Abstract
The Indian political party Aam Aadmi, which assumed power in the city-state of Delhi in 2015, introduced Mohalla Clinics (i.e. neighbourhood clinics) to provide free primary health services for all, as a response to the rising inaccessibility of primary healthcare facilities for the urban poor. These clinics were to be governed through Mohalla Sabhas (i.e. neighbourhood committees), which are instruments of participatory governance within the neighbourhood. The research compares promises and practice for Mohalla Clinics, especially focusing on governance and the politics surrounding it. The authors find that in their current form Mohalla Clinics are limited to providing primary curative healthcare and have shown limited success, although Mohalla Clinic users do save time and expenditure on primary healthcare, and the clinics have led to a more comprehensive form of primary healthcare than in the past. However, Mohalla Clinics are governed in a top-down fashion by the Government of the National Capital Territory-Delhi, and not by urban local bodies or the envisaged neighbourhood committees. As a result, they face problems that may inhibit their functioning in the long term.
Highlights
Cities arguably have a wider range of health and social infrastructure than rural areas
Mohalla Clinics are intended to function as the lowest tier of healthcare service in Delhi; the present study proposes that the population norms of the ‘dispensary’ can be applied for Mohalla Clinics
Reduced waiting times There is a considerable pre-consultation delay at Mohalla Clinics: 30 minutes on average but ranging from five minutes to two hours. Let us compare this with average waiting times in other places providing public health services in the city, such as outpatient departments of hospitals and dispensaries; we find that people are saving two hours and 19 minutes on average
Summary
Cities arguably have a wider range of health and social infrastructure than rural areas. In 2020 this has been subsumed under Pradhan Mantri – Atmanirbhar Swasth Bharat Yojana (PMASBY; meaning prime minister’s self-reliant healthy India scheme), a new scheme created in the wake of the global Covid-19 pandemic for pandemic preparedness and management These schemes are applicable in Delhi though they are not in convergence with Delhi’s health schemes. Another scheme called Pradhan Mantri Jan Arogya Yojana (PMJAY), or the prime minister’s public health scheme, was launched in 2018 It addresses the healthcare needs of the poor in both rural and urban areas through the provision of health insurance of Indian Rupees (INR) 500,000 (USD 6,791) per family for secondary and tertiary care. PMJAY only covers the cost of hospitalisation and not primary healthcare
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