HEALTH & FAMILY WELFARE DEPARTMENT POLICY NOTE ON HEALTH AND FAMILY WELFARE 2011 - 2012 Demand No.19 Health & Family Welfare Department Dr. V.S.VIJAY Minister for Health © Government of Tamil Nadu 2011 POLICY NOTE ON HEALTH AND FAMILY WELFARE 2011-2012 CONTENTS Page No. 1 Introduction - 1-12 2 Medical Education - 13-22 3 Medical and Rural Health Services - 23-39 4 Tamil Nadu State Blindness Control - 40-43 Society 5 Public Health and Preventive Medicine - 44-60 6 Family Welfare Programme - 61-73 7 Drugs Control Administration - 74-79 8 Indian Medicine and Homoeopathy - 80-89 9 Tamil Nadu Health Systems Project - 90-99 10 State Health Society - 100-130 11 Tamil Nadu State AIDS Control Society - 131-150 12 Tamil Nadu Medical Services Corporation - 151-156 13 Tamil Nadu State Health Transport - 157-159 Department Chapter - 1 INTRODUCTION 1.1. „Health is Wealth‟ so says our ancestral wisdom. A healthy nation is a wealthy nation. Good health of the people plays a pivotal role in the all round development of the Society. Only a healthy population can contribute productively to the overall economic growth of the country. Our state is committed to building a healthy society not only by making available quality medicare facilities available and accessible to the people but also by focusing on preventive health care and adoption of healthy life styles. With a view to achieve the objective of a healthy Tamil Nadu, the budget allocation to the Health and Family Welfare Department has been fixed at Rs.4761 Crores for the financial year 2011-2012 as against the provision of Rs.3889 Crores for 2010-2011, recording an increase of more than 20%. 1.2. Based on vital health indicators, Tamil Nadu is a front runner among the various States of India. The State is fast emerging as a good public health model for the rest of the country, especially for maternal and child care. 99.8% of all deliveries in the state are conducted in institutions by qualified and trained personnel. Various policy initiatives which were introduced between 2001-06, such as 24 hours delivery care service in the PHCs, 2 upgradation of existing PHCs to a 30 bedded hospital with modern equipments in each block, provision of CEmONC services in the Govt. Hospitals, birth companion programme and maternal death audit have been responsible for the consistent excellent performance of Tamil Nadu in this field. 1.3. Tamil Nadu has also achieved considerable success in combating communicable diseases like polio, leprosy and tuberculosis. There is also significant progress in the eradication of HIV/AIDS. The Tamil Nadu State AIDS Control Society is focusing to make Tamil Nadu “AIDS free and no new Infection State” by 2012. There is an urgent need now to focus our attention on non- communicable diseases like diabetes, hypertension, cardiovascular diseases and cancer which are emerging as major causes of morbidity and mortality in our society. These diseases can be tackled only by a two pronged strategy which includes creating awareness for prevention through life style changes as well as early detection and treatment. The second phase of the World Bank funded Tamil Nadu Health Systems Project, in co- ordination with the National Rural Health Mission, is now focusing on the prevention and treatment programmes for the above diseases besides taking up IEC activities for creating awareness regarding the risk factors and need for life style modifications. Infrastructure strengthening of Government facilities with modern medical equipments for the detection 3 and early treatment of patients affected with cardiovascular diseases, complications of diabetes and hypertension and cancer of the cervix and breast are being taken up under the project. 1.4. The insurance scheme for the life saving treatments introduced by the previous Government was terminated for the reasons that it was not comprehensive and effective in fulfilling public aspirations. This Govt. has since formulated a new insurance scheme called “Chief Minister‟s Comprehensive Health Insurance Scheme” which will be launched shortly. In the new scheme, the coverage and sum assured will be Rs.1.00 lakh every year for a total period of four years and the ceiling of one lakh will be raised to Rs.1.5 lakh for certain identified procedures. The number of procedures covered will also be increased. The cost of diagnostic tests and, medicines upto 5 days after the discharge including travel expenses will form part of the insurance package. An effort will be made to involve government hospitals more fully under the new scheme. A stop gap arrangement has been made to provide basic health insurance for emergency life saving procedures so as to provide uninterrupted service delivery to the public till the launching of the new health insurance scheme. 