pb-health-2003-04

2

HEALTH AND FAMILY WELFARE DEPARTMENT

PERFORMANCE BUDGET

2004-2005

CONTENTS

Page No 1 Medical Education 1

2 Medical and Rural Health Services 28

3 Primary Health Centres 35

4 Public Health and Preventive Medicine 40

5 Family Welfare Programme 63

6 Drugs Control Administration 68

7 Indian Medicine and Homeopathy 72

8 DANIDA Assisted Tamil Nadu Area Health Care Project 83

9 Reproductive and Child Health Project 85

10 Tamil Nadu State AIDS Control Society 88

11 Tamil Nadu State Blindness Control Society 95

12 Tamil Nadu Medical Services Corporation 96

13 Tamil Nadu State Health Transport Department 100

3

CHAPTER - 1

MEDICAL EDUCATION

The Directorate of Medical Education is entrusted with the responsibility of implementing the Teaching, Training and Research Programme in the Medical Field.

The Director of Medical Education is the Head of the Department and she is assisted at the State Head Quarters by a team of Officers.

FINANCIAL REQUIREMENTS

(PROGRESS AND ACTIVITY CLASSIFICATION)

(Rs. in lakhs) Accounts 2002-2003 Budget Estimate 2003-2004 Revised Estimate 2003-2004 Classification Non-Plan Plan Total Non-Plan Plan Total Non-Plan Plan Total

(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) I. MEDICAL EDUCATION Medical Colleges

Revenue Capital

9041 -

251 456

9292 456

11899 --

201 2831

12100 2831

10232 -

229 1630

10461 1630

II. TEACHING HOSPITALS Revenue Capital

24498

+14 1

643

337

25141

+14 338

28079

+18 --

2937

207

31016

+18 207

25728

+17 1

2204

311

27932

+17 312

III. TUBERCULOSIS CONTROL Revenue Capital

1001

--

-- --

1001

--

1182

--

-- --

1182

--

1137

--

-- --

1137

-- IV. TRAINING

a. Nurses Revenue

Capital b. Other than Nurses

Revenue Capital

-- --

54 --

8 -- -- --

8 --

54 --

-- -- 8 --

7 -- -- --

7 -- 8 --

-- --

52 --

17 -- -- --

17 --

52 --

Total Revenue Capital

54 --

8 --

62 --

8 --

7 --

15 --

52 --

17 --

69 --

V. King Institute , Guindy Revenue Capital

543

--

-- --

543

--

853

--

-- --

853

--

708

--

-- --

708

--

(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) VI. DIRECTION, SUPERVISION AND POLICY FORMULATION Director of Medical Education

Revenue Capital

318 +9 --

--

--

318 +9 --

388 +1 --

--

--

388 +1 --

364 +1 --

--

--

364 +1 --

VII. CANCER CONTROL Revenue Capital

317

--

35 --

352

--

413

--

-- --

413

--

352

--

200

--

552

-- VIII. FREE EYE CAMP

Revenue Capital

Control of Blindness Revenue Capital

77 --

-- --

-- --

95 --

77 --

95 --

108

--

-- --

-- --

-- --

108

--

-- --

64 --

-- --

-- --

-- --

64 --

-- --

TOTAL Revenue Capital

77 --

95 --

172

--

108

--

-- --

108

--

64 --

-- --

64 --

IX MISCELLANEOUS a) Medical

Revenue Capital b) Aids Control

Revenue Capital c) Social Welfare

Revenue Capital

82 --

-- --

7 --

-- --

5

---

-- --

82 --

5 --

7 --

114 1

-- --

10 --

-- 6

-- --

-- --

114 7

-- --

10 --

102 1

-- --

5 --

-- 6

-- --

-- --

102 7

-- --

5 --

Total Revenue Capital

89 --

5 --

94 --

124 1

-- 6

124 7

107 1

-- 6

107 7

GRAND TOTAL Revenue Capital

35938

+23 1

1037

793

36975

+23 794

43054

+19 1

3145

3044

46199

+19 3045

38744

+18 2

2650

1947

41394

+18 1949

OBJECT WISE CLASSIFICATION (Rupees in Lakhs) Accounts 2002-2003 Budget Estimate 2003-04 Revised Estimate 2003-04

Classification Non-Plan Plan Total Non-Plan Plan Total Non-Plan Plan Total (1) (2) (3) (4) (5) (6) (7) (8) (9) (10)

