Mapping & Listing of Urban Slums

Identifying Residents in Need of Services 

Purpose: To assist the Chief Medical and Health Officers (CMHO/CDMO/CMO) 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.

Audience:

  • CMHOs/CDMOs/CMOs
  • District Program Managers
  • Urban Health Coordinators
  • ASHA Facilitators/ANMs
  • Health Education Officers
  • Other concerned authorities

 

Background: The accessibility of health care facilities is a major concern among the slum and vulnerable population and knowledge of the location of this population segment is critical for the positioning of health facilities under the NUHM guidelines and allocating resources for the same under the Program Implementation Plan (PIP). To identify these locations, mapping and listing of poverty clusters and unregistered slums is a key activity under the National Urban Health Mission (NUHM).

This mapping exercise is also critical for ASHAs and ANMs to provide services to vulnerable individuals in their catchment areas.

Evidence of the Importance of Mapping and Listing Urban Slums

Rapid urbanization is producing a growing landscape of poor urban settlements. New poverty clusters are continuously being formed and some of the older registered slums are expanding.

The Urban Health Initiative (UHI) found large variations between the District Urban Development Agency (DUDA) enlisted slums and the actual poverty settlements in the project cities. The UHI community volunteers used data from DUDA and triangulated the information with community level stakeholders, their own mapping and listing data of their catchment areas and data from GIS maps. During this exercise, it was found that the DUDA data had underestimated the actual number of slums by 21% to 46% as they had included only registered slums, and missed unregistered colonies / smaller pockets of the vulnerable population. The adjacent box shows the discrepancy in the data on number of slums in three of the UHI cities. The -updated data was used in the PIP to gain increased funding for program activities in the cities where UHI was operational. This enabled better allocation of community volunteers and resources for meeting the needs of the whole slum population.

Guidance on Improving the Urban Slum Population Database

Mapping of the unregistered slums and poverty clusters is overseen by the Urban Health Coordinator, while the listing of households is undertaken by the ASHAs with support from other front-line workers.

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).
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.
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).
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.
Use the Mapping and Listing Data
  • The district health authorities should use the maps created for the slum and vulnerable urban population to review the total resources needed, and request the necessary funds under the PIP.
  • The data should be shared with the District Health Society and other departments such as the ICDS, National Urban Livelihood Mission (NULM), Municipal Corporations, DUDA etc.

The district health authorities should use the slum and vulnerable urban population maps created to review the total resources needed, and request the necessary funds under the PIP.

The data should be shared with the District Health Society and other departments such as ICDS, National Urban Livelihood Mission (NULM), Municipal Corporations, DUDA etc.

Roles and Responsibilities

Role
Responsibility
CMHOs/CDMOs/CMOs
  • Issue directives to ensure that all registered and unregistered slums and poverty clusters are mapped
  • Conduct periodic review of the progress of slum mapping and the vulnerability assessment
  • Call meetings of the city coordination committee on a monthly basis
  • Ensure meeting of all relevant stakeholders (city coordination committee) for finalization of the mapping process (registered and unregistered slums and vulnerability analysis)
  • Ensure that planning is based on mapping and listing of all slums and poverty clusters
Nodal Officer – Urban Health and FP
  • Ensure the provision of budget for conducting the necessary field work to improve maps and lists of the slums and poverty clusters
  • Ensure that the Urban Health Coordinator triangulates the list of registered and unregistered slums and poverty clusters so that this data can be used for provision of funds through the PIP
  • Review the data from the slum mapping process and use it to plan for additional Urban Primary Health Centers (UPHCs), ASHAs, Information, Education, Communication (IEC) materials and other activities provisioned in the PIP
  • Share updated lists of registered and unregistered slums with other urban stakeholders and departments, namely Integrated Child Development Services (ICDS), Municipal Corporation, Water & Sanitation among others, in order to prioritize the desired health services in unserved and under-served areas.
Urban Health Coordinator
  • Gather city-specific information about all the slums from various departments and organizations like the DUDA, ICDS, WHO, 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
DUDA
  • Support community listing of households by the ASHAs
  • Participate in the city and ward coordination committee meetings
Integrated Child Development Scheme (ICDS)
  • Share the list of all the slums as well as other locations where Anganwadi Centers are located
  • Periodically update information on Anganwadi Centers and staff
  • Support ASHAs in the listing of households
ASHA
  • Conduct mapping and listing of households in their operational area
  • Record and update the household data in the Urban Health Index Register (UHIR)
  • Inform the supervisor/ Community Process Manager of any new or unmapped poverty clusters in or around her area
ASHA Facilitator/ANM
  • Facilitate the household mapping and listing by the ASHAs
  • Compile the slum-wise information and share it with the Community Process Manager /MOIC
Mahila Arogya Samiti (MAS)
  • Support ASHAs in mapping and listing of households, and identifying those in greatest need of information and services

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 catchment area and updated their household lists over a period of three months
  • Whether annual PIP requests are based on updated population data

Cost Elements 

The costs incurred in creating an updated database of the urban vulnerable population include the following. Though these costs are usually included in the PIP, however if these are not included then the following items should be planned and budgeted for in the PIP)

Cost Element FMR Code Source
GIS Mapping P.1 ROP 2016-17, NHM-UP
Stakeholders meetings P.2.2.3 ROP 2016-17, NHM-UP
Mobility support to ANM for supporting U-ASHA P.4.5.3 ROP 2016-17, NHM-UP

Mobility support to MoIC, DPM, CPM, Urban

Health Coordinator

P.2.2.2 ROP 2016-17, NHM-UP
Stationary and Printing P.2.2.3 ROP 2016-17, NHM-UP

*Refer to ROP 2016-17, NHM-UP

This table is indicative and illustrates the manner in which cost elements are provisioned in a government PIP, thus giving guidance to the audience on where to look for elements related to a particular task, such as ‘Mapping and Listing’.


Sustainability

The ongoing update of household listing by the ASHAs will be sustained if the importance of this activity is emphasized upon in their initial training, the refreshers, the periodic review meetings and during the on-going supervision.

Since the required budget for supporting the updating of city maps is available or can be requested through the PIP, the mapping and listing exercise can be sustained if the CMHO/CDMO/CMO takes the initiative to issue a directive for this activity, annually or as needed.

Disclaimer: This document is based on the learnings collated from Urban Health Initiative (supported by BMGF), Health of the Urban Poor (supported by USAID) and Expanded Access and Quality (EAQ) to broaden method choice in Uttar Pradesh (supported by BMGF). This document is not prescriptive in nature but provides overall guidance of how this particular aspect was dealt with in these projects for possible adoption and adaptation.