Siddharth Agarwal

According to a report by the National Institution for Transforming India (NITI) Aayog, Government of India (Composite water management index: a tool for water management. https://niti.gov.in/sites/default/files/2019-08/CWMI-2.0-latest.pdf, 2019), nearly 600 million people in India face extreme water stress. The problem is exacerbated in the hot sum...

Introduction: Restricted mobility during the lockdown led to unprecedented challenges related to women’s access to reproductive health services. The purpose of this research is to learn about the experiences of women in slums who needed abortion services during the COVID-19 lockdown in Agra, India in the year 2020 and 2021. Methods: Qualitative int...

Background and Objective: Accessing timely, affordable services is a crucial health determinant urban for urban poor in India. Urban Health Resource Centre (UHRC) mentors slum-based women’s savings groups in slums of Indore, India. Each group comprises of 10-12 members. We studied how collective savings and loans help families of women’s groups in...

The informal economy is crucial for making cities function, and it provides the main means of income for a significant proportion of all workers globally. At the same time, informal workers are extremely vulnerable to the effects of climate change, with higher temperatures and more intense weather events causing direct physical harm and contributin...

This paper examines the impact of the pandemic on India’s public health system of the country, especially from the perspective of urban slumdwellers. Drawing on a qualitative study carried out by the Urban Health Resource Centre in selected slums in Indore and Agra, the paper reflects the impact of the pandemic on the provision of essential health...

In this working paper, we report on the complex risks, challenges, adaptations and aspirations of informal workers and settlement dwellers in Indore, the economic capital of Madhya Pradesh. India’s economic growth is concentrating in urban areas, where informal employment plays a huge role. Yet informal workers remain marginalised including in thei...

Background The study aims to understand the effect of COVID lockdown on MCH for slum dwellers and coping mechanisms adopted in Indore and Agra, India. Slum women's perspectives on seeking, delaying, avoiding healthcare in COVID-19, barriers and facilitators were explored. Methods In-person qualitative interviews were conducted in slums in Sept-Oct...

Issue With livelihood loss, uncertain earning, slum families are often food insecure, at risk of undernutrition particularly during COVID-19 in Indian and other LMIC cities. While wheat flour was provided free during lockdown, later at subsidized costs and during non-COVID times, vegetables need to be bought at market price. Methods UHRC provided...

Background Birth preparedness and complication readiness (BPACR), promotes utilization of skilled maternal and neonatal care. Preparing for childbirth reduces delays in seeking care. Brick-kiln workers constitute a vulnerable social group who contribute to city infrastructure by laboring at low wages. 37% of the sample were Scheduled Castes, 49% Sc...

The article “Slum Health: Arrresting COVID-19 and Improving Well-Being in Urban Informal Settlements”, written by Jason Corburn et al.

Urban Health Resource Centre’s (UHRC) social facilitators encourage families to grow vegetables in small spaces in slum houses. Seeds were provided. Facilitators motivate families to tend plants as they grow. During 2018–2019, 495 families grew beans, bottle gourds, round gourds, sponge gourds, tomatoes, brinjals, small green peppers, and pumpkins...

Slum children/youth are excluded from the benefits of India’s urbanizing economy. Unequal access to education, self-expression hinder actualizing their potential. This programme research is undertaken in Indore, India to better understand the methods through which slum children (a) overcome gender inequality; (b) overcome hesitation, develop confid...

Issue There is a need for adaptable/scalable methods to understand environmental determinants of health and well-being in slums of LMIC cities. Catalysing grassroots actions to reduce health inequalities is needed with strong community leadership in slums. Methods Conducted in 2016-2017 in Indore (3 m population), India this practice undertakes qu...

Issue Government of India's, NITI Aayog reports that 600 million people in India face extreme water stress. Slums and similarly vulnerable urban populations face huge challenges in accessing water for basic needs, increasing in summers. Indore is an extreme water stressed city in India. Methods During Urban Health Resource Centre's (UHRC) program...

The informal settlements of the Global South are the least prepared for the pandemic of COVID-19 since basic needs such as water, toilets, sewers, drainage, waste collection, and secure and adequate housing are already in short supply or non-existent. Further, space constraints, violence, and overcrowding in slums make physical distancing and self-...