01. Salaries 17066 +7

107

17173 +7

19822 +8

123 19945 +8

17569 +8

117 17686 +8

02. Wages 23 -- 23 10 -- 10 146 -- 146 03. Dearness Allowance 6912

+3 43 6955

+3 10423

+4 65

10488

+4 8116

+4 52 8168

+4 04. Travel Expenses 32 -- 32 29 -- 29 21 -- 21 05. Office Expenses 1501 2 1503 1676 9 1685 1732 9 1741 06. Rent, Rates and Taxes 359 -- 359 320 -- 320 445 -- 445 08. Advertising and Publicity 6 -- 6 8 -- 8 8 -- 8 09. Grants-in-aid 237 359 596 287 2479 2766 283 1797 2080 10. Contribution 59 -- 59 51 -- 51 51 -- 51 12. Scholarship and Stipend 1916 -- 1916 2150 1 2151 2147 1 2148 17. Minor works -- 95 95 -- -- -- -- -- -- 18. Maintenance 16 1 17 23 -- 23 23 -- 23 19. Machinery & Equipment's 1651 385 2036 1604

+1 393 1997

+1 1635

593 2228

21. Motor Vehicles 3 -- 3 5 -- 5 5 -- 5 24. Materials & Supplies 25 -- 25 30 -- 30 28 -- 28 25. Interest 2 -- 2 -- -- -- 4 -- 4 33. Payment of Professional and

special services 52 -- 52 7 1 8 106 -- 106

34. Other Charges 4 -- 4 2 -- 2 2 -- 2 42. Services or commitment

charges 25 -- 25 15 -- 15 15 -- 15

45. Petrol,oil and Lubricants 64 1 65 84 -- 84 92 1 93 46. Clothing 111 1 112 117 -- 117 155 1 156

Accounts 2002-2003 Budget Estimate 2003-2004 Revised Estimate 2003-2004 Classification Non-Plan Plan Total Non-Plan Plan Total Non-Plan Plan Total

(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) 47. Stores and

Equipments 947 -- 947 1053 -- 1053 1053 -- 1053

49. Festival Advances 01 Festival Advances-

Debit 02 Festival Advances-

Credit(-)

116 319

-- 2

116 321

150 150

-- --

150 150

163 163

1 1

164 164

51. Compensatory Charges

9 -- 9 1 -- 1 1 -- 1

59. Prizes & Awards 2 -- 2 8 -- 8 2 -- 2 66. Medicines 4210

+4 8 4218

+4 4239

+5 8 4247

+5 4279

+5 8 4287

+5 67. Dietary Charges 763 -- 763 947 -- 947 653 -- 653 68. Cost of Text Books 138 36 174 117 16 133 157 20 177 72. Training 6 -- 6 1 -- 1 1 -- 1 74. Purchase and upkeep

of Animals 10 -- 10 22 -- 22 11 -- 11

76. Computer & Accessories

-- 1 1 1 50 51 2 51 53

99. Miscellaneous 2 -- 2 3 -- 3 3 -- 3 Total 35938

+23 1037 36975

+23 43054

+19 3145 46199

+19 38744

+18 2650 41394

+18

SOURCE OF FINANCE

(Rupees in lakhs)

Accounts 2002-2003 Budget Estimate 2003-2004 Revised Estimate 2003-2004 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. 18 - Health and Family Welfare Department 03. Directorate of Medical Education Voted

Charged

35938 23

1037 --

36975 23

43054 19

3145 --

46199 19

38744 18

2650 --

41394 18

Total 35961 1037 36998 43073 3145 46218 38762 2650 41412 Demand No.38 2210-Medical (Buildings) 4210.Capital (Buildings)

1 --

--

793

1

793

1 --

--

3044

1

3044

2 --

--

1947

2

1947

Total 1 793 794 1 3044 3045 2 1947 1949 Budget Publication No: 51 2049.01.200.BT- Loan from HUDCO -

(Charged)

9

--

9

200

--

200

353

--

353

Budget Publication No: 52 6003.00.109.BC - Loan from HUDCO

--

--

--

1

--

1

115

--

115

DETAILS OF THE NUMBER OF SANCTIONED STRENGTH OF COURSES OF STUDY FOR THE YEAR 2004- 2005

(1) DEGREE AND POST GRADUATE DIPLOMA COURSES

Name of the Institution MBBS BDS B.Pharm DGO DLO DO DMRT DMRD DA D. Orth DCH DTCD DDVL DCP DPH DIPM DPM DIP in Diabetology Sl.

