• India
  • Jan 23

Explainer - Achievements under National Health Mission

• The Union Cabinet reviewed the progress under the National Health Mission (NHM) over the last three years on January 22.

• It was informed that with significant progress towards achieving the Sustainable Development Goals (SDGs), India is on track to meet its health targets well ahead of the 2030 deadline.

National Health Mission

• The National Rural Health Mission was launched in 2005 with the objective of building public health systems to provide accessible, affordable and quality health care to the rural population, especially the vulnerable groups, up to the District Hospitals (DH) level. 

• In 2012, the National Urban Health Mission (NUHM) was conceptualised and the NRHM was rechristened as the National Health Mission (NHM) with the two sub-missions — the NRHM and the NUHM.

• The National Health Mission aims for attainment of universal access to equitable, affordable and quality health care services, accountable and responsive to people’s needs, with effective intersectoral convergent action to address the wider social determinants of health. 

• It is implemented in all states/UTs in the country.

• The implementation strategy of the Ministry of Health and Family Welfare under NHM is to provide financial and technical support to states/UTs enabling them to provide accessible, affordable, accountable, and effective healthcare up to District Hospitals (DHs), especially to the poor and vulnerable sections of the population. 

• It has also aimed to bridge the gap in rural healthcare services through improved health infrastructure, augmentation of human resource and improved service delivery in rural areas and has envisaged decentralisation of programme to district level to facilitate need-based interventions, improve intra and inter-sectoral convergence and effective utilisation of resources.

• The main programmatic components include Health System Strengthening, Reproductive-Maternal-Neonatal-Child and Adolescent Health (RMNCH+A), and control of communicable and non-communicable diseases.

The major objectives of NHM are:

i) Reduction in child and maternal mortality.

ii) Prevention and control of communicable and non-communicable diseases, including locally endemic diseases.

iii) Access to integrated comprehensive primary healthcare.

iv) Population stabilisation, gender equality and demographic balance.

v) Revitalise local health traditions and mainstream AYUSH.

vi) Universal access to public services for food and nutrition, sanitation and hygiene and universal access to public health care services with emphasis on services addressing women’s and children’s health and universal immunisation.

vii) Promotion of healthy lifestyles.

Achievements of National Health Mission

• During the review meeting, the Union Cabinet was informed that the NHM has contributed to improving India’s public health outcomes through its relentless efforts in expanding human resources, addressing critical health issues, and fostering an integrated response to health emergencies.

• Over the last three years, the NHM has driven substantial progress in multiple areas, including maternal and child health, disease elimination, and healthcare infrastructure. 

• The mission’s efforts have been integral to India’s health improvements, particularly during the COVID-19 pandemic, and have played a vital role in ensuring more accessible and quality healthcare services across the country.

• A key achievement of NHM has been the significant increase in human resources within the healthcare sector.

• In 2021-22, NHM facilitated the engagement of 2.69 lakh additional healthcare workers, including general duty medical officers, specialists, staff nurses, auxiliary nurse midwives, AYUSH doctors, allied healthcare workers, and public health managers. Additionally, 90,740 community health officers were engaged.

• This number grew in subsequent years, with 4.21 lakh additional healthcare professionals engaged in 2022-23, including 1.29 lakh community health officers, and 5.23 lakh workers engaged in 2023-24, which included 1.38 lakh community health officers.

• These efforts have contributed significantly to improving healthcare delivery, especially at the grassroots level.

• By utilising the existing network of healthcare facilities and workers, NHM was pivotal in administering over 220 crore COVID-19 vaccine doses between January 2021 and March 2024.  

• India has also made impressive progress in key health indicators under NHM.

• The maternal mortality ratio declined significantly from 130 per lakh live births in 2014-16 to 97 per lakh in 2018-20, marking a 25 per cent reduction. It declined by 83 per cent since 1990, which is higher than the global decline of 45 per cent. 

• Similarly, the under-5 mortality rate has decreased from 45 per 1,000 live births in 2014 to 32 in 2020 which demonstrates a higher decline of 75 per cent in the reduction of mortality in comparison to the global reduction of 60 per cent since 1990.

• The infant mortality rate has fallen from 39 per 1,000 live births in 2014 to 28 in 2020.

• Furthermore, the total fertility rate decreased from 2.3 in 2015 to 2.0 in 2020.

• These improvements indicate that India is on track to meet its SDG targets for maternal, child, and infant mortality well ahead of 2030.

• The NHM has also been instrumental in the elimination and control of various diseases. For instance, under the National Tuberculosis Elimination Programme (NTEP), the incidence of tuberculosis has reduced from 237 per 1,00,000 population in 2015 to 195 in 2023, and the mortality rate has decreased from 28 to 22 in the same period.

• In 2021, malaria cases and deaths declined by 13.28 per cent and 3.22 per cent respectively as compared to 2020.

• In 2022, malaria surveillance and cases have increased by 32.92 per cent and 9.13 per cent respectively whereas malaria deaths decreased by 7.77 per cent as compared to 2021. In 2023, malaria surveillance and cases increased by 8.34 per cent and 28.91 per cent respectively as compared to 2022.

• Additionally, kala-azar elimination efforts have been successful, with 100 per cent of endemic blocks achieving the target of less than one case per 10,000 population by the end of 2023.

• The Measles-Rubella Elimination Campaign, under the Intensified Mission Indradhanush 5.0, vaccinated over 34.77 crore children, achieving a 97.98 per cent coverage.

• In terms of specialised health initiatives, the Pradhan Mantri TB Mukt Bharat Abhiyaan, launched in September 2022, has seen the registration of 1,56,572 lakh Ni-kshay Mitra volunteers who are supporting over 9.40 lakh TB patients. 

• The Pradhan Mantri National Dialysis Programme has also been expanded, with over 62.35 lakh hemodialysis sessions provided in FY 2023-24, benefiting over 4.53 lakh dialysis patients. 

• The National Sickle Cell Anaemia Elimination Mission, launched in 2023, has screened over 2.61 crore individuals in tribal areas, working toward the goal of eliminating sickle cell disease by 2047. 

• The NHM has also addressed pressing public health concerns such as tobacco use and snakebite envenoming. 

• Through sustained public awareness campaigns and enforcement of tobacco control laws, NHM has contributed to a 17.3 per cent reduction in tobacco use over the past decade. Furthermore, in FY 2022-23, the National Action Plan for Snakebite Envenoming was launched, with efforts focused on prevention, education, and management of snakebites.

• Digital health initiatives have been a major focus as well. The launch of the U-WIN platform in January 2023 ensures the timely administration of vaccines to pregnant women, infants, and children across India.

• By the end of 2023-24, the platform had expanded to 65 districts across 36 states and Union Territories, ensuring real-time vaccination tracking and improving immunisation coverage.

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