Health and Family Welfare Department
Performance Budget
Chapter - 1
MEDICAL EDUCATION
1.1. The Directorate of Medical Education is entrusted with the responsibility of implementing the Teaching, Training and Research Programme in the Medical Field.
1.2. The Director of Medical Education is the Head of the Department and he is assisted at the State Head Quarters by a team of Officers.
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1.3. THE HOSPITALS ATTACHED TO VARIOUS MEDICAL COLLEGES UNDER THE CONTROL OF THE DIRECTOR OF MEDICAL EDUCATION: Sl.No. Name of the Hospitals Medical College to which attached 1. Government General Hospital, Chennai 1. Madras Medical College, Chennai (including Peripheral Hospital, Periyar Nagar, Chennai) Dispensaries attached (i) Secretariat Dispensary, Chennai-9 (ii) Government Estate Dispensary, Chennai-2 (iii) Government Chepauk Dispensary, Chennai-5 (iv) Raj Bhavan Dispensary, Guindy, Chennai-25 (v) High Court Dispensary, Chennai-1 (vi) Queen Mary's College Dispensary, Chennai (vii) Lady Wellington Dispensary, Chennai 2. Regional Institute of Ophthalmology and -do- Government Ophthalmic Hospital, Chennai 3. Institute of Social Obstetrics and -do- Government Kasturba Gandhi Hospital for Women and Children, Chennai 4. Institute of Obstetrics and Gynaecology and -do- Government Hospital for Women and Children, Chennai 5. Government Institute of Rehabilitation -do- Medicine, Chennai 6. Institute of Child Health and Hospital for -do- Children, Chennai 7. Institute of Thoracic Medicine, Chennai-31 -do- 8. Institute of Mental Health, Chennai -do- 9. Tamil Nadu Government Dental College ------and Hospital , Chennai 10. Government Stanley Hospital, Chennai 2. Stanley Medical College, Chennai (including Government Peripheral, Tondiarpet, Chennai) Dispensaries attached (i) Government Press Dispensary, Chennai (ii) Basin Bridge Dispensary, Chennai (iii) Government Industrial Training Institute Dispensary, Chennai 11. Government RSRM Lying in Hospital, -do- Chennai 12. Government Hospital for Thoracic Medicine, -do- Tambaram, Chennai-47 3 13. Government Kilpauk Medical College 3. Kilpauk Medical College, Chennai Hospital, Chennai (including Peripheral Hospital, Arignar Anna Nagar, and City Police Hospital, Chennai ) Dispensaries attached (i) DPI Office Dispensary, Chennai (ii) Government Foreshore Estate Dispensary, Chennai (iii) Government Todhunter Nagar Dispensary, Chennai (iv) Government Modern Medicine, Dispensary, Chennai 14. Government Tiruvotteeswarar Hospital for 3. Kilpauk Medical College, Chennai Thoracic Medicine, Chennai-12 15. Government Royapettah Hospital, -do- Chennai-14 (including Peripheral Hospital, K.K. Nagar) (i) Government Hospital, Saidapet, Chennai-15 (ii) Government Peripheral Hospital, Injambakkam. 16. Government Chengalpattu Medical College 4. Chengalpattu Medical College, Hospital, Chengalpattu Chengalpattu 17. Government Tanjavur Medical College 5. Thanjavur Medical College, Hospital, Thanjavur Thanjavur 18. Government Raja Mirasdar Hospital, -do- Thanjavur 19. Government Rajaji Hospital, Madurai 6. Madurai Medical College, Madurai (including) i) Government Hospital, Balarengapuram, Madurai (ii) Government Infectious Disease Hospital, Thoppur, Madurai (iii) Government Cholera Collection Centre, Thoppur, Madurai (iv) Government Hospital for Thoracic Medicine, Thoppur, Madurai 20. Government Thirunelveli Medical College 7. Thirunelveli Medical College, Hospital, Thirunelveli (including Frieda Thirunelveli Monnier Government Hospital, Kalakkad, Thirunelveli) 21. Government Coimbatore Medical College 8. Coimbatore Medical College, Hospital, Coimbatore Coimbatore 22. Government Mohan Kumaramangalam 9. Government Mohan Medical College Hospital, Salem Kumaramangalam Medical College, Salem 4 23. Government Arignar Anna Memorial Cancer - Institute, Kancheepuram
24. Government Arignar Anna Memorial Cancer - Hospital, Karapettai Kancheepuram 25. King Institute of Preventive Medicine, Guindy, - Chennai-32 26. Annal Gandhi Memorial Govt. Hospital, 10. K.A.P. Viswanatham Govt. Tiruchirapalli Medical College, Tiruchirapalli (including) (i)Government College of Physiotherapy,Trichy. (ii) Government Rajaji T.B.Hospital, Tiruchi. 27. Thoothukudi Medical College Hospital, 11. Thoothukudi Medical College, Thoothukudi Thoothukudi 28. Government Vellore Medical College 12. Vellore Medical College, Vellore Hospital, Vellore (including) Subsidiary Hospital and Government Pentland hospital, Vellore. 29. Government Kanniyakumari Medical College 13. Kanniyakumari Medical College, Hospital, Kanniyakumari (including) Kanniyakumari Subsidary Hospital, Nagercoil 30. Government Theni Medical College Hospital, 14. Theni Medical College, Theni Theni @ Allinagaram
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1.4. FINANCIAL REQUIREMENTS (PROGRESS AND ACTIVITY CLASSIFICATION): (Rs. in lakhs) Accounts 2006-2007 Budget Estimate 2007- Revised Estimate 2007-2008 2008 Classification Non- Plan Total Non- Total Plan Plan Plan Total Non- Plan Plan (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) I. MEDICAL EDUCATION Medical Colleges Revenue 13235 467 13702 19452 327 19779 17825 347 18172 Capital - 4241 4241 - 6942 6942 - 3318 3318 II. TEACHING HOSPITALS Revenue 30644 5794 36438 43285 763 44048 40098 2092 42190 +23 +23 +25 +25 +32 +32 Capital - 1631 1631 - 3256 3256 - 1778 1778
III. TUBERCULOSIS CONTROL 1341 - 1341 1713 - 1763 - 1763 Revenue - - - - - 1713 - - - Capital - IV. TRAINING a. Nurses - Revenue 46 395 441 476 24 500 621 31 652 Capital ------b. Other than Nurses Revenue 4 - 4 45 - 45 6 - 6 Capital ------Total Revenue 50 395 445 521 24 545 627 31 658 Capital ------V. King Institute , Guindy 545 - 545 1066 - 1066 735 - Revenue ------735 Capital -
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(1) (2) (3) (5) (6) (7) (8) (9) (10) (4) VI. DIRECTION, SUPERVISION AND POLICY FORMULATION 402 - 402 578 - 578 502 - 502 +1 +1 +1 +1 +1 +1 Director of Medical Education ------Revenue Capital VII. CANCER CONTROL Revenue 391 45 436 617 - 617 563 - 563 Capital ------VIII. FREE EYE CAMP Revenue 94 - 94 140 - 140 134 - 134 Capital ------Control of Blindness - 4 4 - 6 6 - 2 2 Revenue ------Capital TOTAL Revenue 94 4 98 140 6 146 134 2 136 Capital ------IX MISCELLANEOUS a) Medical Revenue 100 - 100 134 - 134 123 - 123 Capital ------b) Social Welfare Revenue 2 - 2 3 - 3 3 - 3 Capital ------Total Revenue 102 - 102 137 - 137 126 - 126 Capital ------GRAND TOTAL 46804 6705 53509 67509 1120 68629 62373 2472 64845 Revenue +24 +24 +26 10198 +26 +33 +33 Capital - 5872 5872 - 10198 - 5096 5096 + Charged 7 1.5. OBJECT WISE CLASSIFICATION: (Rupees in Lakhs) Accounts 2006-2007 Budget Estimate 2007-2008 Revised Estimate 2007-2008 Non- Plan Total Non- Plan Total Non- Plan Total Classification Plan Plan Plan (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) 01. Salaries 18523 289 18822 25997 147 26144 22631 143 22774 +7 +7 +9 +9 +8 +8 02. Wages 151 1 152 176 _ 176 196 - 196 03. Dearness Allowance 13107 211 13318 23599 130 23729 21387 134 21521 +5 +5 +9 +9 +8 +8 04. Travel Expenses 21 122 28 129 31 132 +4 +4 +1 +1 +5 +5 05. Office Expenses 1981 5 1986 2211 1 2212 2250 1 2251 +1 +1 +1 +1 +1 +1 06. Rent, Rates and Taxes 414 - 414 550 - 550 555 - 555 08. Advertising and Publicity 9 - 9 11 - 11 16 - 16 09. Grants-in-aid 145 - 145 345 - 345 337 - 337 10. Contribution 113 - 113 73 - 73 89 - 89 12. Scholarship and Stipend 2698 2 2700 4006 3 3916 3 3919 4009 17. Minor works 2 - 2 ------18. Maintenance ------19. Machinery & Equipment's 631 6116 6747 751 741 1492 851 2093 2944 21. Motor Vehicles 54 - 54 9 16 25 20 16 36 24. Materials & Supplies 4 11 15 25 1 26 25 1 26 33. Payment of Professional and 493 1 494 435 20 455 308 21 329 special services 34. Other Charges 9 - 9 3 - 3 5 - 5 42. Services or commitment 183 - 183 54 - 54 54 - 54 charges 45. Petrol, oil and Lubricants 97 1 98 146 6 152 147 5 152 46. Clothing,Tentages & Stores 178 - 178 254 - 254 252 - 252 8 47. Stores and Equipments 1518 9 1527 1650 - 1650 1700 - 1700 49. Festival Advances 01 Festival Advances-Debit 83 - 83 153 1 154 307 1 308 02 Festival Advances-Credit -341 -3 -344 -153 -1 -154 -307 -1 -308 51. Compensatory Charges +2 - +2 +1 - +1 +2 - +2 59. Prizes & Awards 21 - 21 5 - 5 5 - 5 66. Medicines 5761 15 5776 6082 15 6097 6389 15 6404 +5 +5 +9 +9 67. Feeding/Dietary Charges 712 - 712 856 - 856 866 - 866 +5 +5 68. Cost of Text Books 206 41 247 206 39 245 300 39 339 72. Training 1 - 1 1 - 1 1 - 1 74. Purchase and upkeep of - - - 12 - 12 12 - 12 Animals 76. Computer & Accessories 2 5 7 19 - 19 24 - 24 99. Miscellaneous 18 - 18 5 - 5 6 - 6 Total 46804 6705 53509 67509 1120 68629 62373 2472 64845 +24 +24 +26 +26 +33 +33 + Charged
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1.6. SOURCE OF FINANCE: ( Rupees in lakhs) Accounts 2006-2007 Budget Estimate 2007-2008 Revised Estimate 2007-2008 Classification Non-Plan Plan Total Non-Plan Plan Total Non-Plan Plan Total (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) Demand No. 19 - Health and Family Welfare Department 03. Directorate of Medical Education - Voted 46804 6705 53509 67509 1120 68629 62373 2472 64845 Charged 24 - 24 26 - 26 33 - 33 Total 46828 6705 53533 67533 1120 68655 62406 2472 64878 2059.01.053 BV(Buildings) 2455 - 2455 2591 - 2591 2591 - 2591 2202-80-107-JH - 7 7 - 160 160 - 122 122 2202-80-789-JD - 5 5 - 40 40 - 31 31
Grand Total 49283 6717 56000 70126 1320 71446 64997 2625 67622 Demand No.39 4210.Capital (Buildings) - 5872 5872 - 10198 10198 - 5096 5096 Total - 5872 5872 - 10198 10198 - 5096 5096 Budget Publication No: 53 2049.01.200.CS(Loan from 472 - 472 - 560 - 560 HUDCO) 51 - 51 560 - 560 56 - 56 2049.01.200.CT(Loan from 56 56 HUDCO) Total – Charged 523 - 523 616 - 616 616 - 616 Budget Publication No: 54 6003.00.109.CA(Loan 1187 - 1187 1187 - 1187 1187 - 1187 fromHUDCO) 111 - 111 111 - 111 111 - 111 6003.00.109.CB(Loan fromHUDCO) Total 1298 - 1298 1298 - 1298 1298 - 1298
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1.7. Number of Seats available in Under Graduate Degree, Diploma and post Graduate Courses: DIP MBB BD B.Phar DMR D.Ort in Name of the Institution DGO DLO DO DMRT DA DCH DTCD DDVL DCP DPH DIPM DPM Sl.No S S m D h Diabe tology (1) (2) (3)(4) (5) (6) (7) (8) (9) (10)(11) (12) (13) (14) (15) (16) (17) (18) (19) 1. Madras Medical College, 165 - 50 38 24 24 8 8 15 8 35 11 20 8 10 3 8 3 Chennai. 2. Stanley Mecical College, 150 - 12 - 2 - 4 12 4 12 - 2 4 - - - Chennai. 3. Kilpauk Medical College, 100 - - 3 4 - - - 4 8 4 - - 2 - - - - Chennai. 4. Chengalpattu Medical 50 ------College,Changalpattu - 5. Madurai Medical College, 155 - 60 16 12 12 - 11 20 6 12 - 4 - - - 5 - Madurai. 6. Thanjavur Medical 2 College, Thanjavur. 150 - - 3 4 - - 1 9 3 2 2 2 - - - -
7. Coimbatore Medical 150 - - 2 1 - - 3 - 4 ------College, Coimbatore. 8. Govt. Mohan Kumaramangalam Medical 75 ------College,Salem. 9. Thirunelveli Medical 150 ------College, Thirunelveli. 10 Tamilnadu Govt.Dental College and Hospital, - 100 ------Chennai 11. Thoothukudi Medical 100 ------College, Thoothukudi 12. K.A.P.Viswanatham Medical College, 100 ------Thiruchirappalli 13 Kanniyakumari Medical 100 ------College, Kanniyakumari 14 Vellore Medical College 100 ------Vellore 15 Theni Medical College, 100 ------Theni TOTAL 1645 100 110 74 44 39 8 24 63 29 69 13 28 14 10 3 15 3
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1.8. Number of Specialities and intake capacity under Post Graduate Courses:
Sl.No Name of the Institution M.D. M.S. M.Ch. D.M. M.D.S M.Pharm M.Sc. (N) Total 1. Madras Medical College, 123 41 21 17 - 20 8 230 Chennai 2. Tamil Nadu Government --- - 35- - 35 Dental College and Hospital, Chennai 3. Stanley Medical College, 49 22 4 6 - - 81 Chennai 4. Kilpauk Medical College, 21 18 6 5 - - 50 Chennai 5. Thanjavur Medical College, 20 13 1 - - - - 34 Thanjavur 6. Thirunelveli Medical College, 17 8 - 1 - - - 26 Thirunelveli 7. Madurai Medical College, 51 34 8 4 - 12 - 109 Madurai 8. Coimbatore Medical College, 24 16 3 - - - - 43 Coimbatore Chengalpattu Medical College, 1131- - - 15 Chengalpattu 10. GovernmentMohanKumarama 42 - - - - - 6 ngalam Medical College ,Salem. 11 K.A.P. Viswanatham 64 -- - -- 10 Government Medical College, Thiruchirapalli 12 Tamilnadu Dr.M.G.R. Medical 2 ------2 University TOTAL 328 161 44 33 35 32 8 641
12 1.9. PARA MEDICAL COURSES (SANCTIONED STUDENTS STRENGTH): Post Basic Dental Dental B.Sc. Diploma Sl. No. Name of the Institution B.Sc. D.Pharm Optician B.P.T. Mechanic Hygienist Nursing in Nursing Nursing * 1. Madras Medical College, Chennai 25 40 ------2. Stanley Medical College, Chennai ------3. Government Stanley Hospital, - - 130 - - - - - Chennai 4. Madurai Medical College, Madurai 50 - 120 - - - - 5. Thanjavur Medical College, ---60--- Thanjavur 6. Coimbatore Medical College, - --60---- Coimbatore 7. Tamil Nadu Govt. Dental College & ------66 Hospital, Chennai 8. Institute of Rehabilitation Medicine, -----25-- K.K. Nagar, Chennai 9. College of Physiotheraphy, -----25-- Thiruchirappalli. 10. Government Ophthalmic Hospital, - ---30--- Chennai 11. King Institute, Guindy, Chennai ------12. Government General Hospital, - - 170 - - - - - Chennai 13. Govt.Rajaji Hospital, Madurai - - 170 - - - - - 14. Government Kilpauk Medical --70---- College Hospital, Chennai 15. Government Mohan Kumaramangalam Medical College - - 130 - - - - - Hospital, Salem 16. Government Thirunelveli Medical - - 130 - - - - - College Hospital, Thirunelveli. 17. Government Thanjavur Medical - - 125 - - - - - College Hospital, Thanjavur. 13 18. Annal Gandhi Government - - 130 - - - - - Memorial Hospital , Thiruchirappalli. 19. Government Coimbatore Medical - - 140 - - - - - College Hospital, Coimbatore 20. Institute of Social Obstetrics and Government Kasturba Gandhi ---50- ---- Hospital for Women and Children, Chennai 21. Government Chengalpattu Medical - -50- ---- College Hospital, Chengalpattu 22. Government Thoothukudi Medical - -50- ---- College Hospital, Thoothukudi 23. Government Kanniyakumari - -50- ---- Medical College Hospital, Nagercoil 24. Government Head Quarters - -50- ---- Hospital, Kancheepuram 25. Government Head Quarters - -50 ---- Hospital, Cuddalore 26. Government Head Quarters - -50 ---- Hospital,Ramanathapuram 27. Government Head Quarters - -50- ---- Hospital, Dindigul 28. Government Head Quarters --50------Hospital, Udagamandalam 29. Government Head Quarters - -50- ---- Hospital, Thiruppur 30. Government Head Quarters - -50- ---- Hospital, Nagapattinam 31. Government Head Quarters - -50- ---- Hospital, Virudhunagar Total 75 40 1795 240 30 50 6 6 * for trained Nurses 14
1.10. DETAILS OF PARA MEDICAL CERTIFICATE / DIPLOMA COURSES: Sl Name of the Institution Cardiac ECG/ Pump Cardiac Emerg Respi- Dialysis Anaesthe- Theatre Ortho- Dip.in Certified Total No Sono - Tread Techni Catheteri - ency ratory Techni- sia Techni- paedic Medical Radio- graphic mill cian sation Care Therapy cian Techni cian Techni Lab. logical Techni Techni Lab. Techni- Techni-cian cian -cian Techni- Assistant cian cian Technician cian cian 1 Madras Medical College, 10 410 20 50 20 20 20 20 30 40 40 40 100 Chennai 2 Stanley Medical College, 10 410 20 50 20 20 20 20 30 40 40 40 100 Chennai 3 Kilpauk Medical College. 10 345 20 50 - 20 20 20 35 35 35 100 Chennai 4 Madurai Medical College, 10 385 20 50 20 20 20 20 20 35 35 35 100 Madurai 5 Thanjavur Medical 10 345 20 50 - - 20 20 20 35 35 35 100 College, Thanjavur 6 Coimbatore Medical 10 345 20 50 - - 20 20 20 35 35 35 100 College, Coimbatore 7 Thirunelveli Medical 10 325 - 50 - 20 20 20 35 35 35 100 College, Thirunelveli 8 Chengalpattu Medical 10 255 - - - - 20 20 - 35 35 35 100 College, Chengalpattu 9 Govt.Mohan 10 325 Kumaramangalam - 50 - -- 20 20 20 35 35 35 100 Medical College, Salem 10 K.A.P.Viswanatham 10 275 Medical College, - - - - 20 20 20 35 35 35 100 Thiruchirappalli 11 Thoothukudi Medical 10 255 - - - - 20 20 - 35 35 35 100 College,Thoothukudi 12 Kanniyakumari Medical 10 255 - - - - 20 20 - 35 35 35 100 College, Kanniyakumari 13 Vellore Medical College, 10 255 - - - - 20 20 - 35 35 35 100 Vellore 14 Theni Medical College, 10 255 - - - - 20 20 - 35 35 35 100 Theni 15 King Institute,Guindy ------50 - 50 16 Physically Handicapped - - 60 ------60 DMLT 17 Thatco-DMLT ------150 - 150 Total 120 400 60 60 280 280 200 500 500 500 1660 140 4700 18 Thatco -Paramedical - 350 ------Courses Grand Total 5050 15
1.11. PERSONNEL STRENGTH OF THE DIRECTORATE OF MEDICAL EDUCATION :
Sl. No. Name of the Post No. of Posts 1. Director of Medical Education 1
2. Additional Director of Medical Education 1
3. Joint Director of Medical Education (Pharmacy) 1
4. Deputy Secretary to Government/Deputy Director of Medical Education 1 (Administration)
5. Deputy Director of Medical Education 9
6. Deputy Secretary to Government/Financial Adviser & Chief Accounts Officer 1
7. Senior Civil Surgeon 1
8. Deputy Secretary to Government/Law Officer 1
9. Manager 1
10. Other Officers 11
11. Ministerial Staff 224
12. Basic Servants 39
TOTAL 291
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1.12. PERSONNEL STRENGTH OF THE COLLEGES: Other than Basic Sl.No. Name of the Institution Medical Para Medical Ministerial Ministerial Servants Total 1. Madras Medical College, Chennai 614 301 103 48 156 1222 2. Stanley Medical College, Chennai 298 59 57 36 126 576 3. Kilpauk Medical College, Chennai 278 35 28 45 71 457 4. Chengalpattu Medical College, 245 96 94 60 85 580 Chengalpattu 5. Thanjavur Medical College, 116 72 35 52 91 366 Thanjavur 6. Madurai Medical College, Madurai 303 274 65 73 139 854 7. Thirunelveli Medical College, 338 323 81 53 89 884 Thirunelveli 8. Coimbatore Medical College, 225 130 47 43 83 528 Coimbatore 9. Tamil Nadu Government Dental 56 26 21 7 21 131 College and Hospital, Chennai 10. Government College of -322512 Physiotheraphy, Thiruchirapalli 11. Government Mohan 235 33 19 11 40 338 Kumaramangalam Medical College, Salem 12. K.A.P.Viswanatham Govt. Medical 141 37 34 14 36 262 College, Thiruchirapalli 13. Thoothukudi Medical College, 116 162 14 - 3 284 Thoothukudi 14. Kanniyakumari Medical College, 184 76 96 2 60 418 Kanniyakumari 15. Theni Medical College, Theni 164 64 70 663 209 1170
TOTAL 3286 1673 799 1113 1211 8082 17
1.13. PERSONNEL STRENGTH OF THE HOSPITALS:
Name of the Institution Medical Nursing Para- Ministerial Other than Basic Servants Total Sl. Medical Ministerial and others No. (1) (2) (3) (4) (5) (6) (7) (8) 1. Government General Hospital, Chennai 114 696 1206 180 260 326 2782 2. Government Stanley Hospital, Chennai 66 383 223 93 225 406 1396 3. Government Kilpauk Medical College Hospital, 51 183 137 57 84 214 726 Chennai 4. Regional Institute of Ophthalmology and 21 83 83 54 132 373 Government Ophthalmic Hospital, Chennai 5. Government Royapettah Hospital, Chennai 63 192 251 98 9 206 819 (including Government Hospital, Saidapet, Chennai) 6. Institute of Social Obstetrics and Government 35 219 61 77 23 319 734 Kasturba Gandhi Hospital for Women and Children, Chennai 7. Institute of Obstetrics and Gynecology & 13 180 35 63 89 311 691 Govt. Hospital for Women and Children, Chennai 8. Institute of Child Health and Hospital for Children, 52 224 125 74 182 233 890 Chennai 9. Government R.S.R.M. Lying Hospital, Chennai 15 129 29 54 8 171 406 10. Institute of Mental Health, Chennai 23 162 61 53 322 215 836 11. Government Thiruvotteswarar Hospital for Thoracic 7 39 16 20 - 101 183 Medicine, Otteri, Chennai 12. Institute of Thoracic Medicine, Chetput, Chennai 11 18 16 14 9 24 92 13. Government Peripheral Hospital, K.K. Nagar, 12 24 12 11 2 43 104 Chennai 14. Govt. Peripheral Hospital, Anna Nagar, Chennai 29 25 19 9 20 24 126 15. Government Peripheral Hospital, Tondiarpet, 20 19 17 8 3 32 99 Chennai
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16. Government Institute of Rehabilitation Medicine, 2 15 88 20 6 33 164 K.K. Nagar, Chennai 17. Government Hospital for Thoracic Medicine, 17 142 68 45 - 243 515 Tambaram, Chennai
18. Government Chengalpattu Medical College 8 160 155 38 - 159 520 Hospital, Chengalpattu 19. Govt. Raja Mirasdar Hospital, Thanjavur 28 161 103 58 28 179 557 20 Govt Thanjavur Medical College Hospital , 36 149 163 35 35 172 560 Thanjavur 21. Government Peripheral Hospital, Periyar Nagar, 19 213 20 10 - 35 297 Chennai 22. Govt.Rajaji Hospital, Madurai (including) 78 378 302 80 570 1516 (i) Govt.Hospital for Thoracic Medicine, 108 Thoppur 7 24 15 1 35 86 (ii) Govt.Hospital, Balarangapuram 10 6 11 4 - 17 49 (iii) Govt. Cholera Collection Centre, Thoppur. 2 8 1 5 4 25 43 (iv) Govt.Infectious Diseases Hospital, 3 Thoppur. 2 12 7 1 16 39 1 23. Government Thirunelveli Medical College Hospital, 66 177 161 74 83 249 810 Thirunelveli (including) (i) Frieda Monniar Government Hospital Kalakkad, 2 4 2 5 15 28 24. Government Coimbatore Medical College Hospital, 90 261 254 76 - 251 932 Coimbatore 25. Government Arignar Anna Memorial Cancer 25 43 32 18 36 76 230 Hospital, Karapettai, Kancheepuram 26. Government Arignar Anna Memorial Cancer 11 4 19 8 - 8 50 Institute, Kancheepuram 27. King Institute, Guindy, Chennai-32 35 - 31 58 206 354 684
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28. Government Mohan Kumaramangalam Medical 83 227 66 22 36 155 589 College, Hospital, Salem 29. Annal Gandhi Memorial Govt. Hospital, 3 7 4 3 3 18 38 Tiruchirapalli (including) Government T.B Hospital, Tiruchirapalli 30. ThoothukudiGovt.Medical College Hospital, 38 108 78 25 16 94 359 Thoothukudi 31. Government Vellore Medical College Hospital, 51 124 54 32 36 157 454 Vellore (including) Subsidiary Hospitals, Vellore 3 20 13 7 7 24 74 Government Pentland Hospital, Vellore 14 21 7 11 22 6 81 32. Government Kanniyakumari Medical College 92 90 17 66 265 Hospital, Kanniyakumari (including) Subsidiary 85520 17 38 105 243 Hospital, Nagercoil 33. Government Theni Medical College Hospital, Theni 138 252 38 30 28 47 533 Total 1400 5147 4061 1592 2039 5734 19973
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1.14. HOSPITALS AND DISPENSARIES - NUMBER OF BEDS:
Name of the Institution A.C.Room A Class B Class C Class Ward General Ward Total Sl.N Ward Ward o. (1) (2) (3) (4) (5) (6) (7) 1. Government General Hospital, Chennai 4 18 74 1 2632 2729 2. Govt. Peripheral Hospital, Periyar Nagar - - - - 100 100
3. Government Stanley Hospital, Chennai - 6 12 - 1263 1281 (i) Government Peripheral Hospital, Tondiarpet, Chennai 4. Government Kilpauk Medical College Hospital, - 2 7 20 773 802 Chennai 100 100 (i) Government Peripheral Hospital, Anna Nagar, Chennai 5. Government Royapettah Hospital, Chennai - - 13 28 671 712 (i) Govt. Hospital, Saidapet, Chennai - - - - 32 32 (ii) Government Peripheral Hospital, K.K. 1 - - - 100 101 Nagar, Chennai 6. Regional Institute of Ophthalmology and Govt. 2 5 16 84 371 478 Ophthalmic Hospital, Chennai 7. Institute of Social Obstetrics and Government - - - - 695 695 Kasturba Gandhi Hospital for Women and Children, Chennai 8. Institute of Obstetrics and Gynaecology and 8 5 14 19 706 752 Government Hospital for Women and Children, Chennai 9. Institute of Child Health and Hospital for Children, - - - - 537 537 Chennai 10. Government R.S.R.M. Hospital-in-Lying Hospital, - - 58 - 452 510 Chennai 11. Institute of Mental Health, Chennai-10 - - 85 -- 1715 1800
12. Government Thiruvotteeswar Hospital for Thoracic - - 4 8 210 222 Medicine, Otteri, Chennai-12 21
13. Government Institute of Rehabilitation Medicine, -- - -6060 K.K. Nagar, Chennai-83 14. Government Hospital for Thoracic Medicine, - - - 24 862 886 Tambaram, Chennai-47 15. Government Chengalpattu Medical College - - 6 24 600 630 Hospital, Chengalpattu 16. Government Raja Mirasdar Hospital, Thanjavur - - - 10 662 672
17. Govt. Thanjavur Medical College Hospital, 1 6 10 - 661 678 Thanjavur 18. Government Rajaji Hospital, Madurai 19 7 23 38 2131 2218 I)Government Hospital, Balarangapuram - - - - 40 40 ii) Government Hospital for Thoracic Medicine, - - - - 207 207 Thoppur - - - - 52 52 iii) Government Hospital for Infectious diseases, - - - - 28 28 Thoppur iv) Government Cholera Collection Centre, Thoppur 19. Tirunelveli Medical College Hospital, Tirunelveli – - - - - 1296 1296 including Frieda Monnier Govt Hospiral, - - - - 30 30 Kalakad 20. Coimbatore Medical College Hospital, Coimbatore 1 3 6 38 997 1045
21. Government Arignar Anna Memorial Cancer - - - - 286 286 Hospital, Karapettai, Kancheepuram 22. Government Mohan Kumaramangalam Medical - 11 - 9 811 831 College Hospital, Salem 23. Annal Gandhi Memorial Government Hospital, - - 12 - 609 621 Tiruchirapalli (including) Government Rajaji T.B. Hospital, Tiruchirapalli - - - - 100 100 24. Thoothukudi Govt. Medical College Hospital, - - 4 10 598 612 Thhothukudi 22
25. Government Vellore Medical College Hospital, - - - - 541 541 Vellore (including) Subsidiary Hospitals - - - - 148 148 and Government Pentland Hospital Vellore. - - - - 100 100 26. Government Kanyakumari Medical College Hospital, Kanyakumari (including) - - - - 404 404 Subsidary Hospital, Nagercoil -- - - - 400 400 27. Government Theni Medical College Hospital, Theni 600 600 Total 36 63 344 313 22580 23336
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1.15. STATEMENT SHOWING THE NUMBER OF IN-PATIENTS ADMISSIONS:
Sl. Total Number of Average Per Day Total Number of No. Name of the Hospitals In-patients Treated Out-Patients Treated 2006-2007 2007-2008 2006-2007 2007-2008 2006-2007 2007-2008
