The Union Minister of State for Health and Family Welfare recently communicated to the Rajya Sabha that the National Health Mission (NHM), supported by health system reforms, significantly contributes to the development of resilient health systems. This article provides a detailed overview of NHM’s conception, its key components, initiatives, achievements, and continued efforts to enhance India’s health sector.
About the National Health Mission
Launched in 2013, the National Health Mission integrates the National Rural Health Mission (initiated in 2005) and the National Urban Health Mission. A core element of its mandate revolves around strengthening health systems in both urban and rural regions. The focus areas include Reproductive-Maternal-Neonatal-Child and Adolescent Health (RMNCH+A), along with Communicable and Non-Communicable Diseases. Through its initiatives, NHM aims to provide equitable, affordable, and quality healthcare services that meet people’s needs and are responsive.
NHM’s Support to States & Union Territories (UT)
NHM extends its support to States/UTs to bridge the infrastructure gaps in health services. This assistance involves the establishment of new facilities as needed and the upgrading of existing ones. Additionally, the provision of an array of free services related to maternal health, child health, adolescent health, family planning, universal immunisation programmes, and major diseases such as Tuberculosis and Leprosy, among others, forms part of the support.
Major Initiatives Supported Under NHM
Several significant health initiatives have been launched under the purview of NHM. These include the Janani Shishu Suraksha Karyakram (JSSK), Rashtriya Bal Swasthya Karyakram (RBSK), implementation of Free Drugs and Free Diagnostics Service Initiatives, PM National Dialysis Programme, and implementation of the National Quality Assurance Framework in all public health facilities. Ayushman Bharat, Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), Mobile Medical Units (MMUs) & Tele-consultation services have also been executed to improve healthcare accessibility, particularly in rural areas.
Achievements of NHM
Over 15 years of implementation, NHM’s contribution has been pivotal in reaching the Millennium Development Goals (MDGs) for health, which have now transitioned to the Sustainable Development Goals. India’s rate of improvements in maternal, newborn, and child health indicators surpasses global averages and has accelerated during NHM’s implementation period. The mission has notably developed a robust network of public health facilities ranging from grassroots Health & Wellness Centres to District Hospitals.
Equitable Development
NHM maintains a consistent focus on the health of tribal populations, those residing in Left Wing Extremism zones, and the urban poor. To ensure equitable access to health services, the Aspirational district initiative has been launched, identifying 115 districts across 28 states with weaker social and human development indicators for additional resources and capacity enhancement.
National Ambulance Services
Before 2005, ambulance networks were practically non-existent in India. However, under NHM, 20,990 Emergency Response Service Vehicles and 5,499 patient transport vehicles, specifically for pregnant women and ill infants, are now operational.
Human Resource Augmentation
NHM supports states in engaging service delivery HR such as doctors, nurses, health workers, and implements the world’s largest community health volunteer programme through the Accredited Social Health Activists (ASHAs), with over 10 lakh ASHAs engaged to date. NHM has facilitated states in acquiring staff with skills in public health, finance, planning, and management to implement interventions effectively.
Health Sector Reforms
NHM has enabled the design and implementation of reforms related to Governance, Procurement, and Technology. Additionally, to address the excessively high Out-of-Pocket Expenditure (OOPE), the initiative Free Drugs and Free Diagnostics Services has been implemented, significantly reducing OOPE levels.
Ultimately, NHM’s ongoing efforts continue to transform India’s public health landscape, making significant strides towards a more accessible, equitable, and quality-focused health care system.
