National Health Mission (NHM)

What is the National Health Mission?

National Health Mission (NHM) is the Government of India's flagship public health programme, run by the Ministry of Health and Family Welfare. NHM was launched in 2013, bringing together the National Rural Health Mission (started in 2005) and the newly created National Urban Health Mission under a single umbrella.

According to the National Health Mission portal, NHM encompasses its two sub-missions, the National Rural Health Mission (NRHM) and the National Urban Health Mission (NUHM), and its main programmatic components are health system strengthening, Reproductive-Maternal-Neonatal-Child and Adolescent Health (RMNCH+A), and communicable and non-communicable diseases.

NHM is not a scheme you apply to. It is the money and the management system behind the government health facility nearest to you - the ASHA in your village, the ambulance that comes when you call 108, the free medicines at the primary health centre, and the labour room at the community health centre.

Key objectives

• Provide accessible, affordable and quality healthcare to rural and urban populations, especially vulnerable groups.
• Strengthen public health infrastructure and human resources at every level.
• Reduce out-of-pocket expenditure on health.
• Achieve national health outcome targets on maternal, infant and disease mortality.

Main features

• Centrally sponsored scheme implemented through state governments, with state-specific Programme Implementation Plans approved annually.
• Funds flow through six financing components: the NRHM-RCH Flexipool, the NUHM Flexipool, the flexible pool for communicable diseases, the flexible pool for non-communicable diseases, injury and trauma, infrastructure maintenance, and the Family Welfare Central Sector component.
• Built on a community health worker network - the ASHA.

What are NHM's targets?

The National Health Mission portal lists the endeavour to achieve:

• Maternal Mortality Ratio reduced to 1 per 1,000 live births.
• Infant Mortality Rate reduced to 25 per 1,000 live births.
• Total Fertility Rate reduced to 2.1.
• Annual tuberculosis incidence reduced by half.
• Malaria incidence brought below 1 per 1,000 population.

How much is NHM funded and how is the cost shared?

The National Health Mission has been allocated Rs 64,180 crore for the period 2021-22 to 2025-26. The Department of Expenditure, Ministry of Finance approved the continuation of the National Health Mission from 1 April 2021 to 31 March 2026, subject to Expenditure Finance Committee recommendations and financial ceilings.

On cost sharing, the Ministry of Health and Family Welfare has stated in Parliament that funds are provided to states through their Programme Implementation Plans with a Centre-to-state share of 60:40, except for the North Eastern and Himalayan states where the share is 90:10. For the National Urban Health Mission, a Press Information Bureau release records the Centre-state funding pattern as 75:25, except for the North Eastern states and the special category states of Jammu and Kashmir, Himachal Pradesh and Uttarakhand, for whom the pattern is 90:10.

Who is eligible for services under the National Health Mission?

You can use NHM-funded services if:

• You are a resident of India using a government health facility. NHM services at public facilities are open to everyone.
• You live in a rural area - services reach you through the sub-centre, health and wellness centre, primary health centre, community health centre and district hospital under NRHM.
• You live in an urban area, particularly a slum or vulnerable settlement - services reach you through urban primary health centres and urban community health centres under NUHM.
• You are a pregnant woman, newborn, child or adolescent, who are the priority groups under the RMNCH+A component.
• You have a communicable or non-communicable disease covered by the national programmes NHM funds - tuberculosis, malaria, leprosy, HIV-linked services, cancer, diabetes, cardiovascular disease and stroke.

You cannot claim under NHM if:

• You are looking for a cash transfer for yourself. NHM is a service delivery programme, not a cash scheme. Specific components such as Janani Suraksha Yojana do pay cash, but they have their own criteria and NHM as a whole pays nothing to individuals.
• You want reimbursement for treatment at a private hospital. Private treatment is not eligible for reimbursement under NHM. For hospitalisation cover at empanelled private hospitals you need Ayushman Bharat PM-JAY.
• You are seeking a grant or loan for a private clinic, nursing home or diagnostic centre. NHM funds go to state governments, not to private providers as individual grants.
• You expect the cash components to be universal. Janani Suraksha Yojana in High Performing States, for example, is restricted to BPL, SC and ST women, so a general category non-BPL woman there is not eligible for that cash even though she can use every free service at the facility.

