National Rural Health Mission of India
Encyclopedia
National Rural Health Mission of India(NRHM) is a program and scheme run by the ministry of health under government of India. The mission was launched on 5th April 2005 for period of 7 years (2005-2012). The mission helps and seeks to improve the health care delivery system. This mission is operational in whole of India with special focus on 18 states Arunachal Pradesh
, Assam
, Bihar
, Chhattisgarh
, Himachal Pradesh
, Jharkhand
, Jammu and Kashmir
, Manipur
, Mizoram
, Meghalaya
, Madhya Pradesh
, Nagaland
, Orissa
, Rajasthan
, Sikkim
, Tripura
, Uttarkhand and Uttar Pradesh
. It is undoubtedly the most ambitious rural health initiative ever been implemented in the country focusing on the above states which are poor and populous.
The primary aim of this mission is to provide accesible, accountable, affordable, effective and reliable health care service to the people of India residing in villages. It also aims proper hygiene
and sanitation
system and to make a synergistic approach by integrating other health programs and other Indian system of medicine. The creation of a Village health worker known as Accredited Social Health Activist(ASHA) to bring the primary health care and basic health care to the people.
and has increased its population to 181 million in a decade. By 2030 India will overtake china in population. Increase in population will have great stress on economy, providing nutrition and will also effect overall health status of the country..
at birth in India was estimated to be 53.5 in 2002. This was 53.3 for males and 53.6 for females
Life expectancy at birth has increased for male and female in India. It is 64.1 years for males and 65.8 years for females (2005). This has revealed the decrease in death rate and the better improvement of quantity and quality health services in India. However, there are inter-state, inter-district and rural-urban differences in life expectancy at birth due to low literacy, differential income levels and socioeconomic conditions and beliefs. In Kerala, a person at birth is expected to live for 73 years while in states like Bihar, Assam, Madhya Pradesh, Uttar Pradesh, etc, the expectancy is in the range of 55-60 years.
A World Health Report (1999) gives the main causes of death
in India as noncommunicable diseases (48 percent), communicable diseases (42 percent) and injuries (10 percent). The dominant communicable diseases are infectious and parasitic diseases, respiratory diseases, maternal conditions, perinatal conditions and nutritional deficiencies. Non-communicable diseases are malignant neoplasm, diabetes mellitus
, neuropsychiatric disorders, sense organ disorders, cardiovascular diseases, respiratory diseases, digestive diseases, musculo-skeletal diseases, congenital anomalies, oral diseases and other non-communicable diseases
, tuberculosis
, jaundice
, malaria
. In India around 2,468 persons per 100,000 populations were reported to be suffering from asthma at the time of survey. The prevalence
of asthma is high in rural areas than in urban areas and is slightly higher in males than in females. The overall prevalence of tuberculosis in India is 544 per 100,000 populations. This is 16 percent higher than the survey done by NFHS-I (467 per 100,000). It is more in case of rural areas than in urban areas and more for male than females. It is more in males because of males are in contact with more people who might have TB and smoking is more in men. The prevalence of TB increases with age. Jaundice cases were reported to be 1361 persons per 100,000 populations. This is more prevalent in rural areas than in urban areas. However, it decreases with age. Thus, highest numbers of jaundice patients are in the age of 0-14. 3,697 persons per 100,000 populations were reported to have suffered from malaria. People of rural area suffer twice than that of urban area and it is slightly high for males than for females. All these diseases however vary and differ from state to state depending on the climate and geographical locations of the areas
According to ICMR (Indian council of Medical Research), cataract
is the main cause of 55 percent of blindness. The major causes of blindness as seen in the survey conducted by the National Programme for Control of Blindness (NCB), included cataract, refractive errors, corneal opacity, glaucoma
, trachoma
and vitamin A deficiency
.
and planning
process involved within health care. NRHM also aims to bring private sectors to help in the rural health
Arunachal Pradesh
Arunachal Pradesh is a state of India, located in the far northeast. It borders the states of Assam and Nagaland to the south, and shares international borders with Burma in the east, Bhutan in the west, and the People's Republic of China in the north. The majority of the territory is claimed by...
