Assessment of National Health Mission

Why in News?

Recently Union cabinet has approved the extension of National Health Mission for another 5 years.

What is National Health Mission (NHM)?

• NRHM - National Rural Health Mission was launched in 2005 to build public health systems to provide accessible, affordable and quality health care to the rural population.
• NUHM - In 2012, the National Urban Health Mission (NUHM) was conceptualized .
• NHM - NRHM was rechristened as the National Health Mission (NHM) with the two Sub Missions viz. the NRHM and the NUHM.
• 1st  Extension - Continuation of the National Health Mission-with effect from 1st April 2017 to 31st March 2020 was approved by Cabinet in 2018.
• 2^nd Extension - Ministry of Finance in 2020 has accorded interim extension of NHM for a period up to 31st March 2021 or till the date the recommendation of 15th Finance Commissions come into effect, whichever is earlier.
• 3rd Extension – In 2022, Ministry of Finance has further accorded the approval for continuation of National Health Mission from 01.04.2021 to 31.03.2026 or till further review.
• Implementation - Ministry of Health and Family Welfare under NHM provides financial and technical support to States / Union Territories (UTs) enabling them to provide accessible, affordable, accountable, and effective healthcare upto District Hospitals (DHs).

• Bride the rural urban gap – Addressing gap in rural healthcare services through improved health infrastructure, augmentation of human resource and improved service delivery.
• Decentralization of programme - NHM is decentralized to district level to facilitate need-based interventions, improve intra and inter-sectoral convergence and effective utilization of resources.

What are the achievements of National Health Mission (NHM)?

• Improvement in health outcomes
  • MMR declined by 83% since 1990, which is higher than the global decline of 45%.

The Maternal Mortality Ratio (MMR) has declined significantly from 130 per lakh live births in 2014-16 to 97 per lakh in 2018-20.

• • 75% in the reduction of Under 5 Mortality Rate in comparison to the global reduction of 60% since 1990.

Under-5 Mortality Rate (U5MR) has decreased from 45 per 1,000 live births in 2014 to 32 in 2020.

• • Infant Mortality Rate (IMR) has fallen from 39 per 1,000 live births in 2014 to 28 in 2020.
  • Total Fertility Rate (TFR) decreased from 2.3 in 2015 to 2.0 in 2020.
• Disease control - TB incidence reduced from 237 per 1,00,000 population in 2015 to 195 in 2023.
  • TB mortality rate decreased from 28 to 22  from 2015 to 2023.

1.56 lakh Ni-kshay Mitra volunteers are supporting over 9.4 lakh TB patients under the Pradhan Mantri TB Mukt Bharat Abhiyan.

• • National Sickle Cell Anemia Elimination Mission screens over 2.61 Crore Individuals.
  • Kala Azar Elimination targets successfully met.

Kala-azar elimination efforts have been successful, with 100% of endemic blocks achieving the target of less than one case per 10,000 population by the end of 2023.

• • In 2021, Malaria cases and deaths have declined by 13.28% and 3.22% respectively as compared to 2020.

• • The Measles-Rubella Elimination Campaign, under the Intensified Mission Indradhanush (IMI) 5.0, vaccinated over 34.77 crore children, achieving a 97.98% coverage.

• Expansion in healthcare human resources - NHM engaged over 12 lakh additional healthcare workers between FY 2021-24.
• Covid management - India COVID-19 Emergency Response and Health Systems Preparedness Package (ECRP), implemented under NHM in two phases, helped further bolster the healthcare system to effectively manage the pandemic.
• Institutional capacity development - Ayushman Arogya Mandir Centers reach 1.72 Lakh mark by FY 2023-24.
• Vaccination - India’s Universal Immunization Programme (UIP) is a part of the Reproductive and Child Health (RCH) Program under National Health Mission (NHM).
  • India achieved 97.98% coverage in measles-rubella vaccination campaign.
  • 220 Crore Covid-19 vaccine doses administered nationwide under NHM.
• U-WIN Platform  - Launched in  January 2023 , It ensures the timely administration of vaccines to pregnant women, infants, and children across India.

By the end of FY 2023-24, the platform had expanded to 65 districts across 36 States/UTs, ensuring real-time vaccination tracking and improving immunization coverage.

• Dialysis - Pradhan Mantri National Dialysis Programme has benefited over 4.53 lakh dialysis patients in FY 2023-24.
• Quality improvement - NHM has also focused on strengthening healthcare infrastructure, including the certification of public health facilities under the National Quality Assurance Standards (NQAS).

As of March 2024, 7,998 public health facilities have been certified, with over 4,200 of them receiving national certification.

• Improving emergency services - By March 2024, 12,348 PHCs had been converted to 24x7 services, and 3,133 First Referral Units(FRUs) were operational across the country.
• Additionally, the fleet of mobile medical units (MMUs) has also expanded.
• Health campaigns - Through sustained public awareness campaigns and enforcement of tobacco control laws, NHM has contributed to a 17.3% reduction in tobacco use over the past decade.
• National Action Plan for Snakebite Envenoming (NAPSE) was launched in 2022 , with efforts focused on prevention, education, and management of snakebites

Reference

PIB | National Health Mission