Kutanga kwe National Rural Health Mission (NRHM) muna 2005 kwakamirira kudzokororwa kwemipimo yehurumende yeIndia. Kwemakumi amakore, voruzhinji vemaruwa venyika vakanga vagoverwa negadziriro dzoutano dzakagara dziri pasi, dzisina kudzorwa, uye kazhinji kazhinji dzisiri kushanda. Nepo nzvimbo dzomumaguta dzeIndia dzairumbidza zvipatara zvapamusoro, misha yomumaruwa yakarwisana nokushayikwa kukuru kwetarisiro huru. NRHM yakanga yakarongedzerwa kutarisana neiyi yakadzika zvikuru, yakaitwa gadziriro huru yokupa, inosvika, inokwana, inokwana, uye inotsiva mamiriro ezvinhu outano kumisha inoita kuti ive yakakurumbira.

Genesi Yebasa Routano Renyika Yose

Ma 2000 apakuvamba akapa mhesano huru nokuda kweIndia. Zviratidzo zvoutano zvakawedzera, asi munharaunda dzomumaruwa zvakaramba zviripo kana kuti zvakavandudzwa panhano inononoka zvikuru kusangana nezvinopfuudzwa nenyika. Materal Mortality Ratity [[FL:1] uye Intality [IMF] Rate (IMR) [[FLT]] yakanga yakakwirira zvikuru, yakasundwa zvikurukuru nedzimba dzinopindwa nedais, kushaikwa kwetarisiro yekurumidziro, uye kushaikwa kwezvokudya zvinovaka muviri kwakapararira. Kushairwa kwoutano hwavanhu panzvimbo dukusai.[FLD] Kubva ku 1% yeGP, zvichisiya mhuri dzomumaruwa dzakavandikano dzinova nenjodzi.

NRHM yakafungwa segadziriro yemishoni, yakasiana nezvirongwa zvehurumende. Yanangidzira ngwariro pamiuyo panzvimbo pezvisakiso chete, ichisimbisa kuchinjika nokuda kwehurumende kuchinjira kuzvinodikanwa zvomunzvimbomo. Chinofungwa chakanga chiri chokuti utano husati huri bedzi kusavapo kwehosha asi mugariro womuviri wakakwana, ndangariro, uye garikano yenzanga, uye uyo unoita ikoku kwaida mitoo ye yechikaro yezvoutano [[FLT: 1]] inobatanidza utano, utsanana, zvokudya, uye mugove wemvura.

Zvinangwa Zvinokosha Zvebasa Racho

  • Kuderedza Matsina naChild Mortality: Nharidzano yokukurumidzira zvikurusa yakanga iri yokuderedza MMR neIMR nenzira inoshamisa. Ikoku kwakabatanidza kuwedzera mwero wezvifambiso zvesangano nokuvimbisa kupinda vane unyanzvi pakuberekwa kuri kwose.
  • Mishoni yakaitirwa kuita kuti tarisiro huru youtano ive yavose zvirokwazvo kupfurikidza nokumutsidzirazve mubatanidzwa uripo weSub-Centres (SCs), Primary Health Centres (PHCs), uye Community Health Centres (CHCs).
  • Kubvisa nokudzora hosha: Kubvisa zvirongwa zvakatemwa zvemarariya, tibhii, maperembudzi, uye HIV/AIDS paruwa uye mwero wezvibiko kuti zviite mhinduro yakabatana.
  • Chibvumirano cheCommunity: Chinopa simba nzanga dzomumusha kuti dzitarisire gadziriro yadzo dzoutano nokutarisira kupfurikidza namatare omunzvimbomo.
  • Kusimbisa Workcence yoUtano: Kurovedza nokurovedza chivako chitsva chavashandi voutano vomunzanga uye kukwidziridza vanachiremba kuti vabatire munharaunda dzomumaruwa.

Kutanga Kunokosha Nokugadziridzwa Kwakaitwa

Kuedza uku kwakachinja kupfuura kungovaka zvinhu zvemagetsi kuti zvivepo kubva panzvimbo yemusha kuenda kuchipatara choruwa.

Accrivism yeSangano Routano (ASHA)

Kuumbwa kwe Actifist yeSocial Health (ASHA) inorangarirwa sechinhu chimwe chinopesvedzera zvikurusa cheNRHM. inoshanda sebhiriji pakati penzanga negadziriro youtano, ASH izvipiri zvoutano zvakarovedzwa zvechikadzi zvinobatira chiverengero chavanhu chinenge 1 000. Iye inhau yokutanga yeonano nokuda kwenhau dzoutano dzinowirirana mumusha.

