What is the National Health Mission and how is it structured?
The National Rural Health Mission (NRHM) was launched by the Prime Minister on 12 April 2005 to give accessible, affordable and quality care to the rural population, especially vulnerable groups. On 1 May 2013 the Union Cabinet approved the National Urban Health Mission (NUHM) as a sub-mission of an over-arching National Health Mission (NHM), with NRHM as the other sub-mission.
- Special-focus states under NRHM: the Empowered Action Group (EAG) states, the North-Eastern states, Jammu and Kashmir and Himachal Pradesh.
- Aim: a fully functional, community-owned, decentralised health system with convergence on water, sanitation, education, nutrition and gender equality.
- Funding (NCD example): NCD funds reach states through the NCD flexi-pool in each state Programme Implementation Plan (PIP), shared 60:40 between Centre and State (90:10 for North-Eastern and hilly states).
What targets did the National Health Mission set?
The NHM framework lists the indicators the mission works towards (Box 1 on nhm.gov.in). They are a favourite source of one-line questions because each target is a round number.
| Indicator | NHM goal |
|---|---|
| Maternal mortality ratio (MMR) | 1 per 1,000 live births |
| Infant mortality rate (IMR) | 25 per 1,000 live births |
| Total fertility rate (TFR) | 2.1 |
| Anaemia | Prevent and reduce anaemia in women aged 15–49 years |
| Tuberculosis | Halve annual incidence and mortality |
| Leprosy | Prevalence under 1 per 10,000 and incidence zero in all districts |
| Malaria | Annual incidence under 1 per 1,000 |
| Lymphatic filariasis | Microfilaria prevalence under 1% in all districts |
| Kala-azar | Elimination by 2015 — under 1 case per 10,000 in all blocks |
| Out-of-pocket spending | Reduce household out-of-pocket expenditure |
Which national health programmes are most important and when did they start?
| Programme | Year | Key point |
|---|---|---|
| National Leprosy Control Programme → NLEP | 1955 → renamed 1983 | Multidrug therapy introduced in India in 1983 |
| National TB Programme → RNTCP → NTEP | 1962 → renamed NTEP on 1 January 2020 | Goal: end TB by 2025, five years ahead of the SDG target |
| NPCB (National Programme for Control of Blindness) | 1976 | India was the first country to launch a national blindness-control programme; centrally sponsored |
| NMHP (National Mental Health Programme) | 1982 | District Mental Health Programme added in 1996 on the Bellary model |
| NACP (National AIDS Control Programme) | 1992 | Run in phases (NACP I, II, III …) |
| JSY (Janani Suraksha Yojana) | 2005 | Cash incentive for institutional delivery under NRHM |
| NPCDCS → NP-NCD | 2010 → renamed 2023 | NCD cells and NCD clinics at district and CHC level |
| JSSK (Janani Shishu Suraksha Karyakram) | 1 June 2011 | Free entitlements for pregnant women and sick newborns (later sick infants) |
| RBSK (Rashtriya Bal Swasthya Karyakram) | 2013 | Screens children 0–18 years for the 4 Ds: defects at birth, deficiencies, diseases, developmental delays |
| RKSK (Rashtriya Kishor Swasthya Karyakram) | 7 January 2014 | Adolescent health — 253 million adolescents |
| Ayushman Bharat — AAM (HWCs) and PM-JAY | 2018 | Comprehensive primary care + hospital insurance |
What are the key facts about NTEP (the TB programme)?
India's national TB effort began in 1962. The Revised National TB Control Programme (RNTCP) was renamed the National Tuberculosis Elimination Programme (NTEP) with effect from 1 January 2020, reflecting the goal of eliminating TB by 2025, five years ahead of the global End TB/SDG target of 2030.
- Diagnosis — TB is confirmed by demonstrating bacilli in a clinical specimen; rapid molecular NAAT also detects rifampicin resistance.
- Treatment is free at all government and identified private and NGO treatment centres.
- Infectiousness — microbiologically confirmed pulmonary TB patients are no longer infectious once they have taken at least 2 weeks of anti-TB treatment; extrapulmonary TB is not infectious.
- Community support — the Ni-kshay Mitra initiative under Pradhan Mantri TB Mukt Bharat Abhiyaan was launched on 9 September 2022 for nutritional and social support to patients.
- Helpline — toll-free 1800-11-6666; the TB Aarogya Saathi app lists treatment centres.
