NHM Programs


Universal Immunization Programme (UIP) Mission Indra dhanush


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Rashtriya Bal Swasthya Karyakram (RBSK)

Rashtriya Bal Swasthya Karyakram

Rashtriya Bal Swasthya Karyakram (RBSK) Programme is a Government of India initiative. Under this Programme, Screening of 0-18 years children is being done. Early Intervention Service is provided to children who are identified with conditions categorized as 4 D’s, namely, (1) Defects at birth, 2) Developmental delays including disabilities, 3) Deficiencies and 4). Diseases (totally covering 30 diseases in 4D’s). The ‘Child Health Screening and Early Intervention Services’ Programme aims at early detection and management of Health conditions among children and thereby to reduce the morbidity and mortality. This Programme is being successfully implemented in Tamil Nadu by providing two Mobile Health Teams in each Block Primary Health Centre, each team consisting of Medical Officer, Staff Nurse, Pharmacist with Driver. There are 770 Mobile health teams in 385 rural blocks.

The annual plan for each team visit will be drawn and Anganwadi centre, and Schools, will be visited as per ATP.

This team will visit the schools once in a year and anganwadi centres twice in a year.

The Children identified with Birth defects, deficiencies, disabilities and diseases etc., will be referred to District Early Intervention Centre(DEIC) which are established in all districts of Tamil Nadu. DEIC are located in Government Medical College hospitals of the districts and Government Head Quarters hospitals of the districts where there is no Medical College hospital.

In Tamil Nadu totally there are 34 District Early Intervention Centres to effectively implement this programme. DEICs are provided with manpower including Pediatrician, Medical Officer, Dentist, Physiotherapist, Audiologist, and Speech Therapist, Psychologist, Optometrist, Early Interventionist cum Social Worker, Lab Technician, Dental Technician, System Analyst, Data Entry Operator.

The Rashtriya Bal Swasthya Karyakram scheme is further Extended to Urban areas also as detailed below:

  1. Greater Chennai corporation – 15 Mobile Health Teams
  2. Coimbatore Corporation - 3 Mobil Health Teams
  3. Madurai Corporation - 3 Mobile Health Teams
  4. Salem Corporation - 2 Mobile Health Teams
  5. Trichy Corporation - 2 Mobile Health Teams
  6. Tirupur corporation – 2 Mobile Health Teams
  7. Dindugal corporation- 2 Mobile Health Teams.
  8. Tirunelveli corporation -3 Mobile Health Teams.
  9. Vellore corporation - 3 Mobile Health Teams.

Totally there are 805 Mobile Health Teams and 34 District Early Intervention Centres are in function to effectively implement this programme.


Integrated Management of Common Childhood Illnesses(IMNCI)


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Nutritional Rehabilitation Centers (NRCs)


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Monitoring: Child Death Review


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Defeat Diarrhoea (D2) Campaign


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Revision of National Guidelines on Facility Based Management of Severe


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Acute Malnourished Children with Medical Complication (2019)


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Childhood Pneumonia Management and Control


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Anemia Mukt Bharat (AMB)

The Anemia Mukt Bharat strategy is being implemented in all villages in blocks of the districts through existing delivery platforms as envisaged in the National Iron Plus Initiative (NIPI) and Weekly Iron Folic Acid Supplementation (WIFS) programme Since 2018.

Anaemia Mukt Bharat Scheme is implemented in Tamilnadu in order to reduce the prevalence of anemia by 3 percentage points per year

Government Orders obtained:


Key Features of Programme:

It is a universal strategy and it focuses on the following interventions:

  1. Prophylactic Iron and Folic Acid supplementation
  2. Deworming
  3. Intensified year-round Behaviour Change Communication Campaign (Solid Body, Smart Mind) focusing on four key behaviours
    • Improving compliance to Iron Folic Acid supplementation and Deworming,
    • Appropriate infant and young child feeding practices,<
    • Increase in intake of iron-rich food through diet diversity/quantity/frequency and/or fortified foods with focus on harnessing locally available resources.
    • Ensuring delayed cord clamping after delivery (by 3 minutes) in health facilities.
  4. Testing and treatment of anemia, using digital methods and point of care treatment, with special focus on pregnant women and school-going adolescents


Target group

  1. Children of 6 – 59 months age
  2. Children of 5 – 9 years age
  3. Adolescent Boys & Girls
  4. Women of Reproductive Age
  5. Pregnant women
  6. Lactating Women

Anemia reduction targets for 2022

Age Groups

Anemia prevalence (%)
Present Status State target 2022
Children 6 – 59 months 55 37
Adolescent Girls (15 – 19 ) Years 54 36
Adolescent Boys (15 – 19 ) Years 26 8
Women of  Reproductive Age 55 37
Pregnant women 44 24
Lactating Women  56 38


Implementation of Anemia Mukt Bharat:


1. Children 6 – 59 months:

Iron and Folic Acid syrup is provided to the children in the age group of 1 to 5 years as 1ml on Monday and 1 ml on Tuesday – i.e., biweekly for 50 weeks in a year along with biannual deworming with half tablet of Albendazole tablet 400 mg during the National Deworming days conducted once in 6 months (February and August of every year)

2. Children of age group (5-9 years- Junior WIFS):

Weekly 1 Iron and Folic Acid tablet is provided to the children (School going / non school going children) in the age group of 5 to 9 years for 50 weeks in a year with biannual deworming with one tablet of Albendazole tablet 400 mg during the National Deworming days conducted once in 6 months (February and August of every year). Each tablet containing 45 mg. of elemental iron + 400 mcg. of folic acid, sugar coated - pink colour.

3. Adolescent Boys & Girls (10 – 19 ) Years:

Weekly 1 Iron and Folic Acid tablet is provided to the Adolescent Boys & Girls of 10 – 19 years age (School going / non school going children) in the age group of 5 to 9 years for 50 weeks in a year with biannual deworming with one tablet of Albendazole tablet 400 mg during the National Deworming days conducted once in 6 months (February and August of every year).

4. Pregnant women:

  • For pregnant mothers, Iron and Folic Acid tablets is provided every day from second trimester of Pregnancy till delivery (Each tablet contains 100 mg elemental Iron + 500 mcg Folic Acid Sugar-coated, red colour) and Deworming is done with albendazole 400mg during 14th week of gestation.
  • For Moderate anemic Mothers (Hb level- 7.1 to 8.9 gm/dl), Intra venous IV Iron sucrose (100 mg) infusion is given.
  • For Severe Anemic Mothers (Hb level < 7gm/dl), Blood Transfusion is done.

5. Lactating Mother:

For Lactating mother one Iron and Folic Acid tablet is provided for 180 days in post-partum period every day (Each tablet contains 100 mg elemental Iron + 500 mcg Folic Acid Sugar-coated, red colour).

Implementing units:

Total No. of HSC: 8713

Total No. of (PHC): 1885 ( Rural PHC – 1422 & Urban PHC – 463)

Total No. of Community Health Centre (CHC): 400 ( Rural CHC – 385 & Urban CHC – 15)

Total No. of Sub – District Hospital (SDH): 278 ( Taluk hospital – 204 & Non -Taluk hospital – 67 & WCH - 7)

Total No. of District Hospitals (DH): 31

Total No. of Medical College & Hospitals (MCH): 23

Mother's Absolute Affection (MAA) program/Baby friendly Hospital initiative (BFHI)

Breastfeeding is an important child survival intervention. Breastfeeding within an hour of birth could prevent 20% of newborn deaths. Infants who are not breastfed are 15 times more likely to die from pneumonia and 11 times more likely to die from diarrhoea than children who are exclusively breastfed.

Given the overwhelming evidence available on the impact of breastfeeding on reduction of neonatal mortality and infant mortality, it is imperative that efforts are intensified to improve optimal breastfeeding practices.

Thus, "MAA – Mother's Absolute Affection" an initiative to improve Infant and young child feeding (IYCF), is being implemented in Tamil Nadu since August 2016.

Goals & Objectives of the Program

The GOAL of the ‘MAA’ Program is to revitalize efforts towards promotion, protection and support of breastfeeding practices and young child feeding practices, through health systems to achieve optimal IYCF and child Nutrition.

The following are the OBJECTIVES of the Program in order to achieve the above mentioned goal:

  1. Build an enabling environment for breastfeeding through awareness generation activities, targeting pregnant and lactating mothers, family members and society in order to promote optimal breastfeeding practices. Breastfeeding to be positioned as an important intervention for child survival and development.
  2. Reinforce lactation support services at all public health facilities through trained healthcare providers and through skilled community health workers
  3. To incentivize and recognize those health facilities that show high rates of breastfeeding along with processes in place for lactation management.

Implementing Units

All health facilities which are providing maternal and child health care

  • DME Hospitals – 24
  • DMS Hospitals – 309
  • Primary Health Centers - 2270

Components of the MAA Programme

The Programme will be implemented at three levels:

  • Macro-level through mass media,
  • Meso-level in all health facilities and
  • Micro-level at communities

An overview of the components of the Programme is as below


Capacity Building

  1. One day sensitization of ASHA – Orientation on benefits of Breastfeeding. Basic concepts of Breastfeeding and Complementary feeding.
  2. IYCF Trainings for VHN/ANMs of all Sub centers in a phased manner - ANMs are oriented in 1 day "MAA" sensitization module and trained in 4 days IYCF training module and provided with IYCF Counseling "MAA" flipchart.
  3. ANMs/Nurses/Doctors at all delivery points /Facilities
    1. Role re-enforcement regarding lactation support services -1 day orientation
    2. 4 day IYCF training package.
  4. Orientation on provisions of IMS ACT for facility and community Health and nutrition workers


Those facilities that perform well will be awarded and recognized at state level, which would act as a motivation for continuing the good work. The nominated and certified facility would be awarded as "MAA- Mother's Absolute Affection award".

A Team Cash award of Rs. 10,000 per facility would be provided after certification following the validated criteria.


ALL the ten steps of BFHI including the adherence to IMS –ACT would be assessed. The assessment by an external assessor would include interviews of Administrators, health care workers involved in mother and child care, mothers themselves and their family apart from assessing the program implementation. If assessor finds any gap, the facility is given time to correct those gaps and reassessment chance will be given to the Institution.

Monitoring and Evaluation

Key Indicators as per MAA guidelines would be collected.



The target will be to get all the facilities converted to awarded units


National Deworming Day (NDD)


The National Deworming Day is an initiative of Ministry of Health and Family Welfare, Government of India to make every child in the country worm free. This is one of the largest public health programs reaching large number of children during a short period. This Program is being implemented by the state since 2015.

Helminths (worms) which are transmitted through soil contaminated with fecal matter are called soil-transmitted helminths (Intestinal parasitic worms). Soil transmitted helminths infection can lead to anemia, malnutrition, impaired physical, mental & cognitive development, and reduced school participation.

Goals & Objectives of the Program

The objective of National Deworming Day is deworming all the children (school enrolled and non-enrolled) aged 1 to 19 years, through the platform of schools and Anganwadi Centers in order to improve their overall health, nutritional status, access to education and quality of life.

Target beneficiaries

All children (both boys and girls) in the age group of 1-19 years


Bi-annual Deworming – February and August of every year

Implementing Units

  • Number of Government/Government aided schools – 45,696
  • Number of private schools – 12,632
  • Number of AWCs – 54,439
  • Total number of children to be benefitted -2,24,37,283
  • Teachers administer Albendazole to all the school enrolled children
  • Anganwadi workers (AWWs) administer Albendazole to all children aged 1-5 years and out-of-school children and adolescents (1-19 years) at the Anganwadi centre (AWC)
  • Non-enrolled children are mobilized to the nearest AWC for deworming through support of VHV/Community Volunteers

Dosage Schedule

NDD Dosage

Important: Children who are sick or are on medication on deworming day/mop up day (MUD)should not be given the drug. These children should be advised to take Albendazole tablet upon recovery or after consultation with the medical doctor.

