{"id":11735,"date":"2025-05-10T18:01:15","date_gmt":"2025-05-10T12:31:15","guid":{"rendered":"https:\/\/vajiramandravi.com\/upsc-exam\/?p=11735"},"modified":"2025-05-10T18:01:15","modified_gmt":"2025-05-10T12:31:15","slug":"national-health-mission","status":"publish","type":"post","link":"https:\/\/vajiramandravi.com\/upsc-exam\/national-health-mission\/","title":{"rendered":"National Health Mission, Objectives, Components, Challenges"},"content":{"rendered":"<p><span style=\"font-weight: 400\">National Health Mission (NHM) has been a key initiative by the Government of India to provide affordable healthcare to its citizens, particularly in rural and underserved areas. Launched in 2005, the mission has undergone various transformations and is a critical part of India's healthcare framework. As India continues to work towards achieving universal health coverage, NHM plays a crucial role in ensuring the accessibility, availability, and quality of healthcare services.\u00a0<\/span><\/p>\r\n<h2><span style=\"font-weight: 400\">National Health Mission Overview<\/span><\/h2>\r\n<p><span style=\"font-weight: 400\">National Health Mission (NHM) was launched by the Government of India in 2013 subsuming the National Rural Health Mission (Launched in 2005) and the National Urban Health Mission (Launched in 2013).\u00a0<\/span><\/p>\r\n<ul>\r\n\t<li style=\"font-weight: 400\"><b>Extension: <\/b><span style=\"font-weight: 400\">The scheme has been extended multiple times, with the most recent extension <\/span><span style=\"font-weight: 400\">for the continuation of the NHM<\/span><span style=\"font-weight: 400\"> till 2026 or further review,<\/span><span style=\"font-weight: 400\"> whichever is earlier, subject to the adherence to Expenditure Finance Committee\u2019s recommendations and the financial ceilings, etc.<\/span><\/li>\r\n\t<li style=\"font-weight: 400\"><b>Aim: <\/b><span style=\"font-weight: 400\">The NHM strives to ensure universal access to affordable, equitable, and quality healthcare services, emphasizing accountability, responsiveness, and inter-sectoral action to address broader social health determinants.<\/span><\/li>\r\n<\/ul>\r\n<h2><span style=\"font-weight: 400\">Components of National Health Mission\u00a0<\/span><\/h2>\r\n<p><span style=\"font-weight: 400\">Under NHM, support to States\/UTs is provided for five key programmatic components. These are as follows:<\/span><\/p>\r\n<ul>\r\n\t<li style=\"font-weight: 400\"><b>Strengthening health systems<\/b><span style=\"font-weight: 400\"> through infrastructure, human resources, essential drugs and equipment, ambulances, mobile medical units (MMUs), and ASHAs under the National Rural Health Mission (NRHM) and National Urban Health Mission (NUHM).<\/span><\/li>\r\n\t<li style=\"font-weight: 400\"><b>RMNCH+A: <\/b><span style=\"font-weight: 400\">Reproductive-Maternal- Neonatal-Child and Adolescent Health<\/span><\/li>\r\n\t<li style=\"font-weight: 400\"><b>Communicable Disease<\/b><span style=\"font-weight: 400\"> Control Programmes<\/span><\/li>\r\n\t<li style=\"font-weight: 400\"><b>Non-Communicable Diseases <\/b><span style=\"font-weight: 400\">Control Programme interventions up to the District Hospital level<\/span><\/li>\r\n\t<li style=\"font-weight: 400\"><b>Infrastructure Maintenance<\/b><span style=\"font-weight: 400\">: To support the salary of\u00a0 Auxiliary Nurse Midwife (ANM) and Lady Health Assistant (LHV).<\/span><\/li>\r\n<\/ul>\r\n<h2><span style=\"font-weight: 400\">National Health Mission Objectives<\/span><\/h2>\r\n<p><span style=\"font-weight: 400\">The objective of the National Health Mission (NHM) is to ensure universal access to quality healthcare services, focusing on maternal and child health, disease prevention, population stabilization, and promoting healthy lifestyles. These are explained below:\u00a0<\/span><\/p>\r\n<ul>\r\n\t<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Universal access to public services for food, nutrition, sanitation, hygiene, and healthcare, with a special emphasis on women\u2019s and children\u2019s health and universal immunization.<\/span><\/li>\r\n\t<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Reduction in child and maternal mortality.<\/span><\/li>\r\n\t<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Prevention and control of communicable and non-communicable diseases, including locally endemic diseases.