Achievements Under The National Rural Health Mission (NRHM)







Achievements Under The National Rural Health Mission (NRHM) 

The National Rural Health Mission (NRHM) was launched to provide accessible, affordable, accountable and effective primary healthcare facilities, especially to the poor and vulnerable sections of the population.

The targets and achievements of the National Rural Health Mission (NRHM) are given below. Certain targets as envisaged in 2005 at the launch of NRHM have not been achieved. This is because public health is a State subject and there have been issues of lack of capacities and human resource shortage in certain States and general underfunding for health sector.
Achievements up to XIth Plan.

Sl. No.
Targets (2005-12)
Achievements (up to 2012)
1
IMR reduced to 30/1000 live births
IMR reduced from 58 in 2005 (SRS) to 42 in 2012 (SRS).
2
Maternal Mortality to reduce to 100/100,000 live births
MMR reduced from 254 in 2004-06 (SRS) to 178 in 2010-12 (SRS).
3
TFR reduced to 2.1
TFR reduced from 2.9 in 2005 (SRS) to 2.4 in 2012 (SRS).
4
Malaria Mortality reduction to 60%
70% Malaria mortality reduction- (Reduced from 1707 in 2006 to 519 in 2012).
5
Kala Azar Mortality reduction to 100%
85% Kala Azar mortality reduction- (Reduced from 187 in 2006 to 29 in 2012).
6
Filaria / Microfilaria Reduction Rate to 80%
60% Filaria / Microfilaria Reduction (Reduced from 1.02 in 2005 to 0.41 in 2012)
7
Dengue Mortality reduction by 50%
8% reduction- Dengue Mortality has reduced from 184 in 2006 to 169 in 2011.
8
Cataract operations- increasing to 46 lakhs per year
Cataract operations of more than 63.49 lakhs per year have been reported in 2012.
9
Leprosy Prevalence Rate reduction to less than 1 per 10,000
Leprosy Prevalence Rate reduced from 1.34 per 10,000 in 2005 to 0.68 per 10,000 in 2012.
10
Tuberculosis Control - over 70% case detection & 85% cure rate
Tuberculosis is having 71% case detection and 88% Cure rate in 2012.

Achievements during XIIth Plan

Physical Outcomes: Targets & Achievements for NHM/12th FY Plan
Sl. No.
Targets (2012-17)
Achievements
1
Reduce IMR to 25/1000 live births
IMR reduced from 42 in 2012 (SRS) to 40 in 2013 (SRS).
2
Reduce MMR to 1/1000 live births
MMR has reduced to 167 in 2011-13 (SRS).
3
Reduce TFR to 2.1
TFR has reduced to 2.3 in 2013 (SRS).
4
Reduce annual incidence and mortality from Tuberculosis by half
Tuberculosis is having 171 incidence (per lakh population) and 19 mortality (per lakh population)  in 2013.
5
Reduce prevalence of Leprosy to <1/10000 population and incidence to zero in all districts
Leprosy Prevalence Rate  is  < 1/ 10,000 population
6
Annual Malaria Incidence to be <1/1000
Annual Malaria Incidence is <1/1000
7
Less than 1% microfilaria prevalence in all districts
Out of 255 districts, 222 have reported mf rate of less than 1%
8
Kala-Azar Elimination by 2015, <1 case per 10000 population in all blocks
Out of 611 block PHCs, 454 have  reported < 1 case per 10000






Infant Mortality Rate(IMR)
Sl. No.
    States
2005
2012

All India
58
42
1
Andhra Pr.
57
41
2
Assam
68
55
3
Bihar
61
43
4
Chhattisgarh
63
47
5
Gujarat
54
38
6
Haryana
60
42
7
Jharkhand
50
38
8
Karnataka
50
32
9
Kerala
14
12
10
Madhya Pr.
76
56
11
Maharashtra
36
25
12
Odisha
75
53
13
Punjab
44
28
14
Rajasthan
68
49
15
Tamil Nadu
37
21
16
Uttar Pradesh
73
53
17
West Bengal
38
32
18
Arunachal Pr
37
33
19
Delhi
35
25
20
Goa
16
10
21
Himachal Pradesh
49
36
22
Jammu and Kashmir
50
39
23
Manipur
13
10
24
Meghalaya
49
49
25
Mizoram
20
35
26
Nagaland
18
18
27
Sikkim
30
24
28
Tripura
31
28
29
Uttarakhand
42
34
30
Andaman and Nicobar Islands
27
24
31
Chandigarh
19
20
32
Dadra andNagar Haveli
42
33
33
Daman and Diu
28
22
34
Lakshadweep
22
24
35
Puducherry
28
17
Source: Sample Registration System, Statistical Report (Registrar General, India)




