Kuyamba kwa National Rural Health Mission (NRHM) mu 2005 kunaimira kusinthika kwakukulu kwa njira ya boma la Indiya ya kuwona thanzi la anthu. Kwa zaka makumi ambiri, madera a kumidzi a dzikolo anatumikiridwa ndi dongosolo la zaumoyo lokhala ndi zipatala zosalimba, zosagwira ntchito bwino, ndipo kaŵirikaŵiri zosagwira ntchito. Pamene kuli kwakuti matauni a India anadzitamandira zipatala za anthu otchuka, midzi yakumidzi yolimbana ndi kusoŵa kwakukulu kwa chisamaliro chachikulu. NRHM inalinganizidwa kuyang'anizana ndi malo ozamawa, kupanga dongosolo la zaumoyo kuti aperekere, okhoza, okhoza, ndi oyenera kukwaniritsa, ndi oŵerengera ntchito zaumoyo kumidzinga ya dziko la 600,000.

Kuyamba kwa Ntchito ya Zaumoyo ya Dzikolo

Kuchiyambi kwa 2000 anapereka chotsutsana chachikulu kwa India. Zizindikiro za zachuma zinawonjezereka, koma m'madera akumidzi zinakhalabe zokhazikika kapena zinawongoleredwa pa liŵiro lakuya kwambiri la kukwaniritsa zigamulo za dziko. Materinal Mortality Ratiation [MMR] ndi Infant Mortality [IMR] [[FLT] inali yosatheka kukwaniritsa, yosonkhezeredwa ndi mabanja obadwa ndi kupezeka ndi ma dais, kusoŵa chisamaliro chamwadzidzidzi, ndi kusoŵa kwa zakudya zopatsa thanzi. Kuwononga thanzi la anthu ochepera 0.9% ku 1% a GP, kusiya mabanja akumidzi a kupululu ya kuopsera kwa anthu osauka.

SOMSOGUPU ya NRHM inalingaliridwa kukhala ntchito yolembedwa, yosiyana ndi njira za boma. Inasumika maganizo pa zotulukapo osati pa ziyambukiro zokha, kugogomezera kusinthika kwa maboma kusinthira ku zosoŵa za kumaloko. Mfundo yaikulu inali yakuti thanzi siliri kokha kusoŵa kwa matenda koma mkhalidwe wathunthu wakuthupi, maganizo, ndi umoyo wabwino, ndi umene unafunikira njira ya [[FLT: 0] yogwirizanitsa thanzi, ukhondo, ndi madzi.

Zonulirapo Zoyambirira za Ntchitoyo

  • Kuchepetsa Mathernal ndi Child Mortality : Chonulirapo chofulumira koposa chinali kutsitsa MMR ndi IMR modabwitsa. Zimenezi zinaphatikizapo kuwonjezera chiŵerengero cha zopereka za makampani ndi kutsimikizira opezekapo aluso pa kubadwa kulikonse.
  • Umboni wa Universal Access to Public Health : Ntchito yofuna kukonzanso njira zothandizira zaumoyo mwa kukhazikitsanso njira zomwe zilipo za Sub-Centres (SCs), Primary Health Centres (PHCs), ndi Community Health Centres (CHCs).
  • Kuchotsa ndi Kulamulira matenda: Kutenga maprogramu oima mochititsa malungo, TB, khate, ndi HIV / AIDS ku mlingo wa chigawo ndi ziwiya kuti apereke yankho logwirizana.
  • Chipangano cha Community : Kupatsa mphamvu anthu a m’mudzi kuti ayang’anire makonzedwe awo a zaumoyo ndi kuyang’anira kupyolera mwa makomiti a kumaloko.
  • Kulimbikitsa Malo Ogwirira Ntchito Athanzi: Kuphunzitsa ndi kuphunzitsa kachipangizo katsopano ka antchito a zaumoyo m'chitaganya ndi kusonkhezera madokotala kutumikira m’madera akumidzi.

Njira Zoyambirira ndi Makonzedwe Atsopano

Bungwe la NRHM linayambitsa pulogalamu yolumikizana imene inasintha kwambiri mmene ntchito zaumoyo zimachitidwira ku India.

Katswiri wa Zaumoyo wa Anthu (Assha)

Kupangidwa kwa ASHISF (ASH) [AFLT:1] kumaonedwa mofala kukhala chinthu chimodzi chokhudza kwambiri cha NRHM. Kugwira ntchito monga mlatho pakati pa anthu ndi dongosolo la zaumoyo, ASH ndi antchito odzifunira athanzi ophunzitsidwa bwino amene amatumikira anthu pafupifupi 1,000. Iye ndi chinthu choyamba chokhudzana ndi nkhani zokhudza thanzi la anthu m’mudzimo.

