National Health Mission in India (NHM)

The Indian Government introduced the National Health Mission to provide quality and affordable health care to the rural population, especially children, women, and society's vulnerable sections and address their necessary healthcare requirements. This blog summarises the objectives of this mission, its types and additional crucial aspects.

The National Health Mission (NHM) in India aims to provide accessible and affordable healthcare, focusing on maternal and, disease control, and infrastructure development, crucial for improving public health nationwide.

The National Health Mission (NHM) is an initiative by the Indian government to improve healthcare services. It focuses on strengthening public health systems, reducing child and maternal mortality, and providing equitable, affordable, and quality health care. NHM integrates health programs, aiming for comprehensive health care for all.

It includes components like the National Rural Health Mission (NRHM) and National Urban Health Mission (NUHM). NHM emphasises community participation and health education. It provides funding to state and district health programs. The mission works to improve infrastructure and train healthcare workers.

As you can understand, the full form of the NHM is the National Health Mission. The Ministry of Health and Family Welfare launched this programme to meet the following objectives:

• Reduce the proportion of Maternal Mortality Rate (MMR) to 1 out of 1000 live births and Infant Mortality Rate (IMR) to 25 out of 1000 in the country.
• Provide affordable universal access to public health care services such as child and women's health, nutrition, immunisation, hygiene and sanitation, and adequate water supply.
• Prevent and control non-communicable and communicable diseases, which includes local endemic diseases.
• Reduce the prevalence of anaemia in women aged between  15 to 49 years.
• This scheme envisages extending comprehensive primary healthcare facilities.
• Stabilise the population, and create a demographic and gender balance.
• Revive AYUSH, local healthcare tradition and promote a healthy lifestyle.

National Health Missions in India aim to enhance healthcare delivery and access, focusing on rural and urban health needs. The Mission is divided into two parts based on the area it serves:

1. NRHM/ National Rural Health Mission

The National Rural Health Mission focuses on providing standard and affordable healthcare services to the country's rural population, emphasising vulnerable sections.

NRHM  will cover cities or towns with less than 50,000 population. It gives special preference to the Empowered Action Group States, which are socio-economically weaker states such as Bihar and Jharkhand, to name a few. It also covers Jammu and Kashmir, North-Eastern states, Himachal Pradesh, etc.

This scheme aims to establish decentralised health care services and take actionable steps to provide rural population access to sanitation, water, healthcare, education, nutrition and gender and social equality. NRHM or NHM has implemented several initiatives such as ASHA, Rogi Kalyan Samiti or Hospital Management Society, etc.

2. NUHM/ National Urban Health Mission

Launched in 2013, National Urban Health Mission aims to provide urban populations, especially vulnerable sections and urban poor, access to primary healthcare facilities. It encompasses district headquarters, State capitals and cities or towns with a population of 50,000 and above, according to the census 2011 in a gradual manner.

It aims to build a service delivery system through  Urban – Primary Health Centres, Urban-Community Health Centres and Referral Hospitals etc.

This scheme is implemented in metropolitan cities like – Mumbai, Kolkata, New Delhi, Chennai, Ahmedabad, Hyderabad, Bengaluru through Urban Local Bodies. The State Health Department determines whether a health department or urban local body will implement the National Urban Health Mission in remaining cities.

Note the following features of NHM or National Health Mission as mentioned below:

• It subsumes the National Urban Health Mission and National Rural Health Mission and aims to provide access to both rural and urban populations to quality and affordable healthcare services.
• The Indian Ministry has set up a Health Management Information System, a web-based monitoring system to check the progress of health programmes under the National Health Mission in India.

Besides, the Government aims to leverage digital infrastructure through the National Digital Health Mission for quick deliveries of healthcare services. The prime example of this is the recent launch of the "Niramay" project by NHM in collaboration with Cisco and Piramal Swasthya. This project is to digitise healthcare deliveries in Assam.