No. (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14) (15) (16) (17) (18) (19) 1. Madras Medical College,

Chennai. 165 - 50 38 24 24 8 8 15 8 35 11 20 8 10 3 8 3

2. Stanley Mecical College, Chennai.

150 - - 12 4 6 - 4 12 4 12 - - 4 - - - -

3. Kilpauk Medical College, Chennai.

100 - - 8 4 - - - 4 8 8 - - 2 - - - -

4. Chengalpattu Medical College, Changalpattu

50 - - - - - - - - - - - - - - - - -

5. Madurai Medical College, Madurai.

155 - 60 16 12 12 - 11 20 6 12 - - - - - 5 `

6. Thanjavur Medical College, Thanjavur.

150 - - 6 4 4 - 1 8 4 4 2 - - - - 2 -

7. Coimbatore Medical College, Coimbatore.

110 - - 6 - 1 - - 3 - 4 - - - - - - -

8. Govt. Mohan Kumaramangalam Medical College, Salem.

75 - - - - - - - - - - - - - - - -

9. Tirunelveli Medical College, Tirunelveli.

150 - - - - - - - - - 2 - - - - - - -

10 Tamilnadu Govt.Dental College and Hosp.ital, Chennai

- 100 - - - - - - - - - - - - - - -

11. Thoothukudi Medical College, Thoothukudi

100 - - - - - - - - - - - - - - - - -

12. K.A.P.Viswanatham Medical College, Trichy.

100 - - - - - - - - - - - - - - - - -

Total 1305 100 110 86 48 47 8 24 62 30 77 13 20 14 10 3 15 3

DETAILS OF NUMBER OF SANCTIONED STRENGTH OF VARIOUS POST GRADUATE ( II ) DEGREE AND HIGHER SPECIALITY 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, Chennai 123 39 22 17 - 8 8 217 2. Tamil Nadu Government Dental

College and Hospital, Chennai - - - - 18 - - 18

3. Stanley Medical College, Chennai 47 19 6 5 - - - 77 4. Kilpauk Medical College, Chennai 19 18 6 2 - - - 45 5. Thanjavur Medical College,

Thanjavur 18 9 1 -- - - - 28

6. Tirunelveli Medical College, Tirunelveli

5 4 - - - - - 9

7. Madurai Medical College, Madurai 49 33 8 4 - 4 - 98 8. Coimbatore Medical College,

Coimbatore 21 17 2 - - - - 40

9. Chengalpattu Medical College, Chengalpattu

- 1 - - - - - 1

10. GovernmentMohanKumaramangalam Medical College ,Salem.

2 2 - - - - - 4

TOTAL 284 142 45 28 18 12 8 537

PARA MEDICAL COURSES (SANCTIONED STUDENTS STRENGTH)

Sl. No. Name of the Institution

B.Sc. Nursing

*

Basic B.Sc.

Nursing

Diploma in

NursingD.Pharm C.R.A. D.R.A.

Lab Technicia

n Gr.I.