The informal settlements of the Global South are the least prepared for the pandemic of COVID-19 since basic needs such as water, toilets, sewers, drainage, waste collection, and secure and adequate housing are already in short supply or non-existent. Further, space constraints, violence, and overcrowding in slums make physical distancing and self-...

This study is an attempt to understand Family Planning (FP) needs and adoption among three categories of urban disadvantaged – older settlers; seasonal migrants and recent migrants, factors contributing to level of FP adoption, access to services and possible strategies to improve implementation in Indore City, India.

According to the latest census, there are about 13.7 million slum households in all of India, of which 4.9 million are neither recognised nor notified. Considered as informal, such settlements are often deemed illegal by authorities, especially when newly formed. This supposed “illegality” presents challenges to the residents, adding housing instab...

This study introduces the three-factor theory to identify a factor structure of tranist service. It classifies service attributes into basic, perfomance,and excitement factors according to their importance to overall satisfaction with transits then identifies improvement priorities. Using a 2013 survey of Bus, Bus Rapid Transit (BRT) and Van riders...

With over half of the world’s population under twentyfive years of age and one third of it under the age of fifteen, young people hold more keys and more power to our world’s sustainable future than ever before. While a substantial proportion of urban youth is benefiting from the technology available and using different media to connect with other...

Background: Many adolescents grow-up with inadequate access to opportunities facing challenges and risks. This study focuses on recently migrant adolescent girls in India’s fast growing urban slum population for whom multiple vulnerabilities intersect, including gender, poverty and migrant status. Objective and Methods: This qualitative study aims...

Rapid and uncontrolled urbanisation across low and middle-income countries is leading to ever expanding numbers of urban poor, defined here as slum dwellers and the homeless. It is estimated that 828 million people are currently living in slum conditions. If governments, donors and NGOs are to respond to these growing inequities they need data that...

This chapter assembles a quantitative portrait of the adolescent girls who migrate to the cities and towns of poor countries, drawing mainly on a large collection of data from demographic surveys and census micro-samples. For adolescent girls and young women, migration puts important urban resources within reach, in the form of access to higher lev...

Abstract India’s urban population is expected to grow from 377 million to 590 million by 2030. Much of this growth will be the result of migration from rural areas and small cities and towns. But despite the significance of migration to India’s urban future, migrants remain largely invisible, voiceless and powerless, especially in the larger cities...

Background: The study tried to identify coping strategies adopted by urban slum dwellers to prevent the situation of food insecurity. Methods: A household-based cross-sectional study on a sample of 446 households was conducted. Structured interview schedule was used to collect data on coping strategies along with group discussions. Standard univari...

Health, nutrition and wellbeing disparities in urban India are stark. Under-5 children in the most vulnerable sections of the urban poor are 2.5 times more undernourished than the urban rich. And their mortality rate is significantly higher than the urban aggregate. The urban poor are in fact far less likely to avail of ICDS and other schemes than...

Objective of the study was to assess the prevalence of food insecurity and malnutrition among young children (6-36 months) in urban slums of India and its consequences on the nutritional status of the children. Household-based cross-sectional study on a sample of 446 mother/child diad was conducted. Structured interview schedules were used to colle...

The paper presents a wealth quartile analysis of the urban subset of the third round of Demographic Health Survey of India to unmask intra-urban nutrition disparities in women. Maternal thinness and moderate/ severe anaemia among women of the poorest urban quartile was 38.5% and 20% respectively and 1.5-1.8 times higher than the rest of urban popul...

Touro College of Pharmacy (TCOP-NY), Urban Health Resource Centre (UHRC) and Federations of Women Health Groups in Agra slums, India (WHFA), conducted health camps in poor Agra communities to: 1) screen for diabetes, hypertension, nutrition status, and pulmonary function; 2) counsel on disease prevention, medication management; and 3) make medical...

The paper presents a wealth quartile analysis of the urban subset of the third round of Demographic Health Survey of India to unmask intra-urban nutrition disparities in women. Maternal thinness and moderate/ severe anaemia among women of the poorest urban quartile was 38.5% and 20% respectively and 1.5-1.8 times higher than the rest of urban popul...

Introduction: Use of experience-based measures of household food insecurity (HFI) remains largely unexplored in India. Objective: We assessed the reliability and validity of an experience-based measure of HFI and the extent and predictors of HFI in Meerut slums in Uttar Pradesh, India. Design/Methods: The 6-item HFI measure developed in the Uni...

