National Rural Health Mission (NRHM)

What is the National Rural Health Mission?

National Rural Health Mission (NRHM) is a Government of India programme launched on 12 April 2005 to provide accessible, affordable and quality health care to the rural population, with particular emphasis on vulnerable groups. According to the National Health Mission portal run by the Ministry of Health and Family Welfare, NRHM became a sub-mission of the National Health Mission (NHM) when the Union Cabinet approved the overarching mission in 2013. The other sub-mission is the National Urban Health Mission.

NRHM is not a cash-transfer scheme. NRHM is a financing and delivery framework: central and state money flows to State Health Societies, which use it to staff, equip and run the rural public health system - sub-centres, primary health centres (PHCs), community health centres (CHCs), sub-district and district hospitals. What a villager experiences is free medicines, free tests, an ambulance that arrives, and an ASHA worker in the village.

Key objectives

• Reduce maternal mortality, infant mortality and total fertility rates in rural India.
• Provide universal access to public health services, including women's health, child health, immunisation, nutrition and sanitation.
• Prevent and control communicable and non-communicable diseases, including locally endemic diseases.
• Build a decentralised, community-owned health system through village-level institutions.
• Promote healthy lifestyles and access to AYUSH systems of medicine.

Main features

• Special focus on the supported Action Group (EAG) states, the North Eastern states, Jammu and Kashmir and Himachal Pradesh, where health indicators historically lagged.
• The ASHA cadre - Accredited Social Health Activists - normally one volunteer per 1,000 rural population, acting as the village link to the system.
• Untied funds and flexible pools that let districts spend against locally identified gaps rather than a rigid central line-item budget.
• Annual Programme Implementation Plans (PIPs) prepared by each state and approved by the Ministry of Health, which decide the year's release.
• Funding shared 60:40 between Centre and most states, 90:10 for the eight North Eastern and three Himalayan states, and 100 per cent central for union territories without a legislature.

Who is eligible for the National Rural Health Mission?

You can use NRHM-funded services if:

• You live in a rural area - broadly villages and towns with a population below 50,000. Larger towns and cities are served by the National Urban Health Mission.
• You need care at any government facility in that area: sub-centre, Ayushman Arogya Mandir, PHC, CHC, sub-district hospital or district hospital.
• You are a pregnant woman, a newborn, a child due for immunisation, an adolescent, or an adult needing routine or emergency care - NRHM services are not means-tested at the point of care.

You cannot apply if:

• You are an individual seeking a cash grant from NRHM. NRHM has no personal benefit application. Cash reaches individuals only through named components such as Janani Suraksha Yojana, which have their own registration.
• You are an NGO, private hospital or company hoping to apply directly to the Ministry of Health for NRHM funds. Money is released to State Health Societies against an approved PIP; NGO partnerships are contracted by the state or district health society, not by a central application form.
• You live in a large city and are looking for the rural sub-mission - you are not eligible under NRHM and should use NUHM facilities instead.

There is no income ceiling, no caste criterion and no requirement to produce a BPL card for ordinary outpatient or emergency care at a government facility.

What documents are required for NRHM services?

Emergency care at a government hospital cannot be refused for want of documents.

How to apply for and access NRHM services

NRHM has no application form for individuals. Follow these steps to use it:

1. Identify your nearest government health facility - the sub-centre or Ayushman Arogya Mandir for routine care, the PHC for outpatient consultation and normal delivery, the CHC or district hospital for specialist and inpatient care.
2. Contact your village ASHA worker or ANM and register your household. The ASHA maintains the village health register and will link you to antenatal care, immunisation days and screening camps.
3. Attend the monthly Village Health, Sanitation and Nutrition Day (VHSND) at the Anganwadi centre for check-ups, immunisation and counselling.
4. For a pregnancy, register in the first trimester with the ANM, collect your MCP card, and complete at least four antenatal check-ups free of charge.
5. Ask for the free entitlement by name at the facility - free drugs, free diagnostics, and under Janani Shishu Suraksha Karyakram free delivery, drugs, diet, blood and transport for pregnant women and sick newborns.
6. In an emergency, dial 108 for the ambulance or 102 for patient transport, both funded under NRHM in most states.
7. If a service is refused or a payment is demanded, call the 104 state health helpline or file a complaint with the District Programme Manager.

How do institutions apply for NRHM funds?

1. The state prepares an annual Programme Implementation Plan listing activities, staffing and budget for each district.
2. The National Programme Coordination Committee and the Ministry of Health appraise the PIP and issue a Record of Proceedings approving the year's outlay.
3. Funds are released to the State Health Society, which passes them to District Health Societies and facility-level Rogi Kalyan Samitis.
4. NGOs and private partners are engaged by the state or district health society through its own tender or empanelment process, not by applying to the Centre.

How much benefit does NRHM provide?

NRHM itself pays no fixed cash amount to individuals. What it provides is free service delivery: essential drugs, diagnostic tests, ambulance transport, institutional delivery and newborn care at government facilities. The measurable cash amounts sit inside NRHM's named components:

• Janani Suraksha Yojana pays Rs 1,400 to a rural mother in a low-performing state and Rs 700 in a high-performing state; the urban figures are Rs 1,000 and Rs 600 respectively, according to National Health Mission documentation.
• ASHA incentives are performance-linked and published by the Ministry of Health in its annual ASHA incentive list; states may add their own honorarium.
• Janani Shishu Suraksha Karyakram entitlements are in-kind - free delivery, drugs, diet, blood and to-and-fro transport - rather than cash.

Because state governments run the delivery, the exact package at your facility depends on the state's approved plan for that year.

What results has NRHM delivered?

According to the National Health Mission portal, maternal mortality has fallen by 83 per cent since 1990 and under-five mortality by 75 per cent, both faster than the global average. TB incidence fell from 237 to 195 per 100,000 population between 2015 and 2023. More than 12 lakh additional health workers were engaged between 2021 and 2024, and 1.72 lakh Ayushman Arogya Mandirs have been established - the renamed Health and Wellness Centres that now form the front line of rural primary care.

Common problems and how to resolve them

• Medicines not available at the PHC - ask for the entry in the stock register and escalate to the Medical Officer in charge, then the District Programme Manager.
• Payment demanded for a free service - free drugs, free diagnostics and JSSK entitlements are not chargeable. Report it on the 104 helpline.
• JSY money not credited - the most common causes are a bank account not seeded with Aadhaar, a name mismatch, or the ASHA not having uploaded the discharge details. Follow up with the ASHA and the facility's accounts clerk.
• Ambulance not arriving - record the call reference given on 108 and raise it with the district health society.

Help and grievance redressal

• State health helpline: 104 - advice, facility information and complaints
• Ambulance: 108 for emergencies, 102 for patient transport
• National Health Helpline: 1075
• Rogi Kalyan Samiti at the facility handles service-quality complaints
• District Programme Manager, NHM for programme-level grievances

NRHM services at government facilities are free. No ASHA, ANM or clerk is entitled to charge you for registration, medicines, tests or an ambulance.