WB Mar 2 2009 TN Experience PREETI Kudesia

8/6/2019 WB Mar 2 2009 TN Experience PREETI Kudesia

1/16

Dr.P.Padmanaban

Advisor

NHSRC


2/16

Slide presentationy Tamil Nadu Medical Services Corporation Flexibility for the doctors

to indent any drugs depending on the morbidity pattern of the area

y Dedicated Public Health Cadre to implement all National HealthProgrammes

y Use of untied funds- NRHM

y Multi skill training of medical and para medical staff

y Integrated service delivery in the PHCs

y New services in PHCs/ CHCs


3/16

VITAL EVENTSVITAL EVENTS 20062006 TAMILNADUTAMILNADU INDIA INDIA

Birth RateBirth Rate 16.216.2 23.523.5

Infant Mortality RateInfant Mortality Rate 3131 (NFHS III)(NFHS III) 5757

Under 5 Mortality RateUnder 5 Mortality Rate 5050 94.994.9

Maternal Mortality RatioMaternal Mortality Ratio 9090 301301

Sex RatioSex Ratio 987987 933933

Child sex ratio (0Child sex ratio (0--6)6) 942942 927927

Life Expectancy at BirthLife Expectancy at BirthM 67.0M 67.0

F 69.8F 69.8

M 64.1M 64.1

F 65.4F 65.4

DEMOGRAPHIC PROFILE


4/16

STRENGTHS OF TAMIL NADU HEALTH SYSTEM

Strong political will

Government is the dominant provider of Maternal and Child

health services

5.6% of the revenue budget allocated to health sector & 10% ofthe budget allotted for drugs and consumables

No user fees

Public Health qualified medical professionals implement all

National Health Programmes thro Primary Health Centresand Health Sub centres.

Sensitive media


5/16

STRENGTHS OF TAMIL NADU HEALTH SYSTEM

y Quality generic drugs and equipmentprocurement system- Tamil NadumedicalServices Corporation- ISO certified

organisation

y Transparency in the procurement of drugsand equipements

y

Drug pass book system for institutions

y Quality drugs at lower rates


6/16

24 availability of multipurpose paramedical

staff nurse in the PHCs

y 24 hour delivery services with 3 staff nurses introducedin all the 1421 PHCs( With NRHM support)

y Provide minor ailments treatment

y Assist in provision of tubectomy operations

y Scope for developing Nurse practitioners


7/16

6.85

7.47

41.25

39.97

4.46

5.42

7.25

42.2

41.52

3.62

6.36

9.91

41.34

40.3

2.09

2.65

22.81

40.54

33.48

0.51

0%

20%

40%

60%

80%

100%

2005 2006 2007 2008

HSC

PHC

GH

PVT

Domi.

DELIVERY PERFORMANCE (%)DELIVERY PERFORMANCE (%)

[[July08]July08]


8/16

Use of untied funds for upgrading the

patient amenities

Flexible funding to PHCs / CHCs for all the activitiesirrespective MCH,HIV/AIDS, IDSP etc.

Private sector participation for patient welfare

initiatives

No need to get the permission of PWD for execution ofthe minor works

Multipurpose fund for Village Health and Sanitationcommittees

Untied funds for the HSCs


9/16

Multi skill training of medical and para medicals

6 months anesthesia training for M.B.B.S doctors (84trained) and x-ray training for lab technicians

Scan training for MBBS doctors for one month

X ray training for Lab technicians

Training the ANMs, LHVs in the use AYUSH drugs

Manual Vacuum Aspiration training

Training nurses in HIV testing -RCH / HIV convergence

Cancer cervix screening training for the PHC staff

Blood bank training to the PHC staff

Diabetes training distance education programme fordoctors


10/16

Integrated service delivery in the PHCsy Routine MCH servicesy Blood storage facilities

y RTI/STI clinics

y Family Welfare services including MVA and tubectomyservices

y Birth certificate distribution in the PHCs

y New born screening for disabilities initiated with

NGO support in selected PHCsy Mainstreaming AYUSH

y Convergence of HIV/AIDS

y Integrated Disease Surveillance Programme, TB ,

Leprosy case detection and management


11/16

Integrated service delivery in the PHCs

y

Special clinicsy - Diabetes and hypertension clinics

y - Gestational diabetes screening ( pregnantwomen) ( scan and semi autonalyser in PHCs)

y - RTI/STI clinicsy - Cancer Cervix screening clinics using VIA method

( 2 districts and Chennai corporation)

y - Mental health programme ( 7 districts)

y - Dental clinics weekly two day clinics ( 35 clinics)

y - Eye clinics cataract screening and refractive errorscreening ( ophthalmic assts in 385BPHCs)

y - Hiring the services of private specialists


12/16

School Health programme

y - Screening for communicable diseases-

y - Deworming

y - Dental health programme with hiring ofprivate dental surgeons

y - Anemia control

y - Adolescent health

y

- Refractive error screening & free spectaclesy - Rheumatic heart disease prevention

y - Congenital heart disease detection

y - Free heart surgery programme for the children


13/16

Free heart surgeries for childreny Heart Surgeries are done for children with private

sector participation to reduce the waiting time forsurgery

y Planned to carryout 10,000 surgeries

y Private hospitals are paid for the surgeries atmutually agreed rates

y Private sponsors also donate funds for the scheme


14/16

Blindness control programme

y Cataract screening by ophthalmic assistants in thePHCs and outreach areas

y

Refractive error screening & free spectacledistribution

y Follow up care for cataract operated cases

y Scope for capacity building of ophthalmic assts inthe detection of eye complications among diabetics


15/16

Suggested new services in the PHCs

y Online reporting system launched for all RCHservices . Unified reporting system remains achallenge

y Adolescent clinics

y Nutrition surveillance

y Couple counseling for family welfare services

y Newborn screening for developmental delays


16/16

Documents

WB Mar 2 2009 TN Experience PREETI Kudesia