PREVENTION OF FOOD ADULTERATION

??????????????????????? ??????????????????????? ??????????? (Rs. in lakhs)

? Scheme	Actual 2002-2003			Budget Estimate 2003-04			Revised Estimate 2003-04
? Scheme	Non-Plan	Plan	Total	Non-Plan	Plan	Total	Non-Plan	Plan	Total
? 2210-06-102-AA Food Analysis Laboratories	203.54	0	203.54	227.53	0	227.53	224.14	0	224.14
2210-06-102-JA & SA Food Analysis Laboratories	0	1.46	1.46	0	9.50	9.50	0	9.50	9.50
? Total	203.54	1.46	205.00	227.53	9.50	237.03	224.14	9.50	233.64

PREVENTION OF AIR AND WATER POLLUTION

?????????????????????????????????????????????????????????????????????? ?????????????????????????????????????????????????????????????????????????????????????????????(Rs. in lakhs)

? Scheme	Actual 2002-2003			Budget Estimate 2003-2004			Revised Estimate 2003-04
? Scheme	Non-Plan	Plan	Total	Non-Plan	Plan	Total	Non-Plan	Plan	Total
2210-06-107-JA Development of Public Health Lab. Services	0	12.04	12.04	0	13.40	13.40	0	14.73	14.73
2215-02-106-AA Water Analysis Laboratory	122.67	0	122.67	144.38	0	144.38	125.87	0	125.87
Total	122.67	12.04	134.71	144.38	13.40	157.78	125.87	14.73	140.60

HEALTH STATISTICS AND EVALUATION

?????????????????????????????????????????????????????????????????????????????? ???????????????????????????????????????????????????????????????????????????????(Rs. in lakhs)

S. No.	Scheme	Actual 2002-2003			Budget Estimate 2003-2004			Revised Estimate 2003-04
S. No.	Scheme	Non-Plan	Plan	Total	Non-Plan	Plan	Total	Non-Plan	Plan	Total
1	2210-80-004-AA Research Work	1.93	0	1.93	3.22	0	3.22	1.70	0	1.70
2	2210-80-004-AB Nutrition Research	15.27	0	15.27	24.44	0	24.44	14.81	0	14.81
3	2210-80-004-AG Medical Statistical Cell	16.69	0	16.69	20.45	0	20.45	19.48	0	19.48
4	2210-80-004-AI Vital Statistical Registration	100.58	0	100.58	127.03	0	127.03	121.75	0	121.75
5	2210-80-004-AJ Strengthening of Surveillance Unit for Expanded and Immunization Programme	5.18	0	5.18	4.65	0	4.65	3.35	0	3.35
?	Total	139.65	0	139.65	179.79	0	179.79	161.09	0	161.09

HEALTH EDUCATION AND PUBLICITY

??????????????????????????????????????????????????????????????????? ????????????????????????????????????????????????????????????????????????????? (Rs. in lakhs)

Scheme	Actual 2002-2003			Budget Estimate 2003-2004			Revised Estimate 2003-2004
Scheme	Non-Plan	Plan	Total	Non-Plan	Plan	Total	Non-Plan	Plan	Total
2210-06-112-AA Head Quarters Unit and RCAP Units in Districts	77.83	0	77.83	108.89	0	108.89	88.79	0	88.79
2210-06-112-AC Training Units	7.85	0	7.85	10.87	0	10.87	9.59	0	9.59
2210-06-113-AD Press	7.48	0	7.48	11.65	0	11.65	6.95	0	6.95
2210-06-113-AE Exhibition and Media Units	10.51	0	10.51	14.77	0	14.77	14.72	0	14.72
2210-06-113-JA Establishment of 10 Media Units	0	2.71	2.71	0	3.14	3.14	0	4.36	4.36
Total	103.67	2.71	106.38	146.18	3.14	149.32	120.05	4.36	124.41

Strengthening of Health Sub-Centre by supplying Equipment and other Accessories

?????????? In order to enhance the quality of maternity and child health services and to enable the VHNs to stay in their HSCs, the HSCs 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 HSCs will be improved to a great extent.

Achievements under the Maternity and Child Health components are furnished below?

Functioning of Health Sub-Centre in Tribal Sub Plan Area:

Out of 8682 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
2.	Salem	Yercaud hill Kolli hill Kalrayan hill.	3 5 2
3.	Villupuram	Kalrayan hill	14
4.	Vellore`	Jawadhu hill	17
5.	Trichirapalli	Pachamalai hills	4
?	?	Total	50

?????????? The Staff employed in these tribal area are rendering the Primary health care services including maternal and child health and immunisation services for the tribal community.

