Rapid urbanisation and quest for better livelihood, push-pull factor of occupations education, policy
changes attract large scale rural population to urban areas. It is well documented that in spite
of better public health facilities including tertiary care hospitals which are available in the urban
areas but the services are underutilised by the urban poor. Aim: Hence, in this paper, it is attempted
to comprehend the reasons for underutilisation of available public health facilities and to
compare the difference with non-slum areas of the major metropolitan cities of India. Methods: A
secondary data from National Family Health Survey-III for five major metropolitan cities namely,
Delhi, Hyderabad, Mumbai, Kolkata and Chennai is used for the analysis. Slum data which are classified
by both the agencies, that is census of India and NFHS-III as slum households only considered
for analysis. Results: In Mumbai slums about 90% of the households are having water
sources from public tap or piped to yard followed by Hyderabad having better water supply and
Chennai slum dwellers having minimum access to good water sources. About 11.4% of the households
do not know where their toilet drainage is connected. There is a significant (P < 0. 001) difference
in the observed proportions of toilet facilities by the cities studied. Proportions of open
defecation is compared among five cities and it is found that Delhi and Hyderabad have similar
proportion (P > 0.05) 75% to 79%, Kolkata and Chennai have parallel high proportion, that is
more than 95% (P > 0.05) and Mumbai stands as median percent age as 89.6. Apart from Delhi,
about 40% to 45% of the slum population is in the opinion of “long waiting time” in the government
hospitals, and the same trend of proportions is observed for “poor quality of service”