National Health Mission (NHM)
Current Affairs & Government Schemes › Health and Nutrition Schemes · Topic 4.4
The National Health Mission (NHM) is the main Centrally Sponsored programme of the Ministry of Health and Family Welfare to strengthen public health systems in rural and urban areas. It has two sub-missions, the National Rural Health Mission launched on 12 April 2005 and the National Urban Health Mission approved in May 2013, which were merged under the NHM umbrella. It funds ASHA workers, sub-centres, primary health centres, ambulances, free drugs and diagnostics, and maternal and child health services. Its goals include lower maternal and infant mortality and stronger district health planning. The Union Cabinet continued the mission in 2025, as reported.
5 min read · UPSC Prelims · Current Affairs & Government Schemes · Health and Nutrition Schemes
At a Glance
- Ministry Health and Family Welfare
- NRHM launched 12 April 2005
- NUHM approved May 2013
- Type Centrally Sponsored Scheme
- Frontline worker ASHA
- Exam link UPSC Prelims, Current Affairs and Government Schemes: Health and Nutrition Schemes
Where Does It Fit?
This is the fourth topic of the macro on health and nutrition. The mission is the delivery base for most health schemes that follow, such as the maternal and immunisation programmes. Previous topic: Ayushman Bharat Digital Mission (ABDM). Next topic: Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA).
What Are the Components of the National Health Mission?
| Component | Feature |
|---|---|
| National Rural Health Mission | Launched on 12 April 2005 to improve rural health in the 18 states with weak indicators first, then all states, with a focus on strengthening villages and primary centres |
| National Urban Health Mission | Approved in May 2013 for towns above 50,000 people and for the urban poor, using urban primary health centres and ASHAs |
| ASHA | Accredited Social Health Activist, a woman volunteer from the village chosen to link households with services, paid performance based incentives |
| Rogi Kalyan Samiti | A hospital management committee that gives local bodies a say and a pool of untied funds |
| Untied funds | Flexible grants to sub-centres and village health bodies for local needs |
| Indian Public Health Standards | Norms for the staff, services and equipment expected at each level of facility |
| Reproductive, maternal, newborn, child and adolescent health | The largest service component, covering safe delivery, immunisation and nutrition |
How Is the Mission Funded and What Does It Deliver?
- Funding pattern: the Centre and states share costs, generally 60:40, with a 90:10 share for the north-eastern and Himalayan states, and full central funding for Union Territories without a legislature
- State Health Societies: funds go through State Health Societies and District Health Societies to local facilities
- Programme Implementation Plans: each state sends an annual plan that is appraised and approved by the Centre
- Free drugs and diagnostics: the Free Drugs Service Initiative and the Free Diagnostics Service Initiative provide medicines and tests at public facilities
- Referral transport: the 108 and 102 ambulance networks and Janani Shishu Suraksha Karyakram, launched in 2011, cover free delivery, drugs, diet and transport for pregnant women and sick infants
- Janani Suraksha Yojana: a cash incentive for institutional delivery under the mission, as in Janani Suraksha Yojana (JSY)
- Immunisation: the Universal Immunisation Programme is supported through the mission, as in Mission Indradhanush (Immunization)
- Human resources: the mission has funded contractual doctors, nurses, Auxiliary Nurse Midwives and specialists on a large scale
What Else Should You Remember?
- Background: the mission was launched on 12 April 2005 for the period 2005 to 2012 and was then extended under the National Health Mission umbrella from 2013
- Sub-missions: NRHM and NUHM are now sub-missions of the NHM
- Targets: the original goals included lowering the infant mortality rate, maternal mortality ratio and total fertility rate, and these were tied to the Millennium Development Goals and then the Sustainable Development Goals
- Maternal mortality: the maternal mortality ratio has fallen sharply, and the Sample Registration System reported a figure of 97 per lakh live births for 2018 to 2020, which met the national target
- Infant mortality: the infant mortality rate has also fallen, though the level and its fall differ by state
- Continuation: the continuation of the mission from 2021 to 2026 was approved earlier, and reports in January 2025 said the Cabinet had noted progress and approved continuing the mission, so that the position beyond March 2026 should be checked in current releases
- ASHA numbers: the country has around 10 lakh ASHAs, who get incentives and a fixed honorarium in some states
- Health systems: the mission also runs the Mother and Child Tracking System, now moved to the RCH portal, to track pregnant women and children
- Link to wellness centres: the Health and Wellness Centres are being funded through the mission, as in Ayushman Bharat – Health and Wellness Centres (HWCs)
- Criticism: critics point to uneven spending between states, delays in releasing funds and dependence on contractual staff
- Public spending: public spending on health is about 2 per cent of GDP, below the 2.5 per cent target of the National Health Policy 2017
- Evaluation: the Common Review Mission, a yearly joint visit by experts to states, assesses progress
Why Does It Matter for the Exam?