Monitoring and Evaluation

  1. RBSK Mobile Health Teams at Block level will monitor the implementation of National Deworming Day in the field. Each team will visit at least four schools/Anganwadi centres on both NDD and MUD (Mop up day).
  2. District monitoring would be undertaken by DDHS, DTTMO, DMCHO and APM
  3. All State level officers of DPH & NHM would conduct the State Monitoring
  4. Designated teams from the MoHFW, GoI will monitor NDD activities by randomly visiting schools and Anganwadi Centers across States / UTs.

Recording and Reporting Process

NDD Dosage


Home Based Care for Young Child (HBYC)

This is a Joint initiative of Ministry of Health and Family Welfare and Ministry of Women and Child Development. Under National Health Mission, Home-Based Care for Young Child Programme (HBYC) is rolled out as an extension of the Home Based New Born Care programme (HBNC) which is currently implemented across the country. Under HBNC, home visits by ASHAs to the infants ends at 42nd day after birth and there exists a gap in the household contact of ASHAs with the child beyond this period except the ones for immunization.

Addressing this gap in health system contact is crucial. Therefore, additional home visits by ASHAs between 3rd and 15th months were proposed under HBYC to fill this gap.

Under Home Based Care of Young Child (HBYC) programme, the additional five home visits will be carried out by ASHA/AWW, from 2-3 month onward ASHAs/AWWs will provide quarterly home visits (3rd, 6th, 9th, 12th and 15th month). The quarterly home visits schedule for low birth weight babies, SNCU & NRC discharges will now be harmonized with the new HBYC schedule.

Goals of the Program

  1. Promoting good CHILD NUTRITION by appropriate infant and young child feeding practices.
    1. Early initiation of breast feeding within one hour of birth,
    2. Exclusive breast feeding for the first 6 months of life,
    3. Appropriate and adequate complementary feeding from 6 months of age with continuation of breastfeeding.
  2. Ensuring age appropriate immunization.
  3. Ensuring optimal early childhood development.
  4. Ensuring reduction in child morbidity and mortality by appropriate health care seeking behaviour.

The purpose of the additional home visits by ASHAs/AWWs are promotion of evidence based interventions delivered in four key domains namely nutrition, health, child development and WASH (water, sanitation & hygiene).




Implementation of the Programme

HBYC Programme is being implemented in Tamilnadu since September 2018 in the aspirational districts (Ramanathapuram and Virudhunagar) and the following activities have been undertaken.


  • 22 blocks (11 blocks in Ramanathapuram district and 11 blocks in Virudhunagar district).
  • HBYC guidelines prepared in consultation with the DPH&PM and issued by NHM.
  • HBYC guidelines customized and communicated to two Districts i.e. Ramanathapuram and Virudhunagar under Phase 1 (TAMIL VERSION).
  • HBYC training at State / District / Block / Facility level at Ramanathapuram and Virudhunagar completed so as to implement the programme in aspirational district initially. Report on training status:

Training Period: Jan 2019 to Mar 2019

No of Batches Conducted: 129

No of Functionaries trained: 3837

From April 2019 to 31 March 2020, about 30,204 children in the age group of 3 months to 15 months have benefitted in the 2 Aspiration Districts (Phase1).

  • Incentives to ASHA and AWW are being given.

The AWW/ASHAs are provided with performance based incentive. Under this programme, performance based incentive of Rs 250/- for 5 visits will be provided to the AWW/ASHAs. In areas where ASHA are not available, the AWW will be paid incentives based on their performance.


  • For Scaling up of HBYC 21 HUDs were selected for phase 2 in additional to HUDs of aspirational districts.
  • In the 39th Executive Meeting (Agenda No: 54/39/2020) The Mission Director NHM was permitted to extend the HBYC Programme in the 10 more districts (In addition to Aspirational districts) instead of 21 HUDs proposed through DPH&PM in coordination with the Directorate of ICDS.
  • The Districts selected are prioritized based on the high Infant Mortality Rate (IMR) in the Health Unit District. The Following districts were selected.
    • Tiruvannamalai
    • Thanjavur
    • Tirupathur
    • Krishnagiri
    • Pudukkottai
    • Theni
    • Kallakurichi
    • Villupuram
    • Tiruvarur
    • Dindigul

Supportive Supervision

  • By SHN/CHN/BMO/DMCHO/DDHS for ASHA/VHN services and CDPO, PO for AWW Services.
  • At least one visit in every month.
  • VHN should undertake joint home visits with ASHAs and AWW to at least 10% new born in her sub centre area.
  • Activity of VHN should be monitored by Medical Officer and reviewed at district level.

Monitoring and Evaluation

Monitoring and reporting being done by officials attached with Maternal and Child Health wing under Directorate of Public and Preventive Medicine.

The progress of implementation of the HBYC Programme will be closely monitored at the State Level on monthly basis. The Implementing Districts are expected to report every month the details of the trainings and home visits conducted under HBYC in the structured format. Quarterly data would be submitted to MoFHW, GoI. The data collection system will maintain child wise tracking of young child provided HBYC home visits and will be linked with RCH portal of Government of India.

The Outcome of the HBYC visits would be measured in terms of child health and nutrition indicators which are specified in the team based incentive system for front line workers by MoHFW. In addition, evaluation of HBYC will be integrated as part of review and monitoring of Child Health activities

Facility Based Newborn Care program


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Rotavirus Vaccine (RVV) Expansion


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Management of Diphtheria outbreak


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Janani Suraksha Yojana (JSY)

Janani Suraksha Yojana (JSY)

Janani Suraksha Yojana (JSY) is a safe motherhood intervention under the National Rural Health Mission (NHM) since 2005. It is being implemented since April 2005 with the objective of reducing out of- pocket expenses during delivery and reducing maternal and infant mortality by promoting institutional delivery among pregnant women.

Government Orders obtained: G.O. (2D.) No.18, H&FW (EAP.II.1) Dept. Dated: 24.02.06

Cash assistance to Pregnant mother who belong to below poverty line under JSY - Expenditure sanctioned

Implementing units:

Institutions in Rural area : 341568
Institutions in Urban area : 96668


  • Under the JSY, pregnant women are entitled for cash assistance irrespective of the age of mother and number of children for giving birth in a government or accredited private health facility.
  • This scheme entitles women for accessing Maternal and child health services with a financial assistance of Rs.700/- and Rs.600/- in rural and urban areas respectively and Rs.500 for home deliveries.
  • SC Population (20.01%) and ST Population (1.10%) in Tamilnadu are also benefitted under JSY.
  • NHM is providing additional inputs such as incentives to ASHA & administrative expenses every year.


Janani Sishu Suraksha Karyakram (JSSK)

Janani Shishu Suraksha Karyakram (JSSK)

Janani Shishu Suraksha Karyakram (JSSK) was launched in Tamilnadu since September 2011. The scheme is to benefit pregnant women who access Government health facilities for their delivery so as to improve Maternal and Child healthcare and to alleviate out of Pocket expenditure on health care. Under JSSK programme, there is an entitlement of free drugs, free referral transport, diagnostics including diet during the duration of stay for every pregnant women and sick neonate up to one year of age.

Government Orders obtained: G.O (Ms) No.220, H & Fw (EAP II -2) Dept., Dt.10.09.2011)

Tamilnadu National Initiative - JSSK guarantying zero expense deliveries & zero expenditure treatment of sick newborn in all public health institutions & provision of free transport

Key features of the scheme

  • The initiative entitles all pregnant women delivering in public health institutions to absolutely free and no expense delivery, including caesarean section.
  • The entitlements include free drugs and consumables, free diet up to 3 days during normal delivery and up to 7 days for C-section, free diagnostics, and free blood wherever required.
  • This initiative also provides for free transport from home to institution, between facilities in case of a referral and drop back home. Similar entitlements have been put in place for all sick infants.

Implementing units:

  • Total 32 districts in Tamilnadu
  • Total 385 blocks

The following are the Free Entitlements for pregnant women:

  • Free and cashless delivery
  • Free C-Section
  • Free drugs and consumables
  • Free diagnostics
  • Free diet during stay in the health institutions
  • Free provision of blood
  • Exemption from user charges
  • Free transport from home to health institutions
  • Free transport between facilities in case of referral
  • Free drop back from Institutions to home after 48hrs stay

The following are the Free Entitlements for sick infants:

  • Free treatment
  • Free drugs and consumables
  • Free diagnostics
  • Free provision of blood
  • Exemption from user charges
  • Free Transport from Home to Health Institutions
  • Free Transport between facilities in case of referral
  • Free drop Back from Institutions to home


Rashtriya Kishor Swasthya Karyakram (RKSK)

Rashtriya KishorSwasthya Karyakram (RKSK)

In India, Adolescents between age of 10 and 19 years account for nearly one fifth of the total population. In order to respond effectively to the needs of adolescent health and development, it is imperative to situate adolescence in a life span perspective within dynamic Psychological, sociological, Cultural and economic realities with better health in order to prepare them for further productive youths.

In this regard Ministry of health and Family Welfare has developed a comprehensive strategy, Rashtriya Kishor Swasthya Karyakram and launched in January, 2014. The six strategic priorities being nutrition, sexual and reproductive health, Non-Communicable Diseases, substance misuse, injuries & violence and mental health.

This activity is being implemented in Tamilnadu since 2014-15 in 9 high priority districts as first phase. In the year 2017-18 the programme has been extended to 10 more districts in the State. Therefore, this programme is being implemented in 19 districts. 4093 villages hae been covered in this programme so far.

Peer educators are selected as 4 per VHSNC and they are trained regarding adolescent health. Adolescent health Club meetings is conducted in sub centres with support from trained Village Health Nurses (VHNs). Adolescent Health Day is conducted by VHSNC once in 3 months. 442 Adolescent Friendly Health Clinics (AFHCs) have been established so far. 220143 (Apr’19 to Mar’ 20) adolescents have received clinical services and 221807 adolescents have received counseling services in these AFHCs.

The success of RKSK could be viewed in the active participation of community peer groups and effective functioning of the Weekly Iron Folic Acid Supplementation (WIFS) and Menstrual Hygiene Scheme (MHS) in schools and Anganwadi centres.

Weekly Iron Folic Acid Supplementation (WIFS)

The programme involves distribution of one Iron and Folic Acid (IFA) tablet a week to all adolescent girls and boys (10 to 19 years of age), both in school and out of school along with biannual de-worming (February and August every year). The IFA and de-worming tablet would be distributed through the school for school going students and through field health functionaries for non-school going girls and boys. Total number children benefitted from April 2019 to Mar 2020 is 469,21,821.

Menstrual Hygiene Scheme

The Programme increases the awareness about menstrual hygiene among rural adolescent girls. The Scheme also increases access to & normalize use of quality sanitary napkins at affordable prices in rural adolescent girls. It also gives importance to ensure safe disposal of sanitary napkins in an environment friendly manner.


WeeklyIron and Folic Acid Supplementation Programme (WIFS)


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Menstrual Hygiene Scheme(MHS)


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Peer Education (PE) Programme


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Communicable Diseases+

National Vector Borne Disease Control Programme (NVBDCP)


In Tamil Nadu, Malaria is confined to some of the Urban, Coastal and Riverine areas such as Corporation of Chennai, Ramanathapuram, Paramakudi, Thoothukudi, Kanyakumari, Krishnagiri, Dharmapuri and Thiruvannamalai.

Malaria screening facility is available in all PHCs and Government hospitals. All fever cases have been screened for malaria by collecting blood smears through Active Case Detection and Passive Case Detection. These slides are being examined within 24 hours and if malaria is confirmed, radical treatment being given within 48 hours as per NVBDCP drug schedule.

