NATIONAL HEALTH MISSION
“Swasth Bharat, Samarth Bharat” – A mission to bring healthcare to every doorstep in India
Let us begin by asking:
➡️ Can any country grow if its children are malnourished, mothers are dying during childbirth, or essential vaccines are unavailable in villages?
To tackle these fundamental issues and ensure health equity across rural and urban India, the National Health Mission (NHM) was launched.
🔷 Quick Facts
| Feature | Details |
| Type | Centrally Sponsored Scheme |
| Purpose | Universal access to equitable, affordable, and quality healthcare |
| Mission Head | Mission Director (Additional Secretary rank) |
| Tenure | 2021–2026 |
🎯 Objectives of NHM
NHM is not just about hospitals — it is about holistic healthcare transformation.
Let’s list its core objectives:
- Reduce maternal and child mortality
- Control both communicable & non-communicable diseases
- Deliver comprehensive primary healthcare
- Achieve population stabilisation, gender, and demographic balance
- Revitalize local health traditions and mainstream AYUSH
- Ensure access to services for food, nutrition, sanitation, hygiene
- Promote healthy lifestyles
UPSC Angle: These objectives directly correlate with Sustainable Development Goals (SDG 3 – Good Health and Well-being).
🧱 Structure of NHM: Dual Sub-Missions
In 2013, the government merged two major initiatives into a single umbrella:
1. National Rural Health Mission (NRHM) – Launched 2005
2. National Urban Health Mission (NUHM) – Launched 2013
➡️ Together, they now form the National Health Mission (NHM)
🏙️ National Urban Health Mission (NUHM)
| Feature | Details |
| Coverage | Cities/towns with population > 50,000 |
| Focus | Need-based, decentralised urban health plans |
| Execution | In partnership with local bodies, NGOs, and communities |
| Infrastructure | Urban PHCs, U-CHCs (Urban Community Health Centres), referral hospitals, outreach services |
| External Aid | Funded partly by Asian Development Bank (ADB) based on progress indicators |
Think of this as urban health planning tailored to each city’s specific needs.
🏡 National Rural Health Mission (NRHM)
- Focus: Decentralised, community-owned rural healthcare delivery system
- Promotes inter-sectoral convergence — health, water, sanitation, nutrition, gender, and education all work in synergy
The idea is: You can’t improve rural health only through doctors; you need to address the determinants of health.
📊 Support to States – Based on Performance
- Funding is routed through each State’s Programme Implementation Plan (PIP)
- States that show improvements in health outcomes (e.g., reduction in IMR, MMR) receive additional incentives
This creates a competitive and result-oriented model of federal healthcare governance.
💉 Electronic Vaccine Intelligence Network (e-VIN)
- A cutting-edge digital tool to manage vaccine logistics
- Monitors real-time stock levels and storage temperatures across the country
- Combines technology, IT infrastructure, and trained human resources
Ensures no wastage, no shortages — a game-changer during the COVID-19 vaccination drive.
🌸 Major Initiatives under NHM
🟣 Janani Suraksha Yojana (JSY)
“Safe motherhood is not a privilege. It’s a right.”
🗓️ Launched: 2005
- A conditional cash transfer scheme to promote institutional deliveries
- Fully centrally sponsored
- ASHA workers act as the bridge between pregnant women and hospitals
🎯 Focus:
- 10 Low-performing states (low institutional delivery rates)
- Incentives provided to both mothers and ASHA workers
| Category | Mother | ASHA |
| Low-performing (Rural) | ₹1400 | ₹600 |
| Low-performing (Urban) | ₹1000 | ₹400 |
| High-performing (Rural) | ₹700 | ₹600 |
| High-performing (Urban) | ₹600 | ₹400 |
🎯 Beneficiaries:
- Low-performing States → All pregnant women after institutional delivery
- High-performing States → Only BPL & SC/ST women (up to 2 live births)
🟡 Janani Shishu Suraksha Karyakram (JSSK)
“Delivering dignity and care to mothers and newborns.”
Launched in 2011 to provide ‘Zero expense delivery’ in government health facilities and prevent out-of-pocket expenditure for poor families.
✅ Entitlements Under JSSK:
| Facility | Services Offered |
| 🚑 Free Ambulance Services | Pickup & drop for mother and baby |
| 💊 Free Medical Care | Drugs, diagnostics, blood transfusions |
| 👩⚕️ Free Delivery Services | Including C-section deliveries |
| 👶 Neonatal Care | Free treatment for newborns up to 1 year |
👶🏻 Rashtriya Bal Swasthya Karyakram (RBSK)
Launched in 2013
“Early detection, timely intervention — because every child deserves a healthy start.”
🎯 Objective
To screen children from birth to 18 years for health issues and intervene early.
✅ What does RBSK cover?
