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PolityFree till Sep 9

National Health Mission: NRHM and NUHM

July 19, 2026

TOPIC CLASSIFICATION

Subject: Governance | Topic: Health Policy & Schemes Sub-topic: National Health Mission — NRHM (rural) and NUHM (urban) Prelims Focus: Launch year, components (NRHM, NUHM), ASHA, JSY, JSSK, Rogi Kalyan Samitis Mains Focus: Health outcomes — IMR, MMR improvement; challenges — urban health, human resources, disease burden

EXAMINER REASONING

NHM is India's flagship public health programme covering both rural and urban areas. UPSC tests its architecture (NRHM + NUHM) and key sub-schemes (ASHA, JSY) in Prelims. Mains questions focus on achievements in maternal/child health, gaps in urban health infrastructure, NHM's role during COVID-19, and the challenge of rising non-communicable diseases.

Core Concept

National Health Mission (NHM) was launched in 2013 by merging the National Rural Health Mission (NRHM, 2005) and the National Urban Health Mission (NUHM, 2013). It is the largest centrally sponsored scheme in the health sector.

NHM Architecture

ComponentFocus AreaKey Features
NRHMRural areas (all states)ASHA workers, Sub-Centres, PHCs, CHCs, Janani Suraksha Yojana, Janani Shishu Suraksha Karyakram
NUHMUrban areas (cities >50k)Urban PHCs, Urban Community Health Centres, Mahila Arogya Samitis
Flexible PoolsDisease controlNational Disease Control Programmes (TB, Malaria, HIV, NCDs)
InfrastructurePublic health facilitiesUpgradation of Sub-Centres to HWC (Health & Wellness Centres) under Ayushman Bharat

Read Next

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Major Sub-Programmes

ProgrammeKey Detail
ASHA (Accredited Social Health Activist)10+ lakh community health volunteers; performance-based incentives
JSY (Janani Suraksha Yojana)Conditional cash transfer for institutional delivery
JSSK (Janani Shishu Suraksha Karyakram)Free delivery, C-section, medicines, diagnostics for pregnant women
RBSK (Rashtriya Bal Swasthya Karyakram)Free health check-ups for children (0–18) — 4D defects
KayakalpHygiene and infection control in public health facilities

Key Facts

  • Total NHM outlay (2025–26): ₹38,000 crore (central share).
  • IMR (Infant Mortality Rate): 28 per 1,000 live births (SRS 2020) — down from 58 (2005).
  • MMR (Maternal Mortality Ratio): 97 per 1,00,000 live births (SRS 2018–20) — down from 254 (2004–06).
  • Institutional delivery: Increased from 38% (NFHS-3) to 88.6% (NFHS-5).
  • ASHA workers: 10.5 lakh across India.
  • HWCs (Health & Wellness Centres): 1.5 lakh operationalised as of 2025 (target: 1.5 lakh).
  • Urban health: NUHM covers 779 cities; only 3.5% of urban health facilities have IPHS standards.

PYQ Table

YearQuestionMarks
2023"Evaluate the role of ASHA workers in strengthening primary healthcare in India."15
2022Which of the following is NOT a component of NHM? (Prelims)2
2021"NRHM has contributed significantly to reducing IMR and MMR." Discuss.12
2020What is the difference between JSY and JSSK? (Prelims)2
2019"Urban health remains a neglected area in Indian healthcare." Analyse.10

Statement Elimination Guide

  1. "NRHM was launched in 2013." → False. NRHM was launched in 2005; NHM was formed in 2013 by merging NRHM + NUHM.
  2. "ASHA workers are salaried government employees." → False. They are community health volunteers who receive performance-based incentives.
  3. "NUHM covers only metros with >10 lakh population." → False. NUHM covers all cities with population >50,000.
  4. "JSY provides unconditional cash transfer." → False. It is conditional on institutional delivery and post-natal check-up.

Current Affairs Hook

  • 2025: NHM revamped — focus on NCD screening at HWC level; ₹8,000 cr additional allocation.
  • 2024: ASHA workers' honorarium increased to ₹5,000/month; demand for regularisation remains.
  • 2023: Kayakalp Award expanded to all district hospitals for infection control.
  • 2022: Ayushman Bharat HWCs integrated into NHM reporting structure.
  • 2021: NHM played key role in COVID-19 vaccination drive (1.8 billion doses).
  • 2020: NHM funds diverted for COVID-19 emergency response (PPE, testing).
  • 2019: RBSK screens 5 crore children annually — identifies 25 lakh children with 4D defects.

Interlinkages

  • Ayushman Bharat: NHM's HWCs are the first pillar of Ayushman Bharat (wellness); PM-JAY is the second pillar (insurance).
  • Nutrition: POSHAN Abhiyan — NHM frontline workers (ASHA, ANM) deliver nutrition counselling.
  • WASH: Jal Jeevan Mission — clean water reduces water-borne diseases (NHM focus).
  • Disease Surveillance: IDSP (Integrated Disease Surveillance Project) under NHM.
  • Mental Health: National Mental Health Programme (NMHP) under NHM — tele-MANAS.
  • Climate Health: NHM heat action plans for heatwave mortality reduction.
  • Demographic Dividend: Better health outcomes = improved human capital and productivity.

Common Mistakes

  • Confusing NHM (health system strengthening) with Ayushman Bharat (health insurance) — NHM is supply-side, PM-JAY is demand-side.
  • Thinking NRHM and NHM are the same — NHM = NRHM + NUHM.
  • Believing ASHA workers cover only rural areas — Mahila Arogya Samiti members in urban areas are analogous.
  • Missing the distinction between JSY (conditional cash transfer) and JSSK (free services) — both maternal but different.
  • Assuming all PHCs are fully functional — severe shortage of doctors and equipment in many states.

Revision Snapshot

ProgrammeLaunch YearKey Feature
NRHM2005Rural health: ASHA, PHCs, JSY
NUHM2013Urban health: UPHCs, MAS
NHM2013Merger of NRHM + NUHM
JSY2005Cash for institutional delivery
JSSK2011Free maternal/child services
RBSK2013Child health screening (0–18)
HWC2018Ayushman Bharat — wellness centres

Source Notes

  • MoHFW – NHM Annual Report 2024–25
  • MoHFW – NRHM Operational Guidelines (2005, revised)
  • SRS Bulletin (2020) – IMR, MMR Statistics
  • NFHS-5 – Health Indicators Report
  • CAG – Performance Audit of NHM (2022)
  • NITI Aayog – Health Systems Strengthening Report (2024)
  • WHO – India Health System Review 2024