NATIONAL HEALTH MISSION (NHM)

INTRODUCTION
Ensuring equitable healthcare for all is crucial for fostering a healthy and flourishing society. A
nation free from the financial strain of healthcare expenses and committed to proactive preventive
care not only enhances public health but also cultivates a stable population. Providing accessible and
fair healthcare is an essential responsibility of government to promote the well-being of its citizens.

NATIONAL HEALTH MISSION (NHM)

The Government of India launched the National Health Mission (NHM) in 2013, encompassing its
two sub-missions, the National Rural Health Mission (NRHM) and the National Urban Health
Mission (NUHM). The NHM envisages achievement of universal access to equitable, affordable &
quality healthcare services that are accountable and responsive to people’s needs by supporting
States and Union Territories in strengthening their healthcare systems.

MAJOR OBJECTIVES
 The mission targets to move beyond earlier missions focus on reproductive and child health
 Tackle 2 categories of diseases – Communicable and Non-Communicable
 To give a major impetus to health infrastructure facilities at District and Sub-District levels.

GOALS
1. Reduce Maternal mortality rate (MMR) to 1 per 1000 live births

2. Reduce Infant mortality rate (IMR) to 25 per1000 live births

3. Reduce Total fertility rate (TFR) to 2.1

4. Prevention and reduction of anaemia in women aged 15–49 years

5. Prevent and reduce mortality & morbidity from communicable, non- communicable; injuries
and emerging diseases

6. Reduce household out-of-pocket expenditure on total health care expenditure

7. Reduce annual incidence and mortality from Tuberculosis by half

8. Reduce the prevalence of Leprosy to <1 per 10,000 population and incidence to zero in all
districts
 9. Annual Malaria Incidence to be <1 per 1000

10. Less than 1 percent microfilaria prevalence in all districts

11. Kala-azar Elimination by 2015, <1 case per 10,000 population in all blocks

History
Before the NHM, India had separate missions for rural health. The National Rural Health Mission
(NRHM) is an initiative undertaken by the government of India to address the health needs of
under-served rural areas. Launched on 12 April 2005 by then Indian Prime Minister Manmohan
Singh, the NRHM was initially tasked with addressing the health needs of 18 states that had been
identified as having weak public health indicators. It did not catered the health care needs of urban
areas. India faced severe malnutrition crises, inadequate healthcare infrastructure, and disparities
between rural and urban populations. The NHM emerged to bridge these gaps.

IMPLEMENTATION STRATEGIES
The National Health Mission (NHM) launched in 2013 is a significant initiative by the Government
of India aimed at addressing healthcare challenges across the country. The key features in order to
achieve the goals of the Mission include –

The public health delivery Human resource Community decentralization

system fully functional & management involvement
accountable

Decentralization Rigorous
monitoring &
evaluation against

Strengthening Healthcare Infrastructure: One of the primary objectives of NHM is to strengthen

the healthcare infrastructure at various levels - primary, secondary, and tertiary. This involves
building new healthcare facilities, upgrading existing ones, and ensuring the availability of essential
medical equipment and supplies.

Human Resource Development: NHM focuses on improving the availability and quality of human
resources in the healthcare sector. This includes recruiting and training healthcare professionals such
as doctors, nurses, and paramedics, especially in rural and remote areas where there is a shortage of
skilled personnel.
Community Participation and Empowerment: NHM emphasizes the involvement of communities
in planning, implementation, and monitoring of healthcare programs. This is achieved through
mechanisms such as Village Health and Sanitation Committees (VHSCs) and Rogi Kalyan Samitis
(RKS), which empower communities to take ownership of local health issues.

Promotion of Maternal and Child Health: A significant portion of NHM's resources is directed
towards improving maternal and child health outcomes. This includes initiatives such as promoting
institutional deliveries, ensuring access to antenatal and postnatal care, immunization drives, and
nutrition programs for mothers and children.

Preventive Healthcare: NHM emphasizes preventive healthcare measures to reduce the burden of
diseases. This includes promoting awareness about hygiene and sanitation, conducting health camps
for early detection and treatment of diseases, and implementing programs for the control of vector-
borne diseases like malaria and dengue.

Integration of Health Services: NHM encourages the integration of various health services to
provide comprehensive care. This includes integrating vertical programs for diseases like HIV/AIDS,
tuberculosis, and malaria with the broader healthcare system to ensure better coordination and
efficiency.

