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Health White Paper 2012

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Know the Health Status of Mumbai.

Know the Health Status of Mumbai.

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  • 1. www.praja.org WHITE PAPER Report onThe STATE of HEALTH of MUMBAI Supported by FORD FOUNDATION MADHU MEHTA FOUNDATION 1 Report on the STATE of HEALTH of MUMBAI
  • 2. www.praja.org Table of Content PageSr. No. Title No. I Foreword 4 II Information on organisations Involved 6 III Note by Healis Sekhsaria Institute for Public Health 7 IV Section A: Compressive of State of Health of Mumbai 8 Section B: Data collected from Municipal Dispensaries, Municipal Hospitals and State 16 V Hospitals VI Section C: Questions asked by Municipal Councillors and MLAs 23 Tables 1 Estimated percentage of Annual Family Income spent on hospital/medical costs 9 2 Whether Respondents has Medical Insurance 9 3 Estimated Citizens using Government Dispensaries/Hospital 9 4 Estimated Occurrence of Diseases/Ailments for the year 2011-12 10 5 Ward wise Malaria as per survey 11 6 Ward wise Hypertension as per survey 12 7 Ward wise Tuberculosis as per survey 13 8 Ward wise Diabetes as per survey 14 9 MLA constituency wise survey 15 10 Sensitive Diseases/Ailments as per RTI Data 17 11 Ward wise registered cases of Malaria (April 2008 to March 2012) as per RTI data 18 Ward wise registered cases of Diarrhoea (April 2008 to March 2012) as per RTI 19 12 data Ward wise registered cases of Hypertension (April 2008 to March 2012) as per RTI 20 13 data 2 Report on the STATE of HEALTH of MUMBAI
  • 3. www.praja.org Ward wise registered cases of Tuberculosis (April 2008 to March 2012) as per RTI 2114 data15 Ward wise registered cases of Diabetes (April 2008 to March 2012) as per RTI data 2216 Questions asked on health by councillors (March 2012 to May 2012) 2417 Issues raised/Questions asked by Councillors 25 Questions asked on health by MLAs during following sessions: Budget 2010, 2618 Monsoon 2010, Winter 2010, Budget 2011, Monsoon 2011 and Winter 201119 Issues raised/Questions asked by MLAs 27 3 Report on the STATE of HEALTH of MUMBAI
  • 4. www.praja.orgI. ForewordIs Mumbai prepared to tackle its woes in health management? Our report on the state of health of Mumbairaises several red flags. While the city’s health is a BMC concern, public health issues involve the state and thecentre as well. It calls for some policy level changes and a deep introspection by all the custodians of publichealth.The Declaration of Alma-Ata in 1978, adopted at the International Conference on Primary Health Care, andaccepted by all member countries of the World Health Organization (WHO) expressed the need for urgent actionby all governments, all health and development workers, and the world community to protect and promotethe health of all people. "Health For All" was the goal set up at this Conference.Three decades later, we still have almost 25% of city’s population suffering from either malaria, TB, diarrhoea,diabetes or hypertension. For a city of over 10 million populations, this is a cause for serious concern. 80% ofthe city’s population is not insured at all. Less than 25% of Mumbai’s population visit municipal hospitals anddispensaries.To put things in perspective, the new agenda for Public Health in India includes the epidemiological transition(rising burden of chronic non-communicable diseases), demographic transition (increasing elderly population)and environmental changes. The causes of health inequalities lie in the social, economic and politicalmechanisms that lead to social stratification according to income, education, occupation, gender and race orethnicity. Lack of adequate progress on these underlying social determinants of health has been acknowledgedas a glaring failure of public health.There indeed is an urgent call for revitalizing primary health care based on the principles outlined at Alma-Ata in1978: Universal access and coverage, equity, community participation in defining and implementing healthagendas and inter-sectoral approaches to health. These principles remain valid, but must be reinterpreted inlight of the dramatic changes in the health field during the past 30 years.The state of health of Mumbai during the last three years has raised several red flags. From 2008-09 (taken asbase year with 100 as a denominator), the incidence of sensitive diseases in the city within the past 4 years hasalmost doubled in some of the diseases.