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Strategic Scaling Up of Post-Partum Family Planning (PPS/PPIUCD) Services in Tamil Nadu

Learn about the successful implementation of PPS/PPIUCD services in Tamil Nadu to improve maternal and child health outcomes. This strategy involves training healthcare providers, enhancing accessibility, and ensuring high-quality post-operative care.

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Strategic Scaling Up of Post-Partum Family Planning (PPS/PPIUCD) Services in Tamil Nadu

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  1. STRATEGIC SCALING UP OF POST PARTUM FAMILY PLANNING (PPS/PPIUCD) SERVICES IN TAMIL NADU Dr. DAREZ AHAMED, IAS., MISSION DIRECTOR, NATIONAL HEALTH MISSION, TAMIL NADU.

  2. POPULATION India 1210 Million Tamil Nadu 72.10 Million 32 Districts in Tamilnadu

  3. ABOUT TAMIL NADU • Population- 7.21 crores. • Decadal growth rate 15.60% (2001-2011). • Seventh most populous state in India. • 6% of country’s population. • Lowest TFR of 1.7 in the country. • One of the most urbanised states (48.45%) in India • Consists 1.1 crore Eligible Couples.

  4. % OF HIGER ORDER OF BIRTH (3 & ABOVE)

  5. Current Use of Family Planning Methods in Tamil Nadu (NFHS-IV) - Acceptors 53.2 %

  6. % OF P.S. INTOTAL STERILISATION

  7. TRENDS IN PPIUCD PERFORMANCE

  8. METHOD WISE PERMANENT STERILISATION PERFORMANCE 2015-16

  9. TRENDS IN PPIUCD PERFORMANCE

  10. METHOD-WISE PPIUCD PERFORMANCE

  11. GRAVIDA WISE MATERNAL DEATH ANALYSIS 2015-2016

  12. Why strategy had to be changed: • MMR 25, IMR 10 by 2023 is target set by our vision document. • High risk Non acceptors had to be brought in to the system , shift from population stabilization strategy to RMNCH +A strategy. The DFW needs this fundamental reorientation to shift from target based to maternal and child health related interventions. • 7.9 % HOB contributes 25% of MMR • Lack of spacing directly contributing to MMR, IMR and other morbidities. • The best way to tackle high risk non acceptors is to counsel them when they are in the health facilities. (99.9% institutional deliveries). The most receptive period in non acceptors is during this period.

  13. Strategy contd.. • Imparting tubectomy training and life saving skill in anaesthesia trained MBBS doctors which has been a key strategy in implementation of PPS even at the level of CHC . • PPIUCD doesn’t require repeat visit to the facility, and state is looking at strengthening MVA/MMA as a logical corollary to PPIUCD as an RMNCH+A strategy. Over the counter abortifacients has been a signifanct contributor to MMR about 1%. • 100 block strategy is being implemented by having specific action plans for blocks. (Reasons were as varied as unmet , religious , etc)

  14. INSTITUTIONS PERFORMING PPIUCD

  15. POSITIVE ATMOSPHERE FOR POST PARTUM STERILISATION AND PPIUCD • Universal awareness of post partum services • 99.6 % of deliveries are institutional • All the pregnant mothers are registered for antenatal care and tracked using PICME • Easy accessibility of post partum sterilisation and PPIUCD services • Motivation by medical and para medical staff during hospitalisation

  16. POSITIVE ATMOSPHERE FOR POST PARTUM STERILISATION AND PPIUCD • Follow up visits at Village level by VHN, SHN, AGW etc • Confidence on the Survival of the baby – IMR has come down to 20/1000 live births • 100% Antenatal, Natal & Postnatal Care resulted in increasing safe delivery practice • Reduction in visits to facilities in PPIUCD

  17. POSITIVE ATMOSPHERE FOR POST PARTUM STERILISATION AND PPIUCD • Health Education & Behavioural Change Communication have helped in removing the Social Taboos to some extent & creating awareness • Constant Post Operative visit, early recognition of complication & Prompt management of complications have resulted in reduction in morbidities & mortalities in Sterilisation • Periodic review of failures by the quality assurance committee and updating the knowledge of Service Providers

  18. POSITIVE ATMOSPHERE FOR POST PARTUM STERILISATION AND PPIUCD • State Level review on sterilisation deaths by the panel of experts • This leads to early redressal of problems associated with such incidence • Prompt Payment of all Financial assistance to the acceptors and service providers

  19. Thank you

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