Notwithstanding the existing differences on many key components and contents, the Union Health Ministry and the Planning Commission are working out the modalities of the National Health Mission (NHM) which seeks to expand the scope of National Rural Health Mission (NRHM).

The modalities are being worked out by the Ministry in consultation with the Planning Commission and the States will also be involved to evolve a consensus as the Centre is planning to launch it during the next financial year itself, sources said.

The Prime Minister, in his Independence Day speech last year, had announced to launch the NHM and the President also reiterated it in his address to the Parliament last month. The present budget has also made provision under the National Health Mission, instead of the NRHM. The allocation stands at Rs.18,880.35 crore against Rs.18,515.30 crore in the last year.

However, it is learnt that the Planning Commission and the Ministry still have some differences of opinion over some elements of the scheme.

NHM is expected to give the States greater flexibility to make multi-year plans for systems strengthening, and addressing threats to health in both rural and urban areas through interventions at Primary, Secondary and Tertiary levels of care. The roles and responsibilities of the Centre and States in the health sector would be made operational through instruments such as State specific and Sector-wide memorandum of understanding (MoU) that will be finalized through a consultative process.

“The NHM shall extend all over the country, both in urban and rural areas and promote universal access to a continuum of cashless, health services from primary to tertiary care. Separate strategies shall be followed for the urban areas, using opportunities such as easier access to secondary and tertiary facilities, and better transport and telecommunication services. There is greater scope for contracting arrangements with the private sector in urban areas, to fill gaps in strengthened public facilities. Area specific NHM plans shall address the challenges unique to their areas such as overcrowding, poor sanitation, pollution, traffic injuries, higher rates of crime and risky personal behaviour in urban areas,” according to the Planning Commission document in this regard.

“A key element of the new NHM is that it would provide considerable flexibility to States and Districts to plan for measures to promote health and address the health problems that they face. The NHM guidelines could provide flexibility to States and districts to plan for results,” it said.