National Health Mission: Most Important Topic for 2021 RBI Assistant Exam

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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

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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