Ukuthunyelwa kwe- kwe-National Rural Health Mission (NRHM) [NRT:1] ngo-2005] kwamelela ukubuyiselwa okuyisisekelo kombuso waseNdiya wendlela yokunakekela impilo yomphakathi. Emashumini eminyaka, iningi lasemaphandleni lalilungiselelwe izakhiwo zezempilo ezihlala njalo, ezingakhokhwa kahle, futhi ngokuvamile ezingasebenzi. Nakuba izakhiwo zase-Indiya zaziziqhayisa ngezibhedlela eziphambili, imadolobhana asemaphandleni ayelwa nokuntula okukhulu kokunakekelwa okuyisisekelo. I-NRHM yaklanyelelwa ukubhekana nale mpilo ejulile ekhona, idala uhlaka olubanzi lokunikeza, olungenayo, olunenzuzo, nolwezentengiselwano lwempilo emadolobheni ango lwesizwe.

UGenesise Wesabelo Sesizwe Sezempilo

Iminyaka yasekuqaleni kuka- 2000 yanikeza indida enkulu kakhulu eNdiya. Izimpawu zezempilo zahlala zimile noma zithuthukisiwe ngejubane elikhulu ukuba zingahlanganwa nezisulu zesizwe. AmaMaterinal Mortality Ratiation [MMR] kanye ne-Infant Mortality [[FLD] [inani elivamile] [IMR] [[FLT] yayiphakeme kakhulu, iqhutshwa ikakhulukazi yizingane ezizalwa zikhona nge-dais, ukuntula ukunakekelwa okuphuthumayo, nokungondleki kokudla okungalawuleki. Ukuchitha impilo ezindaweni eziphansi ezizungezene ze-GP, kushiya izingozi eziphakathi kwemikhaya yasemaphandleni i-GDP, kushiya izingozi enkulu kakhulu ezimpomponi empondweni.

I-NRHM yathathwa njengesimiso sokuthunywa kwe-mode, esihlukile kumacebo kahulumeni avamile. Yagxila emiphumeleni kunasemgomweni nje, igcizelela ukuvumelana nezimo zezindawo ukuze zivumelane nezidingo zendawo. Iphuzu eliyinhloko laliwukuthi impilo akukona nje ukungabi khona kwezifo kodwa isimo esiphelele ngokomzimba, ngokwengqondo, nenhlala - kahle, futhi ukufinyelela lokhu kwakudinga indlela yokuzivumelanisa nempilo, ukuhlanzeka, ukunakekelwa kokudla, nokuthengwa kwamanzi.

Izinhloso Eziyinhloko Zesabelo

  • Ukunciphisa iMathernal neMen. Umgomo ophuthuma kakhulu kwakuwukuletha iMMR ne-IMR ngokuphawulekayo. Lokhu kwahlanganisa ukunyusela inani lezindawo zokuhambisa nokuqinisekisa ukuba khona kwamakhono ekuzalweni kwazo.
  • I-Access ye-public Health: Umkhakha ohloselwe ukwenza ukunakekelwa kwempilo okuyinhloko kube jikelele ngempela ngokuvuselela inxanxathela ekhona ye-Sub-Centres (SCs), Primary Health Centres (PHCs), kanye ne-Community Health Centrees (CHCs).
  • Ukususa nokulawula izifo: Ukususa izinhlelo ezimile zikamalaleveva, isifo sofuba, uchoko, neHIV/AIDS esifundeni nasesithiyeni ukuze kuvele ukusabela okuhlangene.
  • [ Isivumelwano se-Community: inika imiphakathi yedolobha amandla okuqondisa izinhlelo zayo siqu zempilo nokuqondisa ngamakomiti endawo.
  • Ukuqinisa i-Health Workter: Ukuvuselela nokuqeqesha ikhodi elisha lezisebenzi zezempilo zomphakathi nokukhuthaza odokotela ukuba bakhonze emaphandleni.

Izinyathelo Eziyinhloko Nezici Ezintsha Zokwakha

I - NRHM yasungula isuti yezinhlelo ezihlangene ezashintsha indlela izinkonzo zezempilo ezinikezwa ngayo ezindaweni ezisemaphandleni eNdiya.

I - Accreen Activast Yezempilo Ezenhlalo (ASHA)

Ukwakhiwa kwe- eqediwe i-Social Acticist (ASH) kubhekwa njengendawo yokuqala enethonya elikhulu ye-NRHM. ethatha inyathelo njengebhuloho phakathi komphakathi nesimiso sezempilo, i-ASH iyizisebenzi zokuzithandela zezempilo eziqeqeshiwe ezikhonza inani labantu abangaba ngu-1. Uyikhomba lokuqala lokuxhumana ngezindaba zempilo ehlobene nempilo edolobhaneni.

