1. Background (brief history)

The National Health Mission (NHM), as well as its sub-mission the National Rural Health Mission (NRHM), were launched in 2005 by the Government of India as an arm to the Ministry of Health and Family Welfare (MOHFW) to provide equitable, affordable, and quality health care to rural populations and especially vulnerable groups 1. In 2013, an additional program, the National Urban Health Mission (NUHM) was created under the National Health Mission to make primary health care services available to the urban poor and populations and to reduce the expenses for such treatments.  The primary objectives of the National Health Mission are to strengthen state health systems, reduce maternal and infant mortality rates, provide reproductive, maternal, newborn, child health, and adolescent (RMNCH+A) services to disadvantaged populations, and control the spread of communicable and non-communicable diseases.

 

   2. Areas of expertise

• Establishing fully functional, community owned, decentralized health delivery systems with inter-sectoral convergence at all levels to ensure simultaneous action on a wide range of determinants of health such as education, nutrition, and social and gender equality.

• Mapping and identifying key health facilities as “delivery points” and strengthening them for delivery of comprehensive packages of reproductive, maternal, newborn, child health, and adolescent (RMNCH+A) services to ensure universal access to health care to populations in a district.

• Forming and monitoring central and district-wide disease surveillance units to track and control the outbreak of epidemic diseases. 

 

   3. Strengths in the ICPD

The NHM’s and the Ministry of Health and Family Welfare’s priority of providing family planning and reproductive health services to all populations of districts and regions in India aligns with the ICPD agenda. One aspect of the National Health Mission of India that illustrates this is its RMNCH+A Services strategy.  Key components of the strategy related to the ICPD agenda include:

• Strengthening and forming additional health facilities to perform safe abortions through the NHM’s  Comprehensive Abortion Care (CAC) Services

• Providing funds to states to procure medicines and equipment for medical abortions

• [IM1] Training medical officers in the medical termination of pregnancy (MTP) techniques and in providing confidential counselling for MTP and promoting post-abortion care, including adoption of contraception, etc.

• Reorganizing the existing health system to increase  the number of Adolescent Friendly Health Clinics (AFHCs)  through the NHM’S  Rashtriya Kishor Swasthya Karyakram (RKSK) program

• Training more Adolescent Health counsellors at ADHCs

• Developing community-based peer education programs to provide sexual and reproductive health education to adolescents throughout India

 

   4. Quality assurance/ previous evaluation

In its 2013-2017 Country Programme Action Plan in India, the UNFPA asserted that it would provide high quality technical assistance, on request, to the MOHFW for the adoption and implementation of the Adolescent Health Strategy at state and district levels.   Additionally, the UNFPA and MOHFW have partnered to deepen efforts to strengthen the Implementation of Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) in response to the continued decline in child sex ratio according to the results of the 2011 census.  Based on UNICEF’s 2013 Annual Report, it has provided technical assistance to national and state partners, including the Ministry of Health and Family Welfare in India, to enhance the strategic direction of the National Rural Health Mission (NRHM) to implement a continuum of care strategy focus on ensuring that infants and mothers have equitable access to quality services for child survival and development and address adolescent sexual and reproductive health programs.

 

   5. Experience in South-South Cooperation initiatives

The Ministry of Health and Family Welfare, which oversees NHM, represents India in Partnerships in Population and Development (PPD), which is an intergovernmental alliance of 26 nations that was launched at the International Conference on Population and Development (ICPD) in 1994 to use South-to-South collaboration in the fields of reproductive health, population, and development to share experiences on family planning and reproductive health.