Introduction: Ward is the smallest administrative and political unit of civic administration in Indian cities. Services at ward-level are provided by multiple agencies, often working independently. WHO Urban Health Equity Assessment and Response Tool (HEART) has supported urban policy makers in 17 cities worldwide in tackling urban health inequitie...

Introduction: Agra is a rapidly growing, industrialized and tourism-dominated city of Uttar Pradesh, India’s largest State. Agra city has 1.7 million population, with nearly 50% urban poor. Aimed at improving healthcare access in 60 slums (2,00,000 slum population), a consultation-based program started in 2005 involving government Departments, muni...

Introduction: Urban Health Equity Assessment and Response Tool (HEART) developed by WHO has helped tackle health-inequities at city-level but not ward-level. In Indian cities most quantitative indicators suggested by WHO Urban-HEART are unavailable at city or ward-level. We hypothesized that slum-level community organizations working towards better...

Introduction: 195 million children <5 in developing world are chronically undernourished (stunted). Of these, 40% stunted children live in Asia; 31.2% in India, 3.7% in Bangladesh, 1% in Nepal. By 2030, Asia accounts for more than half of world’s urban population. India, Bangladesh, Nepal together house 400 million urban population. Urban – rural c...

Introduction: Even in 2005, when urbanization had been recognized, Government of India launched its flagship health-initiative for rural areas entitled National Rural Health Mission. One-third of urban population lives in poverty, deserving focus for health needs. Methods and Intervention: To bring greater attention to urban poor the following ap...

For 18 months in 2009-2010, the Rockefeller Foundation provided support to establish the Roundtable on Urban Living Environment Research (RULER). Composed of leading experts in population health measurement from a variety of disciplines, sectors, and continents, RULER met for the purpose of reviewing existing methods of measurement for urban health...

There are sharp disparities in urban areas in all social determinants of health and nutrition. There are approaches to move from Metrics to Action: a) Share credible evidence in simple, appealing ways, b) data such as undercounting of slums/vulnerable populations requires several examples and involvement of Government stakeholders in collection of...

India has the world’s second largest urban population (after China). This paper shows the large disparities within this urban population in healthrelated indicators. It shows the disparities for child and maternal health, provision for health care and housing conditions between the poorest quartile and the rest of the urban population for India and...

The Lancet Neonatal Survival Series categorized neonatal health interventions into 3 service delivery modes: "Outreach," "Family-Community Care," and "Facility-based Clinical Care." Family-Community Care services generally have a greater potential impact on neonatal health than Outreach services, with similar costs. Combining interventions from all...

Three hundred twelve mothers of infants aged 2-4 months in 11 slums of Indore, India, were interviewed to assess birth preparedness and complication readiness (BPACR) among them. The mothers were asked whether they followed the desired four steps while pregnant: identified a trained birth attendant, identified a health facility, arranged for transp...

The world is becoming more urbanized. This trend is now particularly pronounced in the developing world, where the urban population is expected to double in the next 30 years. The impact of urbanization on the health of citizens in developing countries has received increasing attention recently. Urban residents in developing countries, especially t...

To assess the validity of human touch (HT) method to measure hypothermia compared against axillary digital thermometry (ADT) and study association of hypothermia with poor suckle and underweight status in newborns and environmental temperature in 11 slums of Indore city, India. Field supervisors of slum-based health volunteers measured body tempera...

India is committed to achieving the Millennium Development Goals (MDGs) set by the UN Millennium Declaration in 2000. MDGs ably summarize crucial global development concerns, encompassing multiple dimensions of economic and social poverty. As a result, they have been incorporated smoothly into the five-year planning framework of the country. Specif...

To examine the association between presence of an urban health center (UHC) in proximity to a slum and immunization status of slum children in a city in India. Cross-sectional study. Slums of Agra, India. Data were obtained from a baseline survey conducted by the US Agency for International Development Environmental Health Project in 2005 in slums...

This presentation discusses the different dimensions of urban poverty, the situation regarding access of city’s poor to basic health care and other basic services and current scenario of education access among city’s poor. It further explains the schemes, services and programs available for improving health and education access. The presentation th...