• Malaria has gone up to 171• Diarrhoea to 123• Dengue to 276• Cholera to 185• Hypertension to 90• TB to 95• Diabetes to 89• Typhoid to 91• Hepatitis B to 94And these figures are after the slight improvement in 2011-12 from previous year that had shown exceptionalhike in almost all diseases, not just in Mumbai but across the country. So while BMC needs to be commended incurtailing the growth rate of diseases from last year, it clearly is not enough. Identification of health objectives 4 Report on the STATE of HEALTH of MUMBAI
  • 5. www.praja.organd targets is one of the more visible strategies to direct the activities of the health sector. For instance, in theUnited States, the “Healthy People 2010” offered a simple but powerful idea by providing health objectives in aformat that enables diverse groups to combine their efforts and work as a team.Similarly, in India, we need a road map to “better health for all” that can be used by states, communities,professional organizations and all sectors. It will also facilitate changes in resource allocation for public healthinterventions and a platform for concerted inter-sectoral action, thereby enabling policy coherence. Mumbaihas perhaps the greatest allocation of funds and resources for its health agenda. Can we seriously consider somepolicy level amendments and at least attempt to make Mumbai a role model for public health issues all acrossIndia?NITAI MEHTAManaging Trustee, Praja Foundation 5 Report on the STATE of HEALTH of MUMBAI
  • 6. www.praja.orgII. Information on organisations InvolvedPraja Foundation:Founded in 1998, the PRAJA Foundation is a non-partisan voluntary organization which empowers the citizen toparticipate in governance by providing knowledge and perspective. PRAJA aims to provide ways in which thecitizen can get politically active and involved beyond the ballot box, thus promoting transparency andaccountability.PRAJAs goals are: empowering the citizens, elected representatives & government with facts and creatinginstruments of change to improve the quality of life of the citizens of India. PRAJA is committed to creating atransparent, accountable and efficient society through peoples participation.Healis -Sekhsaria Institute for Public Health (Healis):Founded in 2004, registered under Section 25 of the Indian Companies Act, 1956 on April 29, 2005 and thusbecame a separate legal entity as a Not for Profit Organization. Healis primarily works towards advancing publichealth through innovative science and evidence-based policy by conduct quality research in public health andcarry forward its outcome for the benefit of the society. Healis is committed to improving the public health inIndia and in other developing countries through epidemiological research. Healis is one of the few institutes thatare solely dedicated to public health research and thus a leader in this field in India. Healis works incollaboration with leading National and International Health and Research organizations.Hansa Research:Hansa Research is a full service global market research agency conducting market research in 77 countriesglobally with offices in India and US. It is the ONLY global market research agency headquartered in India. Underthe leadership of Mr. Ashok Das, Managing Director, Hansa Research became one of the fastest growing marketresearch agencies in India. It specializes in Media, Telecom, Financial Services, Consumer Products andTechnology spaces. With research offices across India and the U.S., Hansa Research’s infrastructure iscomparable to the best in the industry.Hansa Research also has considerable experience in the space of opinion polls as it has done several studiesdealing with social, cultural and political issues in the country. 6 Report on the STATE of HEALTH of MUMBAI