Monitoring and Evaluation: NHM lays emphasis on robust monitoring and evaluation mechanisms
to assess the progress of healthcare programs and identify areas needing improvement. Regular data
collection, analysis, and feedback mechanisms are put in place to track health indicators and measure
the impact of interventions.

Public-Private Partnerships (PPP): NHM promotes partnerships with the private sector to leverage
resources and expertise for improving healthcare delivery. This involves engaging with private
healthcare providers for service delivery, capacity building, and innovation in healthcare delivery
models.

COMPONENTS OF NATIONAL HEALTH MISSION

1. Reproductive, Maternal, Newborn, Child, Adolescent Health and Nutrition (RMNCAH+N)
2. Health systems strengthening
3. Infrastructure Maintenance
4. Aspirational District Program Non-Communicable Disease Control Programmes
5. Other non-communicable disease Control Programmes Communicable Disease Control
Programme
6. Financing Components
1. Reproductive, Maternal, Newborn, Child, Adolescent Health and Nutrition
(RMNCAH+N)
The Quality Improvement Programmes under the National Health Mission (NHM), particularly
focusing on Reproductive, Maternal, Newborn, Child, Adolescent Health and Nutrition
(RMNCAH+N), play a crucial role in enhancing healthcare delivery and achieving better health
outcomes:
 Building Quality Management Systems: NRHM supports initiatives aimed at establishing
quality management systems within healthcare facilities. These initiatives range from
forming quality assurance committees to conducting periodic monitoring visits and
assessments using checklists. This systematic approach helps identify and address quality
gaps, ensuring continuous improvement in service delivery.

 Structured Quality Management Systems: The quality management systems extend to

more structured approaches, including third-party audits and certification processes.
Facilities undergo audits and seek certification either through ISO 9001:2008 or NABH
(National Accreditation Board for Hospitals & Healthcare Providers). This certification
signifies adherence to quality standards and best practices in healthcare delivery.

 Certification Achievements: The efforts towards quality improvement have resulted in

significant achievements, with several facilities being certified by ISO and NABH. As of
now, 82 facilities have been certified by ISO, and nine facilities have been certified by
NABH. Additionally, 446 facilities are currently undergoing the certification process,
reflecting a commitment to maintaining high standards of quality care.

 RMNCAH+N Strategy: The RMNCAH+N strategy, launched under NHM, adopts a holistic
approach encompassing all interventions related to reproductive, maternal, newborn, child,
adolescent health, and nutrition. It emphasizes the continuum of care concept, ensuring
seamless delivery of services throughout the lifecycle.

Key Components of RMNCAH+N Strategy

The strategy includes various key components such as:
 Inclusion of adolescence as a distinct life stage
 Linkages between maternal and child health with other components like family planning,
adolescent health, HIV, gender, etc.
 Integration of home and community-based services with facility-based services
 Establishment of linkages, referrals, and counter-referrals between different levels of the
healthcare system, ensuring a continuous care pathway and maximizing overall outcomes and
impact.
 Overall, the Quality Improvement Programmes and the RMNCAH+N strategy underscore the
commitment to enhancing healthcare quality, promoting integrated care delivery, and
ultimately improving maternal and child health outcomes in India.
2. Health systems strengthening
Adoption of the Indian Public Health Standards: This defined not only the service package that each
facility must provide, but also specified the minimum inputs required to ensure quality of care, in
terms of infrastructure, equipment, skilled human resources, and supplies. It was an assurance to the
states of financing the gaps between available levels of these inputs and the levels needed to achieve
the IPHS norms. A substantial increase in these inputs was driven by facility surveys to identify gaps
and then planning and financing to close these gaps. Quality standards have been defined with
respect to clinical protocols, administrative and management processes and for support services. The
Operational Guidelines for Maternal and Newborn care published by the Ministry of Health and
Family Welfare comprehensively defined such quality standards for RCH care. Skill gaps and
Standard Treatment Protocols: Skill sets and standard treatment protocols required for provide
quality RCH services and training packages that would provide these skill sets were designed. These
include the Skilled Birth Attendance (SBA) training package for ANMs, the Navjat Shishu Suraksha
Karyakram (NSSK) and the IMNCI packages for ANMs, the Home-Based Newborn Care (HBNC)
for ASHAs, and the Emergency Obstetric Care (EmOC) package for doctors. These training
packages also introduced the standard treatment protocols in each of these areas.