(1) (2) (3) (4) (5) (6) 1. Government General Hospital, Chennai 861329 852690 2360 2336 2576900 3214335 (i) Government Peripheral Hospital, Periyar Nagar 23360 22265 64 61 393242 379286 2. Government Stanley Hospital, Chennai 478515 478880 1311 1312 2346220 2372850 (i)Government Peripheral Hospital, Tondiarpet, 18250 18500 50 51 265750 266750 Chennai 3. Government Kilpauk Medical College Hospital, 281050 281415 770 771 1125660 1589003 Chennai 16425 19447 45 53 480705 (i)Government Peripheral Hospital, K.K. Nagar, 476614 Chennai 4. Government Royapettah Hospital, Chennai 260975 261340 715 716 1009943 1008943 (i)Government Hospital, Saidapet, Chennai-15 1825 1900 5 5 511730 512230 5. Regional Institute of Ophthalmology and 103295 103660 283 284 196602 195086 Government Ophthalmic Hospital, Chennai-8 6. Institute of Social Obstetrics and Government 302220 302585 828 829 313220 275447 Kasturba Gandhi Hospital for Women and Children, Chennai 7. Institute of Obstetrics and Gynaecology and 354050 390288 970 1069 202181 177080 Government Hospital for Women and Children, Chennai 8. Institute of Child Health and Hospital for Children, 237980 238710 652 654 742095 814680 Chennai
9. Government R.S.R.M. Lying-in Hospital, Chennai 158410 158775 434 435 123637 121910
10. Institute of Mental Health, Chennai 440920 441285 1208 1209 120450 122110
11. Government Tiruvotteswarar Hospital for Thoracic 42705 43070 117 118 96828 95335 Medicine, Otteri, Chennai-12 24
12. Govt. Peripheral Hospital, Arignar Anna Nagar, 31390 31255 86 85 356240 336672 Chennai
13. Government Institute of Rehabilitation Medicine, 15695 15785 43 43 117402 117905 K.K. Nagar, Chennai- 14. Tamil Nadu Government Dental College and - - - - 271895 326824 Hospital, Chennai 15. Government Hospital for Thoracic Medicine, 319375 319740 875 876 358795 372676 Tambaram,
16. Government Chengalpattu Medical College 253675 254040 695 696 1300495 1287666 Hospital, Chengalpattu 17. Government Raja Mirasdar Hospital, Thanjavur 319010 329019 874 901 1079670 1181621
18. Government Thanjavur Medical college Hospital, 293947 294190 805 806 788035 829095 Thanjavur
19. Government Rajaji Hospital, Madurai 825630 825995 2262 2263 2738230 2881315 (i) Government Hospital, Balarangapuram, 5513 5523 15 15 174430 174532 Madurai (ii) Government Hospital for Thoracic Medicine, Thoppur, Madurai 48696 48701 133 133 - - (iii) Government Infectious Diseases Hospital, 845 732 2 2 - - Thoppur, Madurai 2555 2190 7 6 - - (iv) Government Cholera Collection Centre, Thoppur, Madurai 20. Government Thirunelveli Medical College Hospital, Thirunelveli 367836 1008 746425 935078 361704 (i) Frieda Monniar Hospital, Kalakkad, 3779 10 990 47815 44464 3789 Thirunelveli 10 21. Coimbatore Medical College Hospital, Coimbatore 521950 522315 1430 1431 1715500 1784956
22. Government Arignar Anna Memorial Cancer 86505 86905 237 238 32850 33100 Hospital, Karapettai, Kanchipuram 23. Government Arignar Anna Memorial Cancer - - - - 30660 30945 Institute, Kancheepuram
25
24. Government College of Physiotherapy, - - - - 28401 28407 Thiruchirapalli
25. Government Mohan Kumaramangalam 369745 370475 1013 1015 1746160 1554593 Medical College Hospital, Salem 26. Annal Gandhi Memorial Government Hospital, 268921 269173 737 739 1343200 1344350 Thiruchirapalli (including) Government Rajaji 15058 14395 41 39 48910 48980 T.B. Hospital,Thiruchirapalli. 27. Institute of Thoracic Medicine, Chetput, - - - - 269370 269505 Chennai
28. Thoothukudi Govt.Medical College Hospital, 235052 235425 644 646 1035209 1033680 Thoothukudi
29. Government Vellore Medical College Hospital, 243699 244149 668 670 516761 517951 Vellore (including) Subsidiary Hospital, Vellore and Government Pentland Hospital,Vellore 30. Government Kanniyakumari Medical College 185102 186150 507 511 Hospital, - - - - 821250 823761 Kanniyakumari (including) Subsidiary 29930 30045 Hospital,Nagercoil. Government Theni Medical Gollege, Hospital, 171915 214592 471 587 382977 502214 31 Theni. Total 8167202 8251052 22375 22605 26485773 28111994
26
1.16. STATEMENT SHOWING THE NUMBER OF OUT-PATIENTS AND ADMISSIONS:
Average Number of Total Number of Average Length Out-Patients Per Day In-Patients Discharged of Stay Per Patient Sl. Name of the Institution (in days) No. 2006-2007 2007-2008 2006-2007 2007-2008 2006-2007 2007- 2008 (1) (2) (3) (4) (5) (6) (7) 1. Government General Hospital, Chennai 7060 8806 83009 82913 9 10 2. Government Stanley Hospital, Chennai 6428 6500 57785 57797 8 8 3. Government Kilpauk Medical College Hospital, Chennai 3084 4353 42279 42275 7 8 Regional Institute of Ophthalmology and Government Ophthalmic 4. 538 535 12722 14112 7 7 Hospital, Chennai Government Royapettah Hospital, Chennai 2766 2765 28116 27994 8 7 5. (i) Government Hospital, Saidapet, Chennai-15 1402 1403 282 291 8 5 Institute of Social Obstetrics and Government Kasturba Gandhi 6. 858 754 28278 25688 11 12 Hospital for Women and Children, Chennai Institute of Obstetrics and Gynaecology and Government Hospital for 7. 553 486 33712 34195 11 11 Women and Children, Chennai 8. Institute of Child Health and Hospital for Children, Chennai 2033 2232 34843 36231 6 6 9. Government R.S.R.M. Lying-in Hospital, Chennai 338 334 22858 32451 8 8 10. Institute of Mental Health, Chennai 330 335 3190 3279 106 106 Government Thiruvotteswarar Hospital for Thoracic Medicine, Otteri, 11. 265 262 2571 2884 15 16 Chennai 12. Institute of Thoracic Medicine, Chetput, Chennai 738 738 - - - 13. Government Peripheral Hospital, K.K. Nagar, Chennai 1317 1306 2964 5317 8 9 14. Government Peripheral Hospital, Anna Nagar, Chennai 976 922 5430 7044 8 8 15. Government Peripheral Hospital, Tondiarpet, Chennai 728 731 1972 1983 6 7 16. Government Institute of Rehabilitation Medicine, K.K. Nagar, Chennai 322 323 419 423 25 26 17. Government Hospital for Thoracic Medicine, Tambaram, Chennai 983 1022 24036 24072 12 12 27
18. Government Chengalpattu Medical College Hospital, Chengalpattu 3563 3528 43388 45747 6 6 19. Raja Mirasdar Hospital, Thanjavur 2958 3237 53638 54255 7 6 20. Government Thanjavur Medical College Hospital, Thanjavur 2159 2271 43510 47353 7 7 21. Tamil Nadu Government Dental College and Hospital, Chennai 745 895 -- 22 Government Rajaji Hospital, Madurai 7502 7894 90621 95636 9 8 (i) Government Hospital for Thoracic Medicine, Thoppur, Madurai - - 1205 1205 51 51 (II) Government Hospital, Balarangapuram, Madurai 478 478 713 716 8 8 (iii) Government Cholera Collection Centre, Thoppur, Madurai - - 576 579 2 2 (iiii) Government Infectious Diseases Hospital, Thoppur, Madurai - - 314 317 2 2 Government Thirunelveli Medical College, Hospital, Thirunelveli 2045 2562 45462 49608 11 9 23. (i) Frieda Monniar Government Hospital Kalakkad, Thirunelveli 131 122 562 567 15 15 24. Government Coimbatore Medical College Hospital, Coimbatore 4700 4890 68498 68104 7 8 Government Arignar Anna Memorial Cancer Hospital, Karapettai, 25. 90 91 4151 4187 21 25 Kancheepuram 26. Government Arignar Anna Memorial Cancer Institute, Kancheepuram 84 85 - - - - 27. Government Peripheral Hospital, Periyar Nagar, Chennai 1077 1040 2138 1942 10 10 28. Government College of Physiotheraphy, Thiruchirapalli 78 78 - - - - Government Mohan Kumaramangalam Medical College Hospital, 29. 4784 4259 53079 55755 6 6 Salem Annal Gandhi Memorial Government Hospital, Thiruchirapalli 3680 3683 53358 53397 5 5 30. (including)Government Rajaji T.B. Hospital, Thiruchirapalli 134 134 928 925 15 15 31 Thoothukudi Govt.Medical College Hospital, Thoothukudi 2836 2832 34454 33861 6 6 Government Vellore Medical College Hospital, Vellore (including) 1416 1419 41429 41539 4 4 32. Subsidiary Hospital,Vellore. - - - - - Government Kanniyakumari Medical College Hospital, 2250 2257 27348 30087 7 7 33. Kanniyakumari (including) Subsidiary Hospital ,Nagercoil. 82 82 - - - -
34. Government Theni Medical College Hospital, Theni 1049 1375 23966 27478 7 8 Total 72560 77019 973804 1012207 - - 28
1.17. NUMBER OF OPERATIONS PERFORMED, NUMBER OF X-RAYS TAKEN ETC.DURING THE YEAR 2007-2008:
Name of the Institution Number of Operations Number of Number Number Performed Laboratory of X-rays of MRI /C Sl. Tests Taken T Scan No. Conducted Taken Major Minor Total (1) (2) (3) (4) (5) (6) (7) 1. Government General Hospital, Chennai 20902 42878 63780 1772213 251970 4529/ 29792 2. Government Stanley Hospital, Chennai 13828 24830 38658 878161 147864 16894 3. Government Kilpauk Medical College Hospital, Chennai 18905 6984 25889 289432 72037 8308 4. Regional Institute of Ophthalmology and Government Ophthalmic 21040 20174 41214 126824 2292 12687 Hospital, Chennai 5. Government Royapettah Hospital, Chennai(including) 7731 24032 31753 532514 90763 11853 (i) Government Hospital, Saidapet, Chennai-15 - 6600 6600 35899 1595 - 6. Institute of Social Obstetrics andGovernment Kasturba Gandhi 9456 15559 25015 481268 9791 - Hospital for Women and Children, Chennai 7. Institute of Obstetrics and Gynaecology and Government Hospital 14382 16122 30504 473421 12022 - for Women and Children, Chennai 8. Govt.Inst. of Child Health and Hospital for Children, Chennai 5911 9784 15695 591424 63396 - 9. Government R.S.R.M. Lying-in Hospital, Chennai 9455 1075 10530 448930 1515 3863 10. Government Institute of Mental Health, Chennai - - - 116342 4007 - 11. Govt. Thiruvotteswarar Hospital for Thoracic Medicine, Chennai - - - 52593 4520 - 12. Institute of Thoracic Medicine, Chetput, Chennai - - - 35914 34667 - 13. Government Peripheral Hospital, K.K. Nagar, Chennai 308 627 935 40507 4615 - 14. Government Peripheral Hospital, Anna Nagar, Chennai 368 1039 1407 81535 7866 - 15. Government Peripheral Hospital, Tondiarpet, Chennai 137 156 293 43164 1127 - 29
16. Government Institute of Rehabilitation Medicine, K.K. Nagar, - 39 39 1505 1723 - Chennai 17. Government Hospital for Thoracic Medicine, Tambaram, Chennai - 3822 3822 1003256 83950 - 18. Government Chengalpattu Medical College Hospital, Chengalpattu 9072 18658 27730 352072 51980 10654 19. Government Raja Mirasdar Hospital, Thanjavur 14237 11907 26144 325369 23489 20. Government Thanjavur Medical College Hospital, Thanjavur 5662 4450 10112 538700 72910 12223 21. Tamil Nadu Government Dental College and Hospital, Chennai 469 2853 3322 31965 59809 - 22. Government Rajaji Hospital, Madurai 30529 41072 71601 1767554 101737 2681/202 (i) Government Hospital, Balarangapuram, Madurai 62 257 319 17825 1205 50 (ii) Government Hospital for Thoracic - - - 12345 595 - Medicine,Thoppur,Madurai 23. Government Thirunelveli Medical College, Hospital, Thirunelveli 10869 14616 25485 962467 67373 862/1299 (i) Frieda Monniar Government Hospital Kalakkad, - 149 149 1594 224 6 Thirunelveli _ 24. Government Coimbatore Medical College Hospital, Coimbatore 15659 11001 26660 4121383 57092 16621 25. Government Arignar Anna Memorial Cancer Hospital, Karapettai, 274 2021 2295 64680 3295 - Kancheepuram 26. Government Peripheral Hospital, Periyar Nagar, Chennai 148 939 1087 35862 3617 - 27. Government Mohan Kumaramangalam Medical College Hospital, 8559 24965 33524 883523 70111 16920 Salem 28. Annal Gandhi Memorial Government Hospital, Thiruchirapalli 8970 12845 21815 426155 26795 13324 (including) Government Rajaji T.B. Hospital, Thiruchirapalli - - - 8082 2445 - 29. Thoothukudi Govt. Medical College Hospital, Thoothukudi 5549 3389 8938 447799 31102 8100 30. Arignar Anna Memorial Cancer Institute, Kancheepuram - - - 23465 - - 31. Government Vellore Medical College Hospital, Vellore (including) 5425 2890 8315 247175 17140 7540 Subsidiary Hospital, Vellore. 32. Government Kanniyakumari Medical College Hospital, 6901 21491 28392 427945 20770 4680 Kanniyakumari (including) Subsidiary Hosital, Nagercoil. ------33 Government Theni Medical College Hospital,Theni. 5185 4479 9664 455679 32062 7967 Total 249993 351703 601696 18156541 1439471 8072/ 214672 30
1.18. King Institute of Preventive Medicine, Guindy, Chennai:
1.18.1. The King Institute of Preventive Medicine, Guindy, Chennai was started in 1899 and is being maintained by the Government of Tamil Nadu. It was originally designed to serve as a vaccine lymps depot of the State. This Institute has been developed into a major Public Health Laboratory in the country, manufacturing human vaccines and sera with allied Teaching and Research in the field of Microbiology and Immunology.
1.18.2. Department of Anti-Toxin :
This department is engaged in the manufacture of polyvalent Anti Snake venom that neutralizes Venoms of 4 dangerous poisonous Snakes.
1.18.3. Department of Tetanus Toxoid:
This Department is engaged in the manufacture of Tetanus Toxoid (PTAP) vaccine. This vaccine is supplied to all the Government Hospitals through Tamil Nadu Medical Services Corporation.
1.18.4. Blood Bank:
1. Anti A1, Lectin is manufactured and supplied to Government Hospitals in Tamil Nadu State.
2. Blood grouping and Rh typing are done for Tamil Nadu State Police trainees from various centres and for staff of various Government departments.
3. Rh antibody titre, coombs tests and other tests are carried out for Rh negative pregnant women referred to by Government Hospitals as well as private hospitals.
4. Training on safe blood transfusion for Medical Officers and Nurses from various Government Hospitals in Tamil Nadu State is given. Teaching work for M.D.(Micro). D.C.P. and under graduates and Technicians on Blood Transfusions and Immuno Haematology is also carried out in this department.
5. Storage and supply of AIDS kits to Government and private hospitals.
1.18.5. Therapeutic Vaccine Section:
In the therapeutic vaccine section, maintenance of cultures, manufacture and supply of auto vaccines, therapeutic vaccine, diagnostic, bacterial suspension and Anti-sera are carried out throughout the year.
1.18.6. Clinical Section:
1) Testing of food samples are carried out for VVIPs on their visit to Chennai.
2) Stool samples are received from PHCs for detection of vibro cholera.
1.18.7. Serological section: Various serological tests are carried out. 31
1.18.8. Virology Department:
This Department is recognized by the Government of India and World Health Organization as National Polio Laboratory and National Measles Laboratory for South-East Asian region of W.H.O. It is a multi-site monitoring for human influenza virus centre in collaboration with Indian Council of Medical Research and an Arbo viral centre. Routine laboratory diagnosis of Herpes simplex, Coxsackie and Rubella viruses are also undertaken and a State referral Laboratory for IDSP.
1.18.9. Veterinary Section: Horses and mules are maintained for the production of polyvalent Anti snake venom serum.
1.18.10. Animal House: Small animals like Rabits, rats, Guinea pigs and mice are maintained and supplied.
1.18.11. Department of Biological Control :
It functions as a Laboratory for analysis of schedule C drugs for State under the Drugs and Cosmetics Act. Drug samples received from Tamil Nadu Medical Services Corporation courts and private blood banks are analyzed and reported on payment basis.
1.18.12. Library:
All the standard journals and reference books in Microbiology, Virology, Immunology, Bio-chemistry and its allied subjects are available.
1.18.13. International Vaccine Centre:
This centre mainly deals with issue of International Vaccination Certificate to the Travellers particularly for Yellow Fever.
1.18.14. In this Institute, media sections, Centre filling and packing section, Maintenance section (Mechanical , Electrical ,Refrigeration), Oversee section, Medical Stores, Administrative office are also functioning.
1.18.15. RECEIPT AND EXPENDITURE - KING INSTITUTE: (Rs. in lakhs) Year Receipts Expenditure 2006-2007 15.75 548.16
32 Chapter - 2
MEDICAL AND RURAL HEALTH SERVICES
2.1. The Director of Medical and Rural Health Services is in-charge of planning and execution of all programmes of Medical and Rural Health Services Department in Tamil Nadu. He is responsible for rendering the Medical care services, through the grid of 26 District Headquarters Hospitals, 155 Taluk Hospitals, 80 Non Taluk Hospitals, 11 Dispensaries, 11 Mobile Medical Units, 7 Women and Children Hospitals, 2 TB Hospitals/Sanatorium, 2 TB Clinics and 7 Leprosy Hospitals / Centres. He also implements various Acts like Human Organ Transplantation Act and Pre-conception and Pre-natal Diagnostic Techniques (Prohibition of Sex Selection) Act,1994 and Accreditation of Private Hospitals, District Mental Health Programme etc.
2.2. The State has been divided into 30 Revenue Districts for the implementation of the medical care services. The Joint Directors of Medical and Rural Health Services and Family Welfare are the overall controlling officers of all the Medical Institutions for the implementation of medical care services including family welfare. They are the supervising authority for all health programmes. The Deputy Directors of Medical Services (Thoracic Medicine) in every District look after the TB Control Programme. Specialists in the rank of Civil Surgeons are also provided in the District Headquarters Hospitals. The Deputy Director of Medical Services (Leprosy) in every District looks after the Leprosy Eradication Programme. The Leprosy Programme has been integrated with the Department of Public Health and Preventive Medicine in order to involve Leprosy Field Staff in Public Health work and the Health Inspectors in Leprosy work.
2.3. Improvements to District, Taluk, Non Taluk Hospitals and Dispensaries constitute an important development of plan of activities in the shape of expanded medical facilities, specialized services such as Medicine, Surgery, Obstetrics and Gynaecology, Ophthalmology, ENT, Venereology, Orthopaedic Surgery, Anaesthesiology, Child Health, Dental, Psychiatric Clinics, Ambulance Services, Pathological Laboratory Services, Leprosy, TB, Diabetic clinics, Cardiology, Nephrology and most of other improvements. Accident and Emergency Service to meet the accident hazards is being implemented in a phased manner. The Maternity and Child Health and Family Welfare activities are undertaken effectively through non-teaching medical institutions under family welfare post partum programme.
2.4. This Department is also coordinating the other departments' programmes, such as Control of Blindness, Medical facilities under Hill Area Development Programme and Adi- Dravidar and Tribal Welfare Schemes etc.
2.5. DIRECTION, SUPERVISION AND POLICY FORMATION:
2.5.1.The strength of various categories of staff functioning in the office of the Director of Medical and Rural Health Services is given below:
33
Staff strength at the Directorate
S.No Name of the Post No. of Post
01 Director 1
02 Additional Directors 5
03 Additional Director (Admn) 1
04 Joint Directors 3
05 Joint Director(Admn) 1
06 Deputy Director (Admn) 1
07 Deputy Director (Leprosy) 1
08 Deputy Director (Nursing) 1
09 Financial Advisor & Chief Accounts Officer 1
10 Other A & B Group Officers 9
11 Ministerial staff 186 2.5.2. 12 Others 90 Hospital and Dispensa Total 300 ries:
Each District has a District Headquarters Hospital, Taluk Headquarters Hospitals, Non-Taluk Hospitals and Dispensaries. On need basis, the District level administrative control of the Medical Institutions including Family Welfare Programme is vested with the Joint Director of Medical and Rural Health Services and Family Welfare. The strength of staff under District level Administration is given below: 34
S.No Name of the Post No. of Posts
01 Joint Director Health services 29
02 Senior Civil Surgeon (General) 247`
03 Senior Civil Surgeon (Dental) 24
04 Senior Civil Surgeon (Foreign Service) 78
05 Civil Surgeon Specialists 161
Deputy Director of Medical & Rural Health 06 24 Services & Family Welfare
07 Deputy Director (TB) 28
08 Deputy Director (Leprosy) 19
Assistant Surgeon / Sr. Asst. Surgeon / Civil 09 2041 Surgeon(including Dental )
10 Nursing Staff 4614
11 Ministerial Staff 1286
12 Para Medical Staff 4130
13 Other Staff 4632
Total 17313
2.6. Hill Area Development Programme:
The following institutions are now functioning under Hill Area Development Programme in the State: 1. Forty bedded ward at Government Headquarters Hospital, Udhagamandalam. 2. Forty bedded ward at Government Hospital, Gudalur. 3, Government Dispensary at Gudalur Bazaar. 35 XVI. XVII. 2.7. Tribal Development Programme:
Government have established the following Dispensaries to provide medical facilities to the Tribal Population especially living in remote areas:
1.Thoradipattu, Kalrayan Hills in Villupuram District 2. Melnilavur, Kalrayan Hills, Villupuram District. 3.Government Tribal Dispensary at (Kalrayan Hills) Villupuram District. 4.Kariyakoil, Kalrayan Hills, Salem District. 5. Sempulichampatti, Thiruchi District.
2.8. T.B. CONTROL PROGRAMME:
2.8.1. Every year, about 18 lakh persons develop TB in India. In our State, every year about 1.4 lakh persons develop Tuberculosis, among which forty eight thousand have TB Bacilli in their sputum.
2.8.2. There are 8 TB Hospitals in Tamil Nadu – 2 under the control of the Directorate of Medical and Rural Health Services, 4 under the control of Directorate of Medical Education and 2 private. There are 3091 beds in the State exclusively for in-patient Treatment of acutely ill- patients. All the other patients are under the Directly Observed Treatment Short course (DOTS) treatment in the nearest health facility of the patient. A State level Officer in the rank of Additional Director of Medical and Rural Health Services is acting as State Tuberculosis Officer to coordinate and supervise the Revised National Tuberculosis Control Programme (RNTCP). At the District level, the Deputy Director of Medical Services is the manager of the Programme.
2.8.3. Government of India with the World Bank assistance is providing 100% expenditure for drugs and establishment cost of all District TB Control Societies headed by the District Collectors. The State Government meet the entire expenditure on running all the District TB Centres and Government TB Hospitals.
2.8.4. The Revised National TB Control Programme (RNTCP) is implemented in all the Districts through 142 TB Units (one for every 5 lakh population), 782 Microscopic Centres (one for every one lakh population) and about 11,000 DOT Centres. The RNTCP Programme also has a good partnership with NGOs, Private Hospitals and Private Doctors, Railways, Port Trust and Military Hospitals. The Programme has examined 4 lakh persons and diagnosed about 64,051 TB patients during the year 2007-08 (till 31.12.2007) of them 24,923 persons are new sputum positive patients, 83% of these patients are cured. It has achieved all the parameters and targets fixed by Government of India. 36 2.8.5. ACHIEVEMENTS UNDER THE RNTCP PROGRAMME:
Chest Symptomatics for New Sputum Positive TB Cure rate w.r.t. whom sputum examination Patients diagnosed new sputum was done positive TB patients diagnosed Year
% % Target Target Target Achievement Achievement Achievement
2000-2001 308880 384506 124% 30890 24533 79% 85% 37% 2001-2002 310550 380747 123% 31055 23589 76% 85% 81% 2002-2003 310550 376037 121% 31055 24346 78% 85% 84% 2003-2004 310550 596367 192% 31055 36104 116% 85% 88% 2004-2005 486024 632533 130% 48602 39562 81% 85% 89% 2005-2006 486024 650123 134% 48602 36066 74% 85% 86% 2006-2007 489457 603073 123% 48946 32991 67% 85% 82% 2007-2008 489457 404064 83% 48946 24924 51% 85% 83% * * Upto 31.12.2007
2.8.6. EXPENDITURE DETAILS UNDER TB CONTROL PROGRAM:
YEAR GOI (External Assistance Component) (Rs. in Lakhs) 2000-2001 281.88 2001-2002 755.59 2002-2003 485.54 2003-2004 565.00 2004-2005 735.93 2005-2006 830.32 2006-2007 840.37 2007-2008 * 576.80
* upto 31.12.2007
2.9. DISTRICT MENTAL HEALTH PROGRAMME:
The District Mental Health programme is first implemented as pilot project in Thiruchirappalli district. This scheme has been extended to Madurai and Ramanathapuram districts. It is now under implementation in Theni, Kanniyakumari, Erode, Dharmapuri and Nagapattinam districts. This is a centrally sponsored scheme. The Central assistance for the Thiruchirappalli District is over and the scheme has been taken over by the State from the year 2005-06. And now the District Mental Health programme has been extended to 8 more Districts (i.e) Kancheepuram, Thiruvallur, Cuddalore, Thiruvarur, Virudhunagar, Nagapattinam, Chennai and Perambalur with Central assistance from 2007-08.
2.10. PRE-CONCEPTION AND PRE-NATAL DIAGNOSTIC TECHNIQUES (PROHIBITION OF SEX SELECTION) ACT,1994:
As per the Act, 3,502 scan centers have been registered so far. 72 cases for violation of the Act have been identified and cases filed against them. Out of the 72 cases, judgment has 37 been delivered in 53 cases and 19 cases are under trial.
2.11. UPGRADATION AND STRENGTHENING OF ACCIDENT AND EMERGENCY FACILITIES:
The Government of India have sanctioned Rupees 14.48 Crores for upgradation and strengthing of Accident and Emergency facilities to 10 Government Hospitals which are situated in the National Highways. Out of 10 Government Hospitals, Perambalur Government Headquarters Hospital is functioning from 27/01/2004 and the No. of cases admitted, treated and referred to the other Higher Medical Institutions is as follows:
REFERRED TO YEAR ROAD TRAFFIC ASSAULT OTHER HIGHER ACCIDENT MEDICAL INSTITUTIONS
2004 426 315 30
2005 430 262 72
2006 381 208 33
2007* 340 131 59
*upto 31.12.2007
The new upgradation and strengthening of Accident and Emergency building of Government Head quarters Hospital, Villupuram has started functioning with effect from 09.02.2008. The construction work of remaining Accident and Emergency ward in 8 Government Headquarters Hospital is not yet completed.
