Scope of public health act in

protecting the health of the

community
 By
DR.I.SELVARAJ, I.R.M.S
B.SC., M.B.B.S., D.P.H (MADRAS MEDICAL
COLLEGE).,D.I.H.,PGCH&FW (NIHFW, New Delhi)
Sr.D.M.O (SELECTION GRADE OFFICER)
ON STUDY LEAVE
Post Graduate student in M.D Community Medicine
SREE RAMACHANDRA MEDICAL COLLEGE &
RESEARCH INSTITUTE,CHENNAI,TAMILNADU
Dr.I.Selvaraj
1.The effectiveness of public health service to the community
depends on the way the public health laws prevailing in the
community.
2. Political support
3. People co-operation
4.Public health laws includes very many acts (MTP Act, Prenatal
Diagnostic sex determination act, Indian medical council Act
,Indian nursing council Act, Indian Pharmacy act, PFA Act,
Public health Act etc.,)
5. In this presentation the importance public health act and its
role in the health of the community will be discussed.
6. The public health managers and community medicine experts
have to play a key role in this field
7. This presentation which I made it as a gift to public health
personnel and community medicine experts in my country. This
will enrich their knowledge while teaching undergraduates and
post graduates in community medicine, and post graduate
diploma in public health.
8. This presentation will be able to disseminate various sections
and other provisions of Tamil Nadu public health act to the
public health specialists and make them to understand their
importance in the community.
 PUBLIC HEALTH

Public health is what we, as a society,

do collectively to assure the conditions
for people to be healthy.”
 TEN ESSENTIAL PUBLIC HEALTH SERVICES
• Develop policies, and plans that support individual and
community health efforts
• Diagnose & Investigate the health problems & Health
hazards in the community
• Mobilize community partnerships
• Inform, educate,& empower people about health issues
• Link people to needed personnel health services and
assure the provision of comprehensive health care when
otherwise unavailable
• Assure a competent public health & personnel health
care workforce
• Monitor health status to identify the community health
problems
• Monitoring & evaluation of population based health care
services
• Operational research to find out new innovative solution
to the health problems
• Enforce laws and regulations that protect health and
ensure safety
Courtesy- Super Course
 SIX PUBLIC HEALTH RESPONSIBILITIES
• Prevention of epidemics & spread of disease
• Protection of people against environmental
Hazards
• Prevention of injuries
• Promotion & encouragement of healthy
behavior changes
• Quick response to the disaster & to assist
the communities in recovery phase
• To assure quality, accessible, and affordable
comprehensive health care services

Courtesy- Super Course

THE TAMIL NADU PUBLIC HEALTH ACT (1939)

• A Pioneering Act – 1939

• Steered by Great Scholar and Minister for
Health Dr.T.S.S.Rajan
• The Death Relief Act
• To improve the Health of the people of
Madras province
 Highlights of Tamilnadu public health act
Tamil Nadu is the first state in the
country to enact a law for public health
Tamil Nadu Public Heath Act 1939
remains as a model till today for the
entire country.
Amendments in 1941, 1944 and 1958
The Act was modified in 1970
The Act was translated in Tamil in the
year 1986.
Tamil Nadu to its credit had the first
Act in the country for Food
Adulteration also
Tamil Nadu Prevention of Food
Adulteration Act 1918.
The Act was repealed by the Central
Act, 1954.
Constitution of the Public Health
Board.
Regulations for construction of new
buildings.
Powers of the Police Officers to arrest
offenders
Powers of the Executive Officers
and Public Health Staff to arrest
Offenders.
Act to over right other Enactments
“Public Health Act” is supreme
 Power to the Government to remove
difficulties in implementation of the
Act as and when they appear.
Powers of the Government and of the
Director of Public Health and his
Staff to advise local authorities
There is a provision in this act for
Fairs and Festivals
• Vision
Healthy people in healthy community
• Mission
• To promote physical and mental health
• To prevent disease, injury, and disability
• Goal
• Prevention of disease
• Prolongation of life
• Improvement of quality of life
• Elimination of health disparity
• Organizing community efforts to achieve
above
THE TAMIL NADU PUBLIC HEALTH ACT (1939)
• Chapters – 15
• Sections – 145
• Schedules – 2
Chapter section Outline of Public Health Matters