, Assam
Assam
Assam , also, rarely, Assam Valley and formerly the Assam Province , is a northeastern state of India and is one of the most culturally and geographically distinct regions of the country...
, Bihar
Bihar
Bihar is a state in eastern India. It is the 12th largest state in terms of geographical size at and 3rd largest by population. Almost 58% of Biharis are below the age of 25, which is the highest proportion in India....
, Chhattisgarh
Chhattisgarh
Chhattisgarh is a state in Central India, formed when the 16 Chhattisgarhi-speaking South-Eastern districts of Madhya Pradesh gained separate statehood on 1 November 2000....
, Himachal Pradesh
Himachal Pradesh
Himachal Pradesh is a state in Northern India. It is spread over , and is bordered by the Indian states of Jammu and Kashmir on the north, Punjab on the west and south-west, Haryana and Uttar Pradesh on the south, Uttarakhand on the south-east and by the Tibet Autonomous Region on the east...
, Jharkhand
Jharkhand
Jharkhand is a state in eastern India. It was carved out of the southern part of Bihar on 15 November 2000. Jharkhand shares its border with the states of Bihar to the north, Uttar Pradesh and Chhattisgarh to the west, Orissa to the south, and West Bengal to the east...
, Jammu and Kashmir
Jammu and Kashmir
Jammu and Kashmir is the northernmost state of India. It is situated mostly in the Himalayan mountains. Jammu and Kashmir shares a border with the states of Himachal Pradesh and Punjab to the south and internationally with the People's Republic of China to the north and east and the...
, Manipur
Manipur
Manipur is a state in northeastern India, with the city of Imphal as its capital. Manipur is bounded by the Indian states of Nagaland to the north, Mizoram to the south and Assam to the west; it also borders Burma to the east. It covers an area of...
, Mizoram
Mizoram
Mizoram is one of the Seven Sister States in North Eastern India, sharing borders with the states of Tripura, Assam, Manipur and with the neighbouring countries of Bangladesh and Burma. Mizoram became the 23rd state of India on 20 February 1987. Its capital is Aizawl. Mizoram is located in the...
, Meghalaya
Meghalaya
Meghalaya is a state in north-eastern India. The word "Meghalaya" literally means the Abode of Clouds in Sanskrit and other Indic languages. Meghalaya is a hilly strip in the eastern part of the country about 300 km long and 100 km wide, with a total area of about 8,700 sq mi . The...
, Madhya Pradesh
Madhya Pradesh
Madhya Pradesh , often called the Heart of India, is a state in central India. Its capital is Bhopal and Indore is the largest city....
, Nagaland
Nagaland
Nagaland is a state in the far north-eastern part of India. It borders the state of Assam to the west, Arunachal Pradesh and part of Assam to the north, Burma to the east and Manipur to the south. The state capital is Kohima, and the largest city is Dimapur...
, Orissa
Orissa
Orissa , officially Odisha since Nov 2011, is a state of India, located on the east coast of India, by the Bay of Bengal. It is the modern name of the ancient nation of Kalinga, which was invaded by the Maurya Emperor Ashoka in 261 BC. The modern state of Orissa was established on 1 April...
, Rajasthan
Rajasthan
Rājasthān the land of Rajasthanis, , is the largest state of the Republic of India by area. It is located in the northwest of India. It encompasses most of the area of the large, inhospitable Great Indian Desert , which has an edge paralleling the Sutlej-Indus river valley along its border with...
, Sikkim
Sikkim
Sikkim is a landlocked Indian state nestled in the Himalayan mountains...
, Tripura
Tripura
Tripura is a state in North-East India, with an area of . It is the third smallest state of India, according to area. Tripura is surrounded by Bangladesh on the north, south, and west. The Indian states of Assam and Mizoram lie to the east. The capital is Agartala and the main languages spoken are...
, Uttarkhand and Uttar Pradesh
Uttar Pradesh
Uttar Pradesh abbreviation U.P. , is a state located in the northern part of India. With a population of over 200 million people, it is India's most populous state, as well as the world's most populous sub-national entity...