  • 7. www.praja.orgIII. Note by Healis Sekhsaria Institute for Public HealthThe principles enshrined in our Constitution, particularly in the Directives, emphasise the role of the state notonly for protecting the health and but also for improving the health of its citizens.“Duty of the State to raise the level of nutrition and the standard of living and to improve public health.The State shall regard the raising of the level of nutrition and the standard of living of its people and theimprovement of public health as among its primary duties........” from Part IV of Indian Constitution, Directive Principles of State PolicySince independence, subsequent national, state and local governments have hence taken up several initiativesto control/eradicate diseases, improve environmental sanitation, raise the standard of nutrition, controlpopulation and improve public health. However, public health in India is beset by a vast spectrum of problems.It is important for us to identify big problems and focus upon them. It is to be understood that a solution to a bigproblem will help in improving public health in substantive manner. For public health field research, problemsthat can be addressed by population-based epidemiological research have to be selected. Solutions have to befound to a problem function through evidence-base for formulating policies that should advance public health.Surveillance systems (health information system) play and extremely important role here; they can provideaccurate understanding of the problem. Hence, setting up strong surveillance system should be priority of theadministrator and the data process for capturing should be scientific, up-to-date and sacrosanct. Equallyimportantly, the data captured should be disseminated at all levels to all stakeholders periodically andsuggestions should be actively sought through a more institutionalised manner from all (within theadministration and also from the civil society researchers).The primary objective of any robust health information system should be to provide reliable, relevant, up-to-date, adequate, timely and reasonably complete information for health managers at all levels (Local, State andCentral) and to researchers (NGOS, Media and Academicians) to assist planners/researchers for monitoring thehealth services/state, analysing trends and making policies.Even the Millennium Development Goals (MDG), place health at the heart of development; three of the eightgoals are directly related to health and the others have important indirect effects on health. Hence, the datathat is captured locally must be synthesised with global data for overall evaluation of evidence and for drawingattention towards important but neglected issues. This will further strengthen the health information system.The immediate need of the hour for our country today is to have such a robust, up-to-date health informationsystem that will further complement and assist in achieving the goals of all our present and proposedprogrammes on improving public health. And no part of our country is better poised to build a more perfecthealth information system than Mumbai; with all our administrative resources (local, state and national) andstrong presence of civil society including businesses and range of private organisations. Mumbai can really takethe lead here and then the system can be taken to other parts of the country thus making strides in the directionof achieving those State Directives enshrined in our Constitution on improving public health. 7 Report on the STATE of HEALTH of MUMBAI
