Indian health ministry

The Indian Health Ministry is a part of Indian Government and is responsible for provision of health care / health services for all Indian residents. It also has a special department for new drugs approvals. India is entering global pharmaceutical market and these functions of the Indian Health Ministry are pivotal for successful inclusion of India into global health system.

The Government of India has mandated an increase in expenditure on health, with main focus on Primary Health Care from current level of 0.9% of GDP to 2-3% of GDP over the next five years. The National Rural Health Mission (NRHM) which is the main vehicle for giving effect to the above mandate was launched on 12.4.05 by Hon’ble Prime Minister of India. It is being operationalized throughout the country, with special focus on 18 states which includes 8 Empowered Action Group States (Bihar, Jharkhand, Madhya Pradesh, Chhattisgarh, Uttar Pradesh, Uttaranchal, Orissa and Rajasthan), 8 NE States, Himachal Pradesh and Jammu & Kashmir.

The main aim of National Rural Health Mission is to provide accessible, affordable, accountable, effective and reliable primary health care facilities, especially, to the poor and vulnerable sections of the population. It also aims at bridging the gap in Rural Health care services through creation of a cadre of Accredited Social Health Activists (ASHA) and improved hospital care, decentralization of programme to district level to improve intra and inter-sectoral convergence and effective utilization of resources. The NRHM further aims to provide overarching umbrella to the existing programmes of Health and Family Welfare including Reproductive & Child Health - Phase II, Vector Borne Diseases, Blindness, Iodine deficiency,, Tuberculosis, Leprosy and Integrated Disease Surveillance. Further, it addresses the issue of health in the context of sector-wide approach addressing sanitation and hygiene, nutrition and safe drinking water as basic determinants of good health in order to have greater convergence among the related social sector Departments i.e. AYUSH (Indian Systems of Medicine), Women & Child Development, Sanitation, Elementary Education, Panchayati Raj and Rural Development. The expected outcomes of the Mission include reduction of IMR to 30/1000 live births, MMR to 100/100,000 live births & TFR to 2.1 by 2012. Further the Mission envisages guaranteed service delivery at all health facilities and quantifiable deliverables for all national disesase Control Programmes.

The Mission further seeks to build greater ownership of the programme among the community through involvement of Panchayati Raj Institutions, NGOs and other stake holders at National, State, District and Sub-District levels to achieve the goals of National Population Policy 2000 and National Health Policy.

The first year of the Mission was the Preparatory phase during which the states were setting up the institutional framework of the Mission including the Merger of various departments in the health sector, constituting the State and District Health Missions, and notifying the State Heath Societies formed by converging the several societies relating to the various national programmes. At the GoI level, the detailing of the various strategies of NRHM was being firmed up during the year through a detailed process of stakeholder consultations where the state representatives, NGOs, public health experts and related departments. The guidelines for various activities under the Mission were disseminated to the states during the year and the same were then forwarded to the ground level functionaries for Operationalisation.

The detailed Framework for Implementation of NRHM was finalised after discussions with various stakeholders including State Governments, Public Health experts, Civil Society representatives, other departments of the Government and multilateral donor agencies. The framework received formal approval during the year 2006-07. The Framework, articulates the goals, major strategies and time lines for various activities under NRHM. It elucidates overarching umbrella status of the Mission and provides a road map as well as inclusive norms for additional activities to be undertaken as part of the NRHM.

National Rural Health Mission (NRHM) is a historic opportunity in the largest democraty in the world (home to over 1.14 billion humans) to carry out comprehensive health sector reforms. The NRHM is not a schem or programme or project of the Government of INdia. It is a sector wide reform mechanism which seeks to bring about comprehensive rejuvination of all aspects of the health system. Resarchers in Public Health would not be able to ignore the learnings (and failures) of NRHM when health sector reforms are planned by any country.