. It is undoubtedly the most ambitious rural health initiative ever been implemented in the country focusing on the above states which are poor and populous.
The primary aim of this mission is to provide accesible, accountable, affordable, effective and reliable health care service to the people of India residing in villages. It also aims proper hygiene
Hygiene
Hygiene refers to the set of practices perceived by a community to be associated with the preservation of health and healthy living. While in modern medical sciences there is a set of standards of hygiene recommended for different situations, what is considered hygienic or not can vary between...
and sanitation
Sanitation
Sanitation is the hygienic means of promoting health through prevention of human contact with the hazards of wastes. Hazards can be either physical, microbiological, biological or chemical agents of disease. Wastes that can cause health problems are human and animal feces, solid wastes, domestic...
system and to make a synergistic approach by integrating other health programs and other Indian system of medicine. The creation of a Village health worker known as Accredited Social Health Activist(ASHA) to bring the primary health care and basic health care to the people.
Health status and problem in India
India is 2nd most populous country in the world having 1,210,193,422 peoples on 0:00hrs(IST) on 1 march 2011. It shares 17.5% of the world populationWorld population
The world population is the total number of living humans on the planet Earth. As of today, it is estimated to be billion by the United States Census Bureau...
and has increased its population to 181 million in a decade. By 2030 India will overtake china in population. Increase in population will have great stress on economy, providing nutrition and will also effect overall health status of the country..
Life expectancy
Its very notable that their occurs a bridge in overall socioeconomic and health status between urban and rural population of India and even between the states. Healthy life expectancyLife expectancy
Life expectancy is the expected number of years of life remaining at a given age. It is denoted by ex, which means the average number of subsequent years of life for someone now aged x, according to a particular mortality experience...
at birth in India was estimated to be 53.5 in 2002. This was 53.3 for males and 53.6 for females
Life expectancy at birth has increased for male and female in India. It is 64.1 years for males and 65.8 years for females (2005). This has revealed the decrease in death rate and the better improvement of quantity and quality health services in India. However, there are inter-state, inter-district and rural-urban differences in life expectancy at birth due to low literacy, differential income levels and socioeconomic conditions and beliefs. In Kerala, a person at birth is expected to live for 73 years while in states like Bihar, Assam, Madhya Pradesh, Uttar Pradesh, etc, the expectancy is in the range of 55-60 years.
Mortality
A diverse set of factors are thought to be associated with maternal mortality: factors that influence delays in deciding to seek medical care, in reaching a place where care is available, and in receiving appropriate care. The tenth plan document of India has targeted to reduce the IMR to 45 per 1000 live births by 2007 and 28 per 1000 live births by 2012. The main causes of high MMR being socioeconomic status of women, inadequate antenatal care, the low proportion of institutional deliveries|birth, and the non-availability of skilled birth attendants in two-thirds of cases.A World Health Report (1999) gives the main causes of death
Death
Death is the permanent termination of the biological functions that sustain a living organism. Phenomena which commonly bring about death include old age, predation, malnutrition, disease, and accidents or trauma resulting in terminal injury....
in India as noncommunicable diseases (48 percent), communicable diseases (42 percent) and injuries (10 percent). The dominant communicable diseases are infectious and parasitic diseases, respiratory diseases, maternal conditions, perinatal conditions and nutritional deficiencies. Non-communicable diseases are malignant neoplasm, diabetes mellitus
Diabetes mellitus
Diabetes mellitus, often simply referred to as diabetes, is a group of metabolic diseases in which a person has high blood sugar, either because the body does not produce enough insulin, or because cells do not respond to the insulin that is produced...
, neuropsychiatric disorders, sense organ disorders, cardiovascular diseases, respiratory diseases, digestive diseases, musculo-skeletal diseases, congenital anomalies, oral diseases and other non-communicable diseases
Morbidity
NFHS-II(National Family Health Survey-II) conducted a study on four major diseases prevailing in India, i.e., asthmaAsthma
Asthma is the common chronic inflammatory disease of the airways characterized by variable and recurring symptoms, reversible airflow obstruction, and bronchospasm. Symptoms include wheezing, coughing, chest tightness, and shortness of breath...
