National Health Mission: Most Important Topic For 2020 PAR

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  • The National Health Mission (NHM) envisages achievement of universal access to equitable, affordable & quality health care services that are accountable & responsive to people’s needs.

  • The National Health Mission seeks to ensure the achievement of the following indicators.

    • Reduce Maternal Mortality Rate (MMR) to 1/1000 live births

    • Reduce Infant Mortality Rate (IMR) to 25/1000 live births

    • Reduce Total Fertility Rate (TFR) to 2.1

    • Prevention & reduction of anemia in women aged 15–49 years

    • Prevent & reduce mortality & morbidity from communicable, non-communicable; injuries and emerging diseases

    • Reduce household out-of-pocket expenditure on total health care expenditure

    • Reduce annual incidence and mortality from Tuberculosis by half

    • Reduce prevalence of Leprosy to <1/10000 population and incidence to zero in all districts

    • Annual Malaria Incidence to be <1/1000

    • Less than 1 per cent microfilaria prevalence in all districts

    • Kala-azar Elimination by 2015, <1 case per 10000 population in all blocks.

National health mission

National Health Mission

Components of National Health Mission

  • The National Health Mission (NHM) encompasses its two Sub-Missions, the National Rural Health Mission (NRHM) & the National Urban Health Mission (NUHM).

  • NHM has six financing components:

    • NRHM-RCH Flexipool

    • NUHM Flexipool

    • Flexible pool for Communicable disease

    • Flexible pool for Non communicable disease including Injury & Trauma

    • Infrastructure Maintenance

    • Family Welfare Central Sector component

    • The main programmatic components include

    • Health System Strengthening in rural and urban areas

    • Reproductive-Maternal- Neonatal-Child & Adolescent Health (RMNCH+A)

    • Communicable & Non-Communicable Diseases.

    • Within the broad national parameters & priorities, states would have the flexibility to plan & implement state specific action plans. The state PIP would spell out the key strategies, activities undertaken, budgetary requirements & key health outputs & outcomes.

    • The State PIPs would be an aggregate of the district/city health action plans, & include activities to be carried out at the state level. The state PIP will also include all the individual district/city plans. This has several advantages: one, it will strengthen local planning at the district/city level, two, it would ensure approval of adequate resources for high priority district action plans, & three, enable communication of approvals to the districts at the same time as to the state.

National Rural Health Mission (NRHM)

  • The National Rural Health Mission (NRHM) was launched on 12th April 2005, to provide accessible, affordable & quality health care to the rural population, especially the vulnerable groups.

  • NRHM seeks to provide equitable, affordable & quality health care to the rural population, especially the vulnerable groups. Under the NRHM, the Empowered Action Group (EAG) States as well as North Eastern States, Jammu and Kashmir & Himachal Pradesh have been given special focus.

  • The thrust of the mission is on establishing a fully functional, community owned, decentralized health delivery system with inter-sectoral convergence at all levels, to ensure simultaneous action on a wide range of determinants of health such as water, sanitation, education, nutrition, social & gender equality.

  • NRHM focuses on Reproductive, Maternal, Newborn, Child Health & Adolescent (RMNCH+A) Services. The emphasis here is on strategies for improving maternal & child health through a continuum of care & the life cycle approach. It recognizes the inextricable linkages between adolescent health, family planning, maternal health & child survival.

  • Moreover, the linking of community & facility-based care and strengthening referrals between various levels of health care system to create a continuous care pathway is also to be focused.

Rogi Kalyan Samiti (RKS)

  • Rogi Kalyan Samiti (Patient Welfare Committee) / Hospital Management Committee is a simple yet effective management structure. This committee, a registered society, acts as a group of trustees for the hospitals to manage the affairs of the hospital. It consists of members from local Panchayati Raj Institutions (PRIs), NGOs, local elected representatives and officials from Government sector who are responsible for proper functioning & management of the hospital / Community Health Centre / FRUs. RKS / HMS is free to prescribe, generate & use the funds with it as per its best judgement for smooth functioning and maintaining the quality of services.

Accredited Social Health Activist (ASHA)

  • Accredited Social Health Activist (ASHA) is a trained female community health activist. Selected from the community itself & accountable to it, the ASHA will be trained to work as an interface between the community & the public health system. At present there are over 9 Lakh ASHAs. The ASHA scheme is presently in place in 33 states (except Goa, Chandigarh & Puducherry).

Ayushman Bharat–PM Jan Arogya Yojana

  • Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) is a Centrally Sponsored Scheme having central sector component under Ayushman Bharat Mission anchored in the Ministry of Health & Family Welfare (MoHFW). It is an umbrella of two major health initiatives, namely Health & wellness Centres & National Health Protection Scheme.

    • List of Services to be provided at Health & Wellness Centre

    • Pregnancy care & maternal health services

    • Neonatal & infant health services

    • Child health

    • Chronic communicable diseases

    • Non-communicable diseases

    • Management of mental illness

    • Dental care

    • Eye care

    • Geriatric care Emergency medicine

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