|
Navigation
 |
Background:
The NRHM was launched in the Northeast by the Hon’ble Prime Minister on 8th
November, 2005 at Guwahati, indicating the commitment for the region at the
highest decision making body of the country. Since the launch, activities on
Mission mode, with the objective to deliver services to the unreached,
undeserved, besides others, making central the accessibility of the services
provided and the awareness to access these, a reality.
The National Rural Health Mission (NRHM) aims to provide for an accessible,
affordable, acceptable and accountable health care through a functional
public health system.
It is designed to galvanise the various components of primary health system,
like preventive, promotive and curative care, human resource management,
diagnostic services, logistics management, disease management and
surveillance, and data management systems etc. for improved service
delivery.
This is envisioned to be achieved by putting in place an enabling
institutional mechanism at various levels, community participation,
decentralized planning, building capacities and linking health with its
wider determinants. It also aims to expedite achievements of policy goals by
facilitating enhanced access and utilization of quality health services,
with an emphasis on addressing equity and gender dimension.
Vision
To provide effective healthcare to rural population throughout the country
with special focus on 18 sates, which have weak public health indicators
and/ or weak infrastructure.
To increase public spending on health from 0.9% GDP to 2-3% of GDP, with
improved arrangement for community financing and risk pooling.
To undertake architectural correction of the health system to enable it to
effectively handle increased allocations and promote policies that
strengthen public health management and services delivery in the country.
To revitalize local health traditions and mainstream AYUSH into the public
health system.
Effective integration of health concerns through decentralized management at
district, with determinants of health like sanitation and hygiene,
nutrition, safe drinking water, gender and social concerns.
Addresses inter State and inter district disparities.
Time bound goals and report publicly on progress.
To improve access to rural people, especially poor women and children to
equitable, affordable, accountable and effective primary health care.
OBJECTIVES OF NRHM:
o Reduction in child and maternal mortality.
o 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
immunization.
o Prevention and control of communicable and non-communicable diseases,
including locally endemic diseases.
o Access to integrate comprehensive primary health care.
o Population stabilization, gender and demographic balance.
o Revitalize local health traditions & mainstream AYUSH.
o Promotion of healthy lifestyles.
APPROACHES OF NRHM:
Communitize: this will entail transfer of funds, functions and functionaries
to PRIs and also greater engagement of RKS, hospital development
Committees or user groups etc.
Improved management through capacity: Right from the national level,
NRHM visualizes a sustained process of capacity development of management of
the programme through, NHSRC, SHRCs. Besides these institutional arrangement
districts and block level health management systems are being suggested, so
that programme is more responsive to local management needs and challenges.
Flexible financing: Programme aims for making available untied funds at
different levels of health care delivery system so that service guarantees
as spelled out in the IPHS can be made availed.
Monitor progress against standards: Facility surveys will setup the
benchmarks for the purpose of monitoring achievements of standards. Also
additionally preparation of the annual reports by independent agencies will
help in publishing these reports.
Innovation in human resource management one of the major challenge in making
health services effectively available to the rural poor involves innovations
in human resources management. NRHM proposes, ensuring availability of
locally resident health workers, contractual positions, multi-skilling,
integration with AYUSH etc so as to optimally use human resources.
CORE STRATEGIES OF THE MISSION:
Train and enhance capacity of Panchayati Raj Institutions (PRIs) to own,
control and manage public health services.
Promote access to improved healthcare at household level through the female
health activist (ASHA).
Health Plan for each village through Village Health Committee of the
Panchayat.
Strengthening sub-centre through better human resource development, clear
quality standards, better community support and an untied fund to enable
local planning and action and more Multi Purpose Workers (MPWs).
Strengthening existing (PHCs) through better staffing and human resource
development policy, clear quality standards, better community support and an
untied fund to enable the local management committee to achieve these
standards.
Provision of 30-50 bedded CHC per lakh population for improved curative care
to a normative standard. (IPHS defining personal, equipment and management
standards, its decentralized administration by a hospital management
committee and the provision of adequate funds and powers to enable these
committees to reach desired levels).
Preparation and implementation of an inter sector District Health Plan
prepared by the District Health Mission, including drinking water,
sanitation, Hygiene and nutrition.
Integrating vertical Health and Family Welfare programmes at National,
State, Districts and Block levels.
Technical support to National, State and District Health Mission, for public
health management.
Strengthening capacities for data collection, assessment and review for
evidence based planning, monitoring and supervision.
Formulation of transparent policies for deployment and career development of
human resource for health.
Developing capacities for preventive healthcare at all levels for promoting
healthy lifestyle, reduction in consumption of tobacco and alcohol, etc.
Promoting non-profit sector particularly in undeserved areas.
ROLE OF DISTRICT HEALTH MISSION:
Responsible for planning, implementing, monitoring and evaluating progress
of Mission.
Preparation of Annual and perspective Plans for the District.
Suggesting district specific interventions.
Carrying out survey of non-governmental providers to see what contribution
they can make.
Partnerships with NGOs, Panchayat, Cluster & Block level teams.
Establish Resource Group for Professionals also can facilitate
implementation of core strategies of Mission.
Experiment with risk pooling for hospitalization
Ensure referral chain and timely disbursement of all claims
Arrange for technical support to the blocks teams and for itself.
Arrange for epidemiological studies and operational research to guide
district level planning.
Nurture community processes.
Transparent systems of procurement and accountability.
Activate women’s groups, adolescent girl’s to ensure gender sensitive
approach.
Provide_ data analysis and compilation facility in order to meet regular MIS
needs
Carry out Health Facility Surveys and supervision of household surveys
District Health Mission to ensure that district annual action plan as per
RNTCP requirement would continue to be submitted by the district to the
state TB cell.
Programmes supported by NRHM
|
 |