Due to intensive control measures carried out by the department, the incidence of malaria has been declined considerably. For the year 2018, malaria incidence (3758 cases) has been decreased when compared with the year 2017 (5444 cases). In TamilNadu, 75% of cases are reported from Chennai.

The goal of 12th five year plan for malaria is to reduce (API) Annual Parasitic Incidence <1 in all districts/state.


Dengue Fever (DF), an outbreak prone viral disease is transmitted by Aedes mosquitoes. DF is characterized by fever, headache, muscle and joint pains, rash, nausea and vomiting. Some infection results in Dengue Haemorrhagic Fever (DHF).DF and DHF are caused by the four dengue viruses DEN 1, 2, 3 and 4, which are closely related antigenically. Infection with one serotype provides lifelong immunity to that virus but not to the others.

Aedes aegypti (Ae aegypti) is the main vector species of DF/DHF in India and is common in most of the urban areas on account of deficient water management, presence of non-degradable tyres and long-lasting plastic containers as well as increasing urban agglomerations and in many instances inability of the community to respond to the need to eliminate mosquito breeding sites. Overhead tanks, ground water storage tanks are usually the primary habitats. Aedes aegypti breeds almost entirely in manmade water receptacles found in and around households, construction sites, and factories. Natural larval habitats are rare, but include tree holes, leaf axles and coconut shells. The population of Ae aegypti fluctuates with rainfall and humidity. During the rainy season, when survival is longer, the risk of virus transmission is greater. The rural spread of Aedes is a relatively recent occurrence associated with increase in breeding sites.

In Tamil Nadu,for diagnosis of the disease, the Government of India has identified 30 Sentinel Surveillance Hospitals including Medical College Hospitals, Zonal Entomological Teams, Institute of Vector Control and Zoonoses, Hosur, and District Headquarters Hospitals-Cuddalore and Ramanathapuram and 1 Apex laboratory (King Institute of Preventive Medicine and Research, Guindy) for diagnosis of Dengue and Chikungunya. The Public Health department in coordination with the local bodies and other departments regularly undertake anti larval measures by source reduction of vector breeding places like artificial containers such as broken utensils, discarded tyres, plastic waste cups and broken bottles for the control of Aedes mosquitoes which spread dengue fever.

The State which had reported 23294 cases in 2017 was able to reduce it to 4486 cases in 2018.The Indian medicines such as Papaya juice extract, Nilavembu and Malaivembu kudineer along with conventional medicine are used for the control of Dengue. Daily surveillance is carried out and the disease is now under control.


Chikungunya is caused by a virus and is transmitted to humans by Aedes mosquitoes. 131 cases were reported during 2017,during the year 2018, 284 Cases are reported. The prevention and control measures against Chikungunya are carried out in an integrated manner with the Dengue control measure.


Japanese Encephalitis (JE) is a mosquito borne zoonotic viral disease. The virus is maintained in animals, birds, pigs, which act as the natural hosts. Pigs & wild birds are reservoirs of infection and are called as amplifier hosts in the transmission cycle, while man and horse are dead end hosts. The virus does not cause any disease among its natural hosts and transmission continues through mosquitoes belonging to culex mosquito(vishnui group). Vector mosquito is able to transmit JE virus to a healthy person after biting an infected host with an incubation period ranging from 5 to 14 days.

There are 12 endemic Districts in the State namely Perambalur , Villupuram, Cuddalore, Tiruvannamalai, Virudhunagar, Tiruchirapalli, Thanjavur, Tiruvarur, Madurai, Pudukottai, Karur and Thiruvallur districts. JE Vaccination campaign with SA 14-14-2 type of JE Vaccine is carried out in all these districts in a phased manner since2007 for the children 1-15 years of age .All these districts are fully covered under routine Immunisation as on 2014.

Japanese Encephalitis Control Units at Cuddalore, Villupuram, and Perambalur with Monitoring Unit in Chennai are carrying out Japanese Encephalitis Vector Control activities.

Acute Encephalitis Syndrome (AES) Surveillance is being carried out in District Headquarters Hospitals, Medical College Hospitals and major private hospitals. Serum samples are taken from the AES cases for diagnosis of JE. Lab diagnosis is done in 7 Sentinel Surveillance Hospitals which includes King Institute of Preventive Medicine and six Medical College Hospitals. In 2017, 127 JE cases with 2 deaths and in 2018, 147 cases with nil deaths.

Considering the complexity of JE/AES (Acute Encephalitis Syndrome) problem ,a comprehensive National Programme on Prevention and Control of JE/AES with the participation of concerned Ministries/ Departments has been launched. The goal of the Programme is to reduce morbidity, mortality and disability in children due to JE/AES. Tamil Nadu is one of the five States where this programme has been started.

JE vector monitoring is being carried out regularly in the endemic districts. Fogging operation is being carried out in villages where suspected JE cases are reported.


The National Filaria Control Programme is being implemented in Tamil Nadu since 1957. There are 14 filaria endemic districts namely, Kancheepuram, Thiruvallur, Vellore ,Cuddalore, Villupuram, Trichy, Perambalur, Pudukottai, Thiruvannamalai, Thanjavur, Thiruvarur, Ariyalur, Nagapattinam , Kanniyakumari in the State.Under Filaria Control Programme , 25 Filaria Control Units have been established which carry out disease control activities are carried out in 43 urban areas through Night Clinics (44) and Filaria and Malaria Clinics(42) and conduct anti larval operation.Larvicides and tablets (Di-ethyl Carbamazine (DEC) and Albendozole ) are procured from GoI funds. The entire operational cost is met by the State Government.

Single dose Mass DEC Drug Administration programme (MDA) is being carried out from 1997-98 in all endemic districts. The Mass Drug Administration programme was conducted in 14 endemic districts with the objective to bring down the mf rate to less than 1, namely, Kancheepuram, Thiruvallur, Cuddalore, Villupuram, Trichy, Perambalur, Pudukottai, Thiruvannamalai, Thanjavur, Thiruvarur, Ariyalur, Kanyakumari, Nagapattinam, Vellore and certain villages of Tirunelveli, Thoothukudi, Karur, Krishnagiri, Virudhunagar and Madurai and 64 wards in Chennai Corporation till 2012. In 2013, MDA was conducted in Vellore, Thiruvannamalai, Perambalur and Virudhunagar districts where the mf rate is more than 1. It is proposed to conduct MDA only in Tiruvannamalai & Cuddalore District during 2014.

In the districts with mf rate less than 1, Transmission Assessment Survey (TAS) using Immuno Chromatography Test Cards to detect the antigenemia. Based on MDA will stopped or continued. So far Thiruvarur (2012), Perambalur & Ariyalur (2013) has completed TAS. It is also planned to conduct TAS in remaining district in phased manner.

Govt.of Tamilnadu is giving financial support of Rs.400/- for LF Grade IV patients. Morbidity management kit is issued to LF patients for self care practice. Hydroceletomy are being conducted.


Leptospirosis being one of the reemerging infection of zoonotic origin. It requires timely diagnosis, treatment and control measures. Leptospirosis is being reported from most of the districts of TamilNadu. To strengthen the surveillance system and for early diagnosis of leptospirosis, 7 leptospirosis clinics are functioning in Thiruvallur and Madurai Districts. For screening of fever cases, IgM ELISA kits are procured and supplied to the 9 Zonal Entomological Teams and Institute of Vector Control & Zoonoses, Hosur. Outbreak investigation of leptospirosis is carried out by Zonal Entomological Teams and IVCZ, Hosur. 693 leptospirosis cases have been reported during the year 2013 and 2 deaths has occurred.


Revised National Tuberculosis Control Programme(RNTCP)

The Revised National Tuberculosis Control Programme (RNTCP) was started in the year 1997 and implemented in Tamil Nadu since 2002. RNTCP covers population of 790 lakhs and includes 35 District TB centres and 461 TB units. Tamil Nadu is the first state to implement nutritional support through Direct Benefit Transfer (DBT) under Nikshay Poshan Yojana in the country from April 2018.

It aims at diagnosing and caring for TB cases both in the public as well as in the private sector. The Drug sensitive is treated using Fixed Drug Combinations through Directly Observed Treatment (DOT) strategy.

All patients registered are now being monitored online using the web portal Nikshay. In 2018, 104055 were notified through this portal. Drug logistics are monitored and managed using Nikshay Aushadhi. Notification of cases by private sector is also ensured and so far 22,960 private health facilities are registered in Nikshay.

There are about 1984 Designated Microscopy Centres and 2 Intermediate Reference Laboratory across the state. Active case finding (ACF) was conducted in all the districts of Tamil Nadu using two CBNAAT vans.

The State has also implemented Programmatic Management of Drug Resistant TB services since 2009 which aims at early diagnosis of Drug resistance TB cases and treating them with appropriate regimen. Drug Resistant TB cases are managed at 7 Nodal Drug Resistant TB centre and 24 District Drug Resistant TB centre. Specialised diagnostic labs include 2 C&DST and 2 liquid culture (MGIT). New TB drugs namely Bedaquiline for Adult TB patients and Delamanid for pediatric TB patients have been introduced in our state for the first time in the country for DR- TB patients. 276 eligible patients being treated with Bedaquiline.

All presumptive TB cases are being screened for HIV and all HIV-TB co infected patients are started TB treatment and referred to ART centres. In 2018, 3047 were HIV-TB co infected cases.

Any child contact between the ages of 6 months and 6 years is given Isoniazid Propylactic Therapy to decrease the risk.

Government has decided to give Rs. 500 monthly for all TB patients taking treatment in both public and private sectors.

In 2018, the project “Joint Effort for Elimination of TB” was launched to engage the private service providers to notify the cases. Patient Provider Support Agency (PPSA) “ Zero TB Chennai Project - 2023” has been covered in 21 districts.

As the incidence of TB cases in Tamil Nadu is showing a steady decrease, “TB free Tamil Nadu- 2025”strategy in all districts based on the four pillars of national strategic plan namely “ Detect- Treat- Prevent- Build”(DTPB)has been initiated.


National Leprosy Eradication Programme(NLEP)


---- updating under progress !! ----

Integrated Disease Surveillance Programme (IDSP)


---- updating under progress !! ----

Non Communicable Diseases+

National Programme for Prevention and Control of Cancer and Diabetes


---- updating under progress !! ----

Cardiovascular Diseases and Stroke (NPCDCS)

National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke

The State of Tamil Nadu is a pioneer in implementing the Non-Communicable Diseases Intervention Programme covering all 32 districts. The program is implemented under the aegis of National Health Mission (NHM) as National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS).

The Program covers 2,516 Government health facilities across Primary / Secondary / Tertiary and municipal levels of health care. Under the programme, screening, treatment and follow-up services are provided for Hypertension, Diabetes Mellitus, Cervical and Breast cancer to all individuals aged 30 years and above attending any Government health facility in the State. In addition to the above, counseling services for individuals on ‘Life Style Modification’ are also provided. To augment the follow up services, activities have also been initiated to strengthen the Intensive Care Units (ICUs) in 29 District Headquarter Hospitals and two Medical College Hospitals besides strengthening the Cancer diagnostic services by establishment of Free Pathology Services in Districts without Medical College.