38
2.12. Tamil Nadu State Illness Assistance Society: The Government of Tamil Nadu have constituted the Tamil Nadu State Illness Assistance Society with a Revolving Fund of Rs.15.00 crores as an initial corpus fund. The funding pattern will be in the ratio of 2:1 between State Government and Government of India. The affairs of the Tamil Nadu State Illness Assistance Society is administered by the Executive Committee under the Chairmanship of the Secretary to Government, Health and Family Welfare Department. The Director of Medical and Rural Health Services acts as the Member Secretary. The Society provides financial assistance to the poor patients below poverty line for undergoing life saving surgical treatment in specified categories like, Open Heart Surgery, Kidney Transplantation, Skull opening, Hip replacement, Spinal cord surgeries etc., in accredited private Hospitals through the District collectors as was done under Chief Minister's Public Relief Fund Scheme. In order to facilitate heart surgery for children from poor families requiring it without any delay, the Young Children Heart Surgery Scheme is being implemented by this Government in partnership with private hospitals. Under this scheme, the Government provides grants-in-aid upto Rs.70,000 to private hospitals. So far, 17 reputed hospitals have been selected and 200 children have been provided assistance for heart surgery.
39
2.13. OBJECT-WISE CLASSIFICATION: (Rupees in lakhs) S.No. Object Accounts Budget Revised 2006-07 Estimate Estimate 2007-2008 2007-2008 1 Salaries 11167.42 13936.10 11564.24 2 Wages 4.07 2.27 4.73 3 Dearness Allowance 4263.48 6738.94 6122.13 4 Dearness Pay 4244.26 6239.81 5101.24 5 Travel Expenses 44.89 58.95 48.04 6 Office Expenses 760.14 847.03 858.07 7 R.R.T. 33.61 31.86 32.82 8 Advertisement and Publicity 10.55 11.50 11.50 9 Grants – in – aid 542.56 542.58 542.58 10 Contribution 5.42 5.76 5.02 11 Periodical Maintenance (PWD) 1757.85 1987.43 1987.43 12 Wages (PWD) 96.62 3.64 3.64 13 Machinery & Equipment 638.45 169.17 351.31 14 Motor Vehicle 112.33 10.69 55.23 15 Inter Accounts Transfer -12.62 -20.00 -20.00 16 Payment for Professional and 218.89 364.20 233.59 Special Services 17 Petrol, Oil, Lubricant 106.75 205.17 154.24 18 Clothing Tentage and Stores 50.29 65.31 62.60 19 Stores and Equipments 199.53 377.48 464.86 20 Festival Advance 77.02 117.68 236.04 21 Compensation 27.13 0.02 1.08 22 Prizes and Awards 1.67 3.07 2.36 23 Medicines 4653.91 5105.17 5208.65 24 Feeding Dietary Charges 574.20 668.21 633.00 25 Computer & Accessories 1.14 6.47 6.84 26 Training 25.00 25.00 25.00 27 Deduct Recoveries(-) -138.81 -117.68 -236.04 Total 29465.75 37385.83 33460.20 40 2.14. DISTRICT WISE INSTITUTIONS UNDER DM & RHS – 2007-2008:
NON - HQRS TALUK OTHERH Sl.No. District TALUK TOTAL Hospitals Hospitals Hospitals Hospitals 1 Kancheepuram 1 6 1 3 11 2 Vellore 1 5 4 1 11 3 Thiruvannamalai 1 5 1 0 7 4 Cuddalore 1 5 2 1 9 5 Dharmapuri 0 4 0 3 7 6 Salem 1 6 2 2 11 7 Erode 1 6 3 1 11 8 Coimbatore 1 6 8 2 17 9 The Nilgiris 1 5 0 6 12 10 Thiruchirappalli 1 6 2 1 10 11 Pudukkottai 1 8 3 1 13 12 Dindigul 1 6 5 2 14 13 Madurai 1 4 1 1 7 14 Virudhunagar 1 7 1 1 10 15 Sivagangai 1 5 4 7 17 16 Ramanathapuram 1 6 3 0 10 17 Thirunelveli 1 6 6 1 14 18 Thoothukudi 1 6 2 0 9 19 Kanniyakumari 1 2 6 0 9 20 Nagapattinam 1 7 4 0 12 21 Thanjavur 1 6 6 0 13 22 Villupuram - 7 2 4 13 23 Karur 1 3 2 0 6 24 Perambalur 1 5 1 0 7 25 Thiruvallur 1 7 3 1 12 26 Thiruvarur 0 6 1 1 8 27 Theni 1 3 2 0 6 28 Namakkal 1 3 4 0 8 29 Krishnagiri 1 4 1 1 7 Total 26 155 80 40 301 41 2.15. FINANCIAL PERFORMANCE: DIRECTORATE OF MEDICAL AND RURAL HEALTH SERVICES:
(Rs. in Lakhs)
Sl Programme Activity Classification Accounts 2006-2007 Budget Estimate 2007-08 R No Plan Non Plan Total Plan Non Plan Total P
1.a Direction and Adminstration at Head 4.58 381.26 385.84 - 542.85 542.85 - quarters level
b. Direction and Adminstration at District - 4.70 614.70 - 850.10 850.10 - level 2.a Hospitals & Dispensaries 823.12 23191.70 24014.82 53.48 30435.95 30489.43 1 b. Ambulance and Mortuary van - 64.42 64.42 - 92.80 92.80 - c. Mobile Medical Unit - 28.77 28.77 - 39.69 39,69 - 3a. Leprosy control Programme 11.86 740.41 852.27 - 1332.25 1332.25 - b. T.B.Conntrol Programme 12. 50 629.27 641.77 0.01 894.94 894.95 0 c. Control of AIDS 6.53 - 6.53 5.21 - 5.21 6 d Illness Assistance Society 500.00 - 500.00 500.00 - 500.00 5 4. Grants - 42.56 42.56 - 42.58 42.58 - 5. Laboratory Services - 87.06 87.06 - 116.14 116.14 - 6. Prevention and Control of Blindness - 254.72 254.72 - 345.15 345.15 - 7. Mental Health Programme 92.08 - 92.08 114.76 - 114.76 1 8 Maintenance and Repair - 1854.47 1854.47 - 1991.07 1991.07 - 9. Hill Area Development Programme 0.32 38.04 38.36 0.40 48.44 48.84 0 10 Medical Relief - -12.62 -12.62 - -20.00 -20.00 - 11 Pay Wards - - - 0.01 - 0.01 0 Total 1550.99 27914.76 29465.75 673.87 36711.96 37385.83 7 42 2.16. Physical Performance Report of District Headquarters Hospitals, Taluk and Non-Taluk Hospitals and Dispensaries (District-wise):
Ave- Sl. TOTAL Average TOTAL rage No. DISTRICT OP OP/DAY IP IP/ BEDS DAY Major Opera tions done Minor Operat ions done Emergency cases treated Total Deliveries Caesareans Medico-legal cases treated Post Mortem done Accident cases 01 Kancheepuram 786 2822015 7710 225282 616 6868 59111 242006 8975 1625 12865 1269 7 02 Vellore 972 2880271 7870 305219 834 11843 19262 85360 12103 1558 13712 979 4 03 Thiruvannamalai 773 2497235 6823 271505 742 12798 53388 58294 7509 825 13224 505 3 04 Cuddalore 1026 2835586 7748 323032 883 11579 29453 28744 10557 2120 13160 926 6 05 Dharmapuri 555 1503831 4109 179300 490 4426 7221 16663 5481 1155 14270 562 4 06 Salem 531 2284979 6243 153119 418 2805 17267 26974 3332 516 10476 383 4 07 Erode 1145 3847183 10511 409075 1118 9548 25508 16923 7471 2342 12939 1521 5 08 Coimbatore 1206 3740688 10220 300087 820 7036 11180 38505 9028 2508 10128 1542 4 09 The Nilgiris 811 672468 1837 119985 328 1878 2539 5622 2558 689 2803 337 1 10 Thiruvhirappalli 437 1807413 4938 131943 361 4447 26336 20285 3170 509 5541 283 1 11 Pudukkottai 1040 2283378 6239 297600 813 10482 23481 38375 9813 2333 9398 449 4 12 Dindigul 878 2922949 7986 188173 514 4873 15223 21091 6319 692 12663 1052 3 13 Madurai 436 1860215 5083 119022 325 2725 17902 11282 4094 814 4786 329 2 14 Virudhunagar 1046 2976695 8133 300596 821 6787 10352 15434 5759 1797 6792 610 3 15 Sivaganga 706 1830564 5002 198492 542 8176 12430 29269 5142 1680 4243 331 1 16 Ramanathapuram 938 2467653 6742 187384 512 8939 23478 25063 4583 1171 5334 408 2 17 Thirunelveli 802 2811781 7682 193865 530 7034 5775 14862 5426 1323 4218 540 1 18 Thoothukudi 538 1416135 3869 141005 385 4559 21155 25611 4147 1213 3443 397 3 19 Kanniyakumari 393 1449638 3961 86680 237 926 5616 8989 1048 244 1985 236 20 Nagapattinam 970 2455358 6709 254405 695 8469 25424 115308 6757 1656 11016 421 4 21 Thanjavur 831 2421118 6615 209354 572 2654 20606 29114 7194 1885 8266 579 2 22 Villupuram 559 3197426 8736 227560 622 5052 58357 136189 6429 134 22048 674 9 23 Karur 419 2209762 6038 130470 356 5638 9016 15615 3422 1041 3632 473 1 24 Perambalur 368 2009172 5490 107746 294 5096 23150 15245 2705 463 5584 406 3 25 Thiruvallur 422 2259309 6173 89667 245 3437 8697 25634 3988 676 6995 450 3 26 Thiruvarur 635 2437788 6661 224056 612 6702 8705 42384 5365 1021 5901 244 1 27 Theni 492 2375363 6490 157262 430 4616 7606 25441 3718 1060 5470 236 2 28 Namakkal 659 2516645 6876 220199 602 5841 10631 70902 3460 1224 7265 681 1 29 Krishnagiri 438 1275887 3486 157893 431 7200 14865 20129 6606 1507 9110 862 4 Total 20812 68068505 185980 5909976 16147 182434 573734 1225313 166159 35781 247267 17685 101 2.17. LIST OF SPECIAL DEPARTMENTS:
Sl. District No Paediatric Dept Ortho Dept Ophthalmic Dept ENT Dept VCTC CENTRE Blood Bank Blood Storage Centre Dental Clinic Operation Theatre LABORATORY ICCU Skin Clinic Psych Clinic 1 Kancheepuram 3 2 2 2 5 3 0 7 6 6 2 2 1 2 Vellore 8 2 4 5 8 5 1 8 10 10 2 0 0 3 Thiruvannamalai 0 1 2 1 6 1 2 7 7 7 0 0 1 4 Cuddalore 1 2 3 1 6 3 0 5 3 6 3 1 2 5 Dharmapuri 1 1 1 1 3 1 2 4 5 5 1 0 0 6 Salem 7 3 2 1 5 2 0 5 6 9 2 0 2 7 Erode 2 1 2 1 8 3 2 8 8 9 3 1 1 8 Coimbatore 0 2 3 1 7 4 0 7 8 10 3 1 2 9 The Nilgris 3 2 2 2 4 2 0 6 5 4 1 1 0 10 Tiruchirappalli 5 3 1 0 6 1 2 7 1 9 0 0 6 11 Pudukkottai 6 2 2 2 9 2 1 8 8 10 1 1 1 12 Dindigul 7 2 2 2 9 3 0 2 3 12 2 4 1 13 Madurai 3 2 1 2 5 1 2 5 3 4 1 1 3 14 Virudhunagar 6 2 3 2 7 4 0 5 8 9 2 0 0 15 Sivagangai 6 2 2 1 7 2 2 7 9 11 1 0 1 Ramanathapura 16 m 4 1 1 1 5 1 1 4 7 9 1 3 1 17 Thirunelveli 1 1 1 1 6 3 1 7 13 13 0 1 1 43 18 Thoothukudi 1 1 2 1 7 1 1 6 8 9 0 0 1 19 Kanyakumari 6 2 0 0 3 1 1 4 8 7 0 1 1 20 Nagapattinam 8 3 2 2 5 2 1 7 6 10 2 2 1 21 Thanjavur 5 1 1 1 4 2 0 5 8 10 2 4 1 22 Villupuram 3 2 4 2 7 3 3 8 6 9 1 1 2 23 Karur 0 0 1 1 3 1 1 5 0 4 1 1 0 24 Perambalur 0 2 1 1 4 1 2 6 4 5 1 0 1 25 Tiruvellore 3 2 3 1 4 1 2 7 4 8 1 0 0 26 Thiruvarur 1 1 2 1 4 1 3 6 5 8 2 1 1 27 Theni 1 1 1 1 6 1 1 5 6 6 1 0 1 28 Namakkal 4 3 1 2 5 3 0 4 5 8 1 1 0 29 Krishnagiri 2 2 2 2 3 2 0 4 4 6 2 0 1 Total 97 51 54 41 161 60 31 169 174 233 39 27 33 6
44 CHAPTER - 3 PRIMARY HEALTH CENTRES
3.1. The administration of Primary Health Centres has been brought under the control of the Director of Public Health and Preventive Medicine from the 1st March 1996. 3.2. Details of Primary Health Centres sanctioned and functioning: 1.1 Number of Primary Health Centres functioning at the end of VI Five Year 436 Plan i.e. 1984- 85. 1.2 Number of Primary Health Centres sanctioned during 1985 - 86: a) By Converting Rural Dispensaries as Additional Primary Health Centres 195 b) New Additional Primary Health Centres sanctioned 20 1.3 Number of Primary Health Centres sanctioned during 1986-87 : a) By conversion of Non - Taluk Hospital as Community Health Centres 41 (Upgraded Primary Health Centres) : b) Newly sanctioned Additional Primary Health Centres 5 c) Newly sanctioned Primary Health Centre (Tribal) Nammiampattu 1 1.4 New Primary Health Centres established in 1987-88 (Additional) 140 1.5 Number of Primary Health Centres (Additional) sanctioned during 1988-89 (*)274 (*) By wounding up of Mobile Health Unit in the PHCs and creation of Primary Health Centres. 1.6 Number of New Additional Primary Health Centres sanctioned during 110 1988-89. 1.7 164 Number of New Additional Primary Health Centres during 1989-90 a) New Primary Health Centres : 123 b) Conversion of Panchayat Union Dispensaries : 41 1.8 Number of New Additional Primary Health Centres during 1990-91 43 (Conversion of Panchayat Union Dispensaries) 1.9 Number of New Additional Primary Health Centre sanctioned during 1 1991-92 (Perugopanapalli in Dharmapuri District). Total 1430 14 PHCs have been upgraded as Taluk Hospitals (-) 14 Total 1416 1.10 No. of PHCs sanctioned during 1993-94 1 1.11 No. of PHCs sanctioned during 1995-96 1 1.12 No. of PHCs sanctioned during 1996-97 3 a) New Primary Health Centre : 1 b) Conversion of Panchayat Union Dispensaries : 2 Total 1421 1.13 PHC Sankarapuram made as Taluk Hospital (-) 1 Total 1420 1.14 Conversion of Panchayat Union Dispensaries 11 Total 1431 1.15 23 PHCs have been upgraded as Taluk Hospital (-) 23 Total 1408 1.16 No. of PHCs Sanctioned during 1998-99 6 Total 1414 1.17 5 PHCs have been upgraded as Taluk hospitals/ Non-Taluk Hospitals (-) 5 Total 1409 1.18 No. of PHC’s upgraded as Taluk Hospitals (-) 12 Total 1397
1.19 No. of PHC’s sanctioned during 99-2000 2 Total 1399 1.20 No. of PHCs sanctioned during 2000-2001 12 1.21 Upgradation of PHC Kurinjipadi, Cuddalore Dist. As Non Taluk Hospital (-) 1 Total 1410 45 1.22 No. of PHC sanctioned during 2001-2002 1 Total 1411 1.23 No. of PHCs sanctioned during 2003-2004 2 Total 1413 1.24 No. of PHCs sanctioned during 2004-2005 2 Total 1415 1.25 No. of PHCs sanctioned during 2005-2006 2 Total 1417 1.26 No. of Maternity Centres converted as PHC 3 1.27 No. of Maternity Centres converted as UGPHC 1 Total 1421
3.3. Community Health Centres / Upgraded Primary Health Centres sanctioned and established: 3.3.1. Community Health Centres: No. of Community Health Centres functioning at present: 29 3.3.2. Upgraded Primary Health Centres:- No. of PHCs Upgraded prior to 2001 24 No. of PHCs upgraded during 2001-2002 21 Total 45 No. of PHCs upgraded during 2002-2003 37 Total 82 No. of PHCs upgraded during 2003-2004 35 Total 117 No. of PHCs upgraded during 2004-2005 12 No. of PHCs upgraded during 2005-2006 1 No. of PHCs upgraded during 2007-2008 75 Total 205
3.3.3. Existing staff pattern for Main Block Primary Health Centres:
1. Medical Officer 3 2. Pharmacist 1 3. Auxiliary Nurse Midwife 1 4. Male Nursing Assistant 1 5. Junior Assistant 1 6. Driver 1 7. Cook-cum-Waterman 1 8. Sweeper 1 9. Lab. Assistant 1
3.3.4. Additional Staff for Upgraded Primary Health Centres: 1. Medical Officer - Obstetrician 1 2. Medical Officer - Anaesthetist 1 3. Staff Nurse 2 4. Female Nursing Assistant 1 5. Radiographer 1
3.3.5. Primary Health Centres Building Facilities:
1 Total No. of Primary Health Centres 1421 2 Primary Health Centres Functioning in Government buildings 1375 3 Primary Health Centres under construction at various stages 8 4 In Private/Panchayat Union Buildings 38 Total 1421
3.4. National Scheme for the Prevention of Visual Impairment and Control of Blindness: 46 This scheme is being implemented in Primary Health Centres. The main objectives of the programme are as follows: - a. To render treatment for minor eye ailments b. To prescribe glasses for the correction of refractive errors To educate the school children and the rural masses on eye care and prevention c. of the common causes of blindness. To conduct Mini eye camps at Main PHCs wherever Operation Theatres are d. available. e. To any other works relating to eye care.
384 posts of Ophthalmic Assistants have been sanctioned at the rate of one for each Primary Health Centre in the Block. 3.5. Construction of Health Sub Centres under NABARD & PMGY: 1) Construction of 100 HSCs under PMGY scheme 100 During the year 2000-2001, 2) Construction of 100 HSCs availing NABARD loan 100 Under RIDF VII during the year 2002-2003 3) Construction of 100 HSCs availing NABARD Loan under RIDF VII during the year 2002-2003 . 100 4) Construction of 100 HSCs availing NABARD loan under RIDF VII during the year 2002-2003. 98 5) Construction of 5 HSCs under PMGY scheme during the Year 2003-3004 Availability of quarters 5 ------Total Construction of HSC 403 ------Out of 403 Health Sub Centres, the works have been completed in 392 Health Sub-Centres by Public Works Department Authorities and the remaining 11 works have been deleted due to technical reasons. 47 3.6. In-patients and Out-patients during the year 2007-2008 (Upto February 2008):
OP per Day IP per Month Sl.No. DISTRICT Total OP Total IP per PHC per PHC 1 Coimbatore 3001656 133.76 25714 34.38 2 Cuddalore 3246524 196.76 33174 60.32 3 Dharmapuri 1625232 149.24 34730 95.67 4 Dindigul 2395241 148.13 17938 33.28 5 Erode 2762096 126.82 28108 38.72 6 Kancheepuram 1978297 119.90 19448 35.36 7 Karur 1390608 145.31 10995 34.47 8 Krishnagiri 1378892 112.93 26567 65.28 9 Madurai 2353064 169.77 26540 57.45 10 Nagapattinam 1742077 122.77 18517 39.15 11 Nagercoil 1210532 118.33 9582 28.10 12 Namakkal 1853805 119.52 10105 19.55 13 Perambalur 1810701 114.31 26923 50.99 14 Pudukottai 2190607 127.66 15515 27.12 15 Ramanathapuram 1383882 91.16 15506 30.64 16 Salem 3207116 138.84 14051 18.25 17 Sivaganga 1674474 115.32 13436 27.76 18 Thanjavur 3422158 178.80 28429 44.56 19 The Nilgiris 485125 52.50 3737 12.13 20 Theni 1792554 201.18 19586 65.95 21 Thiruvallur 2201638 155.15 16060 33.95 22 Thiruvarur 1855961 144.21 25029 58.34 23 Thoothukudi 1828847 117.91 19192 37.12 24 Thiruchirapalli 2352440 145.48 24652 45.74 25 Thirunelveli 2797987 136.75 15017 22.02 26 Thiruvannamalai 2721513 103.09 27469 31.21 27 Vellore 3204452 144.93 33501 45.46 28 Villupuram 3196243 121.07 23660 26.89 29 Virudhunagar 1599133 134.61 7312 18.46 Total 62662855 133.63 590493 37.78
48 3.7. Objective Classification (PHC Wing):
(Rupees in lakhs)
Actuals 2006-2007 Budget Estimate 2007-2008 Revis Head of Account Non- Non-Plan Plan C.S.S Total Non-Plan Plan C.S.S Total Plan (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) 01. Salaries 6952.96 1583.44 159.05 8695.45 11272.67 100.48 181.07 11554.22 9856.18 9 02. Wages 0.46 0 0 0.46 0.30 0 0 0.30 0.30 0 03. Dearness Allowance 5408.34 1152.99 129.08 6690.41 10502.23 87.00 168.66 10757.89 9535.01 8 04. Travel Expenses 127.53 76.38 7.28 211.19 190.32 1.94 8.16 200.42 200.23 2 05. Office Expenses 223.84 40.94 0.75 265.53 315.22 2.12 0 317.34 338.00 2 06. Rent, Rates and Taxes 1.14 0.07 0 1.21 2.71 0.08 0 2.79 2.24 0 19. Mach &Equipments 0.08 75.22 0 75.30 17.09 0 0 17.09 113.84 0 21. Motor Vehicles 6.64 7.38 0 14.02 17.25 0.32 0 17.57 21.17 0 24. Materials & Supplies 1500.00 2.05 0 1502.05 3.10 0 0 3.10 75.10 0 33. PPSS 24.83 884.77 0 909.60 507.16 0 0 507.16 30.40 0 42. Service & Commitment 0 62.00 0 62.00 35.00 0 0 35.00 56.50 0 45. P.O.L. 77.19 57.45 0 134.64 215.58 2.46 0 218.04 223.77 2 46. Clothing, Tentage 2.27 4.38 0 6.65 6.50 0.10 0 6.60 6.50 0 47. Stores & Equipments 1.34 738.06 0 739.40 29.31 0.09 0 29.40 181.31 0 4901 F A- Debit 62.06 10.31 1.15 73.52 138.29 1.63 2.04 141.96 222.76 2 4902 F A -Credit -103.84 -39.30 -1.32 -144.46 -138.29 -1.63 -2.04 -141.96 -222.76 -2 51. Compensation 4.03 0 0 4.03 0.01 0 0 0.01 0.01 0 59. Prizes & Awards 0.57 0.45 0 1.02 1.13 0.01 0 1.14 1.12 0 66. Medicines 2069.88 32.84 0 2102.72 2353.71 2.80 0 2356.51 2459.71 2 67. Feeding Diet Charges 9.10 0.11 0 9.21 10.98 0.22 0 11.20 10.98 0 72. Training 0 16.97 0 16.97 2.51 0 0 2.51 16.42 0 73. Transport Charges 1.32 0.23 0 1.55 1.96 0.10 0 2.06 2.07 0 76. Computer and 0.20 0.20 Accessories 0.20 0 0 0.20 0 0 19.40 0 Total 16369.94 4706.74 295.99 21372.67 25484.94 197.72 357.89 26040.55 23150.30 1
49 Chapter - 4
PUBLIC HEALTH AND PREVENTIVE MEDICINE
4.1. The Directorate of Public Health is one of the oldest Departments formed as early as 1923 for the improvement of the general health conditions of the people with special emphasis on providing maternity and child health care to the rural and urban poor and for prevention and control of communicable diseases.
4.2. In 1966, the Department of Health Services and Family Planning was formed by merging the Directorate of Medical Services (after separating the Medical Education from Medical Services) and the Directorate of Public Health. In 1976, the integrated Department was again bifurcated into the Department of Public Health and Preventive Medicine and the Department of Medical Services and Family Welfare. The Drugs Control Administration which continued under this Department was separated in November 1981 to form an independent Department. In February 1980, the functions relating to the static component of Primary Health Centre, the mobile health teams were separated from Public Health Department and a new Department called Directorate of Primary Health Centres was formed. Again the department of Primary Health Centre was brought under the control of Directorate of Public Health and Preventive Medicine in March 1996. The State Health Transport Department was formed by separating the same from Public Health and Preventive Medicine Department.
4.3. During 1988, a separate Directorate of Public Health Training and Continuing Education was formed to oversee pre-service and in-service training programmes for the Multi-purpose Health Workers-male and female and short term in-service training programme for Medical Officers, Health Professionals and Para Medical Professionals. This Directorate was again merged with the Directorate of Public Health and Preventive medicine in March 1991.
4.4. As per the re-organization of the Department during 1980-81, there were seven regions, each headed by a Regional Deputy Director of Public Health and Preventive Medicine with jurisdiction over two or three Revenue Districts. There were 29 Health Unit Districts. Each Health Unit District was headed by a District Health Officer with jurisdiction over 30 to 40 Primary Health Centres on an average. Now there are 42 HUDs for the 30 Revenue districts.
