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Cabinet Reviews Achievements Under National Health Mission (2021-24)

Cabinet Reviews Achievements Under National Health Mission (2021-24)

25-01-2025
  1. On January 22, 2025, the Union Cabinet, led by Prime Minister Narendra Modi, reviewed the progress of the National Health Mission (NHM) for the years 2021-2024.
  2. The Cabinet discussed key developments in areas like maternal and child health, disease control, healthcare infrastructure, human resource expansion, and digital health initiatives.

Key Achievements of NHM (2021-2024):

1. Improvement in Health Indicators

Key Term

Definition

2014-2016

2018-2020

Reduction

Maternal Mortality Ratio (MMR)

Number of maternal deaths per 100,000 live births

130 per lakh

97 per lakh

25% decrease

83% decrease since 1990 (global avg. 45%)

Under-5 Mortality Rate (U5MR)

Number of child deaths before age 5 per 1,000 live births

45 per 1,000

32 per 1,000

75% decrease

India’s reduction in U5MR is much higher than the global reduction of 60% since 1990.

Infant Mortality Rate (IMR)

Number of infant deaths under age 1 per 1,000 live births

39 per 1,000

28 per 1,000

Significant reduction

Total Fertility Rate (TFR)

Average number of children a woman is expected to have in her lifetime

2.3 children

(2015)

2.0 children

(2020)

0.3 child decrease

2. Increase in Healthcare Workforce

Fiscal Year

Total Healthcare Workers Engaged

Details of Healthcare Workers

FY 2021-22

2.69 lakh, Additionally 90,740 Community Health Officers (CHOs) were hired.

General Duty Medical Officers (GDMOs), specialists, staff nurses, ANMs, AYUSH doctors, public health managers,

FY 2022-23

4.21 lakh

Includes 1.29 lakh Community Health Officers (CHOs)

FY 2023-24

5.23 lakh

Includes 1.38 lakh Community Health Officers (CHOs)

These efforts helped strengthen the healthcare delivery system, especially at the community level.

3. Support During COVID-19 Pandemic

  1. 220 crore COVID-19 vaccine doses administered from January 2021 to March 2024.
  2. India COVID-19 Emergency Response and Health Systems Preparedness Package (ECRP) was Implemented in two phases, strengthening the healthcare system during the pandemic.

4. Disease Control and Elimination

  1. Tuberculosis (TB):

    1. TB incidence reduced from 237 per 1,00,000 (2015) to 195 per 1,00,000 (2023).
    2. TB mortality reduced from 28 per 1,00,000 (2015) to 22 per 1,00,000 (2023).

  2. Malaria:

    1. 2021: Malaria cases reduced by 13.28%, and deaths decreased by 3.22% compared to 2020.
    2. 2022: Increased malaria surveillance and cases by 32.92% and 9.13% respectively, but deaths decreased by 7.77% compared to 2021.
    3. 2023: Increased malaria surveillance and cases by 8.34% and 28.91%, respectively, compared to 2022.

  3. Kala-Azar Elimination:

    1. 100% of endemic blocks achieved the target of less than one case per 10,000 population by the end of 2023.

  4. Measles-Rubella Elimination Campaign:

    1. Over 34.77 crore children were vaccinated under the Intensified Mission Indradhanush (IMI) 5.0, achieving 97.98% coverage.

5. Specialized Health Initiatives

  1. In Pradhan Mantri TB Mukt Bharat Abhiyaan, 1.56 lakh Ni-kshay Mitra volunteers registered, supporting over 9.4 lakh TB patients.
  2. In Pradhan Mantri National Dialysis Programme (PMNDP), Over 62.35 lakh hemodialysis sessions were provided in FY 2023-24, benefiting over 4.53 lakh dialysis patients.
  3. In the National Sickle Cell Anemia Elimination Mission, 2.61 crore individuals in tribal areas screened for sickle cell disease, with efforts to eliminate it by 2047.