  • 8. www.praja.orgDr. MANGESH PEDNEKAR, Director (Research & Development), HealisIV. Section A: Compressive of State of Health of MumbaiPraja Foundation had commissioned the household survey to Hansa Research and the survey methodologyfollowed is as below:• In order to meet the desired objectives of the study, we represented the city by covering a sample from each of its 227 wards. Target Group for the study was : Both Males & Females 18 years and above Belonging to that particular ward.• Sample quotas were set for representing gender and age groups on the basis of their split available through Indian Readership Study (Large scale baseline study conducted nationally by Media Research Users Council (MRUC) &Hansa Research group) for Mumbai Municipal Corporation Region.• The required information was collected through face to face interviews with the help of structured questionnaire.• In order to meet the respondent within a ward, following sampling process was followed: 4 – 5 prominent areas in the ward were identified as the starting point In each starting point about 12 – 15 individuals were selected randomly and the questionnaire was administered with them.• Once the survey was completed, sample composition of age & gender was corrected to match the population profile using the baseline data from IRS. This helped us to make the survey findings more representatives in nature and ensured complete coverage.• The total study sample was 15,191. 8 Report on the STATE of HEALTH of MUMBAI
  • 9. www.praja.orgTable 1: Estimated1 percentage of Annual Family Income spent on hospital/medical costs In % Amount spent from total income (in %) Estimated Household2 4.26 More than 30% 1,13,171 7.15 21% to 30 % 1,89,946 18.97 11% to 20% 5,03,955 38.92 6% to 10% 10,33,944 30.7 Less than 5% 8,15,572 100 Total 26,56,588More than 30% of households spend 11% or more of their annual income on hospital/medical costs.Table 2: Whether Respondents has Medical Insurance In % In no. of respondents Respondents have medical insurance 20.45 3,107 Respondents not having medical insurance 79.55 12,084 Total 100 15,191Table 3: Estimated Citizens using Government Dispensaries/Hospital Estimated citizens Estimated citizens No. of Available No. Provisional using Govt. using Govt. Ward Municipal/State of Municipal Population 2011 Dispensary/Hospital Dispensary/Hospital Hospitals Dispensaries (in %) (in numbers) Total 1,24,32,830 24.49 30,44,800 28 160Less than 25% of citizens in Mumbai use government dispensary/hospital; while the rest use privatefacilities.1 The estimated cases percentage of people is computed out of the total sample of 15,191 households surveyed across thecity.2 Household computed at the rate of 4.68 people per household based on Provisional Population for 2011 9 Report on the STATE of HEALTH of MUMBAI
  • 10. www.praja.orgTable 4: Estimated Occurrence of Diseases/Ailments for the year 2011-12 Total Estimated Estimated Cases Per 1000 Diseases/Ailments Cases households Diabetes 274,957 104 Malaria 392,378 148 Tuberculosis 63,227 24 Hypertension 78,635 30 Cancer 39,583 15In 2011-12, for every 1000 households there was atleast one malaria patient was reported in 148households. 10 Report on the STATE of HEALTH of MUMBAI
  • 11. www.praja.orgTable 5: Ward wise Malaria as per survey Estimated cases per Provisional Population Estimated3 Cases Ward 1000 households 2011 2011-124 2011-12 A 148,432 4,710 149 B 127,005 11,593 427 C 165,583 3,768 107 D 346,719 8,809 119 E 413,662 27,675 313 F/N 528,767 16,507 146 F/S 359,980 8,861 115 G/N 602,328 17,310 135 G/S 414,038 21,879 247 H/E 555,179 18,945 160 H/W 329,952 18,380 261 K/E 817,684 29,283 168 K/W 718,375 18,773 122 L 891,208 29,307 154 M/E 806,433 22,435 130 M/W 412,163 8,640 98 N 622,594 19,104 144 P/N 943,605 16,574 82 P/S 461,304 16,776 170 R/C 431,791 15,823 172 R/N 561,870 11,213 93 R/S 690,128 11,355 77 S 742,053 20,692 131 T 341,977 3,749 51B, E & H/W ward have highest number of people suffering from Malaria. In B ward, 427 out of every1000 households had some person suffering from Malaria.3 Estimated cases covers occurrences for the entire ward including cases diagnosed in public as well as private facilities.4 All the years (E.g. 2008-09) in this paper are financial years (E. g. April 08 to March 09). 11 Report on the STATE of HEALTH of MUMBAI
