The National Rural Health Mission (NRHM), launched on April 5, 2005, aims to improve rural healthcare delivery in India, focusing on 18 specific states and integrating AYUSH into mainstream medical care. Key components of the mission include the creation of Accredited Social Health Activists (ASHA) to mobilize communities and strengthen healthcare infrastructure at various levels, such as sub-centers and primary health centers (PHCs). The plan emphasizes accessibility, affordability, and the establishment of a robust health system capable of addressing local health issues effectively.

1. Dr. Shubhangi Kshirsagar
Assistant professor
Department of Swasthavritta &Yoga
Dr. Rajendra Gode Ayurved College, Amravati
National Rural Health
Mission

2. National Rural Health Mission
 "National Rural Health Mission" (NRHM) launched on 5th April,
2005 for a period of 7 years (2005-2012)
 Recently extended upto year 2017.
 The mission seeks to improve rural health care delivery system.
 It is operational in the whole country
 Special focus on 18 states viz. 8 Empowered Action Group
states (Bihar, Jharkhand, Madhya Pradesh, Chattisgarh, Uttar
Pradesh, Uttaranchal, Orissa and Rajasthan), 8 North East states
(Assam,Arunachal Pradesh, Manipur, Meghalaya, Mizoram,
Nagaland, Sikkim and Tripura), Himachal Pradesh and Jammu and
Kashmir.
 It also brings the Indian system of medicine (AYUSH) to the
mainstream of health care

3. Aim of NRHM
 To provide accessible, affordable, accountable, effective and
reliable primary health care.
 To bridge the gap in rural health care through creation of
ASHA.

4. Plan of action to strengthen
infrastructure
1. Creation of ASHA
2. Strengthening sub-center
3. Strengthening PHCs
4. Strengthening CHCs

5. 1. Creation of ASHA
(Accredited Social Health Activist)
Selection of ASHA
 Resident of the village
 Woman - Married/Widow/Divorced
 Preferably in the age group of 25 to 45 years
 Formal education up to eighth class
 Communication & leadeship qualities
 1 ASHA - 1000 population
 Tribal, hilly area- 1 ASHA per habitation

6. Mnemonics - ASHA will Promote villages to do
Informative CME on PDA” .
Promote construction of household toilet
Work with village health and sanitation committee
Inform about birth, death, diseases to PHC, sub-center.
C - Counseling to women
M – Mobilize the community in accessing and health related
services
E – Escort pregnant women and children to PHC, sub-center
P - Provides primary health care
D – Depot holder
A – awareness on health determinant
ASHA role & responsibilities –

7. Integrated Role of ASHA with
Anganwadi worker & ANM
AWW act as
a Resource
person
ANM act
as a
Resource
person
1. Discusses about the problem faced with
ANM
2. Motivate people to attend outreach session
3. Motivate the pregnant women for ANC
4. Distribute oral pills
5. Look for danger signs of pregnancy
1. Organizing Health Day at AWC
2. IEC activity on these days
3. Updating the list of eligible couples
4. Mobilizing pregnant and lactating
women and infants for nutrition
supplement
Organization of the Health
& Nutrition Days at AWC
ASHA

8. 2. Strengthening sub-centers
Supply of essential drugs both allopathic and AYUSH to the
sub-centre.
Provision of multipurpose worker (male)/additional ANMs
wherever needed.
Sanction of new sub-centres and upgrading existing sub-
centres.
Provision of funds of Rs. 10,000 per annum in all 18 states.

9. 3. Strengthening Primary Health
Centres
Aim - strengthening PHCs for quality preventive, promotive,
curative, supervisory and outreach services through
Adequate and regular supply of essential drugs and
equipment to PHCs (including syringes for immunization)
Provision of 24 hours service in at least 50 per cent
PHCs by including an AYUSH practitioner
Following standard treatment guidelines
Upgradation for 24 hours referral service and provision
of second doctor at PHC level (one male and one female)
Strengthening the ongoing communicable disease control
programmes and new programmes for control of NCD (non-
communicable diseases)

10. 4. Strengthening Community Health
Centres for First Referral
Operating all existing CHCs (30-50 beds) as 24 hours first
referral units, including posting of an anaesthetist
Maintain"Indian Public Health Standards" by setting up norms
for infrastructure, staff, equipment, management etc.
Promotion of "Rogi Kalyan Samiti" for hospital
management
Developing standards of services and costs in hospital care.

11. Proposed NRHM infrastructure
Block
level hospital
Cluster of GPs –
PHC level
Gram Panchayat-
Sub center level
Village level –
ASHA,AWW,Village health & sanitation
committee