Study on National Rural Health Mission

1. Making growth inclusive
through social development

2. National
Rural
Health
Mission
(2005-2012)
Reaching affordable,
quality health care to the
poorest households in the
remotest regions

3. NRHM
 • N…Newer Initiatives.
 • R…Rural Poor Population
 • H…Holistic Health Package.
 • M…Monitoring mechanisms
 To cater to the Primary health care
needs of vulnerable segment of pop. to
bring down IMR and MMR . to attain
Pop. Stabilisation.

4. NHRM
 The Government of
India made a
commitment to raise
the public expenditure
on health from 1% of
GDP to 2-3% of GDP
over the Mission period
(2005-12).

5. NRHM
entire
country,
with
Entire Country
Jammu
and
Kashmi
r
Uttar
Prades
h
Madhya
Prades
h
Sikkim
Tripura
Mizora
m
Uttaran
chal
Chhatti
sgarh
Bihar
Jharkha
nd
Orissa
Rajasth
an
Arunac
hal
Prades
h
Manipur
Meghal
aya
Nagala
nd
Assam
Himach
al
Prades
h
special
focus on 18
states

6. Expected outcomes from the
Mission
 IMR reduced to 30/1000 live births by 2012.
 Maternal Mortality reduced to 100/100,000 by 2012.
 TFR reduced to 2.1 by 2012.
 Cataract operations-increasing to 46 lakhs until 2012.
 Leprosy Prevalence Rate –reduce less than 1 per 10,000
thereafter.
 Tuberculosis DOTS series - maintain 85% cure rate
through entire Mission Period.
 Engaging 2,50,000 female Accredited Social Health
Activists (ASHAs) in 10 states.

7. 1.DDK for Clean deliveries at home
2.Tab. Iron Folic Acid (L)
3.Tab Punarvadu Mandur (ISM
Preparation of Iron)
4.ORS Packets
5.Tab. Paracetamol
6.Tab. Dicyclomine
7.Povidine Ointment Tube
8.Thermometers
9.Cotton Absorbent Roll
10.Bandages, 4cm X 4 meters
11.Tab. Chloroquine
12.Condoms 13.Oral Pills (In cycles)

8. IMR reduced to 30/1000 live births by
2012.
 the number per 1,000 children before
one year of age, is 57, which means
over one in 18 infants die before they
are one year old. (2005 – 2006)
 While the figure is a marginal
improvement over the IMR of 68 of
NFHS-2 (1998-99) – about 1 in 14 – this
is unacceptably high.

9. Infant mortality rate
3
0

10. Maternal Health Situation in
India:
 About 28 million pregnancies occur every year
in India.
 24 million deliveries
 15% of these are likely to develop
complications.
 Complications cannot be predicted.
 Over 67,000 avoidable maternal deaths per
year


11. Maternal Mortality reduced to
100/100,000 by 2012.
 The Maternal Mortality Ratio has
reduced from 301 per 100,000 births in
2001-03 period to 254 in the 2004-06
period

12. TFR reduced to 2.1 by 2012.
 TFR of 2.7 (SRS 2007)
 Ranks 83 in the world - India 2.72 2008
est.
 Total fertility rate: 2.68 children
born/woman (2009 est.)

13. 9,000 doctors
60,000 nurses/ANMs

14. Reproductive & Child Health
Programme
 MCP (MOTHER &
CHILD PROJECTION
CARD) CARD
 Information right from
the Antenatal test to
growth monitoring of the
newly born baby in
continuation.

16. Key Strategies for MH under
RCH
 Essential obstetric and new born care for
all .
 Skilled attendance at every birth including
essential new born care.
 Emergency obstetric care for those having
complications and referral services.
 Provision of Safe Abortion Services and
services .

17. Training
 Training of SNs/LHVs/ANMs as Skilled
Birth Attendant
 Training of MBBS doctors in obstetric
and anesthetic skills.
 Setting up of Blood Storage Centers
(BSC) at First Referral Units.

18. At Village Level (1000
population):
 Every month at Anganwadi Center a
Village Health and Nutrition Day is being
organized with a focus on ANC, PNC,
Immunization and Counseling on
Nutrition and Family Planning Services.

