Dr.P.

Padmanaban Advisor NHSRC

Slide presentation
y 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 Health

Programmes
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

DEMOGRAPHIC PROFILE

VITAL EVENTS 2006 Birth Rate Infant Mortality Rate Under 5 Mortality Rate Maternal Mortality Ratio Sex Ratio Child sex ratio (0-6) (0Life Expectancy at Birth

TAMILNADU 16.2 31 (NFHS III) 50 90 987 942 M 67.0 F 69.8

INDIA 23.5 57 94.9 301 933 927 M 64.1 F 65.4

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% of the budget allotted for drugs and consumables No user fees Public Health qualified medical professionals implement all National Health Programmes thro Primary Health Centres and Health Sub centres. Sensitive media

STRENGTHS OF TAMIL NADU HEALTH SYSTEM

y Quality generic drugs and equipment

procurement system- Tamil Nadu medical Services Corporation- ISO certified organisation and equipements

y Transparency in the procurement of drugs y Drug pass book system for institutions y Quality drugs at lower rates

24 availability of multipurpose paramedical staff nurse in the PHCs

y

24 hour delivery services with 3 staff nurses introduced in all the 1421 PHCs ( With NRHM support) Provide minor ailments treatment Assist in provision of tubectomy operations Scope for developing Nurse practitioners

y y y

DELIVERY PERFORMANCE (%) [July08]

100%

4.46

3.62

2.09

0.51

Domi.

80%

33.48 39.97 41.52 40.3

PVT

60%

40.54
40%

GH

41.25
20%

42.2

41.34

PHC
7.47 6.85 7.25 5.42 2006 9.91 6.36 2007 22.81 2.65 2008

0%

HSC

2005

Use of untied funds for upgrading the patient amenities

    

Flexible funding to PHCs / CHCs for all the activities irrespective MCH,HIV/AIDS, IDSP etc. Private sector participation for patient welfare initiatives No need to get the permission of PWD for execution of the minor works Multipurpose fund for Village Health and Sanitation committees Untied funds for the HSCs

Multi skill training of medical and para medicals

 6 months anesthesia training for M.B.B.S doctors (84 trained) 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 for doctors

Integrated service delivery in the PHCs

y Routine MCH services y Blood storage facilities y RTI/STI clinics y Family Welfare services including MVA and tubectomy

services y Birth certificate distribution in the PHCs y New born screening for disabilities initiated with NGO support in selected PHCs y Mainstreaming AYUSH y Convergence of HIV/AIDS y Integrated Disease Surveillance Programme, TB , Leprosy case detection and management

Integrated service delivery in the PHCs

y Special clinics

- Diabetes and hypertension clinics y - Gestational diabetes screening ( pregnant women) ( scan and semi autonalyser in PHCs) y - RTI/STI clinics y - 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 error screening ( ophthalmic assts in 385 BPHCs) y - Hiring the services of private specialists
y

School Health programme

y y y y y y y y y

- Screening for communicable diseases- Deworming - Dental health programme with hiring of private dental surgeons - Anemia control - Adolescent health - Refractive error screening & free spectacles - Rheumatic heart disease prevention - Congenital heart disease detection - Free heart surgery programme for the children

Free heart surgeries for children

y Heart Surgeries are done for children with private

sector participation to reduce the waiting time for surgery

y Planned to carryout 10,000 surgeries y Private hospitals are paid for the surgeries at

mutually agreed rates

y Private sponsors also donate funds for the scheme

Blindness control programme

y Cataract screening by ophthalmic assistants in the

PHCs and outreach areas

y Refractive error screening & free spectacle

distribution
y Follow up care for cataract operated cases y Scope for capacity building of ophthalmic assts in

the detection of eye complications among diabetics

Suggested new services in the PHCs

y Online reporting system launched for all RCH

services . Unified reporting system remains a challenge

y Adolescent clinics y Nutrition surveillance y Couple counseling for family welfare services y Newborn screening for developmental delays