HEALTHY CITIES

A healthy city is one that is continually creating and improving those social and physical environment and expanding those community resource which enables people to mutually support each other to perform all the functions of life and developing to their maximum potential. Healthy cities focuses on process, not just the outcome requiring a continuous development process that has no end point. The concept of health cities originated in year 1842. The British government held a health of town conference and publish a Chadwick report prevailing that living condition of the under privileged population. Health of town association was set up in 1844 to improve people living condition and addressing health problem in the cities. Healthy cities as a concept officially became known after the publication of guideline for healthy cities in 2005. Third goal of sustainable development goal also focus on Good health and well being and there is need to create healthy cities in India. Characteristics of Healthy cities are as follows,

1) A clean, safe physical environment of high quality

2) An ecosystem that is stable now sustainable in long term

3) A strong, mutually supportive and non-exploitative community

4) A high degree of public participation and control by public over the decision affecting their lives, health and well being

5) The meeting of basic needs (Food, water, shelter, income, safety and work) for the city people

6) Access to wide variety of experience and resource with possibility of multiple contacts, interactions and communications

7) A diverse, vital and innovation city economy

8) Encouragement of connectedness with the past, with the cultural and biological heritage and with other groups and individual

9) A city form that is compatible with and enhances the above parameters and behaviours

10) An optimal level of appropriate public health services accessible to all

11) High health status

12) Provisions for good sanitation and hygiene

In India, there are great inequalities in health between states. India's Global Hunger Index ranking of 102 out of 119 nations in 2018 behinds its neighbour Nepal, Pakistan and Bangladesh. It is considered that one in every three malnourished children in the world lives in India. In 2008 there were more than 122 million households that had no toilets, and 33% lacked access to latrines, over 50% of the population (638 million) defecated in the open. Due to the success of Swachh Bharat Mission initiative of the government of India, launched in 2014, India constructed 110 million toilets in the country. As of 2018 about 95.76% of Indian households have access to toilet and in the year 2019 the Government of India declared the country as Open Defecation Free (ODF). Rural India contains over 68% of India's total population, and half of all residents of rural areas live below the poverty line, struggling for better and easy access to health care and services. Health issues confronted by rural people are many and diverse from severe malaria to uncontrolled diabetes, from a badly infected wound to cancer. India has failed to reach its Millennium Development Goals related to health. The healthcare system of India is lacking in three factors related to access to healthcare: provision, utilization, and attainment. Access and entry into hospitals depends on gender, socio economic status, education, wealth, and location of residence. Additionally, there is a lack of sufficient infrastructure in areas with high concentrations of poor individuals and conditions of public hospitals is getting worsen. At present there are 0.7 hospital beds per 1,000 persons which do not match the norms by WHO that is minimum 3 beds per 1000 persons. Due to shortage of hospital beds the government created the 7000 additional beds nearly half of the Indian railways during Nationwide lockdown to treat patient during pandemic COVID-19. Nearly 3.6 million beds will be required in India by 2034 according to the studies. Slums dwellers in urban area are severely affected by waterborne diseases, lack of sanitation and healthcare facilities and due to close proximity in recent years and also during COVID-19 pandemic. Government of India is also taking many initiatives to make better healthcare in India by adopting schemes like Ayushman Bharat mainly consisting of two components Health and wellness centres and Pradhan Mantri Jan Arogya Yojana. 1,50,000 HWCs have been created to ensure better health care of people. PM-JAY is health insurance scheme for the poor with an health cover up to Rs. 5 Lakhs per family on annual basis. Awaz Health Insurance Scheme providing Awaz health insurance of Rs. 15000, while cover for death is Rs. 2 Lakhs for migrant labourers. National Food Security act, 2013, Midday Meal Scheme, Integrated Child Development Scheme and the Public Distribution Scheme for food security and subsidies under targeted public distribution system in 2017-2018.

The Government need to focus on the providing the Healthy City Planners and Healthy City Advisory Committee, who will be solely responsible for the healthcare and health status of the villages/towns/cities. The committee and planners will be advising the ULB’s and local government on providing the equal distribution of healthcare facilities and infrastructure upgradation lacking in villages/towns/city thus making it accessible to all sections of the society with an inclusive approach and indiscriminate the gender and religion biasness by adopting schemes/policies. The Healthy City planners and committee will also be focusing on environmental health by advising the Urban local bodies and local government to adopt and implement the proposals like emphasis on public transport, creation of traffic free zones as special for pedestrian, street network differentiation to prevent through on going traffic on local streets and provision of green spaces for maintaining the environmental health. The pandemic COVID-19 has taught us the importance of sanitation and being hygiene in our daily lives. The government has taken initiative of Swachh Bharat Mission and provided the toilets in public places and household too. Local government need to focus on maintaining and cleaning the toilets at public places here after in order to stop the spread of diseases and prevent the humans from being infected. The 100% swiping of streets and roads should be made mandatory. Planners can focus on providing the hand washing facilities and sanitizing facilities in toilets and public places by preparing plans for the health security and hygiene purpose. Planners need to focus on providing the sewage treatment facilities in village/town/city, so that the water resources can be saved from being polluted and water can be free from germs and safe for the use of domestic purpose.

Planners also need to focus on providing the water treatment facilities to deliver safe and clean drinking water to citizens for maintaining a good health. Planners also need to focus on adopting the Integrated programmes for solving the hunger problem for the city people. Recently launched scheme One nation One ration card would be helpful for poor and migrant labours to obtain the ration from anywhere in the country through one card irrespective to old ration card which was applicable to particular city only.

            If our cities are healthy socially and environmentally, then citizens will likely to enrol in Schools and colleges, this will lead to increase in education and literacy level, if people are literate then employment opportunities will be available, this would lead to earn income for citizens for livelihood purpose, if there is earning people will likely to invest and purchase new things by spending money and will automatically lead to increase in GDP of country. If cities are healthy people will like to invest and start business like restaurant, shops, cafes and will lead to create employment opportunities. This approach of health city will lead to a diverse, vital and innovation city economy thus will lead to increase in standard of living. To achieve this there is need to invest on sanitation, water supply and health care facilities in India. Adopting health city concept would be an next step for self-reliant programme of India (Atmanirbhar Bharat Abhiyaan).

Together We Will Grow, Together We Will Build