Pa mamirioni 1 ASH akaiswa muIndia. Vane mutoro wokusimudzira kupiwa kwesangano, kugovera gadziriro dzokudzivisa kubereka, kutevera rudungwe rwekudzivirira kubereka, kurapa zvirwere zviduku nemirimo, uye kudzora zvirwere zvinozivikanwa navose. Mukati medamu reCHOVAD-19, ASHA akanga ari varwi venharo vaitarisira, vangwarire, uye vazivi venzanga, kazhinji kazhinji kazhinji panjodzi huru yomunhu oga. Basa ravo rakashandura kutakura kwaparwa kwemibato youtano, kuchiita chivako choutano chinovimbwa zvikurusa mumisha isingaverengeki.

Janani Suraksha Yojana (JSY) naJanani Shishu Suraksha Karakram (JSK)

Janani Suraksha Yojana ndiyo gadziriro hurusa yenyika yokutumira mari inotsamira pamitemo nokuda kwoutano hwaamai. Kunogovera vakadzi vane mimba, zvikurukuru avo vanobva pasi poUrombo Line (BP), nechishuvo chemari chokuendesa mwana wavo munzvimbo yeutano hwehurumende. Iyi sundo yemari yakanga iri chishandiso chine simba zvikuru chokubvisa tsika dzokubereka vana vasina kuvimbika.

Kuvaka paiyi budiriro, Janani Shishu Suraksha Karankram [[FSSK: 1] yakatangwa kubvisa ndyiko dzepapureti nokuda kwavakadzi vane mimba navana vachangobva kurwara. JSK inobvumira vakadzi vose vane mimba kubereka vakasununguka (kubatanidza masendi), mishonga yapachena, kunzvera ropa pachena, uye kufambisa kwapachena kubva kumba kuenda kunzvimbo yavakareswa. Uyu mufananidzo wezero-hexpese wakanga uri nhano inokosha kudziviriro yemari muutano.

Utano Hwemumusha, Kuchenesa, uye Matare Ezvekudya (VHSNCs)

NRHM yakaziva kuti miuyo youtano inosarudzwa nezvisakiso zviri kunze kwemadziro echipatara, zvakadai semvura yakachena, utsanana, uye zvokudya zvinovaka muviri. Kutaura nezvaikoku, basa rakaraira kuumbwa kwe Village Health, Sanitation, uye Dontion Committee (VHSNCs) mumusha uri wose unotambirwa mari. Matare aya, anoumbwa nemitezo yenzanga, ASHAM, ANM, uye Panchati Raj vamiri vamiriri, anogamuchira mari yokupfupikisa gadziriro dzoutano dzomumusha. Vanoshanda sechikuva chikuva chedare chedare renzanga uye kuti chisimbise kuti gadziriro youtano iverevire vanhu vanobatira.

Kubatsira Kunoita Zviratidzo Zvoutano

Mashoko akaunganidzwa mumakore makumi maviri apfuura anoratidza kuti NRHM yave iri mutyairi mukuru ane migumisiro yakanaka youtano muIndia. Kuvandudza kunoitwa mumichina yezvoutano yavose kunoshamisa uye kunonyatsonyorwa.

Imstigal Resuretion: Zvichida chinjo inoshamisa zvikurusa yave iri mukubereka mwana. Chikamu chekubereka chinoitika muzvipatara chakakwira kubva pa 40% muna 2005 kusvikira kuinopfuura 88% muNational Family Health Survey (NFHS-5), kubvisa nenzira inobudirira ruzhinji rwemisha inoberekwa isina njodzi.

