Learn — National health programmes

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Child growth and ICDS

The Integrated Child Development Services scheme, launched on 2 October 1975 and now delivered under the Saksham Anganwadi and Poshan 2.0 umbrella of the Ministry of Women and Child Development, provides a package of six services to children under six years, pregnant women, lactating mothers and adolescent girls through the anganwadi centre. Growth monitoring is its front line, because plotting a child's weight month by month shows faltering while the child still looks well, and the direction of that line is the earliest warning the community has of malnutrition.

The six services are supplementary nutrition, immunisation, health check-up, referral services, non-formal pre-school education for 3 to 6 year olds, and nutrition and health education; three of the six (immunisation, health check-up and referral) are delivered by the health system through the auxiliary nurse midwife and the medical officer, which is why the anganwadi worker and the auxiliary nurse midwife work as a pair.
One anganwadi centre covers a population of 400 to 800, or 300 to 800 in tribal, riverine, desert and hilly areas and about 100 in PVTG habitations under PM JANMAN; mini-anganwadi centres, once sanctioned for 150 to 400, are being upgraded to main centres since 2023; the anganwadi worker is an honorary local woman and is assisted by an anganwadi helper.
Supplementary nutrition norms (NFSA Schedule II as revised in 2023): 200 kcal with 8 to 10 g of protein a day for children 6 to 12 months and 400 kcal with 15 to 20 g for children 1 to 6 years; for an undernourished child 400 kcal (6 to 12 months), 700 kcal (1 to 3 years) or 800 kcal (3 to 6 years), with 25 to 30 g of protein after the first year; and 600 kcal with 22 to 25 g of protein for pregnant women and lactating mothers; children 6 months to 3 years receive it as take-home ration, 3 to 6 year olds as a morning snack and hot cooked meal at the centre, and pregnant and lactating women as a hot cooked meal with take-home ration.
Weight is taken monthly for children under 3 years and quarterly for 3 to 6 year olds and plotted on the WHO Child Growth Standards chart in the Mother and Child Protection card; a flat or falling line is growth faltering even when the point is still in the normal band, and a rising line is reassuring even from a low starting weight.
Severe acute malnutrition in a child aged 6 to 59 months is defined by any one of weight-for-height below minus 3 standard deviations, a mid-upper arm circumference below 11.5 cm, or bilateral pitting oedema; moderate acute malnutrition is weight-for-height between minus 3 and minus 2 standard deviations or a mid-upper arm circumference of 11.5 to 12.5 cm.
The three indices measure different things: weight-for-age is underweight and mixes the other two, height-for-age is stunting and reflects chronic deprivation, and weight-for-height is wasting and reflects acute recent loss; NFHS-6 (2023-24) found 29.3 per cent of under-fives stunted, 19.0 per cent wasted and 31.8 per cent underweight (NFHS-5: 35.5, 19.3 and 32.1 per cent).
A child with severe acute malnutrition who has appetite on the appetite test and no medical complication is managed in the community with counselling, energy-dense food and follow-up, while a child who fails the appetite test or has a complication is admitted to a Nutrition Rehabilitation Centre for facility-based care.
The anganwadi centre is also the venue of the monthly Village Health, Sanitation and Nutrition Day, where immunisation, antenatal check-ups, growth monitoring and counselling are delivered together, and it is the point at which Poshan Abhiyaan targets on stunting, undernutrition, anaemia and low birth weight are actually met.

NTEP, NACP, NLEP

NTEP, NACP and NLEP are the three national programmes for tuberculosis, HIV and leprosy, each of which provides free diagnosis, free treatment and a defined reporting system through the general health services rather than through a separate vertical clinic. They are examined together because they share a structure that the nurse must be able to recite: a case definition, a standard regimen with fixed drugs and durations, a notification platform and a contact-tracing obligation.