Sl. No.
India/States
2004-06
2011-13

India
254
167
1
Andhra Pradesh
154
92
2
Assam
480
300
3
Bihar/Jharkhand
312
208
4
Gujarat
160
112
5
Haryana
186
127
6
Karnataka
213
133
7
Kerala
95
61
8
Madhya Pradesh/
Chhattisgarh
335
221
9
Maharashtra
130
68
10
Odisha
303
222
11
Punjab
192
141
12
Rajasthan
388
244
13
Tamil Nadu
111
79
14
Uttar Pradesh/
Uttarakhand
440
285
15
West Bengal
141
113
Source:  Sample Registration System, Statistical Report (Registrar General, India)




Sl. No.
State
2005
2012
All India
2.9
2.4
1
Andhra Pradesh
2.0
1.8
2
Assam
2.9
2.4
3
Bihar
4.3
3.5
4
Chhattisgarh
3.4
2.7
5
Delhi
2.1
1.8
6
Gujarat
2.8
2.3
7
Haryana
2.8
2.3
8
Himachal Pradesh
2.2
1.7
9
Jammu and Kashmir
2.4
1.9
10
Jharkhand
3.5
2.8
11
Karnataka
2.2
1.9
12
Kerala
1.7
1.8
13
Madhya Pradesh
3.6
2.9
14
Maharashtra
2.2
1.8
15
Odisha
2.6
2.1
16
Punjab
2.1
1.7
17
Rajasthan
3.7
2.9
18
Tamil Nadu
1.7
1.7
19
Uttar Pradesh
4.2
3.3
20
West Bengal
2.1
1.7
Source:   Sample Registration System, Statistical Report (Registrar General, India)



Sl.No
State/UT
Prevalence Rate per 10000 Population (2010-2011)
Prevalence Rate per 10000 Population (2011-2012)
Prevalence Rate per 10000 Population (2012-2013)
Prevalence Rate per 10000 Population (2013-2014)
1
Andhra Pradesh
0.49
0.58
0.61
0.55
2
Arunachal Pradesh
0.35
0.21
0.32
0.2
3
Assam
0.4
0.37
0.35
0.3
4
Bihar
1.12
0.89
1.2
0.91
5
Chhattisgarh
1.94
1.69
2.13
2.1
6
Goa
0.29
0.36
0.25
0.4
7
Gujarat
0.79
0.81
0.96
0.83
8
Haryana
0.13
0.21
0.26
0.27
9
Himachal Pradesh
0.27
0.25
0.21
0.22
10
Jharkhand
0.65
0.59
0.66
0.7
11
Jammu and Kashmir
0.16
0.16
0.17
0.15
12
Karnataka
0.44
0.46
0.44
0.44
13
Kerala
0.27
0.26
0.24
0.25
14
Madhya Pradesh
0.6
0.63
0.72
0.7
15
Maharashtra
0.93
1.07
1.09
0.92
16
Manipur
0.06
0.06
0.08
0.03
17
Meghalaya
0.24
0.23
0.09
0.08
18
Mizoram
0.19
0.1
0.16
0.22
19
Nagaland
0.72
0.38
0.5
0.62
20
Odisha
0.85
0.99
0.98
1.47
21
Punjab
0.24
0.24
0.21
0.18
22
Rajasthan
0.17
0.15
0.17
0.17
23
Sikkim
0.23
0.24
0.23
0.24
24
Tamil Nadu
0.44
0.42
0.39
0.4
25
Tripura
0.24
0.26
0.18
0.12
26
Uttar Pradesh
0.79
0.69
0.72
0.68
27
Uttarakhand
0.3
0.28
0.25
0.22
28
West Bengal
0.92
1.08
1.05
0.87
29
Andaman and Nicobar Islands
0.53
0.55
0.36
0.72
30
Chandigarh
0.38
0.55
0.58
1.22
31
Dadra and Nagar Haveli
2.28
2.93
3.61
4.04
32
Daman and Diu
0.08
0.12
0
0.04
33
Delhi
0.78
0.78
0.73
0.64
34
Lakshadweep
0
0.31
0
1.98
35
Puducherry
0.34
0.22
0.21
0.25

