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National Rural Health Mission (NRHM): Objectives, Features, And Benefits

Team AckoDec 26, 2024

According to the World Bank, almost 64.61% of the Indian population lived in rural areas in 2021. Most rural regions lack modern healthcare facilities and the advanced infrastructure required to provide quality services.

The National Rural Health Mission is a step in solving such issues and enabling the rural population to access free health care. Read on to know more.

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Contents

What is the National Rural Health Mission (NRHM)?
Roles and Objectives of the National Rural Health Mission
Benefits of the National Rural Health Mission (NRHM) Scheme
Important Features of the National Rural Health Mission Scheme
Key Initiatives of the National Rural Health Mission
Eligibility for the National Rural Health Mission Scheme
NRHM in the Context of National Health Mission (NHM)
Challenges Faced by the National Rural Health Mission (NRHM)
How to Register for the National Rural Health Mission (NRHM)
Key Takeaway
Frequently Asked Questions

What is the National Rural Health Mission (NRHM)?

The National Rural Health Mission is a government-aided health insurance scheme that was launched in 2005 to provide accessible, affordable, and quality health care in the rural areas. The primary focus of this scheme is on the low-income households in rural areas. The scheme was launched to improve health conditions in eighteen Indian states with the highest rural population concentration. It established functional health facilities by renovating and adding new infrastructure, medical equipment, medicines, and service delivery. The National Rural Health Mission uses a five-point approach to efficiently deliver the services by focusing on the following.

Communication and awareness
Flexible financing
Monitoring progress against standards
Innovation in human resource management
Improvements in the management framework

Roles and Objectives of the National Rural Health Mission

The main goals of NRHM concentrate on the broader vision of the government to support residents' access to inexpensive healthcare facilities. The results of NRHM have mostly stayed the same due to the modifications introduced by the 12th Plan. Consequently, the mission's primary long-term objectives remain aligned with the original goals of the NRHM. Following are the roles and objectives of the National Rural Health Mission.

Roles

To facilitate increased access and utilisation of quality health service in rural areas.
To provide a platform for Panchayati Raj and the community to manage primary health programmes and infrastructure.
To promote equality and social justice.
To provide preventive health care services in rural areas.

Objectives

To reduce MMR (Maternal Mortality Rate) and IMR (Infant Mortality Rate) to 100/1000 and 30/1000 live births, respectively.
To minimise anaemia tendencies in women between the ages of 15 and 49.
To see a 60% drop in annual malaria fatality.
To reduce Leprosy rates to 1/10000 people.
To reduce microfilaria prevalence to less than 1%.
To decrease disease and injury-related mortality and morbidity.

Benefits of the National Rural Health Mission (NRHM) Scheme

Here are the benefits of the National Rural Health Mission (NRHM) Scheme.

1. The mission can provide high-quality medical services and facilities to rural residents.

2. Treatments for both communicable and non-communicable diseases are now affordable to underprivileged people.

3. Rural residents are more conscious than ever and prioritise addressing illnesses immediately.

4. They are now aware of the harmful effects of smoking, and the number of smokers has decreased from previous numbers.

5. Increased facilities and equipment, thanks to funding from the Indian government. This has improved services.

6. Mobile Medical Units in 459 remote districts that cover medical emergencies in remote areas.

7. Access to free ambulance services within 30 minutes.

8. Free healthcare for prenatal and postnatal care of pregnant women.

9. A permanent Accredited Social Health Activist (ASHA) worker resident and accountable for the village.

10. The efforts of this mission are mainly responsible for the decline in maternal and newborn mortality.

Important Features of the National Rural Health Mission Scheme

Following are the important features of the National Rural Health Mission Scheme.

1. Decentralised Health Planning

NRHM places an emphasis on health strategy development at the sub-district and district levels, following a bottom-up planning methodology. This decentralisation promotes the identification and effective resolution of local health concerns by facilitating the development of individualised solutions for distinct area requirements.

2. Enhanced Service Delivery

Initiatives such as Mobile Medical Units (MMUs), free ambulance services, and better-equipped sub-centres have been implemented as part of the objective to enhance service delivery mechanisms. Reducing geographical barriers to healthcare access, these efforts guarantee that underserved and rural locations receive timely services.

3. Creating Knowledge Hubs within District Hospitals

Newly transformed district hospitals under the National Rural Health Mission (NRHM) are becoming centres of expertise in healthcare practice modernisation, skill development, and capacity building. This change guarantees that modern facilities and medical professionals are available to meet a wide range of patient needs.

4. Community Participation

Part of what makes NRHM work is the community's active participation. Local populations are given the power to participate in health planning, monitoring, and decision-making through initiatives such as the ASHA project and the Village Health Sanitation and Nutrition Committees (VHSNC). Accountability is improved, and the connection between communities and the healthcare system is strengthened through this participatory approach.