Newborn care practices in urban slums: Evidence from central India One-third of India's urban population resides in slums and squatters, in extreme poverty conditions. Newborn care is sub-optimal among India's urban poor, yet scarcely documented. We assessed newborn care practices in 11 urban slums of Indore in Central India. Practices such as clea...

Background: Poor water and sanitation infrastructure is responsible for 50% child mortality in urban slums1. Hence it is imperative to address this issue in these vulnerable settlements. Purpose: To increase access and usage of toilets and piped water through renovation of community toilets and linkage with water and sanitation infrastructure progr...

Background: Neonatal morbidities must be recognized early and treated appropriately to optimize chances for survival. Information is lacking on household recognition of neonatal illness, triggers to action' and choice of provider. Methods: We conducted a focused ethnographic study using free listing, severity ranking and in-depth interviewing wit...

Children of the urban poor in India suffer a much poorer health status than the urban non-poor, influenced to a large extent by social determinants. In this paper, National Family Health Survey-3 (2005-06) data were analyzed to assess the health status of urban poor children vis-à-vis the non-poor, and to identify the social determinants precipitat...

Background: Health status of slum dwellers varies across cities. There are multiple factors which influence health outcomes including demographic characteristics of slum population, availability of health care and basic services, municipal governance and migration in the city. This paper analyzes reasons for variation in health indicators across di...

Context: In India, urban poor have largely remained out of gambit of government public health programs. Further, commonly presented urban averages have failed to reflect their dismal health conditions. Complete immunization coverage among the urban poor children is as low (40 per cent) as their rural (39 per cent) counterparts. Expansion of service...

One-third of India’s urban population resides in extreme poverty, in slums and squatters. Food insecurity remains a visible reality among this segment. Yet, it is scarcely documented. This paper describes levels and determinants of experiential household food insecurity (HFI) in an underserved urban slum of Delhi (India) and reports the internal va...

One-third of India’s urban population resides in slums and squatters, their vulnerability being characterized by poverty and powerlessness. Newborn care is sub-optimal among India’s urban poor, yet scarcely documented. Neonates born in urban poor settings are at high risk of death owing to multitudinous factors. This paper discusses the situation o...

One-third of India’s urban population resides in slums and squatters, their vulnerability being characterized by poverty and powerlessness. Newborn care is sub-optimal among India’s urban poor, yet scarcely documented. Neonates born in urban poor settings are at high risk of death owing to multitudinous factors. This paper discusses the situation o...

Background: Sub-optimal hygiene, maternal care, delivery care and child care behaviours in slum households have a cumulative adverse effect on lives of mothers and children. These behaviours are reinforced through informal social processes in the neighbourhood. Eighty slum CBGs have been able to bring positive changes in household MCH behaviours i...

One-third of India's urban population resides in extreme poverty conditions, in slums and squatters. Food insecurity remains a visible reality among this segment. Yet, it is scarcely documented. This paper describes levels and determinants of experiential household food insecurity (HFI) in an underserved urban slum of Delhi (India) and reports the...

Weak linkages between health providers and slum communities hinder the improvement of health services for India's urban poor. To address this issue, an urban health programme is implementing two approaches in Indore city, Madhya Pradesh, the demand–supply linkage approach and ward coordination approach. The former is based on the premise that build...

We examined the diagnostic accuracy of human touch (HT) method in assessing hypothermia against axillary digital thermometry (ADT) by a trained non-medical field investigator (who supervised activities of community health volunteers) in seven villages of Agra district, Uttar Pradesh, India. Body temperature of 148 newborns born between March and Au...

Background: ONE of the dominant concerns of the present age is the improving the living conditions of the rapidly increasing population living in cities. For the first time in human history beginning 2007, more than half of the world’s population will live in cities. Estimates by the United Nations suggest that the world’s urban population has been...

In 2008, for the first time in history, more people will begin to live in cities than in villages. According to the State of World Population Report 2007, the world's urban population is 3.3 billion out of a total world population of 6.6 billion. In India the urban population is expected to become 576 million in 2030. Government bodies should also...

One out of every 14 newborn dies in poor slum dwellings of Madhya Pradesh (M.P.) in India . Neonatal survival is influenced much by care provided by the family before, during and after delivery, which in turn is influenced not only by mother’s beliefs, but also perceptions of her immediate family, which are context specific. Antenatal, intra-partum...

