National Rural Health Insurance Scheme

The NRHM is a health insurance scheme launched by the Indian government. It offers rural residents free and affordable healthcare by building functional and decentralised health facilities in declared rural areas.

Its primary mission is to reduce infant and maternity mortality rates among rural residents by making sure they get access to quality healthcare services and free medicine.

The NRHM is only available to permanent residents of declared rural areas in India. This means people living in urban areas cannot claim the benefits of health insurance under this scheme.

To ensure the efficient delivery of their services to rural residents, the NHRM uses a five-pronged approach:

• The rural community should be able to access the health system with ease.

• Innovative management of human resources.

• Ensuring progress is maintained according to set benchmarks.

• Flexible financing through non-profit organisations.

• Continual improvements within the management framework.

Overall reduction of Infant Mortality Rate (IMR) and Maternal Mortality Ratio (MMR) in rural areas.

• Universal access to free public health services like women's health, child health and access to clean water, immunisation, and nutrition.

• Prevention and control of infectious and non-infectious diseases, with a focus on locally endemic diseases like malaria, dengue, tuberculosis, etc.

• Access to readily available comprehensive primary healthcare services

• Demographic and gender balance and population stabilisation by providing medical services for delivery, safe abortions and Family Planning Services while ensuring full reproductive choices to women.

• Revitalise local health traditions and mainstream AYUSH to revive local health traditions.

• Promoting healthy lifestyles by launching more programmes on Health Education activities and working with education departments to make health promotion and preventive health an integral part of general education.

To institutionalise community-led action for health services. This involves training the Panchayat Raj Institutions (PRIs) – at every level, to own and manage health services set up in their regions.

• Promote access to improved healthcare at the household level through female health activists (ASHA).

• Another facet of this includes reorienting medical education to support rural health issues, including regulation of Medical care and Medical Ethics.

• Strengthening sub-health centres through an untied fund to enable local planning and action. This includes skill upgradation, multi-skilling of the existing medical staff, and introducing more human resources to existing facilities.

• Strengthening existing primary (PHC) and community health centres (CHC) and providing 30- 50 bedded CHC per lakh population for improved medical care to an acceptable standard.

• Launching vertical Health and Family Welfare programmes at National, State, Block, and District levels.

• Strengthening capacities by setting up State Procurement Systems and Distribution Networks for improved supplies and distribution.

• Increasing awareness and facilitating preventive health care at all levels by promoting healthy lifestyles, reduction in consumption of tobacco and alcohol, etc.

• Promotion of Public-Private Partnerships for achieving public health goals.

Significant Reduction of Infant and Maternity Mortality Rates: The Infant Mortality Rate has reduced to 30/1000 live births, and the Maternal Mortality Ratio has reduced to 100/100,000. Pregnant women in rural areas get free healthcare for prenatal and postnatal care

High-Quality Medical Services in Rural Areas: The scheme involves the cooperation of the Panchayat Raj Institutions (PRI) so residents can access high-quality healthcare facilities and services.

Prioritisation of Preventative Healthcare: Rural residents make prevention their first priority and they put more importance into treating illnesses instantly once diagnosed. The rate of tobacco usage has also gone down as a result.

Affordable and Effective Disease Treatment: Residents can now access affordable treatments for infectious and non-communicable diseases, especially locally endemic diseases like malaria or dengue.

Rural Residents Get Offered Higher Employment Chances: The NHRM gives more preference to hiring local residents through programs like ASHA, Janani Suraksha Yojana, Rogi Kalyan Samiti, Village Health Sanitation and Nutrition Committee (VHSNC), etc.

Access to More and Better Equipped Healthcare Facilities: More facilities have been set up with the help of the Indian government through funding and budgetary allocations. Moreover, this has also helped with renovating pre-existing ones.

Ensuring Healthcare Service Delivery in Rural Regions

The activities of the NRHM exist to fill gaps in human resources in the healthcare sector by providing 2.23 lakhs additional healthcare service workers to Indian states.