Mobile Medical Unit at Kalrayan Hills

??????????? The Mobile Medical Unit with head quarters at Karumandurai PHC in Attur 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 new born 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 benefited every week.? The coverage stands at 57.8% at present.

?HEALTH SUB CENTRE

?????????????????????????????????????????????????????? ????????????????????????????? ?(Rupees in lakhs)

Scheme	Actuals 2002-2003			Budget Estimate? 2003-2004			Revised Estimate 2003-04
Scheme	Non-Plan	Plan	Total	Non-Plan	Plan	Total	Non-Plan	Plan	Total
2210-03-101-JD P.U.HSCs	0	0.23	0.23	0	0	0	0	0	0
2211-00-101-SC Sub Centres	0	8006.16	8006.16	0	8980.16	8980.16	0	8473.23	8473.23
2211-00-793-SA Health Sub-Centres in Adi Dravidar Colonies	0	1627.84	1627.84	0	3610.25	3610.25	0	1794.62	1794.62
Total	0	9634.23	9634.23	0	12590.41	12590.41	0	10267.85	10267.85

TRIBAL SUB PLAN

????????????????????????????????????????????????????????????????????????????????? ??????????????????????? ??????????????????????? ??????????????????????? ??????????? ??????????? (Rupees in lakhs)

Scheme	Actuals 2002-2003			Budget Estimate? 2003-2004			Revised Estimate? 2003-2004
Scheme	Non-Plan	Plan	Total	Non-Plan	Plan	Total	Non-Plan	Plan	Total
2210-03-796-JC Mobile Medical Unit facilities at Kalrayan Hills	0	9.40	9.40	0	13.29	13.29	0	12.69	12.69
2211-00-796 SA ?Maternity Centres under Tribal Areas	0	54.32	54.32	0	61.61	61.61	0	56.61	56.61
Total	0	63.72	63.72	0	74.90	74.90	0	69.30	69.30

??????????????Civil Registration System:

????????? The Registration of Births and Deaths is compulsory at the place of occurrence in the State as per the Registration of Birth and Death Act 18 of 1969 and as per the revised Tamil Nadu Birth and Death Registration rules 2000.

??????????? The System of Birth and Death Registration is reviewed based on Reporting and Registration efficiency.? The Reporting efficiency refers to periodical reports submitted by the Primary Registrars and the Registration efficiency refers to actual registration done by the Registrars compared to the expected levels of Births and Deaths as estimated by Sample Registration system.

The? reporting efficiency in the State is 92% for the year 2001.

The registration efficiency of births is 93.5 and for death is 80.7 % for 2001

Estimated Vital Rates under Sample Registration System:

The estimated vital rates pertaining to Tamil Nadu as per Sample Registration Systems are as follows:

Year	Birth Rate	Death Rate	Infant Mortality Rate
1999	19.3	8.0	52.0
2000	19.3	7.9	51.0
2001	19.1	7.7	49.0
2002(Provisional)	18.5	7.7	44.0

National Campaign to issue Birth Certificates:

Registration of Births and Deaths are compulsory under the Registration of Birth and Death Act 1969.? The Act also provides for issue of a certificate free of charge to the informant immediately after registration.? The individual Birth Certificate is a vital document for getting admission to School, obtaining Passport Etc.

In order to create awareness among the public and to know the importance of Registration a National Campaign to issue Birth Certificate is launched from. 14-11-2003 to 31-3-2004.? 29 Lakhs of Birth Certificates have been issued during the campaign.

To focus the Birth as a right of the child the National Campaign is launched.

Multipurpose National Identity Card:

The Government of India has decided to issue of Multi purpose National Identity Card to all citizens.? In Tamil Nadu, Tiruvadanai Taluk of Ramanathapuram District has been selected as the pilot area for the Multi purpose National Identity Card Project.? The Civil Registration System forms the basis for the implementation the Multipurpose National Identity Card Project.? For this Project the Additional Secretary, Home Department has been nominated as State co-ordinator.? The Director of Census Operation is overall incharge for this pilot project.

