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strategies for delivering quality health care to the urban poor
STRATEGIES FOR DELIVERING QUALITY HEALTH CARE TO THE URBAN POOR Urban Poverty The urban poor live with many deprivations. Their daily challenges may include: limited access to employment opportunities and income inadequate and insecure housing and services violent and unhealthy environments little or no social protection mechanisms limited access to adequate health and education opportunities. Issues to Consider When Developing Urban Health Programs 1.Social: Understanding the social complexity of urban poor is an important first step in developing health programs. 2.Economic: Poor health status of urban slum dwellers and its determinants are linked to poverty. Issues to Consider When Developing Urban Health Programs 3.Gender: Urban poverty has become highly feminized. Compared to their male counterparts, poor urban women tend to have lower paying jobs and have higher illiteracy rates. 4.Health of urban poor children: Poverty means chronic undernourishment of poor urban children. The Barriers Lack of transportation Inappropriate hours or services offered Unaffordable services Unrecognized status—lack of identification or other official papers Homelessness or transient status Social barriers of prejudice on the part of health personnel Service Delivery Issues 1.Decentralization of local governments and the delivery of public health services: establishing a legal framework for obligatory authorities, basic health services and minimum service standards for districts and municipalities training local facilitators to carry out health provider performance assessment and improvement activities improving the management of essential drugs strengthening the disease surveillance capacity at all levels of the health system 2.Working with the private and corporate sectors: There may be ways in which private sector activities could be altered to improve the lives of all city residents. Governments and donors could work with the private sector to find cost-effec
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