Total
0.69
0.68
0.73
0.69
Source: National Leprosy Eradication Programme




Malaria Incidence Rate
Sl. No
States/UT
Annual Parasite Incidence (API) of malaria per 1000  (2013)
Annual Parasite Incidence (API) of malaria per 1000  (2014)
1
Andhra Pradesh
0.23
0.41
2
Arunachal Pradesh
4.77
4.30
3
Assam
0.59
0.44
4
Bihar
0.03
0.02
5
Chhattisgarh
4.18
4.72
6
Goa
1.04
0.55
7
Gujarat
0.94
0.66
8
Haryana
0.55
0.17
9
Himachal Pradesh
0.03
0.02
10
Jammu and Kashmir
0.13
0.05
11
Jharkhand
2.84
2.94
12
Karnataka
0.24
0.27
13
Kerala
0.05
0.05
14
Madhya Pradesh
1.04
1.26
15
Maharashtra
0.38
0.46
16
Manipur
0.04
0.05
17
Meghalaya
7.82
12.52
18
Mizoram
10.80
20.74
19
Nagaland
1.14
0.96
20
Orissa
5.32
9.08
21
Punjab
0.06
0.04
22
Rajasthan
0.45
0.20
23
Sikkim
0.20
0.17
24
Tamil Nadu
0.21
0.12
25
Telangana
0.00
0.15
26
Tripura
1.94
13.27
27
Uttarakhand
0.14
0.12
28
Uttar Pradesh
0.24
0.20
29
West Bengal
0.38
0.28
30
Andaman and Nicobar Islands
2.17
1.20
31
Chandigarh
0.14
0.11
32
Dadra and Nagar Haveli
4.54
1.64
33
Daman and Diu
0.34
0.20
34
Delhi
0.02
0.01
35
Lakshadweep
0.12
0.00
36
Puducherry
0.10
0.06

Total
0.72
0.89
Source: National Vector Borne Disease Control Programme





Microfilaria Rate
Average Microfilaria rates (%) in the State since 2005
Sl. No.
States/UT
2005
2006
2007
2008
2009
2010
2011
2012
2013
1
Andhra Pradesh
0.74
0.69
0.26
0.38
0.45
0.35
0.21
0.2
0.22
2
Assam
0.04
0.19
1.46
0.88
0.81
1.06
0.17
0.19
0.15
3
Bihar
2.15
1.38
0.68
ND
1.07
0.94
ND
1.15
ND
4
Chhattisgarh
1.96
ND
0.61
0.45
0.54
0.4
0.1
0.1
0.08
5
Goa
0.04
0.02
0.08
0.01
0
0.01
0
MDA stopped
MDA stopped
6
Gujarat
0.84
0.84
0.42
0.83
0.92
0.46
0.52
0.24
0.31
7
Jharkhand
0.84
1.4
1.34
1.1
1.11
0.82
0.63
NR
ND
8
Karnataka
0.84
0.69
1.15
1.07
0.93
0.89
0.83
0.65
0.6
9
Kerala
0.5
0.67
0.65
0.29
0.39
0.17
0.14
0.21
0.15
10
Madhya Pradesh
0.4
0.38
0.7
0.36
0.4
0.19
0.23
0.09
ND
11
Maharashtra
1.45
1.13
0.83
0.35
0.46
0.53
0.51
0.43
0.46
12
Orissa
2.37
1.11
0.99
0.74
0.69
0.4
0.43
0.34
0.34
13
Tamil Nadu
0.38
0.39
0.29
0.15
0.12
0.07
0.09
0.17
ND
14
Uttar Pradesh
1.01
0.81
0.32
0.41
ND
0.28
0.24
0.38
0.17
15
West Bengal
4.1
2.72
2.83
0.89
0.48
0.44
0.55
0.7
ND
16
Andaman and Nicobar Islands
0.09
0.15
0.34
0.19
0.46
0.1
0.12
0.17
0.14
17
Dadra and Nagar Haveli
2.01
2.91
3.47
1.82
1.23
0.95
1.79
0.71
0.54
18
Daman and Diu
0.14
0.27
0.09
0.07
0.07
0.06
0.07
MDA stopped
MDA stopped
19
Lakshadweep
0.09
0.07
0.02
0.27
0
0
ND
ND
ND
20
Pondicherry
0.5
0.15
0.06
0.03
0
0
0
MDA stopped
MDA stopped
National Average
1.02
0.98
0.64
0.53
0.65
0.41
0.37
0.41
0.29
*Source: National Vector Borne Disease Control Programme
ND: Not Done
NR: Not Reported
MDA= Mass Drug Administration