Diploma in Lab

TechnicianOptician

E.C.G Technicia

n

Physiotheraphy

Dental Mechanic

Dental Hygienist

1. Madras Medical College, Chennai

40 25 - - 5 5 - - - - - - -

2. Stanley Medical College, Chennai

- - - - - 5 - - - - - - -

3. Government Stanley Hospital, Chennai

- - 130 - - - - - - 30 - - -

4. Madurai Medical College, Madurai

- 25 - 120 5 - - - - - - - -

5. Thanjavur Medical College, Thanjavur

- - - 60 - - - - - - - - -

6. Coimbatore Medical College, Coimbatore

- - - 60 - - - - - - - - -

7. Tamil Nadu Govt. Dental College & Hospital, Chennai

- - - - - - - - - - - 6 6

8. Institute of Rehabilitation Medicine, K.K. Nagar, Chennai

- - - - - - - - - - 25 - -

9. College of Physiotheraphy, Trichy

- - - - - - - - - - 25 - -

10. Government Ophthalmic Hospital, Chennai

- - - - - - - - 30 - - - -

11. King Institute, Guindy, Chennai - - - - - - 40 46 - - - - - 12. Government General Hospital,

Chennai - - 170 - - - - - - - - - -

13. Govt.Rajaji Hospital, Madurai - - 170 - - - - - - - - - - 14. Government Kilpauk Medical

College Hospital, Chennai - - 70 - - - - - - - - - -

15. Government Mohan Kumaramangalam Medical College Hospital, Salem

- - 130 - - - - - - - - - -

16. Government Tirunelveli Medical College Hospital, Tirunelveli.

- - 130 - - - - - - - - - -

17. Government Thanjavur Medical College Hospital, Thanjavur.

- - 125 - - - - - - - - - -

18. Annal Gandhi Government Memorial Hospital , Trichy.

- - 130 - - - - - - - - - -

19. Government Mohan Kumaramangalam Medical College, Salem

- - - - - - - 10 - - - - -

20. Government Coimbatore Medical College Hospital, Coimbatore

- - 140 - - - - - - - - - -

21. Government Kasturba Gandhi Hospital for Women & Children, Chennai.

- - 50 - - - - - - - - - -

22. Government Chengalpattu Medical College Hospital, Chengalpattu

- - 50 - - - - - - - - - -

23. Government Thoothukudi Medical College Hospital, Thoothukudi

- - 50 - - - - - - - - - -

24. Government Kanyakumari Medical College Hospital, Nagercoil

- - 50 - - - - - - - - - -

25. Government Head Quarters Hospital, Kancheepuram

- - 50 - - - - - - - - - -

26. Government Head Quarters Hospital, Cuddalore

- - 50 - - - - - - - - - -

27. Government Head Quarters Hospital, Ramanathapuram

- - 50 - - - - - - - - - -

28. Government Head Quarters Hospital, Dindigul

- - 50 - - - - - - - - - -

29. Government Head Quarters Hospital, Udagamandalam

- - 50 - - - - - - - - - -

30. Government Head Quarters Hospital, Thiruppur

- - 50 - - - - - - - - - -

31. Government Head Quarters Hospital, Nagapattinam

- - 50 - - - - - - - - - -

Total 40 50 1745 240 10 10 40 56 30 30 50 6 6 * for trained Nurses

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 2

3. Joint Director of Medical Education (Pharmacy) 1

4. Deputy Secretary to Government/Deputy Director of Medical Education (Administration) 1

5. Deputy Director of Medical Education 8

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 9

11. Ministerial Staff 223

12. Basic Servants 39

TOTAL 288

PERSONNEL STRENGTH OF THE COLLEGES

Sl.No. Name of the Institution Medical Para Medical Ministerial Other than Ministerial Basic Servants Total

1. Madras Medical College, Chennai 578 235 106 67 208 1194 2. Stanley Medical College, Chennai 274 83 44 26 124 551 3. Kilpauk Medical College, Chennai 242 57 28 20 60 407 4. Chengalpattu Medical College,

Chengalpattu 243 106 45 46 78 518

5. Thanjavur Medical College, Thanjavur 177 85 35 30 96 423 6. Madurai Medical College, Madurai 301 175 65 75 139 755 7. Tirunelveli Medical College, Tirunelveli 232 77 40 49 66 464 8. Coimbatore Medical College,

Coimbatore 239 65 50 41 127 522

9. Tamil Nadu Government Dental College and Hospital, Chennai

41 33 16 5 25 120

10. Government College of Physiotheraphy, Tiruchirapalli

1 4 5 2 9 21


98 46 28 9 32 213

12. K.A.P.Viswanatham Govt. Medical College, Tiruchirapalli

145 38 28 4 35 250


75 -- 2 2 -- 79

Total 2646 1004 492 376 999 5517

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 (including Peripheral Hospital, Periyar Nagar and City Police Hospital, Chennai)

1. Madras Medical College, 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 Government Ophthalmic Hospital, Chennai

-do-

3. Government Kasturba Gandhi Hospital for Women and Children, Chennai

-do-

4. Institute of Obstetrics and Gynaecology and Government Hospital for Women and Children, Chennai

-do-

5. Government Institute of Rehabilitation Medicine, Chennai

-do-

6. Institute of Child Health and Hospital for Children, Chennai

-do-

7. Institute of Thoracic Medicine, Chennai-31 -do- 8. Institute of Mental Health, Chennai -do- 9. Tamilnadu Government Dental College

and Hospital , Chennai ------------

10. Government Stanley Hospital, 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

2. Stanley Medical College, Chennai

11. Government RSRM Lying in Hospital, Chennai -do- 12. Government Hospital for Thoracic Medicine,

Tambaram, Chennai-47 -do-

13. Government Kilpauk Medical College Hospital, Chennai (including Peripheral Hospital, Arignar Anna Nagar, Chennai-102) 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

3. Kilpauk Medical College, Chennai

Sl.No. Name of the Hospitals Medical College to which attached

14. Government Tiruvootteeswarar Hospital for Thoracic Medicine, Chennai-12

3. Kilpauk Medical College, Chennai

15. Government Royapettah Hospital, Chennai-14 (including Peripheral Hospital, K.K. Nagar) (i) Government Hospital, Saidapet, Chennai-15 (ii) Government Peripheral Hospital,

