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PUBLIC HEALTH AND PREVENTIVE MEDICINE
??????????? The Department of Public Health and Preventive Medicine is providing Primary Health Care services through a network of 1413 Primary Health Centers and 8682 Health Sub-Centres spread over the entire State.? The policy of the Government is to provide a healthy and disease free life to the people of Tamil Nadu.? Towards this the Government has been formulating and implementing several programmers of Public Health importance through Primary Health Care approach.
PRIMARY HEALTH CARE
??????????? The Primary Health Centres and Health Sub-Centres? provide preventive, promotive, curative and rehabilitative health care services.? All the Primary Health Centres have been equipped with basic facilities like cold chain equipments, surgical instruments for surgeries and deliveries, etc.? Most of the Block Primary Health Centres have facilities for sterilization and for detection of cataract cases and treatment of minor eye ailments.? Sufficient drugs are supplied to the Primary Health Centres through the Tamil Nadu Medical Services Corporation.? Out of 1413 Primary Health Centres, 25 Primary Health Centres are located in tribal areas. 241 Primary Health Centres are functioning as 24 hours Primary Health Centres. 70 Primary Health Centres and 8 Health Sub Centres have been adopted by industrial institutions.
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??????????? During 2003-04, 582.73 lakhs of out-patients and 2,56,389 in-patients were treated in these Primary Health Centres.
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UPGRADATION OF PRIMARY HEALTH CENTRES
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??????????? The policy of this Government is to provide 30 bedded institutions at the rate of one per block where there is no District Headquarters Hospital, Taluk / Non-taluk hospitals and Upgraded Primary Health Centres. These institutions will have modern equipment like ultra Sonogram, ECG, X-Ray with improved facilities and ambulance.??????? In 2001-2002, 21 Primary Health Centres were upgraded.? During 2002-2003, 20 Primary Health Centres were upgraded under the Prime Minister's Gramodaya Yojana Scheme and 17 Primary Health Centres were upgraded with NABARD loan assistance.? During 2003-2004, the Government have accorded sanction for the upgradation of 35 Primary Health Centres under the Prime Minister's Gramodaya Yojana Scheme at a total cost of Rs.1673.19 lakhs.
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BUILDINGS FOR PRIMARY HEALTH CENTRES
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??????????? ?At present 1360 Primary Health Centres are functioning in Government Buildings.? The building construction for 14 Primary Health Centre buildings is in progress.? Out of 39 Primary Health Centres for which buildings have to be constructed,? it is proposed to construct 15 Primary Health Centres at a total cost of Rs.1.92 crores by availing NABARD loan. This proposal is under the consideration of NABARD.
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??????????? Out of 8682 Health Sub-centres in the State, 6510 Health Sub-centres are functioning in Government buildings.? During 2002-03, the Government have accorded sanction for the construction of 298 Health Sub-centre buildings availing NABARD loan assistance.? Buildings for 286 have been completed.? It is proposed to construct 306 Health Sub-centres at a cost of Rs.1951.92 lakhs by availing NABARD loan assistance.
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UNIVERSAL IMMUNISATION PROGRAMME
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??????????? Immunisation against vaccine-preventable diseases is sustained at 100% every year.? Apart from routine Immunisation, Pulse Polio Immunisation is conducted every year.
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The two rounds of Pulse Polio Immunisation? were conducted on 04.01.2004 and 22.2.04 covering 72 lakhs of children below 5 years of age. One more additional round of Pulse Polio Immunisation was conducted on 4th April 2004, covering 72 lakhs of children below 5 years of age.
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??????????? Hepatitis B Vaccination programme is being implemented in Chennai slum area and four districts namely Virudhunagar, Ramnad, Madurai and The Nilgiris.? Around 2.20 lakhs infants are benefited.? The programme will be extended to other districts in a phased manner.
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??????????? MMR and Rubella vaccination programme is launched as a pilot project in 5 districts namely Cuddalore, Perambalur, Theni, Thiruvannamalai and Vellore.
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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 Ante-natal 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 92.3%.
