Rural Healthcare in India (Kurukshetra January 2021)

⪻ Articles ⪼

Rural Healthcare in India

  • National Rural Health Mission of 2005 has been rightly expanded to provide healthcare services to the urban poor who are under-nourished and under-served as well.
  • Focus states Orissa, Rajasthan, Uttaranchal, Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, and Uttar Pradesh known as the Empowered Action Group States also the socioeconomically backward states.
  • North-eastern states, Himachal Pradesh and the then state of Jammu and Kashmir were the focus states.

Coverage and Access for Rural Healthcare

  • Three-tier system of sub-centers (SC) , primary healthcare centers (PHC) and community health centers (CHC) .
  • SCs are the first point of contact in the primary healthcare system, community in a rural set-up.
  • PHCs serve as the first point of contact between the community and a medical officer.
  • The CHCs provide specialized medical care through surgeons, obstetricians and gynecologists, physicians, and pediatricians.
  • Between 2005 - 2019 an increase of
    • 7.8 % in the no. of SCs.
    • 7 % in PHCs.
    • 59.4 % in CHCs.
  • As on March 30,2019, on an avg. , 5,616 people in rural areas were covered by sub-centers, 35,567 people in rural areas were covered by PHCs and 165,702 people in rural areas were covered by CHCs.
  • Bihar had the highest avg. population coverage through all such activities.
  • There are few states with PHCs without a doctor (e. g. , Chhattisgarh) , or a technician (e. g. , Rajasthan) , or a pharmacist (e. g. , Uttar Pradesh) .


  • Accredited Social Health Activist.
  • A grassroot level health worker who is selected from a village to serve that village.
  • A liaison between the local rural community and the public health system.
  • Undergo rigorous and continuous training and development to serve the rural community better.
Accredited Social Health Activist

Some Programmes for Rural Health Care

Janani Suraksha Yojana

  • Launched in 2011.
  • To eliminate out of pocket expenditure for both pregnant mothers and sick infants.
  • A cash incentive programme.
  • To encourage women to use formal healthcare services for institutional deliveries.
  • To reduce neonatal and maternal mortality among poor, pregnant women, especially those in rural areas.
  • Focused states also the low performing states are Uttar Pradesh, Uttarakhand, Bihar, Jharkhand, Madhya Pradesh, Chhattisgarh, Assam, Rajasthan, Orissa and Jammu and Kashmir.
  • All pregnant women who chose to deliver in govt. health centers like Sub-Centers, Primary Healthcare Centers etc. or accredited private institutions are eligible for this initiative in the low performing states.
  • High performing states focus on all BPL/Scheduled Caste/Scheduled Tribe women.
  • In rural areas, the cash incentive amounts to ₹ 1400 in LPS and ₹ 700 in HPS.
  • This programme provides free drugs, consumables, free diagnostic, free blood, and free diet for 3 days during normal delivery and 7 days for caesarian section deliveries.
  • Covers all ante-natal and post-natal emergencies.

Pradhan Mantri Surakshit Matritva Abhiyan (PMSA)

  • Launched in 2016.
  • To provide quality antenatal care, free of cost and universally to all pregnant women on the 9th of every month in their 2nd and 3rd trimesters of pregnancy.
  • Can be availed at all govt. facilities.
  • Engages with the private sector to create campaign awareness and participation.
  • A minimum package of free antenatal care services is provided.
  • By OBGY specialists/Radiologist/Physicians at Govt. Health facilities.
  • Voluntary support from private practitioners at Govt. Health facilities.

Special Newborn Care Units (SNCUs)

  • Established at district levels and sub-district level hospitals.
  • Annual load of more than 3000 to provide care for sick newborns
  • Who did not need assisted ventilation or major surgeries?
  • At PHC level, this initiative provides newborn care corner which is designated space within the health facility i.e.. , Labor Room and Operation Theatres.
  • New born stabilizing units are also provided for resuscitation, oxygen, suction, warmth through trained medical staff for all referral cases from SCs, PHCs and CHCs.

The Rashtriya Kishore Swasthya Karyakaram

  • Targets adolescents between the age of 10 to 19 years.
  • Constitutes 22 % of the Indian population.
  • Investments ensure proper physical, biological, and psychological development along with psycho-social, behavioral, and sexual education.
  • To provide friendly healthcare services to improve nutrition, mental health, sexual and reproductive health, prevent injuries and violence, substance abuse and nom-communicable diseases.

The Rashtriya Bal Swasthya Karyakram

  • Screens children under the age of 18 for four birth deficiencies.
  • Defects at birth, Diseases, Deficiencies and Development Delays including Disabilities.
  • Made significant impact on reducing the child mortality rates under the NRHM.

Key Objectives Are

  • Assessment of health status of the child
  • Early detection of children with defects at birth
  • Disease
  • Deficiency in nutrition and disability.
  • Management of the identified children at primary, secondary and tertiary level
  • Effective referral system.
  • Involving parents, proper and complete follow-up.
  • Health awareness among parents and children.
  • Trainings and capacity building of health providers.
  • Convergence with stake holder departments (Education, SSA, RMSA, WCD and Social Justice and Empowerment) .

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