  • 12. www.praja.orgTable 6: Ward wise Hypertension as per survey Estimated cases per Provisional Population Estimated Cases Ward 1000 households 2011 2011-12 2011-12 A 148,432 1,085 34 B 127,005 2,442 90 C 165,583 1,995 56 D 346,719 1,497 20 E 413,662 4,835 55 F/N 528,767 4,429 39 F/S 359,980 2,123 28 G/N 602,328 2,574 20 G/S 414,038 3,831 43 H/E 555,179 5,255 44 H/W 329,952 2,270 32 K/E 817,684 8,876 51 K/W 718,375 3,423 22 L 891,208 4,323 23 M/E 806,433 3,739 22 M/W 412,163 881 10 N 622,594 5,002 38 P/N 943,605 3,085 15 P/S 461,304 2,366 24 R/C 431,791 1,624 18 R/N 561,870 4,130 34 R/S 690,128 1,076 7 S 742,053 4,947 31 T 341,977 848 12B, C & E ward have highest number of people suffering from Hypertension. In B ward, 90 out of 1000households had some person suffering from Hypertension. 12 Report on the STATE of HEALTH of MUMBAI
  • 13. www.praja.orgTable 7: Ward wise Tuberculosis as per survey Estimated cases per Provisional Population Estimated Cases Ward 1000 households 2011 2011-12 2011-12 A 148,432 257 8 B 127,005 2,963 109 C 165,583 513 15 D 346,719 556 8 E 413,662 6,921 78 F/N 528,767 2,508 22 F/S 359,980 2,146 28 G/N 602,328 3,771 29 G/S 414,038 2,796 32 H/E 555,179 1,578 13 H/W 329,952 2,891 41 K/E 817,684 4,665 27 K/W 718,375 1,857 12 L 891,208 3,790 20 M/E 806,433 7,358 43 M/W 412,163 2,413 27 N 622,594 2,142 16 P/N 943,605 1,794 9 P/S 461,304 1,232 13 R/C 431,791 397 4 R/N 561,870 924 8 R/S 690,128 767 5 S 742,053 6,168 39 T 341,977 1,330 18B, E & M/E ward have highest number of people suffering from Tuberculosis. In B ward, 109 out of1000 households had some person suffering from TB. 13 Report on the STATE of HEALTH of MUMBAI
  • 14. www.praja.orgTable 8: Ward wise Diabetes as per survey Estimated cases per Provisional Population Estimated Cases Ward 1000 households 2011 2011-12 2011-12 A 148,432 4,421 139 B 127,005 1,180 44 C 165,583 2,993 85 D 346,719 6,423 87 E 413,662 12,516 142 F/N 528,767 12,112 107 F/S 359,980 6,538 85 G/N 602,328 9,640 75 G/S 414,038 7,060 80 H/E 555,179 20,214 170 H/W 329,952 10,237 145 K/E 817,684 18,241 104 K/W 718,375 14,721 96 L 891,208 24,375 128 M/E 806,433 19,833 115 M/W 412,163 7,539 86 N 622,594 15,139 114 P/N 943,605 19,820 98 P/S 461,304 5,076 52 R/C 431,791 9,291 101 R/N 561,870 11,550 96 R/S 690,128 10,927 74 S 742,053 19,281 122 T 341,977 4,815 66H/E, H/W & E ward have highest number of people suffering from Diabetes. In H/E ward, 170 out of1000 households had some person suffering from Diabetes. 14 Report on the STATE of HEALTH of MUMBAI
  • 15. www.praja.orgTable 9: MLA constituency wise survey5 Malaria6 Hypertension Tuberculosis Diabetes MLA Name Area (in %) (in %) (in %) (in %)Gopal Shetty Borivali 11.3 0.1 0.2 8.8VinodGhosalkar Dahisar 9.3 3.4 0.8 9.6Pravin Darekar Magathane 25.7 4.2 0.8 12.0Sardar Tara Singh MulundAmboli 5.1 1.2 1.8 6.6Mangesh Sangle Vikhroli 18.2 6.0 3.5 13.1Shishir Shinde Bhandup West 13.1 3.1 3.9 12.2Ravindra Waikar Jogeshwari East 1.5 6.8 0.6 10.6Rajhans Singh Dindoshi 1.5 6.8 0.6 10.6Ramesh Singh Thakur Kandivali East 7.4 1.1 1.1 9.1YogeshSagar Charkop 8.0 0.4 0.0 6.0AslamShaikh Malad West 8.2 1.5 0.9 9.8Subhash Desai Goregaon 17.0 2.4 1.3 5.2Baldev Khosa Versova 8.7 2.8 1.0 13.1Ashok Jadhav Andheri West 13.3 2.1 1.3 8.6Suresh Shetty Andheri East 21.0 5.0 3.1 11.2Krishnakumar Hegde Vile Parle 17.6 3.9 0.4 22.1Arif Naseem Khan Chadivali 16.9 3.7 3.3 7.6Ramchandra Kadam Ghatkopar West 13.0 2.4 1.8 9.2Prakash Maheta Ghatkopar East 14.2 4.3 0.7 13.0Abu Asim Azmi Mankhurd 9.8 1.0 2.7 8.6Nawab Malik Anushakti Nagar 13.0 2.2 4.3 11.5Chandrakant Handore Chembur 9.8 1.0 2.7 8.6Milind Kamble Kurla (SC) 15.4 2.3 2.0 12.8Kripashankar Singh Kalina 15.1 4.7 1.9 14.2Prakash Sawant Vandre East 26.1 3.2 4.1 14.5Ziyauddin Sidikki Vandre West 26.1 3.2 4.1 14.5Varsha Gaikwad Dharavi (SC) 9.7 2.5 1.6 3.1Jagannath Shetty SionKoliwada 19.9 2.7 1.1 9.7Kalidas Kolambkar Wadala 11.0 4.8 3.0 11.4Nitin Sardesai Mahim 15.8 1.7 3.8 10.2Sachin Ahir Worli 24.7 4.3 3.2 8.0Bala Nandgaonkar Shivadi 11.5 2.8 2.8 8.5Madhukar Chavan Byculla 34.1 6.3 8.6 11.8Mangal Prabhat Lodha Malbar Hill 11.9 2.0 0.8 8.7Amin Amir Ali Patel Mumbadevi 10.7 5.6 1.5 8.5Annie Shekhar Colaba 14.9 3.4 0.8 13.95As per the survey data, Byculla is the worst assembly constituency, followed by Vandre East and VandreWest; while Byculla is worst for Malaria cases.6 The estimated cases percentage of households suffering from the disease/ailment out of the total sample of 15,191households surveyed across the city. 15 Report on the STATE of HEALTH of MUMBAI