19. Monthly Health and Nutrition
Days
 Water, sanitation, education, literacy,
nutrition, women’s empowerment have all
been brought together under convergent
community institutions and Health
Missions at various levels.

20. At the level of Sub- Centre
(3000-5000 population):
 The ANMs at the sub-center are being trained
as Skilled Birth Attendant(SBA).
 50% of the PHCs under NRHM are being
developed as 24X7 PHCs with inputs of 3 or
more SNs/ANMs and one Medical Officer.
 To improve the proficiency, skills and quality of
these SNs/ANMs as skilled provider for
delivery, GOI has launched Skilled Birth
Training.

21. Primary Health Centre
(20,000-30,000 population):
 Funds have been given to the States for
infrastructural development including
labour rooms and equipments as per the
laid down standards under IPHS.
 All CHCs are aimed to be converted as
First Referral Units (FRU) with provision of
1 ObGyn or a Trained MBBS Doctor for
EmOC, 1 Anesthetist or Trained MBBS
Doctor proficient in Anesthetic Skills,
Functional OT and a Blood Storage facility.

22. The scheme
focuses on the
poor pregnant
woman with
special
dispensation for
states having
low institutional
delivery rate.

23. key achievement of the NRHM
 One of the key achievement of the
NRHM is a visible growth in the field of
institutional delivery.
 Institutional Delivery:
 3.449 M women benefited so far in 06-07
 5.135 M in 07-08,
 8.378 M in 2008-09

25. Leprosy
eliminated at
National level

26. Rs 125/- for
glasses for
poor children

27. STATE
INITIATIVES
27

28. 28
Gujarat - Chiranjeevi Yojana
 A Health financing scheme for safe
maternity services to BPL beneficiaries
 More than 7793 BPL mothers, that is
nearly 31 % of BPL pregnant mothers
have safely delivered, under the
scheme.
 not a single death in mothers
has been reported

29. 29
Haryana -Delivery Hut
 Delivery Huts established within villages for
providing services during delivery in institutions
having facilities for normal deliveries and referral
support.
 400 Delivery Huts have been established,
16,500 deliveries conducted, 1756 high-risk referred
of RTI / STI.

30. Madhya Pradesh - Sponsors
500 students
 The state government has come up with
decision to strengthen the nursing cadre
by sponsoring M Sc, B Sc and post basic
B.Sc,nursing students.
 These students have to serve
compulsorily in rural areas for 7 years
after completing the course.

31. Tamil
Nadu
Free heart
surgery for
children .
Free spectacles
for children who
are studying .

32. Kalaignar
Kappeetu Tittam

33. In 2006-07
Rs. 38
Crores
In 2007-08
880 Crores
In 2008-09
Rs. 1207.17
Crores.
In 2009 –10
Rs.2,057
crores
 Health related indicators would suggest
that significant gains have been made
over the years.
 India fares poorly in most of the
indicators in comparison with developing
countries like China and Sri Lanka.

34. Challenges
 India needs over 6,800 more hospitals in
rural areas to provide basic health
facilities to people.
 There is still a shortage of 4,477 primary
healthcare centre's and 2,337
community healthcare centre's as per
the 2001 population norms,
Total of 15196 PHC’s & CHC’s and sub centers are functiona

35. Current Population of India in
2010 - 1,150,000,000
(1.15 billion)
 This means the requirement for
hospitals will be much more if the
population figure in 2010 is taken into
account.

36. 26000 Dr’s : 750 Million pop
 we have 30,000 MBBS graduates
coming out of our Colleges every year.
 The entire rural health system for more
than 750 million people never has
more than 26000 doctors.

37. Challenges
 The annual survey presented in
parliament said:
 "Almost 29 percent of the existing
health infrastructure is in rented
buildings.
 Poor upkeep and maintenance, and high
absenteeism of manpower in the rural
areas are the main problems in the
health delivery system."

38. Solution …
 Transparency
 Monitoring
 Additional weight age of marks that will
be given for service in rural areas.
 Doctors who work in rural areas will be
compensated with extra money

39. Thank you
Deepa
Himanshu
Kapil Billa
Pankaj
Subhangkar
Tony
700 consultants (MBA/CA) have been appointed
for state/ district level Program ManagementUnits.