Ngaphezu as[FLT] ayizigidi ezingu - 1 [ASH bebekwe kulo lonke elaseNdiya. Banomthwalo wokukhuthaza ukuthunyelwa kwezinhlangano, ukulungiselela izikhawu eziyisisekelo zokuvimbela inzalo, ukulandela uhlelo lokugoma, ukuthatha izinqubo zokugoma, ukwelapha izifo ezincane ngemithi, nokulawula izifo ezivamile. Phakathi nobhadane lwe-COVOVAD-19, u-ASH wayengumlweli we-arline enomthwalo wokuxhumana, ukuqapha, ukuqapha, nokuqapha komphakathi, ngokuvamile ngengozi enkulu. Indima yabo iye yaguqula ukuhanjiswa kokugcina kwezinkonzo zempilo, izenza zibe umthombo wempilo othenjwa kakhulu emaphandleni amaningi.

UJanani Suraksha Yojana (JSY) noJanani Shishu Suraksha Karakram

I- Janani Suraksha Yojana (JSY) iyicebo elikhulu kakhulu emhlabeni lokudlulisela imali emalini emalini emotweni kamama. Inikeza abesifazane abakhulelwe, ikakhulukazi labo abavela eMazansi Poverty Line (BPL), enesisusa semali sokuyisa umntwana wabo esikhungweni sezempilo sikahulumeni. Lesi sikhuthazo sezimali sasiyithuluzi elinamandla lokususa ukuziphatha okungaphephile kubantwana abazalwa ekhaya.

Kwakhiwa ngalempumelelo, uJanani Shishu Suraksha Karankram wasungulwa ukuba asuse izindleko ze-pacreet kubesifazane abakhulelweyo nakubantwana abagulayo. I-JSK ivumela bonke abesifazane abakhulelwe ukuba babelethe mahhala (kuhlanganise amacandelo C), imithi ekhululekile, ukuxilonga igazi mahhala, kanye nokuthutha ngesihle ekhaya ngenkani. Lesibonelo se-zero-expesenti sasiyisinyathelo esibalulekile ekuvikeleni ngokwezimali empilweni yempilo.

Impilo YaseDolobheni, Ukuhlanzeka, Nezikhungo Zokudla (Izinqumo Ze - VHSNC)

I-NRHM yaqaphela ukuthi imiphumela yempilo inqunywa yizici ezingaphandle kwezindonga zasesibhedlela, njengamanzi ahlanzekile, indle, kanye nokudla okunomsoco. Ukubhekisa kulokhu, umsebenzi wagunyaza ukwakhiwa kwe- Village Health, Sanitation, namaKomiti ezokuhlalisa impilo (VHSNCs) kuleyo naleyo ndawo. Lamakomiti, akhiwe amalungu omphakathi, ama-ASH, ama-AM, nama-Panchati Raj abameleli, athola izimali zokulungisa amalungiselelo empilo yedolobhana. Basebenza njengeqophelo lokuhlola umphakathi futhi baqinisekise ukuthi isimiso sezempilo siyabalwa abantu.

Umphumela Olinganiswayo Ezikhombisweni Zempilo

Ukwaziswa okuqoqiwe eminyakeni engamashumi amabili edlule kubonisa ukuthi i-NRHM ibiwumshayeli omkhulu wemiphumela yempilo engcono eNdiya. Intuthuko ezingeni eliyinhloko zempilo yomphakathi iyahlaba umxhwele futhi ibhalwe kahle.

Izidluliso ze-Instigational: Mhlawumbe inguquko enkulu kakhulu iye yaba ekuzalweni. Amaphesenti okuzalwa okwenzeka ezikhungweni zezempilo anyuka esuka ku-40% ngo 2005 kuya ku-88% ku-National Family Health Survey (NFHS-5], ukuqeda ngokuphumelelayo ukuzala okungaphephile okuningi kwamakhaya.

