STUDY ON NRHM (NATIONAL RURAL HEALTH

MISSION) POLICY AND LACKING IN ITS

IMPLEMENTATION

Submitted By

SUPRIYA TRIPATHI

Enrollment number - A7528713065

BJ & MC -3rd Semester

Under Guidance of

Ms. Areena Zainub Mirza

ASCO Lucknow

AMITY SCHOOL OF COMMUNICATION

AMITY UNIVERSITY LUCKNOW CAMPUS

ABSTRACT –

National Rural Health Mission (NRHM) seeks to provide effective healthcare to rural and urban

population throughout the state with special focus on the backward districts with weak human

development and health indicators especially among the poor and marginalized groups like

women and the vulnerable sections of the society. The goal of NRHM is to improve the

availability and access to quality health care by people, especially for those residing in rural

areas, the poor women and children.

Some principles of NRHM are to provide effective healthcare to especially women and children

in Rural and Urban areas, which have weak indicators. This similarly means to raise access,

equity, accountability, quality and effectiveness of public health services and

Decentralized Management at District level and effective amalgamation of health programs

It aims to emphasize the involvement of Panchayati Raj Institution as well as the community in

management of primary health programs.

NRHM gyrate around some determinants of health like, Sanitation and Hygiene, Safe drinking

water, Nutrition, Gender and Social concerns.

Government spent lot of money for these policies but it is not mention anywhere about all the

lacking behind implementation of their policies. If Government releases a new policy for the

welfare of women and new born baby then how much does it implemented in the particular rural

area is the big question. How much the people of village are immunized, Does Pregnant ladies

know about the ‘Janani Surkasha Yojana’(JSY) which is basically all about to promote

Institutional Delivery. Does they are aware about ‘Swachta Samity’ in which government

promote clean and healthy environment. For this government spent a large amount of money. In

this policy, Gram Pradhan and ANM (Auxillary Nurse Midwives) has a joint account which is

basically for the cleaning of the village. The study through survey analysis attempts to analyze

effectiveness of the government policies in Rural and Urban areas. The study will be significant

in exploring the impact of such policies in Rural and Urban areas it could help to find out the

reason behind lacking in its implementation.

KEYWORDS- Government, Effective, Policies, Implementation, Immunization.

ACKNOWLEDGEMENT

As a part of our course curriculum, I had to make a project report on the NRHM (National Rural

Health Mission) Policy and lacking in its implementation

to get the right exposure to the practical aspects of Journalism & Mass Communication.

I extend my heartiest thanks to everybody who helped me through the successful completion of

my project, which has been a great source of learning and experience for me.

I am also indebted to my teachers, my guide Ms.Areena Zainub Mirza, my family and friends for

their valuable support guidance in carrying out this study.

Student’s Signature

Name- SUPRIYA TRIPATHI

Date:

CERTIFICATE BY PROJECT GUIDE

Certified that the project Name of the Project is prepared by Name of the

Student, student of MJ&MC/BJ&MC (Semester), AMITY SCHOOL OF

COMMUNICATION, in partial fulfillment of award of degree of

Masters/Bachelors of Journalism and Mass Communication from AMITY

UNIVERSITY UTTAR PRADESH, LUCKNOW CAMPUS.

FACULTY GUIDE

Name

Designation

Amity School of Communication

DIRECTOR

S. M. Johri

Professor-Director

Amity School of Communication

Date:

CONTENTS

1. Introduction

2. Project Design

3. Literature Review

4. Results and Discussion

5. Conclusion/Result

6. References / Bibliography

INTRODUCTION

The National Rural Health Mission is a major bellwether program of the government in

the health & hygiene sector, It aims at comprehensive health and improved access to quality

health care for those residing in rural areas, particularly women, children and the poor by

promoting, Decentralization and encouraging community ownership in health

programs.

NRHM is primarily a financing mechanism for strengthening the public health system in the

states. NRHM design recognizes that beyond this increased investment, improved governance,

Institutional reform and innovation are essential, and these cannot be ensured by NRHM alone.

NRHM enabled a flexible program and budgetary environment which in turn stimulated state

governments to pilot innovations in health systems delivery.

NRHM has played a major role by strengthening health facilities to provide services

by adding over one lakh human resources, improving infrastructure, by increasing

availability of equipment and essential supplies and by promoting demand through

community level processes.

Four major innovations have contributed to the reduction in maternal mortality.

These include the Janani Suraksha Yojana (JSY) for promoting institutional delivery,

the “Dial 108” Ambulance System, to address the issue of emergency transport, the

multi skilling of non specialist medical officers to address the lack of specialist skills for

the provision of emergency obstetric care and the Janani Shishu Suraksha Karyakram

(JSSK) is to reduce the financial barriers of access to care.

The objective of this study is to get a ratio about the money expend by the government for the

welfare of women, children and society. The Study is to calculate it in a higher pace, that is it

just become the medium to earn money for the health and Hygiene department or do they follow

up the guidelines given by the government for the welfare of the society.

