GOOD MORNING!

EVERYONE PRESENT HERE,

First of all, I would like to extend my gratitude to our speaker and also thanking him for giving me the
opportunity to speak upon such a crucial topic- NATIONAL HEALTH MISSION, which comes under the
ministry of health and family welfare.

The National Health Policy, 2017 envisages- "the attainment of the highest possible level of health
and wellbeing for all at all ages, through a preventive and promotive health care orientation in all
developmental policies, and universal access to good quality health care services without anyone
having to face financial hardship as a consequence".

This would also enable the country to advance towards meeting Sustainable Development Goal-3,
"Ensure healthy lives and promote well-being for all at all ages", including Universal Health
Coverage.

Today I will speak upon several issues which has become a concern for today’s youth affecting their
mental and physical health, and also will put some light on the initiatives taken by the government.

National Programme for prevention & Control of Cancer, Diabetes, Cardiovascular Diseases &
stroke (NPCDCS)

PROGRAMME BACKGROUND

India is experiencing a rapid health transition with a rising burden of Non-Communicable Diseases
(NCD) surpassing the burden of Communicable diseases like water-borne or vector borne diseases,
TB, HIV, etc. The Non-Communicable Diseases like Cardiovascular diseases, Cancer, Chronic
Respiratory Diseases, Diabetes, etc. are estimated to account for around 60% of all deaths. NCDs
cause considerable loss in potentially productive years of life.

Under NPCDCS, NCD Cells are being established at National, State and District levels for programme
management, and NCD Clinics are being set up at District and CHC levels, to provide services for early
diagnosis, treatment and follow-up for common NCDs. Provision has been made under the
programme to provide free diagnostic facilities and drugs for patients attending the NCD clinics.

PROGRAMME PERFORMANCE

Under the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular
Diseases and Stroke (NPCDCS) launched in 2010 as part of National Health Mission (NHM), the
Union Ministry of Health & Family Welfare provides technical and financial support to the
States/UTs based on the proposals received from the States/UTs and subject to the resource
envelope. The programme focuses on strengthening infrastructure, human resource development,
health promotion & awareness generation for prevention, early diagnosis, management and referral
to an appropriate level of healthcare facility for treatment of the Non-Communicable Diseases
(NCDs).

The total fund provided to States/UTs, in NPCDCS Program under Flexible Pool for Non-
Communicable Diseases programme (NCD) under NHM during 2021-22 is Rs. 56118.07 Lakhs.
Under NPCDCS, 677 NCD clinics at District level, 187 District Cardiac Care Units, 266 District Day
Care Centres and 5392 NCD clinics at Community Health Centre level has been set up to ensure the
treatment of common NCDs.

National Mental Health Programme (NMHP)

It is estimated that 6-7 % of population suffers from mental disorders. The World Bank report
(1993) revealed that the Disability Adjusted Life Year (DALY) loss due to neuropsychiatric disorder is
much higher than malaria, worm infestations and tuberculosis if taken individually. Together these
disorders account for 12% of the global burden of disease (GBD) and an analysis of trends indicates
this will increase to 15% by 2020 (World Health Report, 2001). One in four families is likely to have at
least one member with a behavioural or mental disorder (WHO 2001). These families not only
provide physical and emotional support, but also bear the negative impact of stigma and
discrimination. Most of them (>90%) remain un-treated. Poor awareness about symptoms of mental
illness, myths & stigma related to it, lack of knowledge on the treatment availability & potential
benefits of seeking treatment are important causes for the high treatment gap. The Government of
India has launched the National Mental Health Programme (NMHP) in 1982.

The District Mental Health Program (DMHP) was launched under NMHP in the year 1996 (in IX Five
Year Plan). The DMHP was based on ‘Bellary Model’ with the following components:

o Early detection & treatment.

o Training: imparting short term training to general physicians for diagnosis and treatment of
common mental illnesses with limited number of drugs under guidance of specialist.

o IEC: Public awareness generation.

o Monitoring: the purpose is for simple Record Keeping.

PROGRAMME PERFORMANCE

For providing affordable and accessible mental healthcare facilities to the population, including the
poor and underprivileged, the Government is implementing National Mental Health Programme
(NMHP) in the country. The District Mental Health Programme (DMHP) component of the NMHP
has been sanctioned for implementation in 704 districts for which support is provided to States/UTs
through the National Health Mission. Facilities made available under DMHP at the Community
Health Centre (CHC) and Primary Health Centre (PHC) levels, include outpatient services,
assessment, counselling/ psycho-social interventions, continuing care and support to persons with
severe mental disorders, drugs, outreach services, ambulance services etc. In addition to above
services there is a provision of 10 bedded in-patient facility at the district level.

Besides the above, the Government has announced a “National Tele Mental Health Programme” in
the Budget of 2022-23, to further improve access to quality mental health counselling and care
services in the country.

The data regarding registered colleges and schools having the facility of a qualified counsellor is not
maintained centrally. However, with a view to augment the availability of qualified manpower in field
of mental health, the Government, under NMHP, implements manpower development schemes for
establishment of Centres of Excellence and strengthening/ establishment of Post Graduate (PG)
Departments in mental health specialties. Till date, support has been provided for establishment of
25 Centres of Excellence and strengthening/ establishment of 47 Post Graduate (PG) Departments
in mental health specialties in the country.