The Revised National Tuberculosis Control Programme was renamed the National Tuberculosis Elimination Programme in 2020, and its National Strategic Plan 2017–25 aimed to end tuberculosis in India by 2025, five years ahead of the global Sustainable Development Goal target — a goal not met, so the aim is now elimination ahead of the SDG 2030 target; tuberculosis is a notifiable disease and every case, public or private, must be notified on the Ni-kshay portal.
NTEP diagnosis leads with a molecular test: a nucleic acid amplification test such as CBNAAT or Truenat is the first test wherever available because it also detects rifampicin resistance, with sputum smear microscopy and chest radiography as supports; every diagnosed patient is offered HIV testing and screened for diabetes.
The NTEP regimen for drug-sensitive tuberculosis is daily fixed-dose combination by weight band: two months of isoniazid, rifampicin, pyrazinamide and ethambutol in the intensive phase followed by four months of isoniazid, rifampicin and ethambutol in the continuation phase, with paediatric dispersible formulations and treatment supported and recorded rather than merely dispensed.
Ni-kshay Poshan Yojana pays every notified patient a nutrition support benefit of Rs 1,000 a month by direct benefit transfer for the whole duration of treatment, raised from Rs 500 in 2024, and the Pradhan Mantri TB Mukt Bharat Abhiyaan lets a Ni-kshay Mitra adopt patients for additional nutritional support.
Contact management under NTEP: every household contact is screened for active tuberculosis, and once active disease is excluded, tuberculosis preventive treatment is offered, particularly to children under five and to people living with HIV; BCG given at birth protects the child against disseminated and meningeal tuberculosis, not against adult pulmonary disease.
The National AIDS and STD Control Programme ran its Phase V from April 2021 to March 2026 and works to the 95-95-95 targets, that 95 per cent of people living with HIV know their status, 95 per cent of those diagnosed are on antiretroviral therapy and 95 per cent of those on treatment are virally suppressed; India follows treat-all, so free lifelong antiretroviral therapy starts at diagnosis regardless of the CD4 count.
NACP prevention: HIV testing at the integrated counselling and testing centre uses a three-test strategy with confidential pre-test and post-test counselling; prevention of parent-to-child transmission offers testing to every pregnant woman at her first antenatal contact and puts a positive mother on lifelong therapy with infant prophylaxis; post-exposure prophylaxis after a needle-stick or sexual exposure is started as soon as possible and within 72 hours and continued for 28 days; blood safety, condom promotion, targeted intervention among key populations and opioid substitution therapy complete the package.
Under NLEP, leprosy was declared eliminated as a public health problem in India in 2005, meaning a prevalence below 1 case per 10,000 population, but new cases continue to be found; a case is diagnosed on any one of three cardinal signs, namely a hypopigmented or reddish patch with definite loss of sensation, a thickened or enlarged peripheral nerve with sensory loss or weakness in the muscles it supplies, or acid-fast bacilli in a slit-skin smear. Multidrug therapy is free, with rifampicin given monthly under supervision, dapsone taken daily and clofazimine added in multibacillary disease, for 6 months in paucibacillary and 12 months in multibacillary leprosy, and single-dose rifampicin is used as post-exposure prophylaxis for contacts.

National Rural Health Mission (NRHM)

The National Rural Health Mission, launched on 12 April 2005, is the Government of India programme that funds and manages rural public health through decentralised district planning, flexible financing and a community health worker in every village. Since 2013 it has been the rural sub-mission of the National Health Mission, the other being the National Urban Health Mission, and almost every scheme the community health nurse delivers, from JSY to Mission Indradhanush, is funded and monitored through it.