, tuberculosis
Tuberculosis
Tuberculosis, MTB, or TB is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body...
, jaundice
Jaundice
Jaundice is a yellowish pigmentation of the skin, the conjunctival membranes over the sclerae , and other mucous membranes caused by hyperbilirubinemia . This hyperbilirubinemia subsequently causes increased levels of bilirubin in the extracellular fluid...
, malaria
Malaria
Malaria is a mosquito-borne infectious disease of humans and other animals caused by eukaryotic protists of the genus Plasmodium. The disease results from the multiplication of Plasmodium parasites within red blood cells, causing symptoms that typically include fever and headache, in severe cases...
. In India around 2,468 persons per 100,000 populations were reported to be suffering from asthma at the time of survey. The prevalence
Prevalence
In epidemiology, the prevalence of a health-related state in a statistical population is defined as the total number of cases of the risk factor in the population at a given time, or the total number of cases in the population, divided by the number of individuals in the population...
of asthma is high in rural areas than in urban areas and is slightly higher in males than in females. The overall prevalence of tuberculosis in India is 544 per 100,000 populations. This is 16 percent higher than the survey done by NFHS-I (467 per 100,000). It is more in case of rural areas than in urban areas and more for male than females. It is more in males because of males are in contact with more people who might have TB and smoking is more in men. The prevalence of TB increases with age. Jaundice cases were reported to be 1361 persons per 100,000 populations. This is more prevalent in rural areas than in urban areas. However, it decreases with age. Thus, highest numbers of jaundice patients are in the age of 0-14. 3,697 persons per 100,000 populations were reported to have suffered from malaria. People of rural area suffer twice than that of urban area and it is slightly high for males than for females. All these diseases however vary and differ from state to state depending on the climate and geographical locations of the areas
Disability
4 to 14 million people are blind, 3.2 million people with hearing impairment, 16 million people are affected by locomotor disabilities and 3 percent of India's children are mentally retarded. The government of India has policies related for the disabled, rehabilitation schemes, grant-in-aid schemes and schemes run through NGOs.According to ICMR (Indian council of Medical Research), cataract
Cataract
A cataract is a clouding that develops in the crystalline lens of the eye or in its envelope, varying in degree from slight to complete opacity and obstructing the passage of light...
is the main cause of 55 percent of blindness. The major causes of blindness as seen in the survey conducted by the National Programme for Control of Blindness (NCB), included cataract, refractive errors, corneal opacity, glaucoma
Glaucoma
Glaucoma is an eye disorder in which the optic nerve suffers damage, permanently damaging vision in the affected eye and progressing to complete blindness if untreated. It is often, but not always, associated with increased pressure of the fluid in the eye...
, trachoma
Trachoma
Trachoma is an infectious disease causing a characteristic roughening of the inner surface of the eyelids. Also called granular conjunctivitis and Egyptian ophthalmia, it is the leading cause of infectious blindness in the world...
and vitamin A deficiency
Vitamin A deficiency
Vitamin A deficiency is a lack of vitamin A in humans. It is common in developing countries but rarely seen in developed countries. Night blindness is one of the first signs of vitamin A deficiency. Xerophthalmia and complete blindness can also occur since Vitamin A has a major role in...
.
Objectives and Aims of the Mission
The overall aim of the Program is to strengthen and improve the whole public health delivery and health of the rural sector. NRHM tries to improve the monitoringMonitoring
To monitor or monitoring generally means to be aware of the state of a system. Below are specific examples:* to observe a situation for any changes which may occur over time, using a monitor or measuring device of some sort:...
and planning
Planning
Planning in organizations and public policy is both the organizational process of creating and maintaining a plan; and the psychological process of thinking about the activities required to create a desired goal on some scale. As such, it is a fundamental property of intelligent behavior...
process involved within health care. NRHM also aims to bring private sectors to help in the rural health