This is the presentation of NRHM scheme based on NRHM website, This may help a lot to

1. Presented By: Ronak Maheshwari
1
NMIMS UNIVERSITY

2. National Rural Health Mission (NRHM)
• The National Rural Health Mission (NRHM) was launched
by the Honorable Prime Minister on 12th April 2005, to
provide accessible, affordable and 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
and Himachal Pradesh have been given special focus.
• National rural health mission was launched for a period of
7 years i.e. from 2005 to 2012 than it was extended to the
urban areas as well from 2013
• It was further extended in March 2018 to continue until
March 2020.
2

3. Community owned. Establishing a fully functional.
Decentralized health delivery
system with inter-sectoral
convergence at all levels.
Simultaneous action on a wide
range of determinants of health
such as water, sanitation,
education, nutrition, social and
gender equality.
Missions of
NRHM
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4. Objectives of the Mission
Reduction in child and
maternal mortality
Universal access to
public health services
Universal access to
immunization
programme
Prevention and control
of communicable and
non- communicable
diseases
Promotion of health
lifestyles.
Access to integrated
primary health care
Population
stabilization and
demographic balance
4

5. Key features of NRHM include
• Making the public health delivery system fully functional
and accountable to the community,
• Human resources management,
• Community involvement,
• Decentralization,
• Rigorous monitoring & evaluation against standards,
• Convergence of health and related programmers from
village level upwards,
• Innovations and flexible financing and also interventions
for improving the health indictors,
• Flexible in financing for optimization fund utilization,
• Inter-sectoral coordination for the financial enhancement.5

6. NRHM Main Approaches
Communization
Flexible
financing
Monitor
progress against
standard
Improved
management
capacity
Innovations in
health
management
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7. Goals of NRHM
• Facilitate increased access and utilization of quality
health services by all.
• Form a partnership between the Central, State and the
Local governments.
• Set up a platform for involving the Panchayati Raj
institutions and community in the management of
primary health programmes and infrastructure.
• Provide an opportunity for promoting equity and social
justice.
• Establish a mechanism to provide flexibility to the states
and the community to promote local initiatives.
• Develop a framework for promoting inter-sectoral
convergence for promotive and preventive health care.
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8. Institutional Mechanism under NRHM
Implementation
1. National Level:
• Chairman: Union minister of Health and Family Welfare
• Mission Steering Group
• Empowered Programme Committee
• Function: All the financial proposals scrutinised.
2. State Level:
• State Health Mission under Mission Head
• Functions: Programme, Institute and Resource management
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9. Institutional Mechanism under NRHM
3. District Level:
• District Health Mission/ District Health Society
• Headed by District Collector
• Functions: Managing all NHM programmes in the
district, Education, Health, Training, professionals,
collection of data and analysis, Secondary Care
Provision and considerable Tertiary care
4. Block Level:
• Includes: PHC, CHC, VHC and Sub-Centres
• Fund Management: Block Accounts Officer
• Function: Implementation of Programmes and Fund
management 9

