Concept of CRM

The Common Review Mission (CRM) have been set up as part of the Mission Steering Groups mandate of review and concurrent evaluation. These are annual events and covered thirteen states each on the last two occasions. The Missions comprise state briefings, field visits and state level debriefings eventually culminating in state reports filed before the Government of India. The reports are placed in public domain and widely disseminated to all stakeholders. The CRM provides occasions for state review, sharing of experiences across the states, discussions with wide range of stakeholders and an opportunity for mid course corrections by the Mission at all levels.

Recap of 1st CRM

Recap of the 1st CRM The first CRM took place in November 2007, about an year after the Framework for Implementation NRHM was approved (July 2006) and the actual processes started up. The terms of reference set out for the CRM were, assessing progress of the NRHM on 24 key parameters, which relate to the core strategies and the central areas of concern. Based on make recommendations on the areas that need strengthening and course correction.

these, the CRM was mandated to identify the constraints being faced and

The Mission was made up of 52 members who between them visited 13 states selected for the review. Of the 52 members,

leading public health institutions which had been working with the NRHM. After a one-day orientation briefing by the various

30 were officials from the department of health and family welfare, 4 were from the states and the rest were from the different divisions of the ministry. Of the 20 non-official members, three were former union health secretaries, and the others were public health experts from the

divisions at the ministry in Delhi, the team divided into 13 groups and left for the selected states: Andhra Pradesh, Assam, Bihar, Chhattisgarh, Orissa, Madhya Pradesh, Gujarat, Jammu and Kashmir, Rajasthan, Tamil Nadu, Tripura, Uttar Pradesh and West Bengal.

After a one-day orientation briefing by the various divisions at the ministry in Delhi, the team divided into 13 groups and left for the selected states. At the state level, there was an initial one-day briefing, after which the team divided into two groups and each went to visit one or two districts. The district visits lasted two to three days and the appraisal was done using a protocol that indicated the minimum number of each type of facility (and

villages) that should be visited and the thematic areas that must be covered in the inquiry. Upon returning to the state headquarters, there was an interaction with civil society groups, after which the reports were finalised. Finally, the common review mission teams presented their observations and findings to the host state department heads and NRHM facilitation teams for their feedback.

States Covered during 1st CRM (Nov 2007)

Andhra Pradesh, Assam, Bihar, Chhattisgarh, Orissa, Madhya Pradesh, Gujarat, Jammu and Kashmir, Rajasthan, Tamil Nadu, Tripura, Uttar Pradesh and West Bengal

Recap of 2nd CRM

Recap of the 2nd CRM The second CRM took place in November December 2008, about two years after the Framework for Implementation NRHM was approved (July 2006) and the actual processes operationalised. The terms of reference set out for the 2nd CRM were much the same as 1st CRM and the Mission comprised six member teams (including representatives from Govt of India, State Govt, Civil Society, Development Partners, Academicians and

NHSRC) which visited 13 states. The time line of the M

similar to the 1st CRM and the day long orientation brief

various divisions at the ministry in Delhi was attended b Mizoram, Rajasthan, Chhattisgarh and Madhya Pradesh

the members of the teams. In view of the elections in the

itinerary had to be amended and these states were taken u

second phase of CRM which began from 15th December

The state reports filed by review teams were compiled into a publication and a detailed National workshop was convened on 28th January 2009 at Vigyan Bhawan, New Delhi. This workshop was attended by the representatives of states (including Secretary HFW, Mission Directors and DHS) and all teams members who had visited the

chaired by the HFM. Each state team presented its key findings and respective state presented its plan of action to improve the implementation of NRHM. This well attended workshop gave an opportunity to share the CRM findings across all the states so that the findings could be channeled into doable action plans in the field.

states as per of the 2nd CRM. The workshop was States Covered during 2nd CRM (Nov-Dec 2008) Assam, Bihar, Jharkhand, Karnataka, Kerala, Maharashtra, Orissa, Tamil Nadu, Uttar Pradesh, Mizoram, Rajasthan, Chhattisgarh and Madhya Pradesh Summary note on the findings of 1st & 2nd CRM is appended to this note as Annexure 5 & Annexure 6 respectively.

Introduction to NRHM
The National Rural Health Mission (NRHM) was launched by the Honble Prime Minister on 12th April 2005, to provide accessible, affordable and accountable quality health services to the poorest households in the remotest rural regions. The detailed Framework for Implementation that facilitated a large ago). Under the NRHM, the difficult areas with unsatisfactory health indicators were classified as special focus States to ensure greatest attention where needed. The thrust of the Mission was on establishing a fully functional, community owned, decentralized health delivery system with inter sectoral like water, sanitation, education, nutrition, social and gender equality. Institutional integration within the fragmented health sector was expected to provide a focus on outcomes, measured against Indian Public Health Standards for all health facilities. From narrowly defined schemes, the

range of interventions under NRHM was approved by the Union Cabinet in July 2006 (two years

convergence at all levels, to ensure simultaneous action on a wide range of determinants of health

NRHM was shifting the focus to a functional health system at all levels, from the village to the district.