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PUBLIC HEALTH AND PREVENTIVE MEDICINE
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??????????? ??????????????????????? The Government has been formulating and implementing several programmes of Public Health importance through the primary health care approach.
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??????????? In Tamil Nadu 1411 Primary Health Centres and 8682 Health Sub- Centres? are functioning. These Institutions provide preventive, promotive, curative and rehabilitative health care services.?? Between April 2002 and February 2003,? 498 lakhs outpatients were provided treatment in the Primary Health Centres.? A chart showing the average outpatient strength per Primary Health Centre per day during the years from 2000-2001 to 2002-2003 is available in Annexure 1 and that of inpatient? strength is available in Annexure - 2.? All Block Primary Health Centres have been provided with telephone facilities. To involve the community in the maintenance of Primary Health Centres, Participatory Community Health Committees have been formed in all the Primary Health Centres.
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??????????? This Government has decided to provide at least one 30 bedded Health Institution in each block.? These Institutions will have specialist doctors and modern equipments like Ultra Sonogram, Portable ECG, X-Ray with improved laboratory facilities and ambulance.? During the year 2002-2003, 58 Primary Health Centres have been taken up for upgradation.?
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Improving Quality of Primary Health Care
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??????????? To improve the quality of Health Care at Primary Health Centres, each Block is provided with a Portable ECG machine to diagnose cardiac problems. A Glucometer is also provided to each Block Primary Health Centre? to enable early detection of diabetic patients.? The Operation Theatres attached to the Primary Health Centres have been provided with Boyles apparatus, operating table and surgical instruments to enable them to perform minor surgeries.?
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The Village Health Nurses at Sub-Centres have been trained to take Blood Pressure and each Health Sub Centre is provided with BP Apparatus and Stethoscope.? The Sub-Centres are also supplied with a Medical Equipment Kit consisting of basic instruments and weighing scales.
The Health Sector is fully equipped to maximize the use of Information Technology.? All the District Offices are provided with Computer and E-Mail connectivity.? Computers have been provided to Primary Health Centres in Madurai, Theni, Salem and Namakkal Districts.
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In order to meet the manpower needs of the Primary Health Centres, Government has proposed to recruit 500 more doctors to fill the existing vacancies.
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??????????? Specialised Treatment is not easily available to rural people for illness like cancer, diabetes and heart ailments which are now in increasing proportion.? To provide necessary skilled treatment at the doorsteps of the community, Speciality Medical Camps to detect diseases like cancer, diabetes, heart ailments, hypertension and geriatric problems are conducted at the rate of one per Block.? During 2002-2003,? 385 Speciality Camps have been conducted and 7.98 lakhs people were screened.? 5.24% were found to be affected with diabetes, 5.02 % with heart ailments and hypertension, 0.54 % with cancer and 22.4 % with geriatric problems.? A pictorial diagram showing the Morbidity Pattern found during the Speciality Camp is available in Annexure - 3.
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??????????? In order to ensure that people living in tribal, remote and inaccessible areas get medical facilities, 25 Mobile Health Units have already been launched and 20 more Mobile Health Units are being established in the current year.? So far 1,79,571 patients have been provided with treatment in the Mobile Health Units.
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Maternity and Child Health Care Services
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??????????? Maternal and Child Health Services are the most important of all the services provided by the department.? The services provided are Antenatal registration and? check up, administering vaccination against Tetanus, immunization against vaccine preventable diseases, delivery care and post-natal care. At present the institutional deliveries account for 89.9% of the total deliveries in the State.?? A chart showing the number of deliveries at Primary Health Centres during the years from 2000-2001 to 2002-2003 is available in
Annexure - 4
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??????????? Immunisation against vaccine preventable diseases are sustained at 100% every year.? Apart from routine immunization, Pulse Polio Immunisation is conducted every year and two additional doses of oral polio vaccine are given to all children below 5 years of age.? In the current year the first round of Pulse Polio Immunisation was conducted during 5th January and 9th February covering 73 lakhs of children under 5 years of age.? The successful implementation of Pulse Polio Immunisation added with sustained coverage in routine immunization has made the State free from polio for the past three years.? All other vaccine preventable diseases are also under control.
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??????????? Hepatitis B Vaccination has already been started in the city of Chennai from February, 2003.? This will be extended to 4 more Districts viz. Virudhunagar, Ramanathapuram, Madurai and? Nilgiris during 2003-2004.
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??????????? Todays school children are tomorrows citizen and therefore it is necessary that they attain their full potential in physical, psychological, emotional and intellectual growth.? Under this programme, special emphasis is given to rheumatic heart problems, eye disorders, dental problems etc. All Thursdays are School Health Days.? Students requiring special treatment are referred to higher medical institutions for specialized and continued treatment.? All Saturdays are referral days in Higher Medical Institutions.? During the year 2002-2003, upto February 2003, 70.6 lakhs of school children were examined and 36.1 lakhs were treated.? A bar diagram showing the disease pattern among school going children during 2002-2003 is available in Annexure - 5.
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Micro Nutrient Deficiency
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??????????? In Tamil Nadu, Anemia among women especially among pregnant women is persistently high.? This leads to high maternal mortality rate, high infant mortality rate and complication during pregnancy. All pregnant mothers are given Iron and Folic Acid to control anemia. Towards tackling this problem among adolescent girls, Government has launched a scheme of giving Iron and Folic Acid Tablets to each adolescent girl on a weekly basis, through Self Help Groups, Anganwadi workers, Voluntary women workers etc. Every week, around 53 lakhs of adolescent girls get benefited.