PM- Ayushman Bharat Health Infrastructure Mission (PM-ABHIM)

For the COVID-19 public health challenge, the GOI’s response has been pre-emptive, proactive and
characterized by a ‘whole of government’ approach. The on-going COVID 19 pandemic has
demonstrated that health is a public good and India’s health systems need to be better equipped to
address public health needs across primary, secondary, and tertiary care levels. To strengthen the
Public Health Infrastructure effectively manage and respond towards any future pandemics and
outbreaks, PM-Ayushman Bharat Health Infrastructure Mission (PM- ABHIM) is announced in
Budget 21-22 on 1st February 2021. The PM-ABHIM is a Centrally Sponsored Scheme with some
Central Sector Components, for implementation of the Atmanirbhar Bharat Package for health sector
as announced by Hon’ble Finance Minister in May 2020.

The objective of the scheme is to fill critical gaps in health infrastructure, surveillance and health
research – spanning both the urban and rural areas so that the communities are Atmanirbhar in
managing such pandemic/ health crisis. It is the largest Pan-India scheme for public health
infrastructure since 2005.

Under the scheme the total financial outlay for the scheme period (2021-22 to 2025-26) is Rs 64180
Crore including ME and PMU cost out of which amount of Rs 54204.78 Crore is for implementation
of Centrally Sponsored Scheme Components and amount of Rs 9339.78 Crores for implementation
of Central Sector components.

The components of the PM-ABHIM scheme are: Centrally Sponsored Components:

1. Rural Health and Wellness Centres: Under PM-ABHIM, provision is available for necessary
infrastructure support for construction of 17,788 building less Sub Health Centres level AB-HWCs in
rural areas in 7 High Focus States (Bihar, Jharkhand, Odisha, Punjab, Rajasthan, Uttar Pradesh and
West Bengal) and 3 North-eastern States (Assam, Manipur and Meghalaya) cumulatively over a five-
year duration from FY 21-22 to FY 25-26.

2. Urban Health and Wellness Centres: Under PM-ABHIM, 11,024 Urban HWCs cumulatively over a
five-year duration from FY 21-22 to FY 25-26 are envisaged to be established across all the States &
UTs to ensure provision of comprehensive primary health care to the urban population.

3. Block Public Health Units: Under the scheme, it is envisaged to establish 3382 BPHUs in all the
Blocks of the 11 EAG States/UTs (Assam, Bihar, Chhattisgarh, Himachal Pradesh, UT - Jammu and
Kashmir, Jharkhand, Madhya Pradesh, Odisha, Rajasthan, Uttar Pradesh and Uttarakhand) by 2025-26
with the objective to equip the Block level health units to handle public health emergencies and to
respond & monitor the healthcare services.

4. Integrated Public Health Labs: An Integrated Public Health Laboratories in all 730 districts will be
set-up under the scheme to optimise access to laboratory services, quality assurance efforts, cost-
effectiveness, and efficient use of human resources. The objectives of IPHL are to strengthen the
infectious and non-infectious disease surveillance system, to provide accurate data for enhancing
timely response for disease outbreak, to provide mentorship to block Public Health Lab and serve as
diagnostic hub for block CHC labs (spokes) and to support laboratory investigations of outbreaks.
5. Critical Care Hospital Blocks: Under PM-ABHIM, support is available to establish 602 Critical Care
Hospital Blocks (100/75/50-bedded) in all districts with population more than 5 lakhs and with
referral linkages in other districts. Objective of the critical care blocks is to augment the capacity of
the district for assured treatment and management of patients with infectious diseases or critical
illnesses by creating Critical Care Hospital Blocks /Wings at District Hospitals/ Medical Colleges and to
ensure health system preparedness for future outbreaks.

PROGRAMME PERFORMANCE

Pradhan Mantri Ayushman Bharat Health Infrastructure Mission (PM-ABHIM) is a Centrally

The scheme envisages a new generation of reforms to integrate and strengthen health service
delivery and public health action. The measures under the scheme are aimed at strengthening health
systems and institutions in order to provide a continuum of care at all levels, namely primary,
secondary, and tertiary, as well as preparing health systems to respond effectively to current and
future pandemics and disasters.

Under the CSS components of the scheme, following are the five activities where support is
provisioned to the State/UTs during the scheme period (2021-2026):

1. Construction of 17,788 Building less Sub-Centres as Ayushman Bharat- Health & Wellness
centres, now known as Ayushman Arogya Mandir (AAM).

2. Establishment of 11,024 Health & wellness Centres, now AAM in Urban areas with a focus
on slum and slum like areas.

3. Establishment of 3382 Block Public Health Units (BPHUs) at the block level.

4. Establishment of 730 District Integrated Public Health Labs (IPHL) in the country, wherein
each district will have one such lab.

5. Establishing 602 Critical Care Hospital Blocks (CCBs) in all districts with population more
than 5 lakhs.

The CSS components of PM-ABHIM is implemented by following the existing framework, institutions
and mechanisms of the National Health Mission. Public Health and Hospital are State subjects,
implementation of the scheme lies under the purview of State Government. However, MoHFW
provides technical and financial support to the States/Union Territories (UTs) for effective
implementation of the scheme.

The scheme is implemented by the State government and awareness generation activities including
IEC for the scheme is periodically conducted by the State health department along with other public
health programs under National Health Mission.