Samagra1 is a PSI-led flagship project on urban health in India. This landmark initiative funded by The United States Agency for International Development (USAID) aims to construct a resilient model(s) of urban health by applying user-centric approaches to catalyse the public and private sector to improve primary health outcomes in urban India. PSI is the primary implementation partner in this project and works closely with local partners to increase the use of modern contraceptives, case detection for tuberculosis (TB), multidrug resistant (MDR)-TB and improve the coverage of maternal and child health care including antenatal care (ANC), intra-natal, and postnatal care (PNC), and immunization.
Health indicators for the urban poor in India, are equivalent to, or sometimes even lower than that of those in rural India; affordable and quality healthcare is largely inaccessible to the urban poor. In this backdrop of health and social security needs of a rapidly growing urban population, the extent to which India’s health system can provide for a large and growing city-based population, will determine the country’s success in creating resilience cities and towns. Despite having a high concentration of healthcare providers, access to healthcare services especially primary healthcare among urban poor women, is limited. Weak outreach by frontline health systems, ineffective referral mechanisms, social exclusion for certain vulnerable groups, low awareness among the target population, and lack of enforceable standards of care in the private sector are some of the deterrents to building a strong health system in urban India.
A total of five Health Resource Centres have been established in the five areas of Ahmedabad city namely Juhapura, Behrampura, Vasna, Vatva, and Old City. Every Health Resource Centre caters to the needs of slum settlements as it has limited access to healthcare, basic awareness and correct knowledge on healthcare, nutrition, and hygiene. The HRCs would facilitate technical assistance to the Urban Health Resource Centres, private hospitals and practitioners and communities for strengthening urban health systems. It would use innovative solutions to transform traditional approaches. It would operate as an accelerator hub and build upon evidence- based approaches.
The project is expected to lead to the following outcomes and results:
Key Result Areas
• Result 1: Improved access to affordable quality health services
• Result 2: Improved governance for urban health
• Result 3: Addressed the barriers related to social determinants of health.
• Increased use of modern contraceptives to delay and space births
• Improved coverage of ANC, INC, PNC services
• Improved immunization rates
• Increased case detection and successful treatment outcomes of TB and multi-drug resistant (MDR)- TB.