National Health Mission (NHM) — Complete Overview for 2026
The National Health Mission (NHM) is India's flagship public health programme launched in 2013 by merging the National Rural Health Mission (NRHM, 2005) and the National Urban Health Mission (NUHM, 2013). It anchors almost every major public health intervention in the country — from maternal and child health to disease control — and is one of the most frequently asked topics in UPSC CMS, NEET PG and state PSM papers.
The National Rural Health Mission (NRHM) was launched on 12 April 2005 to provide accessible, affordable and quality healthcare to rural populations, especially in 18 high-focus states with weak public health indicators. The Mission was extended in 2012 and, on 1 May 2013, subsumed into the broader National Health Mission (NHM) by adding the National Urban Health Mission (NUHM) as its second arm. Together, NRHM and NUHM cover the entire geographic and demographic spectrum of India.
NHM is implemented by the Ministry of Health and Family Welfare (MoHFW) through the National Health Mission Society at the national level, State Health Societies at the state level, and District Health Societies at the district level. It is one of the world's largest publicly funded health programmes, with an annual outlay exceeding Rs 35,000 crore. The Mission has been repeatedly praised by the World Health Organization and the World Bank as a model for scaling up community-based health interventions in low-resource settings.
The original NRHM period was 2005-2012; it was extended to 2017 and then to 2020 with continued funding through the 12th Five Year Plan and beyond. NHM now operates in a rolling approval cycle, with annual Programme Implementation Plans (PIPs) submitted by states and approved by the National Programme Coordination Committee.
The NHM has six core objectives that define its scope and accountability framework:
- Reduce IMR and MMR: Bring Infant Mortality Rate and Maternal Mortality Ratio down to nationally set targets (currently part of SDG commitments).
- Universal access to public health: Provide universal access to equitable, affordable and quality healthcare services for both rural and urban populations.
- Population stabilisation: Achieve population stabilisation through gender-sensitive, demographic-balanced strategies.
- Communicable and non-communicable diseases: Prevent and control communicable and non-communicable diseases, including locally endemic illnesses.
- AYUSH integration: Promote integration of AYUSH systems (Ayurveda, Yoga, Unani, Siddha, Homeopathy) into the mainstream public health system.
- Healthy lifestyle: Promote healthy lifestyles and behaviours among the population.
These objectives are operationalised through flexible financial pooling, decentralised planning at district level, and a contractual workforce model that allows rapid scale-up without permanently expanding the state cadre — a feature that also creates employment opportunities for MBBS doctors, nurses and paramedical staff outside the regular government setup.
National Rural Health Mission (NRHM)
NRHM covers rural areas across all states and UTs. Its service delivery architecture is built on a three-tier system: Sub-Centres at the village level (now rechristened Health and Wellness Centres under Ayushman Bharat), Primary Health Centres (PHCs) at the block level, and Community Health Centres (CHCs) at the subdivisional level. ASHAs (Accredited Social Health Activists) form the community-level interface between the formal health system and households.
National Urban Health Mission (NUHM)
NUHM, approved in May 2013, covers urban populations — particularly the urban poor living in listed and unlisted slums. It establishes Urban Primary Health Centres (UPHCs) and contracts with NGOs and private providers for service delivery. NUHM acknowledges the unique challenges of urban health: high population density, hidden poverty amid apparent wealth, vertical slums, and the presence of multiple healthcare providers competing for the same patient pool.
Both NRHM and NUHM report to a single State Health Mission chaired by the Chief Minister and a State Health Society headed by the Chief Secretary, ensuring unified governance while allowing programme-specific implementation strategies.
NHM is an umbrella mission — dozens of vertical programmes and horizontal schemes operate under it. The most clinically relevant ones for MBBS doctors include:
| Scheme / Programme | Focus Area | Key Intervention |
|---|---|---|
| Janani Suraksha Yojana (JSY) | Institutional delivery | Cash incentive to mothers |
| Janani Shishu Suraksha Karyakram (JSSK) | Free maternal & infant care | Zero-expense delivery |
| Rashtriya Bal Swasthya Karyakram (RBSK) | Child screening | 4 Ds screening (Defects, Diseases, Deficiencies, Developmental delays) |
| Rashtriya Kishor Swasthya Karyakram (RKSK) | Adolescent health | Peer education, AFHCs |
| Mission Indradhanush | Immunisation | Catch-up vaccination for left-outs |
| National Vector Borne Disease Control Programme | Malaria, dengue, kala-azar | Vector control + treatment |
| Revised National Tuberculosis Control Programme (now NTEP) | Tuberculosis | DOTS, CBNAAT, Nikshay |
Other major components include the Family Planning programme, NPCDCS for non-communicable diseases, the National Mental Health Programme, and the National Programme for Health Care of the Elderly (NPHCE). All these programmes are financed through NHM's flexible funding envelope and implemented through the same district-level machinery.
NHM follows a 75:25 centre-state funding pattern for most states, with the Government of India contributing 75% and state governments contributing 25%. For North-Eastern states and the three Himalayan states of Jammu & Kashmir (now UT), Himachal Pradesh and Uttarakhand, the ratio is 90:10 in favour of the centre. This differential recognises the higher per-capita cost of delivering healthcare in mountainous terrain and the limited fiscal capacity of smaller states.
Funds flow from the centre to the State Health Society, then to the District Health Society, and finally to the facility level (CHC, PHC, Sub-Centre). The Programme Implementation Plan (PIP) process requires states to submit annual plans by November, which are appraised by the National Programme Coordination Committee and approved with the Record of Proceedings (RoP) by March. This decentralised planning model is one of NHM's most distinctive features compared to earlier centrally-sponsored schemes.
NHM is the single largest employer of MBBS doctors outside the regular central and state government cadres. Contractual positions are advertised regularly for roles such as Medical Officer In-charge of PHC/CHC, RBSK Medical Officer (mobile health screening teams), NHM Specialist (for anaesthetists, paediatricians, OBG specialists at CHCs), and Programme Managers at district level. Salaries typically range from Rs 50,000 to Rs 1,20,000 per month depending on state, role and seniority.
For UPSC CMS aspirants, working under NHM offers unmatched exposure to public health practice — you will see cases of malaria, tuberculosis, complicated labour, severe acute malnutrition and outbreak response that you would rarely encounter in urban private practice. This experience translates directly into the applied PSM questions in the CMS interview and personality test, where the panel specifically probes your understanding of grassroots public health.
Many NHM doctors use their 2-3 year contractual tenure as a bridge to either crack NEET PG / INICET or prepare for UPSC CMS / State PSC Medical Officer exams. Reference: official NHM portal and the NHM Framework for Implementation.
The National Health Mission remains the operational backbone of India's public health system. Whether you are preparing for UPSC CMS, NEET PG, or a state PSC Medical Officer exam, a working knowledge of NHM — its objectives, structure, financing and major schemes — is non-negotiable. Beyond the exam, NHM directly shapes the kind of doctor you become if you ever work in a government facility, which is the trajectory for the majority of MBBS graduates in India.