- An umbrella scheme to achieve universal access to equitable, affordable and quality healthcare services by strengthening health systems, institutions and capabilities.
- NRHM & NUHM are two sub-missions under overarching NHM.
Approach
- Inter-sectoral convergent action to address the wider social determinants of health
Main Components
- Strengthening health systems.
- Reproductive-Maternal-Neonatal-Child & Adolescent Health (RMNCH+A).
- Interventions & control of communicable & non-communicable diseases.
Target
- Reduce MMR to 1/1000 live births.
- Reduce IMR to 25/1000 live births.
- Reduce TFR to 2.1
- Prevention & Reduction of Anaemia in Women aged 15-49 years.
- Reduce annual incidence & mortality from TB by half.
- Reduce the prevalence of Leprosy to < 1/10000 population & incidence to ZERO in all districts.
- Annual Malaria incidence to be < 1/10000.
- Less than 1 % Microfilaria.
- Kala Azar elimination by 2015, < 1/10000 in all blocks
Strategy
National level
- Guidance and monitoring by Mission Steering Group (MSG) headed by Union Minister for H&FW
- Implemented by Empowered Program Committee (EPC) headed by Union Secretary for H&FW.
State level
- Overall guidance of the State Health Mission headed by the Chief Minister.
- Implementation by State Health & Family Welfare Society.
- Decentralised health planning through District/City Health Action Plan.
- Partnerships with the NGOs, Civil Society, and Private Sector
Initiatives
- ASHAs serve as facilitators, mobilizers and providers of community-level care.
- Rogi Kalyan Samiti for hospital management including District Hospitals (DHs), Sub-District Hospitals (SDHs), Community Health Centres (CHCs) and Primary Health Centres (PHCs).
- Mobile Medical Units are set up under NHM.
- National Ambulance Services Launch of National Quality Assurance Framework for Health Facilities
- Launch of Kayakalp (Award to Public Health Facilities) to promote cleanliness, hygiene and infection control practices in public health facilities.
- Free Drug Service Initiative
- Free Diagnostics Service Initiative
- Kilkari: Interactive Voice Response (IVR) based mobile service.
- Launch of Nationwide Anti-TB drug resistance survey
- Kala Azar Elimination Plan
New Initiatives under NHM
- Social Awareness and Actions to Neutralize Pneumonia Successfully (SAANS) was launched to accelerate action to reduce deaths due to childhood pneumonia.
- Surakshit Matritva Aashwasan (SUMAN) initiative was launched to provide assured, dignified, respectful and quality healthcare at no cost and zero tolerance for denial of services and all existing Schemes for maternal and neonatal health have been brought under one umbrella.
- Midwifery Services Initiative aims to create a cadre of Nurse Practitioners in Midwifery who are skilled in accordance with competencies prescribed by the International Confederation of Midwives (ICM) and are knowledgeable and capable of providing compassionate women-centred, reproductive, maternal and newborn healthcare services.
- School Health and Wellness Ambassadors Initiative has been launched under the AB-HWCs Program in partnership with the Ministry of Education to promote health and well-being through an active lifestyle amongst school children
National Digital Health Mission (NDMH)
The National Digital Health Mission (NDHM) aims to develop the backbone necessary to support the integrated digital health infrastructure of the country. It will bridge the existing gap among different stakeholders of the healthcare ecosystem through digital highways.
Vision: Universal Health Coverage
NDHM shall create a seamless online platform “through the provision of a wide range of data, information and infrastructure services, duly leveraging open, interoperable, standards-based digital systems” while ensuring the security, confidentiality and privacy of health-related personal information.
Introduction: PM’s announcement of the National Digital Health Mission (NDMH) on Independence Day has raised hopes of accessible medical services for all citizens of the country.
Benefits
- A good database for diseases and healthcare monitoring.
- Revolutionize healthcare provision and public health research in India.
- Help to understand disease and treatment history, its hotspots, and social and demographic correlates.
- Mapping the follow-up of patients and healthcare-seeking behaviour is critical for the treatment of many chronic diseases.
- The health ID will give a much-needed technological impetus to the sector that has long been found wanting, more so amid the ongoing Covid-19 pandemic.
- With telemedicine also being brought within the ambit, the program ensures that doctors will be able to provide direct access to remote areas across the country.
Challenges in digital health mission:
- Meagre health budget of India.
- Most villages do not have the required digital infra to support doctor consultations via telemedicine platforms.
- The challenge is to bring the private health care sector under the NDHM.
- Given that private sector involvement under the Ayushman Bharat Yojana is not so impressive, handling the private sector will be a greater challenge under NDHM.
- Data can be highly misused by the private healthcare sector, diagnostic labs, pharmaceutical and insurance sectors to exploit people without access to a quality public healthcare system.
- Dealing with ethical issues, breaches of privacy, and dealing with social stigma are significant challenges for the NDHM.
- Experience from Aadhaar and Health Management Information Systems (HMIS) raises doubts about ensuring the quality of registration and maintenance of records and their completeness.
- To bring undiagnosed or untreated ailments into account.
- Raising the demand for healthcare and treatment-seeking behaviour, especially in rural areas.
- Absence of a clear framework.
- The additional burden of record keeping on physical and human resources.
Suggestions
- Enhancing health literacy and knowledge is the key for reporting, diagnosis and treatment of ailments.
- Revamp healthcare system to increase health infrastructure and healthcare human resources and make healthcare affordable to the poor
- Raising demand by enhancing public health provision from a bottom-to-top approach, access to affordable and quality healthcare in rural areas.
- Develop a clear framework and pathway on ways to bring its private sector into confidence under NDHM-adhering confidentiality and ensuring quality of information.