Performance under facility based or opportunistic screening for NCDs

The State level performance of all health facilities under NPCDCS program for screening of NCDs during the period from July 2012 to July 2020 is presented below;

Hypertension0 Screened 7,41,54,151
Positive 59,50,402
Diabetes Mellitus Screened 5,93,31,043
Positive 25,39,901
Screened for Cervical Cancer with VIA test 2,26,70,920
VIA Positive 6,06,949
Screened for Breast Cancer with CBE 2,81,15,255
CBE Positive 2,86,232


National Programme for Prevention and Control of Blindness(NPCB)


The Government of India, in order to reduce the prevalence of preventable blindness from 1.4% to 0.3% among population, launched the National Programme for Control of Blindness (NPCB) in the year 1976, as a 100% centrally sponsored programme. The implementation of the said programme was subsequently decentralized in 1994-95 with formation of District Blindness Control Society in each District of the State. In Tamil Nadu, Tamil Nadu State Blindness Control Society (TNSBCS) was formed on 01.04.1996 as a separate entity to give thrust to the goal by planning, execution and monitoring at the District Level.

The Tamil Nadu State Blindness Control Society is a registered body and headed by a senior ophthalmologist as Project Director who is also the State Programme Officer, NPCB. In the Districts a similar District Blindness Control Society (DBCS)is established, where the District Collector is the Chair person and the programme is executed by the District programme Manager (DPM), a Senior Ophthalmologist from the District Head Quarters Hospital or Government Medical College Hospital, as the case may be. The Tamil Nadu State Blindness Control Society has been brought under the over-all control of the Mission Diretor, State Health Society since 01.04.2007 and is a part of Non-Communicable Diseases programme.

The Cataract being the main reason for avoidable blindness, accounts for more than 64% of blindness. Under NPCB, the cataract operations are done at free of cost both in Government hospitals and NGO Hospitals and Private Hospitals. A Grant-In-Aid of Rs. 2,000/- (Rs.Two Thousand Only) per operation is paid to the NGOs who have made MoU with the DBCS.

The Development of strong eye-care facility supported by well-trained doctors is the necessity to fight avoidable blindness. Frequent training to ophthalmic Surgeon in various sub-specialities is also given under the scheme at various centres well established both in Government and NGO sectors using latest techniques.

Achievements in the year 2019-20

  1. There are 68 NGOs and 89 Government Hospitals in 38 districts of our state. 2,62,903 persons were operated for cataract under NPCB from April 2019 to March 2020.
  2. Children studying at 14,873 schools were screened for refractive errors and 1,90,817 free spectacles was issued to them from April 2019 to March 2020.
  3. An online eye donor registry with registration facility under URL www.hmis.tn.gov.in/eye-donor/ is maintained by us. 17 Eye Banks are functioning in our state. 8,824 Eye balls were collected from April 2019 to March 2020.
  4. A Pilot project under assistance of Queen Elizabeth Trust and Indian Institute of Public Health, Hyderabad to screen for Diabetic Retinopathy eye ailment has been initiated at the CHC level in Thirunelveli District and also extended to 3 more Districts Vellore, Cuddalore and Salem.
  5. Screening all low birth weight and preterm babies for Retinopathy of Prematurity is performed in 74 Special New born Care Units. For this a Tele ROP screening with RETCAM is started throughout the state @ Rs 126 Lakh.
  6. During the last 3 years Rs. 7 Crore worth ophthalmic equipment was supplied to Govt. Facilities at all levels.
  7. Comprehensive Hi-tech computerised eye clinic is to be started in all medical colleges and District Head Quarters Hospital (54 Places) @ Rs. 357.85 Lakh.
  8. New Eye Operation Theatre and Post-operative ward is constructed at 5 District Hospital and Sub District Hospital namely Tiruppur, Palani, Tiruchendur, Tindivanam and Cuddalore.
  9. A centre for excellence is constructed at Regional Institute of Ophthalmology, Chennai for Rs 65.60 Crore and another Regional Eye Care Centre at Raja Mirazdar Hospital Thanjavur for Rs 16.47 Crore.
  10. Fifteen ophthalmic surgeons underwent in-service training in ophthalmic sub specialities from our state under financial assistance of NPCB. Also training programme was conducted in “Retinopathy of Prematurity”, Sterilization of eye operation theatres, recent ophthalmic investigations, tele-ophthalmology and fundus photography for ophthalmic surgeons and PMOAs.

National Programme for Prevention and Control of Deafness(NPPCD)


---- updating under progress !! ----

National Mental Health programme (NMHP)


---- updating under progress !! ----

National Oral Health programme (NOHP)

Oral Health is vital for overall well-being and quality of life. Poor oral health can have a detrimental effect on general health. Taking into account the oral health situation in the country, Government of India has initiated a National Oral Health Programme to provide integrated, comprehensive oral health care in the existing health care facilities with the following objectives:

  • To improve the determinants of oral health
  • To reduce morbidity from oral diseases
  • To integrate oral health promotion and preventive services with general health care system
  • To encourage Promotion of Public Private Partnerships (PPP) model for achieving better oral health.

In order to achieve above listed objectives, in Tamil Nadu, the National Health Mission - Tamil Nadu (NHM TN) initiated the National Oral Health Programme in 2015-16 and now it is implemented in all the Districts across the State. NHM TN assists the State Government in initiating provision of dental care along with other ongoing health programmes implemented at various levels of the health care system to provide accessible, affordable and quality oral health care services. Funding has been made available through the State PIPs for establishment of a dental unit.

The NHM Dental Units are equipped with necessary trained manpower, equipment including dental chair and support for consumables are provided through the NOHP. These units are established primarily in Sub District Hospitals and Primary Health Centres across the State.


Manpower such as a Dental Surgeon and Dental Assistants are supported by NHM TN and are appointed on contractual basis.


Equipment for the dental unit such as dental chair, x-ray machine and other supportive instruments are procured through Tamil Nadu Medical Services Corporation ad are supplied to the NHM Dental Units by the State Government.


Funds are also sanctioned for the procurement of consumables required for the unit.

Oral Cancer Screening Programme

In Tamil Nadu, the burden of oral cancer is very high, contributing greatly to morbidity and mortality. The main risk factors for oral cancer are HPV, tobacco, alcohol consumption, and the rates are higher in disadvantaged groups, who are more likely to smoke or drink and have low access to dental care. Oral cancer is often diagnosed at a late stage, which results in poor prognosis and a low survival rate, hence screening and early detection is crucial.

National Health Mission in Tamil Nadu is leading the country by launching the Oral Pre-Cancer Screening program in 2016 to promote prevention and enable earlier detection. The State Government of Tamil Nadu have taken the initiative to identify Precancerous and Cancerous lesions in oral cavity through the NHM Dental units existing in Primary Health Centers and Sub District Hospitals. This innovative program supports the Oral Health professionals under NHM to raise awareness of Oral Precancer & Cancer, identify people at risk, discuss the risk factors, encourage behavior change, detect early signs, refer appropriately and reduce the impact of the disease.

The programme consists of two components - a door to door comprehensive survey is being carried out by the Dental Assistants and opportunistic (passive) screening by Dental Surgeons for patients attending OP.

A mobile application is used for screening for Oral Precancer and Cancer lesions and real time reporting, data generation and online analysis is being carried out.

Planned activity under the Oral Cancer programme:

  1. To entrust the age group (0-18) years to the RBSK scheme as it is flagged. (RASHTRIYA BAL SWASTHYA KARYAKRAM)
  2. A three-pronged approach to be used for the general population, namely,
    1. The actual survey by Dental Assistant – covering the area systematically.
    2. An opportunistic survey at the PHC & GH. Charts to be placed in the PHC's & GH's & all patients reaching PHC for various ailments, if users of tobacco /alcohol or self-appraised individuals, to be referred & seen by the Dental surgeon posted in the PHC. A register may be maintained at the PHC & entry with the respective VHN for follow up of cases.
    3. The health workers both male and female in various schemes can also refer cases to the Dentist in the PHC.
    4. The Hospital on Wheels – the mobile clinics can also be used to screen individuals as and when approached.

Capacity Building

The State Nodal Unit in Department of Public Health Dentistry, Tamil Nadu Government Dental College, Chennai helps in imparting training to the Oral healthcare professionals and as well as general healthcare professionals for an integrated approach to better oral health. The State Nodal Unit also monitors the implementation and progress of the programme from time to time through established mechanisms.


National Programme for the Healthcare of theElderly (NPHCE)


---- updating under progress !! ----

National Iodine Deficiency Disease Control Programme(NIDDCP)

National Iodine Deficiency Disorder Control Programme

The National Iodine Deficiency Disorder Control Programme is implemented in the State from 1991 and the state IDD Cell started functioning from 1.7.1994 onwards.


  • To promote consumption of iodised salt through various activities
  • To assess the magnitude of the Iodine deficiency disorders.


  • To identify the prevalence of iodine deficiency disorders through the surveys.
  • Conducting Health education session, IEC activities, advices on the dietary supplementation of iodised salt as a control measures.
  • Spot testing of the Salt samples for the retailers.
  • Spot testing of the kitchen salt samples
  • Testing of Non-Statutory salt samples in Food Analysis Laboratories and measuring the Iodine content in salt.
  • Supply of IEC materials to the PHCs for the conducting the regular awareness sessions.
  • Regular review of the programme at District Level by the Deputy Directors & at the State level by the Director.
  • Celebration of Global IDD prevention day throughout Tamil Nadu involving NGOs, Public, School Children for creating awareness among the community.

Notification of Govt

A notification under the prevention of Food Adulteration Act has been issued, banning the sale of Non-iodised salt for edible purposes. The Government have issued orders for sale of iodised salt through fair price shops by both Tamil Nadu Civil Supplies and Co-operatives in public distribution system in pouches in all districts.

Spot testing of the Salt samples for the retailers and spot testing of the kitchen salt samples are being done to assess the presence of iodine and know the availability and use of iodised Salt. During 2018, 14648 salt samples were tested from shops. In that 1970 samples are of nil iodine content, 1972 is less than 15ppm and 10706 is more than 15ppm. Now statutory salt samples are lifted and tested to know the iodine content in salt.

Non-Statutory salt samples are being lifted and sent to Food Analysis Laboratories for analysis to know the Iodine content in salt.Estimation of Urine Iodine Excretion done for 900 students in 3 districts.

Global IDD prevention day 2018 was celebrated throughout Tamil Nadu involving NGOs, Public, School Children for creating awareness among the community. First State Level Co-ordination Committee Meeting on National Iodine Deficiency Disorders Control Program (NIDDCP) conducted in 4th floor, Conference Hall, Secretariat, Chennai on 16.10.2018. Goitre survey will be conducted in five districts during 2018-19 as per the Govt. of India guidelines after receipt of funds from the Govt. of India. It is also planned to give wide publicity throughout the state about the importance of iodised salt to prevent iodine Deficiency Disorders among the community through Health education programmes in schools, Radio jingles, Television, Wall paintings, distribution of pamphlets, books etc., during Trade fair and other notified festivals.


National Programme for Palliative Care(NPPCD)


---- updating under progress !! ----

National Dialysis Programme(NDP)

National Dialysis Programme

End Stage Renal Disease continues to be a result of existing and emerging burden of non-communicable disease. Providing for renal transplant facilities for ESRD patients depends upon availability of infrastructure and robust organ donation system coupled with adequate availability of trained qualified manpower. Within the limited choices, dialysis practically remains the first and in majority of cases, the only choice for ESRD patients.

Every year about 2.2 Lakh new patients of End Stage Renal Disease (ESRD) get added in India resulting in additional demand for 3.4 Crore dialysis every year. With approximately 4950 dialysis centers, largely in the private sector in India, the demand is less than half met with existing infrastructure. Since every Dialysis has an additional expenditure tag of about Rs.2000, it results in a monthly expenditure for patients to the tune of Rs.3-4 Lakhs annually.

Keeping this in mind, strengthening of District Hospitals by providing affordable multispecialty care including dialysis services in district hospitals would be an important step in this direction.

To gain from available capacity of private sector existing in dialysis care segment and their capability to install and operate dialysis care system in quick time, and compliment the emerging strengths of public sector such as availability of drugs and diagnostics, it has been proposed that Dialysis program be undertaken in Public Private Partnership.