From To

I 1 3 Short Title and Extent, Commencement

and Definitions

II 4 7 Public Health Board-Constitution and

Functions Powers of Govt & DPH

8 16 Public Health Establishments of Local

Authorities
III 17 26 Water Supply

IV 27 36 Drainage

V 37 40 Sanitary Conveniences

VI 41 51 Abatement of Nuisances

VII 52 61 Prevention, Notification and Treatment of

Diseases - Part - I: Infectious Diseases in
general
62 77 Part - II: Notified Infectious Diseases

78 80 Part - III: Venereal Diseases

81 Part - IV: Powers to Make Rules

VIII 82 Maternity and Child Welfare

IX 83 88 Mosquito Control

X 89 93 Sanitation and Buildings

Part - I : Residential Areas

94 96 Part - II : Control over In Sanitary

Buildings

98 100 Part - III : Abatement of Overcrowding

(Sce.97 omitted)

XI 101 107 Lodging House

XII 107A 115 Food Control

XIII 116 125A Fairs and Festivals

XIV 126 127 Finance

XV 128 135 Rules, By-Laws, Penalties Etc.,

136 145 Miscellaneous: Appeals, Method of

Serving Notice, Compounding,
Punishment for malicious abuse of
powers, Overriding etc

Schedule - I Ordinary Penalties

Schedule – II Penalties for continuing breaches

 Public health board
• The Minister of public health
• The Minister of local administration
• Three members of the Tamil Nadu
legislatures nominated by the Government
• The Director of Public Health
• Surgeon General
• The sanitary engineer
• One more state Government officer
nominated by the Government
The Main Focus on:-
• Environmental Health
• Communicable Disease Control
• Food Hygiene
• Maternity & Child Health measures
Environmental Health:-
• Water
• Drainage
• Housing
• Rats, Mice and Mosquito control
• Nuisance
• Sanitation
Water
• Establishment of Technical Assistance for
maintenance of Water works.
• Surveillance of Water sources
• Control over bottled water supply
• Govt. ensure local authority to provide adequate
continuous, wholesome water (Sec. 17, 18, 19)
• Role of Govt. and other authorities in Water supply
(Sec. 20, 21)
• Role of Railway Administration (Sec.22)
• Periodical Examination of Water (23)
• Action over the unsanitary sources (24)
• Prevention of Pollution of Water (36, 57)
• Supply of Water during Fair or Festival (120)
• Control over Private Water Sources (124)
Drainage:-
• Responsibility of Local authority and
private in construction of Drains and
Cesspool (27, 28, 29, 30, 31, 32)
• Prevention of Let out of Sullage in the
Streets (34)
• Prevention of Disposal of injurious
refuse into the Drain (35)
H o u s i n g :-
Prohibition of Occupation of House
– If it is without water supply (26)
– If it is without Drain (33)
– If there is nuisance (46)
– If there is notified disease (63, 70)
– If it is unfit for Habituation (96)
– Prohibition of Over crowding (98, 99, 100)
– Not to be erected on certain places (94)
– Registration, Renewal and Maintenance of
Lodging House (101, 102, 103, 104, 105, 106)
– New house should be provided with sanitary
conveniences (38)
 Communicable Diseases:
List of infectious diseases - Section- (52)

1. Acute influenza 9.Measles

pneumonia 10. Plague
2. Anthrax 11. Rabies
3. Cerebrospinal 12. Relapsing
fever fever
4. Chickenpox 13. Scarlet fever
5. Cholera 14. Small pox
6. Diphtheria 15. Tuberculosis
7. Enteric fever 16. Typhus fever
8.Leprosy
 List of Notified Diseases
SECTION- (62)