These include contractual basis workers like medical specialists, General Duty Medical Officers (GDMOs), paramedics (Allied Health Professionals), midwives, nurses, management staff, etc.

This program also works on multi-skilling doctors stationed in rural areas. For example, MBBS doctors qualified for Life Saving Anaesthesia Skills (LSAS), Laparoscopic Surgery and Emergency Obstetric Care (EmOC).

Launching and Maintaining the Rogi Kalyan Samiti (Patient Welfare Committee)

This committee makes sure hospitals abide by minimal standards and guidelines to ensure proper patient care for rural residents covered by the National Rural Health Mission.

This means ensuring all doctors and medical staff are trained properly, proper use of hospital lands and implementing National Health Programmes at hospitals/health institutions under this committee’s administrative jurisdiction.

Other responsibilities include gathering funds to help update and modernise hospital equipment. This is done through outreach services, local donations, and facilitating affiliations with private institutions.

** Launching and Maintaining a Village Health Sanitation and Nutrition Committee (VHSNC)**

This committee aims to create awareness of nutritional issues and good nutrition as an essential determinant of health.

Its members include ASHA workers, other frontline workers and Panchayati Raj representatives whose role is to identify nutrition deficiencies and improve the overall health status of women and children.

First Preference for Locally Trained and Recruited Medical Staff

Local residents are preferred for staff recruitment wherever possible under this scheme.

This includes multi-skilled doctors, Staff Nurses, GDMOs (General Duties Medical Officers) and ANMs (Auxiliary Nurse Midwife) who have been recruited under this scheme, which adds up to well over 1.88 lakh staff.

Maintaining Standardised Procedures at All NRHM Facilities

Residents are guaranteed healthcare services at every level. This is because the National Rural Health Mission has imposed fixed guidelines for public health at every block level (100 villages) – primary, sub and community health (ASHA) centre levels.

Launching and Maintaining the Janani Shishu Suraksha Karyakram Program

A key component of the NRHM, this rural health scheme's main goal is is reduce maternity mortality rates. Pregnant women are encouraged to use public delivery services under the NRHM scheme.

They can claim free deliveries, including c-sections and are provided with food, transportation, blood supply, and free medication and tests.

Maintaining Accessible Healthcare Systems in Rural Areas

The NRHM’s facilities are available in rural areas of Himachal Pradesh, Jammu and Kashmir, North Eastern States, and the Empowered Action Group (EAG). These states receive locally accessible, high-quality medical care services.

To claim this rural health scheme’s benefits, the permanent residents of declared rural areas need to properly enrol as per the given process.

It is available in eight of India's economically backward states – Orissa, Bihar, Jharkhand, Rajasthan, Chhattisgarh, Uttar Pradesh, Madhya Pradesh and Uttaranchal. Additionally, rural areas of Himachal Pradesh, North Eastern States and Jammu and Kashmir also receive NRHM services.

There is no application or registration process for this scheme. You can use the NRHM’s services for free if you are a permanent resident in a declared rural area and your area offers them. For newly assigned areas under the scheme, an assigned worker will reach residents door-to-door.

You can contact the assigned ASHA worker in your village for more assistance. They can be found at the nearest Anganwadi centre.

No. The NHRM is a submission of the NHM. The NHM or National Health Mission is made of two Sub-Missions, the National Rural Health Mission (NRHM) and the National Urban Health Mission (NUHM).

The NHM aims to strengthen rural and urban health systems and prevent and control the spread of communicable and non-communicable diseases.

The National Health Mission (NHM) is the parent scheme, while the National Rural Health Mission (NRHM) is a health scheme provided under it that focuses on improving healthcare systems in rural areas only.

The National Rural Health Mission (NRHM) is a health insurance scheme launched to help permanent residents of declared rural areas. Its main goal is to introduce free healthcare and services to India's economically challenged states.

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