Solution Strategy

There are two main types of dialysis, which are Hemodialysis and peritoneal dialysis.

  1. Hemodialysis (HD, commonly known as blood dialysis): In HD, the blood is filtered through a machine that acts like an artificial kidney and is returned back into the body. HD needs to be performed in a designated dialysis centre. It is usually needed about 3 times per week, with each episode taking about 3-4 hours.
  2. Peritoneal dialysis (PD, commonly known as water dialysis): In PD, the blood is cleaned without being removed from the body. The abdomen sac (lining) acts as a natural filter. A solution (mainly made up of salts and sugars) is injected into the abdomen that encourages filtration such that the waste is transferred from the blood to the solution. There are 2 types of PD - continuous ambulatory peritoneal dialysis (CAPD) and automated peritoneal dialysis (APD). CAPD needs to be done 3 to 5 times every day, but does not require a machine. APD uses an automated cycler machine to perform 3 to 5 exchanges during the night while the patient is asleep.

Close medical supervision is not required for most PD cases, thus making it a feasible option for patients who may want to undergo dialysis in the home setting. Each treatment option has its advantages and disadvantages, which vary with the condition of the patient and presence of underlying diseases. It is therefore important for every patient with ESRD to discuss various treatment options in detail with his doctor before starting treatment.

Public Private Partnership for Hemodialysis services

Based on consultation with experts and discussion with some of the states implementing the Dialysis program in the PPP mode, the following was considered as the ideal and cost -effective approach.

  1. It is desirable to roll out dialysis services in the states, beginning with the District Hospitals in a PPP mode. Direct provisioning by the state governments would be time consuming and likely to be costly and risky.
  2. Service Provider should provide medical human resource, dialysis machine along with RO water plant infrastructure, dialyzer and consumables.
  3. Payer Government should provide space in District Hospitals, Drugs, Power and water supply and pay for the cost of dialysis for the poor patients.


National Tobacco Control Programme (NTCP)

About the Programme

Government of India launched the National Tobacco Control Programme (NTCP) in the year 2007-08 during the 11th Five-Year-Plan, with the aim to

  • Create awareness about the harmful effects of tobacco consumption,
  • Reduce the production and supply of tobacco products,
  • Ensure effective implementation of the provisions under “The Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, 2003” (COTPA)
  • Help the people quit tobacco use, and
  • Facilitate implementation of strategies for prevention and control of tobacco advocated by WHO Framework Convention of Tobacco Control.

NTCP in Tamil Nadu:

In Tamil Nadu NTCP is implemented by the State Tobacco Control Cell, functioning under the Directorate of Public Health and Preventative Medicine, Chennai since 2007.

The District Level activities under NTCP are carried out by the District Health Societies under the supervision of Deputy Director of Health Services. Currently, District Tobacco Control Cells are established in 10 Districts - Kancheepuram, Villupuram, Madurai, Coimbatore, Trichirapalli, Cuddalore, Nagapattinam, Tiruppur and Tirunelveli. Funds have been allocated funds under NHM TN in for carrying out the implementation of Tobacco control activities under the NTCP in the above-mentioned districts.

The major components of the Tobacco Control Programme in Tamil Nadu are as follows,

  • Establishment of Tobacco cessation centers.
  • Enforcement of Tobacco Control Law
  • Capacity Building of Various Stakeholders on Tobacco Control
  • Raising Awareness in Schools, Colleges and Other Educational Institutions
  • Declaration of Tobacco Free Educational Institutions
  • Organizing Mass IEC Awareness Campaigns
  • Taking Pledge against Tobacco use

Enforcement of Tobacco Control Law - Cigarettes and Other Tobacco Products Act, 2003:

Objective: To discourage the use or consumption of tobacco products by eliminating all forms of direct & indirect advertising, promotion & sponsorship of tobacco products.

SCOPE OF THE ACT: The Act is applicable to all products containing tobacco in any form i.e. Cigarettes, Cigars, Cheroots, Bidis, Gutka, Pan Masala (Containing Tobacco) Khaini, Mawa, Mishri, Snuff etc. as detailed in the schedule to the Act. The Act extends to whole of India.

Main Provisions of COTPA, 2003:


COTPA Enforcement in Tamil Nadu:

  • In India, Tamil Nadu is the State which collects maximum number of fine amounts from the violators of the “Cigarette and Other Tobacco Products Act (COTPA), 2003”.
  • Enforcement squad is formed at State and District, Village and Block Level to monitor the violations under the COTPA,2003.


SECTION 4: Prohibition of Smoking in Public Places


SECTION 5: Prohibition of Direct & Indirect advertisement of tobacco products


SECTION 6a: Prohibition of sale of cigarette or other tobacco products to any person who is under 18 years of age”.

SECTION 6.b: “Prohibition of sale of cigarette or other tobacco products in an area within a radius of 100 yards of anyeducational institutions”


Section 7: Depiction of Specified Pictorial Health Warning on all Tobacco Products packs


Ban on Hookah Bars:

  • Hookahs/ E- Hookah are Water pipes that are used to smoke.
  • It comes in different flavors such as Apple, cherry, Chocolate, Coconut, Strawberry etc.,
  • It usually works by passing heated charcoal heated air through the Tobacco mixture and water filled chamber.
  • Hookah smoke contains more Nicotine, Carbon monoxide, Tar than cigarette smoke.
  • It promotes nicotine addiction and exposure to second Hand Smoke (SHS) and causes gum disease, Tuberculosis, Chronic Lung Diseases and Cardio vascular diseases.

Objectives to ban Hookah

  • To minimize the potential health risks to Hookah users and protect non users from exposure to their emissions.
  • To prevent the initiation of Hookah by nonsmokers and youth with special attention to vulnerable groups like pregnant women.
  • Protect Tobacco control activities from all commercial and other vested interests related to Hookah including interests of the Tobacco industry

EXISTING REGULATIONS in favor of Banning Hookah

  • Nicotine is a poisonous drug and the sale, Supply, import, Manufacturing and trade of nicotine can be done through a proper license obtain under the Drugs and Cosmetics Act, 1940.
  • The Insecticides Act 1968’ Lists “Nicotine” as ‘Nicotine Sulphate’ as an Insecticide in the schedule made under Section 3(e) under the heading ‘List of insecticides’.
  • The Food Safety and Standards Act, at 2006 enacted to ensure availability of safe and whole sum food for human consumption, which inter alia from it using of tobacco and nicotine as ingredients in any food product
  • The manufacture, Storage and import Hazardous chemical rules 1986 made under the ‘Environment (Protection) Act, 1986 ‘also lists ‘Nicotine’ under the ‘Lists of Hazardous and Toxic Chemicals ‘in part - II of schedule – I as item no. 421.
  • The Central Government has also enacted the Juvenile Justice (Care and Protection) Act, 2015, that makes giving or causing to be given to any child any Tobacco products punishable with rigorous imprisonment for a term which may extend to 7 years and fine up to Rs.1 lakh.
  • Hence, the Nicotine in the form of Hookah is not allowable and cause extensive health problems not only for the users and also as Second Hand exposure to aerosol from Hookah to the bystanders and Non-Smokers

E- Cigarette Ban

  • Electronic Cigarettes are e-cigarettes include e-pens, e-pipes, e- Hookah & e- cigars which are all collectively known as ENDS Electronic Nicotine Delivery Systems, are battery operated Nicotine delivery devices that allow users to inhale an aerosol containing Nicotine.
  • The liquid used in ENDS contains Nicotine extracted from Tobacco and mixed with a base usually propylene glycol and may also include flavors, colors and other chemicals.

Harmful Effects of E-cigarettes

  • The E-cigarette aerosol that users breathe from the device and exhale contains harmful and potentially harmful substances including - Nicotine, ultrafine particles that can be inhaled deep into the lungs, flavoring such as diacetyl, a chemical linked to a serious lung disease, volatile organic compounds cancer causing chemicals and heavy metals such as Nickel, Tin and Lead.
  • Nicotine is an addiction producing substance. Nicotine is dangerous to pregnant woman and toxic to the developing fetuses. Nicotine can harm adolescent brain development

Ban on E-cigarettes:

  • The govt. of Tamil Nadu prohibit the manufacture, sale(including online sale), distribution, Trade, display marketing, advertisement, use, import and possession of Electronic Nicotine Delivery Systems (ENDS) Known as E- Cigarettes are any other names or components thereof with immediate effect in state of Tamil Nadu in public interest vide G.O. (Ms) No. 384, H&FW (EAP -II) department dated 14.11.2018.
  • The Govt. of India has prohibited the Electronic Cigarette promulgation of “The prohibition of Electronic Cigarettes (Production, manufacture, import, Export, transport, sale, distribution, storage and advertisement) Ordinance 2019.

Penalties / Punishment in force for Manufacturing and Selling E-Cigarettes:


Capacity Building of Various Stakeholders on Tobacco Control:

  • Training on Tobacco Control is provided to officials from other Government departments such as Police, Education, Railway, Airport, Health, Teachers etc.
  • Non-government organizations such as Civil Societies, Self Help Groups, Youth Club, Police boys club, etc., are trained on Tobacco control.
  • Medical Officers, NCD Staff Nurses, ICTC Counsellors and youth health volunteers have been trained on Tobacco Cessation methodologies for setting up of tobacco cessation clinic/ centers in their Hospitals / Primary Health Centers.

Declaration of Tobacco Free Educational Institutions:

In Tamil Nadu, 13080 schools, and 1344 colleges are declared as ‘Tobacco Free Educational Institutions’ under specified criteria since 2007. In addition to that the following places are declared Tobacco free in Tamil Nadu.

  • Smoke Free Embassies
  • Smoke-Free Police Commissioner’s Office and Police Stations
  • Smoke Free Prisons in Tamil Nadu
  • Smoke Free Transportation
  • Smoke-Free Tamil Nadu Postal Circle
  • Smoke Free Educational Institutions, Medical Colleges/ Dental College/ Government Hospitals/ PHCs
  • Smoke Free Government Buildings
  • Smoke Free Hotels/ Restaurants/ Malls
  • Smoke Free Industries,
  • Smoke Free Slums in Chennai City
  • Tobacco Free Cinema Theatres
  • Smoke Free Villages
  • Smoke Free High Court, Secretariat and so on

Organizing Mass IEC Awareness Campaigns

World No Tobacco Day is celebrated on the 31st of May every year. On this day National Health Mission – Tamil Nadu and Directorate of Public Health & Preventative Medicine, Chennai organizes campaigns to raise awareness on the harmful and deadly effects of tobacco, second hand smoking and Tobacco Control laws. The focus of the campaign is to increase awareness on ill effects of tobacco on people’s health causing Non-Communicable Diseases, Cancer and many more. Mass IEC campaigns such as celebration of ‘World No Tobacco Day’, Rallies, IEC on Wheels, Human Chain, Signature campaign, distribution of pamphlets etc. have been held on regular basis to educate Public about ill-effects of tobacco.

For more information or to Report Violations Contact:

State Tobacco Control Cell O/o. DPH & PM
Email: ntcptn@gmail.com
Phone: 044-24335080
Toll Free No.1800110456
Important Links
National Tobacco Control Programme – MoHFW, GOI
Operational Guidelines for National Tobacco Control Programme
COTPA, 2003


National Programme for Prevention and Control of Fluorosis (NPPCF)

To address the problem of fluorosis, mainly due to intake of high fluoride through drinking water, the National Programme for Prevention and Control of Fluorosis (NPPCF) was initiated in 2009 in Dharmapuri District. Strategies:

  • Surveillance of fluorosis in the community and school children.
  • Capacity building in the form of training and man power support.
  • Diagnostic facilities in the form of laboratory support & equipment including ion meter to monitor the fluoride content in water and urinary levels; health education.
  • Management of fluorosis cases by providing for corrective surgeries and rehabilitation.

