National Urban Health

Mission
Introduction
• NUHM has been taken up during the ltth five year
plan to meet the health needs of the urban poor.
• Covers all cities with a population of more than
1,00,000.
Rationale
• Urban population estimated to increase from 35.7
crores to 43.2 crores in 2021.
• This can lead to increase in number of slums.
• Slum population growing at the rate of 7°/o annually.
• Poor health status of urban slums.
• Inadequacy of health care delivery to slums
• Unfriendly treatment at government hospitals.
• Slum people at greater health hazards.
Goal
• Improve health status of poor by:
- Facilitating equitable access to quality health care.
- Revising public health system.
- Building public private partnership.
- Community based risk pooling and insurance
mechanism.
- Active involvement of the urban local bodies.

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Strategies
1. Strengthening urban primary health structure.
2. Strengthening community participation.
3. Establishment of Mahila Arogya Samiti.
4. Appointment of Urban Social Health Activist.
5. Capacity building of stake holders.
6. Prioritizing the most vulnerable.
7. Ensuring quality health care services.

•
Targets under NUHM
• IMR
•MMR
• TFR
• Malaria
• Kala azar
• Filariasis
• Dengue fever
• Chickungunya
• Tuberculosis
• leprosy
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• Coverage and duration of NUHM
- Duration: period of eleventh five year plan (2008-
2012)
- Coverage: entire urban poor population of 430
cities.
- Phase 1: all cities with population of more than 1
lakh.
- Phase 2: all towns with population of less than 1
lakh.

•
Definition
. of
, shun:

Any compact habitation of atleast 300 people or about

60--70 households of poorly built, congested tenements,
in unhygienic environments, usually without adequate
infrastructure and lacking in proper sanitary and
drinking water facilities in these towns irrespective of
the fact whether such slums have been notified or not
as slums by state or local govemement and union
territory administration under any act, recognised or
not, are legal or not, is to be covered under NUHM.

•
Functions of USHA:
- Promote good health practices in their area.
- Facilitate awareness on RCH services.
- Motivate aJJ types of family planning methods.
- Register all pregnant mothers and to motivate them for
antenatal care.
Act as depot holder for essential provisions.
Support ANM/MAS in conducting monthly outreach
session regularly.
- Form and promote MAS.
- Escort patients requiring health services.
- Encourage community participation in health activities.
- Maintain records of vital events in her area.
- Treat minor ailments with drug kit provided II
• Functions of Mahila Arogya Samiti:
- Focus on preventive and promotive care.
- Act as peer education group.
- Facilitate access to identified facilities.
- Community monitoring and referral.
- Risk pooling fund and health insurance.
• Functions of Au!Cillary Nurse rvhdw"fE:: of pritnary
urban health center·
- Provide preventive and promotive health care
services at household level.
- Monitor the activities of USHA
- Arrange outreach medical camps.
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Community risk pooling
• Consist of women from MAS.
• One time seed money (Rs 25/ household) will be
given by the government at the initial time and
again annual performance grant (Rs 25/ household)
is given.
• Uses of this pooling- unforeseen health expenditure
of the member or family, other activities like group
meetings, mobilization for health camps.

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Urban health insurance model
• Benefits-
. Includes hospitalization, in patient services for more
than 24 hours.
. Includes consultation, investigation and room charges
and medicines and surgical/ medical procedures.
- Maternal and childhood conditions and illnesses.
- Monetary coverage is upto a maximum of
50000/year/enrolled household.
- Amount is directly paid to the empanelled.

IS
 Primary urban health center
• Staff pattern-
- Medical officer- 1
- Pharmacist/ lab technician- 2 ;:::;;:;;;;;��
- Program health manager- 1
- Multi-skilled nurse- 2
- ANMs-4
- Account keeper- 1
- Support staff- 3

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• Functions-
Medical care: OPD services, 4 hours in the morning and 2
hours in the evening.
RCH- 2 services.
- National health program
Collection and reporting of vital events
Integrated disease surveillance program
Referral services
- Basic laboratory services
Counselling services
. Services for non communicable diseases

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Social mobilisation and community level activities.
• Referral units-
Existing hospitals including urban local body
maternity homes, state government hospitals and
medical colleges will be accredited as referral points
for health care services.

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Intrasectoral coordination
• Housing and slwn development society to establish new
PUHCs.
• Colocation of RNTCP, ICTC, AYUSH, IDSP, NVBDCP at
UHCs.
• Convergence of all national health programs.
• Convergence with Swarn Jayanthj Shahri Rozgar Yojana.
• Convergence with ICDs and education department.
• Convergence with JawaharlaJ Nehru National Urban
Renewal Mission.

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Monitoring and evaluation

Health
management
information
system for
reporting and
feedback