The document summarizes India's National Health Mission (NHM) and its efforts to improve maternal and child health. NHM consolidates existing health programs and aims to provide universal access to healthcare. Its key components include reproductive, maternal, newborn, child and adolescent health. Major programs under NHM to reduce infant and maternal mortality include antenatal/postnatal care, promoting institutional deliveries, newborn care, immunization, and treating malnutrition. NHM has helped increase institutional deliveries and reduce infant and maternal mortality rates in India.

2. The Ministry of Health and Family Welfare of India is implementing programmes
for universal access to quality health care.
In this plan many different programmes were brought together under NATIONAL
HEALTH MISSION (NHM)- its two subparts were NATIONAL URBAN HEALTH
MISSION(NUHM) and NATIONAL RURAL HEALTH MISSION(NRHM).
NHM was approved on May 2013.
The main components of NHM were- Reproductive –Maternal – Newborn -Child
and Adoloscent Health (RMNCH + A) and control of communicable and non
communicable diseases.
The Government of India has introduced a series of programmes over the past
two decades to address maternal and newborn health. These are:-

3. Under NHM,health initiatives are regularly designed and implemented to address
the healthcare needs of the country. The ones currently implemented to reduce IMR
and MMR are:-
YEAR PROGRAMME
1992 Child Survival and Safe Motherhood Programme (CSSM)
1997 RCH I
2005 RCH II
2013 RMNCH+A strategy
2013 National health mission
2014 India Newborn Action Plan (INAP)

4. 1.ANTENATAL CARE and POSTPARTUM CARE
 Pregnancy tracking-Name based web enabled tracking of pregnant women to
ensure antenatal,intranatal and postnatal care (by MCTS -mother and child
tracking system) .
 Village health and nutrition day – providing antenatal / postpartum care to
pregnant women on a day once in a month including iron and folic acid
supplements to pregnant and lactating women for preventing and treating
anemia.
2. GYNAE AND OBSTETRIC CARE
 Promotion of institutonal deliveries through Janani Suraksha Yojana to reduce
maternal mortality. This programme is under NRHM and has benfitted around
8.55 crore women.
 Capacity building of health care providers in basic and comprehensive
obstetric care.
 Operationalization of sub-centres,primary health centres ,community health
centres and district hospitals for providing 24×7 basic and comprehensive
obsetetric care services.
Janani Shishu Suraksha Karyakram entitles all pregnant women delivering in
public health institutions to absolutely free and no expense delivery including
caesarean section. The initiative stipulates free drugs,diagnostics,blood and
diet,besides free transport from home to institution , between facilities in case of a
referral, and drop back home.

5. 3.NEONATAL AND POSTNATAL CARE
India Newborn Action Plan(INAP) has been launched to reduce neonatal mortality
and stillbiths. The goal is to attain “single digit neonatal mortality rate by 2030” and
“single digit stillbirth rate by 2030”.
Emphasis on facility based newborn care at different levels to reduce child
morbidity and mortality –setting up of facilities for care of sick newborn such as
Special New Born Care Units(SNCUs), Newborn Stabilization Units and Newborn Care
Corners(NBCCs) at different levels is a thrust area under NHM.
Capacity building of health care providers: various trainings are being conducted
under NHM to train doctors,nurses and ANMs for essential newborn care, early
diagnosis and case management of common ailments of children. These trainings
are for Navjaat Shishu Suraksha Karyakram(NSSK), Integrated Management of
Neonatal and Childhood Illnesses (IMNCI), Facility Based Newborn Care (FBNC),
Infant and Young Child Feeding Practices(IYCF),etc.
Newer interventions to reduce newborn mortality – Vitamin K injection at birth,
antenatal corticosteroids for preterm labour , kangaroo mother care and injection
gentamicin to young infants in case of suspected sepsis

6. SPECIALIZED NEWBORN CARE UNITS

7. Home based New Born Care(HBNC)- it has been initiated through ASHAs
to improve newborn practices at community level and early detection of
sick babies.
Intensified Diarrhoea Control Fortnight (IDCF) is observed in July-August
focusing on ORS and Zinc distribution for managing diarrhoea and
feeding practices.
Integrated Action Plan for Pneumonia and Diarrhoea (IAPPD) launched in
4 states with highest infant mortality – U.P. ,M.P. ,Bihar and Rajhasthan).
4. CHILD CARE AND ADOLESCENT CARE
Management of malnutrition: Nutritional Rehabilitation Centres(NRCs)
have been established for managing severe acute malnutrition in
children.
Appropriate infant and young child feeding practices are being promoted
in convergence with Ministry of Women and Child Development.

8. Universal Immunization Programme (UIP) – vaccination protects
children against many life threatening diseases such as tuberculosis,
diptheria, pertussis, polio, tetanus, hepatitis B, Hib, measles and
Japanese encephalitis in endemic districts. Infants are thus immunized
against nine vaccine preventable diseases every year.
Mission Indradhanush has been launched in 201 high focus districts to
fully immunize more than 89 lakh children who are either unvaccinated
or partially vaccinated ; those that have not been covered during the
rounds of routine immunization for various reasons. They will be fully
immunized against seven life-threatening but vaccine preventable
diseases which include diphtheria,whooping cough,tetanus,polio ,etc.
Pregnant women are also covered under this programme for tetanus
vaccine.

9. Rashtriya Bal Swasthya Karyakram (RBSK) for Child Health Screening and Early
intervention services .The purpose of these services is to improve the overall
quality of life of children . The 4 Ds are early detection of birth Defects
,Diseases, Deficiencies, Development delays and Disability.
National Iron Plus Iniatiative(NIPI) is being implemented for the prevention and
treatment of anemia among the vulnerable age groups like children under 5
years and 6-10 years of age , adoloscents, pregnant and lactating women and
women in reproductive age by providing WEEKLY IRON and FOLIC ACID
SUPPLEMENTATION (WIFS).

10. TARGETS AND ACHIEVEMENTS OF NHM
TARGETS (2012-17) ACHIEVEMENTS
Reduce IMR to 25/1000 live births IMR reduced from 42 in 2012 to 39 in
2014
Reduce MMR to 1/1000 live births MMR reduced to 1.67 in 2011-13.
Rashtriya kishor swasthya karyakram(RKSK) is an initiative to reach out
253 million adolescents in the countryfor reproductive care,focussing
on life skills,nutrition,injuries and violence, non communicable diseases
,mental health and substance misuse.