The National Health Mission (NHM) is a centrally sponsored scheme launched by the Government of India in 2013 by integrating the National Rural Health Mission (NRHM) and the National Urban Health Mission (NUHM). NHM aims to provide affordable, accessible, equitable and quality healthcare services.
The National Health Mission (NHM) is a scheme launched by the Government of India in 2013. It aims to provide accessible and affordable quality healthcare to all citizens with a special focus on rural populations. They work on strengthening the healthcare systems, preventing diseases and reducing maternal and child mortality. The National Health Mission (NHM) was launched by the Government of India in 2013 by integrating the National Rural Health Mission (NRHM), launched in 2005 and the National Urban Health Mission (NUHM), launched in 2013, under a single umbrella to strengthen healthcare delivery across both rural and urban areas.
What is the NHM?
The NHM stands for National Health Mission (NHM) and is centrally sponsored by the Government of India launched in 2013. The scheme aims at providing universal, quality and affordable healthcare to all citizens with a special focus on vulnerable populations and the rural poor. NHM integrates the National Rural Health Mission (NRHM) and the National Urban Health Mission (NUHM). The mission aims to provide affordable, accessible, equitable, and quality healthcare services to all citizens, with a special focus on rural, urban poor, and vulnerable populations. The Government of India, through the National Health Mission (NHM), focuses on strengthening healthcare infrastructure, improving maternal and child health, controlling communicable and non-communicable diseases, expanding the healthcare workforce, and ensuring universal access to essential health services, particularly for rural communities, the urban poor, and other vulnerable populations. The mission also supports universal health coverage by reducing out-of-pocket healthcare expenses and improving access to essential health services across India.
Key Objectives of National Health Mission (NHM)
The National Health Mission (NHM) aims at providing comprehensive primary healthcare, strengthening health systems and eradicating diseases. It empowers the state and district health societies to curate flexible budgets suitable for local epidemiological patterns. Let’s take a look at the National Health Mission:-
1. Comprehensive Primary Healthcare
The National Health Mission (NHM) aims at providing comprehensive primary healthcare to all citizens. It works to transform the existing healthcare centres by ensuring strict standards, treatment adherence tracking and enhancing wellness activities.
2. Human Resource Augmentation
The National Health Mission (NHM) works to recruit and train healthcare workforces such as doctors, nurses and the Accredited Social Health Activists. They also ensure quality training for healthcare professionals working in difficult terrains, tribal pockets and economically vulnerable areas.
3. Health Systems Strengthening
The National Health Mission (NHM) aims to strengthen India's public healthcare system by improving health infrastructure, ensuring efficient supply chains for essential medicines and medical equipment, and enhancing healthcare services at district hospitals, sub-district hospitals, Primary Health Centres (PHCs), and Community Health Centres (CHCs). The Prime Minister of India plays a crucial role in supporting national health initiatives by providing policy direction and promoting reforms that improve access to affordable, equitable, and quality healthcare services across the country.
4. Decentralized Planning
The National Health Mission (NHM) ensures local needs driven budgeting. Therefore, it prioritises decentralised planning by empowering state and district health societies to design flexible budgets suited to local epidemiological patterns. It also works to reduce delays in resource allocation.
5. Eradicating Diseases
The National Health Mission (NHM) scheme integrates several National Disease Control Programs to lighten the burden of both communicable and non-communicable illnesses. It aims to reduce the occurrence of diseases such as Tuberculosis, Leprosy and Malaria.
National Health Mission: Goals and Initiatives
The National Health Mission (NHM) has introduced several flagship initiatives to strengthen India's public healthcare system and improve access to quality medical services. These programmes focus on comprehensive primary healthcare, maternal and child health, disease prevention and control, digital healthcare, and the development of modern medical infrastructure. The major initiatives under NHM include:
- Health and Wellness Centres (HWCs): Established to provide comprehensive primary healthcare services, including screening and management of non-communicable diseases, maternal and child healthcare, elderly care, and essential medicines closer to communities.
- Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY): One of the world's largest government-funded health insurance schemes, providing health coverage of up to ₹5 lakh per family per year for secondary and tertiary hospitalization to eligible beneficiaries.