Neelankarai

-do-


4. Chengalpattu Medical College, Chengalpattu

17. Government Tanjavur Medical College Hospital, Thanjavur

5. Thanjavur Medical College, Thanjavur

18. Government Raja Mirasdar Hospital, Thanjavur -do- 19.

Government Rajaji Hospital, 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

6. Madurai Medical College, Madurai

20. Government Tirunelveli Medical College Hospital, Tirunelveli (including Frieda Monnier Government Hospital, Kalakkad, Tirunelveli)

7. Tirunelveli Medical College, Tirunelveli

21. Government Coimbatore Medical College Hospital, Coimbatore

8. Coimbatore Medical College, Coimbatore



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, Tiruchirapalli (including) (i)Government College of Physiotherapy,Trichy. (ii) Government Rajaji T.B.Hospital, Tiruchi.

10. K.A.P. Viswanatham Govt. Medical College, Tiruchirapalli

27. Thoothukudi Medical College Hospital, Thoothukudi


28. Government Vellore Medical College Hospital, Vellore (including) Subsidiary Hospital, Vellore.

12. Vellore Medical College, Vellore

29. Government Kanyakumari Medical College Hospital, Kanyakumari ( including ) Subsidiary Hospital, Nagercoil

13. Kanyakumari Medical College, Kanyakumari

30. Government Theni Medical College Hospital,

Theni @ Allinagaram 14. Theni Medical College, Theni

PERSONNEL STRENGTH OF THE HOSPITALS

Name of the Institution Medical Nursing Para-

Medical Ministerial Other than

Ministerial Basic

Servants and others

Total

Sl. No. (1) (2) (3) (4) (5) (6) (7) (8) 1. Government General Hospital, Chennai 188 474 425 212 326 791 24162. Government Stanley Hospital, Chennai 64 372 310 78 286 308 1418 3. Government Kilpauk Medical College Hospital, Chennai 48 170 135 57 84 217 7114. Regional Institute of Ophthalmology and Government

Ophthalmic Hospital, Chennai 16 83 95 45 72 119 430

5. Government Royapettah Hospital, Chennai (including Government Hospital, Saidapet, Chennai)

718

17512

12113

571

1645

26020

84859


39 156 61 73 89 268 686


18 175 6 69 104 311 683

8. Institute of Child Health and Hospital for Children, Chennai 56 223 110 87 124 237 8379. Government R.S.R.M. Lying Hospital, Chennai 15 82 44 44 21 180 38610. Institute of Mental Health, Chennai 23 118 61 54 323 214 79311. Government Tiruvotteswarar Hospital for Thoracic Medicine,

Otteri, Chennai 7 39 16 20 31 70 183

12. Institute of Thoracic Medicine, Chetput, Chennai 12 19 16 14 9 23 9313. Government Peripheral Hospital, K.K. Nagar, Chennai 18 20 12 9 2 43 10414. Government Peripheral Hospital, Anna Nagar, Chennai 30 25 22 9 5 35 12615. Government Peripheral Hospital, Tondiarpet, Chennai 20 19 17 8 3 32 9916. Government Institute of Rehabilitation Medicine, K.K. Nagar,

Chennai 2 15 88 20 6 33 164

17. Government Hospital for Thoracic Medicine, Tambaram, Chennai

17 146 63 43 57 189 515


6 151 56 34 90 167 504

19. Govt. Raja Mirasdar Hospital, Thanjavur 27 149 14 62 177 158 58720. Government Thanjavur Medical College Hospital, Thanjavur 37 160 107 33 38 170 545

(1) (2) (3) (4) (5) (6) (7) (8) 21. Government Peripheral Hospital, Periyar Nagar, Chennai 17 21 18 9 8 33 10622. Govt.Rajaji Hospital, Madurai (including)

(i) Govt.Hospital for Thoracic Medicine, Thoppur (ii) Govt.Hospital, Balarangapuram (iii) Govt. Cholera Collection Centre, Thoppur. (iv) Govt.Infectious Diseases Hospital, Thoppur.