Since initiation, 42887 people in 141 villages surveyed. There are about 79 Fluoride affected villages (data from MDWS as on Dec 2018) and 137 Fluoride affected habitations (data from MDWS as on Dec 2018 ).

Children between 6-11 years surveyed in 551 schools. In which 19514 were suspected with dental fluorosis.

Last January a surgery done for Skeletal Fluorosis affected child (Date of surgery 24.1.17) child in recovery.

Video spot / Interviews with experts on local TV / Community Radio.Posters are put up in all PHCs, GH, Dharmapuri Medical college, Schools, ICDS and Fluoride affected villages.Pamphlets / booklets distributed to all Medical Officers, Laboratory Technicians, Paramedicals, CHN, SHN, VHN, HI, BHS, ANH, NMS, Health Workers of ASHA and AWWs, Child Development Department, PMOA'S (Paramedical Ophthalmic Assistant) ICDS (CDPO'S), IMA Doctors & School Teachers and Habitation Villages.


Population based NCD screening(PBS)


---- updating under progress !! ----

Occupational Health

Occupational Health Services for Unorganized sector workers

In Tamil Nadu, the un-organized sector work force constitute 93% of the total workforce (Census 2011). They suffer from various occupation-induced diseases like Silicosis, Asbestosis, Deafness, Irritant Dermatitis, Spondylosis etc. Since most of the occupation-induced diseases result in irreversible damage, timely screening, prevention and early treatment is the way forward.

Government has issued orders for implementation of occupational health services for unorganized sector workers in all 385 blocks through respective MMUs. The MMUs visit the unorganized sector areas every Saturday and in addition one working day of first week of every month and provide occupational health services to workers. From April 2019 to July 2020, 1,08,707un-organized sector workers were screened, of whom 9,675workers were suspected and referred to district level hospital for further investigations and treatment.

Government has introduced 50 Mobile Health Clinics for providing Occupational Health Services for construction workers. This activity is funded by Department of Labour and Employment and implemented through NHM-TN.


Day Care Chemotherapy

Day Care Chemotherapy


District Level Day Care Chemotherapy Centres: Day care chemotherapy centres are functional in District Headquarter Hospital in all districts except in Tiruvannamalai, Karur and Pudukkottai where it functions in Government Medical College Hospitals.

The final treatment decision for the patients confirmed with cancer will be done by the tumour board at tertiary care hospital and the first chemo cycle also would be given there. Then, the follow-up or maintenance chemotherapy which involves more cycles will be given at District Headquarters hospital under supervision of one physician and staff nurse in each district trained in Day Care Chemotherapy. This will amply benefit cancer patients who find it most inconvenient to report to the same tertiary care institution for the maintenance chemotherapy and also incur lot of Out-of-Pocket Expenditure (OOPE) or fail to follow-up in the absence of such programme.


Transgender Clinic

Transgender Clinic

Transgender people are those gender identity is different from thr gender corresponding to the sex they were assigned at birth. Transgender people come from all walks of life , all ages, socioeconomic status and all part of the state. People realize that they are transgender at any age. They always ‘knew’ that they are not the kind of gender they were assigned at birth. This discrepancy between a person’s gender identity and that person’s sex assigned at birth is termed as ‘gender dysphoria’. A large pronounced discrimination is imposed on transgenders, due to which they are reluctant to seek health care services.

To cater to the specific needs of Transgender people, Government has established Multi-Specialty Transgender Clinics at Rajiv Gandhi Government General Hospital, Chennai and Government Rajaji Hospital, Madurai. The Multi-Specialty Transgender Clinic at RGGGH, Chennai runs every Friday.

Now in order to further improve the accessibility of transgender services in other parts of the State, Hon’ble Health Minister has announced in the floor of the Assembly (2019-20) that Multi-Speciality clinic for transgender will be established in 3 Government Medical College Hospitals at a cost of Rs.60 lakhs


Family Planning +
  • Post-Partum Intrauterine Copper Device (PPIUCD)
  • Injectable Contraceptive MPA (Antara Program)
  • Family Planning Logistic and Management Information System (FP-LMIS)
Trauma Accident and Emergency Initiative +
  • Trauma
  • PREM
Health Systems Strengthening +


National Quality Assurance Standards (NQAS)

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Name of the Activity :- To obtain Kayakalp Certification for all Hospitals

Back ground:

Swachh Bharat Abhiyaan (Clean India Campaign) launched on 2nd October 2014, focuses on promoting cleanliness in public spaces. Cleanliness and hygiene in hospitals are critical in preventing infections and also provide patients and visitors with a positive experience and encourages moulding behavior related to clean environment. As the first principle of healthcare is “to do no harm” it is essential to have all health care facilities clean and to ensure adherence to infection control practices.

To recognize such efforts of ensuring Quality Assurance at Government Health Facilities, the Government of India has launched a National Initiative to give Awards ‘KAYAKALP’ (Rejuvenating Public Health Care Facilities) in the year 2015 to the Government Health Facilities that demonstrate high levels of cleanliness, hygiene and infection control.

In Tamil Nadu, Kayakalp Award Programme being implemented in all Secondary Care and Primary Care facilities through the Directorate of Medical and Rural Health Services and Directorate of Public Health and Preventive Medicine respectively to improve the quality of healthcare services in Government Facilities. In the year 2015, this activity was initiated in Government District Head Quarters Hospitals. Since 2016, this activity gradually started in Sub District Hospitals, Community Health Centres and Primary Health Centres in all Districts. In the year 2019, this initiative was extended to Health Sub Centres functioning as Health Wellness Centres.

Kayakalp Award Programme includes three levels of assessment i.e. Internal Assessment Peer Assessment and State External Assessment based on Kayakalp checklist which consists of 7 criteria – Hospital Up-keep, Health Promotion, Sanitation & Hygiene, Support Services, Waste Management, Infection Control and Cleanliness beyond boundary wall at facility level. As per the guidelines of Kayakalp and Swachhta, District/Regional/State Quality Assurance Unit is monitoring Kayakalp Award Programme in all Government Health Facilities every year. The facilities which are enrolled in Kayakalp internal and peer assessments are being supported with gap closure funds to correct the non-compliance based on Kayakalp checklist. Finally, the facilities scoring 70% above in Kayakalp State External Assessment will be shortlisted for Kayakalp Award / Certification.


Objective of the Activity

The objectives of award scheme are as under:

  1. To promote cleanliness, hygiene and infection control practices in Public Health Care Facilities.

  2. To incentivize and recognize such public healthcare facilities that show exemplary performance in adhering the standard protocols of cleanliness and infection control.

  3. To inculcate the culture of ongoing assessment and peer review of performance related to hygiene, cleanliness and sanitation.

  4. To create and share sustainable practices related to improved cleanliness in public health facilities linked to positive health outcomes.

Number of Awards:

  • Best two District Hospitals in the State.
  • Best two Community Health Centres/Sub District Hospitals in the State.
  • One Primary Health Centre in every district.

Award amount:

  • Based on the set criteria prize winners will receive a cash award with a citation.
  • Certificate of Commendation plus cash award would be given to such facilities that score over 70%.

Level of Facility Ranked Awards Certificate of Commendation
District Hospital Winner – Rs.50 lakh; Runner Up – Rs. 20 lakh Rs.3 lakhs
CHC & SDH Winner – Rs.15 lakh; Runner Up – Rs.10 lakh Rs.1 lakh
Primary Health Centr Winner – Rs.2 lakh (per district) Runner Up – Nil Rs.50,000
Urban CHC Winner – Rs. 15 lakh ; Runner Up – Rs.10 lakh Nill
Urban PHC Winner – Rs.2 lakh ; Runner Up – Rs.1.50 lakh Rs.50,000
HSC – HWC Winner – Rs.1 lakh (per district) Runner Up – Rs.50,000 (per district) Rs.25,000

ROP and Supplementary PIP Approval (Year wise from 2007 - 08 to 2020 - 21)
Year Approval Amount ROP Approval Amount_ SUP PIP
2007-2008 - -
2008-2009 - -
2009-2010 - -
2010-2011 - -
2011-2012 - -
2012-2013 - -
2013-2014 - -
2014-2015 - -
2015-2016 233.13 lakhs -
2016-2017 1205.02 lakhs -
2017-2018 NHM – 847.68 lakhs NUHM – 124.12 lakhs -
2018-2019 NHM – 496 lakhs NUHM – 160.31 lakhs -
2019-2020 NHM – 1734 lakhs NUHM – 361.23 lakhs -

Implementation of the Programme
  • All Secondary care and primary care facilities
  • DMS institutions: 31 District Headquarters Hospital, 278 Sub District Hospitals
  • DPH institutions: 385 Community Health Centre (CHC), 1422 Primary Health Centre (PHC), 15 Urban Community Health Centre (UCHC) and 420 Urban Primary Health Centre (UPHC)

Physical Performance and Financial Performance (cumulative)

From the year 2015 to 2018, 26 District Head Quarters Hospitals, 102 Sub District (Taluk & Non-Taluk Hospitals), 207 Community Health Centres (CHCs) / Upgrade Primary Health Centres, 359 Primary Health Centres (PHCs), 5 Urban CHCs and 67 UPHCs have been awarded / certified with 70% above score under Kayakalp Programme in the State. During the year 2015-2018, Rs.2705.7 Crore been sanctioned of which Rs.2,100 Crore have been utilized for implementation of Kayakalp award programme in all facilities. 

G.O Obtained : G.O (Ms) No. 479 H&FW (EAP –II-1) Dept. Dt .18.12.2017

Final Outcome : Making all the Government health facilities as Kayakalp certified by 2021.



Name of the Activity : Labour Room Quality Improvement Initiative


Every pregnant woman and her family desires to have a joyful birthing experience with a safe and healthy mother and newborn. The services provided within the Labour Room ana Maternity Operation Theatre are critical to meet this aspiration.

Hence the Ministry of Health and a Family Welfare launched LaQshya to improve the Quality of Care in Labour Rooms and Maternity Operation Theatres in Government Medical Colleges, District Hospitals, Sub District Hospitals and other high case load Health Care Facilities , around childbirth and immediate postpartum period by having targeted intervention . Such patient-centric care, with delivery of appropriate and respectful care to each pregnant woman will go a long way in reducing mortality and morbidity of the mother and her newborn.

LaQshya : Goal & Objectives



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Community Strengthening +

Women Health Volunteers


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Village Health Sanitation and Nutrition Committee


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Patient Support Groups

Patient Support Groups (PSG) in UHC Blocks in Tamil Nadu

Patient Support Group (PSG) is a community-based intervention which is currently being implemented in Tamil Nadu for strengthening communitization efforts for better NCD control including compliance to treatment for common NCDs especially Hypertension and Diabetes. The group can address a lot of issue faced by them in the management of the NCDs and mutually benefit each other through sharing of experiences. It was piloted in the UHC blocks of 3 districts namely Cuddalore, Villipuram and Virudhunagar during August 2019 and is currently being up-scaled to all 47 UHC blocks of Tamil Nadu. This will be integrated with the visit schedule of ‘Hospital on wheels’ program through the Mobile Medical Units (MMU) in villages covered by MMU Team and in rest of the villages, it would be covered as part of the regular work plan of Health & Wellness centres.

The Women Health Volunteer from the SHG network who forms the first point of contact for the community in the household level screening for NCDs play a crucial role in the PSGs due to their closeness and association with the community. An incentive of Rs. 250/PSG meeting will be given to the leader in –charge for the PSG by the MMU /HWC for the conduct of the meeting which shall be met from the untied funds for HWC. The guidelines for the implementation of PSG was framed by State NCD Cell.