3.Non-Communicable Disease Control Programmes

 National Programme for Prevention & Control of Cancer, Diabetes, Cardiovascular

Diseases & Stroke (NPCDCS): Focuses on prevention, early detection, management, and
referral services for non-communicable diseases (NCDs).
 National Programme for Control of Blindness & Visual Impairment (NPCBVI): Aims to
reduce the prevalence of blindness and visual impairment through preventive, curative, and
rehabilitative services.
 National Mental Health Programme (NMHP): Addresses mental health issues through
promotion, prevention, treatment, and rehabilitation services.
 National Programme for Healthcare of Elderly (NPHCE): Provides comprehensive
healthcare services for the elderly population, focusing on preventive and promotive aspects
of health.
 National Programme for Prevention & Control of Deafness (NPPCD): Aims to prevent
and control deafness and hearing impairment through early detection, diagnosis, and
intervention services.
 National Tobacco Control Programme (NTCP): Focuses on tobacco control measures,
including prevention, cessation, and enforcement of tobacco control laws.
 National Oral Health Programme (NOHP): Addresses oral health issues through
promotion, prevention, and treatment services.
 National Programme for Palliative Care (NPPC): Provides palliative care services for
patients with life-limiting illnesses, focusing on pain relief and improving quality of life.
 National Programme for Prevention & Management of Burn Injuries (NPPMBI): Aims
to prevent and manage burn injuries through awareness, prevention, and treatment services.
Other Non-Communicable Disease Control Programmes:
Includes various initiatives focusing on prevention, early detection, and management of specific non-
communicable diseases, such as cancer, diabetes, cardiovascular diseases, and stroke.

Communicable Disease Control Programme:

 National Vector Borne Disease Control Programme (NVBDCP): Focuses on prevention
and control of vector-borne diseases like malaria, dengue, chikungunya, etc.
 Revised National Tuberculosis Control Programme (RNTCP): Aims to control
tuberculosis (TB) through various strategies like early diagnosis, treatment, and prevention.
 National Leprosy Eradication Programme (NLEP): Aims to eliminate leprosy through
early detection, treatment, and rehabilitation services.
 Integrated Disease Surveillance Programme (IDSP): Focuses on surveillance, early
detection, and response to communicable diseases to prevent outbreaks and spread of
diseases.

Infrastructure Maintenance
This component of Family Welfare Programme has been supported over several Plan periods.
Support under this component is provided to states to meet salary requirement of Schemes viz.
Direction & Administration (Family Welfare Bureaus at state & district level), Sub-Centres, Urban
Family Welfare Centres, Urban Revamping Scheme (Health Posts), ANM/LHV Training Schools,
Health & Family Welfare Training Centres, and Training of Multi-Purpose Workers (Male). This
dispensation would continue. However, any new SHCs or health posts under this component would
be supported only with the approval of the GOI.
 Financing Components: outlined in the context of the National Health Mission (NHM)
provide flexibility to states in planning and implementing health action plans.
 NRHM-RCH Flexipool: This pool of funds is designated for the National Rural Health
Mission (NRHM) - Reproductive and Child Health (RCH) initiatives, emphasizing maternal
and child health services in rural areas.
 NUHM Flexipool: Similar to the NRHM-RCH Flexipool, this pool of funds is allocated for
the National Urban Health Mission (NUHM), focusing on health initiatives in urban areas.
 Flexible Pool for Communicable Disease: Funds allocated for addressing communicable
diseases, including prevention, control, and management strategies.
 Flexible Pool for Non-communicable Disease including Injury and Trauma: Funds
designated for addressing non-communicable diseases (NCDs), injuries, and trauma,
emphasizing preventive measures and healthcare services.
 Infrastructure Maintenance: Funds allocated for maintaining and improving healthcare
infrastructure, ensuring the functionality and quality of health facilities.
 Family Welfare Central Sector Component: Funds designated for family welfare
programs, including family planning and reproductive health services.
The State Program Implementation Plans (PIPs) are developed based on these financing components,
outlining state-specific strategies, activities, budgetary requirements, and expected health outputs and
outcomes. The approval process involves appraisal by the National Programme Coordination
Committee (NPCC) and final approval by the Union Secretary of Health & Family Welfare.
Additionally, the Forward Linkage Scheme to NRHM in the North Eastern (NE) region complements
NHM initiatives by improving secondary/tertiary level and other health infrastructure. The scheme is
funded through a sharing pattern between the central and state governments, with recent revisions in
the sharing ratio to 90:10.