The mission was launched on 12 April 2005 with special focus on 18 states with weak public health indicators, including the Empowered Action Group states, the north-eastern states, Jammu and Kashmir and Himachal Pradesh; in 2013 it was subsumed into the National Health Mission along with the newly created National Urban Health Mission.
Its stated purpose was an architectural correction of the health system: decentralised district health action plans, untied funds at facility and village level, community ownership through Village Health, Sanitation and Nutrition Committees and Rogi Kalyan Samitis, and integration of the vertical disease programmes into the general health services.
The accredited social health activist, or ASHA, is the mission's signature intervention: one woman per 1,000 rural population, resident in the village, usually aged 25 to 45 and educated to about class eight, working as an honorary volunteer paid by performance-linked incentives rather than a salary, and acting as the link between the household and the health system.
Rural facility norms under the Indian Public Health Standards: a sub-centre for 5,000 population in the plains and 3,000 in hilly, tribal and desert areas; a primary health centre for 30,000 in the plains and 20,000 in hilly and tribal areas, with a medical officer, six beds and six sub-centres under it; and a community health centre for 120,000 in the plains and 80,000 in hilly and tribal areas, with 30 beds and, when functioning as the First Referral Unit, five essential specialists in medicine, surgery, obstetrics and gynaecology, paediatrics and anaesthesia.
The mission is the delivery vehicle for the RMNCH+A strategy (reproductive, maternal, newborn, child and adolescent health plus nutrition) and for JSY, JSSK, RBSK, RKSK, Mission Indradhanush, the free drugs and free diagnostics initiatives and the National Ambulance Service reached on 102 and 108.
The Village Health, Sanitation and Nutrition Day, usually held once a month at the anganwadi centre, is where the auxiliary nurse midwife, the ASHA and the anganwadi worker jointly deliver immunisation, antenatal check-ups, growth monitoring, family planning supplies and counselling; it is the village-level point at which most of the mission actually reaches people.
Under Ayushman Bharat, announced in 2018, sub-centres and primary health centres are being converted into Ayushman Arogya Mandir, formerly called Health and Wellness Centres and led by a mid-level provider such as a Community Health Officer, which add non-communicable disease screening, mental health, elderly, eye, ear, nose and throat and emergency care to the old maternal and child package; the second component, PM-JAY, provides hospitalisation cover of Rs 5 lakh per family per year to poor and vulnerable households and, since 2024, to everyone aged 70 and above, while the PM Ayushman Bharat Health Infrastructure Mission and the Ayushman Bharat Digital Mission were added in 2021 as the third and fourth components of Ayushman Bharat.
Funding under the mission is shared between the Centre and the states in a fixed ratio with a more favourable share for the north-eastern and Himalayan states, and it is routed through a state health society against an approved Programme Implementation Plan, which is why district-level planning skills are part of the nurse's syllabus.

Janani Suraksha Yojana (JSY)

Janani Suraksha Yojana is a fully centrally sponsored conditional cash transfer launched on 12 April 2005 under the National Rural Health Mission, which pays a pregnant woman, and the ASHA who escorts her, for delivering in a government or accredited private health facility. It matters because it is the standard Indian example of demand-side financing, because it moved the country from a majority of home births to institutional delivery in the great majority of pregnancies, and because the nurse is the person who must tell the family what they are entitled to.

The scheme was launched on 12 April 2005 as a modification of the earlier National Maternity Benefit Scheme, is 100 per cent centrally funded, and links cash assistance with antenatal care, skilled attendance at birth and post-delivery care rather than paying for the delivery alone.
States are grouped as Low Performing States, which are the eight Empowered Action Group states of Bihar, Jharkhand, Madhya Pradesh, Chhattisgarh, Uttar Pradesh, Uttarakhand, Odisha and Rajasthan together with Assam and Jammu and Kashmir, and High Performing States, which are all the rest.
In a Low Performing State every pregnant woman who delivers in a government or accredited facility is eligible irrespective of age, parity or income, and receives Rs 1,400 in rural areas and Rs 1,000 in urban areas.
In a High Performing State the cash is restricted to women below the poverty line and to scheduled caste and scheduled tribe women, who receive Rs 700 in rural areas and Rs 600 in urban areas on facility delivery.
A below-poverty-line woman aged 19 years and above who delivers at home receives Rs 500 in both categories of state, and up to Rs 1,500 is available to hire a private specialist for a caesarean section where the government facility has no obstetrician or anaesthetist on site.
The ASHA receives a separate package for escorting the woman, for the antenatal contacts and for the postnatal visits, amounting to Rs 600 in rural areas; her incentive is paid only when the whole package of contacts is completed, which is what keeps her with the woman after discharge as well as before delivery.
Payment is made by direct benefit transfer into the mother's own account, ideally before she is discharged, and she is to be kept at the facility for at least 48 hours after a normal delivery so that postpartum haemorrhage and newborn problems are detected while she is still under care.
The scheme runs alongside Janani Shishu Suraksha Karyakram of 2011, which removes all out-of-pocket expenditure for a pregnant woman and a sick infant in a public facility, covering free delivery including caesarean section, free drugs and consumables, free diagnostics, free diet for three days after a normal delivery and seven days after a caesarean, free blood, and free transport from home to facility, between facilities and back home; the quality reforms that accompany it are PMSMA, LaQshya and SUMAN.