\u00a0<\/span><\/li>\r\n\t<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Access to integrated comprehensive primary health care.\u00a0<\/span><\/li>\r\n\t<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Population stabilization, gender, and demographic balance.<\/span><\/li>\r\n\t<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Revitalize local health traditions &amp; mainstream AYUSH.<\/span><\/li>\r\n\t<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Promotion of healthy lifestyles.<\/span><\/li>\r\n<\/ul>\r\n<h2><span style=\"font-weight: 400\">National Health Mission Funding<\/span><\/h2>\r\n<p><span style=\"font-weight: 400\">National Health Mission is funded by both the central and state governments. The funding model is designed to ensure that resources are allocated effectively to various healthcare components, particularly those serving marginalized and rural populations.<\/span><\/p>\r\n<ul>\r\n\t<li><b>Central and State Sharing:<\/b><span style=\"font-weight: 400\"> Implementation by State governments with financial and technical support from the central government.<\/span>\r\n<ul>\r\n\t<li><span style=\"font-weight: 400\">Fund sharing is 60:40 between the Central Government and States (90:10 for Northeastern states, including Sikkim).<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n\t<li><b>Global Partnerships<\/b><span style=\"font-weight: 400\">: The mission has also attracted support from international organizations, including the World Bank and Bill &amp; Melinda Gates Foundation, to address specific health challenges.<\/span><\/li>\r\n<\/ul>\r\n<h2><span style=\"font-weight: 400\">National Health Mission Achievements<\/span><\/h2>\r\n<p><span style=\"font-weight: 400\">The NHM has achieved several milestones since its inception, contributing to India's progress in improving health outcomes and achieving its health-related goals. The followings are key achievements of National Health Mission:\u00a0<\/span><\/p>\r\n<ul>\r\n\t<li><b>Improved Health Outcomes:<\/b><span style=\"font-weight: 400\"> NHM has significantly improved key health indicators, reflecting better maternal and child health.<\/span>\r\n<ul>\r\n\t<li><b>Maternal Mortality Rate (MMR):<\/b><span style=\"font-weight: 400\"> Reduced from 130 per lakh live births (2014-16) to <\/span><b>97<\/b><span style=\"font-weight: 400\"> per lakh (2018-20).<\/span><\/li>\r\n\t<li><b>Under-5 Mortality Rate (U5MR):<\/b><span style=\"font-weight: 400\"> Dropped from 45 per 1,000 live births (2014) to <\/span><b>32 <\/b><span style=\"font-weight: 400\">per 1,000 live births (2020).<\/span><\/li>\r\n\t<li><b>Infant Mortality Rate (IMR):<\/b><span style=\"font-weight: 400\"> Declined from 39 per 1,000 live births (2014) to<\/span><b> 28 <\/b><span style=\"font-weight: 400\">per 1,000 live births (2020).<\/span><\/li>\r\n\t<li><b>Total Fertility Rate (TFR): <\/b><span style=\"font-weight: 400\">Decreased from 2.3 (2015) to 2.0 (2020, as per NFHS-5).<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n\t<li><b>Disease Elimination and Control:<\/b><span style=\"font-weight: 400\"> The mission has achieved notable success in combating communicable diseases and ensuring mass immunization.<\/span>\r\n<ul>\r\n\t<li><b>Tuberculosis (TB): <\/b><span style=\"font-weight: 400\">Incidence dropped from 237 cases (2015) to 195 cases per 1,00,000 population (2023).<\/span><\/li>\r\n\t<li><b>Malaria: <\/b><span style=\"font-weight: 400\">Cases decreased by 13.28% in 2021 compared to 2020, with deaths reducing by 7.77% by 2023.<\/span><\/li>\r\n\t<li><b>Kala-Azar:<\/b><span style=\"font-weight: 400\"> Successfully eliminated in 100% of endemic blocks by 2023.<\/span><\/li>\r\n\t<li><b>Measles-Rubella Campaign: <\/b><span style=\"font-weight: 400\">Vaccinated 34.77 crore children, achieving 97.98% coverage.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n\t<li><b>Specialized Health Initiatives<\/b><span style=\"font-weight: 400\">: NHM has introduced targeted programs to address specific health challenges across diverse populations.<\/span>\r\n<ul>\r\n\t<li><b>National Sickle Cell Anemia Elimination Mission (2023): <\/b><span style=\"font-weight: 400\">Screened 2.61 crore individuals, primarily in tribal regions.<\/span><\/li>\r\n\t<li><b>Pradhan Mantri TB Mukt Bharat Abhiyaan<\/b><span style=\"font-weight: 400\">: Mobilized 1.56 lakh <\/span><b>Ni-kshay Mitra volunteers<\/b><span style=\"font-weight: 400\"> to support 9.40 lakh TB patients.