XVIII. 4.5. The Government have re-organised the Department during 1990 and under this set up 42 Health Unit Districts have been formed. Each Health Unit District is functioning under a Deputy Director of Health Services who is overseeing Public Health and Family welfare Programme activities. 50
XIX. 4.6. Statement Showing the Financial Requirements for Public Health Schemes - OBJECTIVE CLASSIFICATION: XX. (Rs. in lakhs) Actual 2006-2007 Budget Estimate 2007-2008
Objects Centrally Centrally Non-Plan Plan Total Non-Plan Plan Total Sponsored Sponsored
01 Salaries 11580.93 2800.85 8431.35 22813.13 19692.06 116.38 9768.17 29576.61
02 Wages 0.63 233.57 0 234.20 0.85 0.01 0 0.86
03 Dearness Allowance 8962.89 2010.19 6562.41 17535.49 18276.84 101.28 9038.98 27417.10
04 Travel Expenses 372.06 124.11 341.13 837.30 478.96 2.92 348.50 830.38
05 Office Expenses 304.39 -25.06 275.83 555.16 417.48 204.98 181.22 803.68
06 Rent, Rates and Taxes 8.55 29.29 85.20 123.04 15.23 0.08 115.70 131.01
07 Publications 0 1.57 0 1.57 2.00 0 0 2.00
08 Advertising & Publicity 2.72 133.84 1.50 138.06 23.03 56.26 0.01 79.30
09 Grants-in-Aid 3.87 10308.32 2.82 10315.01 6.87 12000.00 0.02 12006.89
11 Subsidies 0 0 0 0 0 0 0 0
12 Scholarship & Stipend 0 0 0 0 0.01 0 1.20 1.21
16 Major Works 0 16.03 0 16.03 0 1080.40 0 1080.40
17 Minor Works 13.70 6.17 0 19.87 0.67 0 0 0.67
18 Maintenance 1875.91 0 0 1875.91 2185.79 0 0.01 2185.80
19 Machinery & 3.69 86.61 5.01 95.31 31.37 0.02 0.01 31.40 Equipment
21 Motor Vehicles 15.98 7.99 1.59 25.56 23.45 0.87 2.14 26.46 51
24 Materials & Supplies 173.87 557.88 5.16 736.91 249.92 26.44 10.23 286.59
25 Interest 0 0 0 0 0 0 0 0
33 PPSS 26.85 915.82 191.93 1134.60 510.33 22.51 187.49 720.33
34 Other Charges 0.02 0 0 0.02 0.12 0 0 0.12
42 Service & Commitment 0 62.00 0 62.00 35.00 0 0.01 35.01
45 P.O.L. 173.18 159.93 41.87 374.98 361.45 89.99 54.76 506.20
46 Clothing,Tentage& 2.35 4.39 0 6.74 6.59 0.10 0 6.69 Stores
47 Stores & Equipment 1.48 738.06 102.96 842.50 29.55 0.09 43.00 72.64
49 FA Debit 106.50 15.97 91.45 213.92 261.96 1.82 123.34 387.12
49 FA Credit -200.86 -69.81 -130.27 -400.94 -261.96 -1.82 -123.34 -387.12
51 Compensation Claims 4.03 0 0 4.03 0.02 0 0 0.02
59 Prizes & Awards 3.90 0.17 0.31 4.38 2.21 0.01 0.60 2.82
66 Medicines 2397.33 425.10 173.68 2996.11 2747.22 405.50 173.68 3326.40
67 Feeding Diet Charges 9.10 0.11 0 9.21 11.00 0.22 0 11.22
68 Cost of Books 1.03 0 0 1.03 2.80 0 0 2.80
71 Printing Charges 45.90 93.66 0 139.56 46.01 0.01 0 46.02
72 Training 13.37 19.41 0 32.78 23.62 0 0 23.62
73 Transport Charges 2.23 0.26 1.26 3.75 4.49 0.01 1.74 6.33
76 Computer Maintenance 4.71 11.90 1.94 18.55 3.38 1.22 1.21 5.81
Total 25910.31 18668.33 16187.13 60765.77 45188.32 14109.39 19928.68 79226.39 52
4.7. Statement showing the Financial Requirements for Public Health Schemes - OBJECTIVE CLASSIFICATION: XXI. (Rs. in lakhs) Revised Estimate 2007-2008
Subjects Non-Plan Plan C.S.S Total
01 Salaries 14923.54 109.79 8407.16 23440.49
02 Wages 0.85 490.88 0 491.73
03 Dearness Allowance 14275.03 101.31 8113.51 22489.85
04 Travel Expenses 493.21 3.97 377.51 874.69
05 Office Expenses 454.22 209.70 103.38 767.30
06 Rent, Rates and Taxes 29.56 0.08 48.46 78.10
07 Books & Publications 0.01 0 0 0.01
08 Advertising & Publicity 23.28 56.25 0.01 79.54
09 Grants-in-Aid 1.38 30000.00 0.02 30001.40
11 Subsidies 0 0 0 0
12 Scholarship and Stipend 0.01 0 0.01 0.02
16 Major Works 0 0.03 0 0.03
17 Minor Works 0.67 0 0 0.67
18 Maintenance 2185.79 0 0 2185.79
19 Machinery & Equipment 128.12 0.01 0.01 128.14
21 Motor Vehicles 28.50 0.87 2.60 31.97 53
24 Materials & Supplies 321.92 217.13 5.56 544.61
25 Interest 0 0 0 0
33 PPSS 61.66 32.79 93.89 188.34
34 Other Charges 2.06 0 0 2.06
42 Service & Commitment Charges 56.50 0 0.01 56.51
45 P.O.L. 377.62 113.09 54.96 545.67
46 Clothing, Tentage and Stores 0 0.10 0 0.10
47 Stores & Equipment 181.55 0.09 0.01 181.65
51 Compensation 0.72 0 0 0.72
59 Prizes & Awards 3.42 0.01 0.65 4.08
66 Medicines 2857.44 405.50 0.02 3262.96
67 Feeding/Diet Charges 11.00 0.22 0 11.22
68 Cost of Books 2.80 0 0 2.80
71 Printing Charges 46.00 3.25 0 49.25
72 Training 37.53 0 0 37.53
73 Transport Charges 4.49 0.01 1.74 6.33
76 Computer & Maintenance 24.93 1.62 6.51 33.06
Total 36533.81 31746.79 17216.02 85496.62
54
XXII. 4.8. STATEMENT SHOWING THE FINANCIAL REQUIREMENT OF PUBLIC HEALTH SCHEMES: (Rupees in lakhs) Actuals 2006-2007 Budget Estimate 2007-2008 Revised Estimate 2007-2008 Schemes Non-Plan Plan C.S.S. Total Non-Plan Plan C.S.S. Total Non-Plan Plan C.S.S. Total Direction and 308.90 2.43 1104.50 1415.83 448.89 0 1605.23 2054.12 308.42 0 1286.25 1594.67 Administration School Health 595.06 25.71 0 620.77 672.73 0 0 672.73 674.84 0 0 674.84 Programme
Tribal Sub Plan 0 11.41 70.98 82.39 0 16.55 97.46 114.01 0 12.15 0 12.15
Health Sub Centres 0 26.04 14571.00 14597.04 0.03 0 17551.30 17551.33 0 0 15360.87 15360.87
Prevention and 7359.07 13858.93 17.32 21235.32 15153.43 12775.34 16.26 27945.03 9313.90 31487.10 10.35 40811.35 Control of Diseases Prevention of Food 221.91 1.70 0 223.61 334.89 2.50 0 337.39 251.45 2.50 0 253.95 Adulteration Prevention of Air 147.50 14.11 0 161.61 210.62 0 0 210.62 145.86 0 0 145.86 and Water Pollution Health Statistics and 194.26 0 0 194.26 226.88 0 0 226.88 198.62 0 0 168.62 Evaluation Health Education 109.44 3.21 0 112.65 163.82 7.51 0 171.33 115.39 7.15 0 122.54 and Publicity
Training 200.09 35.01127.34 362.44 310.19 25.45 300.54 636.18 199.76 23.80 149.55 373.11
Total 9136.23 13978.55 15891.14 39005.92 17521.48 12827.35 19570.79 49919.62 11208.24 31532.70 16807.02 59547.96
55
4.9. DIRECTION AND ADMINISTRATION: (Rupees in lakhs)
Actuals 2006-2007 Budget Estimate 2007-2008 Revised Estimate 2007-2008 Schemes Non- Non- Non- Plan C.S.S. Total Plan C.S.S. Total Plan C.S.S. Total Plan Plan Plan
2210-06-001 AA Head 236.81 0 0 236.81 292.75 0 0 292.75 245.04 0 0 245.04 Quarters Administration 2210-06-001 AG Directorate of Training & 72.09 0 0 72.09 156.14 0 0 156.14 63.38 0 0 63.38 CE 2210-06-001 JA Head 0 2.43 0 2.43 0 0 0 0 0 0 0 0 Quarters Administration 2211-00-001 SF Direction & Administration Under 0 0 1104.50 1104.50 0 0 1605.23 1605.23 0 0 1286.25 1286.25 CSSM & Sub Centres
Total 308.90 2.43 1104.50 1415.83 448.89 0 1605.23 2054.12 308.42 0 1286.25 1594.67
56
4.10. STAFF POSITION DETAILS:
Sl.No Name of Post Total
01 Director 1
02 Additional Director 2
03 Joint Director 9
04 Joint Director (Administration) 1
05 Joint Director (Statistics) 1
06 Financial Advisor and Chief Accounts Officer 1
07 Personnel Officer 1
08 Deputy Director of Health Services 42
09 Deputy Director, Research 1
10 Principal 2
11 Deputy Director, Data Management 1
12 Deputy Director, Training 1
13 Government Analyst 1
14 Chief Water Analyst 2
15 Deputy Director (Administration) 1
16 B Grade Officers 4042
17 Para Medical Staff 2175
18 Non Para Medical Staff 29919
19 Ministerial Staff 2143
Total 38346
57
4.11. SCHOOL HEALTH PROGRAMME:
(Rupees in lakhs)
Actuals 2006-2007 Budget Estimate 2007-2008 Revised Estimate 2007-2008 Schemes Non- Non- Non- Plan C.S.S. Total Plan C.S.S. Total Plan C.S.S. Total Plan Plan Plan 2210-01-109 AA 295.09 0 0 295.09 358.15 0 0 358.15 328.01 0 0 328.01 School Medical Inspection 2210-01-109 AB Supply of Drugs through 299.97 0 0 299.97 300.00 0 0 300.00 300.00 0 0 300.00 TNMSC 2210-01-109 JA 0 25.71 0 25.71 14.58 0 0 14.58 46.83 0 0 46.83 Model Health
Total 595.06 25.71 0 620.77 672.73 00 672.73 674.84 0 0 674.84
58
4.12. SCHOOL CHILDREN HEALTH PROGRAMME: 4.12.1. The School Health Programme hitherto being implemented in the State has been revamped and implemented to provide comprehensive health care services to all students studying in Government and Government aided schools from first to twelth standards.
4.12.2. The Medical Officers of Primary health centers and the paramedical staff constitute school Medical teams and visit the schools allotted to them on Thursdays on a pre determined definite programme under advance intimation to the school authorities. Each Medical team is allotted with 200 to 250 students to be covered in a visit. The team will provide health care check up to the students thrice a year.
4.12.3. Childhood diseases that affect education and development lead to serious illness causing handicaps in the students are detected and treated with due care and love. Students who require specialized treatment are referred to higher medical institutions. The referred cases of students are treated in the referral Centers in a special counter. All Thursdays are observed as “school health days”. All Saturdays are observed as “referral days”. Two teachers in each school are identified to co-ordinate and assist in the effective implementation of the scheme. A massive training programme to these teachers has been proposed. The students studying in higher classes are identified to work as “Health Guides”. These students will also identify the students with health problems and bring to the notice of the Teachers, Doctors and the visiting Para medical teams.
4.12.4. School health cards have been printed and supplied. These health cards will be issued to the students with Transfer Certificate when they leave the school. Health appraisal register, Referral registers and Drug stock registers are printed and supplied for recording different health status and morbid conditions. Medicines worth Rs.300 lakhs have been arranged to be supplied through TNMSC Ltd., for the Primary Health Centres, 40 SCHOOL MEDICAL INSPECTION teams, and other local bodies and for referral centers for treating the referred case of school children.
4.12.5. To facilitate easy mobility of school medical teams and transport of referred cases of students POL charges, a sum of Rs.25.00 lakhs has been allotted for IEC and other educative materials like portable exhibition panels and posters carrying health message and visuals on good health habits and practices to strengthen Medicare services and to create awareness among paramedical staff, teachers and students are supplied.
4.12.6. For the year 2007- 2008 (upto March 2008 proivisonal), out of 40308-targeted schools, the visits of the Medical teams to the Schools are as follows: No. OF SCHOOLS No. OF STUDENTS VISIT COVERED COVERED I 35,262 67,15,854 II 8.686 15,72,641 III 1,685 3,57,388 Total 45,633 86,45,883
Of these students 43,96,835 were treated for one or other health problems. 32,885 students were referred to higher Medical Institutions for further treatment. 59
4.12.7. Morbidity pattern of school children under School Children Health programme is as follows:
2007-2008 (%) SL. DISEASE 2006-2007 (%) (upto March '08) No. (Provisional) 1 Dental Carries 9.84 9.65
2 Worm Infestation 10.47 9.38
3 A.R.I. 13.12 13.53
4 Anaemia 2.43 1.85
5 Vitamin – A Deficiency 2.3 1.39
6 Scabies 1.14 0.97
7 Defective Vision 0.18 0.15
8 Ottitis Media 0.25 0.16
9 Leprosy 0.02 0.01
10 Defective Hearing 0.01 0.01
11 Rheumatic Heart Disease 0.03 0.02
12 T.B. 0.05 0.11
13 Goitre 0.01 0.02
60
4.13. PREVENTION AND CONTROL OF DISEASES: (Rupees in lakhs) Actuals 2006-2007 Budget Estimate 2007-2008 Revised Estimate 2007-2008 Schemes Non- Non- Plan C.S.S Total Plan C.S.S Total Non-Plan Plan C.S.S Total Plan Plan Plague Control Measures 29.56 0 0 29.56 42.19 0 0 42.19 27.83 0 0 27.83 Epidemic Control Unit 70.42 0 0 70.42 89.69 0 0 89.69 69.06 0 0 69.06 Epidemiological Unit 22.97 0 0 22.97 21.15 0 0 21.15 16.20 0 0 16.20 Guineaworm Eradication Programme 7.40 0 0 7.40 3.46 0 0 3.46 3.29 0 0 3.29 Cholera Combat Team 18.76 0 0 18.76 42.30 0 0 42.30 28.08 0 0 28.08 Cholera Control Programme 0 25.09 0 25.09 30.59 0 0 30.59 21.41 0 0 21.41 Malaria Rural and Urban, Japanese 2427.87 1571.93 0 3999.80 7909.25 0 0 7909.25 3883.33 0 0 3883.33 Encephalitis and Lab.Asst.in PHCs Filaria Control 375.21 451.37 0 826.58 1242.30 58.20 0 1300.50 807.51 58.20 0 865.71 Leprosy Control 3974.90 0 0 3974.90 4758.18 0 0 4758.18 3891.06 0 0 3891.06 Surveillance for Epidemic Preparedness 101.86 60.30 0 162.16 323.61 0 0 323.61 126.88 0 0 126.88 Institute of Vector Control and Zoonoses, 0 73.98 0 73.98 91.26 0 0 91.26 75.95 0 0 75.95 Hosur Immunization 322.92 19.71 11.77 354.40 548.26 0 9.24 557.50 328.39 0 5.57 333.96 Maternity and Child Health Services 3.14 0 0 3.14 5.51 0 0 5.51 0.02 0 0 0.02 Prevention and Control of Goitre 0 0 5.55 5.55 0 0 7.02 7.02 0 0 4.78 4.78 Care Assisted Feeding Programme 4.06 0 0 4.06 5.31 0 0 5.31 4.80 0 0 4.80 Varumun Kappom Thittam 0 895.23 0 895.23 0 717.05 0 717.05 0 719.59 0 719.59 Leptospirosis 0 28.87 0 28.87 36.47 0 0 36.47 26.19 0 0 26.19 Dengue Control 0 3.97 0 3.97 3.90 0 0 3.90 3.90 0 0 3.90 Prevention and Control of Epidemic 0 419.27 0 419.27 0 0.03 0 0.03 0 709.29 0 709.29 Chikungunya HRHM Planning Wing 0 0.89 0 0.89 0 0.06 0 0.06 0 0.06 0 0.06 Dr.Muthulakshmi Reddy Maternity Assistance 0 10308.32 0 10308.32 0 12000.00 0 12000.00 0 30000.00 0 30000.00 Total 7359.07 13858.93 17.32 21235.32 15153.43 12775.34 16.26 27945.03 9313.90 31487.10 10.35 40811.39 61
4.14. MALARIA - TAMIL NADU 4.14.1. In Tamil Nadu, Malaria continues to be a major Public Health problem in certain pockets of Ramanathapuram, Paramakudi, Thoothukudi, Dharmapuri, Krishnagiri, Thiruvannamalai and Kanniyakumari districts. In 90’s, a total of 1.2 lakhs cases were recorded of which 59.6 % were from the urban areas (inclusive of Chennai city) and 40.4% from rural areas. 4.14.2. In 2006, out of the total number of cases recorded in the state, 28.2% were from rural areas and 71.8% were from urban areas. Among the urban areas, 91.6% were from Chennai city and 8.4% from other urban areas like Thoothukudi, Erode, Vellore, Salem, Thiruvallur and Thiruvottiyur. At present, due to the concerted efforts taken by the department, malaria cases have considerably reduced, from 28219 in 2006 to 22,389 in 2007. 4.14.3. PRESENT STRATEGY: 1) Active surveillance – Fever surveillance to detect malaria cases is being carried-out by house-to-house visit by Health worker. 2) Passive surveillance – Fever cases are detected in the primary health centers, hospitals, nursing homes, Fever Treatment Department etc., and radical treatment is given to the positive cases, with choloroquine and primaquine tablets. 3) Two rounds of residual insecticidal spray during transmission period using synthetic pyrethroids in Malaria endemic villages after technical assessment of vector resistance to insecticide. 4) Anti-larval work in endemic areas. 5) Passive surveillance and anti-larval work in urban areas. 6) Creating awareness among the community for their participation in reducing vector breeding sites. 7) Mass and contact Blood survey are being carried out to prevent the occurrence of Secondary cases in the low risk areas. 8) Establishment of Fever Treatment Depots in all endemic areas. 9) Training of Private clinicians, Lab Assistants, Volunteers to act as FTDs, Advocacy workshops for community leaders and elected representatives is being carried out periodically. 10) Private clinician participation in the control of malaria is stressed. 11) To create awareness among the community on the control and preventive measures for Malaria, Anti Malaria month is being observed every year during the month of June as per National Vector Borne Disease Control Programme guidelines. 12) As a method of eco-friendly biological control, larvivorous fish hatcheries are being established in the problem areas. 13) Village Health Sanitation Committee volunteers are involved in creating awareness on the Malaria Preventive and Control measures. 14) As per the National Drug Policy, Rameswaram island which recorded pf Chloroquine resistance is brought under the second line drug regimen. 4.14.4. CASE INCIDENCE OF MALARIA IN TAMIL NADU CASES DEATHS YEAR 2002 34523 0 2003 43604 0 2004 41693 0 2005 40948 1(Imported from Andhra Pradesh) 2006 27431 0 62
2007 22389 1 (imported from Gujarat) 2008 (upto March) 2653 0 XXIII. 4.15. JAPANESE ENCEPHALITIS CONTROL PROGRAMME: 4.15.1. Japanese Encephalitis has emerged as an important Public Health Problem in the State during the last few years. Health unit Districts such as Perambalur, Kallakurichi, Villupuram, Cuddalore, Thiruvannamalai and Madurai reports Japanese Encephalitis cases. Japanese Encephalitis control Unit at Cuddalore, Villupuram, Perambalur with the Monitoring Unit at Headquarters are carrying out Japanese Encephalitis Vector Control activities. Japanese Encephalitis immunization Programme has been carried out in selected villages in Perambalur District with killed mouse brain vaccine from 1994 onwards with State funds. During July,2007 Japanese Encephalitis vaccination programme was conducted in Villupuram, Cuddalore and Virudhunagar Districts for the Children in the age group of 1-15 years targeting 18,19,000 children. Government of India has funded this programme. During 2008, it is proposed to conduct Japanese Encephalitis vaccination programme in Trichy, Madurai, Tiruvarur Districts. Japanese Encephalitis vector monitoring is being carried out regularly in the endemic districts. Fogging operation is being carried out in villages where suspected Japanese Encephalitis cases are reported. Serum samples are being sent to all Sentinal Surveillance Centres placed in 13 Medical Colleges and Institute of Vector Control and Zoonoses, Hozur for anti – body detection and to confirm the Japanese Encephalitis case. Mosquito pools are sent for virus isolation so as to implement prevention and control measures. 4.15.2. JAPANESE ENCEPHALITIS IN TAMIL NADU: YEAR CASES DEATH. 2002 126 28 2003 163 36 2004 88 9 2005 48 7 2006 18 2 2007 43 0 2008 (upto March) 10 0
4.16.NATIONAL FILARIA CONTROL PROGRAMME: The National Filaria Control Programme is being implemented in Tamil Nadu since 1957. The filarial disease control activities are carried out in 43 urban areas. In these urban areas 25 Control Units, 44 Night Clinics and 42 Filaria and Malaria Clinics are functioning besides one filarial survey unit for delimitation of endemic areas. The larvicides and DEC tablets are supplied by the centre. The entire operation cost is met by the State. The programme is being implemented in the 12 endemic districts. The Physical achievement under this programme is furnished hereunder:
Year No. of No. of Mf. Rate No. of Disease Endemicity persons positive for disease Rate Rate examined Mf case 1998 1136072 2263 0.19 1715 0.15 0.34 1999 1031604 789 0.07 2030 0.20 0.27 2000 1033093 1338 0.12 1590 0.14 0.26 2001 1095717 1007 0.09 1041 0.09 0.18 2002 1155566 775 0.07 849 0.07 0.14 2003 1128494 415 0.04 251 0.02 0.06 2004 1107243 218 0.02 120 0.01 0.03 2005 1123415 234 0.03 217 0.02 0.04 2006 1047083 133 0.01 60 0.01 0.02 2007 1075473 117 0.02 18 0.003 0.012 2008 (March 2008 157386 22 0.01 0 0.00 0.002 63
Prov.) From the above table it is clear that the disease rate and endemecity rate are declining
4.17. SINGLE DOSE MASS DEC DRUG ADMINISTRATION PROGRAMME: Mass Drug Administration programme with DEC tablets was conducted as a pilot project in Cuddalore district during 1996. Later during 1997 with Government of Tamil Nadu funds the programme was extended to 12 Filaria endemic districts. From 2000 onwards Albendazole tablets were co-administrated along with DEC tablets in 6 revenue districts VII rounds of MDA with DEC tablets were conducted during 2004. Due to heavy rain and floods the programme was not conducted during 2005 and 2006. In 2007, the Mass Drug Administration programme was conducted in 14 endemic districts, namely Kancheepuram, Thiruvallur, Cuddalore, Villupuram, Thiruchy, Perambalur, Pudukottai, Thiruvannamalai, Thanjavur, Thiruvarur, Ariyalur, Kanniyakumari, Nagapattinam and Vellore. Besides these districts certain villages of Thirunelveli, Thoothukudi, Karur, Krishnagiri, Virudhunagar and Madurai and 64 wards in Chennai Corporation. 2.60 crores population was covered in the programme. Around 91.5% of the eligible population were administered with DEC + Albendozole tablets on 27.12.2007 and mopping up on 28th and 29th December 2007. Public Health, Medical Education, Social Welfare, Education, Rural Development, Municipal Administration and water supply Revenue Departments have cooperated for this programme. It is proposed to organise selfcare practices training for the Lymphadema cases and hydrocelectomy for hydrocel cases in campaign mode.
4.18. INSTITUTE OF VECTOR CONTROL AND ZOONOSES, HOSUR: 4.18.1. The Institute of Vector Control and Zoonoses, at Hosur is made as Nodal agency for Plague surveillance activities. There exists foci of sylvatic plague among rodents in wild animals in certain forest areas, posing a threat for possible outbreak of plague. Therefore surveillance is being carried out by catching field rodents and examine the organs and serum of these rodents for the presence of plague bacilli, anti-body which is indicative of sylvatic plague foci among these rodents. 4.18.2. The infrastructure available at this institute is utilized to conduct various training programmes, workshops and seminars. The institute is conducting a one year P.G. Diploma course in Public Health Entomology for service Entromologists every year, pre-service and in service training course for Field Assistants, and Health Inspectors condenced course for Lab Assistants. Laboratory diagnosis for Japanese Encephalitis, Dengue, Leptospirosis and Rickettsial infections are also being carried out in the Institute. A team from the institute will also do outbreak investigations in case any outbreak in the Districts.
4.19. LEPTOSPIROSIS CONTROL PROGRAMME: 4.19.1. Leptospirosis is caused by a spirochetes. Water contamination with urine of infected rodents is the source of infection. In Tamilnadu except Uthagamandalam and Thoothukudi, all the districts are endemic for Leptospirosis. The disease is more common during rainy season. If not diagnosed and treated, the patient will die because of liver and kidney complications. Early dagnosis and prompt treatment will save the lives.
4.19.2. In Tamil Nadu there are seven Lepto clinics for diagnosis and treatment. Rapid diagnostic kits have been supplied to these clinics and Zonal Entomological Teams. Institute of Vector Control and Zoonoses, Hosur is given the responsibility of outbreak investigation with specialized team. A reference Laboratory at the State Headquarters will be inaugurated shortly. The incidence of leptospirosis in Tamil Nadu from 2001 to 2008(upto March) are furnished below: 64
Sl. No. Year Cases Deaths 1 2001 2196 3 2 2002 1232 - 3 2003 3634 8 4 2004 3074 3 5 2005 3817 - 6 2006 1882 - 7 2007 1025 - 8 2008(March prov.) 168 -
4.20. DENGUE CONTROL PROGRAMME: The Government have issued orders for the establishment of 12 dengue clinics in the taluk and district headquarters hospitals of Nagercoil, Vellore, Dharmapuri and Coimbatore. Rapid diagnostic test kits are supplied to endemic districts. Necessary guidelines are communicated to all the health unit districts to strengthen the surveillance mechanism and carry out vector control activities so as to avert outbreaks. 707 cases and 2 deaths were reported as dengue fever in Tamil Nadu during 2007. Sentinel Surveillance Centres are established in 12 Medical Colleges and Institute of Vector Control and Zoonoses, Hosur where Diagnostic facilities are available for Dengue, Japanese Encephalitis and Chikungunya. The case details of dengue fever in Tamil Nadu from 2001 to 2008 (Upto March) are furnished below: Sl. No. Year Cases Deaths 1 2001 816 8 2 2002 376 2 3 2003 1610 9 4 2004 1035 - 5 2005 1138 8 6 2006 477 2 7 2007 707 2 8 2008 (Upto March 89 - prov.)
4.21. CHIKUNGUNYA fever in Tamilnadu – 2007: Chikungunya was first reported in Tamil Nadu at Chennai Corporation in the year 1964. More than 3 lakh cases were recorded at that time. In 2006, 29 Districts were affected in Tamil Nadu. 64,802 cases have been recorded. The spread of disease in Tamil Nadu is prevented by Intensive Vector control measures taken with inter sectoral co- ordination. Major outbreak was prevented by the following activities:- Timely appointment of 3850 Mazdoors (10 per block) and 742 health workers was made for vector control activities. Inter State Border meet for Health Officials was organised and information and experience were shared. Border Health Check posts were established in bordering districts. In all the borders with neighbouring States, static medical camps were established. All fever cases on transit were treated. Chikungunya cases were advised not to continue travel. All transport vehicles including trains were screened for Chikungunya vector. IEC activities were intensified. “War Aganist Mosquitoes” was observed to generate mass awareness on 23rd and 24th June 2007. Under National Rural Health Mission, part time workers have been hired for source reduction activities through village health and sanitation committees. The Government have allotted Rs.12 crores for Chikungunya control activities for 2006-07 and 2007-08. 13 Sentinel Surveillance centres have been established with diagnostic facilities. During the year 2007, only 45 cases have been reported. During the year 2008-09 (upto March) 3 cases have been reported. 65
4.22. Epidemic Control in Tamil Nadu: The Control of communicable disease is one of the major programmes under Public Health care services. Of all the diseases, Acute Diarrhoeal Diseases and suspected Cholera are occupying priority among water borne diseases. 61890 water sources were chlorinated during 2007. 14,271 water sources were chlorinated during 2008 9Upto March 2008) As the administration of ORS has been advocated by Government of India as a safe method of controlling dehydration, popularisation of the use of ORS is being done intensively through health education and the method of preparation of ORS solution is also demonstrated by the field public health staff to the community. The details of cases and deaths due to Acute Diarrhoeal Diseases / Cholera and preventive measures taken in Tamil Nadu for the past Seven years: A.D.D. Cholera
Year Deaths Cases Deaths Cases 2002 69889 199 1591 3 2003 59471 66 390 1 2004 77400 119 1505 2 2005 70618 65 777 1 2006 52555 22 152 1 2007 49920 26 725 0 2008 (31.03.2008) 11283 22 242 0
4.23. Industrial Hygiene and Health: The water analysis laboratories established at Chennai and Coimbatore are regularly collecting and examining water samples from various protected water sources to control pollution and contamination of drinking water. These laboratories also assist the Tamil Nadu Pollution Control Board in examining samples of Industrial wastes and conduct field surveys to ensure the prevention and control of Environmental and Industrial Pollution. Air pollution surveys are also carried out around the industries to assess air quality. Efforts are also taken for abatement of nuisances and classify the industrial and residential areas. Upto December 2007, 23,408 water samples have been tested by these laboratories. Upto March 2008, 2670 water samples have been tested by these laboratories.
4.24. National Iodine Deficiency Disorders Control Programme: The National Iodine Deficiency Disorders Control Programme is implemented in Tamil Nadu State from 1991. The State Iodine Deficiency Disorder control Cell has been started functioning from 1.7.94 onwards. The objective of the programme is to identify the areas with Iodine Deficiency Disorders Control Programme and take control measures through dietary supplementation of iodised salt through IEC activities. For the effective implementation of the programme the Co-ordinating officers of the Public Health, Education, Municipal Administration, and Civil Supplies were covered under advocacy programme. The goitre surveys conducted in all Districts have shown that iodine deficiency disorders are prevalent in all the districts. A notification under the PFA Act has been issued banning the sale of non-iodised salt for edible purpose. Spot testing of the salt samples is being done to 66 assess the presence of iodine and know the availability and use of iodised salt for creating awareness among the salt producers, wholesalers, retailers and general public on the use of Iodised salt. Non-statutory salt samples are being lifted and sent to Food Analysis Laboratories for analysis to know the iodine content in salt. During the year 2007-2008 upto March 2008, 282 non-statutory samples were lifted and analysed in the Food Analysis Laboratories. The result shows 12% samples confirmed Nil Iodine, 31% confirmed less than 15ppm Iodine and 57% confirmed more than 15 ppm Iodine.
4.25. IMMUNISATION PROGRAMME: Tamil Nadu started immunization programme against six Vaccine Preventable Diseases viz. Diptheria, Pertusis (Whooping Cough), Tetanus, Measles, Poliomyelitis and Tuberculosis during 1978. Annually, around 12.5 lakhs pregnant women and 11.5 lakhs infants are benefitted by Immunisation Programme. Because of effective implementation of Immunisation services, there is a drastic reduction in the incidence of vaccine preventable diseases.
There is no case of Diphtheria, Pertusis, Neonatal Tetanus, Poliomyelitis. The incidence of measles is reported around 2000 cases annually.
The State adopted the policy of FIXED DAY/ FIXED PLACE immunisation strategy. On every Wednesday, 8706 Village Health Nurses visit villages in their area and around 1500 Health workers in urban areas to carryout immunisation activities. Due to timely immunization and quality coverage, the State achieved 100% coverage and sustains the same over the years. Moreover, special efforts have also been taken to provide immunization services to all slum children and remote area population. 4.26. Pulse Polio Campaigns: As part of polio eradication activities, the State has conducted 14 series of Pulse Polio immunisation campaigns during the period from 1995-96 to 2006-07. Around 65 to 73 lakhs of children under five years are covered with additional dose of oral polio vaccine in each campaign by involving various departments and voluntary organizations. During the year 2007-08, two rounds of Pulse Polio Immunization Campaign were conducted on 6th January 2008 and on 10th February 2008. About 72 lakhs of children have been benefitted. The State is sustaining ‘NIL’ polio status since February 2004.