Smallpox eradication

Smallpox, caused by the Variola virus, is the only human disease that has ever been eradicated, declared globally eradicated by the World Health Assembly on 8 May 1980. It matters in the syllabus as the worked example of what makes a disease eradicable and of the strategy that finished it, namely surveillance and containment with ring vaccination, which is still the method used against polio, measles and any new rash illness that appears in a district.

The agent was Variola virus, an Orthopoxvirus with a DNA genome; variola major had a case fatality of about 30 per cent and variola minor or alastrim about 1 per cent, and humans were the only reservoir with no animal host, no carrier state and no subclinical infection, so every infection produced a visible case.
The features that made eradication possible were a single stable antigenic type, lifelong immunity after one attack, a rash so characteristic that a village worker could make the diagnosis without a laboratory, a short period of communicability, absence of long-term carriers, and a cheap heat-stable freeze-dried vaccine given by the bifurcated needle with the multiple puncture technique.
The rash of smallpox was centrifugal, dense on the face and limbs including the palms and soles and sparse on the trunk; all the lesions were at the same stage at the same time, that is monomorphic, and they were deep-seated and umbilicated, appearing after a two to four day prodrome of high fever and severe backache, which is the exact opposite of chickenpox on all three counts.
The Intensified Smallpox Eradication Programme began in 1967 and changed the strategy from mass vaccination to surveillance and containment, meaning active case search, immediate isolation of the case and ring vaccination of all contacts and the contacts of contacts; this change is the reason the programme succeeded where decades of mass vaccination had not.
India ran the National Smallpox Eradication Programme from 1962, recorded its last case in 1975, and was certified free of smallpox in 1977; the last naturally acquired case in the world was in Somalia in October 1977 and the last death was a laboratory-acquired infection in Birmingham in 1978.
After eradication routine vaccination was stopped everywhere, and the virus is retained under seal in only two WHO-authorised laboratories; smallpox remains a bioterrorism concern, and mpox, a related orthopoxvirus, now causes human outbreaks partly because everyone born after 1980 lacks vaccinia-derived cross-immunity.
The three terms must be used precisely: eradication is the permanent worldwide reduction to zero cases with no further need for intervention and has been achieved only for smallpox in humans and rinderpest in animals; elimination is zero cases or a defined low level in a defined geographical area with intervention continuing, as with leprosy as a public health problem in India in 2005 and polio, for which India was certified free in 2014; control is reduction of the disease to an acceptable level.
Guinea worm disease, poliomyelitis, yaws and measles are the diseases usually named as the next eradication or elimination candidates, and India was certified free of yaws and of maternal and neonatal tetanus in addition to polio.

Trachoma

Trachoma is a chronic keratoconjunctivitis caused by Chlamydia trachomatis serotypes A, B, Ba and C, spread from eye to eye by fingers, shared towels and face-seeking flies wherever water and sanitation are poor. Repeated childhood infection scars the tarsal conjunctiva, turns the lashes inwards years later and abrades the cornea, and it is this slow scarring, not the infection itself, that made trachoma the world's leading infectious cause of blindness.

