The purpose of this study, conducted in coordination with Manchester University, was to test a participatory planning methodology (Urban Asset Planning) in two ‘slum’ settlements of Puducherry through a focus on health and the lived environment. The study had three main objectives: to explore how people understood the relationships between their well-being and their living conditions; to ascertain relevant agencies and institutions; to enable locality-specific solutions through interactions with the communities and governmental and non-governmental agencies. The study found that there is a multifaceted and continuous erosion of people’s health and well-being; people have developed strategies to deal with issues in their immediate lived environment; there is significant differentiation in the patterns of problems, strategies, help-seeking behaviour and access to services among inhabitants of these settlements.