- Dates: NRHM on 12 April 2005 and NUHM in 2013
- Worker: ASHA is the link between households and facilities
- Local bodies: Rogi Kalyan Samitis and untied funds
- Standards: Indian Public Health Standards
- Traps: the mission is Centrally Sponsored, and ASHA is not a full-time government employee
As an analytical point, the mission raised access and used community workers well, but quality and staffing vary. Predictable funds, regular staff and a focus on primary care will matter more for outcomes than new schemes.
Why Is This Topic Important?
- Facts Dates, structure, workers
- Policy Federal health financing
- Mains Outcomes and gaps
What Came Next?
The next topic covers a monthly antenatal care programme run under the mission. Next topic: Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA).
Key People and Terms
- NRHM Rural mission
- NUHM Urban mission
- ASHA Village health activist
- RKS Hospital committee
- IPHS Facility norms
- JSSK Free delivery care
Exam Corner
Points to Remember
- NRHM: 12 April 2005.
- NUHM: May 2013.
- Worker: ASHA, community volunteer.
- Share: 60:40 general states.
- Norms: Indian Public Health Standards.
Do Not Confuse With
- NHM and PM-JAY Health system funding versus hospital insurance
- NRHM and NUHM Rural versus urban sub-missions
- ASHA and Anganwadi worker Health activist versus nutrition and child care worker
Memory Hook
Village woman, free drugs, local committee: the mission built the base.
Mains Angle
Questions ask about outcomes, financing and staffing. These points help structure an answer.
- Gains Access, ASHAs, lower mortality
- Gaps Staff, funds, quality
- Way Primary care and fiscal space
A Question You May Face
An original practice question, not a past paper question.
“Assess the contribution of the National Health Mission to improving health outcomes in India and identify the gaps that remain.”
How to Answer
- Intro State NRHM 2005 and NUHM 2013.
- Gains Maternal and child indicators, ASHAs.
- Gaps Staffing, funds, quality, state gaps.
- Way Stable funds, primary care, accountability.
GS Relevance
Frequently Asked Questions
What is the National Health Mission?
The National Health Mission is the main Centrally Sponsored programme of the Health Ministry to strengthen public health systems. It combines the National Rural Health Mission, launched on 12 April 2005, and the National Urban Health Mission, approved in 2013, and supports ASHA workers, facilities, free drugs and maternal and child health care.
Who is an ASHA worker?
ASHA stands for Accredited Social Health Activist. She is a woman volunteer chosen from the village she serves, trained to link households with health services, promote institutional delivery and immunisation, and escort patients. She is paid performance based incentives rather than a salary, though some states add a fixed honorarium.
How is the National Health Mission funded?
The mission is funded by the Centre and states together, generally in a 60:40 ratio. North-eastern and Himalayan states get a 90:10 share, and Union Territories without a legislature are funded by the Centre. Funds flow through State and District Health Societies based on annual programme plans.
What is a Rogi Kalyan Samiti?
A Rogi Kalyan Samiti is a hospital management committee, set up under the mission at public facilities, that includes local representatives and officials. It can collect and use user fees and untied funds to improve patient services, such as repairs, cleanliness and purchase of small equipment, without waiting for higher approvals.
What are Indian Public Health Standards?
Indian Public Health Standards are national norms that set the expected staff, equipment, services and infrastructure for each level of public health facility, from sub-centres to district hospitals. They are used to assess gaps and to plan upgrades under the mission, and were revised to match the wellness centre model.
PYQ Practice — Statement Analysis
1 The National Rural Health Mission was launched on 12 April 2005.
NUHM followed in 2013.
2 ASHA workers are regular salaried government employees.
They are community volunteers paid incentives.
3 NRHM and NUHM are sub-missions of the National Health Mission.
They run under the NHM umbrella.
4 Rogi Kalyan Samitis are committees that manage public hospitals locally.
They use untied funds and user fees.
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