Public Private Partnerships for Improving Health of the Urban Poor: Lessons and Best Practices from India The rapidly growing urban population especially of the urban poor is a cause of concern for policy makers and program planners. The health of people living in urban slums is poor and is comparable to that in rural areas. An important contributi...

The current poverty scenario in Delhi indicates that one out of every five residents in Delhi resides in slums and nearly half in other urban poor habitations like unauthorized and resettlement colonies. The real health conditions and service coverage for the urban poor is masked by the urban average figures. The reanalysis of the NFHS data by econ...

This document reports the proceedings of a research-to-policy workshop that was organized as part of a multi-country cross-disciplinary research project on the private health care sector in urban poor neighbourhoods in India, Indonesia and Thailand, entitled "Health System Reform and Ethics: Private Practitioners in Poor Urban Neighbourhoods in Ind...

While India is progressing, we are aware of another reality that we cannot deny: malnutrition deaths and destitution even in metropolises like Mumbai and Delhi. Demographers predict that while our urban population would double in the next 10 years, urban poverty will, in fact, double in five years. Each Indian city has two parts: one half lives in...

India has been urbanizing rapidly in recent decades. About 300 million people live in urban areas in India. During the decade 1991 - 2001, the urban population grew by 68 million or by 31.2 per cent. The growth rate of urban population is almost double that of the rural population. Indian cities have a considerable proportion of population residing...

Programs developed and implemented by agencies external to slum are often not able to reach the neediest. They usually reach to small proportion of urban poor, often the relatively better off residing in officially listed slums. Conditions in certain slums are found worse in comparison to those in others. There is need to reach all slums for better...

Birth practices are greatly influenced by the traditions and values of the society. People in slums often continue to practice harmful behaviours. It is imperative to understand birth practices in order to devise strategy for improving maternal and neonatal health of urban poor.

Abstract One of 14 newborns die among urban poor of Madhya Pradesh (M.P.) in India. Neonatal survival is influenced by care received before, during and after delivery, which in turn is influenced by the mother’s beliefs, perceptions of her immediate family. Antenatal, intra-partum and postnatal practices associated with better newborn survival are...

India’s Urbanization and Poverty Scenario Urban migration and simultaneous natural growth of urban population have resulted in rapid proliferation of urban agglomerations. The current urban population of India, 285 million is estimated to double and reach 576 million by 2030. Percentage decadal growth in urban areas was 31.2 percent vis-à-vis 17.9...

India’s Urbanization and Poverty Scenario Urban migration and simultaneous natural growth of urban population has resulted in rapid proliferation of urban agglomerations. The urban population of India constitutes 285 million and is estimated to reach 660 million by 2025. Population growth is significantly faster in urban areas - decadal growth duri...

Background: Urban poor people living in slums have insufficient access to primary health care services due to weak linkage between health care providers and slum communities. Methods: Indore, a mid-sized Indian city has a rich culture of community level processes. The urban health program in 75 slums (150,000 population) of Indore, aims at enhancin...

The challenge at hand: Data averages mask inequalities and disparities: urban poor have significantly worse rates of neonatal mortality indicators than suggested by urban average data. The Neonatal Mortality Rate (NMR) is 31/1000 for urban India while it is nearly 40/1000 for the urban poor. Neonatal mortality constitutes 40 percent of U5 mortality...

The challenge at hand: Data averages mask inequalities and disparities: urban poor have significantly worse rates of neonatal mortality indicators than suggested by urban average data. The Neonatal Mortality Rate (NMR) is 31/1000 for urban India while it is nearly 40/1000 for the urban poor. Neonatal mortality constitutes 40 percent of U5 mortality...

Recent studies are showing that between 70 – 90 of every 100 new households established in urban areas in South Asia are located in slums (1). During 1991-2001, the annual population growth rates in India were: India - 2%, Urban India- 3%, Mega cities – 4% and Slums – 5%. 23.65% of urban population is poor. These estimates do not reflect the true m...

The National Population Policy (2000) aims at complete protection of all children against vaccine preventable diseases by 2010. Urban poor, many residing in slums, comprise about one fourth of India's 285 million urban population. 60% of the children aged 12-23 months in urban India are fully immunized; coverage among urban poor children is a disma...