The information on funds allocated, released and utilized under National Health Mission (NHM) during each of the last three years and the current year State/UT-wise is given below:-





State-wise Allocation, Release and Utilization under National Health Mission
Rs. in crore
Sl. No.
States
2014-15
2015-16

Allocation
Release
Exp
Allocation
Release

1
Andaman & Nicobar Islands
28.22
23.36
24.33
28.21
15.54

2
Andhra Pradesh
707.15
519.73
902.91
616.13
156.24

3
Arunachal Pradesh
185.65
139.41
69.50
160.01
6.86

4
Assam
1095.38
877.13
915.88
941.29
66.38

5
Bihar
1292.13
1148.32
1427.40
1108.61
758.25

6
Chandigarh
19.40
12.15
15.26
14.24
6.07

7
Chattisgarh
555.66
500.41
716.04
479.38
246.46

8
Dadra & Nagar Haveli
13.99
8.40
8.56
11.37
3.94

9
Daman & Diu
9.69
6.91
7.67
9.11
4.21

10
Delhi
192.59
154.04
222.64
142.81
59.01

11
Goa
27.63
26.03
29.50
19.41
3.23

12
Gujarat
858.47
832.86
873.66
677.65
387.82

13
Haryana
317.42
273.60
438.18
249.33
197.86

14
Himachal Pradesh
232.00
185.84
306.92
197.92
139.35

15
Jammu & Kashmir
435.17
335.51
393.29
368.00
21.11

16
Jharkhand
563.92
359.62
372.01
493.37
0.63

17
Karnataka
834.09
697.24
858.18
706.09
422.72

18
Kerala
373.58
521.99
509.83
305.87
43.25

19
Lakshadweep
5.89
5.08
1.36
4.28
1.62

20
Madhya Pradesh
1250.17
1162.50
1738.02
1085.37
676.64

21
Maharashtra
1536.58
1431.76
1834.40
1282.31
144.64

22
Manipur
144.97
128.81
86.91
118.53
10.30

23
Meghalaya
160.21
104.13
70.72
131.00
0.25

24
Mizoram
116.53
103.28
93.29
97.87
14.47

25
Nagaland
131.26
114.92
63.04
108.75
12.12

26
Orissa
730.09
667.16
944.10
624.71
344.28

27
Puducherry
25.46
22.56
23.35
17.77
8.03

28
Punjab
351.89
379.35
460.59
284.75
143.42

29
Rajasthan
1238.11
1115.96
1722.69
1069.38
877.48

30
Sikkim
51.42
51.60
41.36
45.86
6.44

31
Tamil Nadu
968.18
952.75
2248.06
794.38
443.57

32
Tripura
161.75
123.11
130.15
139.08
11.55

33
Uttar Pradesh
2650.25
2431.06
3671.26
2299.49
1160.63

34
Uttarakhand
308.10
270.55
324.42
256.60
27.52

35
West Bengal
1053.27
1058.62
1196.78
883.49
438.47

36
Telangana
506.45
378.72
334.68
440.58
56.88

Sub  Total
19132.72
17124.48
23076.94
16213.00
6917.24

Others
1211.51
35.83
0.00
0.00
0.00

Total
20344.23
17160.31
23076.94
16213.00
6917.24














12th Plan proposes to increase the expenditure on core health by States and the Centre to 1.87% of Gross Domestic Product (GDP) by the end of 12th Plan.
Under NHM, health interventions/ initiatives are regularly designed and implemented to address the healthcare needs of the country. A list of interventions currently being implemented under NHM to reduce IMR and MMR is given below:-
The steps taken by the Government under the National Health Mission (NHM) to accelerate the pace of reduction in maternal mortality and infant mortality:-

