Mumbai’s 35% population have poor access to healthcare infrastructure: IIT-Bombay study - Hindustan Times
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Mumbai’s 35% population have poor access to healthcare infrastructure: IIT-Bombay study

ByPriyanka Sahoo
Jul 05, 2021 12:46 AM IST

Areas such as Chembur, Bhandup, Goregaon, Jogeshwari, Dahisar and parts of Ghatkopar have very poor accessibility to healthcare services, a first-of-its-kind study measuring the accessibility to healthcare in greater Mumbai by the Indian Institute of Technology-Bombay (IIT-B) has revealed

Areas such as Chembur, Bhandup, Goregaon, Jogeshwari, Dahisar and parts of Ghatkopar have very poor accessibility to healthcare services, a first-of-its-kind study measuring the accessibility to healthcare in greater Mumbai by the Indian Institute of Technology-Bombay (IIT-B) has revealed. The study has also found Chembur, parts of Malad and Malwani need to improve the public transport system on priority to improve accessibility to healthcare services for its residents.

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The paper ‘Public transit accessibility approach to understand the equity for public healthcare services: A case study of Greater Mumbai’ was published on June 25 in the peer-reviewed Journal of Transport Geography. The study was conducted by Gajanand Sharma, a PhD student in the department of civil engineering, and Gopal Patil, professor in the same department at IIT-B.

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Inequity in access to government healthcare facilities affects the overall urban population and can impact the vulnerable population that mostly relies on these services. In this study, the researchers measured the accessibility for healthcare services by public transport. They used travel time and the number of transit stops (accounting for transit connectivity) for Greater Mumbai.

They also identified socially vulnerable wards (administrative units) using a social vulnerability index (SVI), developed on the basis of 16 indicators using computational tool Principal Component Analysis.

“Accessibility means the ease by which one can reach services such as hospital, shopping malls and schools/colleges. In transportation, we quantify this ease of reaching services mainly by considering the travel time. For example, suppose from area A it takes 20 minutes to reach a hospital by public transport, whereas it takes 30 minutes from area B, assuming the same level of public transit infrastructure, we can say that the accessibility for hospitals for area A is better than that of B. In our definitions, we also take into account the number of bus stops to measure accessibility. A higher number of bus stops increase accessibility,” said Patil.

In this study, researchers measured the accessibility to healthcare facilities for a population of 12.4 million in Greater Mumbai, which comprises 577 traffic analysis zones.

Four different types of public healthcare services – hospitals, maternity care units, dispensaries and health posts – were considered.

For hospitals, eight of the total 24 wards of Mumbai — R-North (Dahisar), P-North (Malad), P-South (Goregaon and parts of Jogeshwari), S (Bhandup), N (Ghatkopar), M-East (Govandi) and M-West (Chembur)— fell in the critical category.

This meant that these areas had low accessibility for healthcare services and a high social vulnerability.

The city fared better in terms of access maternity care units—only R-North, M-East and S wards fell in the critical category. With respect to access to municipal dispensaries, R-North, P-North, P-South and M-East were critical. For access to health posts, R-North, P-North, and M-East wards fared the worst.

“Let’s assume there are 10 hospitals in an urban area. But from different areas, it can have different accessibility values to reach these hospitals; therefore, we developed an accessibility measure for an area, say A ward. Now, this accessibility measure is estimated for all the areas in the city (A, B, C, D wards and so on). Then we present the spatial distribution of these estimated accessibility measures over the study area and then find which areas have better accessibility and which have poor accessibility,” Patil explained.

Understanding

social vulnerability

Nearly 35% of the city’s population resides in wards where the accessibility for hospital services is low and the social vulnerability is high, the study has found.

Social vulnerability refers to socio-economic factors that affect the resilience of communities to diseases. The study also found that the eastern part of Mumbai lacked reasonable access to healthcare services. Further, those living in slums had poorer access to public healthcare facilities; the average accessibility value for all the public healthcare services is less for those living in slums than those in non-slum areas.

Shankar Das, dean, school of health systems studies, Tata Institute of Social Sciences, who was not a part of the study, said, “We know poverty and poor health status are inextricably linked; therefore, it requires a multidimensional probe into vulnerabilities like poor housing quality, overpopulation, undernutrition, poor education, unemployment/underemployment, economic conditions etc. to recommend holistic and equitable distribution of healthcare in these deprived communities.”

Going ahead

The study by IIT-B makes suggestions for improving the accessibility of healthcare for each ward.

The areas that need urgent improvement in terms of healthcare facilities and public transport are Dahisar, Malad, Chembur, Trombay, Ghatkopar and Govandi.

“These wards could be adopted as high priority wards for public health infrastructure development and service delivery so that the supply of healthcare providers can keep up with the demand for services. A number of strategies could be adopted using telehealth to deliver universal health services along with regular mobile health clinics in the underserved communities,” said Das.

Dr Abhijit More, public healthcare activist from Jan Swasthya Abhiyan, who was not a part of the study, said, “There’s an immediate need to improve the quality and standard of treatment available at primary and secondary healthcare facilities. The facilities should be near people’s homes, especially in a high-density city like Mumbai.”

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