India Toolkit: Advocacy
Mapping & Listing of Urban Slums
Identifying Residents in Need of Services
Purpose: This tool helps in identifying all the slums (registered/ unregistered) and poverty clusters, and categorizing them based on their vulnerability to achieve better planning of health services including Family Planning (FP). This will enable Urban Accredited Social Health Activists (ASHAs) and ASHA facilitators/ Auxiliary Nurse Midwives (ANMs) to better understand their respective operational areas, including vulnerable groups/ communities.
- Additional Director/Joint Director (AD/JD)
- General Manager- FP and Urban
- Chief Medical Officers (CMO)/Additional Chief Medical Officer (ACMO)
- Nagar Swasthya Adhikari
- Divisional Urban Health Consultant (DUHC)/District Program Managers (DPM)
- Urban Health Coordinators (UHC)
- City Community Process Manager (CCPM)
- Medical Officer In-Charge (MOIC)
- Health Education Officers/Project Officer, District Urban Development Agency (DUDA)/Child Development Project Officer, Urban, Integrated Child Development Services (ICDS)
Background: Rapid urbanization in India is estimated to account for 46% urban population by 2030. This is owing to a high influx of people moving into big cities for livelihood opportunities but choose to reside in slum dwellings due to the high cost of living in big cities. India has 505 cities with 227 million populations and it is estimated that around 40% of the urban slum population is not visible as slums. The accessibility of health care facilities is a major concern among the slum and vulnerable population. Awareness of location of this population segment is critical for positioning the health facilities as per National Urban Health Mission (NUHM) guidelines and also for allocating resources to serve identified population under the Program Implementation Plan (PIP). To identify these locations, mapping and listing of poverty clusters and unregistered slums is a key exercise under the NUHM. This mapping exercise is also critical for ASHAs and ANMs to provide services to vulnerable individuals in their coverage areas.
Evidence of ImpactThe government officials of 19 high priority cities of Uttar Pradesh and Madhya Pradesh conducted mapping and listing exercise with the coaching and mentoring support of The Challenge Initiative (TCI) India to identify all the slums and poverty clusters. The NUHM officials of these cities triangulated mapping and listing data with existing multiple government data sources and analysed to identify the difference.
As a result, the listing and mapping exercise in 19 cities indicated 38% increase in slum numbers and 39% increase in slum population. The bar graph shows the hidden areas and population identified in slums which were not visible in any of government planning processes earlier.
The findings helped the government to modify its urban health service delivery plan to cover invisible populations. This enabled better allocation of community volunteers and resources for meeting the needs of the entire slum population. Similarly, the data was used by several other stakeholders to plan and reach hidden population once they were added through a government list.
For the ﬁrst time in Indore, all health facilities have been mapped with a deﬁned catchment area. This has helped in uncovering the left out and underserved areas. Now, we will be able to cover the entire slum population as all the facilities have equal distribution of population. Now, each ward has one facility and each facility has one MOIC and ANM. We initiated monitoring of ASHAs and ANMs for outreach activities. As a result, Madhya Pradesh saw an 18% rise in immunization data within a short span of four-months. The credit of this magical transformation goes to TCI India.”
Dr. Pravin Jadia, Chief Medical and Health Ofﬁcer
Indore, a TCI-supported city in Madhya Pradesh that conducted mapping and listing
Guidance on Correct Estimation of the Urban Slum Population to Ensure Health Provisions
As UHCs are the point person for looking after health concerns of the urban poor population, hence UHC’s must ensure regular mapping of unregistered slums and poverty clusters under the guidance of Nodal Urban Health/(appropriate authority). UHC can capitalize City Health Coordination Committee (CCC) forum to sensitize representatives of other departments such as DUDA, ICDS, National Polio Surveillance Program (NPSP), Municipal Corporations, NGOs, etc. on the significance of mapping and listing exercise. The listing of households is undertaken by the ASHAs, they can take the support from the frontline workers of other departments.
Steps for mapping and listing of unregistered slums and poverty clusters
1. Identify Local Data Points
Identify locally available data and maps of the urban slum population from the NUHM GIS maps, DUDA, the Integrated Child Development Services (ICDS), National Polio Surveillance Program (NPSP), micro plans for urban routine immunization and any other available data sources including the post office, municipal corporations, NGOs and information collected by the ASHA. In addition, GPS coordinates of the slums can be utilized to update digital maps periodically (Refer to GIS maps of UP cities).
2. Review Data
Review data from these sources to determine the locations where vulnerable populations live including registered slums, unregistered slums, temporary settlements and poverty clusters.
3. Create Lists and Maps
Create lists and maps of slums, poverty clusters/temporary settlements from these data sources. Compare these data among each other (triangulation).
4. Verify and Finalize List
- Physically verify the existence of the slums and poverty clusters that are listed only once.
- Check the community maps and listings with community residents for completeness.
- Finalize the lists of the urban locations of vulnerable population and share with the district authorities.