  • Ama-Mortality Rational (MMR): i-MMR yaseNdiya iye yabona ukwehla okungokomlando, ukuncipha kwenani labafayo abangu-301 ku-10,000 ngo-2001 kuya ku-03 97 ngo-2018 . Lokhu kwenza iNdiya ihambe emkhondweni ukuze ifinyelele isisulu se-SDG ka-70. I-NRHM' igxile ekuzalweni okukhona kolwazi olunolwazi kanye nokunakekelwa kombhexilongo kuhlobene ngqo nale mpumelelo.
  • [[NT.0] Ukufa okungalawuleki nokufa kwengane: I-IMR yancipha kusukela ku 58 kwabangu-80 000 abazalwa ngo-2005 kuya kwabacishe babe ngu-28 ezilinganisweni zamuva nje. Ngaphansi kokufa kuka-5 kuye kwancipha ngokufanayo, kuqhutshwa intuthuko ekunakekeleni ibele, imikhuba engcono yokuncelisa, nokugoma okusakazekile.
  • Isilinganiso sokuzala: Ingqikithi i-Fertility Rate (TFR) iwele ngaphansi kwezinga lokubuyisela le 2.1 ezizweni eziningi, okusho ukuthi ukwanda kwenani labantu kuyazinzisa. Lokhu ngokwengxenye kubangelwa ukufinyelela okungcono kweseluleko sokuhlela umkhaya kanye nokuvimbela inzalo okunikezwa ngu-ASHA.
  • Ukulawula kwe-Dissease: I-nethiwekhi ye-NRHM yaqinisa ukuqapha nezimiso zokwelapha izifo ezithathelwanayo. I-India yathola ukwehla okukhulu kwemiphumela yomalaleveva nokufa, futhi uhlelo lokwelapha oluqashelwe ngokuqondile lwe-TB ngaphansi kwe-NRHM lwaphumelela kakhulu.

Lamanani awagcini nje ngokuba izibalo; amelela izigidi zabantu abasinda futhi izigidi zemikhaya zavikela inhlekelele yokufa komama nabantwana okungavinjelwa.

Izinselele Eziqhubekayo Nemisipha Yamabhodlela

Naphezu kwentuthuko yayo enkulu, i - NRHM ilinganiselwe.

Inhlekelele Yemithombo Yezinto Zesintu Ezindaweni Zasemaphandleni

INdiya inenye yendlala enkulu kakhulu yodokotela, abahlengikazi, nochwepheshe emhlabeni. Inkinga ikhuliswa yi-rral-urban sacity. Nakuba amakholeji ezokwelapha ekhiqiza izinkulungwane zodokotela unyaka ngamunye, iningi lithambekele ekuzilolongeni okunenzuzo emadolobheni. I-Maningi e-Community Health Centrees (CHC), ahloselwe ukunikeza ukunakekelwa kochwepheshe (ukuhlinza, i-gnececology, i-paediaology, isebenza ngaphandle kochwepheshe oyedwa. Uhulumeni uye wasungula amasuntswana anjenge "Rral Health Practition", kodwa umqondo osele kakhulu.

Izinga lokunakekela livinjelwa. Ukukwazi ukunakekelwa

I-NRHM yaphumelela ngokuphumelela ekuthuthukiseni inani lokuhambela nokuthutha kwezenhlalakahle. Nokho, izinga lokunakekela ezimbonini eziningi liyahlukahluka. Ukuhlola kuye kwabonisa ukuthi nakuba abesifazane abaningi bethwalisa izibhedlela, izinga lokunakekela kwangemva kwe-partum nokuphathwa kwezinkinga libuthakathaka. Ukuhlolwa kokungaguquguquki komzimba okuqhutshwa yiNkonzo yezempilo kuqokomisa izimpikiswano ezihlobene nenhlanzeko, ukutholakala kwemithi, kanye nokuziphatha kwezisebenzi. [[FLT]] Ukuphuma ezithakweni kudinga ukugxila kakhulu ekwakhelisweni.

Ukusekela Izigaba Nokuthola Imingcele

Nakuba uhlelo lwemali lwe-NRHM lukhuliswe kakhulu ekuhleleni izimali zezempilo, izindleko zempilo yomphakathi we-Indiya zisalokhu zikhona cishe ku-1.5-2% ye GDP, okuphansi uma kuqhathaniswa nezindinganiso zembulunga yonke. Lokhu kucindezela ikhono lokuhlela izakhiwo, ukugcwalisa izikhundla ezingenamuntu, nokugcina amathuluzi. Ezindaweni eziningi ezikude, amaPHC asentula izakhiwo zokuhlola, amanzi ahambayo, noma ugesi ongaguquguquki. Ukuncika ezinkonzweni zemali yokulungisa isilinganiso esikhulu noma ukukhuculisela phezulu kuvame ukubonakala kunganele.

Umthwalo Okhulayo Wezifo Ezingalawuleki (NCDs)

I-NRHM yayiklanywe ekuqaleni igxile kakhulu kumama, empilweni yomntwana, nasezifoni ezithathelwanayo. Nokho, i-Indiya manje ibhekene nomthwalo ophindwe kabili wesifo, izifo ezingathatheki (NCD) njengomfutho wegazi, isifo sikashukela, isifo semithambo yegazi, isifo senhliziyo, nomdlavuza obangela ukufa kwabantu abangamashumi amashanangu-60% abo bonke. Isimiso sezempilo esakhiwe ngu-NRHM kwadingeka ukuba sijwayelene ngokushesha, ihlola, futhi silawule izimo zesikhathi eside, okudinga uhlobo oluhlukile kakhulu lokuhlinzwa uma kuqhathaniswa ne-pigcodiase ngokunakekela kokuphathwa izifo eziyingozi noma ukukhulelwa.

