Rural Health Mission

RHM: Introduction - Mission Kickstart

• National Rural Health Mission (NRHM).
• Launched: 12th April 2005 (initially 2005-2012).
• Vision: Achieve universal access to equitable, affordable, and quality healthcare for rural populations, especially vulnerable groups.
• Core Aims:
  • Reduce Infant Mortality Rate (IMR) & Maternal Mortality Ratio (MMR).
  • Ensure population stabilization.
  • Prevent & control communicable and non-communicable diseases.
  • Promote healthy lifestyles.
  • Mainstream AYUSH.

⭐ NRHM was launched to address health disparities in 18 high-focus states initially identified for concentrated efforts and resources allocation to improve health indicators significantly.

RHM: Key Strategies - Core Action Force

• Core Workforce Pillars:
  • ASHA (Accredited Social Health Activist): Community health volunteer; 1 per 1000 population (1 per 500 in tribal/hilly areas). Acts as a bridge.
  • ANM (Auxiliary Nurse Midwife): Key provider for MCH & immunization at sub-centres.
  • MPW (Multi-Purpose Worker - Male/Female): Delivers preventive & promotive health services.
• Key Strategic Interventions:
  • Janani Suraksha Yojana (JSY): Demand promotion for institutional deliveries via conditional cash transfer.

    ⭐ JSY is a 100% Centrally Sponsored Scheme aimed at reducing maternal and neonatal mortality.

  • Janani Shishu Suraksha Karyakram (JSSK): Entitlements for free services for pregnant women (delivery, C-section) & sick neonates (up to 30 days).
  • Village Health Sanitation and Nutrition Committee (VHSNC): Community platform for local health planning & monitoring.
  • Mobile Medical Units (MMUs): Outreach services for remote & underserved populations.
  • Rogi Kalyan Samiti (RKS): Patient welfare committees for improved hospital management.

RHM: Organisation - Structure & Support

• Key Pillars & Support:
  • ASHA: Accredited Social Health Activist, community bridge.
  • Untied Funds: Flexible financing for local needs.
  • Rogi Kalyan Samitis (RKS): Hospital management committees.
  • JSSK: Entitlements for maternal and newborn health.

⭐ ASHA acts as a bridge between the community and the public health system; typically one ASHA per 1000 population.

RHM: Performance - Progress & Problems

Progress:

• Significant ↓ in Infant Mortality Rate (IMR) & Maternal Mortality Ratio (MMR).
• ↑ Institutional deliveries.
• ↑ Availability of ASHA workers, improving access to primary care.
• Strengthened infrastructure & human resources in some areas.

Problems:

• Persistent inter-state & intra-state disparities.
• Gaps in infrastructure, equipment & drug supply.
• Shortage of specialist doctors & skilled manpower in rural areas.
• High out-of-pocket expenditure remains a concern.

⭐ ASHA (Accredited Social Health Activist) is a key community link under NRHM, with 1 ASHA per 1000 population (or per habitation in tribal/hilly areas).

RHM to NHM: Evolution - Mission Makeover

• National Rural Health Mission (NRHM): Launched 12th April 2005.
  • Initial focus: Strengthening rural public health systems.
• National Health Mission (NHM): Launched 2013.
  • Broadened scope from the initial NRHM.
  • Comprises two Sub-Missions:
    • NRHM (continuing for rural health).
    • National Urban Health Mission (NUHM): Launched 2013 for urban health needs.
• Overall Aim: Achieve universal access to equitable, affordable, and quality healthcare services for all.

⭐ NHM, launched in 2013, integrated the existing NRHM and introduced NUHM, significantly expanding the national health agenda to include urban populations alongside rural areas_._

High‑Yield Points - ⚡ Biggest Takeaways

• NRHM launched in April 2005 to enhance rural healthcare access and quality.
• ASHA workers: crucial link between community and public health system.
• Core strategy: Strengthening SCs, PHCs, CHCs and infrastructure.
• JSSK ensures free, cashless services for pregnant women and sick newborns.
• Mainstreaming AYUSH and Rogi Kalyan Samitis (RKS) for local health governance.
• Special focus on EAG states, NE states, J&K, and Himachal Pradesh.
• Subsumed under National Health Mission (NHM) in 2013, expanding scope.