  • 16. www.praja.orgV. Section B: Data collected from Municipal Dispensaries, Municipal Hospitals and State HospitalsThe data that is compiled and presented in this section is collected through RTI from all the (160) municipaldispensaries, (24) municipal hospitals and (4) state hospitals in Mumbai. Praja since 2008 has been meticulouslycollecting this data, collating it and presenting it through media and also directly to all the stakeholders inimproving public health in the city.The last year white paper released about the same time in 2011, emphasised a lot on the increasing trends inoccurrences of diseases/ailments, particularly, malaria. The public health department officials through variousprogrammes national and local vector control programmes particularly the ‘Fight the bite’ campaign actedpromptly and the data this year shows a vast reduction in malaria cases. It is very important that such strongprogrammes and focussed campaigns be carried out in anticipation of any epidemic breaking out; thusimproving the overall public health in the city. Kudos to the MCGM (Municipal Corporation of Greater Mumbai)and its officials for getting it right. We believe that these efforts need to be continued and strengthened furtherfor improving the public health in the city. 16 Report on the STATE of HEALTH of MUMBAI
  • 17. www.praja.orgTable 10: Sensitive Diseases/Ailments as per RTI7 Data : Sensitive Diseases/Ailments 2008-09 2009-10 2010- -11 2011-12 Malaria 23,317 39,898 78,448 39,828 Diarrhoea 81,321 116,295 125,999 99,839 Hypertension 28,337 32,469 38,388 25,518 Tuberculosis 31,510 29,692 32,383 29,878 Diabetes 23,777 23,838 22,493 21,264 Typhoid 8,288 4,220 6,557 7,561 Hepatitis B 990 444 547 931 Dengue 682 866 1,403 1,879 Cholera 96 124 236 178Inference: 2008-09 as base year8 for total cases % Increase from 2008 2008-09 2009-10 2010-11 11 2011-12 Malaria 100 171 336 171 Diarrhoea 100 143 155 123 Hypertension 100 115 135 90 Tuberculosis 100 94 103 95 Diabetes 100 100 95 89 Typhoid 100 51 79 91 Hepatitis B 100 45 55 94 Dengue 100 127 206 276 Cholera 100 129 246 1857Data as per RTI received from 160 Municipal Dispensaries, 24 Municipal Hospitals and 4 State Hospitals.8Year 2008-09 has been taken as the base year for computing trends for occurrences of cases for the subsequent years. 09 17 Report on the STATE of HEALTH of MUMBAI
  • 18. www.praja.orgTable 11: Ward wise9 registered cases of Malaria (April 2008 to March 2012) as per RTI data Number of cases registered as per RTI data Ward 2008-09 2009-10 2010-11 2011-12 A 133 664 1,221 1,141 B 274 552 1,147 381 C 238 426 1,532 330 D 940 1,645 1,774 277 E 750 756 2,945 1,255 F/N 362 1,365 2,073 1,154 F/S 1,644 2,991 4,499 1,691 G/N 490 1,075 2,088 985 G/S 711 2,149 3,115 1,400 H/E 124 442 804 383 H/W 1,062 817 3,360 595 K/E 747 1,299 3,687 1,610 K/W 652 1,100 2,524 1,080 L 376 832 1,718 751 M/E 536 661 192 1,761 M/W 244 291 622 346 N 244 880 1,909 620 P/N 67 220 385 396 P/S 92 150 251 242 R/C 61 129 334 289 R/N 12 79 83 114 R/S 101 170 417 214 S 99 677 1,083 328 T 45 497 242 1789 Data of cases registered is only from the related municipal dispensaries in the particular wards. Data from municipal/statehospital is not taken into account for computing cases for the ward level data. 18 Report on the STATE of HEALTH of MUMBAI
