Friday, 17 March 2017

National Health Mission

The National Health Mission (NHM) aims for attainment of universal access to equitable, affordable and quality health care services, accountable and responsive to people’s needs, with effective inter-sectoral convergent action to address the wider social determinants of health.

Under NHM, support to States/UTs  is provided for five key programmatic  components:
(i)     Health Systems Strengthening including infrastructure, human resource, drugs & equipment, ambulances, MMUs, ASHAs etc under National Rural Health Mission (NRHM) and National Urban Health Mission (NUHM).

(ii)   Reproductive, Maternal, Newborn, Child and Adolescent Health Services (RMNCH + A)

(iii) Communicable Disease Control Programmes

(iv) Non-Communicable Diseases Control Programme interventions upto District Hospital level

(v)   Infrastructure Maintenance- to support salary of ANMs and LHVs etc.

The objectives of NHM are summarised as under:
                    i.            Reduction in child and maternal mortality
                  ii.            Prevention and control of communicable and non-communicable diseases, including locally endemic diseases.
                iii.            Access to integrated comprehensive primary health care.
                iv.            Population stabilisation, gender and demographic balance.
                  v.            Revitalize local health traditions & mainstream AYUSH.
                vi.            Universal access to public services for food and nutrition, sanitation and hygiene and universal access to public health care services with emphasis on services addressing women’s and children’s health and universal immunisation.
              vii.            Promotion of healthy life styles.

The NHM has been successful in accelerating the decline of Maternal Mortality Ratio (MMR), Under 5 Mortality Rate (U5MR), Infant Mortality Rate (IMR) and Total Fertility Rate (TFR). It has also achieved many of the disease control targets.

The key targets and achievements of NHM are given below:

Targets as per NHM Framework for Implementation
S.no.
Targets (2012-17)
Achievements
1
Reduce IMR to 25/1000 live births
IMR has reduced to 37 in 2015 (SRS).
2
Reduce MMR to 100/1,00,000 live births
MMR has reduced to 167 in 2011-13 (SRS).
3
Reduce TFR to 2.1
TFR has reduced to 2.3 in 2014 (SRS).
4
Reduce annual prevalence and mortality from Tuberculosis by half
Tuberculosis Prevalence and mortality reduced to half as compared to 1990 level.

Incidence reduced from 300 / lakh in 1990 to 217/ lakh in 2015

Mortality reduced from 76/ lakh in 1990 to 32/ lakh in 2015

Data Source : WHO Global TB report 2016
5
Reduce prevalence rate of Leprosy to <1/10000 population in all districts.
Prevalence rate of Leprosy reduced to Less than 1/10000 population in 551 Districts as on 31stMarch 2016.
6
Annual Malaria Incidence to be <1/1000
Annual Malaria Incidence is 0.67 in 2016.(Prov)
7
Less than 1 per cent microfilaria prevalence in all districts
Out of 256 LF endemic districts, 222 districts have reported Mf rate less than 1% as per reports of 2016.
8
Kala-Azar Elimination by 2015, <1 case per 10000 population in all blocks
Out of 628 endemic blocks 492 (78%) have already achieved elimination till 2016.


Variousprogrammes running under theNHM has been regularly evaluated, inter-alia, through external surveys such as, National Family Health Survey (NFHS), District Level Household Survey (DLHS) and Sample Registration System (SRS). Further, Common Review Missions (CRMs) also undertake a review of NRHM/NHM annually.
The details on different evaluations are available in public domain as under:
NFHS-4:
DLHS 4:
SRS:
CRM reports:

A statement showing State/UT-wise Central Release and Expenditure during the last three years is given below:

Rs. in crore
Sl. No.
States
2013-14
2014-15
2015-16
Central Release
Expenditure
Central Release
Expenditure
Central Release
Expenditure
1
Andaman & Nicobar Islands
              29.06
              29.12
              23.36
              24.33
              37.30
              11.47
2
Andhra Pradesh
            878.73
         1,044.81
            519.73
            902.91
            643.52
         1,090.17
3
Arunachal Pradesh
              78.60
              92.03
            139.41
              69.50
            162.65
            146.27
4
Assam
         1,077.81
            956.89
            877.13
            915.88
            971.35
         1,186.01
5
Bihar
         1,110.32
         1,480.68
         1,148.32
         1,427.40
         1,159.49
         1,621.67
6
Chandigarh
              11.46
              14.42
              12.15
              15.26
              23.89
              20.98
7
Chattisgarh
            355.98
            805.50
            500.41
            716.04
            412.26
            758.28
8
Dadra & Nagar Haveli
                9.23
                9.83
                8.40
                8.56
              14.37
              15.54
9
Daman & Diu
                6.50
                8.40
                6.91
                7.67
              10.53
              15.69
10
Delhi
            129.78
            132.59
            154.04
            222.64
            163.80
            137.29
11
Goa
              19.35
              30.58
              26.03
              29.50
              16.77
              24.92
12
Gujarat
            833.72
            977.48
            832.86
            873.66
            693.78
         1,272.42
13
Haryana
            315.94
            423.79
            273.60
            438.18
            291.96
            493.23
14
Himachal Pradesh
            205.29
            158.60
            185.84
            306.92
            246.49
            281.26
15
Jammu & Kashmir
            395.10
            391.10
            335.51
            393.29
            367.90
            420.94
16
Jharkhand
            396.38
            521.49
            359.62
            372.01
            411.50
            590.18
17
Karnataka
            611.11
            812.56
            697.24
            858.18
            740.45
         1,141.61
18
Kerala
            360.98
            673.07
            521.99
            509.83
            304.14
            632.88
19
Lakshadweep
                3.20
                2.28
                5.08
                1.36
                5.69
                2.72
20
Madhya Pradesh
            865.94
         1,583.60
         1,162.50
         1,738.02
         1,132.19
         2,046.60
21
Maharashtra
         1,218.51
         1,806.86
         1,431.76
         1,834.40
         1,085.92
         1,734.44
22
Manipur
              88.93
              74.57
            128.81
              86.91
            112.16
            105.51
23
Meghalaya
            125.51
              71.53
            104.13
              70.72
            102.22
            133.55
24
Mizoram
              77.43
              91.89
            103.28
              93.29
              94.68
            172.38
25
Nagaland
              99.73
              90.40
            114.92
              63.04
            104.85
              81.05
26
Orissa
            604.20
            901.65
            667.16
            944.10
            652.62
         1,205.77
27
Puducherry
              18.10
              25.43
              22.56
              23.35
              18.61
              21.77
28
Punjab
            333.47
            437.57
            379.35
            460.59
            295.23
            649.49
29
Rajasthan
            922.93
         1,457.06
         1,115.96
         1,722.69
         1,287.84
         1,799.11
30
Sikkim
              45.91
              44.82
              51.60
              41.36
              41.01
              50.71
31
Tamil Nadu
            906.24
         1,430.28
            952.75
         2,248.06
         1,093.22
         1,633.37
32
Tripura
            140.15
            101.93
            123.11
            130.15
            136.29
            118.77
33
Uttar Pradesh
         3,024.60
         2,924.38
         2,431.06
         3,671.26
         2,862.83
         4,451.78
34
Uttarakhand
            245.25
            255.28
            270.55
            324.42
            276.41
            335.95
35
West Bengal
            948.51
         1,271.71
         1,058.62
         1,196.78
            959.51
         1,487.62
36
Telangana
                   -  
                   -  
            378.72
            334.68
            436.63
            505.55
Total
       16,493.93
       21,134.19
       17,124.48
       23,076.94
       17,370.07
       26,396.94
Note: 
1. The above Releases relate to Central Govt. Grants & do not include State share contribution.
2. The above releases are as per revised allocation
3. Expenditure (As per FMR submitted by States/UTs) includes Expenditure against Central Release, State release & Unspent balances at the beginning of  the year.




The Minister of State (Health and Family Welfare), ShFaggan Singh Kulaste stated this in a written reply in the Lok Sabha here today.




Courtesy: pib.nic.in

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