Perspective of National Rural Health Mission: Issues and Challenges

Health care is one of the most important interventions to improve the quality of life of people. Rural health care forms an integral part of national health care system. Strengthening primary health care is the cornerstone of all rural health programmes. For developing comprehensive public health infrastructure, providing adequate human resources in health facilities, increasing the pace of socio-economic development and for achieving the aim of quality of life, the primary health care is considered as the main instrument of action. Recognising the importance of health in the socio-economic development of a country, to attain quality of life to its people, and to improve the quality of health and hygiene, nutrition, sanitation and to carry out necessary architectural correction in the basic health care delivery system, National Rural Health Mission was launched throughout the country. It is a flagship programme and adopts synergistic approach by relating health to the determinants of good health such as segments of nutrition, sanitation, hygiene and safe drinking water. The mission aims to provide accessible, affordable and quality health care to rural people especially vulnerable and underserved sections of society. For effective implementation of the mission, a provision of Accredited Social Health Activist (ASHA) at each sub centre level is made. This article analyses the structure of the health care system in the context of Himachal Pradesh. The availability of human resources in improving health delivery and the scheme of ASHA and the role of anganwardi worker as link worker of the mission is highlighted. The health pyramid of the state as well the performance of the mission in terms of achievement of the health indicators is discussed. The challenges being faced in the implementation of the mission are also explained.