National Health Mission (NHM)

All About National Health Mission (NHM)

For the purpose of health systems strengthening in urban and rural areas, the Indian government launched the National Health Mission (NHM) in 2013. NHM encompasses two sub-missions, namely National Rural Health Mission and National Urban Health Mission. The government extended it in March 2018, to continue until March 2020.

(Note: Information listed in this page has been sourced from the website of National Health Mission.)

Types of National Health Mission

National Rural Health Mission (NRHM)

Launched in April 2005, the National Rural Health Mission focuses on providing accessible, affordable and quality healthcare to the rural population, particularly the vulnerable groups. Under the NRHM, the Empowered Action Group States and the North Eastern States, Jammu and Kashmir and Himachal Pradesh are given special focus. The mission aims to establish a fully functional, community-owned, decentralized health delivery system, with inter-sectoral convergence at every level. This has been undertaken to ensure simultaneous action on a range of determinants of health, like water, sanitation, nutrition, education, social and gender equality.

National Urban Health Mission (NUHM)

NUHM seeks to improve the health status of the urban population, especially slum dwellers and other vulnerable sections, by providing them access to quality primary healthcare. NUHM covers all district headquarters, state capital and other cities whose population is over 50,000 (as per census 2011) in a phased manner. Cities and towns whose population is less than 50,000 are covered under NRHM.

Features & Benefits Of National Health Mission (NHM)

Features of National Health Mission

The features of National Health Mission are as follows:

  • It encompasses the National Rural Health Mission (NRHM) and the National Urban Health Mission (NUHM).
  • It aims to provide equitable, affordable & quality healthcare services
  • ASHA, Rogi Kalyan Samiti/Hospital Management Society, Janani Suraksha Yojana (JSY) and The Village Health Sanitation and Nutrition Committee (VHSNC) are some of the major initiatives under National Health Mission.
  • Web-based monitoring system Health Management Information System has been put in place by the Ministry for monitoring health programmes under National Health Mission

Benefits of National Health Mission

The benefits of National Health Mission are as follows:

  • It provides affordable and quality healthcare to the rural population.
  • It has strengthened the healthcare infrastructure.
  • It has brought down maternal mortality among the poor pregnant women.
  • The prevalence of tobacco use and number of tobacco users have reduced.
  • The Janani Shishu Suraksha Karyakram entitles pregnant women to give birth in public health institutions at no expense.

Components of National Health Mission (NHM)

RMNCH+A - Reproductive, Maternal, Newborn, Child and Adolescent Health

Improving the health of mothers and their children as well as ensuring their survival are vital to the achievement of national health goals under the NHM. SDG Goal 3 focuses on bringing down maternal, new-born and child mortality. Innovative strategies have evolved under the national programme to deliver evidence-based interventions to different population groups.

Following the “Call to Action (CAT) Summit” in February, 2013, the Ministry of Health & Family Welfare introduced Reproductive, Maternal, Newborn Child plus Adolescent Health (RMNCH+A) to influence the key interventions for reducing maternal and child morbidity and mortality.

Health Systems Strengthening

Quality standards have been prescribed for clinical protocols, administrative and management processes and support services. Skill sets and standard treatment protocols for providing quality RCH services and training packages have been designed. Additionally, the creation of a hospital management society with untied funds, enabling public participation, has contributed to improved quality of care.

Non-Communicable Disease Control Programmes

Non-communicable diseases are one of the leading causes of mortality and morbidity. The government has initiated a number of national programs for their prevention and control. These include:

  • National Programme for prevention & Control of Cancer, Diabetes, Cardiovascular Diseases & stroke (NPCDCS)
  • National Programe For Control Of Blindness & Visual Impairment (NPCBVI)
  • National Oral Health Programme (NOHP)
  • National Programme for Palliative care (NPPC)
  • National Programme for Prevention & Management of Burn Injuries (NPPMBI)
  • National Mental Health Programme (NMHP)
  • National Programme for healthcare of Elderly (NPHCE)
  • National Programme for the Prevention & Control of Deafness (NPPCD)
  • National Tobacco Control Programme (NTCP)
  • Other Non-Communicable disease Control Programmes

Communicable Disease Control Programme

With a view to limit instances of communicable diseases, the government has initiated the following programs:

  • National Vector Borne Disease Control Programme (NVBDCP)
  • Revised National Tuberculosis Control Programme (RNTCP)
  • National Leprosy Eradication Programme (NLEP)
  • Integrated Disease Surveillance Programme (IDSP)

Infrastructure Maintenance

Releases to State Health & FW Society Infrastructure Maintenance for 2014-15, 2015-16, 2016-17, 2017-18 and 2018-19 are listed on the website of National Health Mission.