- Support the ASHAs to list all the households in their catchment areas in the Urban Health Index register.
- These lists need to be updated on an ongoing basis.
- Mapping of community resources such as Anganwadi Centres, UPHCs, private providers and chemists can also be useful.
5. Use the Mapping and Listing Data
The data insights from the mapping and listing exercise should be presented to the district health authorities and other departments by sharing comparative data of identified slum population versus current resources available in forums like CCC meetings, FP review meetings, NUHM review meetings, District Health Society meetings. Based on mapping and listing exercise data relocation of resources can be done to cater to the health needs of the urban poor population like redefining catchment areas of ASHAs, relocation of UPHCs, activating defunct UPHCs and request can be made for necessary funds under the PIP.
Roles and Responsibilities towards Mappling and Listing of Urban Slums
Additional Director/Joint Director/General Manager FP and Urban
- Include review of mapping and listing data in district/division level meetings.
- Issue guidance to all the cities to refer this tool as a guidance documents to identify unserved population in need of health services.
Chief Medical Ofﬁcer/Additional Chief Medical Ofﬁcer
- Issue directives to ensure that all registered and unregistered slums and poverty clusters are mapped
- Ensure meeting of all relevant stakeholders (CCC members) for finalization of mapping process (registered and unregistered slums and vulnerability analysis)
- Ensure that planning is based on mapping and listing of all slums and poverty clusters
- Ensure availability of additional funds in PIP considering new identified population
Divisional Urban Health Consultant/District Program Manager
- Ensure the provision of budget for carrying-out the necessary field work to improve maps and lists of slums and poverty clusters
- Ensure that the UHC triangulates the list of registered and unregistered slums and poverty clusters so that on the basis of this data, adequate funds are available through the PIP
- Review data from the slum mapping process and use it to plan for additional UPHCs, ASHAs, Information Education Communication (IEC) materials and other activities provided for in the PIP
- Share updated lists of registered and unregistered slums with other urban stakeholders and departments, namely ICDS, Municipal Corporation, Water and Sanitation among others, in order to prioritize the desired health services in unserved and underserved areas.
Urban Health Coordinator
- Gather city-specific information about all slums from various departments and organizations like the DUDA, ICDS, WHO,UNICEF, Postal Department, NGOs etc.
- Compile the information in a database
- Facilitate monthly meetings of ASHAs and ANMs at the UPHC level in order to support their work on mapping and household listing
Nagar Swasthya Adhikari/Project ofﬁcer, DUDA/Health Education Ofﬁcers/ Child Development Project Ofﬁcer, ICDS
- Share the list of all slums as well as other locations
- Support community listing of households by the ASHAs
- Participate in the CCC meetings and provide required support
- Periodically update information on anganwadi centers and staff (for ICDS)
City Community Process Manager/Medical Ofﬁcer in-Charge
Coach ASHAs and ANMs on the following:
- ASHAs complete mapping and listing exercise of each slum area/pocket and update their household list
- Based on new identified slum area, ASHAs work in assigned/uncovered areas
- ASHAs record and update the household data in the Urban Health Index Register (UHIR)
- Take support of MAS members in mapping and listing of households, and identifying those in greatest need of information and services
- Periodically conducting mapping and listing process
Monitoring Progress in Creating an Accurate Database for Urban Health
The mapping and listing data should be updated on an annual basis. The following indicators should be monitored:
- Percentage of ASHAs who have visited all the households in their coverage area and updated their household lists over a period of last three months.
- Number of annual requests for PIP are based on updated population data
- Number of allocations based on current mapping and listing exercise data
Though no additional funds are required for mapping and listing, however in case need arises then current PIP should be checked. And in case, this need is long-term or perpetual, then it can be requested for inclusion in the next PIP.
Concurrent updating of mapping and listing will sustain if the need and significance is established in platforms like CCC. UHC lead the exercise under the guidance and support of Nodal urban/appropriate authority. In addition, ASHAs must be oriented on the mapping and household listing process during their initial training, the coaching, periodic ASHA and ANM meetings and during the supervision visits. Since the required budget for supporting updating of city maps is available or can be requested through the PIP, the mapping and listing exercise can sustain if CMO takes initiative to issue a directives for this activity annually or as required.
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- Slum list from National Pulse Polio Immunization program
- Slum list of Agra
- Urban Health Index Register
- Guidelines and tools for vulnerability mapping and assessment for urban health 2017
- Implementation framework NUHM 2013, section 4, page 27-29
- NUHM orientation module for planners, implementers and partners, 2015, section 3 point 2, page 27-31
- NHM PIP guideline for a particular financial year
- Poster presented in International Conference on Urban Health (ICUH) – “Making invisible, visible by mapping and listing exercise which help in correct estimation of urban slum population to ensure their health provisions”.
- Most Significant story: TCI’s Mapping and Listing Approach Helps Indore, India, More Accurately Allocate Health Resources