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National Urban Health Mission (NUHM) as a sub-mission under the National Health Mission (NHM)

The Union Cabinet gave its approval to launch a National Urban Health Mission (NUHM) as a new sub-mission under the over-arching National Health Mission (NHM). Under the Scheme the following proposals have been approved :

1. One Urban Primary Health Centre (U-PHC) for every fifty to sixty thousand population.
2. One Urban Community Health Centre (UCHC) for five to six U-PHCs in big cities.
3. One Auxiliary Nursing Midwives (ANM) for 10,000 population.
4. One Accredited Social Health Activist ASHA (community link worker) for 200 to 500 households.

The estimated cost of NUHM for 5 years period is Rs.22,507 crore with the Central Government share of Rs.16,955 crore. Centre-State funding pattern will be 75:25 except for North Eastern states and other special category states of Jammu and Kashmir, Himachal Pradesh and Uttarakhand for whom the funding pattern will be 90:10.

The scheme will focus on primary health care needs of the urban poor. This Mission will be implemented in 779 cities and towns with more than 50,000 population and cover about 7.75 crore people.

The interventions under the sub-mission will result in

• Reduction in Infant Mortality Rate (IMR)
• Reduction in Maternal Mortality Ratio (MMR)
• Universal access to reproductive health care
• Convergence of all health related interventions.

The existing institutional mechanism and management systems created and functioning under NRHM will be strengthened to meet the needs of NUHM. Citywise implementation plans will be prepared based on baseline survey and felt need. Urban local bodies will be fully involved in implementation of the scheme. NUHM aims to improve the health status of the urban population in general, particularly the poor and other disadvantaged sections by facilitating equitable access to quality health care, through a revamped primary public health care system, targeted outreach services and involvement of the community and urban local bodies.

Background

The Union Cabinet in its meeting held in April 2012 has already approved the continuation of the National Rural Health Mission (NRHM) and the other sub-mission under NHM till 31.3.2017. Amendments in the National Food Security Bill Introduced in the Lok Sabha Bill Provides Rice at the Rate of Rs 3 and Wheat at Rs 2 Per Kg Food Security Allowance in Case of Non Supply of Foodgrains Proposed Special Focus on Nutritional Support to Women and Children Women to Get 6000 Rs Maternity Allowance Besides Nutritional Food .

The National Food Security Bill was introduced in the Lok Sabha on 22nd December, 2011 to addresses the issue of food security in a comprehensive manner, by adopting a life cycle approach. The Bill was introduced after a wide-ranging consultation with various stakeholders.

After introduction, the Bill was referred to Standing Committee on Food, Consumer Affairs and Public Distribution, who interacted with other Central Ministries, various other organizations and individuals and visited States before submitting its report to the Speaker, Lok Sabha on 17th January, 2013. The recommendations of the Standing Committee were examined in consultation with concerned Central Ministries and also with the Food Ministers and Food Secretaries of States/UT. Based on the recommendations of the Standing Committee and views of various stakeholders thereon, the Government decided to move certain amendments to the Bill. These amendments seek to make the framework of the proposed legislation simpler, provide more flexibility to States/UTs in its implementation and to address some of the concerns raised by them.

Main amendments to the Bill are as under:

• Coverage and entitlement under Targeted Public Distribution System (TPDS): Instead of coverage ofupto 75% of the rural population and upto 50% of the urban population under two categories of priority and general households with different entitlements and issue prices provided in the original Bill, there would be only one category of beneficiaries with uniform entitlement of 5 kg per person per month.

• Protection of entitlements under Targeted Public Distribution System: The entitlement of Antyodaya Anna Yojana (AAY) households, which constitute poorest of the poor will, however, be protected at 35 kg per household per month. It is also proposed to accept the recommendation of the Committee to protect the existing allocation of food grains to the States/UTs, subject to it being restricted to average annualofftake during last three years (2009- 10 to 2011-12).

• State-wise coverage and identification of beneficiaries: Corresponding to coverage of 75%/50% of the rural/urban population at the all India level, State-wise coverage will be determined by the Planning Commission. The work of identification of eligible households is proposed to be left to the States/UTs, which may frame their own criteria or use the Social Economic and Caste Census (SECC) data.

• Subsidized Prices under TDPS and their revision: Uniform prices of Rs. 3/2/1 per kg for rice/wheat/coarse grains will be applicable to all eligible beneficiaries. It is proposed to fix these prices for the first three years of implementation of the Act, and thereafter link the same suitably to MSP.

• Cost of intra-State transportation & handling of foodgrains and FPS Dealers’ margin: In order to address the concerns of States/ UTs regarding additional financial burden, it is proposed that Central Government may provide assistance to States towards cost of intra-State transportation, handling of food grains and FPS Dealers’ margin, for which norms will be devised.

• Maternity benefit: It is proposed to allow States/UTs to use the existing machinery of District Grievance Redressal Officer (DGRO), State Food Commission, if they so desire, to save expenditure on establishment of new set up.

At the coverage and entitlement now proposed, total estimated annual food grains requirement is 612.3 lakhtons and the corresponding estimated food subsidy for implementation of NFSB, at 2013-14 costs, is about Rs. 1,24747 crore. When compared to the estimated food subsidy requirement under existing TDPS and Other Welfare Schemes, the additional food subsidy implication is about Rs.23,800 crore per annum. Requirement for assistance to States for meeting the expenditure on Transportation, Handling and FPS Dealers’ margin, etc., would be additional.

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