ACHIEVEMENTS OF NHM

The National Health Mission (NHM) launched in 2013 in India has achieved several
significant milestones and accomplishments in its mission to improve healthcare
access, quality, and equity across the country. Here are some of the achievements of
NHM since its inception:

1.Improvement in Health Indicators:

 In the 15 years of implementation, the NHM has enabled achievement of the Millennium
Development Goals (MDGs) for health.
The MDGs have been superseded by the Sustainable Development Goals.
 It has also led to significant improvements in maternal, new-born, and child health
indicators, particularly for maternal mortality ratio, infant and under five mortality
rates, wherein the rates of decline in India are much higher than the global
averages and these declines have accelerated during the period of implementation of
NHM.
2.Growth in Public Health Facilities:

 NHM adopts a health system approach and targets to build a network for public health
facilities with Health & Wellness Centres at the grassroot level and District
Hospitals, with robust referral linkage, to offer Comprehensive primary and secondary care
services to citizens.
 NHM has not only contributed to increase in the institutional capacities for service
delivery but also has led to development of capacities for targeted interventions of the
various National Programmes under the NHM.
3.Equitable Development:

 There was also a sustained focus on the health of tribal populations, those in Left Wing
Extremism areas, and the urban poor.
 A more recent effort at ensuring equity in access and use, is the Aspirational district
initiative, in which 115 districts across 28 states, with weak social and human
development indicators have been identified for allocation of additional resources and
capacity enhancement to catch up with more progressive districts.
4.National Ambulance Services:

 At the time of launch of NRHM (2005), ambulance networks were non-existent.

 So far, 20,990 Emergency Response Service Vehicles are operational under NRHM.
 Besides 5,499 patient transport vehicles are also deployed, particularly for providing
“free pickup and drop back” facilities to pregnant women and sick infants.
5.Human Resource Augmentation:

 NHM supports states for engaging service delivery HR such as doctors, nurses and health
workers and also implements the world’s largest community health volunteer
programme through the Accredited Social Health Activists (ASHAs).
 More than 10 lakhs ASHAs and ASHA facilitators are engaged under NHM.
 NHM has also supported states to acquire staff with skills in public health, finance,
planning and management to plan and implement interventions, freeing up clinical staff to
deliver health services.
6.Health Sector Reforms:

 NHM enabled the design and implementation of reforms specifically related to

Governance, Procurement and Technology.
7.Addressing high Out-of-Pocket Expenditure (OOPE):

 Recognising the need for reducing the current high levels of OOPE, and that, almost 70%
of the OOPE is on account of drugs and diagnostics, the Free Drugs and Free Diagnostics
Services Initiatives have been implemented under the NHM.
 The National List of Essential Medicines (NLEM) and the Essential Diagnostics
Lists have been notified and are periodically updated to include more essential drugs
based on new initiatives undertaken.

CHALLENGES
The National Health Mission (NHM) launched in 2013 in India aimed to provide accessible,
affordable, and quality healthcare to all citizens, especially those in rural and underprivileged
areas. While the mission has made significant strides in improving healthcare infrastructure and
service delivery, it has also faced several challenges:

a) Infrastructure and Human Resource Constraints: One of the primary challenges of

