Concept of NRHM
The National Rural Health Mission (NRHM) is a National effort at ensuring effective healthcare through a range of interventions at individual, household, community, and most critically at the health system levels. Despite considerable gains in health status over the past few decades in terms of increased life expectancy, reductions in mortality and morbidity serious challenges still remain. These challenges vary significantly from state to state and even within states.
There has been a progressive decline in budgetary allocation for public health in the country from 1.3% of GDP in 1990 to 0.9% in 1999. Rising inequities are another area of concern. Studies demonstrate that curative services favour the rich over the poor. Only one tenth of the population is covered by any form of health insurance thereby exposing the large majority to the risk of indebtedness in the event of a major illness in the family. Operational integration in policy and programme between various vertical programmes within the health sector, and between health and other related sectors such as drinking water, sanitation, and nutrition has been limited, resulting in a lack of holistic approaches to health. A number of States particularly in North, East and North Eastern parts of the country have stagnant health indicators and continue to grapple with significant morbidity and mortality. The causes for this basically lie in socio-economic factors, under performing health systems and weak institutional framework.
The National Common Minimum Programmer spells out the commitment of the Government to enhance Budgetary Outlays for Public Health and to improve the capacity of the health system to absorb the increased outlay so as to bring all round improvement in public health services. This Mission seeks to provide effective health care to the rural population, especially the disadvantaged groups including women and children, by improving access, enabling community ownership and demand for services, strengthening public health systems for efficient service delivery, enhancing equity and accountability and promoting decentralization.
The goals of NRHM are outlined below:
- Reduction in Infant Mortality Rate and Maternal Mortality Ratio by at least 50% from existing levels in next seven years
- Universalize access to public health services for Women’s health, Child health, water, hygiene, sanitation and nutrition
- Prevention and control of communicable and non-communicable diseases, including locally endemic diseases
- Access to integrated comprehensive primary healthcare
- Ensuring population stabilization, gender and demographic balance.
- Revitalize local health traditions and mainstream AYUSH
- Promotion of healthy life styles
The Mission outcomes are expected to follow a phased approach and are at two levels: