With the sanctioning of an additional Rs 1860 crore for the health care sector in the Union Budget 2005-'06, the National Rural Health Mission is set to take off from April 1, 2005, as planned earlier.

Though the mission covers the entire country, 18 high focus states - Uttar Pradesh, Bihar, Rajasthan, Madhya Pradesh, Orissa, Uttaranchal, Jharkhand, Chattisgarh, Assam, Sikkim, Arunachal pradesh, Manipur, Meghalaya, Tripura, Nagaland, Mizoram, Himachal pradesh and Jammu & Kashmir, would be major beneficiaries by the mission, planned to be implemented with timelines within the next three years.

Mainly envisaged to decentralize rural healthcare management in the country to district and panchayath levels, important goals of the mission include reduction in Infant Mortality Ratio and Maternal Mortality Ratio in rural areas, immunization against childhood diseases, prevention and control of communicable and non-communicable diseases including locally endemic diseases, preparation of panchayath and district level health action plans, strengthening sub centres/ PHCs, institutionalizing district level management of health, raising standards of CHCs and increase utilization of first referral units from less than 20 per cent to more than 75 per cent by 2010.

The mission envisages every village to have a female community health activist chosen by and accountable to the panchayath to act as the interface between the community and the public healthcare systems. These Accredited Social Health Activists (ASHA)'s will be trained by the government with active involvement of community health resources organizations.

Strengthening sub centres and PHCs for improved outreach and delivery services, strengthening the existing CHCs and provision of 30 to 50-bedded CHCs per lakh population as per an Indian Public Health Standards (IPHS) defining personnel, equipment and management standards, preparation and implementation of an inter-sectoral District Health Plan prepared by the District Health Mission, including drinking water, sanitation and hygiene and nutrition, and integrating relevant vertical H&FW programmes at national, state and district levels, form part of the mission.

These strategies will be supplemented by reorienting medical education to support rural health issues, regulation of private sector, including the informal rural practitioners to ensure quality service, promotion of Public Private partnerships for achieving public health goals and by mainstreaming AYUSH.

Each PHCs would be ensured with essential drugs, and provide 24 hour service in 50 per cent of PHCs by addressing shortage of doctors especially through mainstreaming AYUSH manpower. The mission also envisages 3215 existing CHCs of 30 -50 beds as 24-hour first referral units.

Strengthening ongoing national disease control programmes for malaria, TB, Kala Azar, Filaria blindness and iodine deficiency shall be horizontally integrated under the mission, for improved programme delivery. New initiatives would be launched for control of non-communicable diseases. Strengthening disease surveillance system at village levels and supply of generic drugs (both Ayush and allopathic) for common ailments at rural hospitals are also part of the mission.

A National Mission Steering Group chaired by union minister for health & family welfare with dy. chairman, Planning Commission, Ministers of Panchayathi Raj, RD and HRD and public health professionals (nominated by HFM in consultation with PM) and health secretary, as convener will head the programme. State health missions, chaired by Chief Minister and co-chaired by health minister and with the state health secretary as convener will come up in the state level. District health mission will be under leadership of Zila Parishad with district health head as convener and in co-ordination with all relevant departments. Village level Health & Sanitation Samiti at village level and Rogi Kalyn Samithi (or equivalent) for community management of public hospitals are also part of the programme.