Medical Certification of Cause of Death as per International Classification of Diseases X Revision:

S. No.	International Classification of Diseases	% of Total Medically Certified Deaths
S. No.	International Classification of Diseases	1999	2000
1.	Infectious and Parasitic diseases	7.1	7.0
2.	Neoplasms	4.3	4.2
3.	Nutritional metabolic diseases and Immunity disorders.	2.5	0.5
4.	Diseases of blood and blood forming organs.	0.8	3.8
5.	Mental disorders	0.3	0.4
6.	Diseases of Nervous system	1.67	2.75
7.	Diseases of circulatory system.	35.8	35.2
8.	Diseases of Respiratory system	7.2	4.8
9.	Diseases of digestive system	2.3	2.7
10.	Diseases of Genito Urinary System	2.3	3.7
11.	Complications of Pregnancy	0.3	0.4
12.	Diseases of skin	0.04	0.04
13.	Diseases of muscular skeletal system.	0.01	0.01
14.	Congenital Anomalies	0.3	0.3
15.	Certain conditions originating in the perinatal period	4.59	8.5
16.	Symptoms, signs and ill defined conditions.	14.3	8.1
17.	Injury and Poisoning	13.1	15.3
18.	Diseases of eye and? adnexa	-	-
19.	Disease of the ear and mastoid Persons	-	-
20.	External Causes of morbidity and mortality	2.5	1.9

Morbidity Statistics:

The Morbidity reports are collected from 1412 Primary Health Centres and compiled at state Head quarters.

Institutional Services Monitoring through (OMR):

A tool for monitoring the institutional Services of Primary Health Centres has been developed by DANIDA? Tamil Nadu Health Care Project and main streamed to DPH & PM.? The Analysis and monitoring of Institutional services of Primary Health Centres was taken over from 1.4.2002 by this Directorate.? The reports are analysed monthly and feedback sent to the district level Officers and Government.

PUBLIC HEALTH TRAINING AND CONTINUING EDUCATION

Multipurpose Health Workers (Female) Training Course:

??????????? Multipurpose Health Workers (Female) training Schools attached to the District Headquarters Hospitals at Kanchipuram, Cuddalore, Nagapattinm, Ramanathapuram? Tirunelveli Medical College, Tirunelveli are functioning in Tamil Nadu and 30 candidates for every six months are being admitted in each school.? The candidates in respect of Durgabha Deshmukh? Hospital, Chennai? and Kasthuriba Hospital, Gandhigram are also being selected from the Community Nutrition workers of TINP and Anganwadi Workers of ICDS sponsored by? Social Welfare Department.? Government Order has been issued relating to age limit for the selection of Multipurpose Health Workers (Female) Training Course.?? The training course started from 17-2-2003 and 196 candidates were admitted.

Multipurpose Health Supervisors (Female) Training Course

??????????? The Government Order for conduct of Multipurpose Health Supervisors (Female) Training to Village Health Nurse (6 months course) at Multipurpose Health Supervisor (Female) Training School upto 2004 AD have been received. (G.O.Ms.No.150, Health ands Family Welfare Department dated: 18.4.2001)? A sum of Rs.75,000/- each year has been allotted as stipend to the trainees at Rs.250/- per trainee per month.? The Training course commenced from 1.8.2001.? During the year 2001, 50 candidates were admitted for the training course and during the year 2002, 50 candidates were admitted for the training course, and for the year 2003?? 23 candidates were admitted for the training course. Next batch?? for the year 2004 the training course started from February??? (1-2-2004)

Pre-Service Field and Laboratory Assistants Training Course

The pre-service field and laboratory Assistant training course of 6 months duration is being conducted at Institute of Vector Control and Zoonoses, Hosur and at Central Malaria Laboratory of the Directorate of Public Health and Preventive Medicine to the Malaria and Filaria Mazdoor/Head Mazdoor. After completion of the training the candidates are appointed as field and laboratory Assistants.?

Passed out candidates:? 15

Orientation Training Programme for Medical and Para-Medical Staff

??????????? Orientation training programmes are conducted for the Medical and Para Medical staff in the Health and Family Welfare Training Centre, Egmore, Madurai and Gandhigram.3318 candidates Medical Paramedical staff were trained in the above training centres during 2002-2003 upto December'02.

Training Course for newly recruited Assistant Surgeons

??????????? The newly recruited Assistants Surgeons have to undergo the following training course.

1.? One month induction training at Institute of Public Health, Poonamallee, Health and Family Welfare Training Centre, Egmore, Madurai and Gandshigram - Health Manpower Development Institute, Villupuram and Salem.

Public Health Administration.

2.? One week training at Anna Institute of Management.

Management

3.? 21 days at Anna Institute of Management.

Foundation "B" training course

Training Institute

??????????????????????? ?There are 6 Regional Training Institutes such as the Institute of Public Health, Poonamallee, Chennai-56.? 3 Health and Family Welfare Training Centres situated at Chennai, Madurai and Gandhigram and 2 HMDI (One at Villupuram and other at Salem).

?????????? ??????????? The Institute of Vector Control and Zoonoses at Hosur is categorised as a specialised Training Institute.

??????????? ??????????? The in-service training to the male component of field health functionaries of public health department is given in the Regional Training Institute of Public Health, Tiruvarankulam, Pudukottai District every year.? The training calendar will be prepared every year and the training institute have conducted the following training this year.

1.?????? R.C.H..... I.S.D Training

2.?????? Public Health Administration Training

????? Foundational Training? and? Management

????? Training to the newly recruited Medical Officers??

?H.I.V / AIDS training

3.?????? Basic treatment procedures training

4.?????? Computer skill training.

5.?????? Training for Leprosy elimination.

??????????? In the above said training Institute during 2003-04?? 15276??? medical and paramedical staff have been trained,

TRAINING

(Rs. in lakhs)

? Scheme		? Actual 2002-2003			? Budget Estimate 2003-04			? Revised Estimate 2003-04
? Scheme		? Non-Plan	? Plan	? Total	? Non-Plan	? Plan	? Total	? Non-Plan	? Plan	? Total
1.	2210-06-003-AA Orientation Training Centre, Poonamallee	140.85	0	140.85	184.37	0	184.37	156.22	0	156.22
2.	2210-06-003-AB Training of Health Visitor	28.85	0	28.85	29.64	0	29.64	30.70	0	30.70
3.	2210-06-003-AD Nutrition Training	11.24	0	11.24	13.00	0	13.00	11.72	0	11.72
4.	2210-06-003-JE Establishment of Computer Training Centre @ Salem & Madurai	0	0	0	0.02*	49.40	49.42	0	16.40	16.40
5.	2210-06-003-AF Establishment of Regional Institute of Public Health for in-service Training	8.98	0	8.98	9.48	0	9.48	11.19	0	11.19
6	2211-06-003-SG Schools for Training in Multi Purpose Health Workers (Female)	0	81.90	81.90	0	125.90	125.90	0	125.20	125.20
7	2211-00-003-SA Health and Family Welfare Training Centres	0	60.01	60.01	0	67.68	67.68	0	64.36	64.36
8	2211-00-003- SF Grants	0	0	0	0	0.01	0.01	0	10.17	10.17
9	2211-00-003-JA DANIDA Health Care Absorption	0	36.96	36.96	0	35.99	35.99	0	101.39	101.39
10	2211-00-104-SD Motor Vehicle	0	1.63	1.63	0	2.48	2.48	0	2.48	2.48
?	Total	189.92	180.50	370.42	236.51	281.46	517.97	209.83	320.00	529.83

* 2210-06-003 AE Trg.

NATIONAL LEPROSY ERADICATION PROGRAMME:

???? Background and chronology

?????? NLEP in Tamil Nadu was launched in 1954-55.

?????? Multi Drug Therapy was launched in 1983 in a phased manner and a complete geographical coverage for Tamil Nadu was done in 1991.

?????? Prevalence which was 118/10,000 in 1983 was brought down to 1.6/10,000 in 2003 (December)

?????? The WHO fixed the Goal of Eliminating Leprosy as a Public Health Problem in December 2000. This means bringing down the prevalence to 1/10000.

Integration of NLEP with Primary Health Care Services

?????? During August 1997, the T.N. Govt.Integrated Leprosy Services with P.H. Care services.

?????? Urban Leprosy:? As urban problems and situations are different, various strategies are used for case detection. They include special and focal surveys, skin camps continuous IEC and training to health staff for effective implementation of the programme at all levels.

?????? NGOs participation:? After Integration, the Leprosy NGOs services are Co - ordinated in many activities particularly in Urban areas laying emphasis on Prevention of Disabilities, Rehabilitation and Training.

Innovative Strategies

?????? T.N. was the pioneering State to conduct 4 Modified Leprosy Elimination Campaigns MLEC I in Feb.1997, MLEC II in Jan 2000, MLEC III in Oct 2001, MLEC IV in December 2003. The outcome of the campaigns is shown in the table below:

?	SSL	PB	MB	Total
MLEC I	4039	7533	1058	12630
MLEC II	3886	6785	1932	12603
MLEC III	2525	5950	1662	10137
MLEC IV	1432	4018	701	6151

?Structures introduced for effective work

Tamil Nadu was divided into 3 regions geographically. The priorities for work was identified as Case detection/holding & treatment, IEC cum Community Participation, Prevention of Disability, Manpower Development, and Urban Leprosy.? Districts with specific problems were identified and strategies evolved to move towards elimination.? The decentralized concept helped in effective planning, reviewing, implementation and feedback.