·        Promotion of institutional deliveries through Janani Suraksha Yojana.
·        Capacity building of health care providers in basic and comprehensive obstetric care.  
·        Operationalization of Sub-Centres, Primary Health Centres, Community Health Centres and District Hospitals for providing 24x7 basic and comprehensive obstetric care services.
·        Name Based Web enabled Tracking of Pregnant Women to ensure antenatal, intranatal and postnatal care.
·        Mother and Child Protection Card in collaboration with the Ministry of Women and Child Development to monitor service delivery for mothers and children.
·        Antenatal, Intranatal and Postnatal care including Iron and Folic Acid supplementation to pregnant & lactating women for prevention and treatment of anaemia.
·        Village Health and Nutrition Days in rural areas as an outreach activity, for provision of maternal and child health services.
·        Health and nutrition education to promote dietary diversification, inclusion of iron and foliate rich food as well as food items that promote iron absorption.  
·        Janani Shishu Suraksha Karyakaram (JSSK) entitles all pregnant women delivering in public health institutions to absolutely free and no expense delivery including Caesarean section.  The initiative stipulates free drugs, diagnostics, blood and diet, besides free transport from home to institution, between facilities in case of a referral and drop back home.  Similar entitlements have been put in place for all sick infants accessing public health institutions for treatment.
·        To sharpen the focus on the low performing districts, 184 High Priority Districts (HPDs) have been prioritized for Reproductive Maternal Newborn Child Health+ Adolescent (RMNCH+A) interventions for achieving improved maternal and child health outcomes.  

·        Emphasis on facility based newborn care at different levels to reduce child morbidity and mortality: Setting up of facilities for care of sick newborn such as Special New Born Care Units (SNCUs), Newborn Stabilization Units (NBSUs) and Newborn Care Corners (NBCCs) at different levels is a thrust area under NHM.
·        Capacity building of health care providers: Various trainings are being conducted under NHM to train doctors, nurses and ANMs for essential newborn care, early diagnosis and case management of common ailments of children. These trainings are on Navjaat Shishu, Suraksha Karyakram (NSSK), Integrated Management of Neonatal and Childhood Illnesses (IMNCI), Facility Based Newborn Care (FBNC), Infant and Young Child Feeding practices (IYCF), etc.
·        India Newborn Action Plan (INAP) has been launched with an aim to reduce neonatal mortality and stillbirths.
·        Newer interventions to reduce newborn mortality- Vitamin K injection at birth, Antenatal corticosteroids for preterm labour, kangaroo mother care and injection gentamicin to young infants in cases of suspected sepsis.
·        Home Based New Born Care (HBNC): Home based newborn care through ASHAs has been initiated to improve new born practices at the community level and early detection and referral of sick new born babies.
·        Intensified Diarrhoea Control Fortnight (IDCF) to be observed in July-August 2015 focusing on ORS and Zinc distribution for management of diarrhoea and feeding practices.
·        Integrated Action Plan for Pneumonia and Diarrhoea (IAPPD) launched in four states with highest infant mortality (UP, MP, Bihar and Rajasthan).
·        Management of Malnutrition: Nutritional Rehabilitation Centres (NRCs) have been established for management of severe acute malnutrition in children.
·        Appropriate Infant and Young Child Feeding practices are being promoted in convergence with Ministry of Woman and Child Development.
·        Universal Immunization Programme (UIP): Vaccination protects children against many life threatening diseases such as Tuberculosis, Diphtheria, Pertussis, Polio, Tetanus, Hepatitis B and Measles. Infants are thus immunized against seven vaccine preventable diseases every year. The Government of India supports the vaccine programme by supply of vaccines and syringes, cold chain equipment and provision of operational costs.
·        Mission Indradhanush has been launched in 201 high focus districts to fully immunize more than 89 lakh children who are either unvaccinated or partially vaccinated; those that have not been covered during the rounds of routine immunization for various reasons. They will be fully immunized against seven life-threatening but vaccine preventable diseases which include diphtheria, whooping cough, tetanus, polio, tuberculosis, measles and hepatitis-B. In addition, vaccination against Japanese Encephalitis and Haemophilus influenza type B will be provided in selected districts/states of the country. Pregnant women will also be immunized against tetanus.
·        Mother and Child Tracking System (MCTS): A name based Mother and Child Tracking System has been put in place which is web based to ensure registration and tracking of all pregnant women and new born babies so that provision of regular and complete services to them can be ensured.
·        Rashtriya Bal Swasthya Karyakram (RBSK) for health screening and early intervention services has been launched to provide comprehensive care to all the children in the age group of 0-18 years in the community. The purpose of these services is to improve the overall quality of life of children through early detection of birth defects, diseases, deficiencies, development delays including disability.
·        Under National Iron Plus Initiative (NIPI), through life cycle approach, age and dose specific IFA supplementation programme is being implemented for the prevention of anaemia among the vulnerable age groups like under-5 children, children of 6 – 10 years of age group, adolescents, pregnant & lactating women and women in reproductive age along with treatment of anaemic children and pregnant mothers at health facilities.

