Achievements made under NRHM and NUHM

New Delhi: National Health Mission (NHM) envisages achievement of universal access to equitable, affordable & quality health care services that are accountable and responsive to people’s needs. NHM encompasses its two Sub-Missions, the National Rural Health Mission (NRHM) and the National Urban Health Mission (NUHM). The main programmatic components include Health System Strengthening in rural and urban areas, Reproductive-Maternal- Neonatal-Child and Adolescent Health (RMNCH+A) and Communicable and Non-Communicable Diseases.

Public Health & Hospital is a State subject, hence, the responsibility of strengthening public healthcare system, especially to rural & vulnerable population, including strengthening of existing health/ medical facilities lies with the respective State/ UT Governments. Under National Health Mission (NHM), Ministry of Health & Family Welfare, Government of India provides financial and technical support to States/UTs including support for health/ medical facilities, upto District Hospital level, based on the proposals submitted by States/UTs in their Program Implementation Plans (PIPs). Government of India provides approval for the proposals in the form of Record of Proceedings (RoPs) as per available resources.

Government of India extends supports to states to expedite the process of creating health infrastructure as per Indian Public Health Standards. These standards include norms for services, infrastructure, human resource, diagnostics, equipment, medicines etc.

Under Ayushman Bharat, the existing Sub-health Centres (SHCs) and Primary Health Centres (PHCs) are transformed into AB-HWCs to deliver twelve packages of Comprehensive Primary Health Care (CPHC) that includes preventive, promotive, curative, palliative and rehabilitative services which is universal, free and close to the community. Another essential component of Ayushman Bharat Health & Wellness Centres (AB-HWCs) is the roll out of tele-consultation services through ‘eSanjeevani’. This platform provides telemedicine services for the communities through a hub and spoke model which connects AB-HWCs (spokes) to District Hospitals/Medical colleges (Hubs) for specialist consultation services. Teleconsultation services are aimed to improve access of specialist services to the communities, especially in the rural areas.

Further, following steps have been taken for strengthening healthcare systems to cater to future healthcare needs:

“Emergency Response and Health Systems Preparedness Package – II (ECRP-II)” for Rs. 23,123 Crore, including Central Component, was approved by Cabinet to extend support to the States/UTs for establishing District Paediatric Units (including Oxygen Supported beds and ICU beds) in all the Districts of the Country. Besides, support is also provided to increase the availability of ICU beds in Government health facilities. Maintaining buffer stock of essential medicines required for effective COVID management, in addition to provision for required drugs and diagnostics, is also supported. Support is also available for establishing field hospitals (100 bedded or 50 bedded units), wherever required.

PM Ayushman Bharat Health Infrastructure Mission (PM-ABHIM) with an outlay of Rs. 64,180 crores till 2025-26 envisages increased investments in public health and other health reforms to provide better access to health in rural areas by i) Strengthening of Health and Wellness Centres in villages and cities for early detection of diseases; ii) Addition of new critical care-related beds at district level hospitals; iii) Support for Block Public Health Units (BPHU) in 11 high focus States; and iv) Integrated district public health laboratories in all districts.

The recommendations of 15th Finance Commission (FC-XV) w.r.t Health Grants through Local Governments announced in Union Budget 2021-22, addresses the gaps in Primary Healthcare facilities.

The Pradhan Mantri Swasthya Suraksha Yojana (PMSSY) aims at correcting regional imbalances in the availability of affordable tertiary healthcare services and to augment facilities for quality medical education in the country. The Scheme has two components, namely, (i) Setting up of All India Institute of Medical Sciences (AIIMS); and (ii) Upgradation of existing Government Medical Colleges/ Institutions (GMCIs). So far setting up of 22 new AIIMS and 75 projects of upgradation of GMCIs have been approved under the Scheme in various phases. The setting up of AIIMS contains Medical College, Nursing College, Hospital, Trauma Centre, Emergency, Blood Bank, ICU, Diagnostic & Pathology, Research etc. Upgradation of GMCIs under PMSSY broadly involves construction of Super Speciality Block (SSB) and/ or Trauma Centre/ or other facilities and/ or procurement of medical equipment. Under the Centrally Sponsored Scheme (CSS) , ‘Establishment of new medical colleges attached with existing district/referral hospitals’, establishment of 157 medical colleges has been sanctioned.

The Union Minister of State for Health and Family Welfare, Dr. Bharati Pravin Pawar stated this in a written reply in the Rajya Sabha today.

Sunil Kumar Dhangadamajhi

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