Other Features:

?????? An award scheme has been introduced to recognize leprosy work in the State and each district.

?????? Thesis support for 35 students per year among postgraduate students has been implemented and so far 2 students have submitted their thesis.

?????? Validation of cases carried out in certain districts has proved very effective in bringing down the prevalence and reduction of backlog cases unnecessarily retained in the registers. For example, in Dharmapuri and Tiruvannamalai districts the PR was brought down from 2.4 and 4.9 to 1.4 and 2.3 respectively.

OBJECTIVE TARGET AND ACHIEVEMENT FOR THE PAST 6 YEARS

YEAR	New Case Detection			Cases Brought Under Trt			Cases Cured
?	Target	Achievement	%	Target	Achievement	%	Target	Achievement	%
1998-99	40000	45862	114.7	40000	46005	115	43000	51632	120.1
1999-2000	30000	62812	209.4	30000	62911	209.7	50000	56234	112.5
2000-2001	15000	47350	315.7	15000	47327	315.5	34000	54216	159.5
2001-2002	15000	32251	215.0	15000	32274	215.2	43000	32990	76.72
2002-2003	13470	24767	183.9	13470	24767	183.9	27395	28977	105.8
2003 04 (upto Dec 03)	*	13289	-	*	13703	-	*	16414	-

???????? No target fixed by G.O.I. for the year 2003-04

SPECIALITY MEDICAL CAMP

In Tamil Nadu communicable diseases like Cholera have been controlled small pox had been eradicated and vaccine preventable disease like polio are under total control. However much attention has not been paid to non-communicable diseases like Cancer, Diabetes, Hypertension, and Heart-ailments and Geriatric Problem?? In urban area good facilities are available to the people through Government Hospital/Private Hospitals. But the rural population do not have such facilities especially for getting treatment for the above diseases. Therefore Tamil Nadu Government has decided to organize the speciality medical camps with rural areas for giving the treatment to the people suffering from the disease.

??????????? During this year 2003-2004 Government has ordered to conduct the speciality Medical Camp to Block Primary Health Centres of the State vide G.O.Ms.No.320 Health and Family Welfare Department dated 29-9-03.?? Accordingly 374 camps have been conducted during the year and the following persons are benefited.

Male???	:	344289
Female	:	468970
Total	:	813259
Diabetes	:	36832
Hypertension	:	42605
Cancer	:	2516
Geriatrics	:	150662
Others	:	580644

Mobile Health Services

People living in inaccessible and remote area and population at risk have to be served through outreach services for ensuring health services at the doorsteps of the community.? For that Government have sanctioned 25 Mobile Health Service Units since 2001 to 2003. In G.O.M.S. No.293 Health and Family Welfare Department dated 12-10-2001 25 Mobile Health Service Units and in G.O.M.S.No.106, Health and Family Welfare Department dated 7-6-2002 20 Mobile Health Service Units in? 26 districts are functioning in Tamil Nadu State.? For each Mobile Health Service Rs.2.25 Lakhs has been allotted for the purchase of medicine and 1 Lakh for POL and Maintenance per vehicle.? It will be operated by utilising the existing medical and para medical staff. The Mobile Health Service Units will also help in reducing Infant Mortality Rate by adopting targeted intervention in areas in which the infant deaths are high. So far, there are 3,87,180 people have been benefited upto 31-3-2004.

???????? For 2003-2004 budget allotment for drugs/ medicine and POL is Rs. 141.75 lakhs.

????????????????????????????????????????????????????????????????????????????????????????????????????????????????????Page1 ?Page2 ?Page3

Sl. No.	Details of MCH Components	2000-01 ???? %	2001-02 ???? %	2002-03 ???? %	2003-04 ????? %
1.	Antenatal Registration	100.0	99.2	93.1	93.4
2.	Institutional Services	85.6	87.9	90.0	92.3
3.	Deliveries by trained staff	98.4	98.8	99.0	99.3
4.	Deliveries by untrained staff	2.0	1.2	1.0	0.7
5.	Birth weight taken for newborn babies.	98.9	99.0	98.8	99.1

Actual 2002-2003

Revised Estimate 2003-04