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National rural health mission: time to take stock.

Sharma AK - Indian J Community Med (2009)

View Article: PubMed Central - PubMed

Affiliation: Department of Community Medicine, University College of Medical Sciences, Dilshad Garden, Delhi - 110 095, India.

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After groping with the challenges for decades, the planners have come up with a comprehensive mission-oriented approach to revamp the rural healthcare delivery system, which was aptly named National Rural Health Mission (NRHM) [Box 1]... The structural correction of the health system under NRHM is based on the following five principles. (1) Setting norms and standards and achieving service guarantees, (2) Innovations in the human resource development for the health sector, (3) Increasing participation and ownership by the community, (4) Improving the management capacity and (5) Flexible financing... Among the NE states, Manipur and Tripura have shown promising improvement... It is important to note that high priority states have poorer infrastructure and much less OPD attendance to begin with, thus, after the mission, the improvement of the facilities and the scope and proportion for increase in OPD attendance could have been much more, but the results do not reflect such changes... While in large non high focus states, where the status of utilization of services is already better, the resultant proportion of increase in OPD attendance is higher... In the NRHM, it is envisaged to provide basic laboratory testing facility at the PHC level and more advanced services at the CHC and DH levels... Surprisingly, the NRHM state data sheets do not contain information about laboratory facilities and its utilization... The Accredited Social Health Activist (ASHA) became the flag bearer of NRHM in rural India... NRHM has emphasized on community participation in a big way... Although in various places data entry operators are not appointed or training of manpower has not yet been done... In some places severe shortage of electricity and lack of good internet connectivity have been common hurdles in the successful implementation of HMIS as well as IDSP... Tamil Nadu and Maharashtra have good computerized HMIS systems, but most of the states still rely on manual preparation of reports, hence there is delay in transmission and hardly any analysis is undertaken... Assam, Jharkhand, Kerala, and Mizoram have been found to have very weak HMIS... National Rural Health Mission, in its endeavor to improve the healthcare delivery system in rural India may be considered as a paradigm shift in the way healthcare delivery is to be executed.

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Organizational structure of the National Rural Health Mission
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Figure 0001: Organizational structure of the National Rural Health Mission

Mentions: The NRHM framework represents a conscious decision to strengthen public health systems and the role of the state as a healthcare provider [Figure 1]. It also recognizes the need to make optimal use of the non-governmental sector to strengthen public health systems and has increased access to medical care for the poor. In order to meet the core objectives of NRHM [Table 1], increasing the public expenditure on healthcare from 0.9% of GDP to 2 – 3% of GDP in an effective manner, through an increase in the central government budgetary outlay on health and ensuring a matching increase of the states' expenditure on health by at least 10% annually is one of the major steps.(3) As a corollary, the state health sector is required to develop capacities to absorb this additional fund flow.


National rural health mission: time to take stock.

Sharma AK - Indian J Community Med (2009)

Organizational structure of the National Rural Health Mission
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2800893&req=5

Figure 0001: Organizational structure of the National Rural Health Mission
Mentions: The NRHM framework represents a conscious decision to strengthen public health systems and the role of the state as a healthcare provider [Figure 1]. It also recognizes the need to make optimal use of the non-governmental sector to strengthen public health systems and has increased access to medical care for the poor. In order to meet the core objectives of NRHM [Table 1], increasing the public expenditure on healthcare from 0.9% of GDP to 2 – 3% of GDP in an effective manner, through an increase in the central government budgetary outlay on health and ensuring a matching increase of the states' expenditure on health by at least 10% annually is one of the major steps.(3) As a corollary, the state health sector is required to develop capacities to absorb this additional fund flow.

View Article: PubMed Central - PubMed

Affiliation: Department of Community Medicine, University College of Medical Sciences, Dilshad Garden, Delhi - 110 095, India.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

After groping with the challenges for decades, the planners have come up with a comprehensive mission-oriented approach to revamp the rural healthcare delivery system, which was aptly named National Rural Health Mission (NRHM) [Box 1]... The structural correction of the health system under NRHM is based on the following five principles. (1) Setting norms and standards and achieving service guarantees, (2) Innovations in the human resource development for the health sector, (3) Increasing participation and ownership by the community, (4) Improving the management capacity and (5) Flexible financing... Among the NE states, Manipur and Tripura have shown promising improvement... It is important to note that high priority states have poorer infrastructure and much less OPD attendance to begin with, thus, after the mission, the improvement of the facilities and the scope and proportion for increase in OPD attendance could have been much more, but the results do not reflect such changes... While in large non high focus states, where the status of utilization of services is already better, the resultant proportion of increase in OPD attendance is higher... In the NRHM, it is envisaged to provide basic laboratory testing facility at the PHC level and more advanced services at the CHC and DH levels... Surprisingly, the NRHM state data sheets do not contain information about laboratory facilities and its utilization... The Accredited Social Health Activist (ASHA) became the flag bearer of NRHM in rural India... NRHM has emphasized on community participation in a big way... Although in various places data entry operators are not appointed or training of manpower has not yet been done... In some places severe shortage of electricity and lack of good internet connectivity have been common hurdles in the successful implementation of HMIS as well as IDSP... Tamil Nadu and Maharashtra have good computerized HMIS systems, but most of the states still rely on manual preparation of reports, hence there is delay in transmission and hardly any analysis is undertaken... Assam, Jharkhand, Kerala, and Mizoram have been found to have very weak HMIS... National Rural Health Mission, in its endeavor to improve the healthcare delivery system in rural India may be considered as a paradigm shift in the way healthcare delivery is to be executed.

No MeSH data available.