10. Institutional Mechanism under NRHM
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11. ROLE OF DISTRICT HEALTH MISSION
AND THE DISTRICT HEALTH SOCIETY
• The DHS is responsible for planning and managing all health
and family welfare programmes in the district, both in the rural
as well as urban areas.
• Ensuring Inter-sectoral convergence and integrated planning is
a specific task for the Governing Body of the DHS.
• DHS’s planning takes note of both treasury and non-treasury
sources of funds, even though it may not be handling all
sources directly. Secondly, its geographical jurisdiction will be
greater than those of the Zilla Parishad in the district
• The DHS is also viewed as an addition to the district
administrations capacity, particularly for planning, budgeting
and budget analysis, development of operational
policy proposals, and financial management etc.
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12. Goals to be achieved by NRHM
AT National Level
• IMR : Reduce to 30/1000
• MMR : Reduce to 100/100000
• TFR : Reduce to 2.1
• Malaria Mortality rate reduction: 50% by 2010,
additional 10% by 2012
• Filaria Rate Reduction : 70%(2010), 80%(2012),
eliminateby2015
• Dengue Mortality Rate Reduction: 50%(2010)
• Kala Azar Mortality Rate Reduction: 100%(2010)
• JE mortality rate reduction: 50%(2010)
• Cataract Operation : 46 lakhs/year 2012
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13. Achievements under NRHM
Physical Outcomes : Targets & Achievements under NRHM
Sl. No. Targets (2005-12) Achievements (up to 2012)
1 IMR reduced to 30/1000 live births
IMR reduced from 58 in 2005 (SRS) to 42
in 2012 (SRS).
2
Maternal Mortality to reduce to
100/100,000 live births
MMR reduced from 254 in 2004-06 (SRS)
to 178 in 2010-12 (SRS).
3 TFR reduced to 2.1
TFR reduced from 2.9 in 2005 (SRS) to
2.4 in 2012 (SRS).
4 Malaria Mortality reduction to 60%
70% Malaria mortality reduction-
(Reduced from 1707 in 2006 to 519 in
2012).
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14. Achievements under NRHM
5
Kala Azar Mortality reduction to
100%
85% Kala Azar mortality reduction-
(Reduced from 187 in 2006 to 29 in 2012).
6
Filaria / Microfilaria Reduction Rate
to 80%
60% Filaria / Microfilaria Reduction
(Reduced from 1.02 in 2005 to 0.41 in
2012)
7 Dengue Mortality reduction by 50%
8% reduction- Dengue Mortality has
reduced from 184 in 2006 to 169 in 2011.
8
Cataract operations- increasing to 46
lakhs per year
Cataract operations of more than 63.49
lakhs per year have been reported in 2012.
9
Leprosy Prevalence Rate reduction to
less than 1 per 10,000
Leprosy Prevalence Rate reduced from 1.34
per 10,000 in 2005 to 0.68 per 10,000 in
2012.
10
Tuberculosis Control - over 70% case
detection & 85% cure rate
Tuberculosis is having 71% case detection
and 88% Cure rate in 2012.
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15. Intersectoral convergence under NRHM
15

16. Core strategy of the Mission
• Train and enhance the capacity of Panchayati Raj Institutions
(PRIs) to own, control and manage PHS.
• Promote access to improved health care at household level.
• Health plan for each village through village-health committee.
• Strengthening existing primary health care centres (PHCs)
through better staffing.
• Provision of 30–50 bedded community health centres (CHC)
per lakh population.
• Preparation and implementation of an inter-sector District
Health Plan including drinking water, sanitation, hygiene and
nutrition.
• Promoting non-profit sector particularly in underserved areas.16

17. Public health Infrastructure in NHRM
17

18. NRHM Illustrative Structure
Block level
Hospital
Cluster of GP's-
PHC level
Gram panchayat-sub
health center level
Village level-ASHA,AWW,AEC,SC
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19. Functions of NRHM
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20. NRHM Mission Covers
• Population coverage - 740 million
• Households - 148 million (approx.)
• Birth Rate in Rural Areas - 26.6, nearly 20 million
births
• Sub Health Centers - 1,75,000 ( on population,
distance and work load norm)
• P H Cs - 27,000 (single MO, 2 MO, 1 AYUSH)
• C H Cs - 7,000 (every Block)
• Sub Divisional/Taluka Hospitals - 1,800
• District Hospital - 600
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21. NRHM Mission Covered
• ANMs at SHC - 3.50 lakhs
• Staff Nurses at PHC - 81,000
• Staff Nurses at CHC - 63,000
• MOs in PHCs - 40,500
• Specialists in CHCs - 49,000
• ASHAs - 4 - 5 lakhs, in all distant
habitations/villages
• Village Health & Sanitation - 7 lakhs – in all
villages/big hamlets 21

22. Components Strategy
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23. Flow of Funds under NRHM
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24. NRHM wants to achieve
• Raise public spending on health from 0.9% to 2–3% of GDP.
• Undertake architectural correction of the health system to
enable it to effectively.
• Revitalize local health traditions and mainstream Ayurveda,
Yoga, Unani, Siddha and Homeopathy (AYUSH).
• Integrate the health concerns effectively through
decentralized management at the district.
• Addressed inter-state and inter-district disparities, especially
among the 18 high focus states.
• Ensure achievement of time bound goals and report the
progress publicly.
• Improve access of rural people, especially poor women and
children. 24

25. Challenges of NRHM
Regional variation
Health as a state subject
To increase focus
Different kind of working
circumstance
Old ethos and new inputs
Convergence of different programmes
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Rajasthan JSY Report

27. THANK YOU 27