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??????????? To control the Vitamin "A" deficiency among children under 5 years, Vitamin "A" supplementation of 2 lakhs international units are given twice in a year to all children under 5 years of age.
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??????????? Communicable disease surveillance is important to develop strategies for control and prevention of disease.? It helps to forecast epidemics outbreak.? The National Surveillance Programme of Communicable Diseases was started as a Pilot scheme in 1997.? In Tamil Nadu, a National Surveillance Programme for Communicable Diseases has been launched in Dharmapuri, Villupuram, Coimbatore, Madurai and Salem.
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??????????? A Statewide programme with the assistance of World Bank, the Integrated Diseases Surveillance Programme is to be launched in Tamil Nadu.? A pre appraisal team visited Tamil Nadu in February 2003 and the Project Implementation Plan has been submitted to Government of India.? The project aims to strengthen the laboratory structure at district and sub-district level and to put in place an effective disease surveillance network throughout the State.
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??????????? Malaria is prevalent mainly in urban, coastal and riverine areas in the State.? In Tamil Nadu more than 70% of the total malaria cases occur in urban areas.? Chennai is the major problem area.
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??????????? The cases in Chennai city are mostly confined to North Chennai.? To eliminate the Malaria parasite so as to make Chennai free from Malaria, the Directorate of Public Health and Preventive Medicine and Chennai Corporation jointly organized a "Malaria Free Chennai Campaign" from September 15 to December 15 last year.? A total number of 1228 Malaria cases were detected and treated during the campaign. People were advised to adopt measures for the reduction of Vector breeding sources.
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??????????? The National Filaria Control Programme is implemented in Tamil Nadu since 1957.? The recent advances in the field of Filariasis Control have indicated that annual single dose Mass DEC administration for at least 5 years is one of the most cost effective methods of eliminating this disease.? Mass DEC administration has been carried out to 2.3 crores of people in March 2003 to eliminate lymphatic filariasis in 13 filaria endemic Districts.
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??????????? The National Leprosy Eradication Programme was launched in 1954-55.? Tamil Nadu has done? commendable work in the field of Leprosy Eradication.? The prevalence rate which was 118 per 10,000 population in 1983 has been gradually reducing.? The programme is marching towards total elimination of leprosy and the target of case load of less than 1 per 10,000 population will be achieved in the years to come.? Towards this MLEC IV was launched to detect hidden cases in the community, with a specific focus on tackling urban leprosy with the help of Non-Governmental Organisations as facilitators.
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Diarrhoea
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??????????? Acute Diarrhoeal diseases and suspected Cholera are common among the water borne diseases in Tamil Nadu.? 2232 Anti Cholera inoculations were given and 60,507 water sources were chlorinated in 2002 as preventive measures.? Administration of Oral Rehydration Salt during epidemic outbreaks of Acute Diarrhoeal diseases has been popularized through Intensive Health Education.
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??????????? Water samples from various protected water supplies are being collected and analysed by water analysis laboratories established at Chennai and Coimbatore.? So far upto February 2003, 22,671 water samples were tested by these two laboratories.? Air pollution surveys are also being carried out by these laboratories to assess air quality.
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??????????? Food safety requires to be placed high on the agenda.? For this purpose Prevention of Food Adulteration Act 1954 and Tamil Nadu Prevention of Food Adulteration Rules 1955 are implemented in Tamil Nadu.
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??????????? There are 7 Laboratories to analyse the food samples.? During the year 2002-2003, 2737 samples were analysed of which 530 were found adulterated.? The percentage of adulteration is 19.36.? 244 cases were launched and 58 cases were convicted of which 11 were fined and 47 were fined with imprisonment.
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??????????? In the interest of public health, the sale of chewing tobacco, gutka and pan masala containing tobacco or any other ingredients injurious to health has been banned in the State of Tamil Nadu for a period of 5 years from 19.11.2001.
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Ban on smoking and spitting in public places
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??????????? The Tamil Nadu Prohibition of Smoking and Spitting Bill 2002, as passed by the Legislature has got the assent of the President of India and it has been published in the Tamil Nadu Government Gazette.? The Rules under the Act will also be framed shortly.
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??????????? Registration of births and deaths is compulsory and is done under the provisions of Registration of Births and Deaths Act, 1969. Tamil Nadu has reached 95% registration level in births and 80% registration level in deaths. Universal? registration of births and deaths is our aim. Thiruvadanai Taluk of Ramanathapuram District has been identified to introduce the Multipurpose National Identity Card.? The staff involved in this project have been given a Sensitization Training.
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??????????? In order to ensure that the doctors and field public health staff are kept updated in respect of various programmes, in service training programmes are organized by this department.? Regional level Training Institutions have been established at Egmore, Poonamallee, Madurai, Salem, Villupuram, Gandhigramam and Tiruvarankulam.? Regular long term training courses are conducted in 5 Multipurpose Health Worker(F) Schools and one Multipurpose Health Supervisor(F) Training School.? Voluntary Health Organizations and reputed Institutions like Cancer Institute, Spastics Society, etc are also involved in imparting training.
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1.???Electrification of 600 Health Sub-Centres at a total cost of Rs.30 lakhs.
2.???Establishment of Computer Training Centres at Salem and Madurai at a total cost of Rs.49.40 lakhs.
3.???Extension of Hepatitis B Vaccination programme to 4 more Districts.
4.???Establishment of Dental Health Clinics in Primary Health Centres of select Districts in tie up with Private Dental Colleges for the benefit of school going children.
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