NHM has been the lack of adequate healthcare infrastructure and human resources in rural
and remote areas. Many primary health centres (PHCs) and community health centers
(CHCs) lack basic facilities and skilled healthcare professionals, leading to inadequate
healthcare services.
b) Healthcare Financing: Despite increased government spending on healthcare through
NHM, financing remains a challenge. The allocation of funds often falls short of the actual
requirements, hindering the implementation of essential healthcare programs and
initiatives.
 c) Quality of Healthcare Services: Ensuring the quality of healthcare services across all
levels of the healthcare system is another challenge. There are concerns regarding the
competence and accountability of healthcare providers, as well as the availability of
essential drugs and equipment in public health facilities.
a) Healthcare Access and Equity: Disparities in healthcare access and utilization persist,
with marginalized communities, women, and children often facing barriers to accessing
essential healthcare services. Addressing these disparities requires targeted interventions
and strategies to improve access and equity.
b) Health Information Systems and Data Management: Effective planning, monitoring,
and evaluation of healthcare programs depend on robust health information systems and
data management mechanisms. However, challenges such as inadequate data collection,
poor data quality, and limited capacity for data analysis hinder evidence-based decision-
making and program implementation.
c) Disease Burden and Emerging Health Challenges: India continues to face a significant
burden of communicable and non-communicable diseases, as well as emerging health
challenges such as antimicrobial resistance and outbreaks of infectious diseases. NHM
needs to adapt and respond effectively to these evolving health priorities.
d) Community Participation and Engagement: Meaningful community participation and
engagement are essential for the success of NHM initiatives. However, mobilizing
communities and ensuring their active involvement in healthcare planning and decision-
making processes pose challenges, particularly in culturally diverse and geographically
dispersed regions.
e) Intersectoral Collaboration: Addressing the social determinants of health requires
collaboration across multiple sectors, including health, education, nutrition, sanitation, and
social welfare. Coordination and collaboration among various government departments
and stakeholders remain a challenge in achieving comprehensive and integrated healthcare
delivery.
While NHM has made significant progress in addressing these challenges since its inception,
sustained efforts and investments are needed to overcome the remaining barriers and achieve the
mission's goals of universal health coverage and health equity for all citizens.

ROLE OF DIFFERENT STAKEHOLDERS IN NATIONAL HEALTH

POLICY

Role of public sector

The public healthcare system consists of facilities run by the central and state government. These
public facilities provide free or subsidized rates to lower income families in rural and urban areas.
The Constitution of India divides health-related responsibilities between the central and the state
governments. While the national government maintains responsibility for medical research and
technical education, state governments shoulder the responsibility for infrastructure, employment, and
service delivery. The concurrent list (in the 9th schedule to the Constitution of India) includes issues
that concern more than one state, e.g., preventing extension of infectious or contagious diseases
among states. While the states have significant autonomy in managing their health systems, the
national government exercises significant fiscal control over the states’ health system.

Subcenters - In rural areas, health sub-centres form the institutional basis of primary health care. It
typically performs basic medical services, immunizations, and referrals. Subcenters are usually
temporary structures that employ 1–2 care workers in most locations.

Primary health centers (PHCs) typically perform preventive and curative medical services. PHCs are
usually small (about 5 beds) with 1–2 qualified doctors, and 14 paramedics and support staff. Each
PHC is typically a referral unit for a subcenter cluster of about six.
Surveyed public and private primary level health facilities

Source 1. NNMS 2017-18 (https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-021-06530-0/figures/1)

Community health centers
The secondary sector of the Indian health care system consists of rural hospitals and community
health centres (CHC). Serving four PHCs, the CHC’s specialised medical services are intended for
120,000 people.
Surveyed public secondary level health facilities

Source 2. NNMS 2017-18 (https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-021-06530-0/figures/2)

Role of private sector

India is encouraging investment in healthcare sector; over the years, the private sector in India has
gained a significant presence in all the sub-segments of medical education and training, medical
technology and diagnostics, pharmaceutical manufacture and sale, hospital construction and ancillary
services, as also the provisioning of medical care. Over 75% of the human resources and advanced
medical technology, 68% of hospitals and 37% of total beds in the country are in the private sector.

Problems with private sector

The private sector is not only India’s most unregulated sector but also its most potent untapped
sector. Although inequitable, expensive, over-indulgent in clinical procedures and without quality
standards or public disclosure of practices
 INEQUITABLE
 EXPENSIVE
 OVERINDULGENT IN CLIMNICAL PROCEDURES
 WITHOUT QUALITY STANDARDS

