National Urban Health Mission (NUHM)

What is the National Urban Health Mission?

National Urban Health Mission (NUHM) is the urban sub-mission of India's National Health Mission, approved by the Union Cabinet on 1 May 2013 with an outlay of Rs 22,507 crore for five years. According to the National Health Mission portal of the Ministry of Health and Family Welfare, NUHM exists to "meet health care needs of the urban population with the focus on urban poor" by delivering essential primary health care and reducing out-of-pocket spending.

NUHM was created because urban health data hid a problem. City averages looked good, but slum populations - migrant workers, street vendors, construction labour, rag pickers, homeless people - had indicators worse than rural averages, and the urban public health system was thin: a handful of large hospitals and almost no functioning primary care layer. NUHM funds that missing layer.

Key objectives

• Deliver essential primary health care to the urban population, especially slum and vulnerable groups.
• Reduce out-of-pocket expenditure on health for the urban poor.
• Strengthen and rationalise existing urban health infrastructure rather than build a parallel system.
• Achieve convergence with programmes handling the determinants of health - drinking water, sanitation, housing, school education and nutrition.
• Build community institutions - Mahila Arogya Samitis and urban ASHAs - to give slum residents a voice in the system.

Main features

• Coverage of state capitals, district headquarters and towns above 50,000 population; below that, the National Rural Health Mission applies.
• Facility norms of one Urban PHC per 50,000-60,000 people, one Urban Community Health Centre for five to six UPHC areas in large cities, one ANM per 10,000 population.
• One urban ASHA per 200-500 households in slum and vulnerable settlements.
• Mahila Arogya Samitis, community women's groups covering 50-100 households each, with an untied fund.
• Implementation through urban local bodies in convergence with the state health department, and coordination with the ministries handling urban development, housing, poverty alleviation, education, and women and child development.
• Same NHM funding pattern: 60:40 Centre-state for most states, 90:10 for the eight North Eastern and three Himalayan states, 100 per cent central for union territories without a legislature.

Who is eligible for the National Urban Health Mission?

You can use NUHM services if:

• You live in a city or town covered by NUHM - broadly a state capital, a district headquarters, or any urban area with a population above 50,000.
• You are within the catchment of an Urban Primary Health Centre or Urban Ayushman Arogya Mandir. No income test applies at the counter.
• You are a slum resident, migrant worker, homeless person, construction worker, street vendor, rickshaw puller, rag picker, sex worker or other vulnerable urban resident - these groups are the mission's stated priority for outreach.
• You are a pregnant woman, newborn, child due for immunisation or adult needing screening for hypertension, diabetes or common cancers.

You cannot apply if:

• You are an individual looking for a cash benefit - NUHM does not have a personal benefit application. Cash reaches individuals only through named components such as Janani Suraksha Yojana, which have separate registration.
• You are an NGO, private clinic or company hoping to apply to the Ministry of Health for NUHM money. NUHM funds are released to State Health Societies against an approved Programme Implementation Plan; partnerships are contracted by the state health society or urban local body.
• You live in a rural area or a town below 50,000 population - you are not eligible under the urban sub-mission and should use NRHM facilities.

Absence of a slum address, ration card or formal residence proof is not a ground for refusing care at an Urban PHC.

What documents are required for NUHM services?

How to apply for and access NUHM services

NUHM has no application form for citizens. Use these steps instead:

1. Locate your nearest Urban Primary Health Centre or Urban Ayushman Arogya Mandir. The urban local body's health department or the 104 helpline can tell you which UPHC covers your address.
2. Get your household registered by the urban ASHA for your settlement, or through the Mahila Arogya Samiti in your cluster of 50-100 households.
3. Attend the UPHC during its published hours - many Urban PHCs run evening OPD timings specifically so that daily-wage and shift workers can attend.
4. For a pregnancy, register in the first trimester, collect the free MCP card, and complete your antenatal check-ups and Tetanus-diphtheria doses at the UPHC.
5. Ask by name for the free drugs and free diagnostics entitlements, and for Janani Shishu Suraksha Karyakram benefits if you are pregnant or have a sick newborn.
6. Attend the Urban Health and Nutrition Day held in your settlement for immunisation, screening and counselling.
7. If a UPHC cannot treat you, insist on a written referral to the Urban CHC or district hospital; NUHM is designed as a referral chain, not a dead end.

How do institutions get NUHM funds?

1. The city or district prepares an urban component of the Programme Implementation Plan, listing UPHCs, staffing, outreach and civil works.
2. The state consolidates it and submits it to the Ministry of Health and Family Welfare for appraisal.
3. The Ministry issues a Record of Proceedings approving the year's outlay, and funds are released to the State Health Society.
4. The State Health Society routes money to the City Health Society or urban local body, which runs the facilities and contracts any NGO partners.

How much benefit does NUHM provide?

NUHM pays no fixed sum to individuals. NUHM's benefit is free urban primary care: consultation, essential medicines, laboratory tests, antenatal and postnatal care, immunisation, screening for non-communicable diseases, and referral. The cash amounts within the NUHM envelope are:

• Janani Suraksha Yojana for urban mothers - Rs 1,000 in a low-performing state and Rs 600 in a high-performing state, according to National Health Mission documentation.
• Urban ASHA incentives - performance-linked payments published in the Ministry of Health's ASHA incentive list.
• Mahila Arogya Samiti untied funds - a small annual grant held by the community group for local health needs, not paid to individuals.

The exact service package at any UPHC depends on the state's approved plan for that year, so confirm locally rather than assuming a uniform national list.

How NUHM fits with other health schemes

NUHM covers primary care. Hospitalisation cover for eligible families comes from Ayushman Bharat PM-JAY, which pays up to Rs 5 lakh per family per year at empanelled hospitals. Health infrastructure creation in cities - Urban Ayushman Arogya Mandirs, block public health units, critical care blocks - is financed by PM-ABHIM. Treating NUHM as a substitute for hospital insurance is the most common misunderstanding: NUHM keeps you out of hospital, PM-JAY pays when you land in one.

Common problems and how to resolve them

• UPHC closed or unstaffed - report to the City Health Officer of the urban local body and the District Programme Manager, NHM.
• Payment demanded for free drugs or tests - these are chargeable to no patient at a public facility. Call 104.
• Refused care for lack of address proof - NUHM explicitly targets slum and homeless populations; escalate to the Medical Officer in charge.
• No urban ASHA in your settlement - raise it with the Mahila Arogya Samiti or the City Health Society; ASHA placement is a planned NUHM position.

Help and grievance redressal

• State health helpline: 104
• Ambulance: 108 for emergencies, 102 for patient transport
• National Health Helpline: 1075
• City Health Officer / urban local body health department for facility complaints
• District Programme Manager, National Health Mission for programme issues

NUHM services at government urban facilities are free. No fee is payable for registration, consultation, essential drugs or diagnostics.