5. Increased Fund Allocation

To close the funding shortfall, the mission has pushed for more healthcare spending. Improved infrastructure, necessary equipment, and health programs like the Janani Shishu Suraksha Karyakram (JSSK) that provide free and high-quality healthcare are all recipients of these funds.

Key Initiatives of the National Rural Health Mission

The key initiatives under the National Rural Health Mission (NRHM) are as follows:

ASHA:

The volunteers who work to connect the targeted community and the health system are known as Accredited Social Health Activists or ASHAs. This mission has benefited from the contributions of almost 8.84 lakh community health volunteers. For underprivileged groups of people, particularly women and children, who have trouble accessing health care in rural areas, ASHA is the first place they should go for any health-related needs.

This initiative, which is spreading throughout the states, has proven very effective at reintroducing people to the public health system. Additionally, it has led to a rise in the use of inpatient treatment, diagnostic centres, outpatient services, and institutional deliveries.

Rogi Kalyan Samiti (Patient Welfare Committee)/Hospital Management Society:

The Hospital Management Society, also known as the Rogi Kalyan Samiti (Patient Welfare Committee), is a recognised society that serves as a board of trustees to oversee hospital operations.

Funding and other financial support for these communities engaged in patient welfare initiatives are handled by a single fund.

The United Grants to Sub-Centres

Auxiliary nurse midwives (ANMs) in the field feel more confident since they have better tools, such as a weighing machine, stethoscope, and blood pressure measurement devices.

In fact, they are capable of providing appropriate prenatal care as well as other medical treatments.

The Village Health Sanitation and Nutrition Committee (VHSNC), which operates at the local level, is another crucial instrument for community empowerment.

Health Care Service Delivery

The delivery of health care services necessitates significant human resource input. Numerous surveys have shown that the nation's public health care system severely lacks human resources.

By contractually supplying approximately 1.7 lakh individuals for health services to States, including 8,871 doctors, 2,025 specialists, 76,643 ANMs, 41,609 staff nurses, etc., NRHM has made an effort to close the human resource gaps.

Mobile Medical Units (MMU) have provided coverage in numerous unserved locations. As of 2024, MMUs are functioning in 459 districts nationwide.

Additionally, the government offers free ambulance services nationwide, with a toll-free hotline available within 30 minutes after a call. NRHM has made more than 12,000 basic and emergency patient transport vehicles available.

Janani Shishu Suraksha Karyakram

The government launched the Janani Shishu Suraksha Karyakram (JSSK) program to support universal healthcare. This programme provides pregnant women who deliver at public health facilities and their sick newborns with free transportation, medications, diagnostics, blood, and food.

Eligibility for the National Rural Health Mission Scheme

The targeted beneficiaries were socially backward people needed help to that are unable to access affordable health services in rural areas. Any permanent resident of declared rural areas can benefit from the scheme. The NRHM aims to serve socially and economically backward states.

NRHM in the Context of National Health Mission (NHM)

In 2013, the National Rural Health Mission (NRHM) was subsumed under the broader National Health Mission (NHM) framework, which also incorporated the National Urban Health Mission. This transition marked a significant shift, broadening the scope of health interventions to encompass both rural and urban areas and emphasising integrated healthcare delivery systems.

Transition from NRHM to NHM

The NRHM initially focused on rural health challenges, including maternal and child health, immunisation, and combating communicable diseases. Its integration into the NHM expanded its mandate to address urban health issues, non-communicable diseases (NCDs), and universal health coverage (UHC). The NHM framework aimed to create a unified health system, addressing human resources, infrastructure, and governance gaps across diverse settings.

Expanded Scope and Objectives

The NHM retained the core focus areas of NRHM—like Reproductive, Maternal, Neonatal, Child, and Adolescent Health (RMNCH+A)—while adding newer dimensions such as:

Strengthening primary healthcare, especially in underserved areas.
Tackling NCDs like diabetes, hypertension, and cancer.
Enhancing disease surveillance and emergency response capabilities.
Integrating health programs with other social welfare schemes for a holistic approach.

The NHM also emphasised:

Convergence with ministries such as Women and Child Development for improved nutrition and anaemia control.
Leveraging technology to enhance health systems, including telemedicine and digital health records.
Expanding community-based programs like empowering Accredited Social Health Activists (ASHAs) to act as grassroots health mobilisers.

Continuing Relevance of NRHM Principles

Despite its integration, NRHM's foundational principles continue to drive the NHM:

1. Decentralisation: Village Health Committees remain central to local health planning.

2. Equity: High-priority districts with poor health indicators receive special focus.

3. Community Engagement: Initiatives like social audits and participatory planning have been strengthened under NHM to ensure accountability.

