National Rural Health Mission

National Rural Health Mission (NRHM) is an Indian health program for improving health care delivery across rural India. The mission, initially mooted for 7 years (2005-2012), is run by the Ministry of Health. The scheme proposes a number of new mechanism for healthcare delivery including training local residents as Accredited Social Health Activists (ASHA),^[1] and the Janani Surakshay Yojana (motherhood protection program). It also aims at improving hygiene and sanitation infrastructure.^[2] Noted economists Ajay Mahal and Bibek Debroy have called it "the most ambitious rural health initiative ever".^[3]
The mission has a special focus on 18 states Arunachal Pradesh, Assam, Bihar, Chhattisgarh, Himachal Pradesh, Jharkhand, Jammu and Kashmir, Manipur, Mizoram, Meghalaya, Madhya Pradesh, Nagaland, Orissa, Rajasthan, Sikkim, Tripura, Uttarkhand and Uttar Pradesh.
Under the mission, health funding had increased from 27,700 crores in 2004-05 to 39,000 crores in 2005-06 (from 0.95% of GDP to 1.05%).^[4] This has further increased from 14,974 crores in 2007-08 to 34,488 crores in 2012-13. ^[5] As of 2009, economists noted that "the mid-term appraisal of the NRHM has found that there has been a significant improvement in health indicators even in this short period".^[3] However, in many situations, the state level apparatus have not been able to deploy the additional funds, often owing to inadequacies in the Panchayati Raj functioning. Fund utilization in many states is around 70%.^[3]