Health And Family Welfare

The Union ministry of Health and Family Welfare is instrumental and responsible for implementation of various
programmes on a national scale in the areas of health and family welfare ,prevention and controlling of communicable
diseases. The Ministry also assists states in preventing and controlling the spread of seasonal disease outbreaks and
epidemics through technical assistance .In Addition to centrally sponsored family welfare programmes ,mit also
implements the world bank assisted programmes on AIDS, Tuberculosis, Malaria etc.

National Health Policy 2015 :

The primary aim of the of the new health policy draft is to inform , clarify ,strengthen and prioritize the role of the
government in shaping health systems in all its dimensions by following certain key principles including equity
,universality and inclusive partnership. The objectives are set in the present draft are aspirational like in a vision
document .They need to be transformed into a policy which should have a clear cut goals and targets and a stipulated
time frame to achieve these objective. The policy should aim at a 10 to15 year time frame and the goals should be
harmonized with the sustainable development goal. The policy reiterates the commitment to increase investments to
2.5 percent of GDP But no specific time frame has been set to reach the target. The draft proposes the following
objectives as its goal posts for achieving affordable, accountable and responsive health care to the Indian masses

•Improve population health status through concerted policy action in all sectors
and expand preventive, promotive, curative, palliative and rehabilitative services
provided by the public health sector.

•Assure universal availability of free, comprehensive primary health care services, as an

entitlement, for all aspects of reproductive, maternal, child and adolescent health and for
the most prevalent communicable and non-communicable diseases in the population

•Achieve a significant reduction in out of pocket expenditure due to health care costs and
reduction in proportion of households experiencing catastrophic health expenditures and
consequent impoverishment.

•Enable universal access to free essential drugs, diagnostics, emergency ambulance

services, and emergency medical and surgical care services in public health facilities, so as
to enhance the financial protection role of public facilities for all sections of the
population.

•Ensure improved access and affordability of secondary and tertiary care services through a
combination of public hospitals and strategic purchasing of services from the private
health sector.

•. Influence the growth of the private health care industry and medical technologies to
ensure alignment with public health goals, and enable contribution to making health care
systems more effective, efficient, rational, safe, affordable and ethical.
Outcomes for NHM in the 12th Plan are synonymous with those of the 12th Plan, and are part of the overall vision. The
endeavor would be to ensure achievement of those indicators . Specific goals for the states will be based on existing
levels, capacity and context. State specific innovations would be encouraged. Process and outcome indicators will be
developed to reflect equity, quality, efficiency and responsiveness. Targets for communicable and non-communicable
disease will be set at state level based on local epidemiological patterns and taking into account the financing available
for each of these conditions

National National
National
Rural Urban
Health
health health
Mission
Mission Mission

National Urban Health Mission

The National Urban Health Mission (NUHM) as a sub-mission of National Health Mission (NHM) has been approved by
the Cabinet on 1st May 2013.

NUHM envisages to meet health care needs of the urban population with the focus on urban poor, by making available
to them essential primary health care services and reducing their out of pocket expenses for treatment. This will be
achieved by strengthening the existing health care service delivery system, targeting the people living in slums and
converging with various schemes relating to wider determinants of health like drinking water, sanitation, school
education, etc. implemented by the Ministries of Urban Development, Housing & Urban Poverty Alleviation, Human
Resource Development and Women & Child Development.

National Rural Health Mission (NRHM)

The National Rural Health Mission (NRHM) was launch on 12th April 2005, to provide accessible, affordable and quality
health care to the rural population, especially the vulnerable groups. The Union Cabinet vide its decision dated 1st May
2013, has approved the launch of National Urban Health Mission (NUHM) as a Sub-mission of an over-arching National
Health Mission (NHM), with National Rural Health Mission (NRHM) being the other Sub-mission of National Health
Mission.

NRHM seeks to provide equitable, affordable and quality health care to the rural population, especially the vulnerable
groups. Under the NRHM, the Empowered Action Group (EAG) States as well as North Eastern States, Jammu and
Kashmir and Himachal Pradesh have been given special focus. The thrust of the mission is on establishing a fully
functional, community owned, decentralized health delivery system with inter-sectoral convergence at all levels, to
ensure simultaneous action on a wide range of determinants of health such as water, sanitation, education, nutrition,
social and gender equality. Institutional integration within the fragmented health sector was expected to provide a focus
on outcomes, measured against Indian Public Health Standards for all health facilities.