4.27. Hepatitis B Vaccination:
Hepatitis B Vaccination programme was launched by the Hon’ble Chief Minister on 6-1-2008, and the programme was started in all the districts. The Hepatitis B Vaccines have been supplied to all the districts. Annually 11.5 lakhs children will be protected from Hep-B Virus causing Jaundice, liver cancer by giving 3 doses of Hep-B vaccination.
4.28. MMR AND RUBELLA VACCINATION PROGRAMME: 4.28.1. Due to successful implementation of immunisation programme, the incidence of vaccine preventable disease cases namely Diptheria, Pertusis, Neo Natal Tetanus are almost nil for the past 4 years. Measles cases are reported around 2000 to 2500 cases annually for the past few years. During 80’s, about 1500 children were affected due to Measles every year. 67
4.28.2. TAMIL NADU – IMMUNISATION PERFORMANCE: ( in Lakhs)
2005-06 2006-07 2007-08* S.N Vaccine T A % T A % T* A P.T %
1 T 12.73 12.49 98 12.49 11.30 98 12.49 12.32 99
2 D.P.T 11.57 11.57 100 11.35 11.22 99 11.36 11.34 100
3 Polio 11.57 11.58 100 11.35 11.23 99 11.36 11.34 100
4 B.C.G 11.57 11.60 100 11.35 11.24 99 11.36 11.30 100
5 Measles 11.57 11.56 100 11.35 11.18 99 11.36 11.25 99 Note: * - Provisional report. T - Annual Target, A - Achievement T* - Annual Target adopted as per G.O.I. P.T% - Proportionate percentage to target.
4.28.3. REPORTED INCIDENCE OF V.P.D CASES IN TAMIL NADU:
2005 2006 2007 2008 (Prov.)* S.No. DISEASE C D C D C D C D 1 DIPTHERIA 1 0 0 0 2 0 1 0 2 PERTUSIS 0 0 0 0 0 0 0 0 3 TETANUS(NEO) 0 0 0 0 0 0 0 0 4 TETANUS(OTH) 0 0 0 0 0 0 0 0 5 POLIO 0 0 0 0 0 0 0 0 6 MEASLES 2331 1 1619 1 1204 0 203 0
C- Cases D- Death * Provisional
68
4.29. NATIONAL LEPROSY ERADICATION PROGRAMME: The National Leprosy Eradication Programme was launched in 1954-55 with the main thrust on detection and sustained regular treatment of all leprosy patients. Multi Drug Therapy was launched in 1983 in a phased manner and a complete geographical coverage for Tamil Nadu was done in 1991. The prevalence rate 118/10000 Population in the year 1983 was brought down to 0.61 /10000 in 2007.
4.30. VARUMUN KAPPOM THITTAM: The ‘Varumun Kappom Thittam’ Scheme has been revived to facilitate early detection and treatment of illness. This scheme envisages conduct of 9,000 medical camps by teams of medical experts all over the State and up to 31.03.2008, 5894 medical camps have been conducted so far. This scheme has been widely welcomed by the public and so far 61,23,417 persons have been benefitted. The Varumun Kappom Thittam provides comprehensive health check up, treatment and health education to the rural and urban people. These camps are conducted at the Health Sub Centre level, every week covering 5000 population. In addition, camps are held in the urban areas also. During the Camps, all the Specialist doctors screen the beneficiaries for communicable and non-communicable diseases. In addition, treatment is given for minor ailments. Every week 3 camps are conducted in each district. All the investigations like blood, urine examination are done by using modern lab equipments like Semi Auto Analyser. All pregnant mothers are examined with Ultra Sonogram to detect any foetal abnormalities. Camp timing is from 8.00 a.m. to 4.00 p.m. The referral and follow up camps are conducted in the referral institutions. All the reports including morbidity data are collected through the Internet /Website and are used for monitoring, evaluation and planning purposes. As on 22.02.2008, 5343 Varumun Kappom thittam camps have been conducted. Totally 55.92 lakhs of people were benefited in the Varumun Kapoom Thittam Camps.
4.31. PREVENTION OF FOOD ADULTERATION:
(Rs. in lakhs)
Revised Estimate 2007- Actuals 2006-2007 Budget Estimate 2007-2008 2008 Scheme Non- Non- Non- Plan C.S.S Total Plan C.S.S Total Plan C.S.S Total Plan Plan Plan
2210-06-102- AA Food 221.91 0 0 221.91334.89 0 0 334.89 251.45 0 0 251.45 Analysis Laboratories 2210-06-102- JA Food 0 1.70 0 1.70 0 2.50 0 2.50 0 2.50 0 2.50 Analysis Laboratories
Total 221.91 1.70 0 223.61334.89 2.50 0 337.39 251.45 2.50 0 253.95
69
4.32. PREVENTION OF FOOD ADULTERATION:
4.32.1. The food is the basic need and requirement for the survival of human race. As it is largely consumed, demand is high, to make extra profit, it is adulterated with cheaper or inferior quality substituted or by extraction of essential ingredients. To counter this unlawful activities and to ensure quality, pure and wholesome food to consumers to consume and to prevent consumers from deception and to encourage fair trade practice, the Government of India have enacted Prevention of Food Adulteration Act, 1954 (PFA) and Rules, 1955 to be implemented by the State.
4.32.2. In Tamil Nadu, the Act is being implemented in 481 local bodies and the Government are taking action to implement the same throughout the State. 4.32.3. To implement PFA Act, the requirement of Food Inspectors in the State is 854. But there are only 192 Food Inspectors in the State. For filling up the gap, the Government have ordered to impart training for Sanitary Inspectors/ Health Inspectors as Food Inspectors and so far 307 persons have been trained.
4.32.4. The food samples lifted by the Food Inspectors are being analysed at the Food Analysis Laboratory, Corporation of Chennai and at Food Analysis Laboratories at Guindy, Coimbatore, Madurai, Thanjavur, Palayamkottai and Salem. Due to globalization, there is a huge flow of foreign foods in the Country. The Food Analysis Laboratories at Guindy, Thanjavur and Palayamkottai near the sea ports are being upgraded by World Bank Aided Capacity Building Project at a cost of Rs.833.56 lakhs. The Laboratory at Guindy has been provided with new building and laboratories at Guindy, Thanjavur and Palayamkottai are being supplied with latest equipments.
4.32.5. During the year 2007-08 upto February 2008, 4636 samples were analysed. Out of which 863 samples were found to be adulterated. Adulteration is 18.61 %.
4.33. PREVENTION OF AIR AND WATER POLLUTION: (Rs. in lakhs) Budget Estimate 2007- Revised Estimate 2007- Actuals 2006-2007 2008 2008
Scheme Non- Non- Non- Plan C.S.S Total Plan C.S.S Total Plan C.S.S Total Plan Plan Plan
2210-06-107- JA/CA Development 0 14.11 0 14.11 19.44 0 0 19.44 12.55 0 0 12.55 of Public Health Lab. Services 2215-02-106- AA Water 147.50 0 0 147.50 191.18 0 0 191.18 133.31 0 0 133.31 Analysis Laboratory
Total 147.50 14.11 0 161.61 210.62 0 0 210.62 145.86 0 0 145.86 70
4.34. Activities of Water Analysis Laboratories at Guindy and Coimbatore:
4.34.1. The Water Analysis Laboratories at Guindy and Coimbatore are providing water quality monitoring services for all the approved protected water supply systems located in several local bodies (including the rural water supply schemes). The local authorities maintain the water supply systems with the assistance of the Health Inspectors (General) of this Department. Trained water samples collectors visit all the protected water supply systems and collect samples of water for a detailed examination of physical, chemical, bacteriological and biological quality from the water sources, water treatment units service reservoirs and distribution net work. The results of the analysis are communicated to the local authorities for rectification of defects pointed out therein.
4.34.2. Special field investigations are also carried out wherever problems in water supplies arise during the outbreak of water borne epidemics, droughts, floods etc., and in places wherever important fairs and festivals are held, so as to check up the water quality and distribution system on the spot and to carryout remedial measures. The achievement made by the existing two water analysis laboratories at Guindy and other at Coimbatore for the past four years from 2004 to 2008 (upto March 2008) is furnished below:
4.34.3. Physical achievement for the past Five Years: 2008 Sl. 2004 2005 2006 2007 (Upto Item No March) Total No. of samples received and 29076 26077 10207 18936 1347 tested in connection with the 1 periodical examination of protected water supply 720 438 164 69 34 Total number of water samples 2 received from Rural Water supply
10 17 170 106 84 New water supplies included 3 under periodical examination
Total number of samples of water 19628 17698 15962 11431 1577 etc. tested for Bacteriological 4 Physical and Chemical examinations 30 13 34 12 1 Number of field investigations etc. 5 carried out
71
4.35. HEALTH STATISTICS AND EVALUATION: (Rs. in lakhs)
Actuals 2006-2007 Budget Estimate 2007-2008 Revised Estimate 2007-2008 Scheme Non- Non- Non- Plan C.S.S. Total Plan C.S.S. Total Plan C.S.S. Total Plan Plan Plan
2210-80-004-AA Research Work 2.51 0 0 2.51 2.86 0 0 2.86 2.69 0 0 2.69
2210-80-004-AB Nutrition Research 20.57 0 0 20.57 26.16 0 0 26.16 20.06 0 0 20.06
2210-80-004-AG Medical Statistical Cell 11.86 0 0 11.86 16.37 0 0 16.37 11.82 0 0 11.82
2210-80-004-AI Vital Statistical 154.85 0 0 154.85176.35 0 0 176.35 159.48 0 0 159.48 Registration 2210-80-004-AJ Strengthening of Surveillance Unit for Expanded and 4.47 0 0 4.47 5.14 0 0 5.14 4.57 0 0 4.57 Immunization Programme
Total 194.26 0 0 194.26226.88 0 0 226.88 198.62 0 0 198.62 72
4.36. HEALTH EDUCATION AND PUBLICITY: (Rs. in lakhs)
Actuals 2006-2007 Budget Estimate 2007-2008 Revised Estimate 2007-2008 Scheme Non- Non- Non- Plan C.S.S. Total Plan C.S.S. Total Plan C.S.S. Total Plan Plan Plan
2210-06-112-AA Head 77.18 0 0 77.18 109.30 0 109.30 78.74 0 0 78.74 Quarters Unit and RCAP 0 Units in Districts
2210-06-112-AC Training 11.61 0 0 11.61 17.93 0 0 17.93 12.10 0 0 12.10 Units
10.76 0 0 10.76 9.72 0 0 9.72 2210-06-113-AD Press 8.28 0 0 8.28
2210-06-113-AE 22.00 0 0 22.00 14.71 0 0 14.71 Exhibition and Media 12.37 0 0 12.37 Units
2210-06-113-JA 3.83 0 0 3.83 0.12 0 0 0.12 Establishment of 10 0 0.01 0 0.01 Media Units 2210-80-004 JD Publicity 0 3.20 0 3.20 0 7.51 0 7.51 0 7.15 0 7.15
163.82 7.51 0 171.33 115.39 7.15 0 122.54 Total 109.44 3.21 0 112.65 73
4.37. STATE BUREAU OF HEALTH INTELLIGENCE: 4.37.1. Civil Registration System: The Registration of Births and Deaths is compulsory at the place of occurrence in the State as per Registration of Birth and Death Act 18 of 1969 and as per revised Tamil Nadu Births and Deaths Registration Rules, 2000. The Birth Rate is 16.2 / 1,000 population The Death rate is 7.5 / 1,000 population Infant Mortality Rate is 37 / 1,000 Live births. Maternal Mortality Rate : 90/1,00,000 Live Births
for the year 2006 as per Sample Registration System.
4.37..2.Training on Medical Certification of Cause of Death has been organized for 750 Doctors / Coders in 10 Revenue Districts and 13 Health Unit Districts. Training on Birth and Death Registration to 1000 Police Officials have also been organized during 2007-08 in 15 Districts at the In Service Training Centres of Police Department itself.
4.37.3. Institutional Services Monitoring Report: The institutional Services of 1421 Primary Health Centres are being monitored through ISM report monthly and feed back are sent to Districts. During the year 2007-08, 683.50 lakhs out patients at the rate of 133 per PHC/Day, 6.47 lakhs inpatients at the rate of 38 per PHC/Month were treated and deliveries at the rate of 9 per PHC/Month were conducted.
4.38. HEALTH SUB CENTRE: (Rupees in lakhs)
Actuals 2006-2007 Budget Estimate 2007-2008 Revised Estimate 2007-2008 Scheme Non- Non Non- Plan C.S.S Total Plan C.S.S Total Plan C.S.S Total Plan Plan Plan
2210-03- 101-JD P.U. 0 26.04 0 26.04 0.03 0 0 0.03 0 0 0 0 HSCs 2211-00- 101-SC 0 0 12206.34 12206.34 0 0 14714.46 14714.46 0 0 12900.74 12900.74 Sub Centres 2211-00- 793-SA Health Sub- 0 0 2364.66 2364.66 0 0 2836.84 2836.84 0 0 2460.13 2460.13 Centres in Adi Dravidar Colonies
Total 0 26.04 14571.00 14597.04 0.03 0 17551.30 17551.33 0 0 15360.87 15360.87
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4.39. Maternal and Child Health Services: Maternity and Child Health Services in the rural area are rendered through a network of 8683 Health Sub-Centres attached to 1421 Primary Health Centres. The Health Sub- Centre is the peripheral most unit established at the village level, providing outreach health care to the rural population. Health Sub-Centres are established and maintained at the rate of one Health Centre for every 3000 population in the hilly, tribal and difficult terrain areas and one for every 5000 population in other plain areas. Each Health Sub-Centre is manned by a Village Health Nurse assisted by trained Dais. Besides the salary of Village Health Nurse the following recurring and non-recurring expenditure are sanctioned towards the running of each Health Sub Centre. Non-Recurring: Equipment and furniture Rs.33,000/- Recurring: 1. Drugs for Health Sub-Centres Rs.2000/- 2. Rent for buildings Rs.3000/-per annum per Health Sub-Centre, wherever Health Sub-Centres are functioning in Rental buildings. 3. Contingencies Rs.2000/- per annum per Health Sub- Centre. 4. Honorarium to Female attendant Rs.100/-p.m. The expenditure on Health Sub Centres is borne by Government of India by way of 100% Central Assistance. 4.40. Strengthening of Health Sub-Centres: In order to enhance the quality of maternity and child health services and to enable the Village Health Nurses to stay in their Health Sub Centres, they were provided with electricity and water supply facilities and other obstetric equipments and furniture on need basis every year. Because of these supplies of essential equipments and other accessories, the institutional deliveries in the Health Sub Centres has been improved to a great extent. Achievements under the Maternity and Child Health components are furnished below: - 2004- 2005- Sl. 2006- 2007-08 Details of MCH Components 2005 2006 No. 2007% (prov.) % % % 1. Antenatal Registration 97.5 93.9 99.1 100 2. Institutional Deliveries 94.2 92.5 96.0 98.2 3. Deliveries by trained persons 99.6 99.5 99.7 99.1 4. Deliveries by untrained persons 0.4 0.5 0.03 0.9 5. Birth weight taken for newborn 99.4 98.6 99.6 99.7 6. FST (Large) 85.6 61.7 74.9 44.6 Vitamin – A Dose – I 86.5 81.2 84.8 7. 73.3 Dose - II 88.0 81.9 81.7
4.41. Dr.MUTHULAKSHMI REDDY MEMORIAL MATERNITY ASSISTANCE SCHEME:
4.41.1. Dr. Muthulakshmi Reddy Maternity Benefit Scheme is under implementation from 15/09/2006. Under this scheme, cash assistance of Rs.6000/- is given to pregnant women falling Below Poverty Line to compensate the wage loss during pregnancy and to get nutritional food to avoid low birth weight babies. An amount of Rs.100.00 crores was sanctioned for implementing the scheme in 2006-07. This scheme has also been extended to Sri Lankan pregnant women refugees. During the year 2006-07, a total of 2,41,095 number of pregnant women were provided with cash assistance. During the year 2007– 75
2008, a sum of Rs.300.00 crores was released for the implementation of the scheme. As on 31.03.2008, a total of 4,59,037 pregnant women have been benefitted under the scheme. As per the guidelines of this scheme, pregnant women have to obtain family income certificate to avail maternity assistance. As this is a hardship for them during pregnancy, this Government have decided to relax this condition. From the coming financial year onwards, financial assistance will be given under this scheme to women from poor families based only on the recommendation of the Village Health Nurse who examines the beneficiary during pregnancy and without having to produce an income certificate.
4.41.2. The Government of India have released a sum of Rs.8,70,60,000/- as untied funds for the year 2007-08 under National Rural Health Mission to 8706 Health Sub Centres to meet the contingency expenditure in the Health Sub Centres at the rate of Rs.10000/-
4.42. NATIONAL RURAL HEALTH MISSION: 100 Mobile Medical units have been established to provide Out Reach Services to un reached vulnerable group of population. 100 more such units are to be established shortly. Rs.14.21 crores have been provided to 1421 Patient Welfare Societies which have been constituted in Primary Health Centres. 12,618 Village Health Water and Sanitation Committees have been formed in the Village Panchayats for improving the sanitation and hygiene and a untied fund of Rs.10,000/- is provided to each committee amounting to Rs.12.62 crores. 2540 Village Health Water and Sanitation Committees have been constituted in 561 Town Panchayats during 2007-2008 and each Committee has been provided Rs.10,000/- for various welfare activities amounting to Rs.2.54 crores.
4.43. TRIBAL SUB PLAN: (Rupees in lakhs) Actuals 2006-2007 Budget Estimate 2007-2008 Revised Estimate 2007-2008 Scheme Non- Non- Non- Plan C.S.S Total Plan C.S.S Total Plan C.S.S. Total Plan Plan Plan
2210-03-796-JC Mobile Medical 0 11.41 0 11.41 0 16.55 0 16.55 0 12.15 0 12.15 Unit facilities at Kalrayan Hills 2211-00-796 SA Maternity 0 0 70.98 70.98 0 0 97.46 97.46 0 0 75.18 75.18 Centres under Tribal Areas
Total 0 11.41 70.98 82.39 0 16.55 97.46 114.01 0 12.15 75.18 87.33
4.44. Functioning of Health Sub-Centre in Tribal Sub Plan Area: Out of 8683 Health Sub-Centres 50 Health Sub-Centres are functioning in the tribal areas as detailed below:
Sl.No. Name of District Tribal Area Health Sub-Centres
1. Dharmapuri Sitheri hill 5 Yercaud hill 3 2. Salem Kolli hill 5 Kalrayan hill. 2 76
3. Villupuram Kalrayan hill 14
4. Vellore Jawadhu hill 17
5. Thiruchirapalli Pachamalai hills 4
Total 50
The staff employed in this tribal area are rendering the Primary health care services including maternal and child health and immunisation services for the tribal community.
4.45. Mobile Medical Unit at Kalrayan Hills: The Mobile Medical Unit with head quarters at Karumandurai PHC in Athur taluk with the following staff is functioning under the control of the Deputy Director Health Services, Salem to provide curative and preventive care services in these areas.
Sl.No. Name of post No. of post 1. Assistant Surgeon 2
2. Laboratory Technician 1
3. Pharmacist 1
4. Auxiliary Nurse Midwife 1
5. Attendant 1
6. Driver 1
7. Health Inspector 3
A majority of the women in Tamil Nadu and the adolescent girls in the age group 11 to 19 years are suffering from some form of anaemia. This contributes to low birth weight of newborn babies and maternal and Infant deaths. Hence as part of antenatal services package, the expectant mothers are given with 100 FST (Large) tablets. Identified anaemic pregnant mothers are administered with 200 tablets. To control the Iron deficiency anaemia among adolescent girls. each girl is given with an IFA (Large) tablet- weekly once. About 53 lakhs adolescent girls are benefitted. 92
4.46. TRAINING:
(Rs. in lakhs)
Revised Estimate 2007- Actuals 2006-2007 Budget Estimate 2007-2008 2008 Schemes Non Non- Non- Plan C.S.S. Total Plan C.S.S. Total Plan C.S.S Total Plan Plan Plan 2210-06- 003-AA Orientation Training 154.79 0 0 154.79 235.37 0 0 235.37 155.14 0 0 155.14 Centre, Poona mallee 2210-06- 003-AB Training of 28.17 0 0 28.17 35.52 0 0 35.52 25.37 0 0 25.37 Health Visitor 2210-06- 003-AD 10.73 0 0 10.73 14.45 0 0 14.45 11.83 0 0 11.83 Nutrition Training 2210-06- 003-JE Establishm ent of Computer 0 15.43 0 15.43 0.20 0 0 0.20 0.20 0 0 0.20 Training Centre @ Salem & Madurai 2210-06- 003-AF Establishm ent of Regional 6.40 0 0 6.40 24.65 0 0 24.65 7.22 0 0 7.22 Institute of Public Health for in-service Training 2211-06- 003-SG Schools for Training in 0 0 63.31 63.31 0 0 173.53 173.53 0 0 76.83 76.83 Multi Purpose Health Workers (Female) 78 2211-00- 003-SA Health and Family 0 0 61.21 61.21 0 0 126.99 126.99 0 0 72.70 72.70 Welfare Training Centres 2211-00- 003- SF 0 0 1.87 1.87 0 0 0.01 0.01 0 0 0.01 0.01 Grants 2211-00- 003-JA DANIDA 0 19.58 0 19.58 025.45 0 25.45 0 23.80 0 23.80 Health Care Absorption 2211-00- 003 SB 0 0 0.95 0.95 0 0 0.01 0.01 0 0 0.01 0.01 Grants
Total 200.09 35.01 127.34 362.44 310.19 25.45 300.54 636.18 199.76 23.80 149.55 373.11
4.47. PUBLIC HEALTH TRAINING AND CONTINUING EDUCATION:
4.47.1. In-service Training Programmes are being conducted for the Medical and Para-medical staff in the Institute of Public Health, Health and Family Welfare Training Centres, Health Manpower Development Institutes and Regional Training Institutes of Public Health to enhance their technical skill and latest scientific information in the field of Health and Medicine.
4.47.2. Training Institutes:
There are 6 Regional Training Institutes namely, Institute of Public Health, Poonamallee, Chennai, three Health and Family Welfare Training Centres situated at Chennai, Madurai and Gandhigram and 2 Health Manpower Development Institutes at Villupuram and Salem. The Institute of Vector Control and Zoonosis, at Hosur is categorized as a specialized Training-cum Research Institute for Vector Borne and Zoonotic Diseases Control. The in-service training to the male component of field Health functionaries of Public Health Department is given at Regional Training Institute of Public Health, Thiruvarankulam in Pudukkottai District. It is planned to organize the following training programmes during 2008-09.
1. RCH Training: a) Indian Systems of Medicine Training under Reproductive and Child Health Project b) Manual Vacuum Aspiration Training for Primary Health Centre Women Medical Officers and Staff Nurses c) Training of Trainers for BEmONC Training d) Training of Staff Nurses and Auxiliary Nurse Midwives of BEmONC Primary Health Centres. e) Mobility and communication skill Training for Village Health Nurses f) Mobility and communication skill training –staff from 8 training centres. g) Tubectomy Training for Primary Health Centre Medical Officers h) Obstetric ultra Sonogram training for women Medical Officers i) Training of Trainers in Integrated Management of New Born and Childhood Illness j) Training of Village Health Nurses/Auxiliary Nurse Midwives, Community Health Nurse, Sector Health Nurse in Integrated Management of New Born and Childhood Illnesses 79 k) Training of MBBS doctors in life saving Anaesthetic skills for Emergency obstetric care. l) Cancer Cervix Detection and Cancer Breast Detection Training for Primary Health Centres Women Medical Officers and Staff Nurses-Training of Trainers. m) Integrated Management of New Born and Childhood Illnesses training Supervisor Training-CHN/SHN/Child Development Project Officer / Nutrition supervisor. n) Integrated Management of New Born and Childhood Illness training - Auxiliary Nurse Midwives /Anganwadi Workers/Village Health Nurse o) Skilled Birth Attendant training-Staff Nurse, Auxiliary Nurse Midwives of other than BEmONC PHC, all Village Health Nurses, Sector Health Nurses and Community Health Nurses. p) Colposcopic training for BEmONC PHC Women Medical Officer q) Obstetric Anaesthesia training-Anaesthetist from CEmONC Centres. r) Blood Bank Training- Doctors, Staff Nurse and Lab. Technicians of Government Hospital not trained in Blood Bank Management . s) Training of Trainers on Adolescent Friendly Health Service - Principals, Medical Officers, Maternity and Child Health Officers of 7 training institutes, Selected Medical Officers of PHCs,CHNs,SHNs, Block Extension Educators. t) Adolescent Friendly Health Service Training Primary Health Centres -Medical Officers. u) Adolescent Friendly Health Service Training - Staff Nurses, ANM, CHN, SHN, VHN, Health Inspector, Block Extension Educators and Counselors. v) Training of Trainers-State level- Principals, Medical Officers, Maternity and Child Health Officers of 8 training institutes, District level-Maternity and Child Health Officers (Selected) Block Medical Officers, CHN,SHN Trained Nurses Grade-1 & II, Block level- Selected VHN, Anganwadi Workers and Village level – Accredited Social Health Activist.
2. HIV/AIDS Training to Village Health Nurses 3. Computer skill training to all Health Staff 4. Training for Health Inspector Grade –I B 5. In-service training to all field Health functionaries based on Training need assessment.
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Chapter - 5
FAMILY WELFARE PROGRAMME
5.1. The main aim of the Family Welfare programme is to bring down fertility through improving maternal and child health services in the State. Under “Community Needs Assessment Approach” the needs of the community have been assessed and Family Welfare and Maternity Child Health Programmes are implemented based on the requirements of the people. Tamil Nadu is forerunner in the implementation of Family Welfare Programme all over the country. It is implemented as a people’s programme involving the active co-operation and participation of the community at large.
5.2. Demographic Scenario: The Demographic Scenario of Tamil Nadu compared with India is as follows
Sl. CURRENT LEVEL INDICATORS No. TAMIL NADU INDIA 1. Population 6,24,05,679 102,70,15,247
2. Decennial Growth Rate (%) 11.72 21.35
3. Sex Ratio (female per 1000 males) 987 933
4. Density of population (per sq. K.M.) 480 324
5. Percentage of Urban population 44.04 27.78
Male 82.33 75.85 6. Literacy Rate (%) Female 64.55 54.16
Source: 2001 Census
Crude Birth Rate (per 1000 7. 16.2 23.5 population) Crude Death Rate (per 1000 8. 7.5 7.5 population) Infant Mortality Rate (per 1000 live 9. 37 57 births) 10. Natural Growth Rate (%) 0.87 1.63
Source: SRS 2006 81
5.3. The Infrastructure facilities under Family Welfare programme: The Family Welfare and Maternity & Child Health Services are provided to the Eligible couples in the state through the following Government, Voluntary and Private Medical Institutions.
1 Primary Health Centres 1421
2 Health Sub-centres 8706
3 Rural Family Welfare Centres 382
4 Post Partum Centres 110
5 Urban Family Welfare Centres 108
6 Urban Health Posts 193
7 Voluntary Organisations 27
8 Private Approved Nursing Homes 1706
5.4. Family Welfare performance:
2007-08 Sl. No Programme 2006-07
1. Sterilisation 357568 3,52,856
2. I.U.D. Insertion 360601 3,53,149
3. Oral Pill Users 129196 1,29,515
4. C.C. Users 143900 1,51,234
5. M.T.P 67315 61,435
5.5. Impact of Family Welfare Programme:
1. Couple Protection Rate (as on 31st March 2007) 49.2 % 2. Sterilisation acceptors with two and less than two living 70.9 % children 2006-2007 3. Percentage of Higher Order Births (2006) 14.8 % 4. Mean age at acceptance of sterilisation (2006-07) 27.2 5. Mean number of living children to the sterilisation acceptors 2.4 (2006-07)
82
5.6. The district wise Performance on Family Welfare in Tamil Nadu for 2007-2008 (Provisional) is furnished below:
Sl. District Sterilization IUD O.P. Users C.C. Users M.T.P No 1 Chennai 37473 40439 9570 17042 11855 2 Coimbatore 19752 22493 7216 7693 1072 3 Cuddalore 12535 14202 6315 6835 2705 4 Dharmapuri 11017 9617 4270 4776 1422 5 Dindigul 11581 10972 5029 5313 3022 6 Erode 15128 13115 5771 6337 1796 7 Kancheepuram 14151 12638 5696 3783 1163 8 Kanniyakumari 10422 6514 2972 3537 846 9 Karur 4472 7596 2289 1882 1598 10 Krishnagiri 9158 10239 4088 3098 1715 11 Madurai 16414 15028 4604 6044 3617 12 Nagapattinam 4990 8771 3394 3285 168 13 Namakkal 8729 10003 3498 6463 1759 14 Perambalur 3839 6727 3347 2295 205 15 Pudukkottai 6976 9666 2716 4400 618 16 Ramanathapuram 6215 8469 2080 4396 1420 17 Salem 20104 14996 6012 6519 7521 18 Sivagangai 6541 8130 2955 3204 1067 19 Thanjavur 13408 15503 6862 5401 1302 20 The Nilgiris 3386 3972 987 1676 843 21 Theni 7434 5441 2041 2891 608 22 Thiruchirapalli 10590 11465 3557 4198 3517 23 Thirunelveli 14537 13507 4198 5296 2413 24 Thiruvallur 10844 10418 4730 4887 1647 25 Thiruvannamalai 12530 12124 4820 4917 522 26 Thiruvarur 5197 7807 1885 2734 500 27 Thoothukudi 8712 8815 3592 2390 856 28 Vellore 22047 13144 5182 7555 2484 29 Villupuram 13018 11524 6284 7919 1380 30 Virudhunagar 11656 9814 3555 4470 1794 Total 352856 353149 129515 151234 61435
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5.7. Information, Education and Communication Activities: 5.7.1. From 11.07.2007 to 20.07.2007 World Population Day was observed this year. Information, Education and Communication activities are being carried out at the District level and Block level as follows. A sum of Rs.17,58,750/- was sanctioned by the Government in G.O. No.1029, Health and Family Welfare (EAP II) Department dated 2.7.07 for these activities from the amount of Rs.60.00 Lakhs received from Government of India through National Rural Health Mission.