PUBLIC PRIVATE PARTNERSHIP

The private sector is perceived to be easily accessible, better managed and more efficient than its
public counterpart. It is assumed that collaboration with the private sector in the form of
Public/Private Partnership would improve equity, efficiency, accountability, quality and
accessibility of the entire health system. Advocates argue that the public and private sectors can
potentially gain from one another in the form of resources, technology, knowledge and skills,
management practices, cost efficiency and even a make-over of their respective images. Partnerships
are expected to ameliorate the resource constraints of the public sector by reducing investments in
expensive tertiary care services.
Partnership with the private sector has emerged as a new avenue of reforms, in part due to resource
constraints in the public sector of governments across the world. There is growing realisation that,
given their respective strengths and weaknesses, neither the public sector nor the private sector alone
can operate in the best interest of the health system. There is also a growing beliefthat public and
private sectors in health can potentially gain from one another. Involvement of the private sector is,
in part, linked to the wider belief that public sector bureaucracies are inefficient and unresponsive
and that market mechanisms will promote efficiency and ensure cost effective, good quality services

ROLE OF CIVIL SOCIETY IN HEALTH POLICY

We find that civil society helps the health system to connect with difficult-to-reach populations and
achieve wider coverage. They can also build the capacity of frontline staff in the public systems in
formal and informal ways. They can recommend ways to change the attitudes and motivations of
these workers. Civil society organizations with their close connection with the community can play
the part of a “gap-filler” and data messenger. Finally, they can refer people to appropriate health
facilities minimizing out-of-pocket expenditure on health.

Case study of covid pandemic

Recently, the pandemic placed a great burden on the existing public health system and civil society
stepped forward not only to help the vulnerable population to mitigate challenges that subsequently
arose but also to fill the gaps the pandemic exposed in India's health care system . The number of
NGOs working in India has grown significantly since the 1990s. The United Nations recognizes that
civil society organizations have a crucial role to play in delivering Sustainable Development Goals
(SDGs). The third goal (SDG 3) pertains to ensuring “healthy lives and promote wellbeing for all at
all ages.” This is probably among the most ambitious goals in terms of breadth, scale and complexity.
Within this, target 3.8 relates to “universal health coverage.” The goal of universal health coverage
(UHC) is that everyone should receive the health care they need without facing any financial
hardships.

FUTURE DIRECTIONS FOR NATIONAL HAELTH POLICY

India’s health scenario currently presents a contrasting picture. While health tourism and private
healthcare are being promoted, a large section of Indian population still reels under the risk of curable
receive adequate attention of policymakers. India’s National Rural Health Mission is undeniably an
intervention that has put public heath care upfront. Although the government has been making efforts
to increase healthcare spending via initiatives like the National Rural Health Mission, much still
remains to be done. The priority will be to develop effective and sustainable health systems that can
meet the dual demands posed by the growth in non communicable diseases and peoples.

FUTURE DIRECTIONS AT THREE STAGES

POLICY FORMULATION IMPLEMENTATION EVALUATION
Establishment of rational Use of multi prone strategy Regular monitoring
policies
Community engagement participation of multi stakeholders Grievance redressal
mechanism
Role of civil society 3A’s Community or social
auditing
Availabality, Affordability, Accessibility

More public expenditure on 3Es Use of technology

health
Effective, Efficient, Economic
More focus on communicable Feedback
diseases mechanisms
and mental health
A CASE STUDY BASED ON APPROACH OF SOUTH KOREA HEALTH
POLICY
 KEY AREAS TO FOCUS

Establishment of a Sustainable Long-term Plan

Through Sufficient Preparation
Establishing a national long-term plan involves analyzing
current social conditions and future policy directions for the
promotion of sustainable policies in the future. Furthermore,
the overall flow of health promotion policies can be derived
by analyzing the establishment and improvement of relevant
legal systems and the development process of policies and
projects in different periods

Improvement of Universal Health Standards and

Health Equity
Regarding the improvement of health equity, the symbolic
general goal was made more concrete to emphasize health
equity, which had drawn little interest in the past, and rein1

force its effectiveness as a general goal.

Change into a Policy That Everyone Participates in and

Makes Together
it was not only decreed that anyone can take part in the plan,
but that
this value should be put in place while establishing this plan.
A plan is truly national only if it involves the participation of
the public, as well as government and private sector experts,
in proposing and making the policy. Because the vision and
goal of the long-term plan reflect the current social environ1
ment and implicitly express the direction of development pur1
sued by the country,.
 Focus on Prevention and Health Promotion: Shift emphasis from treating illness to preventing
it through initiatives such as public health campaigns, community education, and incentivizing
healthy behaviors.