  • 19. www.praja.orgTable 12: Ward wise10 registered cases of Diarrhoea (April 2008 to March 2012) as per RTI data Number of cases registered as per RTI data Ward 2008-09 2009-10 2010-11 2011-12 A 1,213 1,440 1,522 2,051 B 1,220 1,654 1,844 1,557 C 944 1,309 2,019 2,203 D 1,175 3,579 4,536 5,114 E 5,490 8,147 8,201 4,605 F/N 4,063 5,796 5,295 2,994 F/S 4,424 5,824 7,261 4,753 G/N 3,431 4,343 5,849 4,464 G/S 6,874 6,776 7,252 4,864 H/E 3,442 5,697 6,041 3,949 H/W 2,657 3,338 3,946 2,567 K/E 5,997 7,219 7,885 7,066 K/W 3,358 4,042 4,023 3,354 L 5,379 11,971 12,588 10,592 M/E 1,461 3,769 6,108 4,433 M/W 3,715 4,763 5,083 3,384 N 3,381 6,636 7,869 6,321 P/N 2,104 2,861 2,741 3,373 P/S 804 1,423 1,062 860 R/C 2,922 2,686 1,801 1,850 R/N 1,011 1,067 946 698 R/S 2,920 3,972 2,657 1,569 S 2,950 4,445 5,242 3,686 T 1,387 1,620 1,976 1,84510 1) Data of cases registered is only from the related municipal dispensaries in the particular wards. Data frommunicipal/state hospital is not taken into account for computing cases for the ward level data.2) Estimated cases for Diarrhoea are not computed as our survey was structured to capture data of atleast one occurrenceof a disease in a household. And, in case of diseases like diarrhoea, cold, cough there is high probability of multipleoccurrences in any household. Hence it would be difficult to estimate an ‘accurate’ number of probable cases for diarrhoea. 19 Report on the STATE of HEALTH of MUMBAI
  • 20. www.praja.orgTable 13: Ward wise11 registered cases of Hypertension (April 2008 to March 2012) as per RTI data Number of cases registered as per RTI data Ward 2008-09 2009-10 2010-11 2011-12 A 2,562 1,369 1,338 1,076 B 436 750 1,353 913 C 641 653 599 381 D 532 949 686 225 E 866 1,213 1,154 1,270 F/N 575 972 1,234 407 F/S 2,649 3,868 3,586 1,305 G/N 341 548 746 548 G/S 1,681 3,241 2,198 1,970 H/E 443 625 844 1,004 H/W 639 306 496 456 K/E 1,319 1,715 2,241 1,592 K/W 693 - 174 1,122 L 251 502 580 644 M/E 379 142 392 563 M/W 321 529 709 611 N 50 41 24 132 P/N 405 172 282 254 P/S 49 132 155 100 R/C 915 839 890 992 R/N 62 94 249 297 R/S 679 184 201 287 S 75 214 308 316 T 75 160 176 37011 Data of cases registered is only from the related municipal dispensaries in the particular wards. Data frommunicipal/state hospital is not taken into account for computing cases for the ward level data. 20 Report on the STATE of HEALTH of MUMBAI
  • 21. www.praja.orgTable 14: Ward wise12 registered cases of Tuberculosis (April 2008 to March 2012) as per RTI data Number of cases registered as per RTI data Ward 2008-09 2009-10 2010-11 2011-12 A 292 438 461 348 B 100 155 160 130 C 156 133 131 106 D 378 265 246 259 E 592 516 417 704 F/N 858 1,274 1,332 1,581 F/S 577 573 600 116 G/N 714 404 417 561 G/S 276 221 361 235 H/E 444 503 518 594 H/W 275 250 226 365 K/E 2,048 1,391 1,164 1,703 K/W 395 260 240 360 L 760 1,118 1,118 1,037 M/E 146 67 147 152 M/W 181 200 218 166 N 120 96 65 133 P/N 187 124 96 135 P/S 71 65 69 31 R/C 129 111 137 167 R/N 123 128 86 281 R/S 542 765 572 472 S 417 671 1,551 315 T 334 393 191 23612 Data of cases registered is only from the related municipal dispensaries in the particular wards. Data frommunicipal/state hospital is not taken into account for computing cases for the ward level data. 21 Report on the STATE of HEALTH of MUMBAI
  • 22. www.praja.orgTable 15: Ward wise13 registered cases of Diabetes (April 2008 to March 2012) as per RTI data Number of cases registered as per RTI data Ward 2008-09 2009-10 2010-11 2011-12 A 39 28 46 191 B 189 165 464 818 C 89 66 29 47 D 2 - - 80 E 156 80 212 669 F/N 292 878 938 136 F/S 10 80 24 81 G/N 16 73 105 18 G/S 131 291 492 625 H/E 65 68 71 63 H/W 142 207 167 125 K/E 385 597 613 747 K/W 246 136 301 471 L 93 164 189 369 M/E 231 89 242 266 M/W 180 240 273 217 N 12 10 24 144 P/N 25 10 21 77 P/S 27 42 98 88 R/C 111 159 127 250 R/N 18 7 11 140 R/S 87 72 50 196 S 42 45 53 184 T 5 21 16 18713 Data of cases registered is only from the related municipal dispensaries in the particular wards. Data frommunicipal/state hospital is not taken into account for computing cases for the ward level data. 22 Report on the STATE of HEALTH of MUMBAI
  • 23. www.praja.orgVI. Section C: Questions asked by Municipal Councillors and MLAs 23 Report on the STATE of HEALTH of MUMBAI