I State level Activities Amount allotted (Rs.) 1 Organising Debate through Door Darshan Kendra for one 1,25,000/- hour on population problems and other related topics Advertisement through all Leading News papers, Magazines in Tamil Nadu on World Population day and 7,50,000/- Family Welfare Programme II District Level Activities Organising Population Seminar, Essay/Elocution Competitions at District Head Quarters 1,80,000/- Rs.6000 x 30 District Prize distribution to candidates selected through essay / Elocution Competition 30,000/- Rs.1000 x 30 District III Block Level Activities Organising Population Seminar, Essay/Elocution Competition at Block level 3,85,000/- Rs.1000 x 385 Prize distribution to candidate selected through essay / Elocution Competition 2,88,750/- Rs.750 x 385 Total 17,58,750/-
84
5.7.2. In G.O.(Ms.)No.20, Health and Family Welfare (EAP I-2) Department dated 5.1.2008, Government have sanctioned a sum of Rs.42,41,250/- towards the following activities. (Rs.) 1. Printing of Posters, Pamphlets and other print materials of Non Scalpel Vasectomy, Emergency contraceptive pills, 5,00,000 Anaemia, and other FW activities 2. Participation in the 34th Trade Fair 2008 at Chennai for Pavilion erection, EB Charges, Interior and Exterior 5,00,000 Decorations, Electronic Display, and preparation of Display materials. 3. Purchase of electronic media materials (DVD players, Television, Audio Players, mikesets, etc.) for State Bureau, 3,00,000 District FW Bureaus and computer and computer accessories to State Bureau. 4. Production of one short film through Tamil Nadu Films 2,00,000 Division on NSV/FW Programmes. 5. Publication on Public Health awareness camp of Water 10,43,443 borne Diseases published through all leading Newspapers 6. Radio-Gingles on ‘Chickunguniya awareness campaign’ and ‘Varumun Kappom Thittam’ through All India Radio/ 12,00,000 Private F.M. Channels. 7. Payments to NFDC (National Films Divisions Corporation) for recopying of earlier films productions of 16mm, 35mm 2,05,000 films, VHSs for conversion into VCD and DVD 8. Expenditure towatds Float of Health and Family Welfare Department, during pageantry Procession on 2007 Republic 2,13,140 Day. 9. Printing of Booklet on the New Schemes of Health and 32,800 Family Welfare Department during 2007. 10. Miscellaneous expenditures 46,867 Total 42,41,250
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5.8. OBJECTWISE CLASSIFICATIONOF BUDGET:
(Rs. in thousands) Budget Actuals Revised Estimate Details Estimate 2007- 2006-2007 2007-2008 2008
XXIV. STATE PLAN 01- Salaries 73852 0 0
03 - D.A 56892 0 0
04 - Travel Expenses 221 0 0
05 - Office Expenses 373 0 0
09 - Grants-in Aid 0 1 0
10 - Contribution -5 0 0
19 - Machinery and Equipments 1000 601 601
21 - Maintenance of functional vehicles 129 0 260
33 - Payments for Professional and Special 70 0 0 Services
45 - Petrol oil & Lubricants 1226 0 3700
46 - Clothing,Tentage & Stores 3043 2000 2000
49 - Festival Advances -612 0 0
59 - Prizes and Awards 62 0 0
76 – Computer and Accessories 0 180 180
Total 136251 2782 6742
NON PLAN
01- Salaries 0 90299 73922
03 - D.A 0 84773 72646
04 - Travel Expenses 0 202 252
05 - Office Expenses 0 450 450
21 - Maintenance of functional vehicles 0 180 180 33 - Payments for Professional and Special 0 144 154 Services 45 - Petrol, Oil & Lubricants 0 2050 2450
46 - Clothing, Tentage & Stores 0 250 250
86
( Rs. in thousands) Details Budget Actuals Revised Estimate Estimate 2007- 2006-2007 2007-2008 2008 59 - Prizes and Awards 0 12 12
66 – Medicines 6125 6125 6125
79 - Salary Grants 114614 93720 93720
Total 120739 278205 250161
CENTRALLY SPONSORED
01 – Salaries 45035 55550 46833 03 - D.A 33387 50146 44506 04 - Travel Expenses 1748 1951 1941 05 - Office Expenses 2469 2934 2912 06 - Rent Rates&Taxes 289 300 300 08 – Advertising 0 1 1 09 - Grants-in-aid 112273 133300 126300 10 - Contribution 3426 3800 8000 19 - Machinery and Equipments 17100 42790 42950 21 - Maintenance of functional vehicles 177 260 0 24 - Materials & Supplies 10688 45000 45000 33 - Payments for Professional and Special 446 315 350 Services 45 - Petrol oil & Lubricants 3093 3675 0 46 – Clothing, Tentage & Stores 82 116 150 49 - Festival Advances -546 0 0 51 - Compensation 74874 86770 146972 59 - Prizes and Awards 192 59 86 66 – Medicines 78082 93570 93570 72 – Training 84 165 165 76 - Computer and Accessories 137 180 220 Total 383036 520882 560256
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Chapter - 6
DRUGS CONTROL ADMINISTRATION
6.1. The Drugs Control Administration has the prime object of enforcement of the following enactments for regulating the Manufacture, Distribution and Sale of Drugs and Cosmetics:-
a) Drugs and Cosmetics Act 1940 and Rules 1945 b) Drugs Prices Control Order 1995 c) Drugs and Magic Remedies (Objectionable Advertisement) Act 1954.
The officers of this Department are also empowered to act under Narcotic Drugs and Psychotropic Substances Act, 1985. The Director of Drugs Control is the Controlling and Licensing Authority for grant and renewal of licences for manufacture and sale of Allopathic, Ayurveda, Siddha, Unani Drugs, Homeopathic Medicines and Cosmetics and also Licensing Authority for Blood Banks in Tamil Nadu along with the Central Licence Approving Authority.
6.2. Functioning of Mobile Squad and Legal-cum-Intelligence Wing:
There is a Mobile Squad at Madurai as its headquarters and a Legal-cum-Intelligence Wing in this Directorate to attend complaints relating to Spurious Drugs and to investigate specific complaints in Southern Region and in Chennai respectively. Apart from this work, the Legal-cum-Intelligence Wing processes Legal matters and undertakes special investigations.
6.3. Drugs Testing Laboratory:
There is a full fledged Drugs Testing Laboratory attached to this Department which undertakes testing of samples, drawn by the Drugs Inspectors (other than Parenteral Preparations) from various Retail, Wholesale Units, Manufacturing Units and Hospitals, Government as well as Private Hospitals. The Parenteral Preparations are tested at King Institute of Preventive Medicine at Guindy.
6.4 The Department of Drugs Control Administration has the following Staff:
Sl No Name of the Post No. of Posts 1 Director of Drugs Control 01 2 Joint Director of Drugs Control 01 3 Deputy Director of Drugs Control 03 4 Assistant Director of Drugs Control 14 5 Assistant Director of Drugs Control (Administration) 01 6 Senior Drugs Inspector 10 7 Drugs Inspector 74 8 Legal Adviser 01 9 Assistant Accounts Officer 01 10 Ministerial Staff 117 11 Office Assistant 79 12 Driver 04 13 Telephone Operator 01 TOTAL 307 88
89
6.5 Drugs Testing Laboratory, Chennai-6 has the following Staff:
Sl No Name of the Post No. of Posts 1 Government Analyst 01 2 Deputy Government Analyst 02 3 Senior Analyst 11 4 Junior Analyst 28 5 Junior Administrative Officer 01 6 Technician Grade-I 04 7 Technician Grade-II 04 8 Gas Mechanic 01 9 Electrician Grade-I 01 10 Plumber 01 11 Laboratory Attendant 04 12 Animal Attendant 01 13 Ministerial Staff 10 14 Office Assistant 05 15 Sweeper 01 16 Sweeper-cum-Watchman 01 TOTAL 76
6.6. Achievements during 2007-2008:
6.6.1. Drug Information and Pharmaco Vigilance Centre:
Drug is an important commodity in the day to day life of the common man. But unlike other items consumed by them, they are unaware of the nature and usefulness of the drugs. For the other item of day to day use, they confirm its usefulness and worthiness before purchasing them. But for drugs , there is no choice, except to purchase what is prescribed. The Physicians or Surgeons prescribe the medicine and they do not have time to give the full details about the drugs to the Patient. The Pharmacists in the dispensaries are also not having adequate time to give the complete details of the drugs prescribed by the Doctors. The Drug Regulatory officials who are less in number are always occupied with other works. Hence, to overcome the problems or difficulties of the common man especially poor in getting information about the drugs, method of usage i.e. its Dosage, Safety, Precaution and time and methods of intake, a Drug Information and Pharmaco Vigilance Centre has been created. This centre shall function from 10.00 a.m to 5.00 p.m initially on all working days and later on depending on the demand from the public, the working hours will be increased. This centre can be used by Doctors and other Professionals in getting any information relevant to them within half an hour. But in cases where it requires collection of relevant materials from other sources, reply will be given by the next day after getting the contact phone number or Email I.D. or by post. This centre is provided with all facilities like Broadband connection with computers to access internet and with all other accessories. This centre will be operated by one Pharmacologist with M.Pharm Qualification and one with Graduate in Pharmacy and one with Diploma in Pharmacy. This is a joint venture of Directorate of Drugs Control and Tamil Nadu Pharmacy Council. This center has following E mail ID: 90
[email protected] [email protected] Phone No: 044 - 2433 8421
This centre will also receive information from general public, Hospitals and others about any adverse effect on any drug which they have consumed and this data will be collected and used for future studies on the nature of the drug so that if any abnormal incidence of Toxic effect is reported, corrective steps can be taken.
6.6.2. Handycam for the use of Zonal Offices, Mobile Squad at Madurai and Intelligence Wing in the Office of the Director of Drugs Control, Chennai have been purchased at a cost of Rs. 2.25 Lakhs.
6.6.3. LAPTOP and LCD Projector for Seminar Hall in the Office of the Director of Drugs Control, Chennai have been purchased at a cost of Rs.1.35 lakhs.
6.6.4.. On information that drug I-Pill (Emergency Contraceptive pill) and Levonorgestral Tablets B.P.1.5 mg, manufactured by M/s. Cipla Ltd., Goa, contravene the provision of Drugs and Cosmetics Act 1940 and Drugs and Magic Remedies (Objectionable Advertisement) Act 1954, a Joint inspection was conducted at the Depot of the firm and seized drugs worth Rs.1,98,750/-. Legal action is being initiated against the marketer for the contravention of Section 18 of the Drugs and Cosmetics Act 1940 & rules 1945 there under Drugs and Magic Remedies (Objectionable Advertisement) Act 1954.
6.6.5. On information that the drug Preventol Tablets (Emergency oral Contraceptive Pills) manufactured by M/s.Hindustan Latex India Ltd., Karnataka, contravene the provision of Drugs and Magic Remedies (Objectionable Advertisement) Act 1954, a Joint inspection by the Drugs Inspectors of this Department was conducted and legal action is being initiated for the contravention under Drugs and Magic Remedies (Objectionable Advertisement) Act,1954.
6.6.6.. Other legal actions initiated against manufacturers and dealers:
A total of 242 Prosecutions have been sanctioned for the period from 01.04.2007 to 31.03.2008. The following are the major contraventions for which sanction has been accorded:-
(i) Two (2) sanction for prosecution has been accorded under Drugs and Magic Remedies (Objectionable Advertisement) Act 1954.
(ii) Fifty Four (54) sanctions for prosecution have been accorded for having manufactured for sale of Not of Standard Quality Drugs, Spurious Drugs and Adulterated Drugs against different manufacturers.
(iii) One hundred and Eighty Four (184) sanctions have been accorded for other contraventions under Drugs and Cosmetics Act,1940.
(iv) Two (2) sanction has been accorded under Drugs Price Control Order.
6.7. New Schemes for 2008-09: 1. Provision of Lift facilities to the Office of the Director of Drugs Control, at a cost of Rs.20 Lakhs. 2. Provision of one Direct Telephone Line for augmentation of Net facilities and for changing the existing EPABX Board to the Office of the Director of Drugs Control, at 91 a cost of Rs. 0.80 Lakh. 3. Purchase of Reference Books for Administrative Office and Zonal Offices at a cost of Rs.2.00 Lakhs. 4. Purchase of New Instruments/Equipments to replace the old and outdated Instruments/Equipments for the use of Drugs Testing Laboratory, at a cost of Rs. 50 Lakhs. 5. Purchase of Computers for the use of Drugs Testing Laboratory, at a cost of Rs.2 Lakhs. 6 Installation of LPG cylinders in Drugs Testing Laboratory, at a cost of Rs.0.25 Lakh. 92
6.8. Financial requirements: (Rupees in Lakhs)
Sl. Actuals for 2006-2007 Revised Estimate No. Sub-Head of Account 2007-2008 Non- Non- Plan Plan Total Plan Plan To tal 2210-06-104 1 AA – Administration of Drugs Act 334.15 - 334.15 390.90 - 390. 1940 90 2 AB – Administration of Drugs Act 4.54 - 4.54 - - - 1940 King Institute, Guindy. 3 AC – Establishment of Drugs 111.89 - 111.89 123.03 - 123. Testing Laboratory. 03 4 AD - Intelligence Wing of the Drugs 1.39 - 1.39 1.56 - 1.56 Control Administration. 5 JA – Establishment of Drugs Testing ------Laboratory. 6 JB - State Drug Control - - 4.51 4.51 - 5.25 5.25 Administration 7 CA - Buildings - Drugs Control 47.26 - 47.26 - - - (Administered by Chief Engineer (Buildings) TOTAL 499.23 4.51 503.74 515.49 5.25520. 74
6.9. Summary of work carried out by the Drugs Control Administration in Tamil Nadu during the period from 2004-2005 to 2007-2008:
Details of Inspection 2004-05 2005-06 2006-07 2007-08 (upto 30.11.2007) TOTAL NO. OF INSPECTIONS 28,649 26,951 22179 13999 1. Number of Inspections of Sales Concerns 25,624 24,372 20133 12683 2. No. of Inspections of Manufacturing 2,404 1,890 1507 958 Concerns 3. No. of Inspections of Hospitals and Medical 621 689 539 358 Stores. Details of Licences Issued/ Renewed/ Cancelled: 1. Sales Licences Granted 3,164 3,227 4102 2283 2. Sales Licences Renewed 209 05 462 2913 3. Manufacturing Licences Granted 196 151 74 113 4. Manufacturing Licences Renewed 400 260 38 132 5. Licences granted for Manufacturing 46 48 21 25 Ayurvedic, Siddha and Unani 6. Homoeopathic Licences Granted 12 - 12 - 93 TOTAL NO. OF SAMPLES DRAWN 4,082 3,840 3136 1967 Details of Samples Tested 1. No. of Samples Tested 4,794 3,457 3209 763 2. No. of Samples declared as Standard 4,232 3,191 3011 524 Quality 3. No. of Samples declared as Not of 562 266 198 239 Standard Quality.
38409 40560 45389 42422 No. of Sales Concerns (upto30-11-07)
List of Manufacturers in Tamil Nadu as on 30-11-2007 Allopathic Indian Homoeopathic Cosmetics Medicine Medicine Medicine (a) Regular Licences 546 607 14 212 (b) Loan Licences 119 63 -- 04 © Repackers Licences ------TOTAL 665 670 14 216
Blood Bank Licences as on 31-12-2007 .. .. 248
6.10. Details of Prosecution Launched
2004- 2005- 2006- 2007-08 2005 2006 2007 Details of Inspection (upto
31.03.08) 1. Total No. of Prosecutions sanctioned 155 151 244 242 (a) No. of Prosecutions sanctioned under the 151 146 234 238 Drugs & Cosmetics Act 1940. (b) No. of Prosecutions sanctioned under the Drugs 04 05 09 02 & Magic Remedies (Objectionable Advertisements) Act 1954. (c) No. of Prosecutions under Drugs Price Control - - 01 02 Order. (d) No. of Prosecutions under Narcotic Drugs & --- - Psychotrophic Substances Act.
92 6.11. OBJECTWISE CLASSIFICATION: (Rs. in lakhs) Actuals for 2004 - Actuals for 2005 - Actuals for 2006 - Detailed 2005 2006 2007 Head Non- State Total Non- State Total Non- State Total Plan Plan Plan Plan Plan Plan 01 Salaries 253.52 - 253.52 243,31 - 243.31 241.24 - 241.24 02 Wages - 0.14 0.07 - 0.07 0.09 - 0.09 0.14 03 Dearness 129.67 - 129.67 139.52 - 139.62 108.68 - 108.66 Allowanc4es 04 Travel 4.35 - 4.35 3.22 - 3.22 4.62 - 4.62 Expenses 05 Office 10.53 - 10.53 11.11 - 11.11 10.66 - 10.66 Expenses 06 Rent, 11.43 - 11.43 8.97 - 8.97 10.19 - 10.19 Rates & Taxes 08 - - - 0.04 - 0.04 - - - Advertising & Publicity 18 13.43 - 13.43 17.30 - 17.30 47.26 - 47.26 Maintenance 19 Machinery 1.86 - 1.86 5.02 - 5.02 3.39 0.60 3.99 & Equipments 21 Motor 0.04 - 0.04 0.06 - 0.06 0.05 - 0.05 Vehicles 24 Materials 4.50 - 4.50 4.68 - 4.68 4.50 - 4.50 & Supplies 33 Payment 0.05 - 0.05 0.06 - 0.06 0.03 - 0.03 for Professional & Special Services 45 0.69 - 0.69 0.84 - 0.84 0.66 - 0.66 Pe4troleum, Oil & Lubricants 49 Festival 1.66 - 1.66 1.57 - 1.57 1.68 - 1.68 Advance - Debit 49 Festival -3.74 - -3.74 3.43 - 3.43 -1.68 - -1.68 Advance - Credit 51 Other ------Compensation 59 Prizes & 0.01 - 0.01 0.07 - 0.07 0.01 - 0.01 Awards 66 Medicines 2.81 - 2.81 2.69 - 2.69 2.88 - 2.88 68 Cost of 0.46 - 0.46 0.31 - 0.31 0.50 2.00 2.50 Books / Note Books / States etc. 76 Computer - 7.50 7.50 - 4.00 4.00 - 1.91 1.91 & Accessories TOTAL 431.61 7.50439.11 435.41 4.00 439.41 499.234.51 503.74
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Chapter - 7
INDIAN MEDICINE AND HOMOEOPATHY
7.1. "FOOD IS MEDICINE - MEDICINE IS FOOD" Indian Systems of Medicine had reached a high level of perfection and excellence in ancient India. The great curative value of the decoctions and juices of Medicinal Plants and herbs is again being recognized and appreciated by the people belonging to different parts of the modern world. The increasing cost of the modern system of medicine and the incidence of toxicity and side effects have once again highlighted the importance and relevance of traditional systems of medicine in the world. The Department of Indian Systems of Medicine was attached with Directorate of Medical Education till 1970 and a separate administrative department for the Indian Medicine and Homoeopathy system was created in 1970 with a view to give thrust to the growth and development of native system and to popularize the age old proven system having no side effect to the masses.
7.2. The department is dealing with (a) Teaching in UG and PG courses (b) providing health care in District, taluk and Non-taluk and Primary Health Centre level in Siddha, Ayurveda, Unani, Homoeopathy, Naturopathy & Yoga (c) Research and (d) Production, Standardization and quality control of drugs.
7.3. Staff Strength: The total number of personnel employed under the Indian Medicine and Homoeopathy Department as on 01.01.08 is furnished below:
1 Medical Personnel 1201 2 Nursing Personnel 108 3 Pharmacists/Chief Pharmacist/Pharmacy Supervisor 857 4 Ministerial Staff 239 5 Nursing Assistant/Hospital Worker 810 6 Others 428 Total 3643
7.4. Old age Pension to Hereditary Siddha Medical Practitioners: Old age pension of Rs.500/- per month is sanctioned to the Hereditary Siddha Medical Practitioners who have attained the age of 60 years and whose annual income is less than Rs.6000/-. About 602 persons are being benefited under this scheme and an amount of Rs. 38.00 lakhs has been allotted for the purpose during 2007 - 2008.
7.5. District Siddha Medical Offices at District Level : District level administrative offices headed by the District Siddha Medical Officer have been set up to streamline the administration at District level and to provide technical guidance to the Assistant Medical Officers working in Siddha, Ayurveda, Unani and Homoeopathy Wings attached to the District Headquarters Hospitals, Taluk Hospitals, Non-Taluk Hospitals, Primary Health Centers, Government Siddha dispensaries and Mobile dispensaries etc., in the State. These District Offices are functioning in 22 Districts headed by a District Siddha Medical Officer in each district.
96 7.6. MEDICAL EDUCATION: 7.6.1. Government Siddha Medical College and Hospital, Palayamkottai:
7.6.1.1. The Government Siddha Medical College at Palayamkottai was started during the year 1964. The Bed Strength of the Hospital attached to this College is 250. Total student strength in BSMS course as on 1.1.2008 is 471 (Male-119 & Female- 352) The student strength of UG & PG courses are detailed below:
Sl. No. Name of the Course No. of Seats 1. UG – BSMS 100 2. PG- MD(Siddha) 60
7.6.1.2. Distribution of branches in MD(Siddha):
Sl. Name of the Branches No.of seats No. allotted 1. Gunapadam 10 2. Maruthuvam 10 3. Sirappu Maruthuvam 10 4. Kuzhanthai Maruthuvam 10 5. Noi Nadal 10 6. Nanju Noolum Maruthuva Neethi Noolum 10 Total 60
7.6.1.3. Total student Strength in M.D. (Siddha) Course as on 1.1.2008 is as follows:
S.No Name of the Branches Male Female Total
1. Maruthuvam 10 23 33 2. Gunapadam 11 21 32 3. Sirappu Maruthuvam 6 26 32 4. Kuzhanthai Maruthuvam 6 25 31 5. Noi Nadal 6 24 30 6. Nanju Noolum Maruthuva Neethi 8 20 28 Noolum Total 47 139 186
7.6.1.4. Hostel: The total numbers of inmates in the College Hostel as on 1.1.08 are as follows:
Male 107 Female 307 Total 414
7.6.2. Government Siddha Medical College, Chennai: 7.6.2.1. The College is imparting five and half years BSMS Degree course with an annual intake of 50 students. The total strength of students of the College as on 1.1.2008 is 236. (57 Male and 179 Female) 97
7.6.2.2. The Government have sanctioned M.D. ( Siddha ) Post Graduate courses in Maruthuvam and Gunapadam with an annual intake of 10 students in each branch during 1997-98. The students for these courses have been admitted from the academic year 1998-99 onwards. Total strength in M.D. (Siddha) Maruthuvam is 29 (Male 7 and 22 Female) and in Gunapadam is 29 (Male 13 and Female 16) as on 1-1-2008.
7.6.2.3. Hostel: The total number of inmates in the College Hostel as on 1.1.08 is as follows: Male 41 Female 154 Total 195
7.6.3. Government Homoeopathy Medical College and Hospital, Thirumangalam:
7.6.3.1. The Government Homoeopathy Medical College was started at Madras during 1975 and subsequently it was transferred to Thirumangalam, Madurai District with total bed strength of 50. The College is imparting five and half years BHMS Degree course with an annual intake of 50 students. 7.6.3.2. The total strength of the College as on 1.1.2008 is 258 in BHMS course (67 Male and 191 Female). The number of women inmates accommodated in the College Hostel as on 1.1.2008 is 52.
7.6.4. Government Unani Medical College, Chennai:
The Government Unani Medical College was started during1977 in the campus of the Arignar Anna Government Hospital of Indian Medicine, Chennai. The College is imparting five and half years BUMS Degree course with an annual intake of 26 students. Its total strength as on 1.1.08 is 118 (Male 63 and Female 55).
7.6.5. Government Yoga and Naturopathy Medical College, Chennai :
The Govt. Yoga and Naturopathy Medical College has been functioning in the campus of the Arignar Anna Govt. Hospital of Indian medicine, Chennai with an annual intake of 10 students till the academic year 2006-2007 and the intake capacity has been increased to 20 per annum from the academic year 2007-2008. The total students’ strength of the college as on 1.1.2008 is 65 (Male 18, Female - 47).
7.6.6. Government Ayurveda Medical College and Hospital, at Nagercoil in Kanyakumari District:
Government have sanctioned for the establishment of Government Ayurveda Medical College and Hospital at Nagercoil, Kanyakumari District and the College will start functioning from the academic year 2008-09.
7.6.7. Self Financing Indian System of Medicine Colleges:
There are 4 Siddha Private Medical Colleges, 4 Ayurveda Private Medical Colleges, 8 Homoeopathy Private Medical Colleges and 3 Private Yoga and Naturopathy Colleges functioning in this State. The total annual intake of the colleges is given below system wise: 98
VII. S VIII. Name of System Annual intake l . N o 1 Siddha 150 2 Ayurveda 160 3 Homoeopathy 400 4 Yoga and Naturopathy 150 TOTAL 860
7.7. MEDICAL RELIEF: 7.7.1. Arignar Anna Government Hospital of Indian Medicine, Chennai: 7.7.1.1. Out Patient treatment facilities in five systems of medicine i.e., Siddha, Ayurveda, Unani, Homoeopathy and Yoga & Naturopathy and Inpatient treatment facilities in three systems of Medicine viz.. Siddha, Ayurveda and Unani with bed strength of 120, 55, and 78 respectively are available at Arignar Anna Government Hospital of Indian Medicine,Chennai under one roof. This Institution is considered as a teaching hospital for Government Siddha Medical College, Chennai and Government Unani Medical College, Chennai. Apart from the above, 7 Siddha, 4 Homoeopathy, one Ayurveda, one Unani and one Yoga & Naturopathy Dispensaries are functioning at various places in Chennai city under the control of Arignar Anna Govt. Hospital of Indian Medicine. 99
7.7.1.2. A separate Department with 25 beds for Varma and 10 beds for Thokkanam is functioning at Arignar Anna Govt. Hospital of Indian medicine.
7.7.2. Siddha wings attached to District Headquarters Hospitals, Taluk Hospitals, Non-Taluk Hospitals and Primary Health Centres, Medical Colleges and Dispensaries:
Siddha Wings are functioning in 29 District Headquarters Hospitals, 156 Taluk Hospitals, 75 Non-Taluk Hospitals, 428 Primary Health Centers and 9 Medical College Hospitals. Besides, 57 Government independent Siddha dispensaries are also functioning in the State. In patient treatment facilities are provided in 20 District hospitals, one Taluk hospital and one non- taluk hospital.
7.7.3. Ayurveda wings attached to District Headquarters Hospitals Non Taluk Hospitals, Primary Health Centres and Government Ayurveda Dispensaries:
Ayurveda wings are functioning in 4 Dist. Headquarters Hospitals, 3 in Medical College Hospitals, 2 in Non Taluk Hospitals and 25 in Primary Health Centers. In addition Ayurveda wings in 6 dispensaries and in 3 Government Rural Dispensaries are also functioning at various places in the State.
7.7.4. Unani Wings attached to District Headquarters Hospital, Non Taluk Hospitals and Primary Health Centres:
Unani wings are functioning at five District Headquarters Hospitals viz. Nagapattinam, Ramanathapuram, Thiruvarur, Vellore and Dindigul, 4 Non Taluk Hospitals and 12 in Primary Health Centers.
7.7.5. Homoeopathy wings attached to District Headquarters Hospitals, Taluk Hospitals and Government Homoeopathy Dispensaries:
Homoeopathy wings are functioning in 29 District Headquarters Hospitals including Medical College Hospitals, in 8 Taluk Hospitals, in 4 Primary Health Centers and in 5 Government Homoeopathy Dispensaries at various places in the State.
7.7.6. Government Siddha Dispensaries and Mobile Medical Unit under Tribal Sub-Plan:
The Government have opened 7 Siddha Dispensaries in Hill areas and one Mobile Medical Unit at Powerkadu in Kolli Hills of Namakkal District under Tribal Sub-Plan and all of them are functioning.