 Health Equity and Access: Develop policies to reduce disparities in healthcare access and
outcomes among different demographic groups, including marginalized communities and rural
populations.

 Integration of Mental Health Services: Integrate mental health services into primary care
settings to ensure early detection and treatment of mental health disorders, reducing stigma, and
improving access to care.

 Investment in Telemedicine and Digital Health: Expand telemedicine services and digital health
technologies to improve access to healthcare in underserved areas, increase efficiency, and
facilitate remote monitoring of patients with chronic conditions.

 Addressing Social Determinants of Health: Implement policies that address social determinants
of health such as housing, education, employment, and nutrition to improve overall health
outcomes and reduce healthcare costs.

 Data-driven Decision Making: Utilize data analytics and health informatics to inform policy
decisions, improve population health management, and identify areas for intervention and
improvement.

 Healthcare Workforce Development: Invest in training and retaining healthcare professionals,

particularly in underserved areas and in fields facing shortages, such as primary care, nursing, and
mental health.

 Innovative Financing Models: Explore alternative financing models such as value-based care,
bundled payments, and accountable care organizations to incentivize quality of care over quantity
and contain healthcare costs.

 Patient-Centered Care: Promote patient-centered care models that empower patients in decision-
making, improve communication between patients and providers, and prioritize patient
preferences and values.

 Global Health Collaboration: Foster collaboration with international partners to share best
practices, exchange knowledge, and address global health challenges such as pandemics,
infectious diseases, and climate change-related health issues.

 Health Technology Assessment: Strengthen the evaluation of healthcare technologies and

interventions to ensure that resources are allocated efficiently and effectively, considering both
clinical effectiveness and cost-effectiveness.

 Emergency Preparedness and Response: Enhance national preparedness and response

capabilities to effectively manage public health emergencies, including pandemics, natural
disasters, and bioterrorism threats.

 Community Engagement and Empowerment: Involve communities in the design,

implementation, and evaluation of health policies to ensure they meet local needs and preferences,
and to build trust in healthcare systems.
  Environmental Health Policies: Develop policies to mitigate environmental factors that
impact health, such as air and water pollution, climate change, and exposure to toxins, to
prevent related diseases and promote population health.

WAY FORWARD
C= COMMUNITY ENGAGEMENT AND PUBLIC PARICIPATION
A= AVAILABILITY, ACCESSEBILITY, AFFORDABILITY
R= RESPONSIBILITY AND ACCOUNTABILITY
E= EFFECTIVE, ECONOMIC, EFFICIENT

CONCLUSION
So far as the concept of the right to health is concerned it is nowhere mentioned in the Constitution
of India. The Apex Court has interpreted the right to health right under the right to life provided
under Article 21.20 Right to Health is an inclusive right. Further, it can be said that the quality
growth of a Nation depends upon the sound public health in that particular territory. In Consumer
Education and Research Centre vs. Union of India, the Supreme Court, for the first time held that,
“the right to health is an integral facet of a meaningful right to life” and that the Right to Health is a
fundamental right. It is one of the dimensions of Article 21 of the Indian Constitution. Thereafter in
many decisions right to health has been held as a fundamental right. The role of the Supreme Court is
significant as there is no Indian legislation that gives the right to health to the people at large. It is
only the desire of the state which can fulfil the public health needs. From the law point of view the
State is under a legal obligation to protect the right to health as India is a party to various
international treaties on health rights. Finally, it can be said that optimum use of resources available
and utilisation of fund available for public health will improve the status of public health so that
government enact national legislation providing Right to Health. In a welfare country like India
welfare of the people is the prime responsibility of the government. The current situation is not up to
the mark and therefore Union Government has straightway rejected providing the Right to Health as
a legal right by enacting a special law. The present situation of the health sector for which both
Union and State Government are responsible and same is the reasons for not providing the right to
health as a justiciable right. It is only possible if the Union Government and State Governments are
willing to do the same.

SUBMITTED BY-
1. Kashish Keshari (Introduction of NHM)
2. Pooja Mina (Achievements and challenges of NHM)
3. Kiran (Case study and Conclusion)
4. Pooja Kumari (Implementation strategies)
5. Kaniska Chundawat (Goals and Objectives)
6. Rinky (Components of NHM)