Under the program, the WHVs are also eligible to get additional incentives if they are able to achieve community control rate for HT and DM through Patient Support Groups. The State NCD Cell also has framed a guidelines for ‘Achieving community control for Hypertension and Diabetes Mellitus through Patient Support Groups’.


Accredited Social Health Activist (Asha)


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Community Action for Health (CAH)


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Village Health Nutrition Day


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Rogi Kalyan Samities


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Training & Capacity Building +
Training Capacity Building

Regional Training Institutes

Sl. No. Training Institute Address Contact Numbers
1 State Institute of Health & Family Welfare The Deputy Director,
Public Health and Preventive Medicine,
Institute of Public Health,
Poonamallee, Thiruvallur District,
PIN : 600 056
Phone 044 - 26272062
Fax 044 - 26272062
e-Mail dphpme@tn.nic.in
2 Regional Training Institute The Principal,
Health and Family Welfare Training Centre,
12/1, Old Commissioner Office Road,
Adhithanar Statue Rountana, Egmore.
PIN : 600 008.
Phone 044 – 28192922
Fax 044 – 28192922
e-Mail hfwtcegmore2013@gmail.com
3 Regional Training Institute The Principal,
Health and Family Welfare Training Centre,
Viswanathapuram, Madurai District.
PIN : 625 014
Phone 0452-2641169
Fax 0452-2641169
e-Mail hfwtcmadurai@gmail.com
4 Regional Training Institute The Director
Gandhigram Institute of Rural Health and Family Welfare Trust
Dindigul District,
PIN : 624 302.
Phone 0451 - 2452346
Fax 0451 - 2452347
e-Mail hfwtcggm@gmail.com
5 Regional Training Institute The Principal,
Health Manpower Development Institute,
Kandamanady, Villupuram Taluk,
Villupuram District, PIN : 605 401
Phone 04146- 259412
Fax 04146-259485
e-Mail hmdivpm2005@yahoo.com
6 Regional Training Institute The Principal,
Health Manpower Development Institute,
MohanNagar, Opp.to Steel Plant 2nd Gate,
Salem District.
PIN : 636 030
Phone 0427 - 2383331
Fax 0427 - 2383331
e-Mail principalhmdi@yahoo.com
7 Regional Training Institute The Health Officer,
Regional Training Institute of Public Health,
Pudukottai District.
PIN : 622 303
Phone 04322-242350
e-Mail rtiph.thiruvarankulam@gmail.com
8 IVCZ, HOSUR Institute of Vector Control and Zoonoses,
Hosur – 635126.
Phone 04344-276225
e-Mail ivczhosur@yahoo.co.in


Comprehensive Training Plan


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Trainings Conducted

In National Health Mission (NHM), capacity building of concerned health functionaries and allied staff is being given prime importance. Skill based and knowledge based trainings are being implemented to improve the skills & knowledge of service providers and exclusive trainings for creating awareness to the community on availability and utilization of health care services. Based on the training needs assessment, requirement of training programmes both at institutional and field level is being prepared from district/area specific data and district programme managers plan and included in the programme implementation plan of the State. Programmes approved by the NPCC are being implemented as follows;

  • Skill based trainings; Through major Government health institutions and 7 Regional Training Institutes
  • Knowledge based trainings; Through 7 Regional Training Institutes and district /block training teams
  • Community based trainings; Through the district /block training teams coordinated and supervised by the 7 Regional Training Institutes.

IMNCI Training

Integrated Management of Neonatal and Childhood Illness (IMNCI)

IMNCI is a strategy that targets children less than 5 years old, the age group that bears the highest burden of deaths from common childhood diseases. The IMNCI strategy includes both preventive and curative interventions that aim to improve practices in health facilities, in the health system and at home. It specifies integrated case management of the most common neonatal and childhood problems with a focus on the most common causes of death. The strategy includes three main components:

  • Improvements in the case-management skills of health staff through the provision of locally-adapted guidelines on IMNCI and activities to promote their use.
  • Improvements in the overall health system required for effective management of neonatal and childhood illness.
  • Improvements in family and community health care practices.

In Tamilnadu, as per the Government of India (GOI) operational guidelines, NHM has initiated IMNCI training in a phased manner based on IMR. IMNCI training was initiated in 2007-08 and at present all 31 districts have been covered.

The Institute of Child Health, Chennai is the nodal center for IMNCI training with a team of pediatricians and neonatologists for coordinating the planning, training and implementation of the IMNCI program.

Health and nutrition field functionaries are being trained for 8 days in IMNCI addition to the supervisory staffs who are being additionally trained for 3 more days on issues and solutions pertaining to the implementation of the programme at the grass root level.

Facility Based IMNCI Training

F-IMNCI focuses on the care of under 5 children during their stay at the health institutions. In Tamil Nadu, 22 Government Medical College Hospitals are imparting this training to the district health staff since April, 2010.

Revised Facility Based Newborn Care module integrating the additionalities recommended by GoI was then prepared by the State IMNCI Nodal Centre and Facility Based Newborn Care Programme was rolled out from Feb 2010. All the 22 Medical College faculties were oriented in January 2010.

The State IMNCI Nodal Centre has developed training modules for Facility Based Newborn Care. Training of Trainers (TOT) of 22 Government Medical College Hospitals were completed, which was then followed with in-service training of all the Pediatric & Obstetric faculty including Staff nurses of 22 Government Medical College Hospitals. With the modules for Facility Based Newborn Care and F-IMNCI from GOI, training for Master trainers for both the trainings has been completed. Navjot Sishu Suraksha Karyakram [NSSK] training has been incorporated in the F-IMNCI training programme itself.

Pre Service IMNCI Training

In Pre Service -IMNCI training, the medical students of the Government Medical Colleges (final and pre final years) have been trained in IMNCI programme by Department of Paediatrics and Special and Preventive Medicine.

IMNCI Refresher Training

Refresher training to the health and nutrition field functionaries at regular intervals is being provided at 7 Regional Training Institutes for 3 or 4 days.

Facility Based New Born Care Training

This training is being provided at to staff nurses and Paediatrician of SNUCs followed by observership programme for 14 days at Medical College Hospitals. New Born Stabilization Unit (NBSU) training also provided to Doctors and staff nurses for 4 days.

Home Based New Born Care Training (HBNBC)

Healthy new born with adequate birth weight will be staying at the health institutions for about 48-72 hours only. By then, the mother has to be oriented and guided towards neonatal and infant care practices so as to empower her to identify the early warning signs of sick newborn when she returns home. Health volunteers, SHG members & NGOs in the districts have been trained by the health staff to reinforce the practices and help mothers identify sick newborn and refer them back to the hospital in time and counsel and guide the mothers during the house visits. 1,500 Anganwadi workers have been provided training in HBNBC in 15 high IMR blocks. About, 2650 ASHAs working in tribal and hard to reach difficult areas have also been trained in HBNBC. (6th and 7th module)

SBA Training (Skilled Birth Attendant)

Skilled Birth Attendant training is imparted to PHC staff nurses/ANMs to improve their skills for conducting normal deliveries, identify high risk deliveries and early referral and care of mother and newborn baby during and after delivery. This is a 21 days training.

BEmONC Training (Basic Emergency Management of Obstetric & Neonatal care)

This is a six days training being imparted to the PHC Medical Officers to update their skills in Basic emergency management of obstetric & Neonatal complications & to reduce MMR/IMR.

EmOC Training (Emergency Obstetric care)

25 weeks training is being imparted to MBBS qualified medical officers to effectively manage 3rd stage of labor and high risk cases during labor. ISO & KGH, Triplicane, Chennai is the nodal center for this training and it also acts as a Tertiary Training Centre with Government Medical College Institutions ,Trichy, Tirunelveli, Madurai and Coimbatore responsible for district training.

LSAS Training (Life Saving Anaesthesia Skills)

Life Saving Anesthesia Skills is being imparted to MBBS qualified medical officers for 24 weeks in 11 Government Medical College Institutions.

In order to provide skilled man power for providing safe confinement to AN mothers, 24 weeks intensive training programme has been provided in Life Saving Anesthetic Skills and Emergency Obstetric Care to manage maternal complications in the Community Health Centers (CHCs), Taluk and Non-Taluk Hospitals. The training provides training in Obstetric Anesthesia and in Cardio-pulmonary cerebral resuscitation.

The trained Medical officers have been conducted caesarian sections and family planning procedures.

RTI/STI Training (Reproductive Tract Infection / Sexually Transmitted Infection)

A three day training was imparted to the medical officers and two day trainings is being imparted to the staff nurses and lab technicians to upgrade their knowledge in Syndromic approach for diagnosis and treatment of Sexually Transmitted Diseases.

Integrated Refresher Training (IRT) - Supervisors

This training is being imparted to all the female supervisory functionaries such as Community Health Nurses and Sector Health Nurses as on refresher course all ongoing programmes and their monitoring tools and activities.

IRT Training (Integrated Refresher Training)- – Laboratory Technicians<

This hands-on-training is being imparted to all laboratory technicians of the PHC to handle semi- auto analyzers and other lab equipment.nded in PHCs.

Managerial Skill / Induction Training for Medical Officers

This training for 15 days is being imparted to all the newly recruited medical officers on orientation to all health programmes being implemented and also on their administrative role in the PHCs. The trainings are being conducted in 6 Regional Training Institutes.

Maternal and Child Health Skill Lab Training

This 6 days hands-on-training is being given in the skill labs established at Regional Training Institutes to all the PHC medical officers and staff nurses related to maternal and child health.

In turn helps in achieving NHM Goals by acquiring necessary knowledge and skills in Maternal and Child care & to reduce MMR/IMR.

RMNCH+A training to staff nurses in identified CEmONC/ NICU

This training provides hands-on-training on MCH Skills especially in CEmONC and NICU practices to the newly recruited 7700 staff nurses in the health department. It is being conducted in CEmONC /NICU for 30 days spell wise in CEmONC & NICU and Regional Training Institutes.

The Obstetricians and Pediatricians are being the resource persons for these trainings.

National Nodal Centre NNC College of Nursing - Madras Medical College

This centre acts as a Centre of Excellence for the pre-service education for nursing-midwifery cadre in the region/ state and would contribute to the overall strengthening of nursing-midwifery cadre in the region/ state.The first batch of training with 15 participants commenced from November 7th to December 17, 2016.

This six weeks training course for ANM/GNM faculty aimed at strengthening their teaching skills, knowledge and skills in MNCH, FP and clinical care with which, they transmit the same to their students in their colleges. Post training mentorship visits are being conducted in order to provide support to the trained faculties.

Training Adolescent – Friendly Health Services ( RKSK-AFHS)

A four days training was imparted to the medical officers and five days trainings for ANM/LHV is being imparted to upgrade their knowledge in Syndromic Approach in Reproductive & Sexual Health, Nutrition Injuries and Violence (including gender based violence), Non-communicable diseases, Mental Health and Substance misuse services to adolescents through community participation.

Rashtriya Bal Swasthya Karyakram Training (RBSK)

Government of India’s initiative, Rashtriya Bal Swasthya Karyakram (RBSK) is a child health screening and early intervention service with the aim to screen all the children from 0-18 years for four Diseases - Defects at Birth, Diseases, Deficiencies and Developmental Delays including Disabilities. 770 Mobile Health Teams including medical officers, staff nurses and pharmacists have been trained for 5 days in 6 of the 7 Regional Training centers after completion of TOT at Chennai.


Financial Norms


Financial Norms


Universal Health Coverage (UHC)+

Comprehensive Primary Healthcare Services: Health and Wellness Centres in Tamil Nadu

Comprehensive Primary healthcare Services; Universal Health Coverage (UHC) project has been piloted successfully in 3 pilot blocks of Veppur, Shoolagiri and Viralimalai in 3 Health Unit Districts (HUDs) of Perambalur, Krishnagiri and Pudukottai respectively covering 67 HSCs and 17 PHCs (including block PHCs) since 2016. In 2017-18, the program was up-scaled to additional 39 blocks @ 1 block per HUD.

