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NATIONAL RURAL HEALTH MISSION: 

NATIONAL RURAL HEALTH MISSION TAMIL NADU

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BASIC DEMOGRAPHIC INDICATORS TAMILNADU Source: Census 2006 Mid year estimated population : 65.7 million

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DEMOGRAPHIC PROFILE

ACCEPTANCE OF SMALL FAMILY: 

ACCEPTANCE OF SMALL FAMILY

HEALTH INFRASTRUCTURE : 

HEALTH INFRASTRUCTURE Teaching institutions (Govt.) 14 Teaching institutions (Quasi govt.) 1 Private medical colleges 7 Nursing colleges (Govt.) 14 Nursing colleges (Pvt.) 45 Nursing schools (Govt.) 21 Nursing schools (Pvt.) 110

HEALTH INFRASTRUCTURE : 

HEALTH INFRASTRUCTURE District headquarters hospitals 29 Taluk Hospitals 155 Non-taluk hospitals 80 Women and children hospital 7 Primary health centres 1417 Health sub-centres 8683

HEALTH INFRASTRUCTURE : 

HEALTH INFRASTRUCTURE Urban health posts 193 Urban Family Welfare Centres 104 Approved Pvt. Institutions 1513

Indian System of Medicine HEALTH FACILITIES: 

Indian System of Medicine HEALTH FACILITIES

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1971 1981 1991 1996 INSTITUTIONAL DELIVERIES DELIVERIES CONDUCTED BY TRAINED PERSONNEL DELIVERIES CONDUCTED BY UNTRAINED PERSONNEL 2005 GROWTH OF SAFE DELIVERIES (%)

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CLASSIFICATION OF DELIVERIES - 2005-06 Source: PHC Records

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TRENDS IN IMR andamp; NNMR – TAMILNADU Source: SRS 113 52.8 30.0 41

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NUMBER OF MATERNAL DEATHS REPORTED-TAMILNADU Source: RCH

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CASES YEAR INCIDENCE OF POLIO CASES SINCE 1985

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CASES YEAR INCIDENCE OF MEASLES CASES SINCE 1985

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CASES YEAR INCIDENCE OF DIPTHERIA CASES SINCE 1985

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CASES YEAR INCIDENCE OF PERTUSIS CASES SINCE 1985

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INCIDENCE OF NNT CASES SINCE 1988

State Health Mission: 

State Health Mission Constitution in G.O.Ms.No.309, Handamp;FW Dept. , dt.16.12.05 Hon’ble Chief Minister of Tamil Nadu is the Chairman Hon’ble Health Minister of Tamil Nadu is the Co-chairman Hon’ble ministers of Social Welfare, Information and Publicity, Local Administration, Finance, Forest and Environment, Adidravida and Tribal Welfare are members State Health Society registered under Tamilnadu Registration of Societies Act 1975 Project Director, RCH Project is the Mission Director

District Health Mission: 

District Health Mission District Health Mission and District Health Societies were formed Collector of the Revenue District is the Chairman Deputy Director of Health Services of the revenue district is the District Mission Director Hospital Management Society / Rogi Kalyan Samiti for community management of public hospitals is being formed for all PHCs, Sub district hospitals and district hospitals

RCH - II PROGRAMME: 

RCH - II PROGRAMME

ACTIVITIES – ROUND THE CLOCK DELIVERY SERVICES IN THE PHCs : 

ACTIVITIES – ROUND THE CLOCK DELIVERY SERVICES IN THE PHCs To improve the access to delivery services in the rural areas, 24 hour delivery services in 780 PHCs with 3 staff nurses and one sanitary worker established Total PHCs in the State : 1417 * - proposal to extend this scheme to 637 PHCs during 2006-07 is under consideration.

THENI – 24 HOUR DELIVERY PERFORMANCE (% OF CONTRIBUTION) : 

THENI – 24 HOUR DELIVERY PERFORMANCE (% OF CONTRIBUTION) DOMI HSC PHC GH PNH Source: DPH

DHARMAPURI – 24 HOUR DELIVERY PERFORMANCE (% OF CONTRIBUTION) : 

DHARMAPURI – 24 HOUR DELIVERY PERFORMANCE (% OF CONTRIBUTION) DOMI HSC PHC GH PNH Source: DPH

HIRING OF PRIVATE SPECIALISTS : 

HIRING OF PRIVATE SPECIALISTS To improve the access to family planning services, the services of private specialists are hired by the PHCs and Govt hospitals. Private specialists are also hired (anesthetists and obstetricians) in the Govt hospitals for the provision of caesarean operations. 15% of the emergency caesarean surgeries are performed in the Govt hospitals with the help of private anesthetists which has contributed in the reduction of maternal deaths by 36%

FIXED DAY OUTREACH SERVICES: 

