National Rural Health Mission

The National Rural Health Mission (NRHM) was launched by the Government of India in 2005 to strengthen healthcare delivery in rural areas. It aimed to reduce maternal and infant mortality, control communicable diseases, and improve access to healthcare for rural populations. In 2013, NRHM was subsumed into the National Health Mission (NHM) along with its urban counterpart.

What Was NRHM?

NRHM was a flagship health programme that recognised the weak state of rural public health infrastructure in India. It focused on:

– Strengthening public health facilities (sub-centres, PHCs, CHCs)
– Reducing maternal mortality and infant mortality rates
– Increasing immunisation coverage
– Controlling diseases like malaria, tuberculosis, and dengue
– Improving nutrition and sanitation

Key Innovations Under NRHM

**ASHA (Accredited Social Health Activist):**
The most significant innovation of NRHM. ASHAs are community-level health workers trained to act as a link between the community and the public health system. There are currently over 10 lakh ASHAs across India who facilitate ante-natal care, institutional deliveries, immunisation, and disease reporting.

**Janani Suraksha Yojana (JSY):**
A cash incentive scheme for pregnant women to encourage institutional delivery. Women who deliver in a government facility receive cash incentives to cover transport and other costs.

**Rogi Kalyan Samiti:**
Hospital management committees at each facility to improve governance and accountability.

Impact of NRHM

– India’s maternal mortality ratio improved significantly between 2005 and 2020
– Institutional birth rates rose from under 40% to over 80% in many states
– Immunisation coverage improved, reducing child mortality
– Increased presence of ASHAs improved health awareness at the community level

National Health Mission

Since 2013, NRHM is implemented as part of the National Health Mission (NHM), which covers both rural (NHM-Rural) and urban (NHM-Urban) components. NHM continues to fund health infrastructure, human resources, disease control, and maternal and child health programmes.

Practical Example

Sita lives in a remote village in Odisha. Before NRHM, women in her village delivered at home with untrained attendants, leading to high maternal and infant deaths. The ASHA in her village helped her register for ante-natal care, get iron supplements, and arrange transport to the PHC for delivery. Both Sita and her baby received safe care at no cost.

Key Takeaways

– NRHM was launched in 2005 to strengthen rural healthcare and reduce maternal and infant mortality
– The ASHA programme created a network of over 10 lakh community health workers
– Janani Suraksha Yojana incentivised institutional deliveries, significantly reducing home birth risks
– NRHM became part of the National Health Mission in 2013, continuing its focus on rural and urban health
– Institutional birth rates and immunisation coverage improved dramatically under NRHM