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Like for an example, if a lady know about the Janani Suraksha Yojana (JSY) then it is also very

much necessary to know about the mature gap between two children for the better health of

mother. The relatively small enabling report is the sum given as part of JSY would significantly

influence women families to have repeated pregnancies, just to earn some money.

This directly influences the Maternal Mortality Rate (MMR), Infant Mortality Rate (IMR) and

lastly Total Fertility Rate (TFR).

Bringing families into contact with the health system increases their confidence in child survival

and helps to empower and motivate women for family planning. There is however a problem in

service provision of contraceptive services as there is a mismatch between the rate of

growth of skilled service providers and the utilization of services.

PROJECT DESIGN –

The research methodology used in this Survey is the Questionnaire method.

Survey was conducted to examine the impact of NRHM Policies in Rural and Urban Areas and

its related implementation. To analyze the opinion and reaction towards the same, the general

public from Rural and Urban areas of Bulandshahr were selected. The sample size was of 100

respondents drawn through random sampling. The questionnaire consisted of close ended

question which focused on gauging opinion of Rural and Urban living people for the different

government policies.

The questionnaire consist 21 questions, some with appropriate options. There are 5 questions for

Demographic Details and remaining from the existing topic. The questionnaire is as following –

प्रश्नमा�ला�1-ना�मा

2- पि�ता� / �पिता/ �त्ना� का� ना�मा

3- उम्र 2/12

4- लिंला�ग

5- ग्रा�मा�ण / शहरी�- खं�ड

6- पि���पिहता / अपि���पिहता

7- आ�का� श�दी� का औसता उम्र �ता� ह#

a-18b-21c- 16

8- क्या� आ� मा�ता&त्� का औसता उम्र जा�नाता( ह�

a- ह��b- - नाह)c- - �ता� नाह�

9- पिकाताना( बच्चे( ता,म्ह�री( ��स ह#

10 - प्रस� काह�. हुआ था�a- अस्पता�लाb- घरीc- ला�ग3 नाह)

11- गर्भा�5�स्था� का( दी7री�ना प्रपितारीक्षण हुआ

a- ह��b- नाह)c- ला�ग3 नाह)

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12- प्रपितारीक्षण टी�का� ना�मा क्या� ह#

a- टी�टी� 1b- टी�टी� 2c- �ता� नाह)d- ला�ग3 नाह)

13- आयारीना फो�लिलाका एलिसड का दी�� मिमाला� था�

a- ह��b-नाह)c- ला�ग3 नाह)

14- आ� जानाना� स,रीक्ष� या�जाना� का( ब�री( मा> का, छ जा�नाता( ह�

a- ह��b- नाह)c- �ता� नाह)

15- प्रस� का( ब�दी �#स� मिमाला� था�

a- ह��b-नाह)c- ला�ग3 नाह)

16- पिकाताना� धना मिमाला� था�

a-1000b-1400c- ला�ग3 नाह)

17- आ� सबला� सला�ना� या�जाना� का( ब�री( मा> का, छ जा�नाता( ह�

a- ह��b- नाह)

c- �ता� नाह) 4/12

18- क्या� आ�का( बच्चे( का� सर्भा� टी�का�कारीण हुआ ह#

a- ह��

b- नाह)

c- �ता� नाह)

19- आ� स्�च्छता� समिमापिता या�जाना� का( ब�री( मा> का, छ जा�नाता( ह�

a- ह��

b- नाह)

c- �ता� नाह)

20- आ� स्ताना��ना का( प्रका�री जा�नाता( ह�

a- ह��

b- नाह)

c- �ता� नाह�

21- आ� पिकाताना( बच्चे( का� स,खं� �रिरी��री का( लिलाए �या�5प्ता समाझता( ह�

a-2b-4c- 6d-

LITERATURE REVIEW –

People of Rural and Urban areas think that the government policies needs to be much more

effective to serve a valuable role in developing an organization and enhancing a organization’s

merciless position ability according to research survey analysis.

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Strengthen capacity for district planning and decentralized governance in health by more

responsive resource allocation strategies, and better capacities for district level planning and

management and Build up the capacity at the district level for providing advanced secondary and

tertiary care services in all basic specialists, in acting as a training and education center for

paramedical, nurses and mid-level care providers, and for purposes of planning and knowledge

management are some major topic for consideration.

Research has also found an impact of these policies which helps the people to reposition the

organizations and its relatively changing policies very effectively. The impact of these policies

has also been found to generate a positive impact on the economic return of the country and it

also help to generate the awareness among all of them.

The review of literature suggests that the government policies and its related awareness have

impact on the Rural and Urban people behaviors.

RESULTS AND DISCUSSIONS –

The serious issue which create clash between the Objective of NRHM Goal is lack of education

or Illiteracy and Lack of Community ownership. Following is the result shown in the Pie Chart

to exaggerate the same.

1- आ�का� श�दी� का औसता उम्र �ता� ह#

Sales182116

Majority of respondents (35%) were of opinion that they think the appropriate age of marriage is 16 years. Other 20% thinks that 21 years is average age and the remaining 45 % people think that 18 years is the proper age for a girl to get married.

