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Enhancing Primary Health Care Delivery in Tamil Nadu

Explore Tamil Nadu's innovative approach to integrated service delivery in primary health care, showcasing strengths like strong political will, quality drug procurement system, and robust training programs for medical staff.

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Enhancing Primary Health Care Delivery in Tamil Nadu

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  1. Integrated service delivery in Primary Health Care – Tamil Nadu experience Dr.P.Padmanaban Advisor NHSRC

  2. Slide presentation • Tamil Nadu Medical Services Corporation – Flexibility for the doctors to indent any drugs depending on the morbidity pattern of the area • Dedicated Public Health Cadre to implement all National Health Programmes • Use of untied funds- NRHM • Multi skill training of medical and para medical staff • Integrated service delivery in the PHCs • New services in PHCs/ CHCs

  3. DEMOGRAPHIC PROFILE

  4. STRENGTHS OF TAMIL NADU HEALTH SYSTEM • Strong political will • Government is the dominant provider of Maternal and Child health services • 5.6% of the revenue budget allocated to health sector & 10% of the budget allotted for drugs and consumables • No user fees • Public Health qualified medical professionals implement all National Health Programmes thro Primary Health Centres and Health Sub centres. • Sensitive media

  5. STRENGTHS OF TAMIL NADU HEALTH SYSTEM • Quality generic drugs and equipment procurement system- Tamil Nadu medical Services Corporation- ISO certified organisation • Transparency in the procurement of drugs and equipements • Drug pass book system for institutions • Quality drugs at lower rates

  6. 24 availability of multipurpose paramedical staff – nurse in the PHCs • 24 hour delivery services with 3 staff nurses introduced in all the 1421 PHCs ( With NRHM support) • Provide minor ailments treatment • Assist in provision of tubectomy operations • Scope for developing Nurse practitioners

  7. DELIVERY PERFORMANCE (%) [July’08] Domi. PVT GH PHC HSC

  8. Use of untied funds for upgrading the patient amenities • Flexible funding to PHCs / CHCs for all the activities irrespective MCH,HIV/AIDS, IDSP etc. • Private sector participation for patient welfare initiatives • No need to get the permission of PWD for execution of the minor works • Multipurpose fund for Village Health and Sanitation committees • Untied funds for the HSCs I

  9. Multi skill training of medical and para medicals • 6 months anesthesia training for M.B.B.S doctors (84 trained) and x-ray training for lab technicians • Scan training for MBBS doctors for one month • X ray training for Lab technicians • Training the ANMs, LHVs in the use AYUSH drugs • Manual Vacuum Aspiration training • Training nurses in HIV testing -RCH / HIV convergence • Cancer cervix screening training for the PHC staff • Blood bank training to the PHC staff • Diabetes training distance education programme for doctors

  10. Integrated service delivery in the PHCs • Routine MCH services • Blood storage facilities • RTI/STI clinics • Family Welfare services including MVA and tubectomy services • Birth certificate distribution in the PHCs • New born screening for disabilities initiated with NGO support in selected PHCs • Mainstreaming AYUSH • Convergence of HIV/AIDS • Integrated Disease Surveillance Programme, TB , Leprosy case detection and management

  11. Integrated service delivery in the PHCs • Special clinics • - Diabetes and hypertension clinics • - Gestational diabetes screening ( pregnant women) ( scan and semi autonalyser in PHCs) • - RTI/STI clinics • - Cancer Cervix screening clinics using VIA method ( 2 districts and Chennai corporation) • - Mental health programme ( 7 districts) • - Dental clinics – weekly two day clinics ( 35 clinics) • - Eye clinics – cataract screening and refractive error screening ( ophthalmic assts in 385 BPHCs) • - Hiring the services of private specialists

  12. School Health programme • - Screening for communicable diseases- • - Deworming • - Dental health programme with hiring of private dental surgeons • - Anemia control • - Adolescent health • - Refractive error screening & free spectacles • - Rheumatic heart disease prevention • - Congenital heart disease detection • - Free heart surgery programme for the children

  13. Free heart surgeries for children • Heart Surgeries are done for children with private sector participation to reduce the waiting time for surgery • Planned to carryout 10,000 surgeries • Private hospitals are paid for the surgeries at mutually agreed rates • Private sponsors also donate funds for the scheme

  14. Blindness control programme • Cataract screening by ophthalmic assistants in the PHCs and outreach areas • Refractive error screening & free spectacle distribution • Follow up care for cataract operated cases • Scope for capacity building of ophthalmic assts in the detection of eye complications among diabetics

  15. Suggested new services in the PHCs • Online reporting system launched for all RCH services . Unified reporting system remains a challenge • Adolescent clinics • Nutrition surveillance • Couple counseling for family welfare services • Newborn screening for developmental delays

  16. THANK YOU

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