<\/span><\/li>\r\n\t<li><b>Pradhan Mantri National Dialysis Programme (PMNDP): <\/b><span style=\"font-weight: 400\">Conducted 62.35 lakh hemodialysis sessions for 4.53 lakh patients during FY 2023-24.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n\t<li><b>COVID-19 Pandemic Response: <\/b><span style=\"font-weight: 400\">NHM played a pivotal role in managing the pandemic through vaccination and healthcare preparedness.<\/span>\r\n<ul>\r\n\t<li><span style=\"font-weight: 400\">Over 220 crore doses were administered from January 2021 to March 2024, covering 85% of the eligible population with at least one dose.<\/span><\/li>\r\n\t<li><span style=\"font-weight: 400\">Healthcare capabilities were enhanced through the India COVID-19 Emergency Response and Health Systems Preparedness Package (ECRP).<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n\t<li><b>Digital Health Innovations:<\/b><span style=\"font-weight: 400\"> NHM has leveraged technology to improve healthcare delivery and real-time tracking systems.<\/span>\r\n<ul>\r\n\t<li><b>U-WIN Platform (2023):<\/b><span style=\"font-weight: 400\">\u00a0 Enabled real-time vaccination tracking across 65 districts.<\/span><\/li>\r\n\t<li><b>Ayushman Arogya Mandir (AAM):<\/b><span style=\"font-weight: 400\"> 1.72 lakh centers operational, offering 12 key healthcare services.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n\t<li><b>Healthcare Infrastructure:<\/b><span style=\"font-weight: 400\"> Strengthening infrastructure has been a priority, with enhanced facilities at grassroots levels.<\/span>\r\n<ul>\r\n\t<li><b>Public Health Facilities Certification:<\/b><span style=\"font-weight: 400\"> 7,998 facilities certified under National Quality Assurance Standards (NQAS).<\/span><\/li>\r\n\t<li><b>24x7 Primary Health Centers (PHCs): <\/b><span style=\"font-weight: 400\">12,348 PHCs converted to 24x7 services., marking a <\/span><b>40% increase<\/b><span style=\"font-weight: 400\"> in availability.<\/span><\/li>\r\n\t<li><b>Mobile Medical Units (MMUs):<\/b><span style=\"font-weight: 400\"> 1,424 MMUs operational, supported by the MMU Portal.\u00a0<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n\t<li><b>The National Health Mission (2021-26) <\/b><span style=\"font-weight: 400\">seeks to ensure the achievement of the following indicators.<\/span>\r\n<ul>\r\n\t<li><span style=\"font-weight: 400\">Reduce Maternal Mortality Rate (MMR) to 87 per 1 lakh\u00a0<\/span><\/li>\r\n\t<li><span style=\"font-weight: 400\">Reduce Infant Mortality Rate (IMR) to 22 per thousand<\/span><\/li>\r\n\t<li><span style=\"font-weight: 400\">Reduce Total Fertility Rate (TFR) to 2.0 at national level<\/span><\/li>\r\n\t<li><span style=\"font-weight: 400\">Achieve the operationalization of 1.5 lakh Ayushman Arogya Mandir (erstwhile AB-HWC)<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<p><span style=\"font-weight: 400\">These improvements indicate that India is on track to meet its SDG targets for maternal, child, and infant mortality well ahead of 2030.<\/span><\/p>\r\n<h3><span style=\"font-weight: 400\">NHM Major Initiatives\u00a0<\/span><\/h3>\r\n<p><span style=\"font-weight: 400\">Initiatives under the National Health Mission (NHM) aim to strengthen healthcare delivery across India by focusing on comprehensive primary care, disease management, maternal and child health, and digital health innovations. These efforts encompass a range of programs designed to enhance accessibility and improve health outcomes, as outlined below:\u00a0<\/span><\/p>\r\n<ul>\r\n\t<li><b>Health and Wellness Centres (HWCs): <\/b><span style=\"font-weight: 400\">Establishing 1.5 lakh centers to deliver comprehensive primary healthcare, including non-communicable disease management and maternal-child health services.<\/span><\/li>\r\n\t<li><b>Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY): <\/b><span style=\"font-weight: 400\">World\u2019s largest health assurance scheme, offering \u20b95 lakh per family annually for secondary and tertiary care; 28.45 crore Ayushman Cards issued as of December 2023.<\/span><\/li>\r\n\t<li><b>Janani Shishu Suraksha Karyakram (JSSK): <\/b><span style=\"font-weight: 400\">Ensures free deliveries (including caesareans) and care for pregnant women and sick infants in public health facilities, covering drugs, diagnostics, transport, and diet.