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2 - क्या� आ� मा�ता&त्� का औसता उम्र जा�नाता( ह�

SalesYesNo 30Don't Knw 45

Majority of people 45 % do not know the average age to become mother, 30% admitted that they know but unfortunately they cannot give correct answer and the remaining 25% were right and they know the average age to be pregnant.

3- प्रस� काह�. हुआ था�

SalesHospitalHomeOther

Majority of respondents 75 % admit that they have institutional Delivery, 20 % in Home and remaining 5 % others.

4- गर्भा�5�स्था� का( दी7री�ना प्रपितारीक्षण हुआ

SalesYes

No

Not Ap-plicable

Majority of respondents 65% agree that they go through all the immunization through pregnancy, 10% not get proper care and the remaining 25% is not applicable

question. 7/12

5- प्रपितारीक्षण टी�का� ना�मा क्या� ह#

SalesTT 1stTT 2ndDnt KnwNot applicable

Majority of respondents 39% TT 1st, 25% TT 2nd, 20% Don’t Know and 16% not applicable.

6- आयारीना फो�लिलाका एलिसड का दी�� मिमाला� था�

SalesYesNoNot applicable

Majority of respondent (75%) agree that they got the Iron doses from the hospitals during their pregnancy, 20% admit that they do not get and the remaining 5% where not applicable for this question.

7- आ� जानाना� स,रीक्ष� या�जाना� का( ब�री( मा> का, छ जा�नाता( ह�

SalesYesNoDon't Know

Majority of respondents (65%) admit that they know about the JSY, other 25% agree that they do not have any knowledge about the same and the remaining do not know it particularly.

8/12

8- प्रस� का( ब�दी �#स� मिमाला� था�

SalesYesNoNot applicable

Majority of respondent (79%) agree that they receive the amount of money from the hospitals, rest 13% admit that they do not get any money and the remaining 8% were not eligible to answer this question.

9- पिकाताना� धना मिमाला� था�

Sales 14001000Not applicable

Majority of respondent 45% get 1400 as they belong to rural area, 35% get 1000 as those women belongs to urban area and remaining 20% were not eligible for this question.

10- आ� सबला� सला�ना� या�जाना� का( ब�री( मा> का, छ जा�नाता( ह�

SalesYesNoDon't know

Majority of people 69% know about SSY, 23% do not know about this policy and the remaining 8 have no knowledge about this as they are not totally aware.

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11- क्या� आ�का( बच्चे( का� सर्भा� टी�का�कारीण हुआ ह#

SalesYesNoNot applicable

55% agree that their child is fully immunized,30% were not able to do so and the remaining were not eligible to answer this question.

12- आ� स्�च्छता� समिमापिता या�जाना� का( ब�री( मा> का, छ जा�नाता( ह�

SalesYes No

Majority of respondents 52% agree that they know about SSY but the remaining 48% were not fully aware about the same.

13- आ� स्ताना��ना का( प्रका�री जा�नाता( ह�

SalesYesNo

Majority of respondents 59% do not know the types of breast Feeding and the remaining 41 % know about the two types of feeding.

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14- आ� पिकाताना( बच्चे( का� स,खं� �रिरी��री का( लिलाए �या�5प्ता समाझता( ह�

Sales246

Majority of people 49% admit that in their opinion 4 child can be the average number for the happy family,33% admit 2 child and the remaining 18% mark 6 child for the same.

This survey lead to an inevitable result, as it show the ratio of unaware people in Rural and Urban areas and give a rough ratio about how much does the policies being implemented in the high risk areas.

CONCLUSION –

As per the NRHM goal, they focus on the issue of Healthy Mother and Healthy Child. So, the journey of a Healthy Mother starts from the Adolescence age where it is very much necessary to have proper Health and Hygiene knowledge and in the series proper Nutritious meal related information etc. But, I acknowledge that they are not fully aware about the situations related with their Health and Care. So, they need to be fully sensitized and mobilize by the government. I concluded that to attach community emotionally and mentally, the system of Road Show (Nukad Natak) can work extremely well. As, people get aware and sensitized through Entertainment. I also analyze that for much better result simultaneously Community Ownership is also very much important, as if they are willing to have the services even then they could be properly sensitized and mobilized. And for this particular process, if a Community Influencer support the program then it can lead to better community ownership.

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Through the research I analyze that the serious issue which create clash between the objective of NRHM goal is lack of education or illiteracy and Lack of Community ownership. It is also very much important for the organization to do such programs like Nukad Natak, according to the community which can affect the masses emotionally. NRHM employees must also get proper Training & Orientation, as it is also very much necessary for the technical staff to do follow up of Vaccination through Four key messages as per the NRHM Guideline, with this method Parents could know about the vaccines and related reactions.

REFRENCES / BIBLIOGRAPHY –

NRHM Eleventh Five year plan from the official site, nrhm.gov.in

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