SCHOOL OF NURSING SCIENCES AND RESEARCH
SHARDA UNIVERSITY
› LESSON PLAN ON NATIONAL RURAL HEALTH MISSION
SUBMISSION ON:
SUBMITTED TO: SUBMITTED BY:
Ms. Sonia Chongtham Ms. Binju Karki
Assitant Professor Msc. Nursing- 2nd year
SNSR SNSR
Tittle page
Name of the faculty: Ms. Sonia Chongtham
Name of principal: Prof. Urmila Devi Bhardwaj
Name of the subject: Community Health Nursing
Name of topic: National Rural Health Mission
Date:
Time: 11:00- 11:52 am
Place:
Duration: 52 min
Group: M.Sc. Nursing – 2nd year
Av aids: Meta card, Flash cards, Flip chart, Chart paper and PowerPoint
Name of college: School of Nursing sciences and Research
Method of teaching: Ask and discussion
OBJECTIVES:
General objective: By the end of the class students will be able to understand the complete about National Rural Health
Mission
Specific objective: By the end of the class student will be able to:
to introduce the background before NRHM
to introduce about NRHM
to list about the aims of NRHM
to enlist the Goals of NRHM
to list the core strategies of NRHM
to enlist the supplementary strategies of NRHM
to explain the plan of action of NRHM
to describe the institutional set up of NRHM
to explain about the goals to be achieved by NRHM
to describe about District Health Mission
to enumerate about monitoring and evaluation
summary
S.N Objective Tim Content Teaching Learning AVAIDS Evaluation
. e Learning Activities
Activities
1. to introduce the 2 Background before NRHM Ask and Answer and Powerpoin What is the
background before min discussion participate t condition before
NRHM State of public health in India NRHM?
before NRHM. There is health gap
at urban and urban level i.e.
characteristics Rural Urban
1. Infant 39 62
Mortality
Rate
2. Government 68.1% 31.9%
beds
3. Beds per 1.1 0.2
1000 beds beds
population
4. Gradute 74% 28%
doctor
distrribution
And also Multiple health crisis
( malnutrition, maternal and infant
deaths, inadequate water supply
etc. But Shortfall of there is
imbalance distribution of health
care facilities.
•8% doctors at PHC’s
•65% specialist at community
health centers
•55.3% male health workers
•12.6% female health workers
Because of this inequality of
distribution of health in the country
the union government launched,
2. to introduce about 2 National Rural Health Discussion Participate Powerpoin When was NRHM
NRHM min Mission(NRHM) t launched?
The National Rural Health Mission
has been in operation since June
2005 and has been extended upto
2017 keeping in view its
achievemwnt towards improving
the healthcare agency towatds
improving the healthcare delivery
system and healthoutcomes in the
rural areas.
NRHM initially had high focus on
18 States (8 EAG, 8 North East,
Jammu & Kashmir and Himachal
Pradesh), but now all the states are
included. RCH-II was an important
component of NRHM.
3. to list about the 2 Aim of NRHM Discussion Participate Meta card What is the the
aim of NRHM min aim of NRHM?
To provide accessible,
affordable, accountable,
effective and reliable
primary health care and
bridging the gap in rural
health care through creation
of ASHA.
4. to enlist the goals 5min Goals of NRHM Discussion Participate Flash cards What are the
of NRHM goals of NRHM?
Reduction in Infant
Mortality Rate (IMR) and
Maternal Mortality Ratio
(MMR)
Universal access to public
health services such as
Women’s health, child
health, water, sanitation &
hygiene, immunization, and
Nutrition.
Prevention and control of
communicable and non-
communicable diseases,
including locally endemic
diseases
Access to integrated
comprehensive primary
healthcare
Population stabilization,
gender and demographic
balance.
Revitalize local health
traditions and mainstream
AYUSH
Promotion of healthy life
styles
5. to list the core 3 Core strategies of NRHM Discussion Participate Flip chart What are the core
strategies of min strategies of
NRHM Decentralisation of village NRHM?
and district level health
planning and management
Appointing ASHA for
facilitating the access to
health services
Strengthen public health
delivery services at primary
and secondary level
Mainstreaming AYUSH
Improve management
capacity to organise health
systems and services
Improve intersectorial
coordination
6. to enlist the 3 Supplementary startegies of Discussion Participate Powerpoin What are the
supplementary min NRHM t supplementary
startegies of startegies of
NRHM 1. Regulation of private sector NRHM
to ensure availability of
quality service to citizens at
reasonable cost.