<\/span><\/li>\r\n\t<li><b>Rashtriya Bal Swasthya Karyakram (RBSK): <\/b><span style=\"font-weight: 400\">Screens 27 crore children (0\u201318 years) for diseases, birth defects, and developmental delays, with free treatment, including surgeries, for diagnosed conditions.<\/span><\/li>\r\n\t<li><b>National Digital Health Mission (NDHM): <\/b><span style=\"font-weight: 400\">Provides Health IDs for digital health records, ensuring continuity of care; as of December 2023, 50 crore individuals have unique IDs for seamless healthcare access.<\/span><\/li>\r\n\t<li><b>Pradhan Mantri Swasthya Suraksha Yojana (PMSSY)<\/b><span style=\"font-weight: 400\">: Focuses on upgrading healthcare facilities and creating state-of-the-art medical institutions.<\/span><\/li>\r\n\t<li><b>Other Major Initiatives:\u00a0<\/b>\r\n<ul>\r\n\t<li><b>Free Drugs and Diagnostics Service Initiative: <\/b><span style=\"font-weight: 400\">Offers essential medicines and tests at no cost.<\/span><\/li>\r\n\t<li><b>Pradhan Mantri National Dialysis Programme (PMNDP):<\/b><span style=\"font-weight: 400\"> Provides subsidized dialysis sessions nationwide.<\/span><\/li>\r\n\t<li><b>Tribal TB Eradication Project: <\/b><span style=\"font-weight: 400\">Focuses on eliminating tuberculosis in tribal areas.<\/span><\/li>\r\n\t<li><b>Mobile Medical Units (MMUs): <\/b><span style=\"font-weight: 400\">Enhances healthcare access in remote regions.<\/span><\/li>\r\n\t<li><b>Mission Indradhanush<\/b><span style=\"font-weight: 400\">: This initiative aims to increase immunization coverage for children and pregnant women.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<h2><span style=\"font-weight: 400\">National Health Mission Challenges<\/span><\/h2>\r\n<p><span style=\"font-weight: 400\">Despite its achievements, the National Health Mission faces several challenges that hinder its full potential in delivering quality healthcare to all citizens. These are explained below in detail:<\/span><\/p>\r\n<ul>\r\n\t<li><b>Infrastructure Limitations<\/b><span style=\"font-weight: 400\">: Many rural areas still lack adequate healthcare infrastructure, such as primary health centers, hospitals, and medical staff.<\/span><\/li>\r\n\t<li><b>Human Resource Shortages<\/b><span style=\"font-weight: 400\">: A shortage of qualified medical professionals, including doctors and nurses, especially in rural areas, remains a significant challenge.<\/span><\/li>\r\n\t<li><b>Health Financing<\/b><span style=\"font-weight: 400\">: Insufficient funds allocated to the healthcare sector and delays in fund disbursement can hamper the effective implementation of health programs.<\/span><\/li>\r\n\t<li><b>Quality of Services<\/b><span style=\"font-weight: 400\">: While healthcare access has improved, the quality of healthcare services remains a concern in many regions, particularly in government-run facilities.<\/span><\/li>\r\n\t<li><b>Socio-Cultural Barriers<\/b><span style=\"font-weight: 400\">: Socio-cultural factors, including gender biases and illiteracy, can prevent marginalized communities from accessing healthcare services.<\/span><\/li>\r\n\t<li><b>Non-compliance with Centre Guidelines: <\/b><span style=\"font-weight: 400\">Some states have not adhered to the Centre-mandated branding and design guidelines for Ayushman Bharat Health and Wellness Centres (AB-HWCs), undermining the program's national identity and uniform implementation.<\/span>\r\n<ul>\r\n\t<li>For instance, <span style=\"font-weight: 400\">Punjab renamed HWCs as \"Aam Aadmi Clinics,\" while Kerala, West Bengal, and Tamil Nadu used alternative colors and terms.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n\t<li><b>Partial Implementation:<\/b><span style=\"font-weight: 400\"> Incomplete adherence to NHM standards by some states has slowed the program's full-scale execution.<\/span>\r\n<ul>\r\n\t<li>For instance,<span style=\"font-weight: 400\"> Telangana included only some branding elements, while Andhra Pradesh and Odisha showed substantial but incomplete compliance.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n\t<li><b>Lack of Activity Implementation: <\/b><span style=\"font-weight: 400\">Some states failed to implement key activities under NHM, reducing program impact on healthcare delivery.<\/span>\r\n<ul>\r\n\t<li>For instance,<span style=\"font-weight: 400\"> Punjab did not execute core activities under Ayushman Bharat, prompting the Centre to flag non-performance.