The reservoir is the infected child, the source is ocular and nasal discharge, and transmission is by the four Fs of fingers, flies (Musca sorbens), fomites such as shared towels and face cloths, and unclean faces; overcrowding and scarce water sustain it.
The WHO simplified grading has five signs: TF, trachomatous inflammation-follicular (five or more follicles of at least 0.5 mm on the upper tarsal conjunctiva); TI, intense inflammation obscuring half the deep tarsal vessels; TS, trachomatous conjunctival scarring; TT, trachomatous trichiasis with at least one lash touching the eyeball or evidence of epilation; and CO, corneal opacity.
Herbert's pits at the limbus are pathognomonic scars of healed limbal follicles, and Arlt's line is the horizontal scar across the upper tarsal conjunctiva; both are late signs that tell you the infection has been present for years.
The WHO SAFE strategy is Surgery for trichiasis (bilamellar tarsal rotation), Antibiotics, Facial cleanliness and Environmental improvement, and only the last two prevent re-infection; mass drug administration is given to the whole district when TF prevalence in children aged one to nine years is five per cent or more.
The antibiotic is azithromycin as a single oral dose, 20 mg/kg in children up to a maximum of 1 g and 1 g in adults; the alternative where azithromycin cannot be used is one per cent tetracycline eye ointment twice daily for six weeks.
The elimination thresholds are a TF prevalence below five per cent in children aged one to nine years in every formerly endemic district and trachomatous trichiasis unknown to the health system in fewer than 0.2 per cent of adults aged fifteen and over.
India declared itself free of infective trachoma in 2017 on the National Trachoma Survey and was validated by WHO in 2024 as having eliminated trachoma as a public health problem; surveillance and trichiasis surgery continue under the National Programme for Control of Blindness and Visual Impairment, because scarring in old eyes outlives the infection.

Theme of World Health Day

World Health Day is observed on 7 April every year, the date on which the Constitution of the World Health Organization came into force in 1948, and each year it carries one theme on which WHO and its member states campaign. Indian recruitment papers ask for the date, the founding year and the current theme, and they group it with the rest of the health calendar, so this is fixed memory work that also gives the sub-centre a ready-made peg for its yearly health education activity.

The WHO Constitution came into force on 7 April 1948; the First World Health Assembly decided that the date should be marked every year, and World Health Day has been observed annually since 1950.
Recent themes to be able to quote are Health for All in 2023, which marked WHO's seventy-fifth anniversary; My health, my right in 2024; and Healthy beginnings, hopeful futures in 2025, which opened a year-long campaign on maternal and newborn health.
The rest of the WHO calendar most often asked: World TB Day on 24 March, World Malaria Day on 25 April, World Hand Hygiene Day on 5 May, World No Tobacco Day on 31 May, World Blood Donor Day on 14 June, World Population Day on 11 July, World Breastfeeding Week from 1 to 7 August, World Mental Health Day on 10 October and World AIDS Day on 1 December.
Two dates that are not WHO's but are asked with them: International Nurses Day on 12 May, observed by the International Council of Nurses on Florence Nightingale's birthday, and India's National Deworming Day on 10 February, with a second round in August in many states.
The theme is not decoration: WHO issues campaign material, and the district uses the day to run rallies, school activities, health melas and camps at Ayushman Arogya Mandirs, which the sub-centre records in its information, education and communication register.
For the paper, keep the three facts separate — the date is always 7 April, the founding year of WHO is always 1948, and only the theme changes each year, so a candidate who confuses the theme still answers the date and the year correctly.

No Tobacco Day

World No Tobacco Day is observed on 31 May every year to draw attention to the harm tobacco does and to the measures that reduce it; the World Health Assembly created the observance in the late 1980s and it has been marked on that date ever since. In India the day is the peg for enforcement drives under the Cigarettes and Other Tobacco Products Act and for the school and cessation activities of the National Tobacco Control Programme, so the examination asks the date, the law and the cessation service together.

