NHM Programs

RMNCH+A+

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:

Nil

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

Tamilnadu
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

National Deworming Day (NDD)

 

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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).

HBYC

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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)

 

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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)

 

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Integrated Disease Surveillance Programme (IDSP)

 

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Non Communicable Diseases+

National Programme for Prevention and Control of Cancer and Diabetes

 

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Cardiovascular Diseases and Stroke (NPCDCS)

 

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National Programme for Prevention and Control of Blindness(NPCB)

 

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National Programme for Prevention and Control of Deafness(NPPCD)

 

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National Mental Health programme (NMHP)

 

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National Oral Health programme (NOHP)

 

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National Programme for the Healthcare of theElderly (NPHCE)

 

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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.

Objectives

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

Activities:

  • 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)

 

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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

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.

PUNISHMENT FOR VIOLATIONS:

SECTION 4: Prohibition of Smoking in Public Places

S4

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

S5

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”

S6b

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

S7

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:

ECig

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)

 

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Occupational Health

 

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Day Care Chemotherapy

 

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Transgender Clini

 

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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
  • SCRIPT
  • STEMI
  • POISON
  • PREM
  • BURNS
Health Systems Strengthening +

 

National Quality Assurance Standards (NQAS)

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KAYAKALP

 

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.

 

LaQshya

 

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Meraaspataal

 

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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
Ambathurai,
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
Fax  
e-Mail rtiph.thiruvarankulam@gmail.com
8 IVCZ, HOSUR Institute of Vector Control and Zoonoses,
Hosur – 635126.
Phone 04344-276225
Fax  
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.

RoP APPROVAL:

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
Mobile Medical Units
AYUSH
TANII