Kuposa ASH 1 miliyoni [Mliri wa ASH [1] waikidwa ku India. Iwo ali ndi thayo la kupititsa patsogolo ntchito zopereka, kugaŵira njira zotetezera kubereka, kulondola mandandanda a katemera, kuchiritsa matenda aang'ono ndi ziwiya za mankhwala, ndi kuyang'anira matenda ofala. Mliri wa CHOVAD-19, ASHA anali ankhondo otsogolera ofunikira kupenda, kuyang'anira, ndi kuzindikira kwa anthu, kaŵirikaŵiri paupandu waukulu. Ntchito yawo yasintha kuperekedwa kwa mautumiki a zaumoyo kwanthaŵi zonse, kupangitsa iwo kukhala chuma chathanzika chodalirika kwambiri m'midzi.

Janani Suraksha Yojana (JSY) ndi Janani Shishu Suraksha Karakram

Janani Suraksha Yoyana (JSY) ndi njira yaikulu kwambiri yapadziko yotumizira ndalama zapakhomo kwa amayi. Imapereka kwa akazi apakati, makamaka a m'mabanja a Pansi pa Umphaŵi Line (BP), ndi chifuno cha ndalama choperekera khanda lawo ku malo a zaumoyo a boma. Chisonkhezero cha za ndalama chimenechi chinali chiŵiya champhamvu chopatsira khalidwe lolakwika kwa ana obadwa .

Kumanga pa chipambano chimenechi, [[FLT: 0] Janani Shishu Suraksha Karakram (JSK) adakhazikitsidwa kuchotsa zowonongedwa za amayi oyembekezera ndi ana obadwa kumene odwala. JSK amalola akazi onse oyembekezera kubereka kwaulere (kuphatikizapo magawo), mankhwala aulere, kupima mwazi kwaulere, ndi kuyendetsa kwaulere kuchokera kunyumba kupita ku malo akuya. Chitsanzochi cha zero-expesse chinali site yofunikira kwambiri ku chitetezero cha ndalama m’chitetezo cha mankhwala.

Makomiti Oona za Umoyo a M’mudzi, Chiyeneretso, ndi Zakudya Zodya Zam’thupi (VHSNCs)

NRHM inazindikira kuti zotulukapo za thanzi zimadziŵika ndi zinthu zochokera kunja kwa zipupa za chipatala, zonga ngati madzi oyera, ukhondo, ndi chakudya. Kuthetsa zimenezi, ntchito inalamula kupangidwa kwa Village Health, Sanitation, ndi Nutrition Committee (VHSNCs) [[FL:1] m’mudzi uliwonse wa ndalama. Makomiti ameneŵa, opangidwa ndi ziŵalo za mudzi, ASHA, ANM, ndi Panchati Raj oimira, amalandira ndalama zotsegulira mapulani a zaumoyo a m'mudzi. Amachita monga papulatcho kuyang'anira anthu ndi kutsimikizira kuti dongosolo la zaumoyo lili ndi mlandu kwa anthu.

Chiyambukiro Choyelekezera pa Zisonyezero za Thanzi

Zimene zalembedwa zaka 20 zapitazi zikusonyeza kuti bungwe la NRHM lakhala loyendetsa kwambiri zinthu zolimbikitsa thanzi ku India.

Kupereka kwa Zaumoyo : Mwinamwake kusintha kwakukulu koposa kwakhala m'kubala. Maperesenti a kubadwa kwa ana m'zipatala anakwera kuchokera pa 40% mu 2005 kufika pa 88% mu National Family Health Survey yaposachedwapa (NFHS-5], kuchotsa chipambano kuchuluka kwa ana obadwa mwangozi.