  • 24. www.praja.orgTable 16: Questions asked on health by councillors (March 2012 to May 2012) Health Ward Councillors Name Political Party Total question question F/N LalitaYadav* INC 1 1 F/N ManojkumarSansare IND 1 2 F/S NandkishorVichare SS 1 2 F/S Sanjay Ambole SS 1 2 G/N Sudhir Jadhav MNS 1 7 G/S MansiDalvi* SS 1 2 G/S Ratna Mahale NCP 1 3 G/S Sunil Ahir NCP 1 3 H/E Krishna Parkar BJP 1 3 H/E Pooja Mahadeshwar SS 1 2 H/E SnehalShinde* MNS 1 1 K/E ManishaPanchal* SS 2 4 K/W AmeetSatam BJP 1 3 K/W Dilip Patel* BJP 1 6 K/W YashodharPhanse SS 2 11 L Anuradha Pednekar* SS 3 8 L DilipLande MNS 1 10 L Saeeda Khan* NCP 6 6 M/E ReshmaNevrekar* SP 1 3 M/W Vandana Sable INC 1 5 N Bharti Bawadane* SS 1 6 P/N Kamarjaha Siddiqi INC 1 2 P/N ParminderBhamra* INC 1 1 P/N VinodShelar BJP 1 4 P/S PramilaShinde* SS 2 2 R/C Chetan Kadam MNS 2 3 R/C SandhyaDoshi NCP 1 5 R/N Hansaben Desai SS 1 2 R/N Prakash Darekar MNS 1 5 R/N Sheetal Ashok Mhatre INC 1 4 R/N Sheetal Mukesh Mhatre* SS 2 2 R/S SunitaYadav* BJP 1 1 T NandakumarVaity* NCP 1 3 194 Councillors have not asked a single City 0 279 question on health City 227 Councillors 45 403Note - (*) This councillors are members in Health committee which has total of 35 members out of which only14 members have asked questions on Health. 24 Report on the STATE of HEALTH of MUMBAI
  • 25. www.praja.orgTable 17: Issues raised/Questions asked by Councillors Issues Question askedEpidemic/Sensitive Diseases 4Equipments 1Health Related Issues 2Human Resources 9Infrastructure 10Maternity homes / Primary Health Centre(PHC) 3Mortality rate 1Scam/Corruption 1Schemes / Policies in Health 11Treatment/Medicine 3Total 45 25 Report on the STATE of HEALTH of MUMBAI
  • 26. www.praja.orgTable 18: Questions asked on health by MLAs14 during following sessions: Budget 2010, Monsoon2010, Winter 2010, Budget 2011, Monsoon 2011 and Winter 2011 Health Total Health TotalName of MLA Political Question Question Question Question Party Area 2010 2010 2011 2011Gopal Shetty BJP Borivali 14 190 13 134VinodGhosalkar SS Dahisar 20 270 31 347PravinDarekar MNS Magathane 5 31 0 7Sardar Singh BJP MulundAmboli 14 202 13 137Mangesh Sangle MNS Vikhroli 18 261 39 345ShishirShinde MNS Bhandup West 69 1144 63 960RavindraWaikar SS Jogeshwari East 1 20 1 8Rajhans Singh INC Dindoshi 1 15 0 2Ramesh Thakur INC Kandivali East 32 371 31 349YogeshSagar BJP Charkop 13 201 15 180AslamShaikh INC Malad West 6 78 9 87Subhash Desai SS Goregaon 3 55 2 17BaldevKhosa INC Versova 6 51 4 37Ashok Jadhav INC Andheri West 13 177 12 172KrishnakumarHegde INC Vile Parle 35 480 40 472Ramchandra Kadam MNS Ghatkopar West 34 764 53 771Prakash Maheta BJP Ghatkopar East 3 69 3 34Abu Azmi SP MankhurdShivaji Nagar 14 177 5 41Nawab Malik NCP Anushakti Nagar 27 419 30 322ChandrakantHandore INC Chembur 38 522 7 338MilindKamble NCP Kurla (SC) 5 99 9 126Kripashankar Singh INC Kalina 42 708 42 566Prakash Sawant SS Vandre East 5 75 3 50ZiyauddinSidikki INC Vandre West 12 261 31 441Jagannath Shetty INC SionKoliwada 9 127 17 218KalidasKolambkar INC Wadala 50 788 32 740NitinSardesai MNS Mahim 49 620 55 610BalaNandgaonkar MNS Shivadi 10 224 31 375MadhukarChavan INC Byculla 72 1102 29 695MangalLodha BJP Malbar Hill 49 732 20 552Amin Patel INC Mumbadevi 37 506 43 504Annie Shekhar INC Colaba 0 20 2 28Total 706 10759 685 966514 Only 32 out of 36 MLAs representing Mumbai are shown in the table as the other four MLAs being ministers cannot askquestions. 26 Report on the STATE of HEALTH of MUMBAI
  • 27. www.praja.orgTable 19: Issues raised/Questions asked by MLAs Issues 2010 2011Bio Medical Waste 7 0Epidemic/Sensitive Diseases 154 58Epidemic/Sensitive State Hospital 21 0Equipments 51 3Health Education/Institute 42 48Maternity homes / Primary Health Centre(PHC) 6 23Quacks 12 10Health Service Related 3 3Health Related Issues 18 17Human Resource 118 112Infrastructure 45 75Mortality Rate 53 101Private Health Service 12 5Schemes / Policies in Health 109 202Treatment/Medicine 55 28 Total 706 685 27 Report on the STATE of HEALTH of MUMBAI