National Urban Health Mission

All about National Urban Health Mission (NUHM)

The National Urban Health Mission (NUHM), a government undertaking that is a sub-mission of National Health Mission (NHM), was launched on 1st May, 2013, after being approved by the Cabinet. It is implemented in all States/UTs in the country. NHM is a flagship programme of the Ministry of Health & Family Welfare that continues to support the State Governments in strengthening their health systems.

NUHM envisages to meet health care needs of the urban population with the focus on urban poor, by making available to them essential primary healthcare services and reducing their out of pocket expenses for treatment. This will be achieved by strengthening the existing healthcare 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. It is an initiative that is implemented by the Ministries of Urban Development, Housing and Urban Poverty Alleviation, Human Resource Development and Women and Child Development.

NUHM seeks to improve the health status of the urban population particularly slum dwellers and other vulnerable sections by facilitating their access to quality primary health care. NUHM would cover all state capitals, district headquarters and other cities/towns with a population of 50,000 and above (as per census 2011) in a phased manner. Cities and towns with population below 50,000 will be covered under NRHM.

Launch Date & Year: 1st May, 2013

Features of National Urban Health Mission (NUHM)

Poor compliance of the 74th Amendment in the Constitution has affected the health outcomes at ground level. Decentralized urban planning for urban health adopted by corporations/State health departments is to be followed under NUHM. Separate planning mechanism for Notified Area Committees, Town Panchayats and Municipalities will be part of the District Health Action Plan drawn up for NUHM. The Municipal Corporations will have a separate plan of action as per broad norms for urban areas. The existing structures and mechanisms of governance under NRHM will be suitably adapted to fulfil the needs of NUHM also.

Large scale presence of nongovernmental providers of health care: The urban locale have abundant profit & private hospitals which are largely unregulated with a compromised quality of health care. NUHM will explore the possibility of seeking partnerships with the non-governmental sector very closely in urban areas.

Special healthcare needs of urban poor and vulnerable populations will be provided under NUHM. Urban primary healthcare services will be ensured to these marginalized sections of the urban population.

Establishing synergies with other Government programmes with similar objectives like JnNURM, SJSRY and ICDS to optimize the expected outcomes of NUHM.

Public health thrust on social determinants of health such as sanitation, clean drinking water, vector control, etc. as these play a major role in management of communicable/non-communicable diseases.

Lack of information on services/resources in public health facilities such as availability of beds, etc. in different health facilities leads to unnecessary referral of patients to different health facilities.

Focus extensively on communitization by engaging existing community mobilisation structures such as ASHA. The NUHM encourages the effective participation of community in planning and management of healthcare services. States have the flexibility to take the work of motivating community from the Mahila Arogya Samitis (MAS) and ASHA also wherever needed. NUHM also promotes the role of the urban local bodies in the planning and management of the urban health programmes.

NUHM aims to provide a system for convergence of all communicable and non-communicable disease programmes including HIV/AIDS through integrated planning at the City level. The objective is to enhance the utilization of the system through convergence, by providing a common platform and availability of all services at one point (U-PHC) and establishing a robust referral mechanism. At the same time, NUHM specifically addresses the peculiarities of urban health needs, which constitutes non-communicable diseases (NCDs) as a major proportion of the burden of disease.

Leveraging the existing structure of NRHM: The existing institutional arrangements/structures under NRHM are adapted and modified under NUHM. This is to suit the city-specific need and provide the states a flexibility to adapt these city-specific models.

Use of ICT in NUHM: The existing systems will be strengthened and newer ones will be established as per the urban requirements in context of information and communication technology. ICT Systems would be established/strengthened for registrations, maintaining Personal Health Records, supply chain management of drugs, vaccines and logistics, and developing urban healthcare specific HMIS.

Objectives of National Urban Health Mission (NUHM)

NUHM would cover all state capitals, district headquarters and cities/towns with a population of more than 50,000. 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.

Goal

Gateway to authentic health information for all.

Vision

The National Health Portal aims to make this as a single point access for authenticated health information for citizens, students, healthcare professionals and researchers.

Mission

The National Health Portal will achieve the above vision by collecting, verifying and disseminating health and healthcare delivery services-related information for all citizens of India.

Initiatives for Community Participation under NUHM

  • Need-based city-specific urban healthcare system to meet the diverse healthcare needs of the urban poor and other vulnerable sections.
  • Institutional mechanism and management systems to meet the health-related challenges of a rapidly growing urban population.
  • Partnership with community and local bodies for a more proactive involvement in planning, implementation, and monitoring of health activities.
  • Availability of resources for providing essential primary healthcare to urban poor.
  • Partnerships with NGOs, for profit and non-profit health service providers and other stakeholders.

Achievement of National Urban Health Mission (NUHM)

The following illustration highlights the allocation, release and expenditures made under the National Urban Health Mission (NUHM) for all the states and Union Territories of India for the F.Y. 2017-18:

Sr. No.Names of Indian StatesAllocation (Rs. in crores)Release (Rs. in crores)Expenditure (Rs. in crores)
1Andaman & Nicobar Islands0.33-0.17
2Andhra Pradesh46.7835.0961.58
3Arunachal Pradesh0.80.540.78
4Assam17.958.986.65
5Bihar17.08-3.79
6Chandigarh2.742.061.43
7Chhattisgarh14.811.1013.80
8Dadra & Nagar Haveli0.2-0.17
9Daman & Diu0.18-0.02
10Delhi47.6542.8921.86
11Goa0.520.390.57
12Gujarat34.56117.0436.27
13Haryana16.9647.0914.73
14Himachal Pradesh0.570.290.04
15Jammu & Kashmir6.364.773.55
16Jharkhand9.17-0.92
17Karnataka39.5881.9930.81
18Kerala18.8114.1113.15
19Lakshadweep---
20Madhya Pradesh46.65-13.06
21Maharashtra113.3656.6857.08
22Manipur1.86-0.20
23Meghalaya3.851.731.30
24Mizoram4.371.973.33
25Nagaland4.271.922.62
26Odisha13.9739.5821.95
27Puducherry2.932.201.38
28Punjab16.9112.6812.51
29Rajasthan25.77-28.35
30Sikkim1.520.680.39
31Tamil Nadu59.26-56.05
32Tripura6.883.100.60
33Uttar Pradesh72.2654.2054.87
34Uttarakhand5.183.503.21
35West Bengal61.1355.0252.80
36Telangana36.84-8.24
Total752.05599.60528.24

Conclusion

National Urban Health Mission serves the objective of improving the primary healthcare facilities in urban India and making them easily accessible for the economically weaker sections of the society in these areas. This health scheme covers all state capitals, district headquarters, and other cities and towns with a population that exceeds 50,000, according to 2011 census. Cities and towns that have a population of less than 50,000 are covered under National Rural Health Mission (NRHM).

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