  • Materal Mortality Ragati (MMR): MMT: 1's MMR yawona kutsika kwa m'mbiri, kuchokera pa 301 wa imfa pa 1000,000 ya moyo wa kubadwa mu 2001-03 kufikira 97 mu 2018 . Zimenezi zachititsa India kulondola njira kuti apeze chikole cha SDG cha 70. NRHM' yomwe imaganizira za kupezekapo pamwayi ndi chisamaliro chamwayi imagwirizana mwachindunji ndi kupambana kumeneku.
  • Kusintha ndi Mwana Mzukwa: IMR inatsika kuchokera pa 58 imfa pa ana 1,000 alionse amene anabadwa mu 2005 mpaka pafupifupi 28 m'mayeso aposachedwapa. Pafupifupi 5 imfa zawonjezeka, chifukwa cha kuwongolera kwa chisamaliro cha mwana wobadwa, njira zoyamwitsira bwino, ndi katemera wofala.
  • [[FLT: 0] Mwezi wa kubereka: [[FLT :1] Madeti onse Fertality Rate (TFR) agwa pansi pa mlingo woloŵa m'malo wa 2.1 m'maiko ambiri, kutanthauza kuti kuwonjezeka kwa anthu kumakhazikika. Izi zina chifukwa cha kupezeka bwino kwa uphungu wolinganiza banja ndi zoletsa kulera zoperekedwa ndi ASH ASHA.
  • Dyssease Control : Troupe inalimbitsa kuyang'anira ndi njira zochiritsira matenda opatsira. India anachepetsa kwambiri kuchuluka kwa malungo ndi imfa, ndipo programu yoyang'anira mwachindunji ya TB (DOTS) pansi pa ambulera ya NRHM inapambana kwambiri.

Ziŵerengero zimenezi siziri kokha ziŵerengero; zimaimira mamiliyoni a miyoyo yopulumutsidwa ndipo mamiliyoni a mabanja anapulumutsa tsoka la imfa za amayi ndi ana okhoza kupeŵedwa.

Mavuto Okhalitsa ndi Mikwingwirima

Ngakhale kuti bungweli lachita zinthu zambiri, limakhala ndi malire ake.

Vuto la Anthu la Chuma M’madera a Kumidzi

India ali ndi chimodzi cha kupereŵera kwakukulu kwa madokotala, manesi, ndi akatswiri m'dziko. Vutolo limakula ndi limakhala ndi malungo a zamankhwala owonjezera . Pamene kuli kwakuti makoleji amatulutsa zikwi zambiri za madokotala chaka chilichonse, ambiri amafunitsitsa kuchita ntchito zachinsinsi zopindulitsa m’mizinda. Ambiri a Community Health Centrees (CHCs), amene amayenera kupereka chisamaliro cha akatswiri (kutumbuka, kulera, kulera, kulera), kugwira ntchito popanda katswiri mmodzi. Boma layamba machenjera onga "Rral Health Practition", lingaliro la , koma mpukutuwo udakalipo.

Kusamala N’kovuta

NRHM inapambana mwaluso kuwonjezera kuchuluka kwa maulendo oleza mtima ndi zopereka za boma. Komabe, chisamaliro m'zipatala zambiri nchosiyana. Kufufuza kwasonyeza kuti pamene kuli kwakuti akazi ambiri amaperekedwa m'zipatala, kuchuluka kwa chisamaliro chapambuyo pa apartum ndi kuchepetsako kaŵirikaŵiri kumachepa. Patient system Survey yochitidwa ndi Ministry of Health inagogomezera nkhani zokhudza ukhondo, kupezeka kwa mankhwala, ndi khalidwe la antchito. Kutuluka kuchokera ku ziyambukiro kumafuna kuwongolera kwabwino.

Kupereka Malo Ophunzitsira ndi Mipata ya Zopangapanga

Pamene kuli kwakuti ndalama za NRHM zikuwonjezereka poikizira thanzi, zotayikiridwa za thanzi la anthu za India zidakali kuzungulira 1.5-2% ya GDP , , yomwe njochepa poyerekeza ndi miyezo ya dziko lonse. Zimenezi zimaletsa kuwongolera zinthu, kudzaza malo a zaumoyo, ndi kusungitsa zipangizo. M'madera ambiri akutali, PHCs akusoŵabe malo osungirako zinthu, madzi oyenda, kapena magetsi osasintha. Kudalira kwa ndalama zotsegulira katundu wokonza ndi wokwera kwambiri kaŵirikaŵiri kumatsimikizira kukhala kosakwanira kukonza kapena kukwera kwa malo.

Mtolo Womakula wa Matenda Osachiritsika (NCDs)

NRHM inakonzedwa ndi kusumikidwa kwambiri pa amayi, thanzi la ana, ndi matenda opatsirana. Komabe, India tsopano akuyang'anizana ndi mtolo wa matenda, ndi matenda osapatsirana (NCDS) mofanana ndi kuthamanga kwa mwazi, matenda a mtima, ndi matenda a kansa ochititsa imfa 60% ya anthu onse. Dongosolo lathanzi lopangidwa ndi NRHM linayenera kuzoloŵera mwamsanga kupima, kupima, ndi kuyang'anira matenda osatha, amene amafunikira mtundu wina wa ntchito popereka chithandizo poyerekezera ndi kipiso ya matenda aakulu kapena mimba.