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??????????? The School Health Programme hitherto being implemented in the State has been revamped and implemented to provide comprehensive health care services to all students in Government and Government Aided Schools in first to twelfth standards. 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.? Students studying in higher classes are identified to work as "Health Guides".? School Health Cards have been printed and supplied.? These health cards will be issued to the students with the Transfer Certificate when they leave the school.? Health appraisal registers, Referral registers and Drug stock registers are printed and supplied.? Medicines worth Rs.300 lakhs are supplied through Tamil Nadu Medical Services Corporation Limited.
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??????????? Upto March 2004, out of 40,308 targeted schools, 35,327 schools were visited by the Medical teams and 91,13,289 children were given health checkup and 46,503? were referred.
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Sl. No. |
Disease |
% (Upto Mar.2004) |
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1. |
Dental carries |
?10.29 |
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2. |
Worm Infestation |
?9.64 |
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3. |
Acute Respiratory Infections |
12.65 |
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4. |
Anaemia |
3.38 |
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5. |
Vitamin-A Deficiency |
1.91 |
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6. |
Scabies |
1.23 |
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7. |
Defective vision |
0.16 |
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8. |
Ottitis Media |
0.35 |
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9. |
Leprosy |
0.05 |
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10. |
Defective hearing |
0.05 |
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11. |
Rheumatic Heart Disease |
0.04 |
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12. |
T.B. |
0.09 |
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13. |
Goitre |
0.05 |
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??????????? Control of Communicable diseases is one of the major programmes under the Primary Health Care services, especially for the diseases occurring in epidemic forms.? Acute Diarrhoeal Diseases and suspected Cholera are common among the water borne diseases.? All the District level officials and executive authorities of local bodies have been asked to take necessary preventive measures including proper disposal of solid wastes and maintain sanitation and hygiene, chlorinate all water sources and undertake fly control measures. 53,625 water sources were chlorinated.? Administration of Oral Rehydration Salt has been popularised through Health Education and the method of preparation of ORS solution is also demonstrated by the field staff to the public.
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?INDUSTRIAL HYGIENE AND HEALTH
??????????? The Water Analysis Laboratories established at Chennai and Coimbatore collect and examine water samples from various protected water services 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 survey to ensure the prevention and control of Environmental and Industrial Pollution.
??????????? Air pollution surveys are also carried out around industries to assess air quality.? Efforts are also taken for abatement of nuisances and classifying the industrial and residential areas.? So far 33,004 water samples have been tested.
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??????????? The Government of Tamil Nadu is taking measures to control the adulteration of food by implementing the Prevention of Food Adulteration? Act 1954 and Rules 1955.? At present 481 Local Bodies are implementing the Act.? During 2003-2004, 4277 samples were analysed out of which 761 samples were found adulterated.? The percentage of adulteration is 17.79%.? Prosecutions were launched in 206 cases and 82 were convicted.? 72? were fined with imprisonment and 10 were fined.
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??????????? The sale of? non-iodised salt has been banned with effect from 01.01.1995 and it has been extended for another 5 years with effect from 01.01.2000.
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??????????? The sale of chewing tobacco, Gutkha? and Pan Masala has been banned in the State for a period of 5 years with effect from 19.11.2001.
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??????????? Smoking and spitting in public places has also been prohibited in the State with effect from 14.05.2003.
??????????? The Registration of Births and Deaths at the place of occurrence is compulsory and is enforced throughout the State as per the Registration of Birth and Death Act 1969 and as per the Tamil Nadu Birth and Death Registration Rules 2000, the Birth rate of Tamil Nadu is 18.5 per 1000 population and the Death rate is 7.7 per 1000 population.? The Infant Mortality rate is 44.0 per 1000 live births.
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??????????? In order to create awareness on birth registration, a massive National Campaign was organised from 14th November, 2003 in which free birth certificates to all children below 10 years have been issued.? 28.00? lakhs of birth certificates have been issued free of cost.
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??????????? Malaria problem is prevalent in Tamil Nadu mainly in urban areas.? More than 75% of Malaria cases occur in urban areas.? The coastal villages of Ramanathapuram, Paramakudi, Nagapattinam Health Unit Districts and riverine villages of Dharmapuri, Krishnagiri and Thiruvannamalai districts were once endemic for Malaria.? Due to intensive control measures the problem of Malaria in the villages has been brought down, as a result of which Malaria case incidence has been drastically brought down to 43396 as against 1,20,029 in the 90's.? Geographical information system is being developed in Tamil Nadu for identifying vulnerable areas and seasonal pattern of disease outbreak.
