NATIONAL HEALTH

PROGRAMS

- DR. HARYAX PATHAK

NATIONAL
HEALTH MISSION

 Framework of all
National Health
Programs in India
 2 Sub-missions –
 National Rural Health
Mission (NRHM)
 National Urban Health
Mission (NUHM)
 NATIONAL HEALTH MISSION -
COMPONENTS

NHM

NRHM NUHM

NON-
COMMINUNICABLE HEALTH SYSTEMS INFRASTRUCTURE
RMNCH+A COMMUNICABLE
DISEASE CONTROL STRENGTHENING MAINTENANCE
DISEASE CONTROL
 NATIONAL HEALTH MISSION -
FRAMEWORK

 NATIONAL LEVEL
 Mission Steering Group (MSG) headed by the Union Minister for Health & Family
Welfare
 Empowered Programme Committee (EPC) headed by the Union Secretary for
Health & FW
 The EPC will implement the Mission under the overall guidance of the MSG.
NATIONAL
HEALTH
MISSION -
FRAMEWORK
 NATIONAL RURAL HEALTH MISSION
(NRHM)

AIM: Provide accessible, affordable and quality health care to the rural
population, especially the vulnerable groups.

Under the NRHM, the Empowered Action Group (EAG) States, as well as the North-
Eastern States, Jammu and Kashmir and Himachal Pradesh, have been given
special focus.
Establish a fully functional, community-owned, decentralized health delivery system
with inter-sectoral convergence at all levels.

Ensure simultaneous action on a wide range of determinants of health such as

water, sanitation, education, nutrition, social and gender equality.
  Objectives
 Reduction in child and maternal mortality.
 Universal access to public services for food
and nutrition, sanitation and hygiene.
 Universal access to public health care
services with emphasis on services
NATIONAL addressing women’s and children’s health
and universal immunization.
RURAL HEALTH  Prevention and control of communicable
and non-communicable diseases,
MISSION including locally endemic diseases.

(NRHM)  Access to integrated comprehensive

primary health care.
 Population stabilization, gender and
demographic balance.
 Revitalize local health traditions &
mainstream AYUSH.
 Promotion of healthy lifestyles.
NATIONAL
RURAL
HEALTH
MISSION
(NRHM)
  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).

NATIONAL  Health Plan for each village through Village Health

Committee of the Panchayat.

RURAL HEALTH  Strengthening sub-centre through better human resource

development, clear quality standards, better community

MISSION
support and an untied fund to enable local planning and
action and more Multi Purpose Workers (MPWs).
Strengthening existing (PHCs) through better staffing and
(NRHM) –

human resource development policy, clear quality
standards, better community support and an untied fund to

CORE enable the local management committee to achieve

these standards.

STRATEGIES  Provision of 30-50 bedded CHC per lakh population for

improved curative care to a normative standard. (IPHS
defining personnel, 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.

NATIONAL  Integrating vertical Health and Family Welfare

programmes at National, State, District and Block

RURAL HEALTH 
levels.
Technical support to National, State and District Health

MISSION 
Mission, for public health management
Strengthening capacities for data collection,
(NRHM) – assessment and review for evidence-based planning,
monitoring and supervision.

CORE  Formulation of transparent policies for deployment and

career development of human resource for health.

STRATEGIES  Developing capacities for preventive health care at all

levels for promoting healthy lifestyle, reduction in
consumption of tobacco and alcohol, etc.
 Promoting non-profit sector particularly in underserved
areas
 NATIONAL URBAN HEALTH MISSION
(NUHM)

AIM: Meet health care needs of the urban population with the focus on urban
poor, by making available to them essential primary health care services and
reducing their out-of-pocket expenses for treatment.

Strengthening the existing health care service delivery system, targeting the
people living in slums and converging with various schemes relating to wider
determinants of health like drinking water, sanitation, school education, etc.

Implemented by the Ministries of Urban Development, Housing & Urban

Poverty Alleviation, Human Resource Development and Women & Child
Development.
NATIONAL
URBAN
HEALTH
MISSION
(NUHM)
NATIONAL
URBAN
HEALTH
MISSION
(NUHM)
  Improving the efficiency of public health system in
the cities by strengthening, revamping and
rationalizing existing government primary urban
NATIONAL health structure and designated referral facilities
Promotion of access to improved health care at
URBAN

household level through community-based groups :
Mahila Arogya Samitis
HEALTH  Strengthening public health through innovative
preventive and promotive action
MISSION  4 Increased access to health care through creation
of revolving fund
(NUHM) –  IT enabled services (ITES) and e- governance for