Cerebrospinal Infectious
fever Hepatitis
Chickenpox Epidemic Influenza
Cholera Whooping cough
Diphtheria
Leprosy Viral Encephalitis
Measles Hemorrhagic fever
Plague Malaria
Rabies Tetanus
Scarlet fever Poliomyelitis
Small pox AIDS
Tuberculosis
• Information by Medical practitioners (56)
• Persons responsible for giving information (64)
• Appointment of Health staff, medicines appliances
(53)
• Isolation wards, ambulance (54, 155)
• Disposal of bodies of person died from notified
diseases (74)
• Venereal diseases control (78,79)
• a) Provision of Diagnosis and Treatment (78)
• b) Education of Patients (79)
• Destruction of Rats and Mice (77)
• Prevention of spread of disease (57, 58, 59, 60, 61)
• To prevent spread of disease in public places (63,
65, 66, 67, 68, 69, 70, 71, 72, 75)
• Control of other Diseases during Epidemic
and Endemic (81)
Mosquito control -
• Prevention of Mosquito breeding (83)
• Protection of Anti Mosquito works (86)
• Power to entry and inspect (85,86)
S a n i t a t i o n :-
• Responsibility of Local authority to provide
Sanitary conveniences (37, 40)
• Provision Sanitary arrangements during
Fairs and Festival (120)
• Provision of Sanitary conveniences in
Houses (28, 39)
Maternity & child health
• Local authority is responsible in providing
these services (82)
Food control
• Section 107-A – prohibition of sale of food without license in certain
places (Hotel, Tea shop, Coffee house, Café, Refreshment room,
Mobile canteen, or catering establishment)
• Section-108 – No person shall keep store or prepare for sale any
animal intended for human consumption which is diseased
• If any child < 7 years of age commits offence u/s 108 (1), the
employer or the parent of the child are punishable as if the offence
was committed by him (Sec.109)
• Section -112 deals with the power of the health officer to enter
premises used for food trade
• Section-113 deals with power of the health officer to deal with
infected vendors
• Meat Hygiene (110, 111)
• Milk and Dairy products (114, 115)
• There is provision for prohibition of sale of unsound foods, power
of the Health Officer to enter premises used for food and power
of the Health Officer or a person duly authorized by him to destroy
such food article and to incorporate expenses for such
destruction from the owner himself.
FAIRS & FESTIVALS
• Notification of Fairs & Festivals (116)
• Levy of pilgrim tax and vehicle toll (117 & 118))
• Authority i/c of Festival to notify HO not less than 60 days in
advance to the commencement (119.1)
• Sanitary arrangements (120. 1 - 12)
– Demarcation & Preparation of site / Roads
– Cleaning & Draining
– Drinking (&Cooking) Water Supply
– Accommodation for pilgrims
– Lighting
– Supply of wholesome food at reasonable price
– Collection, removal & disposal of refuse
– Provision & maintenance of latrines
– Detection and segregation of cases of Infectious diseases.
– Medical Relief
– Others as may be specified
SECTION-(121) - Supervision & Control of arrangements by HO or
Authorized Persons
SECTION (122) HO or Authorized Persons to Seize & destroy any
food believed to be unwholesome(& perishable or value does not
exceed Rs3/-)
• If not destroyed by HO, to be produced to prescribed authority for
destruction if unwholesome or for analysis to ascertain the fitness
for human consumption
In any case, the expenditure to be paid by the person concerned
• SECTION 123
• The local authority may, in case of emergency with the
sanction of the District Collector, depute any person to enter
upon, occupy and use, without resorting to Land Acquisition
Act, 1894 any land or any building not being a Dwelling
house in the notified Fair or Festival Centre which in the
opinion of the Health Officer, is required and suitable for any
purposes connected with the Fair or Festival, such as the
construction of Pilgrim sheds, Water sheds, Hospitals,
Segregation sheds, Latrines and the like……….. This
provision is unique for Public Health Act.
• HO can direct to disinfect / close any Private Water Source (124)
• In default, HO can take necessary action and the expenditure to be
recovered from the person (124)
• En route Arrangements, Where large number of persons halt on their
way to or return from a festival site (125)
N u i s a n c e:-
• Nuisances and the powers of Health Officer for abatement of Nuisances
(41 to 49)
• Any premises in such a state as to be prejudicial to health or a nuisance
(41.1)
• Any pond, pool, latrine, watercourse which is so foul or in such a state
as to be prejudicial to health or nuisance (41.2)
• Any accumulation or deposit of refuse which is prejudicial to health or a
nuisance (41.4)
• Any factory or work place is not provided with adequate ventilation or
not clean or not free from noxious effluence or over crowded while
work is carried as to be prejudicial to health of those employed therein
(41.5)
• Any fire place or furnace which does not as far as predictable consume
the smoke arising from the combustible used therein (41.6)
• Any chimney sending forth smoke in such quantity as to be a nuisance
(41.7)
• Any noise, vibration, dust, irritating smell or offensive odour produced
by a factory or work place which is nuisance to the neighborhood(41.8)
• It deals with inspection from time to time to detect nuisance(42)
• Section-45 deals with power of the health officer to abate nuisance by
serving notice to defaulter or the premises owner
• Section – 47 deals with the powers of the health officer for disposal of
articles removed it while abating nuisance
• Section-48 deals with the power of entry of any executive or any
officer from the public health department
• Deposition of Rubbish in streets (51)
Power of Entry
48. a: If the entry is related to Abatement of Nuisance:
Any premises not to enter between sunset and sunrise except when
the nuisance is committed between sunset and sun rise
48. b: In cases of dwelling houses
– Consent of the occupier is obtained
– 24 hrs. Prior notice has been issued
If the entry is related to Notifiable diseases
Section 65.1: Any premises
• Without any notice in cases of factories, workshops, work
places, business houses
• After issuing a reasonable notice in other cases and in case of
dwelling house
Entry relating to Mosquito Control:
Section 88: Entry at reasonable time after issuing notice
Entry relating to Lodging Houses:
Section 106.2: Entry at all times – Manager to allow
Entry relating to Food Control:
Section 112.1: Anytime – Day or Night – without notice
Any person who prevents lawful entry shall be punishable with
simple imprisonment (up to 1 month) or fine (Rs. Five
Hundred) or both” (section 135)
General Guidelines for Enforcement of the Act
• Periodic Inspection of the Places, Premises
or Institutions etc.,
• Investigation of Complaints related to Public
Health matters
• Taking note of Violations, omissions,
Nuisances, failure to adopt conditions or
precautions etc., - if any
• Advising to rectify the above
• Taking action – if required (64 penalties)
described in this schedule
• Penalty ranges from 10 rupees to 1000
rupees)
Method of Taking Action
• Taking note of Violations, omissions, Nuisances,
failure to adopt conditions or precautions etc., - if
any
• Issue of Notice:
a) The time limit prescribed
b) Method of writing and serving
• Power of Entry and Inspection
• If replied – Inspection and Acceptance of reply If not
replied– to remind if desirable
• compounding as may be permissible
• In default / not compounded – Prosecution
Procedure for prosecution