UHC aims to bring comprehensive set of services near to the doorsteps of the people thereby reducing out-of-pocket expenditure. UHC also aims to address the healthcare needs of the people in long-term basis. The full spectrum of essential, quality health services should be covered including health promotion, prevention and treatment, rehabilitation and palliative care. The major focus under UHC in context of Tamil Nadu is on NCD screening and management starting from the community level through a Women Health Volunteer (WHV) from Women Development Corporation without compromising MCH and Communicable diseases management. The UHC programme is named as “Anaivarukkum Nalavazhvu Thittam”.

In the year (2018-19), Government had made an announcement to transform its 985 Health Sub-Centres, 716 Additional PHCs and 214 Urban PHCs to Health & Wellness Centres (HWCs) with Government of India support of Rs. 9357.47 lakhs (rural & urban). In 2019-20, the State will transform 668 Additional PHCs and 246 Urban PHCs to Health & Wellness Centres (HWCs) with Government of India support of Rs. 13573.64 lakhs (rural & urban). Among the larger States, Tamil Nadu became the first State to transform all PHCs and U-PHCs into HWCs. Under UHC, all PHCs in Tamil Nadu will be functioning 24x7. Staff Nurses (SNs) will be the healthcare provider at PHC level between 4 p.m. and 9 a.m. under the supervisory control of the PHC Medical Officer.

The roll out plan for HWC in Tamil Nadu is given in below table

Year. HSCs Addl. PHCs Urban PHCs Total
2017-18 67 14 - 81
2018-19 918 702 214 1834
2019-20 796 668 246 1710
2020-21 667 - - 667
Total Target for 2020-21 2448 1384 460 1982
(47% of target)
Total Target set by GoI (2022-23) 7921 1421 420 9132

The program is being implemented through the State Programme Management Unit (SPMU), Universal Health Coverage (UHC) & Maternal Child Health (MCH) established at the Directorate of Public Health and Preventive Medicine in Tamil Nadu in co-ordination with NHM Tamil Nadu. The HWCs would be the window of opportunity for strengthening the primary health care system in our State.

Essential Diagnostic Services+

Essential Diagnostics Services System (EDSS)

Inception of the Programme

  • In the absence of Free Essential Diagnostic Services, many patients end up spending a lot resulting in poor compliance in treatment and control rates of disease
  • To achieve the goal of UHC, ensuring availability of all essential diagnostics at free of cost in Government institutions is of utmost importance.
  • The Govt. made an announcement in Budget Speech 2019-20 as follows

This Government will launch an ambitious programme to formulate an essential diagnostics list guaranteeing a set of diagnostic tests at each level of health care. The necessary equipment and consumables will be supplied and protocols will be evolved for this. This scheme will be implemented at a cost of Rs.247 Crore over a period of 3years

Need for Free Essential Diagnostics

Need for Free Essential Diagnostics

  1. Enables accurate and early diagnosis of various diseases.
  2. Enables initiation of timely treatments
  3. Improved and focused management of disease conditions
  4. Diminishes chances of complications
  5. Improved long-term outcomes
  6. To detect emerging infectious threats
  7. Decreased burden on the poor.

Objectives of the Essential Diagnostics Services System are:

  1. Ensure the availability of a minimum set of diagnostics appropriate to the level of care.
  2. Reduce high out of pocket expenditure incurred by patients for diagnostics.
  3. Use of appropriate diagnostics to screen patients for a set of chronic conditions to enable secondary prevention measures.
  4. Improve overall quality of healthcare and patients experience as a result of availability of comprehensive healthcare in public health facilities.

Salient features of the Essential Diagnostics Services System include:

Hierarchy-of-labsHub-and-Spoke model
  1. The Essential Diagnostics Services System would be rolled out under the National Health Mission, in order to build on and leverage existing institutional structures that are already in place and facilitate integration.
  2. The scheme would be synergized with existing packages to avoid duplication.
  3. Strengthening of existing laboratories:
  4. Hub-and-Spoke model: Hubs are various medical colleges in the state.
  5. Hub-and-Spoke model: Spokes
  6. Hub-and-Spoke model: Interconnecting Hub and Spokes
  7. Laboratory Information and Management System (LIMS)
  8. Quality Assurance and Rational Use of Laboratory Tests.


In order to implement this, a proposal at a total cost of Rs. Rs.273.14 Crores . The Govt of India has approved Rs.81.94. crores in NHM- RoP 2019-20 and Rs. 81.94. crores in NHM- RoP 2020-21.

  • EDSS Programme is implemented in the Tiruvallur on Pilot Basis.
  • LIMS Interfacing was done and samples were transported through Hub & Spoke model in the Pilot District.
  • Equipment, reagents, Hardware, HR- IT coordinators, Outsourcing transport of samples.
  • Programme is being up scaled to the other Districts.

Assured Test Menu Health facility wise

Assuring the following number of tests for the patients visiting the respective level of health facilities.

Sl. No. Levels Nos. Tests
1. Apex labs – MCH 10 193
2. Non Apex labs - MCH 13 147
3. DHQ 29 62
4. SDH 273 42
5. UGPHCs & HSCs 385 25
6. PHCs 1882 20
7. HSC 8712 5

LIMS (Laboratory Information Management System)


The LIMS software is rolled out in all Health facilities from 01.06.2020 onwards.

Tribal Health+

Tribal Health

Birth waiting room in 17 tribal PHCs

On analysis of the maternal deaths, it was observed that the tribal mothers find it difficult to reach the delivery point on time. Though 108 vehicles with four-wheel drive facility are provided due to the long distance to be travelled it was observed that if the tribal mothers were admitted in advance, i.e two weeks before the Expected Date of Delivery in birth waiting room established at the foot hills of the 17 PHCs in tribal areas it would ensure that safe delivery happens under institutional care. If referral to a CEmONC centre is required, it can be done well in advance.

Tribal Mobile outreach services

Already there are 396 Mobile Medical Units are being operated throughout Tamil Nadu. To augment the Mobile Outreach Services in tribal areas additional 20 Mobile Medical Units are being operationalized through NGOs in tribal blocks. This mobile outreach team with one Medical Officer / Staff Nurse / Lab Technician / Driver conducts minor ailment clinic, Antenatal screening, Non Communicable Disease screening and lab tests. Free drugs are also distributed. These tribal mobile teams also help in screening Hemoglobinopathies among 10th& 12th Standard Tribal school children and school dropouts.

Referral Services in Tribal Districts

The State has a well-established emergency referral transport system established through TN-EMRI. In order to reach those tribal areas which are inaccessible, four wheel drive vehicles suitably equipped as ambulances have been provided in 76 identified points in tribal / hilly areas considering the issue of reaching the tribal hamlets due to the size of the regular ambulances and hilly terrains. This ensures that timely referral of tribal people to higher referral centre’s. Regular replacement of these vehicles ensures that these vehicles are road worthy.

Tribal Counselors

Tribal Counselors act as ambassadors between the health systems and tribal community. Tribal communities in general and primitive tribal groups in particular are compounded by lack of education / awareness, illiteracy, ignorance of causes of diseases, hostile environment, poor sanitation, lack of safe drinking water and blind beliefs, etc. Hence, Tribal Counselors have been placed in the 10 Government Hospitals in the tribal districts. These persons function as health activists in the institution who create awareness on health and its determinants. They motivate the community towards healthy living practices.

Prevention & Control of Hemoglobinopathies

Tamil Nadu is the first State among the South Indian States to implement this program for early detection of Hemoglobinopathies like sickle cell anaemia, Thalassemia among the tribal population. The timely identification and genetic counselling will prevent the transmission of the carrier from parent to offspring. This breaks the propagation of the disease.

NHM TN along with line departments has implemented screening of Hemoglobinopathies (Sickle Cell Anaemia & Thalassemia) in adolescent children studying in 10th, 12th standard and unmarried school dropouts above the age of 14 in 30 selected tribal blocks in 13 Districts since November 2017. The programme implemented at a cost of Rs 216.00 lakhs in Dharmapuri, Salem, Krishnagiri, Namakkal, Nilgiris, Coimbatore, Tiruvannamalai, Villupuram, Vellore, Thiruchirapalli, Dindigul, Erode and Kanyakumari Districts in phased manner. The programme involves primary screening with NESTROFT & SOLUBILITY TESTs are done with the support of (TMORS) Tribal Mobile Outreach Services and final confirmatory diagnosis at 5 Government Medical College Hospitals with HPLC which is a highly specific and sensitive equipment. The children are provided with genetic counseling at District Early Intervention centers.

This year the programme , will also be expanded to screen antenatal mothers. With the successful implementation of the programme the incidence of Hemoglobinopathies trait will be reduced and the future generations will become free from Hemoglobinopathies.

Establishment of Integrated Centre for Treatment of Hemophilia & Hemoglobinopathies (ICHH) in 5 Government Medical College Hospitals of Tamil Nadu

Estimated Prevalence of inherited bleeding disorders like Hemophilia A & B, etc., in India is 0.9 /1, 00,000 population. (Source: India Journal of Medical Research) . Since case detection of such inherited blood disorders is required and requirement of a comprehensive day care centre to treat children already on treatment is essential, GOI has issued certain guidelines on the issue. Based on the guidelines and reviews by expert teams, it is decided establish 5 Integrated Centre for Treatment of Hemophilia & Hemoglobinopathies at regional zones to benefit such children requiring frequent blood transfusions due to Thalassemia or Hemophilia and also to establish treatment centres to provide Chelation therapy for other variant hemoglobinopathies.

Hemoglobinopathies & Hemophilia are transfusion dependent /clotting factor dependent diseases, resulting in stress and psychological problems not only to the child but to the whole family. Management of thalassemia, Sickle Cell Disease patients and Hemophiliac patients through a Day Care Facility is convenient, economical and provides a supportive environment friendly area for children with a chronic illness. It helps in better compliance and efficient monitoring of patients.


  1. Integrated Centre for Treatment of Hemophilia & Hemoglobinopathies will provide transfusion facility / ward with 10- beds, where transfusion services on daily basis will take place in shifts to accommodate more patients including night shift for working or school going patients./li>
  2. Integrated Centre for Treatment of Hemophilia & Hemoglobinopathies in the General Medicine Department / Pediatric Department will have exclusive management protocols for transfusion therapy, transfusion reactions and chelation therapy/li>
  3. Trained Pediatrician/Hematologist with nursing staff for treating complications, conducting regular transfusions, monitoring of growth and development and maintenance of records, during the period of blood transfusions with low staff turnover to provide continuity of care will be made available./li>
  4. Exclusive Laboratory Diagnostic kits for conduction of regular tests (serum ferritin, viral markers) for evaluation and monitoring purposes &Provision of Drugs like oral iron chelator drugs/li>
  5. ICHH will have recreational facilities to keep children engaged during transfusion/ other treatment.


Establishment of Comprehensive Integrated Centre for Treatment of Hemophilia & Hemoglobinopathies in 5 Government Medical College Hospitals namely:-

  1. Institute of Child Health& Hospital for Children , Government Madras Medical College Hospital, Egmore, Chennai 8(Nodal Centre)
  2. Government Dharmapuri Medical College Hospital, Dharmapuri
  3. Government Rajaji Madurai Medical College Hospital, Madurai
  4. Government Theni Medical College Hospital, Theni
  5. Government Mohan Kumaramangalam Salem Medical College Hospital, Salem

These facilities will be a 6 to 10 bedded day care centre to ensure adequate management and to serve as a baseline of minimum monitoring that is needed for care of these children & to prevent frequent school absenteeism among these children.


Mobile Medical Units