CORE improving access improved surveillance and

monitoring

STRATEGIES 


Capacity building of stakeholders
Prioritizing the most vulnerable amongst the poor
 Ensuring quality health care services
 RMNCH+A

COMMUNICABLE DISEASES

• AIDS CONTROL
• IDSP
• NTEP

NATIONAL
• NVBDCP
• NLEP

HEALTH NON-COMMUNICABLE DISEASES

PROGRAMMES •
•
NPCDCS
NPCBVI
NMHP
IN INDIA
•
• NPHCE
• NPPCD
• NTCP
• NOHP
• NPPC
• NPPMBI
• NOTTO
• NPPCF
• NIDDCP
  REPRODUCTIVE, MATERNAL, NEONATAL,
CHILD HEALTH + ADOLESCENT
 Health Outcome Goals established in
the 12th Fiver Year Plan
 Reduction of Infant Mortality Rate
(IMR) to 25 per 1,000 live births by
RMNCH+A 2017
 Reduction in Maternal Mortality Ratio
(MMR) to 100 per 100,000 live births
by 2017
 Reduction in Total Fertility Rate(TFR)
to 2.1 by 2017
RMNCH+A
 RMNCH+A - ADOLESCENT HEALTH
Adolescent nutrition; iron and folic Facility-based adolescent Information and counselling on
acid supplementation: reproductive and sexual health adolescent sexual reproductive
services: health and other health issues:
•Child Health Screening and Early Intervention
•National Iron Plus Initiative
Services
•Weekly Iron-Folic Acid supplementation •Reproductive and Sexual health information •Adolescent Health Day
and services
•‘Kishori Samooh’ under SABLA scheme
•Adolescent Information and Counselling (Ministry of Women and Child Development)
Centre – Sub-centre level
•Teen Clubs (Nehru Yuva Kendra Sangathan,
•Adolescent Health Clinics under the Ministry of Sports & Youth Affairs)

Menstrual hygiene: Preventive health check-ups:

•Free Days – Sanitary Pads •School Health Programme

•Screening, basic health services and referral
•Immunization
•Micronutrient supplementation (IFA, Vitamin
A)
•De-worming
 RMNCH+A – PREGNANCY AND CHILDBIRTH

Preventive use of folic acid in Antenatal care package and Skilled obstetric care and Emergency obstetric and
peri-conception period tracking of high-risk pregnancies Immediate essential newborn newborn care
care and resuscitation
•Folic acid supplementation – 3 months •Nishchay – Pregnancy testing kits •Maternal and Child Health Wing
before and 3 months after conception •Mother and Child Tracking System •Janani Suraksha Yojana (JSY)
•Planning of pregnancy •Anemia treatment •Janani Shishu Suraksha Karyakram (JSSK)
•Birth Spacing •PPTCT •Navjat Shishu Suraksha Karyakram (NSSK)

Postpartum care for mother and

Postpartum IUCD and sterilisation Implementation of PC&PNDT Act
newborn
 RMNCH+A – NEWBORN AND CHILDCARE
Home-based newborn care and Facility-based care of the sick Child nutrition and essential
prompt referral newborn micronutrients supplementation

• Immediate post-natal care upto 42 days – • Special Newborn Care Units (SNCU) • Monitor Low Birth Weight babies
ASHA workers • Newborn Stabilisation Unit (NBSU) • Iron-Folic acid supplementation
• JSSK • De-worming
• Nutritional Rehabilitation Centres

Integrated management of Immunisation Early detection and management

common childhood illnesses of defects at birth, deficiencies,
(diarrhoea, pneumonia and diseases and disability in children
• Universal Immunisation Programme
malaria) (0–18 years)

• Integrated Management of Neonatal and • Child Screening and early Intervention

Childhood Illnesses (IMNCI) Services
• 4Ds – Defects, Diseases, deficiencies,
Developmental delays
 RMNCH+A – REPRODUCTIVE YEARS
Community-based promotion Promotion of spacing methods Sterilisation services
and delivery of contraceptives
• Birth spacing • Promote non-scalpel vasectomy –
• Doorstep delivery of condoms, OCPs, • IUCD insertion – 5-10 years increase male participation
Emergency Contraceptive Pills • Minilap, Laparoscopic Tubectomy
• IEC and BCC

Comprehensive abortion care Prevention and management of

sexually transmitted and
reproductive infections (STI/RTI)
• Medical Termination of Pregnancy Act

• Collaboration with National AIDS Control

Programme
• Colour coded Syndromic management
kits
  Civil Registration System
 Web-based Maternal and Child Tracking
System
 Name based tracking of mother and
children upto 3 years
RMNCH+A –  Maternal Death Review
MONITORING  Perinatal and Child Death Review
AND  Health Management Information System
(HMIS)
EVALUATION  Review Missions
 National Surveys
 Rapid Programme Assessments
 Leveraging Technology
 COMMUNICABLE DISEASES