The date is 31 May, it is a WHO observance, and each year has its own theme; a World No-Smoking Day was first held in 1987 and the annual 31 May observance followed.
Tobacco kills more than eight million people a year worldwide, of whom well over a million are non-smokers exposed to second-hand smoke, and it is the leading preventable cause of death in India as well as the leading cause of oral cancer there.
The second Global Adult Tobacco Survey, GATS-2 of 2016-17, found that 28.6 per cent of Indian adults aged fifteen and over use tobacco in some form — 42.4 per cent of men and 14.2 per cent of women — and that smokeless forms such as khaini, gutkha and betel quid with tobacco are commoner in India than smoking.
COTPA 2003 is the law to quote by section: section 4 prohibits smoking in public places, section 5 bans direct and indirect advertising, promotion and sponsorship, section 6 bans the sale of tobacco to and by persons under eighteen and within 100 yards of an educational institution, and section 7 requires the specified health warnings, which in India cover 85 per cent of both principal display areas of the pack.
India ratified the WHO Framework Convention on Tobacco Control in 2004 and applies its MPOWER package — Monitor tobacco use, Protect from smoke, Offer help to quit, Warn about the dangers, Enforce bans on advertising and Raise taxes; the Prohibition of Electronic Cigarettes Act of 2019 additionally bans the manufacture, import, sale, storage and advertisement of e-cigarettes.
The National Tobacco Control Programme, running since 2007-08, funds state and district tobacco control cells, school and community awareness, enforcement support and cessation services, and it operates a national toll-free tobacco quitline together with a text-message mCessation service whose numbers are printed on tobacco packs.
Cessation counselling in the clinic follows the five As — Ask about use, Advise to quit, Assess willingness, Assist with a quit plan and Arrange follow-up — with nicotine replacement therapy or bupropion where indicated, and the five Rs of relevance, risks, rewards, roadblocks and repetition for the patient who is not yet willing.

Anganwadi worker roles

The Anganwadi worker is the honorary, village-level woman functionary of the Integrated Child Development Services, selected from the community she serves and running the Anganwadi centre from which all six ICDS services are delivered. She is the health system's continuous contact with every child under six, every pregnant and lactating woman and the adolescent girls of her area, which makes her the nurse's partner on immunisation days, on growth monitoring and on the referral of severe acute malnutrition.

ICDS was launched on 2 October 1975 and is now delivered as Saksham Anganwadi and Poshan 2.0 under the Ministry of Women and Child Development, which brought the earlier ICDS, POSHAN Abhiyaan and the scheme for adolescent girls into one mission.
The six services are supplementary nutrition, immunisation, health check-up, referral services, nutrition and health education, and non-formal pre-school education; immunisation, health check-up and referral are delivered through the health system by the ANM and the medical officer, while the other three are the Anganwadi worker's own.
The population norm is one Anganwadi centre for 400 to 800 people, one for 300 to 800 in tribal, hilly, riverine and desert areas, and one for about 100 people in PVTG habitations under PM JANMAN; mini-Anganwadi centres, once sanctioned for 150 to 400 people, are being upgraded to main centres since 2023; the worker is assisted by an Anganwadi helper and supervised by the Supervisor or Mukhya Sevika, the Child Development Project Officer heading the project at block level.
The supplementary nutrition norms are per beneficiary per day: 200 kilocalories with 8 to 10 grams of protein for children of six to twelve months and 400 kilocalories with 15 to 20 grams from one to six years; for an undernourished child 400 kilocalories (six to twelve months), 700 (one to three years) or 800 (three to six years), with 25 to 30 grams of protein after the first year; 600 kilocalories with 22 to 25 grams of protein for a pregnant woman or a lactating mother; and 600 kilocalories with 18 to 20 grams for an adolescent girl — as take-home ration for the under-threes and a morning snack with a hot cooked meal at the centre for the three to six year olds (norms revised in 2023).
Growth monitoring is her core clinical task: she weighs children under three years every month and children of three to six years every quarter, plots the weight on the WHO-standard growth chart in the Mother and Child Protection card, and shows the mother the direction of the line rather than the single point, because a flat or falling line is the warning.
She identifies severe acute malnutrition in a child of six to fifty-nine months by a mid-upper arm circumference below 11.5 cm, weight-for-height below minus three standard deviations, or bilateral pitting oedema, and refers such a child the same day — to a Nutrition Rehabilitation Centre if there is oedema, a failed appetite test or a medical complication, and to community-based management with weekly follow-up if the child is alert and feeding.
Her other duties are the survey register and the centre's records, now entered in the Poshan Tracker application; running pre-school education for three to six year olds; holding the Village Health, Sanitation and Nutrition Day each month with the ANM and the ASHA; mobilising children and pregnant women for immunisation; and conducting community events such as Godh Bharai and Annaprashan Diwas.
She differs from the ASHA in employer, base and payment: the Anganwadi worker belongs to the Ministry of Women and Child Development, works from a centre with a fixed catchment and receives a monthly honorarium shared between the Centre and the state, while the ASHA belongs to the health department under the National Health Mission, works house to house for about a thousand people and is paid performance-based incentives.