7.7.7. Details of Patients treated during the year 2007 (From January - December 2007): No of Patients treated during the Name of System year 2007
Out-Pati In- Patients
a. Siddha 17251150 169095
b. Ayurveda 400234 12881
c. Unani 152493 13590 100 d. Homoeopathy 1347471 13892 e. Naturopathy & Yoga 23492 0 Total 19174840 209458
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7.8. PHARMACIES: 7.8.1. Pharmacy attached to Arignar Anna Government Hospital of Indian Medicine, Chennai: This Pharmacy is preparing medicines in Siddha, Ayurveda and Unani systems. The medicines prepared in this pharmacy are supplied to the Arignar Anna Government Hospital of Indian Medicine, Chennai and seven Siddha dispensaries attached to it in Chennai city. This Pharmacy is also supplying the medicines to the Siddha Hospital/Wings located in the following 6 districts i.e., (1) Kancheepuram, (2) Villupuram, (3) Thiruvallur, (4) Vellore, (5) Thiruvannamalai and (6) Cuddalore.
7.8.2. Pharmacy attached to Govt. Siddha Medical College, Palayamkottai:
This pharmacy is preparing and supplying the required Siddha medicine to cater to the needs of both In-Patients and Out-Patients of the Government Siddha Medical College Hospital, Palayamkottai. This Pharmacy is also supplying the medicines to the Siddha Hospitals/ Wings functioning in the following 5 districts i.e. (1) Thirunelveli (2) Virudhunagar, (3) Thoothukudi,(4) Kanniyakumari (5) Ramanathapuram.
7.9. Drug Testing Laboratory (Indian Medicine), Chennai : A Government Drug Testing Laboratory (Indian Medicine) is functioning in the Campus of Arignar Anna Government Hospital of Indian Medicine, Chennai-106 as a Statutory Body under the provision of the Drugs & Cosmetics Act 1940 and Rules 1945 of Government of India. Its main objectives are: i. To ensure the quality of Indian Medicine drugs to the general public, the consumer. ii. To derive some standards for the Indian Medicine drugs- to ensure the quality and iii. To create awareness in the minds of the manufacturers to manufacture good quality drugs, as the Government Drug testing Laboratory (Indian Medicine) as a Monitoring Agency, has vigil on their products.
The Drug Testing Laboratory is being strengthened in a phased manner in such a way that it is fully equipped to meet the task of analyzing Indian Medicine samples to be received from various parts of the State.
7.10. State Drug Licensing Authority: The licensing functions of Indian System of Medicine drugs hitherto exercised by the Drugs Control Department of allopathy side have been separated from it and vested with this department. Separate office of State Drug Licensing Authority ( Indian Medicine ) has started functioning with effect from 29.11.2007 under the control of this department.
7.11. Tampcol: The Tamil Nadu Medicinal Plant Farms and Herbal Medicine Corporation is a Government of Tamil Nadu Undertaking. The Corporation manufactures Siddha, Ayurveda and Unani Medicines and supplies medicines to all ISM wings functioning in the State.
7.12. National Institute of Siddha: The National Institute of Siddha established at Tambaram is a joint venture of Government of India and Government of Tamil Nadu. It is established with an objective to impart post Graduate education in Siddha systems and to provide medical care through Siddha systems of medicine to suffering humanity. This premier Institution is also to develop, promote and propagate the science and art of Siddha.
7.13. Medicinal Plants Board:
The Tamil Nadu Medicinal Plants Board, an autonomous body, is functioning to address the issues connected with conservation and sustainable use of Medicinal Plants, cultivation of Medicinal Plants and export of such products. 102 7.14. VARUMUNKAPPOM THITTAM:
Nearly 4335 Siddha Camps were conducted during the year 2007 under Varumun Kappom Thittam and 52224 patients have been benefitted in these camps.
7.15. Tamil Nadu Board of Indian Medicine:
7.15.1. The number of Indian Medicine Practitioners registered with the Tamil Nadu Board of Indian Medicine is as follows:
S.No Name of the Naturo IX. A Unani Total course pathy y u r v e d a 1 BUMS (Unani) - - 410 410 2 LIM/ LAM, etc - 290 37 327 3 BAMS - 1715 - 1715 (Ayurveda) 4 DAM - 193 - 193 (Ayurveda) 5 GCIM - 160 24 184 6 Tabib-Kamil - - 25 25 7 B2 Class - 1889 628 2517 8 Enlistment - 856 198 1054 9 Naturopathy 16 - - 16 Diploma 10 B.N.Y.S 350 350 Total 366 5103 1322 6791
7.15.2. Tamil Nadu Siddha Medical Council, Chennai: The Number of Siddha Medical Practitioners registered with Tamil Nadu Siddha Medical Council as on 1.1.2008 is as follows: Class No. of Practitioners Registered BIM & BSMS 3083 LIM, LAM etc. 6 GCIM 3 B. Class 2245 C. Class 24 Enlistment 2411 Total 7772
7.15.3. Board of Integrated Medicine: Siddha Ayurveda Unani Total Name of the Course GCIM 3 160 24 187 L.I.M. 6 290 37 333 Total 9 450 61 520
7.15.4. Tamil Nadu Homoeopathy Medical Council, Chennai:
Class No.of Practitioners Registered 103 A. Class i) BHMS 1726 ii) DHMS 524 iii) Others 91 B. Class 14125 C. Class 1050 Total 17516
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Chapter - 8
TAMIL NADU HEALTH SYSTEMS PROJECT
8.1. The World Bank supported Tamil Nadu Health Systems Project is being implemented from 2005 onwards. The Project aims to improve the effectiveness of the Secondary Health Care System in Tamil Nadu. The original outlay of Rs.597.15 crores was revised to Rs.482.49 crores due to diversion of funds for Tsunami relief activities in Tamil Nadu during 2005. However, the World Bank has assured consideration of reallocation of the diverted funds during the phase III of the Project. The Project is being implemented in three phases.
Phase I : January 2005 to June 2006 Phase II: July 2006 to December 2007 Phase III: January 2008 to March 2010
8.2. The project has completed phase I and phase II. The following activities have been carried out during the above period.
8.2.1. Civil works: Additions and extensions to hospital buildings have been constructed in 35 hospitals in 5 districts namely Dharmapuri, Krishnagiri, Theni, Pudukottai and Kanniyakumari districts. During phase II of the project, Government orders have been obtained for construction of buildings in 227 hospitals in 24 districts. Detailed drawings have been drawn and tenders are being invited for the above works. It is expected to complete all the construction activities by March 2009.
8.2.2. Emergency Ambulance Services: Emergency ambulance services have been established in 187 blocks during phase I of the project. During phase II of the project, Government orders have been obtained to establish emergency ambulance services in the remaining 198 blocks and the ambulances are being procured.
8.2.3. Supply of hospital equipments: Hospital equipments have been supplied to 38 hospitals during phase I. Remaining hospitals have been provided with hospital equipments during phase II of the project.
8.2.4. Mortuary Van Services: Mortuary Van Services which was started during phase I has been continued during phase II and is in operation during phase III also.
8.2.5. Strengthening of Maternity and Child Health Services: 24 hours Comprehensive Emergency Obstetric and New born Care services have been initiated in another 32 hospitals in addition to the 51 hospitals already having these services.
8.2.6. Bio Medical Waste Management System: Bio Medical Waste Management System has been established in 11 hospitals in Dharmapuri and Krishnagiri districts which is being scaled up to all hospitals in the State.
8.2.7. Cervical Cancer Screening Pilot Project: Cervical cancer screening pilot Project is being carried out in Theni and Thanjavur districts.
8.2.8. Cardio Vascular disease prevention pilot Project: Cardio Vascular disease prevention pilot Project is being carried out in Virudhunagar and Sivagangai districts.
8.2.9. Mobile outreach clinical services: Mobile outreach clinical services in 12 tribal areas is being continued to provide medical relief to the tribal population.
8.2.10. Patient counseling centres: Patient counselling centres have been established in 166 hospitals during phase I and this activity is being continued.
105
8.3. OBJECTIVE WISE CLASSIFICATION OF BUDGET 2007-2008:
(Rs.in Lakhs) State Plan Accounts Budget Revised Objects 2006- Estimate Estimate 2007 2007-2008 2007-2008 01. Salaries 52.14 96.90 169.81 02. Wages 0.89 0.68 0.00 03. Dearness Allowances 37.33 88.17 155.65 04. Travel Expenses 1.18 17.83 15.81 05. Office Expenses 323.70 177.90 151.39 06. Rent, Rate and Taxes 0.70 1.50 1.50 08. Advertisement & Publicity 24.27 169.73 203.10 09. Grants-in-aid 197.41 1174.30 811.75 13. Hospitality/Entertainment Expenditure 0 0.50 0.50 16. Major Works 2141.93 4131.50 12444.89 17. Minor Works 10.82 0.01 0.01 18. Periodical Maintenance 0 0.01 0.01 19. Machinery & Equipment 346.84 9109.46 4348.72 21. Motor Vehicles 186.05 9.61 1404.98 24. Materials and Supplies 0 0 45.00 33. Payment for Professional and Special 182.13 2984.97 1251.77 Services 45. Petrol, Oil and Lubricant 4.10 27.76 25.26 47. Stores & Equipment 742.76 522.68 1769.11 49. Festival Advance (+) & (-) -0.70 0 0 59. Prize & Awards 0.07 0.02 0.02 60. T.A/D.A. to Non Official Members 1.40 30.70 36.30 66. Medicines 0 35.00 0 68. Cost of Books 0.25 0.75 0.75 71. Printing Charges 265.00 222.04 57.49 72. Training 113.82 1074.22 473.38 76. Computer & Accessories 17.25 1620.52 1622.31 80. Lump sum Provision 68.84 258.86 20.11 99. Miscellaneous 77.27 141.65 93.19 Total 4795.45 21897.27 25102.81
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8.4. Financial Year 2007-2008 Summary of Major Heads: (Rs.in Lakhs) Revenue Account Revised Accounts Budget Estimate Major Head Estimate 2007- 2006-2007 2007-2008 08 2210. Medical & Public Health 2088.07 12749.58 8999.14 2211. Family Welfare 554.63 5016.18 3658.78 Revenue Total 2642.70 17765.76 12657.92 Capital Account 4210. Capital Outlay on Medical 834.37 2678.01 8703.30 & Public Health 4211. Capital Outlay on Family 1318.38 1453.50 3741.59 Welfare Capital Total 2152.75 4131.51 12444.89
Grand Total 4795.45 21897.27 25102.81
8.5. Statement Showing the Financial Requirement of Summary of Minor Heads: (Rs.in Lakhs) Budget Revised Accounts Minor Head Estimate Estimate 2006-2007 2007-2008 2007-2008 001. Direction and Administration 308.79 550.63 393.32 110. Hospital and Dispensaries ® 961.93 7081.57 4671.51 © 799.64 728.00 8501.84 200. Other Health Schemes 59.39 130.51 94.51 200. Other Systems 21.62 567.24 1153.98 200. Other Programmes © 0 1500.00 0 003. Training 150.77 832.14 207.93 101. Prevention and Control of 208.37 371.47 248.27 Diseases 112. Public Health Education 28.78 38.50 71.92 113. Public Health Publicity 24.74 324.00 11.00 796. Tribal Areas Sub Plan 97.02 433.72 189.54 800. Other Expenditure ® 24.32 70.01 56.16 © 34.73 450.00 201.46 004. Health Statistics & Evaluation 202.32 2003.21 1801.00 103. Maternity and Child Health ® 476.91 4017.29 3187.02 © 1318.38 1453.50 3741.59 104. Transport 0 606.51 191.75 190. Assistance to Public Sector and 3.27 55.01 3.60 Other Undertaking 200. Other Services & Supplies 74.45 238.76 266.41 800. Other Expenditure 0 40.01 10.00 Total 4795.45 21897.27 25102.81 ® Revenue © Capital
107
8.6. COMPONENT WISE CLASSIFICATION OF BUDGET 2007-2008: (Rs.in Lakhs) Budget Revised Accounts Component Estimate Estimate 2006-2007 2007-2008 2007-2008 I. Increasing Access and Utilization of 1966.76 6143.27 7384.56 Health Services II. Developing Effective Models to 233.11 2812.57 451.02 Combat Non-Communicable Diseases III. Building The Capacity for Oversight 683.22 4055.72 3885.95 and Management of the Health System IV. Maximizing the Efficiency of the 1912.36 8885.71 13381.28 Public Sector to deliver essential services Total 4795.45 21897.27 25102.81
8.6.1. Increasing Access and Utilization of Health Services: (Rs.in Lakhs) Budget Revised Accounts Sub Component Estimate Estimate 2006-2007 2007-2008 2007-2008 1. Reduction of Maternal and Neo Natal Mortality 1795.29 5470.79 6928.61 2211-00-103 PA,PB and 4211-00- 103 PA 2. Improving Tribal Health 97.02 433.72 189.54 2210-06-796 PA,PB 3. Facilitating Use of Hospitals by the poor and 74.45 238.76 266.41 the Disadvantaged 2211-00-200 PA Total 1966.76 6143.27 7384.56
8.6.2. Developing Effective Models to Combat Non-Communicable Diseases: (Rs.in Lakhs) Budget Revised Accounts Sub Component Estimate Estimate 2006-2007 2007-2008 2007-2008 1 Health Promotion 24.74 334.59 11.00 2210-06-113 PA 2. Pilot Testing of Clinic Based NCD Control 208.37 371.47 248.27 2210-06-101 PA 3.Accident Prevention and Trauma Care 0 2106.51 191.75 2211-00-104 PA, PB & 4210-04-200 PC Total 233.11 2812.57 451.02
108
8.6.3. Building the Capacity for Oversight and Management of the Health System:
(Rs.in Lakhs) Budget Revised Accounts Sub Component Estimate Estimate 2006-2007 2007-2008 2007-2008 1. Monitoring and Evaluation (i) Strengthening HMIS (ii) Evaluation and 231.10 2041.71 1872.92 Assessment of Innovations 2210-80-004 PA,PB and 2210-06-112 PA 2. Improving Quality of Care (i) Protocol Development 24.32 212.01 156.16 (ii) Regulation of Public & Pvt. Hospt. 2210-06-800 PA - 2210-80-800 PA 3. Health Care Waste Management 21.62 567.24 1153.98 2210-05-200 PA,PB and 4211-00-108 PA 4. Strategy Development and Implementation (i) Strategic Planning (ii) PPP Management (iii) Health Insurance Pilot 406.18 1234.76 702.89 (iv) Project Management 2210-01-001 PA,PB + 2210-01-200 PA 2211-00-190 PA ,2211-00-800 PA and 4210-01-800 PA Total 683.22 4055.72 3885.95
8.6.4. Maximizing the Efficiency of the Public Sector to deliver essential services:
(Rs.in Lakhs) Budget Revised Accounts Sub Component Estimate Estimate 2006-2007 2007-2008 2007-2008 1. Rationalization of secondary care facilities 808.99 1569.56 8701.35 2210-01-110 PA + 4210-01-110 PC 2. Rationalizing of Equipment 952.58 6240.01 4472.00 2210-01-110 PB 3. Human Resource Planning & Development 150.79 832.14 207.93 2210-06-003 PA 4. Enhancing Management of Public facilities (a) Management Strengthening 0 244.00 0 (b) PPP for facilities facing difficulties 2211-00-003 PA & 2210-05-800 PA Total 1912.36 8885.71 13381.28
109
Chapter - 9
STATE HEALTH SOCIETY
9.1. The National Rural Health Mission (NRHM) has been launched in Tamil Nadu with the view to bring architectural correction of the health system to enable it to effectively handle increased allocations and promote policies that strengthen public health management and service delivery. It aims to improve the health status of the people, especially those who live in the villages. The vision is to provide universal access to equitable, affordable and quality health care services, which is accountable at the same time responding to the needs of the people. The programme is for the period 2005-2012. The programme is funded by Government of India.
9.2.OBJECTIVES: • Reduction in infant mortality and Maternal mortality. • Universal access to Public Health Services – Women’s Health, Child Health, drinking water, sanitation and hygiene, nutrition and universal Immunization. • Prevention and control of communicable and non-communicable diseases. • Population stabilization – Gender and demographic factors. • Access to integrated comprehensive primary health care. • Revitalizing local health tradition and mainstreaming AYUSH. • Promotion of health life styles.
9.3. Constitution of State Health Society:
To achieve the objectives of the mission, the State Health Society is constituted and registered under Tamil Nadu Societies Registration Act, 1975 with Registration No.47/2006, merging all the health related societies except Tamil Nadu AIDS Control Society, to provide better health status and improved quality of health care, through integrated approach of preventive and curative streams, covering primary to tertiary levels, and partnership with the community, with special focus on a life cycle approach for mother and child health and welfare. Also it is contributing to raising the status of the girl child. The society is implementing programme activities achieving the goals through co-ordinated working with the departments concerned.
9.4. Constitution of District Health Society (DHS):
District Health Societies have been constituted in all Revenue Districts for planning and managing all health and family welfare programmes in the district both in rural as well as in urban areas. This society is also responsible for preparation of a District Health plan which coordinates work of other departments as well as for meeting health goals. It also enables block and village plans to be prepared and achieved.
9.5. National Rural Health Mission:
9.5.1. Establishing Rogi Kalyan Samiti (Patient welfare society) in PHCs and hospitals:
In 1421 PHCs, Rogi Kalyan Samiti has been constituted and money released @ Rs.1.00 lakh per PHC. Rs.1421.00 lakhs have been released to the District Health Societies. In 235 Sub District Hospitals, Rogi Kalyan Samiti has been constituted and money released @ Rs.1.00 lakh per Hospital. An amount of Rs.235.00 lakhs have been released towards this scheme. In 29 District Headquarters Hospitals, Rogi Kalyan Samiti has been constituted and money released @ Rs.5.00 lakhs per Hospital. An amount of Rs145.00 lakhs has been released for this scheme. 110
9.5.2. Establishing Village Health and Sanitation Committees in all Villages:
Under NRHM 12618 Village Health and Sanitation Committees are formed in 2006-07 and 2540 Village Health Sanitation Committees are formed in 561 Town Panchayats during 2007-08. Totally 15158 Vlillage Health and Sanitation Committees have been formed in Tamil Nadu. An amount of Rs.1515.80 has also been released during 2007-08 for this scheme @ Rs.0.10 lakh for each VHSC. This Committee will be involved in participatory planning and implementation of all health Programs at HSC level.
9.5.3. Annual Maintenance Grant for PHCs :
An amount of Rs.878.00 lakhs has been released towards AMG @ Rs.50,000/- for 1383 Primary Health Centres functioning with own building and 385 BEmONC Centres Primary health Centres. Tremendous progress is made by utilizing AMG by improving the appearance of the PHCs, providing patient amenities like drinking water and planting trees and formation of herbal gardens.
9.5.4. Annual Maintenance Grants for HSCs:
Under NRHM an amount of Rs.635.80 lakhs has been released towards this scheme to the 6358 HSCs functioning with own building at Rs.10,000/= per annum towards under taking minor masonry, carpentry plumbing and electrical works, formation of herbal garden in HSC premises etc.,
9.5.5. Untied funds to PHCs:
An amount of Rs.355.25 lakhs has been released towards untied fund to each PHC @ Rs.25,000/-. It is utilized for the minor modifications to the centre, curtains to ensure privacy, repair of water supply system, installation of bulbs, minor repairs carried out at local level etc.
9.5.6. Untied funds to HSC:
An amount of Rs.870.60 lakhs has been released during the year 2007-08 under this scheme. for the minor modifications to the sub centre, curtains to ensure privacy, repair of water supply system, installation of bulbs, minor repairs carried out at local level, adhoc payments for cleaning up sub centre, especially after child birth., Transport of emergencies to appropriate referral centres, environmental sanitation, payment of ANM cell phone bills etc.
9.5.7. Mobile Medical Units and Out reach services:
9.5.7.1. 100 Mobile Medical Units were sanctioned during 2006-07 to serve the people in hilly and difficult terrain areas which are inaccessible to PHC services and Vehicles are also provided to each Mobile Medical Unit at the cost of Rs.600.00 lakhs. Further, an amount of Rs.600 lakhs was also provided to another 100 Mobile Medical Units for acquiring Vehicles.
9.5.7.2. An amount of Rs.592.16 lakhs has been released towards Drugs, lab reagents, vehicle maintenance, POL staff cost contingencies and equipments for out reach services with a dedicated team of staff appointed for 100 Mobile Medical Units (comprising of one Medical Officer, one staff nurse, one driver and one sanitary worker) under this scheme.
No. of Camps conducted during 2007-08 55,514
No. of people examined and treated 23,59,415
111
9.5.8. Strengthening of District Head Quarters Hospital:
An amount of Rs.580 lakhs has been released towards the strengthening of District Head Quarter Hospitals during 2007-08, to enhance MCH care facilities.
9.5.9. Health Mela: An amount of Rs.312.00 lakhs allocated by GOI is being utilized towards Health Mela to conduct in all the 39 Parliamentary constituencies in Tamil Nadu as part of the advocacy strategy to position the NRHM as en effective tool to show case the programmes and services to the people.
9.5.10. Establishment of Mother care facilities including Birth Waiting Rooms:
An amount of Rs.50 lakhs has been released to Krishnagiri and Dharmapuri districts at Rs.25 lakhs for each district towards construction of Birth Waiting Room.
9.6. Reproductive Child Health activities under NRHM:
9.6.1. MATERNAL HEALTH:
9.6.1.1. 24 Hour Delivery Care Services:
The Introduction of 24 hour delivery care services in 780 PHCs with 3 staff nurses is increasing the number of deliveries in the PHCs. The scheme has been extended for another 220 PHCs during the year 2007-08, and the staff nurses have been appointed and an amount of Rs.1525.13 lakhs has been released under this scheme.
No. of PHCs functioning with 24x7 hours 1000 Delivery Care services
No. of deliveries conducted by Staff Nurses 87901
9.6.1.2. Family Health Clinics in BEmONC PHCs:
Family Health Clinic services are established in all the BEmONC PHCs jointly with TANSACS to provide lab services for diagnosis, treatment of RTI/STI, voluntary counseling and testing services for HIV. An amount of Rs. 257.95 is released under this scheme.
No. of Family Health Clinics conducted 40,362
No. of Beneficiaries 3,03,286
No. of Patients referred for higher medical 4,494 treatment
9.6.1.3.Gestational diabetes control Programme:
Towards Gestational Diabetic Control Programme. an amount of Rs.38.50 lakhs is released to the District Health Societies towards sensitisation of PHC and ICDS staff and Orientation of SHGs and Pregnant women, by conducting meetings.
No. of Antenatal / Postnatal Mothers tested 54912 (GTT) No. of Antenatal / Postnatal Mothers found to 1396 have GTT 112
9.6.1.4. Hiring of Anaesthetists and Obstetricians for providing emergency obstetric care services. Towards Hiring the services of private Anaesthetists and Obstetricians for providing emergency obstetric care/MTP/Tubectomy services in PHCs/FRUs an amount of Rs.200 lakhs is released.
No. of Sterilisations performed 15097
No. of MTPs performed 242
9.6.1.5. Community Blood Donation Camp:
In 130 upgraded PHCs blood storage facilities is being established. An amount of Rs.14.28 lakhs is released to the District Health Societies to conduct 2 Blood Donation camps per HUD.
No. of Blood Donation Camps conducted 638
No. of Blood Units collected 24196
9.6.1.6. Ambulance services for the emergency transport of mothers and children :
With the Help of UNICEF, six ambulances fully equipped with ultra modern equipments are stationed in 6 PHCS in the Tsunami affected Districts of Nagapattinam, Kancheepuram and Cuddalore to take care of seriously sick babies and mothers en route while they are being referred for specialized care in higher institutions. Towards the maintenance of ambulance services in Tsunami Districts, an amount of Rs.13.98 lakhs is released.
9.6.1.7. JANANI SURAKSHA YOJANA(JSY):
Under this scheme, an amount of Rs.2126.15 lakhs is released to Deputy Director of Health Services Janani Suraksha Yojana aims at reducing Maternal and infant morality by focussing on skilled attendance during childbirth for all the women of 19 years and above belonging to BPL families. An amount of Rs.700/- for institutional deliveries and Rs.500/- for domiciliary deliveries in rural areas and Rs.600/- for institutional deliveries and Rs.500/- for domiciliary deliveries in urban areas is given. Towards Anaesthesia Training to Doctors Programme, an amount of Rs.22.79 lakhs is released.
No. of Mothers benefitted - RURAL - 1,79,976 - URBAN - 15,840 - TOTAL - 1,95,816
9.6.2. Child Health:
9.6.2.1. Hiring of Paediatricians for provision of emergency new born care:
The Medical Officers in the Hospitals and PHCs are permitted to hire private paediatricians for emergency newborn care and paediatric care wherever the paediatricians are not available in the hospitals and PHCs. An amount of Rs.50 lakhs is released to the DHS towards this scheme. 113
9.6.3. FAMILY WELFARE :
On the guidelines of Government of India, Tamil Nadu Government is implementing increased compensation to the sterilized acceptors from 1.2.2007 for the sterilization done in the Government Medical Institutions. An amount of Rs.2620.00 lakhs for compensation to the sterilized acceptors, and Rs.170.00 lakhs for conducting NSV camps are being released in the districts.
9.6.4. ADOLESCENT HEALTH:
The Medical Colleges are involved to carry out the programme. Funds are released to Medical Colleges and guidelines are issued to carryout the programme. The total amount released is Rs.312.20 lakhs.
9.6.5. Urban Health:
An amount of Rs.308.00 lakhs is released towards the implementation of urban Health scheme. The Medical Colleges are involved in this programme by adopting urban slum for providing Health Care.
9.6.6. INNOVATIONS/PPP/NGO:
9.6.6.1. Scan Centre Audit:
An amount of Rs.81.20 lakhs is released towards scan centre audit to District Health Societies to regulate the functions of scan centres in order to eliminate the practice of revealing sex and to prevent the practice of female foeticide.
No. of Visits made to Scan Centres by the Health staff - 16942
. 9.6.6.2. Gender Equity:
An amount of Rs. 38.50 lakhs is released to the District Health Societies to conduct Sensitization of self Help groups, Panchayat raj institutions members and NGOs are permitted to conduct meetings at block level in 385 PHCs towards addressing the gender related issues and to promote the gender equality to tackle the situation and to disseminate the gender issue related problems among the community. The Women self help groups are becoming main force in the rural area. By giving awareness to these women the scenario will change.
9.6.7. Infrastructure and Human Resource:
9.6.7.1. Communication facilities:
Under RCH Project 806 PHCs are provided telephone facilities in Tamil Nadu. Now it is extended for further 615 PHCs also at the cost of Rs.22.14 lakhs at Rs.300 per month from RCH funds in addition to State fund. An amount of Rs.59.43 lakhs is released to the DHS for incurring expenditure towards telephone charges for 1421 PHCs.
9.6.7.2. Improving the quality of obstetrics and newborn care services in tertiary institutions:
For developing mother and childcare services in tertiary institutions through the departments of obstetric, paediatric and anaesthesiology, an amount of Rs.350 lakhs has been released to the 15 Medical College Hospitals at Rs.10 lakhs for each paediatric and obstetric departments(35 institutions). 114
9.6.7.3. Repairs to residential quarters, Labour rooms and wards and water supply improvements to the 24 x 7 PHCs: Facility surveys reveal that ANM quarters and Nurse quarters need renovation and repairs, Labour rooms and wards also require repairs, modification and extension works are also needed to cope with the increased number of deliveries and new born care requirements. Hence it is proposed to undertake essential civil works from RCH II funds for which an amount of Rs.430.00 lakhs is released.
9.6.8. INSTITUTIONAL STRENGTHEINING: 9.6.8.1. Mobility Support: Under Mobility support system to provide additional fuel to the blocks and DDHS office Rs.70.35 lakhs is released to the DHS.
9.6.9. TRAINING: 9.6.9.1. Integrated Management of Neonatal and Child hood Illness(IMNCI): IMNCI training extended to all remaining districts during the year 2007-08 with a cost of Rs.374.44 lakhs and with the support of State level arrangements for programme management from Institute of Child Health, Egmore, Chennai.
9.6.9.2. Human resource development under RCH II:
1. MVA Training programme is conducted for the Women Medical Officer, Staff Nurses/ANM of PHCs with Operation theatre for 13 working days at HFWTC, Egmore, Madurai, and HV School Triplicane in coordination with Chennai Corporation, Madurai Medical College and Kasturba Gandhi Hospital, Triplicane at the cost of Rs.5.53 lakhs.
2. ISM training programme counducted for the Community Health Nurse, Sector Health Nurse, Village Health Nurse, ANM and DMCHOs for 13 working days in training institutues. Masters trainers training for SBA conducted for 3 working days at IPH Poonamallee for the Obstetrician and Paediatrician and Obstetric Nurse and Paediatric nurse from all Medical Colleges and faculties from RTIs, all DMCHOs, DDHS for 3 working days. BEmONC training including poison management training to BEmONC Medical Officers for 3 working days at Medical Colleges BEmONC staff training for Staff Nurses/ANM of 24 x 7 PHCs for 13 working days conducted at 6 Regional Training Institutes in coordination with medical Colleges Skilled Birth attendant training for Staff Nurses at Govt. Institutions having more than 150 deliveries per month for 14 days. Skilled Birth attendant training for VHNs and ANMs at Govt. Institutions having more than 150 deliveries per month for 21 days. An amount of Rs.105.73 lakhs released to the training Institutions and District Health Societies.