AIDS Control
Integrated Disease Surveillance Programme
National Tuberculosis Elimination Programme
National Vector Borne Disease Control Programme
National Leprosy Eradication Programme
NON-COMMUNICABLE DISEASES

National Programme for Prevention & Control of Cancer, Diabetes, Cardiovascular Diseases & Stroke (NPCDCS)
National Programme For Control Of Blindness & Visual Impairment (NPCBVI)
National Mental Health Programme (NMHP)
National Programme for healthcare of Elderly (NPHCE)
National Programme for the Prevention & Control of Deafness (NPPCD)
National Tobacco Control Programme (NTCP)
National Oral Health Programme (NOHP)
National Programme for Palliative care (NPPC)
National Programme for Prevention & Management of Burn Injuries (NPPMBI)
•National Organ Tissue and Transplant Organization (NOTTO)
•National Programme for Prevention & Control of Flurosis (NPPCF)
•National Iodine Deficiency Disorders Control Programme
National OBJECTIVES

Programme for •Health promotion through behaviour change with involvement of

community, civil society, community-based organizations, media etc.

Prevention &
•Screening at all levels in the health care delivery system from sub-centre
and above for early detection of diseases covered under the program
including management and follow up.
Control of •To build capacity at various levels of health care for prevention, early
diagnosis, treatment, rehabilitation, IEC/BCC, operational research and
Cancer, rehabilitation.
•To provide logistic support for diagnosis and cost-effective treatment at
Diabetes, primary, secondary and tertiary levels of health care.
•To support for development of database of NCDs through Surveillance

Cardiovascular System and to monitor NCD morbidity and mortality and risk factors.

STRATEGIES
Diseases & •Health promotion awareness generation and promotion of healthy lifestyle

Stroke •Screening and early detection

•Timely affordable and accurate diagnosis

(NPCDCS) •Access to affordable treatment

•Rehabilitation
NPCDCS –
ORGANIZATIONAL
FRAMEWORK
  GOALS & OBJECTIVES
 To reduce the backlog of blindness through
identification and treatment of blind at
primary, secondary and tertiary levels based
on assessment of the overall burden of visual
impairment in the country.
National  Develop and strengthen the strategy of
NPCBVI for “Eye Health” and prevention of
Programme For visual impairment; through provision of
comprehensive eye care services and quality
service delivery.
Control Of  Strengthening and upgradation of RIOs to
Blindness & become centre of excellence in various sub-
specialities of ophthalmology

Visual  Strengthening the existing and developing

additional human resources and infrastructure
facilities for providing high quality
Impairment comprehensive Eye Care in all Districts of the
country;
(NPCBVI)  To enhance community awareness on eye
care and lay stress on preventive measures;
 Increase and expand research for prevention
of blindness and visual impairment
 To secure participation of Voluntary
Organizations/Private Practitioners in eye Care
National
Programme For
Control Of
Blindness &
Visual
Impairment
(NPCBVI)
  COMPONENTS
 Treatment of Mentally ill
 Rehabilitation
 Prevention and promotion of positive mental health.
 OBJECTIVES
 To ensure the availability and accessibility of minimum
mental healthcare for all in the foreseeable future;

National Mental  To encourage the application of mental health

knowledge in general healthcare and in social

Health
development;
 To promote community participation in the mental
health service development; and
Programme  To enhance human resource in mental health sub-
specialties.
(NMHP)  STRATEGIES
 Integration mental health with primary health care
through the NMHP
 Provision of tertiary care institutions for treatment of
mental disorders
 Eradicating stigmatization of mentally ill patients and
protecting their rights through regulatory institutions
like the Central Mental Health Authority, and State
Mental health Authority.
  DISTRICT MENTAL HEALTH PROGRAM
 Envisages provision of basic mental health
care services at the community level.

National  Objectives

Mental Health  To provide sustainable basic mental health

services to the community and to integrate
these services with other health services
Programme  Early detection and treatment of patients

(NMHP) 
within the community itself
To reduce the stigma of mental illness through
public awareness.
 To treat and rehabilitate mental patients
within the community.
 Millennium Development
Goals – 2000-2015

SUSTAINABLE Post-2015 – MDG replaced by

DEVELOPMENT 17 Sustainable Development
GOALS Goals

SDG-3 - Ensure healthy lives

and promote well-being for all
ages
SDG-3 – HEALTH RELATED TARGETS