National Health Mission’s Impact on India’s Public Health

The National Health Mission (NHM) has played a very important role in enhancing India’s public health landscape. Its recent assessment report marks achievements from 2021 to 2024. The NHM has focused on reducing maternal and child mortality rates, controlling infectious diseases, and increasing healthcare workforce capacity.

Reduction in Maternal and Child Mortality

• The NHM has successfully reduced the Maternal Mortality Ratio (MMR) by 83% since 1990. This figure surpasses the global decline of 45%.
• The Under-5 Mortality Rate (U5MR) has also seen a dramatic fall from 45 per 1,000 live births in 2014 to 32 in 2020.
• Similarly, the Infant Mortality Rate (IMR) decreased from 39 to 28 per 1,000 live births during the same period.
• The Total Fertility Rate (TFR) has declined from 2.3 in 2015 to 2.0 in 2020. These improvements indicate India’s commitment to achieving United Nations Sustainable Development Goals (SDGs) by 2030.

Healthcare Workforce Expansion

The NHM has increased the healthcare workforce. In FY 2021-22, 2.69 lakh healthcare workers were engaged. This number rose to 4.21 lakh in FY 2022-23 and further to 5.23 lakh in FY 2023-24. The recruitment included general duty medical officers, specialists, and community health officers (CHOs). The enhanced workforce has improved healthcare delivery, particularly at the grassroots level.

Control of Infectious Diseases

• The NHM has progressed in controlling infectious diseases.
• The incidence of tuberculosis (TB) decreased from 237 per 100,000 population in 2015 to 195 in 2023. The mortality rate from TB fell from 28 to 22 in the same period.
• Malaria cases and deaths also declined by 13.28% and 3.22%, respectively, in 2021 compared to 2020.
• The successful elimination of kala-azar was achieved, with all endemic blocks meeting the target of less than one case per 10,000 population by the end of 2023.

Vaccination Campaigns

Under the Intensified Mission Indradhanush 5.0, the NHM launched the Measles-Rubella Elimination Campaign. This initiative vaccinated over 34.77 crore children, achieving a remarkable coverage of 97.98%. Such initiatives have boosted immunisation efforts across the country.

Integrated Response to Health Emergencies

The NHM has encourageed an integrated approach to health emergencies. This includes preparedness for outbreaks and enhancing the capacity of healthcare systems to respond effectively. The focus on community health has strengthened the overall public health infrastructure.

Future Goals and Directions

The NHM aims to sustain and build upon these achievements. Continued efforts will focus on improving healthcare access and quality. The mission will also address emerging health challenges and strive for the elimination of diseases.

Questions for UPSC:

1. Examine the role of the National Health Mission in improving maternal and child health in India.
2. Critically discuss the strategies employed by the National Health Mission to control infectious diseases.
3. Point out the significance of expanding the healthcare workforce in achieving public health goals.
4. Analyse the impact of vaccination campaigns on child mortality rates in India.

Answer Hints:

1. Examine the role of the National Health Mission in improving maternal and child health in India.

1. NHM has reduced Maternal Mortality Ratio (MMR) by 83% since 1990, surpassing the global decline.
2. Under-5 Mortality Rate (U5MR) decreased from 45 to 32 per 1,000 live births between 2014 and 2020.
3. Infant Mortality Rate (IMR) fell from 39 to 28 per 1,000 live births during the same period.
4. Total Fertility Rate (TFR) reduced from 2.3 in 2015 to 2.0 in 2020, indicating improved reproductive health.
5. These improvements align with India’s commitment to the U.N. Sustainable Development Goals (SDGs) for maternal and child health.

2. Critically discuss the strategies employed by the National Health Mission to control infectious diseases.

1. NHM implemented targeted interventions for tuberculosis, reducing incidence from 237 to 195 per 100,000 population from 2015 to 2023.
2. Mortality rate from TB decreased from 28 to 22 in the same timeframe, showcasing effective treatment strategies.
3. Malaria cases and deaths declined by 13.28% and 3.22%, respectively, in 2021 compared to 2020.
4. Successful elimination of kala-azar, with all endemic blocks achieving less than one case per 10,000 population by 2023.
5. Focused vaccination campaigns, like the Measles-Rubella campaign, enhanced community immunity against infectious diseases.

3. Point out the significance of expanding the healthcare workforce in achieving public health goals.

1. NHM facilitated the engagement of 2.69 lakh healthcare workers in FY 2021-22, improving service delivery.
2. In FY 2022-23, 4.21 lakh additional healthcare professionals were engaged, enhancing healthcare capacity.
3. By FY 2023-24, 5.23 lakh workers were engaged, including number of community health officers (CHOs).
4. The expanded workforce has strengthened healthcare delivery, especially at grassroots and rural levels.
5. Increased human resources have been crucial in addressing health emergencies and improving overall public health outcomes.

4. Analyse the impact of vaccination campaigns on child mortality rates in India.

1. The Measles-Rubella Elimination Campaign vaccinated over 34.77 crore children, achieving 97.98% coverage.
2. High vaccination rates contribute to the reduction of preventable diseases among children.
3. Improved immunization efforts have led to a decline in child mortality rates, particularly in vulnerable populations.
4. Vaccination campaigns are integral to achieving health targets and enhancing child health outcomes.
5. Overall, these initiatives support the broader goal of reducing under-5 mortality and improving public health in India.