Important Sub missions of National Health Mission :

The India Newborn Action Plan (INAP) was launched in September 2014 with the aim of ending preventable newborn
deaths and stillbirths by 2030.
The salient features are:

INAP has set the goals for neonatal mortality and stillbirths. The goal is to attain Single Digit Neonatal Mortality
and Stillbirth Rates by 2030.
INAP is to be implemented within the existing Reproductive, Maternal, Newborn, Child and Adolescent health
(RMNCH+A) framework of the National Health Mission (NHM).
Six pillars of intervention packages impacting stillbirths and newborn health have been identified, which include:
Preconception and antenatal care
Care during labour and child birth
Immediate newborn care
Care of healthy newborn
Care of small and sick newborn
Care beyond newborn survival

· For effective implementation, a systematic plan for monitoring and evaluation has been developed with a list of
dashboard indicators.

INAP is now serving as a framework for the States to develop state-specific action plans and it is expected that these
interventions would have an impact in reducing newborn mortality in the country.

Birth Defect surveillance has been started recently in 37 Medical Colleges across the country. This aims to build and
strengthen surveillance capacity and expand the availability of standardized and accurate data on congenital anomalies.

INAP has been disseminated at the national and regional levels in order to facilitate the States to formulate their own
need-based plans. As a result, the States are now in the process of developing their State-specific Newborn Action Plans.

Rashtriya Kishor Swasthya Yojana

According to the 2011 census the adolescent population(10years -19 years) is about a fifth of the total population.
Government of India recognizes the importance of influencing health seeking behavior of adolescents. The health
situation of this age group is a key determinant of India’s overall health ,mortality ,morbidity and population growth
scenario. There fore the government has started the Rashtriya Kishor Swasthya Yojana ,the programme expands the
scope of adolescent health programming in India from being limited to sexual and reproductive health ,it now includes
in its ambit nutrition, injuries, non communicable disease etc. The key drivers of the program are community based
interventions, adolescent friendly health clinics across all levels. Focus is on reorganizing the public health system in
order to meet the service needs of adolescents. The programme has the following components namely:

 Peer Education: It is a major component of this programme ,In every village four peer educators will be
selected per village /1000 population who will inform and educate the young
Adolescents and young people.
 Adolescent Health Day : It’s a quarterly activity to be organized in every village to apprise adolescent ,their
parents about health issues and their importance.
 Weekly Iron and Folic Acid Supplementation Programme : During this period in life ,there is significant increase
in nutritional requirement ,especially for iron. Amaemia a manifestation of under nutrition and poor dietary
intake of iron is a public health problems which makes this programme extremely important.
 Menstrual Hygiene Scheme: The ministry of Health and Family Welfare launched this scheme for the promotion
of Menstrual Hygiene among adolescent girls in the age of 10-19 years, To increase awareness among
 adolescent girls on menstrual hygiene, To increase access to quality sanitary products and ensure safe disposal
of sanitary products.

So it may be reiterated that above mentioned interventions under Rashtriya Kishor SwasthyaYojana , are of
utmost importance to ensure transition of these adolescent as health and
productive adults contributing to country’s economic growth.

Janani Shishu Suraksha Karyakram:

About 56,000 women in India die every year due to pregnancy related complications. Similarly, every year more than 13
lacs infants die within 1year of the birth and out of these approximately 9 lacs i.e. 2/3rd of the infant deaths take place
within the first four weeks of life. Out of these, approximately 7 lacs i.e. 75% of the deaths take place within a week of
the birth and a majority of these occur in the first two days after birth. In order to reduce the maternal and infant
mortality, Reproductive and Child Health Programme under the National Rural health Mission (NHM) is being
implemented to promote institutional deliveries so that skilled attendance at birth is available and women and new born
can be saved from pregnancy related deaths.

