Climate events and an umbrella for urban health – On the post monsoon water-borne diseases | 9 August 2023 | UPSC Daily Editorial Analysis

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What's the article about?

  • It talks about the issue of spread of water and vector-borne diseases in the Monsoon and post-monsoon season, particularly on vulnerable urban populations.

Relevance:

  • GS2: Issues Relating to Development and Management of Social Sector/Services relating to Health;
  • Prelims

Context:

  • Flooding is not the only major issue in the Monsoon season in India. Once the floods recedes, the new health issue emerges – spread of water and vector-borne diseases.
  • These include typhoid, cholera, dysentery, leptospirosis, malaria, and dengue

Analysis:

  • Vulnerable groups:
    • While every section of the population is affected in different ways as a result of extreme climate events.
    • Households in urban areas, particularly in less developed parts of a city such as slums and urban settlement colonies, are the most vulnerable groups.
    • A large majority of people in these slums and resettlement colonies live in poverty, working in the informal sector of the urban economy with no social security benefits.
  • Disease vulnerability:
    • As per the Indian Journal of Public Health, the vulnerability of a disease is different in different areas.
    • As per the findings in this journal, households in general with poor socio-economic indicators are more vulnerable to malaria.
    • It is also highlighted that the urban households, when compared to their rural counterparts, are significantly at much greater odds of suffering from malaria.
    • Another disease, dengue, too affects the urban population more.
    • The journal also found that households from climatically high and moderately high vulnerable States are at greater odds of suffering from malaria.
  • Suggestions:
    • To improve the primary healthcare system and ensure its resilience against unpredictable and extreme climatic events, the following steps are necessary:
    • Rebuilding the urban primary healthcare system with a focus on vulnerable urban populations, especially those living in urban slums and peri-urban areas.
    • Developing a resilient health system that can respond to emergency situations, prepare well in advance against impending crises, and adapt to changing public health needs.
    • Greater public investment, with an immediate focus on urban areas that are more vulnerable to climatic shocks.
    • A special fund from statutory institutions such as the Finance Commission that is targeted towards building a resilient system for vulnerable urban areas.
    • Attention needs to go beyond cities, to towns.

Way Forward:

  • It is important to recognise the complexities of urban health governance with multiple agencies and fragmented care provisioning, alongside the increasing presence and dominance of the private sector.
  • Tackling these health issues need greater coordination and cooperation across various actors in terms of knowledge and data sharing, preventive and curative functions, treatment practices and, above all, the regulation of rates and standards.
  • The realm of surveillance and information systems such as the Integrated Disease Surveillance Programme needs to be universalised, made comprehensive and strengthened.
  • The current system of vertical disease control programmes needs to give way to a comprehensive health system approach in the management of public health programmes.
  • An immediate step in working towards this could be the integration of front line workers across various disease management programmes to create a cadre of multipurpose, front line public health cadres in urban areas, who would be accountable to communities as well as to the health system.



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