National Rural Health Mission of India

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.^[1]

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.^[2][3]

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 population 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.^[4].

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 expectancy 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.^[5]

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 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^[6]

Morbidity

NFHS-II(National Family Health Survey-II) conducted a study on four major diseases prevailing in India, i.e., asthma, 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^[6]

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 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^[6].

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 monitoring and planning process involved within health care. NRHM also aims to bring private sectors to help in the rural health^[1]

References

1. ^ ^{a b} Ajay Mahal, Bibek Debroy and Laveesh Bhandari (2010). India Health Report 2010. Business Standard Books. pp. 138. ISBN 9789380740003. 
2. ^ "NRHM". http://mohfw.nic.in/NRHM.htm. Retrieved September 16, 2011. 
3. ^ "National Rural Health Mission". http://india.gov.in/citizen/health/national_rural.php. Retrieved September 16, 2011. 
4. ^ "Provisional Population Totals Paper 1 of 2011 India Series 1". Census of India and Ministry of Home affairs. http://www.censusindia.gov.in/2011-prov-results/prov_results_paper1_india.html. Retrieved September 18, 2011. 
5. ^ "World Health Report 2005" (Press release). WHO. 
6. ^ ^{a b c} "Country Health System Profile-INDIA". World Health Organisation-SEAR. http://www.searo.who.int/en/Section313/Section1519_10855.htm. Retrieved September 18, 2011.