Challenges Faced by the National Rural Health Mission (NRHM)

Introduced in 2005, the National Rural Health Mission (NRHM) sought to enhance the Indian rural population's healthcare access. However, various obstacles still compromise its efficacy.

Limited Resources

The lack of financial and personnel resources is the most important obstacle NRHM faces. Doctors and nurses are among the much-needed medical personnel lacking in rural areas. Only over one-third of Indian health professionals work in rural areas, where almost seventy per cent of the population lives. Furthermore, insufficient infrastructure, including sub-centres and inadequately equipped primary health centres (PHCs), aggravates the situation.

2. Geographic Constraints

Geographic remoteness still presents great difficulty. Terrain and inadequate road connections make many rural and tribal areas difficult to reach. This influences the timely provision of medical supplies, healthcare services, and emergency treatment. For example, these limitations can prevent emergency response services from reaching far-off areas inside the "golden hour."

3. Lack of Awareness

NRHM's performance suffers even more from ignorance of the accessible healthcare facilities. Many people living in rural areas are unaware of their rights under the program, which results in underusing healthcare facilities. Furthermore, cultural values and customs may discourage people from seeking official medical attention, especially for women and children.

4. Gaps in Implementation

Delayed fund disbursement, poor planning, and a lack of responsibility clearly show implementation flaws. Although the initiative brought Accredited Social Health Activists (ASHAs) to close gaps, low pay and poor training impede their efficacy. Furthermore, structural problems, including bureaucratic delays and inadequate inter-departmental collaboration, restrict the program's reach.

Socio-economic differences have a substantial impact on rural healthcare. Even when they are accessible, poverty and illiteracy discourage people from obtaining healthcare services. Systemic injustices often prevent vulnerable groups—including women, children, and scheduled castes/tribes—from getting necessary treatment.

6. Dependence on External Support

Although alliances with non-governmental organisations and private businesses have been encouraged, too much reliance on such alliances occasionally results in uneven service delivery. When outside money or support is taken away, sustainability becomes difficult.

Potential Solutions

To overcome these challenges, several measures could be adopted:

Strengthening Infrastructure: Building more well-equipped PHCs and sub-centres in rural areas.
Capacity Building: Enhancing training and incentives for ASHAs and other healthcare workers.
Innovative Approaches: Leveraging technology such as telemedicine to reach remote regions.
Community Engagement: Raising awareness and addressing socio-cultural barriers through education and outreach.

How to Register for the National Rural Health Mission (NRHM)

Application procedures for the National Rural Health Mission are not predetermined. If a person lives permanently in a region where NRHM is in operation, they can benefit from it. Before submitting an application for the NRHM, you can visit the National Health Mission's official website and review your options.

If the scheme benefits are just being introduced in your area, the assigned worker will visit households directly to inform residents. If you need any specific assistance, contact the assigned ASHA worker in your village. They can be found in the nearest Anganwadi centre. You can also call the official toll-free helpline number 1800-180-1900 to seek assistance. In case of any query or complaint, you can call the helpline and check the complaint status online.

Contact address

To get in touch with the relevant person, please visit the National Health Mission website's official Contact Us page.

Key Takeaway

One of India's most prominent programmes, the National Rural Health Mission (NRHM), seeks to improve healthcare delivery and accessibility in rural areas. Its key goals are improving healthcare infrastructure, lowering baby and maternal mortality rates, and expanding access to inexpensive, high-quality healthcare for underprivileged communities. Increased community involvement, the deployment of Accredited Social Health Activists (ASHAs), and a focus on cleanliness, disease prevention, and maternity and child health are the key characteristics of NRHM. The mission's expansion of facilities, healthcare personnel training, and preventative care promotion have greatly improved rural healthcare. Rural communities are empowered to improve their health and well-being through NRHM's holistic approach.

Frequently Asked Questions

Here are some common questions and answers about the National Rural Health Mission.

Which ministry supervises the NRHM scheme?

The Ministry of Health and Family Welfare supervises the NRHM scheme.

Who launched the NRHM scheme?

The NRHM scheme was launched by the then-Prime Minister of India in 2005, Dr. Manmohan Singh.

I am a pregnant woman. Can I get benefits from NRHM?

Yes, if you are pregnant and have a permanent address in a rural area, you are eligible to enrol in the scheme.

What is the toll-free number for the National Health Mission?

The toll-free number for the National Health Mission is 1800-180-1900.

Why was the National Health Mission launched?

As per the Constitution of India, Article 47, the government must take measures to raise the level of nutrition and the standard of living of people to improve public health. Thus, the National Health Mission was launched.

Source

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. It is based on industry experience and several secondary sources on the internet, and is subject to changes.