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??????????? The National Filaria Control programme is being implemented in Tamil Nadu since 1957.? The scheme is financed by the Centre to the extent of 50% of the cost of larvicides, materials and equipment. The entire operational cost is met by the State.? The programme is being implemented in 13 endemic districts.? Single Dose Mass DEC Drug Administration Programme is being carried out from 1997-98 in all endemic districts.? During the fifth round (2001-2002), the Government of Tamil Nadu came forward to launch the COMBI (Communication of Behavioural Impact) strategy of the WHO.? The WHO came forward to assist Tamil Nadu only in six districts where DEC and Albendazole are co-administered.? During the sixth round in 2003, the WHO provided Rs.49.00 lakhs worth of IEC materials and Rs.14.40 lakhs worth of Albendazole tablets for 6 districts namely Kancheepuram, Vellore, Thiruvannamalai, Thanjavur, Nagapattinam and Thiruvarur.? The seventh round of DEC Mass Drug Administration will be held during July 2004.
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??????????? For plague surveillance activities, the Institute of Vector Control and Zonoses, Hosur is the nodal agency.? The infrastructure available at this institute is also utilized to conduct various training programmes, workshops and seminars.? The Government have accorded sanction during 2002 for starting M.Sc. course at IVCZ, Hosur in affiliation with Dr.M.G.R. Medical University.
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??????????? 7 Leptospirosis clinics in Taluk and District Headquarters hospitals of Madurai and Thiruvallur districts are sanctioned and functioning at present.
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NATIONAL LEPROSY ERADICATION PROGRAMME
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??????????? The National Leprosy Eradication Programme was launched in 1954-55.? Tamil Nadu has done a commendable work in the field of Leprosy Eradication.? The prevalence rate which was 118 per 10,000 population in 1983 has been brought down to 1.4/10,000 population in 2003.?
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??????????? Tamil Nadu state has been quite successful in controlling and eradicating communicable diseases.? 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 2003-2004, the Government allotted an amount of Rs. 259.39 lakhs for the conduct of 385 camps.? So far 360 camps have been conducted benefiting 7,38,326 persons.
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MOBILE HEALTH SERVICES
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???? There are 45 Mobile Health Units functioning in 26 Health Districts in Tamil Nadu sanctioned under PMGY scheme. An amount of Rs.200.70 Lakhs has been sanctioned for drugs and POL to 45 Mobile Health units. During 2003-2004 the total beneficiaries were 2,35,933.
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TRAINING AND CONTINUING EDUCATION
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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 organised by this department.? Regional level training institutions have been established at Egmore, Poonamallee, Madurai, Salem, Villupuram, Gandhigram and Thiruvarankulam.? Regular long-term training courses are conducted in 5 Multipurpose Health Worker (Female) Training Schools and one Multipurpose Health Supervisor (Female) Training school.? Voluntary Health organisations and reputed institutions like Cancer Institute, Spastics Society, etc. are also involved in imparting training.
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NEW SCHEMES FOR 2004 - 2005
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1.????? Diabetes Control Pilot Programme at a total cost of Rs.5.00 lakhs.
2.????? Publicity for Registration of Births and Deaths at a cost of Rs.5.00 lakhs.
3.????? Computers for District Public Health Officer at a total cost of Rs.6.00 lakhs.
4.????? Extension of Dental Health Programme in 2 Districts at a total cost of Rs.20.00 lakhs.
5.????? Administration of Vitamin A supplementation to Post Natal Mothers at a total cost of Rs.15.00 lakhs.
6.????? Supply of Labour Board to 1000 Health Sub Centres at a total cost of Rs.90.00 lakhs.
7.????? Provision of Telephone facilities to 150 Primary Health Centres at a total cost of Rs.6.90 lakhs.
8.????? Anaemia control programme using Indian systems of medicine at a total cost of Rs.9.50 lakhs.
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