Here are some of the benefits of the National Health Mission mentioned below:

• The National Health Mission aims to provide affordable and quality healthcare services to the rural and urban populace and identifies other areas that need attention. This includes reducing the Total Fertility Rate and diseases like leprosy, malaria, tuberculosis, etc., to a specific target rate. For example, it aims to reduce the Total Fertility Rate to 2.1, reduce the prevalence of leprosy to 1 out of 10,000 population and incidence to zero in every district.
• Several initiatives under this National Health Mission, such as Social awareness and Actions to Neutralise Pneumonia Successfully, aim to reduce childhood death due to pneumonia. Similarly, schemes like Janani Shishu Suraksha Karyakram allow pregnant women to give birth in public healthcare institutions without incurring any expenses.
• It also aims to bridge the disparity in rural healthcare services by developing healthcare infrastructure and employing more human resources to improve healthcare services in rural areas. 

The National Health Mission (NHM) aims to improve healthcare delivery across India, focusing on accessible, affordable, and quality services. Take a look at the following five components of NHM:

1. Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCH+A)

The Ministry of Health and Family Welfare introduced RMNCH+A following the "Call to Action (CAT) Summit" in 2013. It aims to ensure the health of mothers and their children and to reduce maternal, child mortality and morbidity rates.

2. Non-Communicable Disease Control Programmes

Non-communicable diseases constitute two-thirds of the total mortality rate in India. The Government had developed several programmes to prevent and control it. Take a look at some of them:

• National Programme for Palliative Care (NPPC)
• National Oral Health Programme (NOHP)
• National Programme for Prevention & Control of Cancer, Diabetes, Cardiovascular Diseases & Stroke (NPCDCS)
• National Programme For Control of Blindness & Visual Impairment (NPCBVI) etc.

3. Communicable Disease Control Programme

The Indian Government has developed several schemes to reduce communicable diseases. They are as follows:

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

4. Health Systems Strengthening

It prescribes quality standards for maintaining clinical guidelines, support services, and management and administrative processes. It develops treatment protocols and skillsets to extend quality Reproductive and Child Health services.

Training packages such as Skilled Birth Attendance and Navjat Shishu Suraksha Karyakram have been designed to provide the same. Establishing Hospital Management Societies and strengthening this with untied funds and quality improvement programmes are also part of NHM's programmatic component.

5. Infrastructure Maintenance

This component under NHM extends support to states to fulfil the salary requirement of selected departments. These include Direction & Administration (Family Welfare Bureaus at state & district level), Health & Family Welfare Training Centres, etc.

The National Health Mission (NHM) encompasses several major initiatives aimed at enhancing healthcare delivery in India. These initiatives target various aspects of health care and public health.

1. National Rural Health Mission (NRHM)

Focuses on improving healthcare infrastructure in rural areas. Enhances access to quality health services and reduces disparities in rural health.

2. National Urban Health Mission (NUHM)

Targets urban areas, particularly underserved communities and slums. Aims to improve health outcomes in cities by expanding urban health services.

3. Reproductive, Maternal, Newborn, Child, and Adolescent Health (RMNCH+A)

Addresses the health needs of women, children, and adolescents.Focuses on reducing maternal and child mortality rates through targeted interventions.

4. National Health Mission (NHM) and Health Systems Strengthening

Enhances the overall healthcare system by improving infrastructure and training. Supports the development of robust health systems and management practices.

5. National Immunization Program (NIP)

Provides immunization to prevent vaccine-preventable diseases.Works to increase vaccination coverage and ensure disease control.

6. Health and Wellness Centres (HWCs)

Establishes primary health care facilities to deliver comprehensive health services.Aims to provide accessible and affordable healthcare in local communities.

Thus, the National Health Mission is an overarching programme of the Indian Government that focuses on providing affordable and quality healthcare to the rural and urban populace and recognises other diseases and causes of mortality and morbidity to ensure the healthy lives of Indians.

Implementing the mission involves collaboration between central and state governments, ensuring a decentralised approach. Overall, NHM plays a crucial role in enhancing India's healthcare system.

You may also like to read:

• Universal Health Insurance Scheme
• Central Government Health Scheme