- Progress quoted by NHM: TB incidence fell from 237 per lakh (2015) to 195 (2023) and mortality from 28 to 22 per lakh.
Which diseases does the vector-borne disease programme cover?
The National Center for Vector Borne Diseases Control (NCVBDC) runs the umbrella National Vector Borne Disease Control Programme (NVBDCP) for six diseases: malaria, Japanese encephalitis, dengue, chikungunya, kala-azar and lymphatic filariasis. States implement the programme; NCVBDC gives technical and financial support.
| Group | Diseases |
|---|---|
| Targeted for elimination | Malaria, lymphatic filariasis, kala-azar |
| Outbreak-prone and climate-sensitive | Malaria, dengue, Japanese encephalitis |
| Others in the programme | Chikungunya |
How are non-communicable diseases and mental health covered?
NHM notes that non-communicable diseases account for about 60% of all deaths in India. The NPCDCS (National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke) was launched in 2010, piloted in 100 districts of 21 states in 2010–12, and renamed NP-NCD in 2023.
- NCD cells at national, state and district level for programme management.
- NCD clinics at district hospitals and CHCs for early diagnosis, treatment and follow-up, with free diagnostics and drugs.
- Cardiac care units in identified districts and day-care centres for cancer care.
- Opportunistic screening for diabetes, hypertension and common cancers from the sub-centre level upwards.
The National Mental Health Programme (NMHP) has run since 1982 to ensure minimum mental healthcare for all, especially the vulnerable, and to integrate mental health into general healthcare. Its District Mental Health Programme (DMHP) began in 1996 (IX Five Year Plan) on the Bellary model — early detection and treatment, training general physicians and health workers, public awareness and simple record-keeping.
Which maternal, child and adolescent schemes should you know?
| Scheme | Launched | What it does |
|---|---|---|
| Janani Suraksha Yojana (JSY) | 2005 | Cash incentive to promote institutional delivery |
| Janani Shishu Suraksha Karyakram (JSSK) | 1 June 2011 | Free and cashless delivery including C-section, drugs, diagnostics, diet, blood and transport (with drop-back after 48 hours); free care for sick newborns up to 30 days, now expanded to sick infants |
| Rashtriya Bal Swasthya Karyakram (RBSK) | 2013 | Early identification and management of 32 conditions in children aged 0–18 years under the 4 Ds — defects at birth, developmental delays, diseases and deficiencies |
| Rashtriya Kishor Swasthya Karyakram (RKSK) | 7 January 2014 | Reaches 253 million adolescents — male and female, rural and urban, married and unmarried, in and out of school |
| School Health & Wellness Programme | February 2020 | Health promotion in schools under Ayushman Bharat; two trained teachers per school |
What are Ayushman Arogya Mandirs and PM-JAY?
Ayushman Bharat has two complementary components. The first transforms 1,50,000 sub-health centres, PHCs and urban PHCs into Ayushman Arogya Mandirs (originally Health and Wellness Centres) delivering comprehensive primary health care — preventive, promotive, curative, rehabilitative and palliative — free at the point of use. The first centre opened in Bijapur, Chhattisgarh in April 2018; over 17,000 were working in the first year against a target of 15,000.
The second component, Pradhan Mantri Jan Arogya Yojana (PM-JAY), launched in 2018, gives health insurance cover of five lakh rupees per family per year to over 10 crore poor and vulnerable families for secondary and tertiary hospital care.
Which programme facts are most often confused in the exam?
- NRHM 2005 vs NHM 2013 — NRHM came first; NHM is the umbrella created when NUHM was approved in 2013.
- Leprosy 1955 vs 1983 — 1955 is the control programme; 1983 is both the rename to NLEP and the start of multidrug therapy in India.
- TB 1962 vs 2020 — 1962 is the original national programme; 2020 is only the rename from RNTCP to NTEP.
- NMHP 1982 vs DMHP 1996 — the district programme (Bellary model) came 14 years after the national programme.
- NPCDCS 2010 vs NP-NCD 2023 — same programme, new name; NCD clinics sit at district hospitals and CHCs.
- JSY 2005 vs JSSK 2011 — cash incentive vs free entitlements.
- RBSK (0–18 years, 4 Ds) vs RKSK (adolescents, 2014) — child screening vs adolescent health.
- AAM vs PM-JAY — free primary care at upgraded SHCs/PHCs vs insurance for secondary and tertiary hospital care.
- Elimination vs control — among vector-borne diseases only malaria, lymphatic filariasis and kala-azar are targeted for elimination.