NUHM 2013

National Urban Health Mission (NUHM) 

1. Introduction

• Launched: 1st May 2013
• Under: National Health Mission (NHM)
• Aim: Improve health of urban poor, especially slum dwellers and vulnerable populations.
• Components: Health system strengthening, RMNCH+A, Communicable & Non-communicable diseases.

2. Objectives

• Reduce Infant Mortality Rate (IMR)
• Reduce Maternal Mortality Ratio (MMR)
• Universal access to reproductive healthcare
• Converge all health-related interventions

3. Salient Features

1. City-specific, need-based urban healthcare system
2. Institutional and management mechanisms
3. Community and local body participation
4. Resource availability for primary care
5. Partnerships with NGOs and private sector

4. Key Initiatives Under NHM

S.No	Initiative	Description
1	ASHA	First contact for community healthcare
2	Rogi Kalyan Samiti (RKS)	Local hospital management by trustees
3	Untied Grants to Sub-Centres	Fund for patient welfare by ANMs
4	Health Care Contractors	Contractual staff for underserved areas
5	Janani Suraksha Yojana (JSY)	Cash incentive for institutional deliveries
6	Janani Shishu Suraksha Karyakram (JSSK)	Free delivery & treatment for mother and newborn
7	Rashtriya Bal Swasthya Karyakram (RBSK)	Child health screening & early interventions
8	Mother & Child Health Wings (MCH)	Additional beds in high-load facilities
9	Free Drug & Diagnostics Service	Reduces out-of-pocket healthcare expense
10	District Hospital & Knowledge Centre	Multi-specialty and telemedicine care hubs
11	National Iron+ Initiative	Iron/folic acid for all age groups
12	Tribal TB Eradication Project	TB elimination in tribal areas

5. NUHM Targets

• IMR: ≤ 30/1000 live births
• MMR: ≤ 1/1000 live births
• Malaria: 50% mortality reduction
• Kala Azar: 100% elimination
• Filariasis: >80% MDA coverage
• Dengue: 50% mortality reduction
• Chikungunya: Outbreak control
• TB: 85% cure rate via DOTS

6. Budget Allocation

• Total: ₹30,000 Crores (12th Plan)
• Centre:State ratio = 75:25

7. Core Strategies 

1. Efficient public health system
2. Household-level access
3. Preventive & promotive care
4. Revolving fund for healthcare access
5. IT & e-Governance
6. Stakeholder capacity building
7. Focus on most vulnerable
8. Quality healthcare services

8. Process/Throughput Indicators 

• Cities/population covered
• Health plans developed
• Functional U-PHCs
• Slum mapping
• Health & Sanitation Days
• MAS formed
• Trained ASHAs
• Programme Managers at U-PHCs

9. Output Indicators 

• Increased OPD attendance
• Referrals from U-PHCs
• Institutional deliveries
• Immunization for <12 months
• Detection of malaria, TB, dental ailments
• ANC and TT coverage
• 100% birth & death registration

10. Impact Level Focus

• 50% reduction in IMR
• 40% reduction in MMR
• 100% ANC coverage
• Universal immunization
• Access to reproductive health
• Disease control targets

11. Mahila Arogya Samiti (MAS) 

• Community women's group for health awareness, service linkage
• Covers 50–100 HHs, led by elected members
• Promoted by ASHA with support from ANM, AWW, NGOs
• Focus: Preventive/promotive health, revolving fund management

12. Outreach Sessions by ANMs 

• One monthly routine outreach per ANM
• One weekly special outreach in slums
• Services: Screening, lab tests, drug dispensing, counselling
• Focus: Vulnerable groups (slum dwellers, rag pickers, etc.)
• Mobility support: ₹500/month per ANM

13. Institutional Framework 

• National: Mission Steering Group (Health Minister)
• State: State Health Mission (CM), State Health Society (Chief Secretary)
• City: Urban Health Missions or NHM structures
• ULBs: Units of planning with facility norms
• 1 U-CHC per 2.5 lakh population (5 lakh in metros)

14. Urban Health Care Facility Norms 

Population Level	Facility/Staff
50–100 HHs (250–500)	MAS, ASHA
1000–2500 people	1 ANM, Weekly outreach
Every 10,000	1 U-PHC
Every 50,000	Outreach expanded
Every 2.5 lakh (5 lakh metro)	U-CHC, 30–50 beds (100 in metros)

15. Role of NGOs 

• Extend outreach and utilization
• Involved in planning, slum mapping, IEC/BCC, capacity building
• Strengthen community participation in urban health

Reference 

Malviya K, Sahoo S, Dasadiya D, Acharya V. Social and Preventive Pharmacy. 1st ed. Pee Vee (Regd.); 2021.