Rashtriya Swasthya Bima Yojana (RSBY)

The Rashtriya Swasthya Bima Yojana was India's first large cashless hospitalisation insurance scheme for poor families, launched in 2008 by the Ministry of Labour and Employment with a smart card and a cover of Rs 30,000 a family a year. It has been subsumed by Ayushman Bharat Pradhan Mantri Jan Arogya Yojana since 2018, and the two are examined together because the comparison is what shows whether a candidate knows the scheme that is actually running today.

RSBY, launched in 2008 and later moved to the Ministry of Health and Family Welfare, gave below-poverty-line families a cover of Rs 30,000 per family per year on a floater basis for up to five members, cashless at empanelled public and private hospitals through a biometric smart card, for a registration fee of Rs 30, with the premium shared 75 to 25 between the Centre and the state and a transport allowance for each hospitalisation.
Ayushman Bharat began in 2018 with two components and now has four, and the commonest trap is to describe only the insurance scheme: the Health and Wellness Centres, renamed Ayushman Arogya Mandir, deliver comprehensive primary care and PM-JAY covers hospitalisation, while the PM Ayushman Bharat Health Infrastructure Mission and the Ayushman Bharat Digital Mission were added in 2021 — a candidate who equates Ayushman Bharat with the insurance scheme has answered only part of the question.
PM-JAY, launched on 23 September 2018, gives Rs 5 lakh per family per year for secondary and tertiary hospitalisation with no cap on family size or age, to about 12 crore poor and vulnerable families identified from the deprivation and occupational criteria of the Socio-Economic and Caste Census of 2011.
The cover is cashless and paperless at empanelled public and private hospitals, is portable across states, and includes three days of pre-hospitalisation and fifteen days of post-hospitalisation expenses along with medicines and diagnostics; the beneficiary is verified and the Ayushman card generated at the hospital by the Ayushman Mitra, so a family without a card in hand is not to be turned away.
The scheme was extended in 2024 to cover all citizens aged seventy years and above irrespective of income, under a separate senior citizens' card, which is the most recent change and therefore the most likely to be asked.
Insurance is not the whole answer to the financing problem: out-of-pocket expenditure remains a large share of health spending in India and a common cause of catastrophic expenditure and impoverishment, and PM-JAY covers hospitalisation but not the outpatient care and medicines where much of that spending actually happens.
Contrast it with the other schemes in the same question: the Employees' State Insurance scheme for organised-sector workers below the wage ceiling, the Central Government Health Scheme for central government employees and pensioners, and the various state health assurance schemes that PM-JAY is aligned with.

MCH program

Maternal and child health care is the package of services given to a woman through pregnancy, birth and the weeks after it, and to her child through infancy and childhood, on the principle that mother and child are one biological and social unit whose health cannot be separated. In India it is delivered as the Reproductive, Maternal, Newborn, Child and Adolescent Health plus Nutrition strategy of the National Health Mission, and the examination tests its indicators, its schedules and the names of its schemes.

