Eleventh Five Year Plan

Health and Family Welfare and AYUSH 71Box 3.1.4Five Planks of the NRHMThe Mission is expected to address the gaps in the provision of effective health care to rural population with a special focuson 18 States, which have weak public health indicators and/or weak infrastructure.The Mission is a shift away from the vertical health and family welfare programmes to a new architecture of all inclusivehealth development in which societies under different programmes will be merged and resources pooled at the districtlevel.The Mission aims at the effective integration of health concerns with determinants of health like safe drinking water,sanitation, and nutrition through integrated District Plans for Health. There is a provision for flexible funds so that the Statescan utilize them in the areas they feel are important.The Mission provides for appointment of ASHA in each village and strengthening of the public health infrastructure,including outreach through mobile clinics. It emphasizes involvement of the non-profit sector, especially in the under-servedareas. It also aims at flexibility at the local level by providing for untied funds.The Mission, in its supplementary strategies, aims at fostering PPPs; improving equity and reducing out of pocket expenses;introducing effective risk-pooling mechanisms and social health insurance; and taking advantage of local healthtraditions.• Promotion of PPPs for achieving public healthgoals.• Reorienting medical education to support healthissues including regulation of Medical Care andMedical Ethics.• Effective and viable risk-pooling and social healthinsurance to provide health security to the poor byensuring accessible, affordable, accountable, andgood quality health care.3.1.48 The expected outcomes of NRHM are listedbelow:• IMR—reduced to 30/1000 live births by 2012.• Maternal Mortality—reduced to 100/100000 livebirths by 2012.• TFR—reduced to 2.1 by 2012.• Malaria Mortality Reduction—50% up to 2010,additional 10% by 2012.• Kala-azar Mortality Reduction—100% by 2010 andsustaining elimination until 2012.• Filaria/Microfilaria Reduction—70% by 2010, 80%by 2012, and elimination by 2015.• Dengue Mortality Reduction—50% by 2010 andsustaining at that level until 2012.• Cataract operations—increasing to 46 lakh until2012.• Leprosy Prevalence Rate—reduce from 1.8 per10000 in 2005 to less that 1 per 10000 thereafter.• Tuberculosis DOTS—maintain 85% cure ratethrough entire Mission Period and also sustainplanned case detection rate.• Upgrading all health establishments in the districtto IPHS.• Increase utilization of First Referral Units (FRUs)from bed occupancy by referred cases of less than20% to over 75%.3.1.49 Under the NRHM, it is planned to have:• Over 5 lakh ASHAs, one for every 1000 population/large habitation, in 18 Special Focus States and intribal pockets of all States by 2008• All SCs (nearly 1.75 lakh) functional with twoANMs by 2010• All PHCs (nearly 30000) with three staff nurses toprovide 24 × 7 services by 2010• 6500 CHCs strengthened/established with sevenspecialists and nine staff nurses by 2012• 1800 Taluka/Sub Divisional Hospitals and 600District Hospitals strengthened to provide qualityhealth services by 2012• Mobile Medical Units for each District by 2009• Functional Hospital Development Committees inall CHCs, Sub Divisional Hospitals, and DistrictHospitals by 2009• Untied grants and annual maintenance grants toevery SC, PHC, and CHC released regularly andutilized for local health action by 2008