Information on IMR for the period 2011 to 2013 and on MMR for the period 2010-12 to 2011-13 is given below:-

Infant Mortality Rate (IMR)


    States
2011
2012
2013



All India
44
42
40


1
Andhra Pradesh
43
41
39


2
Assam
55
55
54


3
Bihar
44
43
42


4
Chhattisgarh
48
47
46


5
Gujarat
41
38
36


6
Haryana
44
42
41


7
Jharkhand
39
38
37


8
Karnataka
35
32
31


9
Kerala
12
12
12


10
Madhya Pradesh
59
56
54


11
Maharashtra
25
25
24


12
Odisha
57
53
51


13
Punjab
30
28
26


14
Rajasthan
52
49
47


15
Tamil Nadu
22
21
21


16
Uttar Pr.
57
53
50


17
W. Bengal
32
32
31


18
Arunachal Pr
32
33
32


19
Delhi
28
25
24


20
Goa
11
10
9


21
Himachal Pradesh
38
36
35


22
J & K
41
39
37


23
Manipur
11
10
10


24
Meghalaya
52
49
47


25
Mizoram
34
35
35


26
Nagaland
21
18
18


27
Sikkim
26
24
22


28
Tripura
29
28
26


29
Uttarakhand
36
34
32


30
A&N Islands
23
24
24


31
Chandigarh
20
20
21


32
D&N Haveli
35
33
31


33
Daman & Diu
22
22
20


34
Lakshadweep
24
24
24


35
Puducherry
19
17
17


Source: Sample Registration System, Statistical Report (Registrar General, India)

Maternal Mortality Ratio (MMR)
Sl. No.
India/States
2010-12
2011-13

India
178
167
1
Andhra Pradesh
110
92
2
Assam
328
300
3
Bihar/Jharkhand
219
208
4
Gujarat
122
112
5
Haryana
146
127
6
Karnataka
144
133
7
Kerala
66
61
8
Madhya Pr/Chhattisgarh
230
221
9
Maharashtra
87
68
10
Odisha
235
222
11
Punjab
155
141
12
Rajasthan
255
244
13
Tamil Nadu
90
79
14
Uttar Pradesh/Uttarakhand
292
285
15
West Bengal
117
113
Source:  Sample Registration System, Statistical Report (Registrar General, India)

The Health Minister, Shri J P Nadda stated this in a written reply in the Lok Sabha here today.

                                                       *****


Achievements Under The National Rural Health Mission (NRHM) Achievements Under The National Rural Health Mission (NRHM) Reviewed by Ajit Kumar on 5:01 PM Rating: 5

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