1. Report on The STATE of HEALTH of MUMBAI Supported by FORD FOUNDATION MADHU MEHTA FOUNDATION 1

2. Part 1 2 Data from (160) Municipal Dispensaries, (24) Municipal Hospitals and (4) State Hospitals

3. Sensitive Diseases/Ailments 2008-092009-102010-112011-12 Malaria23,31739,89878,44839,828 Diarrhoea81,321116,295125,99999,839 Hypertension28,33732,46938,38825,518 Tuberculosis31,51029,69232,38329,878 Diabetes23,77723,83822,49321,264 Typhoid8,2884,2206,5577,561 Hepatitis B990444547931 Dengue6828661,4031,879 Cholera96124236178 % Increase from 2008-09 as base year for total cases 2008-092009-102010-112011-12 Malaria100171336171 Diarrhoea100143155123 Hypertension10011513590 Tuberculosis1009410395 Diabetes100 9589 Typhoid100517991 Hepatitis B100455594 Dengue100127206276 Cholera100129246185 3

4. Part 2 4 Data based on Household survey of 15,191 respondents across the city of Mumbai

5. Provisional Population 2011 Estimated citizens using private facilities (in %) Estimated citizens using private facilities (in numbers) Total1,24,32,83075.51%93,88,030 Estimated Citizens using private dispensaries/hospitals More than 75% of citizens in Mumbai use private health care facilities. 5

6. In % Amount spent from total income (in %) 4.26More than 30% 7.15 21% to 30 % 18.97 11% to 20% 38.92 6% to 10% 30.7 Less than 5% 100Total Estimated percentage of Annual Family Income spent on hospital/medical costs Hospitalised Indians spend more than 58% of annual income on medical costs. Over 25% hospitalised Indians fall below poverty lines because of medical costs (Source: NRHM Website) 6 More than 30% of households spend 11% or more of their annual income on hospital/medical costs.

7. In % Respondents having medical insurance20.45 Respondents not having medical insurance79.55 Total100 Medical Insurance Coverage 5 Only 10% Indians have medical insurance and it covers only hospitalisation costs (mainly for chronic diseases) and not expenses incurred for OPD (Out Patient) or drugs (Source: NRHM Website)

8. Diseases/Ailments Total Estimated Cases Estimated Households suffering from the disease/ailment (in %) Diabetes274,95710.4 % Malaria392,37814.8 % Tuberculosis63,2272.4 % Hypertension78,6353 % Cancer39,5831.5 % Estimated Occurrence of Diseases/Ailments for the year 2011-12 8

9. Red Flags 9  Over 3.8 Lakh Mumbaikars suffered from Malaria last year  Over 2.7 Lakh Mumbaikars suffered from Diabetes  63,227 citizens of Mumbai were prone to the life threatening Tuberculosis  80% Mumbaikars do not have health insurance  30% of Mumbaikars spend more than 11% of annual income on medical costs  Public Health Surveillance (Health Information System) is inadequate  Government focus is more on tertiary healthcare & not on primary healthcare