NATIONAL RURAL HEALTH MISSION

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NATIONAL RURAL HEALTH MISSION
TAMIL NADU
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BASIC DEMOGRAPHIC INDICATORS TAMILNADU
2006 Mid year estimated population 65.7 million
Source Census
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DEMOGRAPHIC PROFILE
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ACCEPTANCE OF SMALL FAMILY
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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

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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
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HEALTH INFRASTRUCTURE

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

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Indian System of Medicine HEALTH FACILITIES
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GROWTH OF SAFE DELIVERIES ()
1981
1991
1971
1996
2005
INSTITUTIONAL DELIVERIES
DELIVERIES CONDUCTED BY TRAINED PERSONNEL
DELIVERIES CONDUCTED BY UNTRAINED PERSONNEL
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CLASSIFICATION OF DELIVERIES - 2005-06
Source PHC Records
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TRENDS IN IMR NNMR TAMILNADU
113
52.8
41
30.0
Source SRS
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NUMBER OF MATERNAL DEATHS REPORTED-TAMILNADU
Source RCH
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INCIDENCE OF POLIO CASES SINCE 1985
CASES
YEAR

14

INCIDENCE OF MEASLES CASES SINCE 1985
CASES
YEAR

15
INCIDENCE OF DIPTHERIA CASES SINCE 1985
CASES
YEAR

16
INCIDENCE OF PERTUSIS CASES SINCE 1985
CASES
YEAR

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INCIDENCE OF NNT CASES SINCE 1988
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State Health Mission

• Constitution in G.O.Ms.No.309, HFW Dept. ,
  dt.16.12.05
• Honble Chief Minister of Tamil Nadu is the
  Chairman
• Honble Health Minister of Tamil Nadu is the
  Co-chairman
• Honble 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

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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

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RCH - II PROGRAMME
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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.
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THENI 24 HOUR DELIVERY PERFORMANCE ( OF
CONTRIBUTION)
PNH
GH
PHC
HSC
DOMI
Source DPH
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DHARMAPURI 24 HOUR DELIVERY PERFORMANCE (
OF CONTRIBUTION)
PNH
GH
PHC
HSC
DOMI
Source DPH
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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

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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

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SERVICES PROVIDED FIXED DAY OUTREACH SERVICES

• Management of RTI/STI cases
• TB 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

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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

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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

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

• Normal deliveries
• Manual Vacuum Aspiration (MVA) for safe abortion
  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

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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

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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

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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

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SCAN CENTRE AUDIT FOR ELIMINATING SEX SELECTIVE
ABORTION

• IMPLEMENTATION OF PRECONCEPTION AND PRENATAL
  DIAGNOSTICS TECHNIQUES ACT (PC 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

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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

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BUDGET 2005-06
(Rs. In crores )
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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

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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)

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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

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THANK YOU