2. Mainstreaming AYUSH –
revitalizing local health
traditions.
3. Reorienting medical
education to support rural
health issues including
regulation of Medical care
and Medical Ethics.
4. Effective and viable risk
pooling and social health
insurance to provide health
security to the poor by
ensuring accessible,
affordable, accountable and
good quality hospital care.
7. to explain the plan 15 Plan of action of NRHM Discussion Participate Powerpoin What are the plan
of action of min t of action of
NRHM Accredited social health NRHM?
activists
Strengthening sub-centers
Strengthening primary
health centers
Strengthening CHCs for
first referral center
District health plan under
NRHM
Converging sanitation and
hygiene under NRHM
Strengthening disease
control program
Public-private partnership
for public health goals,
including regulation of
private sector
New health financing
mechanisms
Reorienting health/medical
education to support rural
health issues
1.ASHA (Accredited social
health activists)
- Resident of the village, a
woman (M/W/D) between
25-45 years, with formal
education up to 8th class,
having communication
skills and leadership
qualities.
- One ASHA per 1000
population.
- Around one 100,000
ASHA’s are already
selected.
- Chosen by the panchayat to
act as the interface between
the community and the
public health system.
- Bridge between the ANM
and the village.
- Honorary volunteer,
receiving performance
based compensation .
Responsibility of ASHA
- To create awareness among
the community regarding
nutrition, basic sanitation,
hygienic practices, healthy
living.
- Counsel women on birth
preparedness, imp of safe
delivery, breast feeding,
complementary feeding,
immunization,
contraception, STDs
- Encourage the community
to get involved in health
related services.
- Escort/ accompany pregnant
women, children requiring
treatment and admissions to
the nearest PHC’s.
- Primary medical care for
minor ailment such as
diarrhea, fevers
- Provider of DOTS.
2.Strengthening subcenters
- Supply of essential
medicines and equipments.
- Each sub-centre will have
an Untied Fund for local
action @ Rs. 10,000 per
annum.
- Provision of MPW /
additional ANM
- Provision of funds
3. Strengthening of PHC
- Adequate and regular
supply of essential quality
drugs and equipment to
PHCs.
- Provision of 24 hour
service in 50% PHCs.
- Intensification of ongoing
communicable disease
control programmes, new
programmes for control of
non- communicable
diseases and provision of
2nd doctor at PHC level (I
male, 1 female).
4.Strengthening of CHC’Sor first
referral unit
- Existing CHC (30-50 beds)
as 24 Hour FRU, including
posting of anaesthetists
- Codification of new Indian
Public Health Standards,
setting norms for
o Infrastructure
o Staff
o Equipment
o Management
- Promotion of Rogi Kalyan
Samitis for hospital
management.
5. District health plan under
NRHM
- District becomes core unit
of planning, budgeting and
implementation Health
Programmes Family
Welfare Programmes
“District Health Mission”
6. Converging sanitation and
hygiene under NRHM
- Total Sanitation Campaign
(TSC) is presently
implemented in 350
districts, and is proposed to
cover all districts in 10th
Plan.
- Components of TSC
include rural sanitary marts,
individual household toilets,
women sanitary complex,
and School Sanitation
Programme
7. Strengthening disease control
programmes
› Disease surveillance
system at village level
would be strengthened.
› Supply of generic drugs
(both AYUSH &
Allopathic)
› Provision of a mobile
medical unit at District level
for improved Outreach
services. 33
8. Public-private partnership for
public health goals, including
regulation of private sector
- 75% of health services are
provided by the private
sector.
- Identifying areas of
partnership, which are need
based, thematic and
geographic.
- Public sector to play the
lead role in defining the
framework and sustaining
the partnership.
9. New health financing
mechanisms
- Progressively the District
Health Missions to move
towards paying hospitals for
services .
- Standardization of services
– outpatient, in- patient,
laboratory, surgical
interventions- and costs will
be done periodically by a
committee of experts in
each state.
- An ombudsman to be
created to monitor the
District Health Fund
Management , and take
corrective action.
- The Central government
will provide subsidies to
cover a part of the
premiums for the poor, and
monitor the schemes.
10. Reorienting health/medical
education to support rural health
issues
- While district and tertiary
hospitals are necessarily
located in urban centers,
they form an integral part of
the referral care chain
serving the needs of the
rural people.
