About the Scheme:
The National Health Mission (NHM) was launched by the Government of India in 2013, subsuming the National Rural Health Mission (NRHM) (launched in 2005) and the National Urban Health Mission (NUHM) (launched in 2013).
The main goal of NHM is to provide universal access to equitable, affordable, and quality health care services. The mission covers both rural and urban areas and aims to improve health outcomes through comprehensive interventions in Reproductive-Maternal-Neonatal-Child-Adolescent Health (RMNCH+A) and the management of communicable and non-communicable diseases. NHM emphasizes a people-centered health system, which is accountable and responsive to people’s needs, focusing on strengthening the existing healthcare infrastructure and service delivery systems.
Support to States and Union Territories (UTs)
Health Facilities:
NHM provides significant support to
States/UTs for the creation and
upgradation of health facilities. This includes building
new healthcare infrastructure and upgrading existing facilities based on the local requirements, thereby helping bridge infrastructure gaps.
Health Services: The NHM supports the provision of free services across various health sectors:
- Maternal Health (including safe delivery and antenatal care)
- Child Health (immunization, nutrition, etc.)
- Adolescent Health
- Family Planning
- Universal Immunization Programme
- Major Diseases such as Tuberculosis, Malaria, Dengue, Kala Azar, Leprosy, and more.
Major Initiatives Supported Under NHM- Janani Shishu Suraksha Karyakram (JSSK):
- Aimed at providing free and cashless services to pregnant women and sick infants, covering everything from delivery to postnatal care.
- Rashtriya Bal Swasthya Karyakram (RBSK):
- Focuses on the early identification and treatment of health issues among children, including congenital defects, nutritional disorders, and other diseases.
- Free Drugs and Free Diagnostics Service Initiatives:
- NHM supports the free provision of essential medicines and diagnostics services to reduce the out-of-pocket expenditure (OOPE) of patients.
- PM National Dialysis Programme:
- Provides free dialysis services to patients suffering from chronic kidney diseases, improving access to treatment in rural and underserved areas.
- National Quality Assurance Framework (NQAF):
- Aims to ensure that all public health facilities meet the required quality standards through continuous monitoring and improvement.
- Mobile Medical Units (MMUs) & Tele-consultation Services:
- Mobile units and telemedicine services are being implemented to extend healthcare access to remote and rural areas.
- Ayushman Bharat & Pradhan Mantri Jan Arogya Yojana (PMJAY):
- NHM supports the Ayushman Bharat PMJAY scheme, which provides health insurance to economically vulnerable families.
Achievements of NHM
Improvement in Health Indicators: NHM has significantly contributed to improving
health indicators across India. Key achievements include:
- Reduced maternal mortality rates (MMR) and infant mortality rates (IMR).
- Significant progress in child health and reproductive health outcomes.
- NHM’s implementation has accelerated these improvements, leading to outcomes that surpass global averages in some indicators.
Growth in Public Health Facilities: NHM has adopted a
health system approach, aiming to build a
network of
public health facilities that ensure
comprehensive primary and secondary healthcare services.
Key developments include:- Health & Wellness Centres (HWCs) at the grassroots level.
- Increased institutional capacity for service delivery.
- Development of district hospitals with robust referral linkages.
Equitable Development: NHM has placed a strong emphasis on improving
health access for marginalized and vulnerable populations:
- Tribal populations and those in left-wing extremism (LWE) areas.
- Focus on urban poor and remote areas.
- The Aspirational Districts Programme focuses on enhancing the health infrastructure of 115 districts with weak social and health indicators.
National Ambulance Services:- Prior to the launch of NRHM in 2005, ambulance networks were non-existent. Now, 20,990 Emergency Response Service Vehicles and 5,499 patient transport vehicles are operational, providing free pickup and drop-back services for pregnant women and infants.
Human Resource Augmentation: NHM supports
human resource development by engaging
doctors,
nurses, and
health workers. It also implements the
world’s largest community health volunteer programme, the
Accredited Social Health Activists (ASHAs):
- More than 10 lakh ASHAs and ASHA facilitators are engaged under NHM to assist with outreach and health education activities.
Health Sector Reforms: NHM has enabled several reforms, including:
- Governance improvements to streamline operations.
- Procurement and technology reforms to ensure cost-effectiveness and quality.
- Technology adoption to improve data management and monitoring systems.
Addressing Out-of-Pocket Expenditure (OOPE):To reduce the burden of high
OOPE, especially on
drugs and diagnostics, NHM has implemented the
Free Drugs and Free Diagnostics Service Initiatives. The
National List of Essential Medicines (NLEM) and
Essential Diagnostics Lists are regularly updated to provide affordable healthcare solutions.
Way Forward:
The
National Health Mission continues to be a crucial driver for healthcare reform in India, with an emphasis on
accessibility,
quality, and
affordability. The future directions include:
- Sustainability and Equity: Ensuring health services are accessible to all, especially marginalized communities.
- Technology Integration: Expanding digital health solutions and telemedicine services for better healthcare delivery in remote areas.
- Strengthening Governance: Ensuring better oversight of healthcare services and accountability at all levels.
- Focus on Non-Communicable Diseases (NCDs): With the rise of lifestyle diseases, NHM will increasingly focus on prevention and management of NCDs alongside traditional public health concerns.
- Private Sector Partnerships: Expanding collaboration with the private sector to enhance service delivery in under-served areas.
By continuing these efforts, NHM aims to strengthen India's healthcare system and ensure
Universal Health Coverage (UHC) for all its citizens.
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