3. Tubectomy Training for Medical Officers in PHCs with OT or adjoining PHCs for 15 days at all District Head Quarters Hospitals/Medical College Hospitals at a cost of Rs. 5.93 lakhs.
4. Obstetric Ultra Sonogram Training for Medical Officers from PHCs having scan or adjoining PHCs for 30 working days at District Head Quarters Hospital/Medical College Hospitals at a cost of Rs.8.62 lakhs.
5. Training of MBBS Doctors in life saving anaesthetic skills for emergency obstetric care for MBBS Doctors from PHCs and secondary care hospitals for 24 weeks at all Govt. Medical College Hospitals and 14 District Head Quarters Hospitals at a cost of Rs.44.69 lakhs.
6. Training of MBBS Doctors in Obstetric skills for emergency obstetric care for MBBS Doctors from PHCs for 24 weeks at all Govt. Medical College Hospitals and 14 District Head Quarters Hospitals at a cost of Rs.10.26 lakhs. 115
Chapter - 10
TAMIL NADU STATE AIDS CONTROL SOCIETY
10.1. The Tamil Nadu State AIDS Control Society (TANSACS) approach has been to increase the quality of services, to promote better understanding of HIV/AIDS, resulting in attitude and behaviour changes. Such empowerment also results in many vulnerable groups spreading their knowledge in their communities and initiating overall social change. In selecting the target groups, the agency has seized upon readily available opportunities such as the use of existing structures. An example of such a successful programme is the completion of Phase 1 of the training in sexual health and AIDS awareness of poor rural women, using the framework of the women's self-help groups which have a major presence and strength in rural Tamil Nadu. Such grass roots level initiatives also involve local Government institutions such as panchayats. Other initiatives are addressed to high risk groups like People living with HIV / AIDS (PLHA) and vulnerable groups such as youth. The programmes of TANSACS can be classified as:
1. Programmes to prevent infection, 2. Treatment services, 3. Care and support 4. Surveillance, monitoring and training activities 10.2. Targeting high risk groups: These interventions are aimed at reducing high-risk behaviour among specific population groups whose chances of getting and transmitting the HIV infection are high. Such groups are categorized as Core Groups - Female Sex Workers (FSW), Men who have Sex with Men (MSM) and Injecting Drug Users (IDU) - and Non Core Groups which includes truckers, migrants and prison inmates. 10.3. Condom Promotion: Condoms are the most effective means of prevention of HIV infection among both high risk and general populations. TANSACS has a plan to provide wide coverage to all groups adopting the best way to reach out to each group. The different strategies include: Recent Behavioural Sentinel Surveillance conducted by APAC shows that ♦ 66% of the FSW are using condoms consistently with their one-time clients. Consistent usage is significantly low with their regular partners and clients ♦ Condom use with regular partners is low because perception of risk of contracting HIV from regular partners is very low. FSW also do not think it is necessary to use condoms with regular partners.
Condom Usuage - Urban, FSW
91.2 91.8 100 88.3 88.0 87.2 89.5 88.1 85.9 90 74.0 80.0 88.3 88.0 87.0 86.7 80 83.7 84.9 70 78.2 79.6 60 56.0 51.5 41.0 50
Percent 40 28.3 28.5 19.1 30 23.3 14.0 16.0 20 6.4 8.4 10 0
I I I V V I I I X X I I I I V I I I X I V I e e e e e V e e e v e v v v v e e v v v a v a a a v v a a a W W W Wa W W W W Wa Wa Wa
With Any Client With Regular Client With Regular
116 10.3.2. Achievements: ♦ Social marketing: NGOs have sold 11.47 lakh condoms through non traditional outlets, while Fair Price Shops have sold 500 lakhs. ♦ Free supply of condoms: About 300 lakh condoms have been distributed through medical clinics and Sexually transmitted disease clinics, Self Help Groups and Non- governmental Organisations. ♦ Distribution of female condoms: 60,000 female condoms have been procured and supplied to the six NGOs involved in promotion activity. During the first month of the pilot project to promote female condoms, a total of 10,340 pieces were sold.
10.4. Empowering rural women to fight HIV/AIDS:
10.4.1. Women in India are more vulnerable to HIV infection because of their limited role in decision making and limited opportunity to discuss issues related to sex and sexuality. UNAIDS estimates 50% of new infections occur among women. In this context, informing women about sexual health and empowering them to make decisions and negotiate with their partners on condom use becomes essential. The first phase of a project on sexual health and AIDS awareness has been implemented in seven districts of Tamil Nadu - Cuddalore, Dharmapuri, Madurai, Namakkal, Nilgiris, Ramnathapuram and Vellore - which has covered 8,23,744 women in 51,484 SHGs. 10.4.2. Achievements: ♦ Thirty master trainers and 417 PLF trainers have been trained across the State. ♦ 51,484 animators have been trained in seven districts. ♦ 8,23,744 SHG members, belonging to 51,484 SHGs, have been trained. ♦ Process documentation of the project has been completed.
10.5. School AIDS Education Programme: SAEP is implemented in Tamil Nadu through the Directorate of Technical Education Research and Training (DTERT) to provide information on HIV/AIDS transmission and prevention in the context of growing up, and to impart related life skills to students in all senior secondary schools in the State. When the programme was first implemented in 1997, it covered 357 schools, with a budget of Rs 8.32 lakhs. During the academic year 2006-07, the programme was implemented in 9423 schools, with a budget of Rs 5 crores. IX and XI standard students in Government, Government aided, private, corporation, matriculation and Anglo-Indian schools in the State formed the target group. 10.6. The Red Ribbon Club : The Red Ribbon Club (RRC) Programme is a voluntary on-campus intervention, aimed at heightening risk perception and preventing HIV among youth. Red Ribbon Clubs have become a powerful medium to reach out to young people. RRCs empower students in the age group of 17-25, by giving them information and life skills to protect themselves from HIV/ AIDS and transforming the most active among them into peer educators. Red Ribbon Clubs have been formed in 874 colleges and, with a strong volunteer base of above 50,000 students, reaches out to nearly seven lakh students all over the State. 300 peer educators and 865 other functionaries have been trained. Among other activities, 525 blood donation camps, in which approximately 25,000 blood donors participated, have been held. 10.7. IEC activities: IEC activities have been formulated taking into consideration the diverse cultural, linguistic and social backgrounds of different communities across the State. IEC interventions have also helped to reduce stigma and discrimination associated with HIV/AIDS and to safeguard and protect the human rights of PLHA. The recent NFHS-III data show that more than 90% of people in Tamil Nadu have awareness, at different levels, of HIV/AIDS.
117 10.8. WORLD AIDS DAY - 2007: 10.8.1. With leaders across the world endorsing the campaign theme of the year Stop AIDS. Keep the Promise, and emphasizing the required leadership qualities in the fight against the dreaded epidemic, the World AIDS Day 2007 was observed by TANSACS at Corporation Kalai- Arangam, Coimbatore on 1st December 2007. The programme was attended by over 1,200 people, which includes PLHAs, NGOs, Women in sex work, Transgenders and MSMs from all over Tamil Nadu. During the programme, an announcement was made for free HIV testing which was Rs.10/- earlier. 10.8.2. Many pioneers and leaders representing HIV Positive networks were honoured for their role as crusaders in raising the morale and confidence of people living with HIV and waging a determined struggle against stigma and discrimination. 10.8.3. The partner organizations were also honoured for their tremendous involvement and extending support and cooperation in the field of HIV/AIDS epidemic. Lifetime achievement awards were given to Dr.P.Padmanaban, Director of Public Health & Preventive Medicine and Dr. Manoharan, Medical Director, I-TECH for working tirelessly and silently in improving the health systems and to increase the access for people living with HIV. IEC stalls were put up by TANSACS and partner organisations and cultural programmes relating to HIV/AIDS awareness were organised. TANSACS funded all the District Collectors and PLHA Networks for the observance of World AIDS Day in their respective districts. 10.9. Counselling, Treatment & Care: 10.9.1. Tamil Nadu has pioneered the concept of promoting integrated services. HIV counseling and testing, HIV-TB co-infection services, blood safety, STD, ART etc. have all been clubbed together under a single window system. This helps in convergence and client convenience. 10.9.2. Offering a single window system for delivery of services - Integrated Counselling and Testing Centres (ICTC): 10.9.2.1. The Integrated Counselling and Testing Centers (ICTCs) offer counselling and testing services, ensure safe blood availability and storage and also make available, ART treatment for sexually transmitted infections (STI) and Reproductive Tract Infections (RTI). To make the Prevention of Parent to Child Transmission (PPTCT) programme more widely available to pregnant women throughout the State, it was decided to integrate the programme with related services and make it available through existing clinical facilities. Complete integration of all related services has increased access to all these services through a single window system. 10.9.2.2. During 2006, no.of ICTCS in the State was up-scaled from 276 to 730 ICTCs. Now the services offered by ICTCs are available even at the Block Primary Health Centres, thus benefitting rural communities. In the year 2007 - 08, 19.7 lakh people have been tested in the ICTCs 10.10. Service providers appointed at crucial levels: 10.10.1. With increase in coverage, follow-up of clients who drop out at different stages of the counselling-testing-treatment process has become crucial. Appointment of 405 ORWs (one in each of 385 blocks and 20 in Chennai city) has made such follow-up possible. More than half the ORWs are themselves PLHA women. The work provides them income and self confidence and increases empathy with clients. ♦ 72% increase in utilization of counselling, testing and treatment services in 2006-07, compared to 2000 levels. ♦ Increase in client load (general public seeking ICTC services) by 92%. ♦ 96% of those counselled opted for testing, demonstrating the efficacy of counselling services. ♦ Coverage of mother and child for Nevirapine administration is 91% for deliveries conducted in Government facilities. The overall coverage in the State has risen from 80% to 91% in the year 2007-2008. 118 10.11. Blood Safety: 10.11.1. Blood transfusion service should provide effective blood and blood products which are safe and adequate to meet the needs of patients. This is essential to safeguard the health of patients. A total of 83 Government 9 central/quasi Government, 3 ESI and 149 licensed private blood banks are in the State. 10.11.2.Significant results: ♦ Increase in voluntary blood donation from 57.3% in 2002 to 82 % in 2007; ♦ Decrease in Sero positivity among blood donors from 0.30 % in 2002 to 0.1% in 2007; ♦ Increase in use of components. 10.11.3. From the existing 65 maternity / CEMONC Centers, TANSACS has identified 38 Government blood banks as recipients for minus 20 degree Celsius deep freezers for storage of fresh frozen plasma, for use during obstetric emergencies. 26 • TANSACS has provided five Government medical college blood banks with computers and printers for computerized networking and identified 12 more Government medical college and district head quarters hospitals for this facility. • A compendium on blood banks and a Voluntary Blood Donation Calendar has been printed. 10.12. STD Services: Sexual transmission is a major route for the spread of HIV/AIDS. People vulnerable to HIV infection are also vulnerable to other sexually transmitted and reproductive track infections (STI/RTI). The rate of prevalence of HIV among those who suffer from STDs is very high. Presence of any STI accelerates the transmission of HIV/AIDS by 2-9 times more. To prevent this acceleration, STI clinics are functioning to provide Syndromic Case Management (SCM). With the establishment of these clinics, activities related to STD services have been intensified. For Quality Services, TANSACS provides-
1. Drugs ( including Ol ) to all STD clinics. 2. Computer with accessories and band connection. 3. Infrastructure and equipments. 4. Bio medical waste management facilities. 5. IEC materials regarding the STI disease and availability of treatment to all STD clinics, VCTC, PPTCT, RNTCP and to Blood banks. 6. Training for all MOs incharge of STD clinics and all Para medical workers to update their knowledge in STD management / SCM. 7. Contingency to meet emergency expenditure.
10.13. Anti Retroviral Treatment: The Government of India launched a free ART initiative, on 1st April 2004, in eight Government hospitals in six high prevalence States. The Government Hospital of Thoracic Medicine, Tambaram Sanatorium, near Chennai, was one of the centers to implement free ART roll out. Within four years, the number of centers has increased to 26. Twelve of them are located in medical college hospitals and 13 in district HQ hospitals. These centers provide ART free of cost to needy PLHA. A direct correlation is evident between the increase in number of ART centres and PLHA registration. Of an estimated 3.5 lakh PLHA in the state, 68,450 are currently registered in the 26 centres. Of these, free ART has been initiated for 28,468 patients in the year 2007. 10.14. Community care centers: Commmunity care centers (CCC), providing support for those affected by HIV/AIDS, are run by NGOs. These centers were started in 2002-03 and the programme was expanded during 2004-05. Initially, there were 17 centers, slowly the number was increased to 23 in 2005-06. In the year 2007-08, there are 27 functioning CCCs (Twenty three for adults and four for children). 119
10.15. Drop - in- Centers: The drop-in-center (DIC) is a place which, as the name signifies, is open to PLHA to ’drop in’ at need, to avail themselves of a variety of services. It is a place where they are made to feel at home, where trained counseling is available and where, also, they draw support and strength from each other. 10.16. Support from TANSACS: TANSACS currently supports six DICs. The Positive network organizations running these centers are: ♦ Tamil Nadu Network of Positive People (TNP +), Villupuram District ♦ Tamil Nadu Aravanighal Association (THAA), Kancheepuram District ♦ HIV Ullor Nala Sangam, Namakkal ♦ Cuddalore District HIV Positive Society (CDS +), Cuddalore ♦ South India Positive Network, Chennai ♦ People Living with and affected by HIV/AIDS Trust, Theni 10.17. Sentinel surveillance: The HIV sentinel surveillance programme is implemented by the Health and Family Welfare Department of the Central Government through the National AIDS Control Organisation (NACO). The programme monitors trends in HIV infection over time, by group and by place, through testing of blood samples. The surveillance can be either community-based or clinic/health facility-based; the latter, being more convenient, is preferred. The testing is done by the unlinked unanimous method. NACO approves the number of sites for testing. Tamil Nadu has 97 sites approved for sentinel surveillance in 2006. 10.18. HIV prevalence in different groups in the year 2006:
Site /group Median of HIV prevalence rate (%) ANC 0.38 STD 8 FSW 3.6 IDU 24.2 MSM 5.6
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CHAPTER - 11
TAMIL NADU STATE BLINDNESS CONTROL SOCIETY
11.1. The Government of India launched the National Programme for Control of Blindness in 1996 as 100% centrally sponsored scheme with the goal of reducing the prevalence of blindness. On 01.04.1996, Tamil Nadu State Blindness Control Society was formed as a separate entity, to give thrust to the goal by planning, execution and monitoring at the district level. Every district in the State has one District Blindness Control Society to govern the activities of the National Programme for Control of Blindness. The District Collector is the Chairman of the District Blindness Control Society concerned. The cataract being the major cause of the avoidable blindness, was given importance and various infrastructural facilities like eye wards, dark room etc., have been built till 2002 and they are now in use. Under the programme, the society was funded by World Bank till 30.06.2002, through Union Government. From 1.7.2002 onwards, Central Government is funding the programme. The State Blindness Control Society, Chennai has been merged with the State Health Mission with effect from 01.04.2007.
11.2. PERFORMANCE:
11.2.1. The Government of India every year fixes target for cataract operations, school eye screening and collection of donated eyes to the State of Tamil Nadu. This society in turn demarcates the target among the 30 District Blindness Control Societies in the State. The Secretary to Government, Health & Family Welfare Department and Mission Director, National Rural Health Mission, reviews the achievement and the problems hindering the target at the end of each quarter. The physical target and achievement for the year 2007-2008 is as below.
Sl Particulars Target Achievement % in No upto achievement 31.12.2007 1 Cataract operations 5,00,000 3,86,410 77% Implantation of IOL 3,50,000 3,76,652 108%
Women Beneficiary 2,75,000 1,85,776 68% Surgery on bilaterally blind 2,50,000 50,546 20% SC/ST/Below poverty line 2,50,000 1,86,073 74% beneficiaries 2 School Eye Screening
School children screened 8,00,000 14,94,671 186% Children with refractive error 56,000 49,739 89% Free spectacles to poor children 16,800 15,421 92%
3 Eye Donation Eyes collected 7,500 5,714 76%
11.2.2. Manpower Training:
15 Ophthalmic surgeons from various Government Hospitals were trained in IOL implantation, small incision cataract surgery techniques during 2007-2008 at Regional Institute of Ophthalmology & Government Ophthalmic Hospital, Egmore, Chennai TELC Joseph Eye Hospital, Trichy and Aravind Eye Hospital, Madurai. 121
11.2.3. Financial:
On the financial side, there is no prescribed target as such. The Government of India release Grant-in-aid in two instalments, to compensate NGOs at a prescribed rate per operation. The Non Governmental Organisations based on the actual case reported, are paid compensation from the District Blindness Control Societies. The District Collector is the Chairman who releases the Grant-in-aid to the NGOs for the eye care activities performed by them.
11.3. The details of financial release and expenditure incurred for the year 2007-2008 are as follows:
(Rs. in lakhs) SL. DETAILS SBCS DBCS TOTAL NO. 1 Total sum released during 15 660 675 the financial year 2007-2008 (Upto 31.12.2007)
2 Total expenditure incurred 68.04 624 692.04 by the District Blindness Control Society towards NGOs compensation, conduct of free eye camps etc.
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Chapter - 12
TAMIL NADU MEDICAL SERVICES CORPORATION
12.1. Organisation:
The Tamil Nadu Medical Services Corporation Limited, has been incorporated on 01.07.1994, under the Companies Act 1956, as a Company, owned by Government of Tamil Nadu. Over a period 13 years, it has grown rapidly and is now an ISO 9001:2000 Certified Organization. The activities of the Corporation have expanded from the basics of procurement and supply of drugs to the medical institutions, to providing diagnostic facilities, procurement, storage and supply of drugs to the Veterinary Department, procurement and supply of high value equipments to the various medical institutions in the State and the latest development is maintenance of Pay Wards and medical equipments.
12.2. Purchase of Drugs and Medicines:
12.2.1. During the year 2008-2009, TNMSC has planned to procure drugs and medicines worth Rs.275.00 Crores (including the procurement of new generations specialty Drugs to the tune of Rs.50 crores) through transparent and open tender process, against the current procurement worth Rs.193.00 crores. As such, the activity level of TNMSC for drugs will rapidly increase by 43% when compared with the previous years as detailed below.
Year Procurement (Rs. in Crores) Increase (%)
2005-06 119.53 --
2006-07 140.25 17%
2007-08 195.05 39%
12.2.2. The availability of drugs for the distribution to the various Government medical institutions through the warehouses in the State is ensured by closely monitoring the stock position and the procurement process. By means of effective communication systems, required stocks are made available in all the warehouses at any point of time, and the actual stocks is also available on the Website which can be easily accessed by the medical institutions.
12.2.3. In the year 2007-2008, TNMSC has also procured drugs and medicines to the tune of Rs.13.60 crores for North Eastern States of Assam, Meghalaya, Tripura, and Mizoram under the NRHM programme of Govt. of India and this service is likely to be further extended to Manipur in the year 2008-2009.
12.3. Storage:
Scientific storage facility is another achievement of TNMSC logistics management. So far, the Corporation has constructed 25 Drug warehouses, at the District Headquarters in the State for quick movement of the drugs to the medical institutions and hospitals. The process for construction of 2 more warehouse at krishnagiri and Perambalur districts is also in progress to quicken the movement to the bifurcated districts .
12.4. Distribution:
The medical institutions are provided with passbooks for drawal of medicines, surgical and suture items on the basis of the financial allocation made by their respective Head of the Departments according to which the distribution is made to the respective Hospitals / Institutions. 123
12.5. Quality Control:
TNMSC is ensuring quality control measures on all aspects, and the distribution of quality medicines to the Government medical institutions after satisfying the samples to rigorous quality testing process in reputed analytical laboratories empanelled through open tender system. The drugs are issued to the hospitals only if they pass the quality test.
12.6. Computerization:
The success of the Tamil Nadu Medical Services Corporation Limited is attributable mainly to the well designed Computer Network System. The Corporation has established a well knit Computer Network with all the Warehouses. The information from Warehouses are transferred to the Head Office daily. This has enabled the Corporation to have full control over the availability of stock of drugs at different Warehouses and also to make available the required medicines to the needy warehouse from the other warehouses where it is found surplus. Daily monitoring of the stock position is done at the Head Office, by which, action is taken either to transfer the surplus drugs to the needy Warehouses or place further purchase orders to replenish the depleting stock. The Computer Hardware has been upgraded with higher configuration and models, i.e., from FoxPro to ORACLE for handling huge volume of data.
12.7. Advanced Diagnostic facilities:
12.7.1. The Corporation, apart from its normal functioning of procurement and supply of drugs, has expanded its activities by providing advanced diagnostic facilities to the public at nominal charges.
12.7.2 MRI Scan: The Corporation was earlier maintaining 2 MRI Scan Centres at Government General Hospital, Chennai and Government Rajaji Hospital, Madurai and providing advance diagnostic services to the patients at an affordable charges for Scanning. As permitted by the Government, one 64 Slice C.T. Scan at a cost of Rs.5.50 crores has been procured & installed at the Government General Hospital, Chennai during the year 2007-2008. At a cost of Rs.28.74 crores, 6 more MRIs have been procured during the year 2007-2008 and 5 MRIs were already installed in 1) Vellore Medical College Hospital, 2) Thiruchirappalli Annal Gandhi Memorial Hospital, 3) Thirunelveli Medical College Hospital, 4). Chennai Stanley Medical College Hospital and 5). Coimbatore Medical College Hospital and the remaining one MRI is being commissioned at Thanjavur Medical College Hospital.
12.7.3. CT Scan: The Corporation is maintaining 40 CT Scanners at 37 Centres in Government Hospitals and thereby at least 1 CT Scanner is available in each District to serve the Public. The Corporation is charging nominally for scanning.
12.7.4. Lithotripsy: The Corporation is also maintaining 2 Lithotripsy machines, one each at Govt. General Hospital, Chennai and Govt. Rajaji Hospital, Madurai procured at a total cost of Rs.3.00 crores and collecting nominal charges from the patients.
12.8. Special Wards: 12.8.1. GI Bleed and Hepato Biliary Centre; Government Stanley Hospital, Chennai – 1
The GI Bleed and Hepato Biliary Centre is maintained by TNMSC and is functioning as a separate unit under the control of Surgical Gastroenterology Department in Government Stanley Hospital, Chennai. Necessary additional infrastructure facilities are provided by TNMSC out of the funds generated by the Centre itself. 124
12.8.2. Institute of Obstetrics and Gynaecology, Chennai – 8:
TNMSC is maintaining Maternity Wards with 40 beds on payment basis in the Institute of Obstetrics & Gynaecology and Government Hospital for Women and Children, Egmore, Chennai with a nominal fee fixed by the Government.
12.8.3. Government Kasturba Gandhi Hospital for Women and Children, Chennai – 5:
TNMSC is also maintaining maternity wards with 40 beds on payment basis at the Government Kasthuribai Gandhi Hospital, with a nominal fee fixed by the Govt. for affordable patients and functioning from 3.5.2004 onwards.
12.8.4. Government General Hospital, Chennai:
206 bedded payward is functioning with logistic support by TNMSC for its maintenance, with a nominal charges from the affordable patients.
12.9. Maintenance of Medical and Non-medical equipments at various Government Medical Institutions / Hospitals:
12.9.1. This Corporation is also taking care of maintenance of equipments / Instruments, both (Medical & non Medical) in all the Government medical institutions.
12.9.2. The TNMSC has finalized tenders and placed orders this year for procurement of high value equipments worth Rs.108.00 crores including the equipments for TNHSP, RCH and Public Health & Family Welfare and TANSACS which include Ventilators, Monitors, Ultra sound scanner, Digital X-ray Unit, Echo Cardiogram, Digital Cardiac Catheterisation equipments and Mobile Medical units and essential items like Cots, Mattress, Pillows and Bed sheets to various district and sub district hospitals, and these equipments and facilities will be in place shortly.
12.10. Tamilnadu Health Website:
The Government of Tamil Nadu has launched a Web site “www.tnhealth.org.” which provides all information regarding various health activities under the Health and Family Welfare Department. The Website also provides Health chat between 4.00 p.m. and 6.00 p.m. daily. The site also has a Bulletin Board where public can access the Medical Specialists for getting expert opinion. TNMSC maintains the Website.
12.11. Other Activities:
a) Government of Tamil Nadu permitted TNMSC to procure and supply the required Medicine Kits for the willing States under National Rural Health Mission and for National AIDS Control Organisation, Government of India.
b) TNMSC has been appointed as procurement agency for equipments for Tamil Nadu Health Systems Project aided by the World Bank. TNMSC is also acting as procurement agency for procurement of testing kits, blood bank consumables etc. for Tamil Nadu State AIDS Control Society.
c) The Corporation is also serving other institutions like TNEB dispensaries, Municipal and Corporation dispensaries, Panchayat union dispensaries, Prison and Police Medical Hospitals, Juvenile Homes, Rehabilitation Homes, Co-operative Sugar Factories, Veterinary Institutions, Transport Corporation Dispensaries etc.
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Chapter - 13
TAMILNADU STATE HEALTH TRANSPORT DEPARTMENT
13.1. Tamil Nadu State Health Transport Department was formed in 1981 as a separate Directorate for attending the repairs/maintenance and servicing of Motor vehicles under the administrative control of the Health and Family Welfare Department. The above patterns of works are got executed by the Departmental Workshops namely 7 Regional Workshops, 9 District Workshops and 27 Mobile Maintenance Units.
SANCTIONED STAFF STRENGTH:
Sl. NO NAME OF THE POST Sanctioned Posts as on 31.03.2008 1 Director 1
2 Deputy Director (Technical) 1
3 Deputy Director (Administration) 1
4 Accounts officer 1
5 Automobile Engineer 1
6 Technical Officer 1
7 Material Manager 1
8 Workshop Superintendent 7
9 Assistant Accounts Officer 7
10 Assistant Engineer 9
11 General Foreman 10
12 Ministerial Staff 87
13 Technical Staff 448
14 Office Assistant, Sweeper and Watchman 94 15 TOTAL 669
126
13.2. Details of workshops:
Headquarters of 9 Headquarters of 27 Mobile Head Quarters of 7 District Workshops. Maintenance Units. Regional Workshops. 1.Chennai Chengalpattu Chennai (S) Chennai (N) Chengalpattu Kancheepuram Tiruvellore 2.Vellore Villupuram Vellore Cuddalore Villupuram Tiruvannamalai 3.Salem Dharmapuri Salem Dharmapuri. 4.Coimbatore Udhagamandalam Tiruppur Erode. Erode Udhagamandalam 5.Thiruchirappalli Thanjavur Thiruchirappalli, Pudukkottai Thanjavur Perambalur Nagappattinam. 6.Madurai Virudhunagar Madurai Theni Ramnathapuram Sivagangai Dindigul 7.Thirunelveli Nagercoil Thirunelveli Sankarankoil Nagercoil. Thoothukudi
13.3. The year wise figures of jobs attended are given below :
S.NO. YEAR JOBS ATTENDED 1. 2001-02 12,940 2. 2002-03 13,559 3. 2003-04 13,859 4. 2004-05 14,768 5. 2005-06 15,529 6. 2006-07 15,208 7. 2007-08* 15,068 (*) as on 31.03.2008 Fleet utilisation has been improved to 96%. 127
13.4. Directorate-wise fleet strength maintained by this department is given hereunder (as on 31.03.2008): S.No. DIRECTORATE No. of Vehicles 1. PUBLIC HEALTH AND PREVENTIVE MEDICINE 1110 2. MEDICAL AND RURAL HEALTH SERVICES 588 3. FAMILY WELFARE 608 4. MEDICAL EDUCATION 266 5. TAMIL NADU STATE HEALTH TRANSPORT DEPARTMENT 51 6. INDIAN MEDICINE AND HOMOEOPATHY 12 7. REPRODUCTIVE ANDCHILD HEALTH PROJECT 8 8. DRUGS CONTROL 3 TOTAL 2646
13.5. OBJECTWISE CLASSIFICATION (Rupees in Thousands) Details (Non Plan) Actuals Budget Revised 2006-07 Estimate Estimate 2007-08 2007-2008 01. Salaries 42475 48811 42494 03. Dearness Allowances 20758 22320 21157 04. Travel Expenses 605 630 910 05. Office Expenses 1238 1626 1528 06. Rent, Rates & Taxes 262 364 364 12. Scholarship & Stipend 510 931 889 19. Machinery & Equipments 162 175 180 24. Materials and Supplies 17606 20581 21581 33. Payment for Professional and 2 5 70 Spl Services 34. Other Charges 3 11 0 45. Petrol, Oil and Lubricants 2899 5000 5000 46. Clothing, Tentage and Stores 360 484 484 49-01 Festival Advance - Debit 414 550 1100 49-02 Festival Advance - Credit -1164 -550 (-)1100 59. Prizes & Awards 26 12 20 72. Training 23 25 25 76. Computer and Accessories 20 20 125 03.03. Dearness Pay 10873 20667 17631 TOTAL 97072 121662 112458
13.6.OBJECTWISE CLASSIFICATION (Rupees in Thousands) Details (State Plan) Actuals Budget Revised 2006-07 Estimate Estimate 2007-08 2007-2008 76. Computer and Accessories 350 90 90 19.01. M & E Purchase 0 240 240 TOTAL 350 330 330