  • Materal Mortality Ragati (MMR): MMR yakaona kuderera kwenhau, kuderera kwe 301 pakufa pa100 000 kunorarama muna 2001-03 ku 97 muna 2018. Izvi zvinoisa India pakutevera kuti isvike donzo reSDG ra70. NRHM' inonangidzira ngwariro pakupinda nokubereka vane unyanzvi uye kutarisira kwekurumidziro inowirirana zvakananga neiyi budiriro.
  • Kutsakatika naChild Mortality: IMR yakaderera kubva pa 58 kufa pa1 000 pavanoberekwa muna 2005 kusvikira panenge pa 28 mufungidziro dzemisi ichangobva kupfuura iyi. Pasi pokufa 5 vakadzikira zvakafanana, vakasundwa nevandudzwa mukutarisira mwana kwokuberekwa, miitiro yokuyamwisa iri nani, uye kudzivirira utachiona kwakapararira.
  • Mwero wokubereka: Iyose Fertlity Ratiti (TFR) yaderera nemwero unotsiva wa 2.1 munyika zhinjisa, kureva kuti kukura kwechiverengero chavagari vemo kunodzikamiswa. Ikoku kunoparirwa murutivi nokuvakwa kuri nani kwezano rokuronga mhuri uye kudzivirira chibereko zvinogoverwa naASHASHA.
  • Dyspease Control: Ungano yeNRHM yakasimbisa kuongororwa nokurapa nokuda kwehosha dzinotapukira. India yakasvika kuderera kukuru mukuitika kwemarariya nokufa, uye gadziriro yakacherekedzwa yeTB munhevedzo yeNRHM yakaita ndyiko dzakakwirira dzokurapa.

Nhamba idzi hadzisi nhamba chete; dzinomirira mamiriyoni oupenyu hwakaponeswa uye mamiriyoni emhuri akarega ngwavaira yenzufu dzaamai navana vanodzivisika.

Zvinetso Zvinoramba Zvichivapo Nemitsipa Yemabhotoro

Pasinei nezvayakaita, iNRHM inoramba ichinetsa pakuchinja utano.

Dambudziko Rezviwanikwa Zvevanhu Mumaruwa

India ine imwe yeperevedzo yakakomba zvikurusa yavanachiremba, vakoti, uye nyanzvi munyika. Chinetso chacho chinowedzerwa ne rral-murban mardis tradis[. Nepo makoreji ezvokurapa anoshayisa zviuru zvavanachiremba gore rimwe nerimwe, vazhinji vanokweverwa kukushanda kwemari yapachivande kwepachivande mumaguta. Nhamba dzeUtano dzevedzeri dzemari (CCCC), idzo dzinorehwa kupa tarisiro yezvokurapa (kuvhiyamwa, kuvhiya kwechinyakare, kuvhiya), kushanda pasina nyanzvi imwe. Hurumende yakatanga zvirongwa zvakafanana ne "Rral Health Practition", pfungwa inosara iripo.

Kunaka Kwetarisiro Kunopesana. Kukwanisa Kutarisirwa

NRHM yakabudirira nokuchenjera mukuwedzera uwandu hweshanyo dzeshiviriro nedzinofambiswa. Zvisinei, kunaka kwetarisiro muzvipatara zvakawanda kunosiana. Nzvero dzakaratidza kuti nepo vakadzi vakawanda vachiendesa muzvipatara, kunaka kwepashure pepartum napane zvinova nechinetso kazhinji kazhinji kusava nesimba. Patient system Survey inoitiswa neMinistry of Health yakasimbisa nhau dzine chokuita norucheno, kuvapo kwemishonga, uye mufambiro wevashandi. Kubuda mumiuyo kunoda kunyanyova nezvinoguma.

Kushandisa Zvikamu Zviduku uye Misiyano Yezvirongwa

Nepo bhajeti yeNRHM yakawedzerwa nokuda kwoutano hunokosha, ndyiko dzoutano dzavanhu vose dzeIndia dzichiri kutenderera kunenge 1.5-2% yeGDP, iyo yakaderera zvikuru kana ichienzaniswa nemipimo yenyika yose. Ikoku kunodzikamisa mano okuvandudza zvivako, kuzadza nzvimbo dzisina basa, uye midziyo inochengetedza. Munzvimbo zhinji dziri kure, PHCs dzichiripo zvivako zverabhoritari, mvura inoyerera, kana kuti magetsi asingachinji. Kutsamira pamaripidhishishi ezvirongwa kazhinji kazhinji kunobvumikisa kusakwanira kugadziriswa kwemikwidza kana kuti kukwidzwa.

