Abstract
In the past 200 years, urban spaces have been imagined as neatly laid out, well-planned, sanitised and civilised places of dense human habitation with regulated economic activity, where political power, financial capital, the frontiers of knowledge and technology thrive. This has been the urban planners dream, even while it does not reflect the full reality, whether of cities in the LMICs or the HICs. In the face of such homogenising visions arising from Euro-American models, formal urban systems fail to provide adequately for residents' needs, who then carve out their own resources and processes for meeting them, largely within the domain of urban “informality.” While large part of literature presents urban informality as reflected in the slum, others have shown how it is found in relation to all classes (1). The concept of informality has largely been applied to the core dimensions of economic life of the city. Applied to people's “ways of life,” intermingling of the formal and informal becomes distinctly evident in everyday practices in locations such as the peri-urban, and in activities such as health care. This paper opens up the sphere of health care for urban planning that has, in recent decades, left it largely untouched. It uses data from a rapid assessment of health seeking behaviour of three socioeconomic groups—the middle class, slum-dwellers, and homeless— in Delhi, the capital city of India. The findings, relevant beyond the specific location, reveal that people of all sections resort to myriad informal arrangements for their health care, challenging the dominant connotation of the formal-informal denoting a legitimate-illegitimate dichotomy. This provides potential directions to bridge the formal-informal divide, to re-configure urban planning towards more sustainable futures with plural visions of land use and urban greening for healthier urban conditions and for health care provisioning. The analysis posits that, besides the economic and political relations shaping the formal and informal, the politics of knowledge must be factored in if the informal has to be adequately understood for building sustainable futures.
Highlights
Reviewed by: Unnikrishnan Payyappallimana, United Nations University, Japan Jesús Mario Siqueiros-García, National Autonomous University of Specialty section: This article was submitted to Environmental Health, a section of the journal Frontiers in Public Health
In this paper we examine urban informality related to health through a brief discussion on the implications of periurban areas, and to health care service utilisation through empirical data from Delhi, the capital city of India
An exploitative economic system in conjunction with deeply entrenched social hierarchies have created a landscape of precarious employment and perilous living conditions for the urban underclass, all marking the pervasive poverty by the notion of informality
Summary
Reviewed by: Unnikrishnan Payyappallimana, United Nations University, Japan Jesús Mario Siqueiros-García, National Autonomous University of Specialty section: This article was submitted to Environmental Health, a section of the journal Frontiers in Public Health. A large segment of health care that is undertaken in homes and communities, with traditional and new evolving knowledge in addition to the modern conventional providing the basis, lies outside this formal sector and forms the informal healthcare.
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