Iziyalezo Zesikhathi Esizayo: Ukusuka E - NRHM Kuya Ekufuyweni Kwempilo Yomhlaba Wonke

Ifa le-NRHM likhulu. Ngo-2013, lo msebenzi wafakwa eMnyangweni wezeMpilo wesizwe (NTM) , owanwebela izimiso zawo ezindaweni zasedolobheni ngeNational Urban Health Mission (NUHM). Namuhla, izinguquko ezakhelwe esisekelweni se-NRHM's ziqhubela i-Indiya emgomweni we-Universal Health Civerage (UHC).

U - Ayushman Bharat Nempilo Nezikhungo Zokuhlala Ngomuzwa (HWCs)

Kulindeleke ukuba ukuziphendukela kwemvelo okukhulu kwe-NRHM kungama- Ayushman Bharat uhlelo. Isingxenye sokuqala sihilela ukuguqula i-Sub-Centres ne PHCs ezingu- Izingxenye ezinkulu [i-HWCs [i-HYP] . Lezi zingxenye zokuqala zinikeza ukunakekelwa okuyinhloko okudlula impilo kamama nomntwana ukuba kuhlanganise ukubukiswa nokunakekelwa kwe-NCD, izinkonzo zempilo zezengqondo, nokunakekelwa kwezempilo ye-Gatria. Lokhu kukhuluma ngokuqondile igebe eliyinhloko legebhu elise-NRMym'ult. Ingxenye yesibili ye-Mantane-A.

Impilo Yezinombolo Ne - Abyushman Bharat Digital Mission (ABDM)

Ikusasa lefa le-NRHM lixhunyiwe kwezobuchwepheshe. [[FLT: 0] I-Ayushman Bharat Digital Mission (ABDM) ihlose ukudala isizinda sempilo yezibalo lapho izakhamuzi zine-ID yezempilo eyingqayizivele nemibhalo yazo yezempilo ephathekayo ehamba ngezindawo zokunakekela. E-Indiya yasemaphandleni, lapho ukufinyelela kochwepheshe kulinganiselwe, i-telemedicine ivela njengethuluzi elinamandla. I-e-Sanjevani platifomu, eye yasiza izigidi zezingxoxo ze-intanethi, iyinhloso eqondile yeNRM's. Enyakazayo yokufinyelela igebeba.

Ukugxila Ezintweni Eziyinkambiso Engokwenhlalo Ezenhlalakahle

I-NRHM yayivuma njalo ukuthi impilo yakhiwa ekhaya, hhayi isibhedlela. Amasu esikhathi esizayo kumelwe aqinise ukuhlobana phakathi komnyango wezempilo neminye iminyango ye-layini njenga Abesifazane nentuthuko yezingane (i-ICDS), [[[FLT:]] [FLT]] [FLT]], , [FLT] [FLT], [FLT], [FLT]], [[FLT] akusekho nje okusadlayo, [uphuzisayo, [i-Santation, ingu-'irightat] [irn , [inkulu] , [i-FT] ne-FYPT] edinga kakhulu imithombo yempilo yasendaweni yasekhaya.[5]

Isiphetho: Ifa Lesisekelo Lokunakekela Impilo YaseNdiya

I-National Rural Health Mission yayingewona nje amasu kahulumeni; kwakuyinhlangano yesizwe ekwazi ukufinyelela impilo yedemokrati. Yadala iqoqo elikhulu lezisebenzi zezempilo zomphakathi, yavuselela isimiso somphakathi esiwohlokayo, futhi yasindisa izigidi zabantu ngokunciphisa ukufa okunganqandeki. Nakuba izinselele ezinkulu zisekhona, ukusebenza, nezimali, i-NRHM yasungula i-[FLD:0] eyasungulwayo yokwakha [[ ekwakhelwe kuyo i-Indiya eyakha indlela yayo eyakhela kuyo i-Universal Health Civigage. Yasusa i-paragm eqeni, ezindaweni ezihlukene, emadolobhaneni, futhi isekela ezempilo, lapho ekugcineni isaqaphela khona izakhamuzi zasemaphandleni ukuba zinikezelwe. Izifundo ze-NMLD ziyokuqhubeke nokuphumelela kwezempilo zamashumi eminyaka ye-Indiane.