Under the National Health Mission (NHM), which state-level institution is responsible for coordination and implementation of health programs at the district level?

Explanation

## National Health Mission – Institutional Framework **Key Point:** The NHM operates through a three-tier governance structure: National, State, and District levels, each with dedicated institutions. ### District-Level Governance Under NHM **District Health Mission (DHM)** is the nodal agency for implementation of health programs at the district level. ### Composition and Leadership | Component | Details | |-----------|----------| | **Headed by** | District Collector (Chief Executive Officer) | | **Vice-Chairman** | Chief Medical Officer / District Health Officer | | **Members** | District officials, health professionals, civil society representatives | | **Role** | Coordination, planning, monitoring of health schemes | | **Reporting** | To State Health Mission (SHM) | ### Three-Tier NHM Structure ```mermaid graph TD A[National Health Mission]:::outcome --> B[National Health Authority]:::action A --> C[State Health Mission]:::action C --> D[District Health Mission]:::action D --> E[Block Health Management Unit]:::action E --> F[Health Facilities & Workers]:::action ``` **High-Yield:** The District Collector (not the Chief Medical Officer alone) chairs the DHM, reflecting the administrative and financial authority needed for program implementation. **Mnemonic:** **DHM = District Health Mission** headed by **District Collector** (administrative authority) with **CMO as Vice-Chair** (technical authority). ### Key Responsibilities of DHM - Coordinate implementation of NRHM/NHM programs - Monitor performance of health facilities - Ensure convergence with other health schemes (AB-PMJAY, etc.) - Facilitate community participation through Village Health Sanitation Committees (VHSCs)