In view of the difficulty being faced by the pregnant women and parents of sick new- born along-with high out of pocket
expenses incurred by them on delivery and treatment of sick- new-born, Ministry of health and Family Welfare
(MoHFW) has taken a major initiative to evolve a consensus on the part of all States to provide completely free and
cashless services to pregnant women including normal deliveries and caesarean operations and sick new born(up to 30
days after birth) in Government health institutions in both rural & urban areas.
Government of India has launched Janani Shishu Suraksha Karyakaram (JSSK) on 1st June, 2011.
The following are the Free Entitlements for pregnant women:
 Free and cashless delivery

 Free C-Section

 Free drugs and consumables

 Free diagnostics

 Free diet during stay in the health institutions

 Free provision of blood

 Exemption from user charges

 Free transport from home to health institutions

 Free transport between facilities in case of referral

 Free drop back from Institutions to home after 48hrs stay

Rashtriya Bal Swasthya KaryaKram:

Ministry of Health and Family Welfare under the flagship National Rural Health Mission launched Rashtriya Bal
Swasthya Karyakram (RBSK) as structured health screening and management of childhood health conditions in February
2013.RBSK aims at early detection and management of the prevalent health conditions in children groups in 4 broad
groups, ‘4Ds’- Defects at birth, Diseases of childhood, Deficiency and Developmental delays including disabilities. A
total of 30 conditions have been identified for screening and appropriate referral and management.
The services aim to cover all children of 0 to 6 years of age in rural areas and urban slums in addition to children enrolled
in classes 1st to 12th in Government and Government aided schools. It is expected that these services will reach to
about 270 million children in a phased manner.
The following mechanisms as per GOI Operational Guidelines will be used to reach children for health screenings:
Community based newborn screening at home through ASHAs for newborn till 6 weeks of age during home
visitation.
Angan wadi Centre based screening by the dedicated mobile health teams for children 6 weeks to 6 years
Government and Government aided school based screening by dedicated mobile health teams for children 6
years to 18 years.
Facility based newborn screening at public health facilities, by existing health manpower.

The ‘Child Health Screening and Early Intervention Services’ will also translate into economic benefits in the long run.
Timely intervention would not only halt the condition to deteriorate but would also reduce the out-of-pocket (OOP)
expenditure of the poor and the marginalized population in the country. Additionally, the Child Health Screening and
Early Intervention Services will also provide country-wide epidemiological data on the 4 Ds (i.e., Defects at birth,
Diseases, Deficiencies and Developmental Delays including Disabilities). Such a data is expected to hold relevance for
future planning of area specific services.

AYUSH
th
The Ministry of AYUSH is formed in 9 November 2014 for providing more healthcare to the public. The Department of
Indian Medicine and Homeopathy (ISM&H) was created in March 1995 and renamed as Department of Ayurveda, Yoga
and Naturopathy, Unani, Siddha and Homoeopathy (AYUSH) in November 2003, with a view to providing focused
attention to development of Education and Research in Ayurveda, Yoga and Naturopathy, Unani, Siddha and
Homoeopathy systems.

NATIONAL AYUSH MISSION (NAM)

1. Introduction:
Department of AYUSH, Ministry of Health and Family Welfare, Government of India has launched National
AYUSH Mission (NAM) during 12th Plan for implementing through States/UTs. The basic objective of NAM is to
promote AYUSH medical systems through cost effective AYUSH services, strengthening of educational
systems, facilitate the enforcement of quality control of Ayurveda, Siddha and Unani & Homoeopathy (ASU
&H) drugs and sustainable availability of ASU & H raw materials. It envisages flexibility of implementation of
the programmes which will lead to substantial participation of the State Governments/UT. The NAM
contemplates establishment of a National Mission as well as corresponding Missions in the State level. NAM is
likely to improve significantly the Department’s outreach in terms of planning, supervision and monitoring of
the schemes.
2. Vision:
To provide cost effective and equitable AYUSH health care throughout the country by improving access
to the services.
To revitalize and strengthen the AYUSH systems making them as prominent medical streams in
addressing the health care of the society.
To improve educational institutions capable of imparting quality AYUSH AYUSH education
To promote the adoption of Quality standards of AYUSH drugs and making available the sustained
supply of AYUSH raw-materials.
3. Objectives:
To provide cost effective AYUSH Services, with a universal access through upgrading AYUSH Hospitals
and Dispensaries, co-location of AYUSH facilities at Primary Health Centres (PHCs), Community Health
Centres (CHCs) and District Hospitals (DHs).
To strengthen institutional capacity at the state level through upgrading AYUSH educational
institutions, State Govt. ASU&H Pharmacies, Drug Testing Laboratories and ASU & H enforcement
mechanism.
Support cultivation of medicinal plants by adopting Good Agricultural Practices (GAPs) so as to provide
sustained supply of quality raw materials and support certification mechanism for quality standards,
Good Agricultural/Collection/Storage Practices.
Support setting up of clusters through convergence of cultivation, warehousing, value addition and
marketing and development of infrastructure for entrepreneurs.