private Sector. Moradabad city plan has proposed to involve

NGOs/CBOs to support in innovations and implementing NUHM strategies. Also NUHM

will work closely with other private providers and trusts like Janani, TMU and UHI for

quality service provision.

Role of Urban Local Bodies: The NUHM would promote active participation of the ULBs

in the planning and management of the urban health programmes. City plan has

proposed special focus on urban local bodies to involve in implementation strategy and

it will play a supportive role for achieving program goals.

Funding / budget mechanism: Funds will flow to the District Health Society through

State Health Society. There will be separate books of account for NUHM or as guided by

the NHM.

Convergence: Intra-sectorial convergence is envisaged to be established through

integrated planning for implementation of various health programmes like RCH,RNTCP,

NVBDCP, NPCB, National Mental Health Programme, and National Programme for

Health Care of the Elderly, etc. at the city level. City plan will have the scope and

potential to work with PAC, Northern Railway divisional HQ, ESIC and other CSR as

appropriate.

4. City programme Management Arrangement

The city programme management arrangement will be done accordingly to the

guideline and norms allocated by state NHM official’s. Also it will depend on the district

health society guidance and other stakeholders from time to time.


City Level Indicators and Targets

Processes & Inputs

Indicators Baseline (as applicable)

Number Proposed (2013-14)

Number

Achieved

(2013-14)

Community Processes

1. Number of MahilaArogyaSamiti (MAS) formed * 0 460 0

2. Number of MAS members trained * 0 4600 0

3. Number of Accredited Social Health Activists (ASHAs) selected and trained *

0 230 0

Health Systems

4. Number of ANMs recruited * 0 117 0

5. No. of Special Outreach health camps organized in the slum/HFAs * 0 88 0

6. No. of UHNDs organized in the slums and vulnerable areas * 0 490 0

7. Number of UPHCs made operational * 0 26 0

8. Number of UCHCs made operational * 0 0 0

9. No. of RKS created at UPHC and UCHC * 0 23 0

10. OPD attendance in the UPHCs 0 18000 0

11. No. of deliveries conducted in public health facilities 0 2400 0

RCH Services 0

12. ANC early registration in first trimester 0 600 0


13. Number of women who had ANC check-up in their first trimester of pregnancy

0 600 0

14. TT (2nd dose) coverage among pregnant women 0 600 0

15. No. of children fully immunised (through public health facilities) 0 2400 0

16. No. of Severely Acute Malnourished (SAM) children identified and referred for treatment

0 120

Communicable Diseases 0

17. No. of malaria cases detected through blood examination 0 NA 0

18. No. of TB cases identified through chest symptomatic 0 NA

19. No. of suspected TB cases referred for sputum examination 0 NA

20. No. of MDR-TB cases put under DOTS-plus 0 NA

Non Communicable Diseases 0

21. No. of Diabetes cases screened in the city 0 NA

22. No. of Cancer cases screened in the city 0 NA

23. No. of Hypertension cases screened in the city 0 NA

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