6. Digital Health Initiatives

  1. U-WIN Platform:

    1. Launched in January 2023, the platform tracks vaccinations for pregnant women, infants, and children.
    2. By FY 2023-24, the platform expanded to 65 districts across 36 states/UTs, improving immunization coverage and vaccination tracking.

7. Healthcare Infrastructure and Services Expansion

  1. 7,998 public health facilities certified under National Quality Assurance Standards (NQAS), with over 4,200 receiving national certification.
  2. 1,72,148 Ayushman Arogya Mandir (AAM) centers were operational by FY 2023-24, with 1,34,650 centers offering 12 key healthcare services.
  3. 24x7 Primary Health Centres (PHCs): By March 2024, 12,348 PHCs converted to 24x7 services.
  4. 3,133 First Referral Units (FRUs) operational across the country.
  5. 1,424 Mobile Medical Units (MMUs) now operating to ensure healthcare access in remote and underserved areas.
  6. MMU Portal: Introduced in 2023, enhancing monitoring and data collection on health indicators, especially for vulnerable tribal groups.

8. Public Health Campaigns and Focus Areas

  1. NHM’s campaigns and the enforcement of tobacco control laws contributed to a 17.3% reduction in tobacco use over the last decade.
  2. National Action Plan for Snakebite Envenoming (NAPSE) was Launched in FY 2022-23, focusing on prevention, education, and management of snakebites.

Background of National Health Mission (NHM):

  1. Launch of the National Rural Health Mission (NRHM) - 2005:

    1. The NRHM was introduced in 2005 with the goal of building strong public health systems to ensure accessible, affordable, and quality healthcare for rural populations, especially for vulnerable groups.
    2. The program aimed to provide healthcare services up to District Hospital (DH) levels in rural areas.

  2. Introduction of National Urban Health Mission (NUHM) - 2012:

    1. In 2012, the National Urban Health Mission (NUHM) was introduced to focus on healthcare needs in urban areas.
    2. The NRHM was then renamed to National Health Mission (NHM), combining both NRHM and NUHM as two sub-missions under NHM.

  3. Approval for Continuation of NHM (2017-2020):

    1. In March 2018, the Cabinet approved the continuation of NHM from April 1, 2017, to March 31, 2020.

  4. Interim Extension for NHM (2020-2021):

    1. On January 10, 2020, the Ministry of Finance extended NHM's funding until March 31, 2021, or until the recommendations of the 15th Finance Commission were implemented.

  5. Long-Term Extension of NHM (2021-2026):

    1. In February 2022, the Ministry of Finance extended NHM’s framework for another 5 years (April 2021 to March 2026), subject to financial norms and recommendations from the Expenditure Finance Committee (EFC).

  6. Cabinet's Annual Progress Review:

    1. The Cabinet also required that an annual progress report on NHM be submitted, covering any changes in financial norms, modifications to ongoing schemes, and details of new schemes.

Implementation Strategy of NHM:

The National Health Mission is implemented by the Ministry of Health and Family Welfare and follows a strategic approach to ensure effective healthcare delivery across India, particularly for poor and vulnerable populations.

1. Financial and Technical Support to States/UTs:

  1. NHM provides both financial and technical support to states and Union Territories (UTs) to help them provide effective, affordable, and accountable healthcare services.
  2. The focus is on enhancing healthcare services up to the District Hospital (DH) level, ensuring equitable healthcare for all.
  3. NHM has a special focus on bridging gaps in rural healthcare, through:
    1. Improved health infrastructure.
    2. Increasing human resources like healthcare workers and medical professionals.
    3. Improved service delivery in rural areas to ensure better healthcare access for underserved populations.
  4. The program emphasizes decentralizing decision-making to the district level, allowing local health authorities to identify needs and implement designed interventions.
  5. This approach helps in better resource utilization, improving healthcare responses to local challenges.
  6. The NHM promotes inter-sectoral convergence, meaning it encourages collaboration between various sectors (like health, education, and nutrition) to improve overall public health.
  7. A key goal of NHM is to provide healthcare to vulnerable and marginalized groups, ensuring equal access to quality healthcare services for all sections of society.

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