A critical review of National Rural Health Mission in India

Abstract

National Rural Health Mission (NRHM) has been envisaged as a focal point of all the programs targeted to improve the health of people in rural India. It has been widely debated both, before and after the implementation. Ongoing corrective measures and performance appraisal are integrated with this program. Deliberations by experts from various fields, adaptation of the successful best practices, and learning from the failures make NRHM a different program. No government program was as meticulously prepared or planned as NRHM since Independence. The key functionary of this program, Accredited Social Health Activist (ASHA), a voluntary worker, incorporates all the good qualities of previous similar functionaries in various programs. The active involvement of Panchayati Raj Institutions (These Panchayati Raj Instittutions or PRIs, as they are known here, are the institutions for local self government where locally elected representatives make decision for the people in the area. The PRIs have been formed at every village level throughout the country.), community (The involvement of community ensure that people decide for themselves to increase their participation in the programs), (Non Government Organisations (NGO), and Private Practitioners are welcome steps. Although, this also does not mean that everything is good in NRHM. The issues of attrition of ASHA, over dependancy of it on Anganwadi (Anganwadi literally means courtyards, The government of India has setup an Anganwadi for every 1000 population in rural India, where one government worker provide immunisation , health check ups, supplementary nutrition, non formal preschool education, health education, growth monitoring and referral services for children and pregnant women to improve the health status of the rural population specifically women and child.) worker etc need to be addressed. This review analyse NRHM in the light of past health experiences, specially focusing on ASHA. At present, it can be said that this program has all the necessary components to make improved health scenario, in rural India, a reality.