1.5. In 2004-05, a scheme was taken up to screen all children under 15 years for congenital disorders and ensure that all the children with cleft lip and 4 palate were operated in the Govt. Medical College Hospitals so that Tamil Nadu would become a „cleft lip-cleft palate‟ free State. It has now been decided to revive the programme. All visible congenital defects in children under the age of 15 years would be surveyed and those children who need surgery for congenital disorders will be operated in the Govt. Medical College Hospitals or through the comprehensive insurance scheme, free of cost. 1.6. As a new initiative, the “Hospital on Wheels Scheme” will be launched by this government to provide health care services at the door step of remote and far flung areas of the state. The existing 385 Mobile Medical Units will be strengthened with additional man power and lab facilities and the medical team will visit remote villages based on a fixed tour programme. 1.7. Though there has been significant improvements in the health care delivery in the rural areas of our state, it is a matter of concern that the under privileged population in the urban areas, especially in the urban slums and small urban towns are unserved and under served To correct this imbalance, it is proposed to implement a comprehensive plan for urban health care service delivery. The government will focus on the improvement of primary health care facilities in urban areas on par with the PHCs in rural areas. The existing health posts will be strengthened by providing 24 hour delivery care. The 60 Urban 5 Health Centres already sanctioned under the National Rural Health Mission, but not yet established will be provided with adequate staff and equipments and brought under the control of Directorate of Public Health and Preventive Medicine. 75 more such Urban Primary Health Centres will be set up in small urban towns with less than one lakh population which do not have primary health care facilities as on date. 1.8. The state has always given prominence to the empowerment of women and children. As evidence of this priority, a number of health programmes focusing on women‟s welfare have been announced for implementation. The existing Dr.Muthulakshmi Reddy Maternity Benefit Scheme will be strengthened to provide enhanced maternity assistance of Rs.12,000 upto two deliveries for poor women. Of this, the first Rs.4000/- will be paid during the seventh month after completing antenatal care, Rs.4,000/- immediately after delivery in a government health facility and the final installment of Rs.4,000/- in the fifty month after the child receives the immunization as per the national schedule. The scheme will be implemented at a cost of Rs.596 crores during this year. 1.9. Promotion of menstrual hygiene among adolescent girls will go a long way to reduce the risk of infection and infertility among women in the future. The Government of India has announced a scheme for sale of sanitary napkins to rural girls at 6 a subsidized cost of Rs.6/- per pack of 6 napkins in 10 districts. But the state has proposed to distribute the napkins free of cost to girls in the rural areas through the ICDS network using the Village Health Nurses in the entire state. A sum of Rs.46 crores has been provided for this year to implement the programme. This is a path breaking scheme as Tamil Nadu is the only state in the country to take up implementation for the entire state using state funds. 1.10. The World Bank assisted Tamil Nadu Health Systems Project has mainly been focusing on infrastructure improvement in the Government. Hospitals so as to improve the services available to the public. Utilising the funds allotted to the Project in the second phase, the diagnostic services in all the District Head Quarters Hospitals will be upgraded with additional supply of medical equipments and life saving equipments for poison treatment centres at a cost of Rs.55 crores. It is also proposed to set up „state of the art‟. computer aided laboratory facilities in all the districts under Public Private Partnership in a phased manner. 1.11. The Govt. of India has enacted the Food Safety and Standard Act 2006 by repealing the existing Prevention of Food Adulteration Act 1954 to control the adulteration of food items. The new Act has come into force with effect from 5th August 2011. Tamil Nadu has also taken action to implement the above Food Safety and Standard Act 7 2006 in Tamil Nadu with effect from 5th August 2011. To ensure that standard and non-adulterated food and non-spurious drugs are supplied to the public, this Government has decided to set up a separate Food Safety and Drug Control Administration under an officer of the rank of Commissioner and Secretary to Government .