National Review of National Health Mission

Fodder Points:

The need for innovative approaches to make the facilities at the peripheries work to avoid crowding of tertiary care facilities which impacts the quality of healthcare.

Issues on the agenda included

  • reduction of MMR,

  • IMR,

  • improving immunization and uptake of family planning measures in selected States /UTs,

  • roll out of recent initiatives such as,

  • strengthening sub Centres as Health and Wellness Centres,

  • screening for NCDs, progress in TB elimination,

  • status of preparedness for swine flu,

  • addressing HR challenges,

  • DBT payments,

  • digital payments,

  • rare diseases etc.


  • There has been considerable improvement as reflected in accelerated decline of MMR, U5MR, TFR and reversing the incidence of diseases such as TB, HIV, AIDS and Malaria, areas such as NCD prevention and control requires better response.

Cause of concern:

  • The disease burden on account of NCDs is increasing resulting in substantial economic loss for families and the nation as a whole.

What the states/UTs need to do?

  • The States/UTs to take a critical look at problem areas at all layers and resolve them through innovative approaches and new ideas. 

  • NHM provides unparalleled flexibilities to address healthcare challenges specific to State context and needs. Mission Indradhanush is not a programme but a campaign towards increasing immunisation coverage.

  • Strengthening health systems, particularly making SNCUs, FRUs and NBCCs functional with requisite HR and equipment backed by trained team for provisioning of quality services.

  • To focus on labour room protocols for intra partum care, carry out 100% Maternal Death Audit for understanding cause of maternal death and monitoring of inborn and out born deaths of sick newborns separately.

  • The states must focus on strengthening routine immunization. There is gap in initiation of early breast feeding which needs to be actively bridged through interventions/programmes such Mothers’ Absolute Affection-MAA. Complementary feeding and its quality are also issues that States need to address.

  • To utilise the NHM flexibilities to devise new strategies and sharpen existing strategies for last mile approach.

  • To start measuring service delivery and monitoring performance based on a set of deliverables with clear allocation of responsibilities and roles for incentivising and fixing accountability.

  • To co-opt the private sector as elimination of TB is not possible otherwise.


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