<\/span><\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<h2><span style=\"font-weight: 400\">National Health Mission Way Forward<\/span><\/h2>\r\n<p><span style=\"font-weight: 400\">To overcome these challenges and build a stronger healthcare system, the following steps are essential:<\/span><\/p>\r\n<ul>\r\n\t<li style=\"font-weight: 400\"><b>Strengthening Primary Healthcare<\/b><span style=\"font-weight: 400\">: Focus on improving the quality of primary healthcare services by expanding infrastructure, upgrading facilities, and increasing the number of trained healthcare workers.<\/span><\/li>\r\n\t<li style=\"font-weight: 400\"><b>Private Sector\u2019s Role<\/b><span style=\"font-weight: 400\">: The private sector has the potential to bridge the gaps in the public health system, but a collaborative approach is needed to ensure equity in service provision.<\/span><\/li>\r\n\t<li style=\"font-weight: 400\"><b>Public-Private Partnerships (PPP)<\/b><span style=\"font-weight: 400\">: Engaging the private sector to bridge gaps in service delivery, infrastructure, and technology, while ensuring equity.<\/span><\/li>\r\n\t<li style=\"font-weight: 400\"><b>Community-Based Health Interventions<\/b><span style=\"font-weight: 400\">: Enhancing community health programs, such as ASHA, to promote health awareness and preventive care.<\/span><\/li>\r\n\t<li style=\"font-weight: 400\"><b>Increased Investment<\/b><span style=\"font-weight: 400\">: Allocating more resources to the healthcare sector to meet the growing demand for health services and improve overall healthcare delivery.<\/span><\/li>\r\n\t<li style=\"font-weight: 400\"><b>Telemedicine and Technology<\/b><span style=\"font-weight: 400\">: Leveraging technology to improve access to healthcare services, especially in remote areas, through telemedicine and digital health platforms.<\/span><\/li>\r\n<\/ul>\r\n<h2><span style=\"font-weight: 400\">National Health Mission UPSC PYQs<\/span><\/h2>\r\n<p><b>Question 1.<\/b><span style=\"font-weight: 400\"> \u201cBesides being a moral imperative of the Welfare State, primary health structure is a necessary pre-condition for sustainable development.\u201d Analyze. <\/span><b>(UPSC Mains 2021)\u00a0<\/b><\/p>\r\n<p><b>Question 2. <\/b><span style=\"font-weight: 400\">Appropriate local community-level healthcare intervention is a prerequisite to achieve \u2018Health for All\u2019 in India. Explain. <\/span><b>(UPSC Mains 2018)<\/b><\/p>\r\n<p><br \/>\r\n<b>Question 3.<\/b><span style=\"font-weight: 400\"> Public health system has limitations in providing universal health coverage. Do you think that the private sector can help in bridging the gap? What other viable alternatives do you suggest? <\/span><b>(UPSC Mains 2015<\/b><span style=\"font-weight: 400\">)<\/span><\/p>","protected":false},"excerpt":{"rendered":"<p>National Health Mission (NHM) was launched in 2013 subsuming the National Rural &#038; Urban Health Mission. Check more Objectives, Components, Funding, Challenges of NHM<\/p>\n","protected":false},"author":22,"featured_media":11813,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[28,38],"tags":[1220,40,634],"class_list":{"0":"post-11735","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-upsc-social-justice-notes","8":"category-upsc-notes","9":"tag-national-health-mission","10":"tag-quest","11":"tag-upsc-social-justice-notes"},"acf":[],"_links":{"self":[{"href":"https:\/\/vajiramandravi.com\/upsc-exam\/wp-json\/wp\/v2\/posts\/11735","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/vajiramandravi.com\/upsc-exam\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/vajiramandravi.com\/upsc-exam\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/vajiramandravi.com\/upsc-exam\/wp-json\/wp\/v2\/users\/22"}],"replies":[{"embeddable":true,"href":"https:\/\/vajiramandravi.com\/upsc-exam\/wp-json\/wp\/v2\/comments?post=11735"}],"version-history":[{"count":0,"href":"https:\/\/vajiramandravi.com\/upsc-exam\/wp-json\/wp\/v2\/posts\/11735\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vajiramandravi.com\/upsc-exam\/wp-json\/wp\/v2\/media\/11813"}],"wp:attachment":[{"href":"https:\/\/vajiramandravi.com\/upsc-exam\/wp-json\/wp\/v2\/media?parent=11735"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vajiramandravi.com\/upsc-exam\/wp-json\/wp\/v2\/categories?post=11735"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vajiramandravi.com\/upsc-exam\/wp-json\/wp\/v2\/tags?post=11735"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}