The strategy is a continuum of care across the life cycle and across levels of care, from the home and the Village Health, Sanitation and Nutrition Day through the Ayushman Arogya Mandir and the primary health centre to the First Referral Unit and the district hospital, with a defined referral link at each step.
Antenatal care: registration within twelve weeks, a minimum of four antenatal contacts under the national programme against the eight contacts of the WHO 2016 model, and a free assured check-up by a specialist on the ninth of every month under the Pradhan Mantri Surakshit Matritva Abhiyan; tetanus protection is now given as two doses of Td four weeks apart, or a single booster if she received two Td doses in a pregnancy within the last three years.
Under Anemia Mukt Bharat Abhiyaan — the 7×7×7 strategy of June 2026 (seven beneficiary groups, seven interventions and seven institutional mechanisms; 6×6×6 from 2018) — a pregnant woman takes one iron and folic acid tablet of 60 mg elemental iron with 500 micrograms of folic acid daily for at least 180 days in pregnancy and 180 days after delivery, with 500 mg of calcium twice a day over the same periods and albendazole 400 mg once after the first trimester.
Intranatal care: institutional delivery with cash assistance under JSY and free entitlements under JSSK, monitoring of labour on the partograph, active management of the third stage with oxytocin 10 IU intramuscularly within one minute of birth, delayed cord clamping, immediate skin-to-skin contact and breastfeeding within the first hour.
Postnatal and newborn care: home visits by the ASHA under the Samagra Shishu Bal Swasthya Karyakram (which replaced HBNC in 2026) on days 3, 7, 14 and 42 for a healthy newborn, with a day-1 visit added after a home delivery and nine visits up to day 42 for an at-risk newborn, exclusive breastfeeding for six months, complementary feeding from six months with breastfeeding continued to two years, and facility newborn care through newborn care corners, newborn stabilisation units and sick newborn care units.
Child health: the National Immunization Schedule, biannual vitamin A from nine months to five years, oral rehydration solution with zinc for fourteen days in diarrhoea, integrated management of neonatal and childhood illness, and screening of every child from birth to eighteen years under Rashtriya Bal Swasthya Karyakram for the four Ds of defects at birth, deficiencies, diseases and developmental delays including disability.
The indicators and their denominators: the maternal mortality ratio is maternal deaths per 1,00,000 live births and stands at 87 for India in the current Sample Registration System bulletin (2022-24), while the infant mortality rate of 24, the neonatal mortality rate of 18 and the under-five mortality rate of 28 (SRS 2024) are all per 1,000 live births; the Sustainable Development Goal targets for 2030 are a maternal mortality ratio below 70, a neonatal mortality rate of 12 or fewer and an under-five mortality rate of 25 or fewer.
A maternal death is the death of a woman while pregnant or within 42 days of the termination of pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes; the scheme names to keep apart are JSY of 2005 for cash on institutional delivery, JSSK of 2011 for free entitlements, PMSMA of 2016 for the assured antenatal check-up, PMMVY of 2017 for the maternity benefit of Rs 5,000 for the first living child, LaQshya for labour room quality and SUMAN of 2019 for assured, dignified and free care.

Janani Shishu Suraksha Karyakram (JSSK)

Janani Shishu Suraksha Karyakram, launched on 1 June 2011, entitles every pregnant woman and every sick infant to completely free and cashless treatment at a public health facility, covering drugs, consumables, diagnostics, diet, blood and transport, and abolishing all user charges. It was created because the out-of-pocket costs a family met at the hospital door were keeping women away from institutional delivery even after JSY had paid them to come, so the examination asks the list of entitlements and the difference between the two schemes.

The scheme runs in public health institutions in both rural and urban areas under the National Health Mission; it began with delivery, including caesarean section, and was extended to cover complications during pregnancy and after delivery, care for abortion and ectopic pregnancy, and the treatment of sick infants up to one year of age rather than only sick newborns.
A pregnant woman is entitled to free delivery including caesarean section, free drugs and consumables, free essential diagnostics, free diet during her stay, free blood where needed, free transport from home to the facility and between facilities on referral, free drop back home, and exemption from every user charge.
The free diet is provided for three days for a normal delivery and seven days for a caesarean section, which is the specific figure most often asked.
A sick infant up to one year of age is entitled to free treatment, free drugs and consumables, free diagnostics, free blood, free transport in all three directions and no user charges of any kind.
Transport is operationalised through the 102 and 108 ambulance networks, and the drop back home is the entitlement facilities most often fail to provide and questions most often test.
It differs from JSY in kind and not merely in amount: JSY of 2005 is a conditional cash transfer paying the mother for delivering in an institution — in the low performing states Rs 1,400 for a rural and Rs 1,000 for an urban mother, with a separate incentive for the ASHA, and Rs 700 rural and Rs 600 urban for eligible women in the high performing states — while JSSK pays nothing to the mother and instead removes every cost she would have faced at the facility.
Implementation is monitored through the display of entitlements at the facility, a grievance redressal mechanism and reporting into the health management information system, and JSSK now sits inside SUMAN, the Surakshit Matritva Aashwasan initiative of 2019, which brings JSY, JSSK and quality assurance into one assured package with zero tolerance for denial of services.

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