- Medical and Para-medical
education facilities need to
be created in states, based
on need assessment.
8. to describe the 2 Institutional set up of NRHM Discussion Participate Powerpoin What is the
institutional set up min t institutional set up
of NRHM 1. At national level: Mission of NRHM?
steering group,
chairman is union minister of
health and family welfare
2. At state level : State health
mission: led by CM
3. At district level : District health
mission: led by chairman of zila
parishad
9. to explain about 7 Goals to be achieved by NRHM Discussion Participate Powerpoin What are the
the goals to be min t goals to be
achieved by At National Level achieved by
NRHM • IMR :Reduce to 30/1000 NRHM?
• MMR : Reduce to
100/100,000
• TFR :Reduce to 2.1
• MALARIA MORTALITY
RATE REDUCTION: 50%
by 2010 , addtl 10% by
2012
• FILARIA RATE
REDUCTION : 70%(2010),
80%(2012), elimn by 2015
• DENGUE MORTALITY
RATE REDUCTION:
50%(2010)
• KALA AZAR
MORTALITY RATE
REDUCTION:
100%(2010)
• JE MORTALITY RATE
REDUCTION: 50%(2010)
• CATARACT
OPERATION: increase to
46 lakhs/year 2012
• LEPROSY PREVALENCE
RATE : reduce from
1.8/10,000 in 2005 to less
than 1/10,000
• TB DOTS SERVICES :
85% Cure rate
• Upgrading CHC to Indian
Public Health Standards
• Increase utilisation of
FIRST REFERRAL
UNITS from <20% to 75%
• Engaging 250,000 female
ASHA in 10 states
10. To describe at 3 At community Level Discussion Participate Chart What do NRHM
community level min paper do at community
PHC/CHC should provide level?
good hospital care. Generic
drugs at subcentre level
Access to UIP
Facilities for institutional
deliveries
Trained community level
worker at village level
Health day at
ANGANWADI
- Immunization
- antenatal/postnatal
check ups Provision of
house hold toilets
- Improved outreach
services through
MOBILE MEDICAL
UNIT at district level
- Community health
insurance
11. to describe about 3 District Health Mission Discussion Participate Powerpoin What is the
District Health min t function of DHM?
Mission The Core unit in planning,
budgeting and implementation of
the programme.
Functions
Selection and training of
ASHA Organising health
camps at ANGANWADI
Mainstreaming AYUSH
Upgrading CHCs to IPHS
Outreach services through
mobile medical units
12. to enumerate 2 Monitoring and evaluation Discussion Participate Powerpoin How monitoring
about monitoring min t and evaluation is
and evaluation done?
Baseline survey at district
level & household level
Community monitoring at
village level Eventual
monitoring of the outcomes
is done by planning
commission of India
13. summary 3 Summarization Discussion Participate Powerpoin
min t
NRHM was lunched on 12th
April,2005 for 7 year by GOI
which specially focused on 18
states i.e. assam, Andhra Pradesh,
Manipur, Meghalaya, Mizoram,
Nagaland, Sikkim, Tripura, Bihar,
Jharkhand, Madhya Pradesh,
Chattisgarh,Uttar Pradesh,
Uttaranchal, Orissa, Rajastan,
Himachal Pradesh, Iammu and
Kashmir but now all the states are
included. To provide accessible,
affordable, accountable, effective
and reliable primary health care
and bridging the gap in rural health
care through creation of ASHA
References
K. Park. Park’s Textbook of Preventive and Social Medicine. 23rd edition. Jabalpur. Bhanot. January 2015
Park, K. (2015). Park's textbook of preventive and social medicine (23rd Ed.). Jabalpur: M/S Banarsidas Bhanot.
Kumari, N. (2011). A Text Book of community health nursing. Jalandhar: S.vikas and company (medical ) India.
Gulani, K.K. (2009).Community health nursing principles and practice(2nd ed.).New Delhi:Kumar publishing house.
Kamalam, K.(2012). Essentials in community health nursing practice(1st ed.). New Delhi: Jaypee Brothers Medicine.
https://www.slideshare.net/SwatiSingh118/nrhm-58869373
https://www.slideshare.net/pavithrar22/national-rural-health-mission-64878752
https://www.slideshare.net/AbinoDavid/national-rural-health-mission-14541337