Njira Zamtsogolo: Kuchokera ku NRHM Kufikira ku Kutsekeredwa kwa Universal Health

Choloŵa cha NRHM nchachikulu. Mu 2013, ntchitoyo inaikidwa pa National Health Mission (NHM) [NT: 0], yomwe inafutukula malamulo ake ku mizinda kudzera ku National Urban Health Mission (NUHM). Lerolino, kusintha kopangidwa pa maziko a NRHM kukusonkhezera India kukwaniritsa cholinga cha Universal Health Sunder Cubeage (UHC).

Ayushman Bharat ndi Thanzi ndi Wellness Centres (HWCs)

Motsimikizirika chisinthiko chachikulu cha NRHM chiri [FLT: 0] Ayushman Bharat programu. Chigawo choyamba chimaphatikizapo kusintha 150,000 amene alipopo a Kansa ndi PHCs kukhala Nkhalango ndi Wells (HWC) [HLT [HFLD:3]. HWCS zimapereka chisamaliro chachikulu chimene chimaposa thanzi la mwana kuti aphatikizepo kujambula ndi kuyang'anira NCD, mautumiki a zamaganizo, ndi chisamaliro cha anthu a matenda. Zimenezi zimakamba mwachindunji mpata waukulu mu NHM, kulimbitsa mkhalidwe wa chisamaliro chachikulu. Mbali yachiŵiri, ya Ancria (M-A) Yam'A (Im'A) yopereka thandizo la ndalama, ndi la ndalama.

Kuthandiza Anthu Odwala ndi Ntchito Yopanga Mabuku

Tsogolo la NRHM lagwirizana ndi luso la zopangapanga. [FLT: 0] Ayushman Bharat Digital Mission (ABDM) cholinga chopanga mlingo wa zinthu za umoyo wa anthu kumene nzika zili ndi njira yapadera yochitira zinthu ndi zolembera zawo zathanzi zoyendera. Kumidzi, kumene ku India, kumene kupezeka akatswiri ambiri, telemedicine watulukira monga chida champhamvu. E-Sanjevani plat , imene yathandiza anthu mamiliyoni ambiri kukambirana pa Intaneti, ndiyo cholinga cha NRM's kunyamula malo ofikira. Msika wa magetsi wambiri wa NHM. Kujambula zida zimenezi ku Nermaptionstion.

Kuganizira Kwambiri za Thanzi la Anthu

NRHM nthaŵi zonse anavomereza kuti thanzi limapangidwa m’nyumba, osati m’chipatala. Makonzedwe amtsogolo ayenera kulimbitsa kugwirizana pakati pa dipatimenti ya zaumoyo ndi madipatimenti ena a m'mizere monga Akazi ndi Chitukuko cha Child (ICD:1], [ LIND [[FLT:]]] , [FLT], [FLT:] [FLT]], [FLT]], [FLT] [FLD , [zifunsinsi ]] , [zifukwa zamphamvu zowonjezereka]. [machenjera ndi].

Kumaliza: Malo Opangidwira Kusamalira Umoyo wa Aindiya

National Rural Health Mission sinali chabe bungwe la boma; linali gulu la dziko limene linapezako zaumoyo wa democracy. Ilo linayambitsa gulu lalikulu la antchito a zaumoyo wa anthu, libwezeretsa dongosolo laumoyo la anthu lomawonongeka, ndi kupulumutsa miyoyo ya anthu mamiliyoni ambiri mwa kuchepetsa imfa zosapeŵeka. Pamene kuli kwakuti mavuto aakulu adakalipo, kugwira ntchito, ndi kuchirikiza ndalama, NRHM inakhazikitsa [maluso a zaumoyo a democracycratic . [FLT:] yoyambirira ya maluso a zaumoyo [[[FLT:] yokhazikiridwa ndi yosagonjetsedwa] Indiyake njira yake yopitira ku Universal Health Succagegege. Idzatenga njira ya zaungwe ya za ku mizinda, yaumoyo wa ku mizinda ku njira imodzi kumene nzika za kumudzi pomalizira pake zadziŵikitsa kuilo kuti iperekedwe.