Mutoro Unokura Wehosha Dzisingatapurwi (NCDs)

NRHM yakagadzirwa pakuvamba nengwariro inorema pamimba, utano hwavana, uye hosha dzinopomeranwa. Zvisinei, India zvino iri kutarisana nomutoro unopetwa kaviri wehosha, ne hosha dzisingatapukiri (NCD) kufanana neBP, chirwere cheshuga, hosha yemwoyo, uye kushushikana nekenza nokuda kwe60% yenzufu dzose. Utano hwoutano hwakavakwa naNRHM hwaifanira kuchinjika nokukurumidza kuruku, kunzvera, uye kudzora migariro yenguva refu, inoda rudzi rwakasiana zvikuru rwebasa pakutakura rukudzoso rwehosha dzakakomba kana kuti pamuviri.

Nhungamiro Dzomunguva Yemberi: Kuvambira paNRHM Kuenda Kuchifukidzo Choutano Chenyika Yose

Nhaka yeNRHM yakakura. Muna 2013, basa racho rakazoiswa paNational Health Mission (NHM), iyo yakapa mipimo yayo kunharaunda dzomumaguta kupfurikidza neNational Urban Health Mission (NUHM). Nhasi, kuchinja kwakavakirwa pahwaro hweNRHM kuri kupfuudzira India kunharidzano yeUniversal Health Subecage (UHC).

Ayushman Bharat Noutano Nenzvimbo Dzinochengeterwa Vanhu (HWCs)

Sezvinofungidzirwa kuti mhindumupindu huru ye NRHM i Ayushman Bharat. Chikamu chokutanga chinobatanidza kuchinja 150 000 varipo kumusoro ne PHC kuva [[FL:2]] NeWells Centers [HWCCs . HWC inogovera tarisiro huru inopfuura utano hwaamai kuti vabatane nokutarisira NCD, mabasa outano, uye kudzivirira kwemari. Izvi zvinotaura zvakananga mukamura mukuru muNHM inosimbiswa nokutarisira kukuru. Rutivi rwepiri, RYNY, RYNY - Aget-A (Man-A)

Utano Hwemadhigirii uye Kushanda Kwemabharati

Nguva yemberi yeNRHM yakabatana noruzivo rwokugadzira zvinhu. [FLT: 0] Ayushman Bharat Digital Mission (ABDM) inovavarira kugadzira mamiriro ezvinhu ezvoutano asina kusiana umo vagari vemo vane kurukurirano dzoutano dzakasiana nezvinyorwa zvavo zvoutano zvinotakurika. KuIndia yomumaruwa, uko kusvika kwomuviri kuna vanachiremba kwakaganhurirwa, telemedicine yabuda sechishandiso chine simba. E-Sanjevani chikuva chenzvimbo chenzvimbo chepamusoro, chakapfavisa mamirioni ekurukurirano dzepaIndaneti, inharidzano yakananga yeNRM's yokuwana. Mukufambisa aya maturuko anowanika muNHM inzvimbo yepamusoro.

Kunyanya Kufunga Nezvezvinhu Zvinokonzera Utano

NRHM nguva dzose inobvuma kuti utano hunosikwa mumusha, kwete chipatara. Gadziriro dzenguva yemberi dzinofanira kusimbisa batano pakati pedhipatimendi routano uye mamwe mapato omutsetse se Vakadzi neChild Child Development (ICDS), [[FLT:]] RFLT [[FLT]], [[FLT:]], [[FLT]]

Mugumisiro: Nhaka yeFosal for Indian Health

National Paral Health Mission yakanga iri inopfuura zvikuru gadziriro yehurumende; rakanga riri sangano renyika iro rinoshandisa ugwinyi hwedemokrati. Rakaparira mubatanidzwa mukuru wavashandi vezvoutano vomunzanga, rakamutsidzira gadziriro youtano yavose yakaputsika, uye rakaponesa mamirioni oupenyu kupfurikidza nokuderedza nzufu dzinodzivisika. Kunyange zvazvo denho dzinokosha dzichiri muukombi, kushanda, uye mari, NRHM yakatanga [[FLD:] yakavakwa negadziriro youtano yehurumende [[FLT] yakadzikwa] pairi kuvakira India nzira yayo kuUniversal Health Civigagege. Yakabvisa paumbini, kuruwa, uye kurapa kweguta kurwe kumumwe muitiro woutano apo mugari womuruwa pakupedzisira anozivikanwa nomugariro woutano. Zvidzidzo zvakadzidzwa kubva muNMM] pazviri kupfurikidza nokundikano yezvirongwa zveutano zvamaIndia kuti zvipfuurire kupfuurira kundo zvamakumi amakumi amakore.