Initiatives for Community Participation Under NHM

Some of the initiatives for community participation under National Health Mission are as follows:

Rogi Kalyan Samiti: This committee is a registered society whose members act as trustees, managing the hospital affairs. It is responsible for maintaining the facilities and ensuring provision of better facilities for the patients in the hospital. Financial assistance through untied fund is provided for the purpose of undertaking activities for patient welfare. 31,763 Rogi Kalyan Samitis have been established, involving the members of the community in nearly all District Hospitals (DHs), Sub-District Hospitals (SDHs), Community Health Centres (CHCs) and Primary Health Centres (PHCs).

Accredited Social Health Activist (ASHA): Over 9.15 lakh ASHAs are in place across the nation. They serve as facilitators, mobilizers and providers of community level care. ASHA is the first port of call in the community, particularly for marginalized sections of the population, with a focus on women and children.

Objectives & Achievements Of National Health Mission (NHM)

Objectives of National Health Mission

National Health Mission endeavours to:

  • Bring down MMR to 1/1000 live births
  • Bring down IMR to 25/1000 live births
  • Bring down TFR to 2.1
  • Prevention and reduction of anaemia in women from the ages 15 to 49 years
  • Prevent and reduce mortality & morbidity from communicable, noncommunicable; emerging ailments and injuries.
  • Bring down household out-of-pocket expenses on overall health care expenditure
  • Bring down annual incidence and mortality from Tuberculosis by half
  • Bring down prevalence of leprosy to <1/10000 population and incidence to zero in all districts
  • Annual malaria incidence to be <1/1000 10
  • Less than 1% microfilaria prevalence in all districts
  • Kala-azar elimination by 2015, <1 case per 10000 population in all blocks

Achievements of National Health Mission

  • National Tobacco Control Programme is in-force in around 612 districts in all States/UTs.
  • Tobacco use has gone down by 6 percentage points from 34.6% to 28.6% from 2009-10 to 2016-17. Tobacco users have come down by around 81 lakhs
  • The National Tobacco Cessation Quitline Services was launched.
  • 'mCessation' initiative introduced to help tobacco users quit through text-messaging via mobile phones.
  • Regulating the use of cigarettes and other tobacco products in TV programmes and films.
  • Established the ‘Global Knowledge Hub for Smokeless Tobacco’.
  • Acceded to the Protocol to Eliminate Illicit Trade in Tobacco Products under Article 15 of the WHO Framework Convention on Tobacco Control.
  • Issued an advisory to ban Electronic Nicotine Delivery System, including Heat-Not-Burn devices, e-Cigarettes, Vape, e-Sheesha, e-Nicotine Flavoured Hookah, and similar devices that allow nicotine delivery besides other than for the purpose and to the extent, as may be approved under the Drugs and Cosmetics Act, 1940 and Rules made thereunder.
  • Three national tobacco testing laboratories have been set up.

National Health Mission - Janani Suraksha Yojana

Janani Suraksha Yojana is a safe motherhood intervention whose objective is to reduce the mortality rate of mothers and new-born babies by promoting institutional delivery. The scheme aims to encourage poor pregnant women to give birth in registered health institutions, where medical staff are on-hand, in case something goes wrong. Janani Suraksha Yojana integrates cash assistance along with delivery and post-delivery care. The success of the scheme can be determined by the increase in institutional delivery among the poor families.

Conclusion

The NHM was introduced with the aim to provide universal access to equitable, affordable and quality healthcare services that are responsive to the needs of the country's citizens. Many states have shown improved progress in healthcare facilities as well as the health of the individuals following the implementation of various initiatives under NHM. The mission, launched by the government in 2013, is set to continue until March 2020.

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