FIXED DAY OUTREACH SERVICES Visit of dedicated team of medical and paramedical functionaries in the villages on the fixed days Development of micro plan in consultation with elected leaders Monthly monitoring by District Collector Camp dates cannot be changed on any account Ensure accountability of the service providers Proposed to commence from 15th August 2006

SERVICES PROVIDED – FIXED DAY OUTREACH SERVICES: 

Management of RTI/STI cases TB andamp; Leprosy case detection Follow up of DOTS Hypertension and diabetes detection Adolescent clinic Mothers meeting, IEC activities Lab services – Sputum, malaria blood smear, VDRL, Urine routine, Hb%, vaginal smear Referrals SERVICES PROVIDED – FIXED DAY OUTREACH SERVICES

ADDL. SUPPORT FOR FIXED DAY OUTREACH SERVICES : 

ADDL. SUPPORT FOR FIXED DAY OUTREACH SERVICES Additional drugs including ISM drugs and lab reagents Additional fuel for vehicles Additional equipments Stationary Contingency Driver if needed Lab technician

Basic emergency Obstetric and Newborn care services(BEmONC) in PHCs: 

Basic emergency Obstetric and Newborn care services(BEmONC) in PHCs One PHC per block ( 1,00,000 popln) to be upgraded to provide BEmONC services Convergence of HIV /AIDS with RCH Programme

Basic Emergency Obstetric & Newborn Care Services(BEmONC) in 385 PHCS: 

Basic Emergency Obstetric andamp; Newborn Care Services(BEmONC) in 385 PHCS Normal deliveries Manual Vacuum Aspiration (MVA) for safe abortion andamp; tubectomy ISM clinic for A/N care – Dadimathi Girtham and Danwanthra thailam after counseling Stabilization of obstetric and newborn emergencies Essential newborn care esp LBW and premature babies SERVICES

NGO run Emergency Transport services : 

NGO run Emergency Transport services 29 control rooms for controlling the ambulances provided under TNHSP TNHSP provide 187 vehicles for 187 blocks during first phase Fully equipped ambulances would be handed over to NGO

JANANI SURAKSHA YOJANA SCHEME : 

JANANI SURAKSHA YOJANA SCHEME Below Poverty Line (BPL) pregnant women are given Rs. 700 as financial assistance for first 2 deliveries to facilitate institutional deliveries. Rs.8.91 crores have been dispersed (51,085 beneficiaries) GOI released Rs.14.50 crores as 2nd Installment

Mainstreaming Indian Systems of Medicine : 

Mainstreaming Indian Systems of Medicine 50 ISM drugs are being supplied to all the 8683 Health Sub Centres ISM drugs are manufactured by Tamil Nadu medicinal plants Corporation Training the health functionaries on the use of ISM drugs is under progress. Total value of the ISM drugs - Rs.30 crs Training cost – Rs. 3.03 Crs Beneficiaries - 8.6 lakhs - steadily increasing

SCAN CENTRE AUDIT FOR ELIMINATING SEX SELECTIVE ABORTION : 

SCAN CENTRE AUDIT FOR ELIMINATING SEX SELECTIVE ABORTION IMPLEMENTATION OF PRECONCEPTION AND PRENATAL DIAGNOSTICS TECHNIQUES ACT (PC andamp; PNDT). Total scan centres registered - 2911 Lowest child sex ratio is noticed in Edapadi taluk of Salem district. Team visited all the 6 scan centres in Edapadi and derecognized 3 centres for revealing the sex of the fetus Identification of scan centers revealing sex of the fetus Follow up all women undergone scan test thro field health functionaries to find out how many ended in abortions Decoy patients would be sent to the defaulting scan centres to lay a trap

UNTIED FUNDS: 

Untied funds of Rs. 10,000/- per HSC per year has been released to HSCs in the State to meet the day to day maintenance expenses of HSC Mobile Phones with pre-paid cards for easy contact by the public Minor modifications in the HSC, travel cost of referral cases, gas cylinders, electrical repairs Joint account opened by Village Health Nurses and PHC Medical Officers for operating the bank account UNTIED FUNDS

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BUDGET 2005-06 (Rs. In crores )

Issues: 

Issues Services of male health workers needed for the control of communicable diseases and emerging new diseases Funding support needed under NRHM- - for salary component of male multipurpose health workers - For starting the male multipurpose health workers training school

Issues (contd): 

Issues (contd) Sanction of PHCs and HSCs as per population norm as per 2001 census (601 HSCs and 130 PHCs) Support for the tertiary institutions under NRHM ( present support restricted to Rs. 50 lakhs per medical college)

Issues (contd): 

5 years Compulsory Govt service for the postgraduates from private sector Upgrading the skills of nurses and posting them in the rural areas- nurse clinician Issues (contd)

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THANK YOU