- Janani Shishu Suraksha Karyakram (JSSK): Ensures completely free and cashless maternity services, including normal and caesarean deliveries, medicines, diagnostics, blood, transport, and nutrition for pregnant women and sick newborns in public health facilities.
- Rashtriya Bal Swasthya Karyakram (RBSK): Provides early screening and free treatment for children (0–18 years) to detect birth defects, developmental delays, disabilities, and common diseases, ensuring timely medical intervention.
- National Digital Health Mission (NDHM): Promotes digital healthcare by creating unique Health IDs, enabling secure electronic health records, seamless healthcare access, and improved continuity of care across healthcare providers.
- Pradhan Mantri Swasthya Suraksha Yojana (PMSSY): Aims to strengthen tertiary healthcare by establishing new AIIMS institutions and upgrading Government Medical Colleges to reduce regional disparities in healthcare infrastructure and medical education.
Components of National Health Mission (NHM)
The National Health Mission (NHM) comprises health system strengthening, RMNCAH+N initiatives, national disease control programmes and non communicable diseases control programmes. Let’s take a look at the components of the National Health Mission:-
1. Health Systems Strengthening
The National Health Mission (NHM) scheme focuses on upgrading health systems such as infrastructure, emergency response services, diagnostic services and human resources to ensure health centers meet quality benchmarks.
2. RMNCAH+N Initiatives
The National Health Mission (NHM) does a lot of work to safeguard the lifespan of people through the Reproductive, Maternal, Neonatal, Child, Adolescent Health + Nutrition initiative. It utilises demographic indicators to guarantee safety for mother and child before, during and after childbirth.
3. National Disease Control Programmes
The National Health Mission (NHM) implements centralized and vertical budgets to eradicate and eliminate highly infectious communicable diseases through national disease control programmes such as the National Tuberculosis Elimination Programme and the National Leprosy Eradication Programme. These initiatives are aligned with the public health goals and disease control strategies promoted by the World Health Organization (WHO) to strengthen disease prevention and improve health outcomes.
4. Non Communicable Diseases Control Programmes
The National Health Mission (NHM) runs non communicable diseases control programmes such as National Mental Health Programme, National Programme for Health Care of the Elderly and National Tobacco Control Programme.
5. Community Processes and Innovations
The National Health Mission (NHM) bridges the gap between public healthcare systems and remote local communities through community processes and innovations. It has various committees such as village health sanitation committee, Jan Arogya Samity and the ASHA worker network.
Challenges of National Health Mission (NHM)
There are many challenges in the National Health Mission (NHM) such as urban dominance bias, ASHA overburdening, frequent medicine stockouts, rural connectivity issues and lack of dedicated workers. Let’s take a look at the challenges of the National Health Mission:-
1. Urban Dominance Bias
The National Health Mission (NHM) can be biased at times. The National Urban Health Mission remains severely underfunded compared to its rural counterpart which leaves urban slum populations with very limited access to physical health posts.
2. ASHA Overburdening
The ASHA workers face an overburdening checklist of programmatic tasks which include infant vaccination tracking to chronic cancer screenings without a matching increase in their fixed base remuneration.
3. Frequent Medicine Stockouts
Poor state-level warehouse planning leads to repeated medicine stockouts of free generic medicines. This forces poor patients to purchase expensive branded medicines from private pharmacies.
4. Rural Connectivity Issues
The National Health Mission (NHM) experiences rural connectivity issues. It faces problems such as poor cellular network coverage, absent broadband links and frequent power blackouts. This drastically impacts healthcare services.
5. Lack of Dedicated Workers
The National Health Mission (NHM) has a lack of dedicated workers. Despite digital tracking systems, high levels of absenteeism continue to affect the quality of health services. To solve this problem, the scheme relies on short term contracts.
Conclusion
The National Health Mission (NHM) is a scheme launched by the Ministry of National Health and Family Welfare. It aims at providing comprehensive primary healthcare, health system strengthening and eradicating diseases. However, it faces many challenges such as urban dominance bias, overburdening work on ASHA workers, frequent medicine stockouts, lack of dedicated workers and rural connectivity issues.