It focuses on the 4 D’s of childhood health:
| 4 D’s | Meaning |
| Defects at birth | Congenital conditions like cleft lip, Down syndrome |
| Deficiencies | Nutritional issues like anaemia, Vitamin A deficiency |
| Diseases | Common childhood illnesses |
| Developmental Delays (including disability) | Cognitive, motor, sensory delays |
👥 Target Group
- 0–6 years in rural areas and urban slums
- 6–18 years enrolled in Government and Government-aided schools
🏥 What is provided?
- Screening for 30 predefined conditions
- Free treatment and follow-up through Early Intervention Centres (DEICs)
👧🏻 Rashtriya Kishor Swasthya Karyakram (RKSK)
Launched in 2014;
“Healthy teens, empowered future.”
🎯 Aim
To empower adolescents (10–19 years) to make informed decisions about health, hygiene, and lifestyle.
🔑 Key Components:
- School-based screening: Early detection of NCDs
- Peer educators – Saathiya: Specially trained adolescents who spread awareness
- Saathiya Resource Kit: Booklets and tools for sensitive topics (puberty, gender, emotional health, etc.)
- Menstrual Hygiene Scheme (MHS): Subsidized sanitary pads for rural girls
🤝 Strategic Partners
National Adolescent Health Strategy designed by MoHFW and UNFPA
🤱 RMNCH+A Strategy
Launched in 2013.
Reproductive, Maternal, Newborn, Child & Adolescent Health — an integrated lifecycle approach to healthcare.
🧩 The “Plus” means more than just covering stages. It includes:
| Component | Focus |
| 👤 Adolescence as a Life Stage | Special focus on 10–19 years as a sensitive period |
| 🔗 Integrated Approach | Linking maternal, child, HIV, gender-based services |
| 🏥 Community–Facility Bridge | From home-based care to hospital-based services |
| 🚦 Referral Mechanism | Timely coordination across healthcare levels |
Instead of treating each stage in isolation, RMNCH+A ensures continuity and coherence across a person’s health journey.
💉 Universal Immunisation Programme (UIP)
“Prevention is better than cure — especially when it’s free.”
🧾 About UIP
- Launched: 1985
- Fully Centrally Funded
- One of the largest public immunization programmes in the world
🔬 Vaccines Provided Under UIP
| Category | Vaccines |
| Core Vaccines | Diphtheria, Pertussis, Tetanus (DPT), Polio, Measles, Hepatitis B, Rubella, Pentavalent, Rotavirus, MR, IPV, bOPV |
| Adult/Endemic Specific | Japanese Encephalitis (JE), Adult JE, Pneumococcal (in endemic districts) |
🛡️ Coverage Against 12 Diseases
| National Coverage | Sub-National Coverage |
| Diphtheria, Tetanus, Polio, Pertussis, Measles, Hepatitis B, Rubella, TB (severe), Hib Meningitis & Pneumonia | Rotavirus Diarrhoea, Pneumococcal Pneumonia, Japanese Encephalitis |
🎯 Mission Indradhanush & IMI
“No child left behind.”
🏁 Mission Indradhanush (2014)
- Aims to improve routine immunization coverage to >90%
- Focuses on hard-to-reach and underserved populations
⚡ Intensified Mission Indradhanush (IMI)
- Launched to accelerate coverage in poorly performing districts
- Special immunization drives with community outreach
🦟 Communicable Disease Control Programmes
A. National Vector Borne Disease Control Programme (NVBDCP)
Launched in 2003-04
Covers 6 major diseases:
- Malaria
- Japanese Encephalitis (JE)
- Dengue
- Chikungunya
- Kala-azar
- Lymphatic Filariasis
B. National Tuberculosis Elimination Programme (NTEP)
Launched 1962 as NTP; revamped in 2017
Target: End TB by 2025 – 5 years before SDG timeline
- Provides free diagnosis and treatment
- Nikshay Poshan Yojana: ₹1000/month via Direct Benefit Transfer (DBT) to all TB patients for nutritional support
C. National Leprosy Eradication Programme (NLEP)
- Launched in 1983
- Offers free treatment to all leprosy patients
- Focus on active case detection and community-based care
❤️🩹 Non-Communicable Disease (NCD) Control Programmes
India is facing a double burden — communicable diseases + lifestyle diseases.
Key NCD Programmes:
| Programme | Focus |
| NPCDCS | Cancer, Diabetes, Cardiovascular Diseases, Stroke |
| NPCBVI | Control of Blindness & Visual Impairment |
| NMHP | Mental Health |
| NPHCE | Healthcare of Elderly |
| NPPC | Palliative care (terminal illnesses) |
| NPPCD | Hearing & Deafness prevention |
| NTCP | Tobacco use reduction |
| NPPMBI | Burn injury management |
| NOHP | Oral health awareness and care |
These address chronic and often neglected health challenges that impact long-term productivity and dignity.
🔄 Conclusion
Together, NHM ensures that:
- A child in a slum, a teen in a village, a pregnant woman in a remote area, or a TB patient in a tribal belt — all are part of India’s health net.
It is a people-centric mission, aligned with:
- SDGs
- Ayushman Bharat
- Health for All by 2030