Context: The National Health Mission (NHM) has significantly contributed to improving India’s public health, including lowering of the maternal mortality ratio, incidence of tuberculosis (TB), and sickle cell anaemia. It has also contributed to expanding human resources in the field while fostering an integrated response to health emergencies, the Union government said on Wednesday in its assessment report (2021-24) presented to the Union Cabinet. Under NHM, the Maternal Mortality Ratio (MMR) has declined by 83% since 1990, which is higher than the global decline of 45%. Infant Mortality Rate (IMR) has fallen from 39 per 1,000 live births in 2014 to 28 in 2020.
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Key points
· Overview: Listing out key achievements of the NHM in the past three years, the Centre noted that there had been a significant increase in human resources within the healthcare sector.
· Data from the report: In FY 2021-22, NHM facilitated the engagement of 2.69 lakh additional healthcare workers, including general duty medical officers, specialists, staff nurses, AYUSH doctors, allied healthcare workers, and public health managers. Additionally, 90,740 community health officers (CHOs) were engaged. This number grew in subsequent years, with 4.21 lakh additional healthcare professionals engaged in FY 2022-23, including 1.29 lakh CHOs, and 5.23 lakh workers engaged in FY 2023-24, which included 1.38 lakh CHOs.
· Support to States & Union Territories (UT): Health Facilities – NHM support is provided to States/UTs for setting up of new facilities as per norms and upgradation of existing facilities for bridging the infrastructure gaps based on the requirement posed by them.
Health Services
NHM support is also provided for provision of a range of free services related to maternal health, child health, adolescent health, family planning, universal immunisation programme, and for major diseases such as Tuberculosis, vector borne diseases like Malaria, Dengue and Kala Azar, Leprosy etc.
· Major Initiatives Supported Under NHM: Janani Shishu Suraksha Karyakram (JSSK). Rashtriya Bal Swasthya Karyakram (RBSK). Ayushman Bharat. Pradhan Mantri Jan Arogya Yojana (AB-PMJAY). PM National Dialysis Programme.
· Growth in Public Health Facilities: NHM adopts a health system approach and targets to build a network for public health facilities with Health & Wellness Centres at the grassroot level and District Hospitals, with robust referral linkage, to offer Comprehensive primary and secondary care services to citizens.
· Equitable Development: A more recent effort at ensuring equity in access and use, is the Aspirational district initiative, in which 115 districts across 28 states, with weak social and human development indicators have been identified for allocation of additional resources and capacity enhancement to catch up with more progressive districts.
· Health Sector Reforms: NHM enabled the design and implementation of reforms specifically related to Governance, Procurement and Technology.
· Addressing high Out-of-Pocket Expenditure (OOPE): Recognising the need for reducing the current high levels of OOPE, and that, almost 70% of the OOPE is on account of drugs and diagnostics, the Free Drugs and Free Diagnostics Services Initiatives have been implemented under the NHM.