Make a report Submit for sanction

Enclose Inspection of Prosecution
report Filing of the charge
Enclose Served copy sheet in the court
of notice Conducting
Enclose Reply prosecution
received and the Obtaining a copy of
opinion thereupon (or the judgment
the fact of non- Reviewing the
receipt of reply) judgment
Prepare and enclose Renewed action if
Charge Sheets necessary
induplicate / triplicate Further prosecutions
Consult public for continuing breach
prosecutor if any
Miscellaneous
– Power to compound Offences (138.A)
– Power of Police Officer to arrest offenders
(139)
– Power of Health officers, Public health
Staff to arrest Offenders (140)
– Punishment for malicious abuse of powers
(143)
Penalties
• Breach of rules (129)
• Breach o by-laws (132)
• Offences under the Act (134.1)
&Schedule I &II
• Preventing entry (135)
STRENGTHENING OF
PUBLIC HEALTH ACT
•Emerging and re-emerging diseases
•Increasing industries in food production
• Emerging social issues like Gender
issues, adolescents, geriatric issues
Increasing environmental hazards –
Ozone layer, weaning greenery, radiation,
bio-degradation, environmental pollution
due to changing life styles.
Public Health Service – Made as an
essential service
Control of Health Officer over Public
Health staff need to be strengthened
Education and Training of Public Health
Staff
The Penalty provisions has to
be increased
Stringent action should be
taken against those violating
the act
Medical institutions to maintain register of
communicable diseases.
Control over disposal from Hospitals
•Prohibition of Tobacco and Related
items Establishment of Health
Education units
Provision of Public Health Laboratory
for diagnosis of communicable diseases
•Establishment of Sentinel
surveillance
•Special provision for treatment of
other diseases like Tuberculosis,
Leprosy, Hepatitis, Leptospirosis etc.
•Licensing of hospitals, all
type of laboratories, blood
bank.
•Control over the burial ground and
burning ghat
•Places of swimming pools,
Holiday resorts, Holiday
camps to be monitored
•Fixing standards of
pollution (use of Plastics,
Air, Noise and Radiation
hazards
•Schools, Hostels, Colleges and
Factories to be inspected periodically
•Prevention of “Quack”
practitioners.
•Prevention of sale of Medicines across
the counter
CONCLUSION:
The developing countries have to develop a model
Public Health Act and modifications and
amendments if and when necessary could be made
at the appropriate time and appropriate level.
Public Health Act if it has any weak areas, It has to
be identified and modified by suitable amendment
to suit the present needs.

Acknowledgement:
1.Supercourse
2.Dr
2. .P. Krishnamurthy
Rtd. Director of Public Health and Preventive Medicine,
Government of Tamil Nadu - Chennai 600 006
3. Tamil Nadu Public health Act, 1939
4. Dr G. Palani, Professor, Department of community medicine, SRMC&RI