National Health Mission

Ministry of Health and Family Welfare

About:

• The National Health Mission (NHM) encompasses its two Sub-Missions, The National Rural Health Mission (NRHM) and The National Urban Health Mission (NUHM).
• The main programmatic components include Health System Strengthening, Reproductive-Maternal- Neonatal-Child and Adolescent Health (RMNCH+A), and Communicable and Non-Communicable Diseases.
• The NHM envisages achievement of universal access to equitable, affordable & quality health care services that are accountable and responsive to people’s needs.
• Continuation of the National Health Mission – with effect from 1st April 2017 to 31st March 2020 has been approved by Cabinet in its meeting dated 21.03.2018.

Six financing components:

(i) NRHM-RCH Flexipool,

(ii) NUHM Flexipool,

(iii) Flexible pool for Communicable disease,

(iv) Flexible pool for Non-communicable disease including Injury and Trauma,

(v) Infrastructure Maintenance and

(vi) Family Welfare Central Sector component.

Forward Linkages Scheme to NRHM in NE : 

With a view to complement & supplement the initiatives under the NRHM for improving the Secondary/Tertiary level and Other health infrastructure in the north eastern region, the Forward Linkage Scheme to NRHM was introduced in the 11th Plan (to be financed form likely saving from other Health schemes). This scheme was also continued in the 12th Plan. The project proposals sent by the NE States are appraised and for the approved projects, funds are released by the Ministry. 

Goals :

Outcomes for NHM in the 12th Plan are synonymous with those of the 11th Plan and are part of the overall vision. Specific goals for the states will be based on existing levels, capacity, and context. State specific innovations would be encouraged. Process and outcome indicators will be developed to reflect equity, quality, efficiency, and responsiveness. Targets for communicable and non-communicable diseases will be set at state level based on local epidemiological patterns and taking into account the financing available for each of these conditions.

The endeavor would be to ensure the achievement of indicators in Box 1 as follows :

1. Reduce MMR to 1/1000 live births

2. Reduce IMR to 25/1000 live births

3. Reduce TFR to 2.1

4. Prevention and reduction of anaemia in women aged 15–49 years

5. Prevent and reduce mortality & morbidity from communicable, non- communicable; injuries and emerging diseases

6. Reduce household out-of-pocket expenditure on total health care expenditure

7. Reduce annual incidence and mortality from Tuberculosis by half

8. Reduce the prevalence of Leprosy to <1/10000 population and incidence to zero in all districts

9. Annual Malaria Incidence to be <1/1000

10. Less than 1 percent microfilaria prevalence in all districts

11. Kala-azar Elimination by 2015, <1 case per 10000 population in all blocks

1)   NATIONAL RURAL HEALTH MISSION

• The National Rural Health Mission (NRHM) was launched by the Hon’ble Prime Minister on 12th April 2005, to provide accessible, affordable and quality health care to the rural population, especially the vulnerable groups.
• The Union Cabinet vide its decision dated 1st May 2013, has approved the launch of National Urban Health Mission (NUHM) as a Sub-mission of an over-arching National Health Mission (NHM), with National Rural Health Mission (NRHM) being the other Sub-mission of National Health Mission.
• NRHM seeks to provide equitable, affordable, and quality health care to the rural population, especially the vulnerable groups.
• Under the NRHM, the Empowered Action Group (EAG) States, as well as the North Eastern States, Jammu and Kashmir and Himachal Pradesh, have been given special focus.
• The thrust of the mission is on establishing a fully functional, community-owned, decentralized health delivery system with inter-sectoral convergence at all levels, to ensure simultaneous action on a wide range of determinants of health such as water, sanitation, education, nutrition, social and gender equality. Institutional integration within the fragmented health sector was expected to provide a focus on outcomes, measured against Indian Public Health Standards for all health facilities.

2)   NATIONAL URBAN HEALTH MISSION

• The National Urban Health Mission (NUHM) as a sub-mission of National Health Mission (NHM)
•  Approved by the Cabinet on 1st May 2013.
• NUHM envisages to meet health care needs of the urban population with the focus on urban poor, by making available to them essential primary health care services and reducing their out of pocket expenses for treatment.
• This will be achieved by strengthening the existing health care service delivery system, targeting the people living in slums and converging with various schemes relating to wider determinants of health like drinking water, sanitation, school education, etc.
• implemented by the Ministries of Urban Development, Housing & Urban Poverty Alleviation, Human Resource Development and Women & Child Development.

Goals :

i)  Need based city specific urban health care system to meet the diverse health care needs of the urban poor and other vulnerable sections.

ii)  Institutional mechanism and management systems to meet the health-related challenges of a rapidly growing urban population.

iii)  Partnership with community and local bodies for a more proactive involvement in planning, implementation, and monitoring of health activities.

iv)  Availability of resources for providing essential primary health care to urban poor.

v)  Partnerships with NGOs, for profit and not for profit health service providers and other stakeholders.

NUHM would cover all State capitals, district headquarters and cities/towns with a population of more than 50000. It would primarily focus on slum dwellers and other marginalized groups like rickshaw pullers, street vendors, railway and bus station coolies, homeless people, street children, construction site workers.

The centre-state funding pattern will be 75:25 for all the States except North-Eastern states including Sikkim and other special category states of Jammu & Kashmir, Himachal Pradesh and Uttarakhand, for whom the centre-state funding pattern will be 90:10.The Programme Implementation Plans (PIPs) sent by the by the states are apprised and approved by the Ministry.

Major initiatives under National Health Mission (NHM) are as follows:

National Digital Health Mission

Our PM has launched the National Digital Health Mission on 15th August 2020.

The mission aims to create an integrated healthcare system linking practitioners with the patients digitally by giving them access to real-time health records.

It is a complete digital health ecosystem. The digital platform will be launched with four key features — health ID, personal health records, Digi Doctor and health facility registry.

At a later stage, it will also include e-pharmacy and telemedicine services, regulatory guidelines for which are being framed.

Its implementation

The NDHM is implemented by the National Health Authority (NHA) under the Ministry of Health and Family Welfare.

The National Health Authority (NHA), is also the implementing agency for Ayushman Bharat.