What services does NHM provide free?

NHM funds a set of entitlements that a citizen can claim at a public health facility without paying:

• Free Drugs Service Initiative - essential medicines free at public facilities, against a state-notified essential drug list.
• Free Diagnostics Service Initiative - notified laboratory tests, and in many districts radiology and tele-diagnostic services, free at public facilities.
• Janani Shishu Suraksha Karyakram (JSSK) - free delivery including caesarean section, free drugs, diagnostics, diet, blood and transport for pregnant women, and free treatment for sick newborns up to one year.
• Janani Suraksha Yojana (JSY) - cash assistance for institutional delivery, ranging from Rs 600 to Rs 1,400 for the mother depending on state category and rural or urban residence.
• Emergency Response Services - the 108 ambulance for emergencies and the 102 service for patient transport, principally pregnant women and sick infants.
• Universal Immunization Programme - free vaccination against 12 vaccine-preventable diseases, with Mission Indradhanush as the catch-up drive.
• Rashtriya Bal Swasthya Karyakram (RBSK) - screening of children for defects at birth, deficiencies, diseases and developmental delays, with free follow-up treatment.
• Rashtriya Kishor Swasthya Karyakram (RKSK) - adolescent health services including Adolescent Friendly Health Clinics.
• National disease control programmes - tuberculosis, malaria, kala-azar, leprosy, blindness control, and the programme for cancer, diabetes, cardiovascular disease and stroke.
• Ayushman Arogya Mandirs (health and wellness centres) delivering comprehensive primary healthcare close to home.

Who is an ASHA?

An Accredited Social Health Activist (ASHA) is the community health worker at the centre of NHM's delivery model. According to the National Health Mission portal, one ASHA is designated for every 200 to 500 households.

An ASHA is a resident woman of the village she serves, trained and supported by the health system, and paid through performance-linked incentives rather than a regular salary. In practice she is the person who registers a pregnancy, escorts a woman to the facility for delivery, brings children to immunisation sessions, tracks newborns in the first weeks, and follows up tuberculosis patients on treatment.

If you are trying to access any NHM entitlement and do not know where to start, your ASHA is the correct first contact.

How to apply for National Health Mission services

NHM has no application form and no beneficiary list. Access is direct.

1. Identify your nearest public health facility - the sub-centre or Ayushman Arogya Mandir for primary care, the primary health centre or urban primary health centre for outpatient care and basic tests, the community health centre for specialist and emergency obstetric care, and the district hospital for secondary care.
2. Contact your ASHA, ANM or anganwadi worker in a village or urban ward. They maintain the household register and can tell you what you are due - antenatal check-ups, immunisation, child screening or disease follow-up.
3. Register at the facility with your name and address. Aadhaar helps but emergency care is never refused for want of a document.
4. Ask explicitly for the free entitlement - free drugs from the essential drug list, free notified diagnostics, and free delivery care under JSSK. State entitlement charters are displayed at facilities.
5. For cash-linked components such as Janani Suraksha Yojana, submit your JSY card, MCP card, Aadhaar and bank passbook at the facility so the claim can be filed by Direct Benefit Transfer.
6. For an emergency, call 108; for transport of a pregnant woman or sick infant, call 102.

What has NHM achieved?

The Ministry of Health and Family Welfare publishes NHM achievements in periodic updates, covering expansion of health infrastructure, the health and wellness centre network, deployment of ASHAs and health workers, and improvement in maternal and child health indicators. Because these figures are revised frequently, check the latest NHM update on mohfw.gov.in or the annual NHM progress report on nhm.gov.in rather than relying on an older number.

Help and grievance redressal

• 104 - state health helpline, available in most states for health advice, facility information and complaints.
• 102 and 108 - ambulance and emergency response services.
• 1075 - National Health Helpline of the Ministry of Health and Family Welfare.
• Your ASHA, ANM or Medical Officer in charge for service-level problems.
• State Health Society and District Health Society, whose contacts are listed state-wise on nhm.gov.in, for programme and payment grievances.

All NHM-funded services described above are free at public health facilities. If a government facility charges you for a listed free drug, a notified free test or delivery care under JSSK, that is a violation and should be reported to the Medical Officer in charge or the district health officer.