Both large survey-based studies as well as case studies have repeatedly shown

 that education and health services in India are characterized by (i) inadequate and inferior infrastructure; (ii) poor public service delivery; (iii) lack of quality choices for consumers; and (iv) lack of access especially for the poor

 

Original article available here 

In over fifty years since independence, India has developed

an extensive public delivery system for the provision of

health care. This was preceded in 1946 by the Bhore

Commission that recommended basic health services be

provided for all through Primary Health Centres (PHCs). In

line with the recommendations, PHCs were set up all across

the country, each serving about 30,000 inhabitants in its

vicinity. At the time, the urban population of India was less

than 18 per cent. Since then, the urban population has grown

over fourfold to 285 million of over the 1 billion people

living in India. 22.6 per cent of this 285 million live in slums

(GOI 2001).

As in the case of health services, provision of education for

all in India has also largely been envisaged within the public

delivery system even though this sector has a significant presence

of private providers. Since independence the government has

launched various schemes and programmes for increasing

literacy among all sections of the population, the Sarva Shiksha

Abhiyan and the Right to Education Bill are the two seminal

steps in this direction. Recently there has been a growing

demand for privatization and growth in the number of private

institutions. This phenomenon is more strongly visible in

the urban areas where there is a greater proportion of literate

23.4 per cent of the urban population was below the poverty

line (as against 76.3 million, that is, 32.4 per cent in 1993–4).

However, variations both across and within economic classes,

castes, and states are high. Many disenfranchized segments

suffer from high levels of deprivation not revealed by aggregate

numbers. This also affects their health indicators.

The Food Insecurity Atlas of Urban India (MSSRF 2002)

suggests approximately 38 per cent of children below the age

of three years in urban India are underweight and more than

35 per cent short for their age. Further, a high proportion of

the urban poor are not able to meet the nutrition norms laid

down by the Indian Council of Medical Research (ICMR).

It is not clear whether the urban poor are generally better

off than the rural poor. On the one hand, aggregate figures

such as wages, poverty levels, expenditures, all show better

performance of urban areas. It is also believed that access to

schools and health facilities is better in urban areas. On the

other hand casual employment, daily wages, high level of

competition for the few unskilled jobs, all contribute to the

vulnerability of the urban poor.

An aspect of urban poverty rarely captured by published

data relates to the condition of those living at the fringes of the

urban 

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