817

1022

3102468

12

388151117

1084531

861-71

57435172516

154786494639

23. Government Tirunelveli Medical College Hospital, Tirunelveli (including) (i) Frieda Monniar Government Hospital Kalakhad,

66

2

236

4

180

3

58

2

14

4

325

13

879

2824. Government Coimbatore Medical College Hospital,

Coimbatore 105 221 156 57 133 254 926

25. Government Arignar Anna Memorial Cancer Hospital, Karapettai, Kancheepuram

25 43 32 18 38 74 230


11 4 13 4 10 8 50

27. King Institute, Guindy, Chennai-32 58 - 190 59 85 299 69128. Government Mohan Kumaramangalam Medical College,

Hospital, Salem 83 227 66 22 36 155 589

29. Annal Gandhi Memorial Govt. Hospital, Tiruchirapalli (including) Government T.B Hospital, Tiruchirapalli

243

1267

1444

334

382

14618

51138

30. Thoothukudi Govt.Medical College Hospital, Thoothukudi 38 121 54 20 24 92 34931. Government Vellore Medical College Hospital, Vellore

(including) Subsidiary Hospital, Vellore. 513

12420

5414

327

363

15727

45474

32. Government Kanyakumari Medical College Hospital, Kanyakumari (including) Subsidiary Hospital, Nagercoil

4210

7757

3818

1916

4625

72121

294247

Total 1362 4431 3198 1510 2613 6306 19420

HOSPITALS AND DISPENSARIES - NUMBER OF BEDS

Name of the Institution A.C.Room A Class Ward B Class Ward C Class Ward General Ward Total

Sl.No. (1) (2) (3) (4) (5) (6) (7) 1. Government General Hospital, Chennai 4 18 74 163 1770 2029 2. Govt. Peripheral Hospital, Periyar Nagar - - - - 100 100 3. Government Stanley Hospital, Chennai

(i) Government Peripheral Hospital, Tondiarpet, Chennai

- -

6 -

12 -

55 -

1208 100

1281 100

4. Government Kilpauk Medical College Hospital, Chennai (i) Government Peripheral Hospital, Anna Nagar,

Chennai

-

-

2

-

7

-

20

-

486

100

515

100 5. Government Royapettah Hospital, Chennai

(i) Govt. Hospital, Saidapet, Chennai (ii) Government Peripheral Hospital, K.K. Nagar,

Chennai

- - -

- - -

7 - -

18 - -

687 32

100

712 32

100

6. Regional Institute of Ophthalmology and Govt. Ophthalmic Hospital, Chennai

2 5 16 84 371 478

7. Government Kasthurba Gandhi Hospital for Women and Children, Chennai

- - 16 55 624 695


9 4 13 13 713 752


- - - - 537 537

10. Government R.S.R.M. Hospital-in-Lying Hospital, Chennai

- - 58 - 452 510

11. Institute of Mental Health, Chennai-10 - 20 122 - 1658 1800 12. Government Thiruvotteeswar Hospital for Thoracic

Medicine, Otteri, Chennai-12 - - 6 16 200 222

13. Government Institute of Rehabilitation Medicine, K.K. Nagar, Chennai-83

- - - - 60 60

14. Government Hospital for Thoracic Medicine, Tambaram, Chennai-47

2 4 24 21 725 776


6 - 4 15 605 630

(1) (2) (3) (4) (5) (6) (7) 16. Government Raja Mirasdar Hospital, Thanjavur - - 3 12 625 640 17. Govt. Thanjavur Medical College Hospital, Thanjavur 1 6 10 20 641 678 18. Government Rajaji Hospital, Madurai

I)Government Hospital, Balarangapuram ii) Government Hospital for Thoracic Medicine, Thoppuriii) Government Hospital for Infectious diseases, Thoppur iv) Government Cholera Collection Centre, Thoppur

19 - - - -

7 - - - -

23 - - - -

38 - - 2 -

2131 40

207 50 28

2218 40

207 52 28

19. Tirunelveli Medical College Hospital, Tirunelveli – including Frieda Monnier Govt Hospiral, Kalakad

- -

1 12 -

-- 1078 30

1091 30

20. Coimbatore Medical College Hospital, Coimbatore 1 4 6 16 993 1020 21. Government Arignar Anna Memorial Cancer Hospital,

Karapettai, Kancheepuram -

-- - - 270 270


- 18 - 14 679 711

23. Annal Gandhi Memorial Government Hospital, Tiruchirapalli (including) Government Rajaji T.B. Hospital, Tiruchirapalli

-

-

-

-

12

-

-

-

609

100

621

100

24. Thoothukudi Govt. Medical College Hospital, Thoothukudi

- - 4 10 598 612

25. Government Vellore Medical College Hospital, V ellore (including) Subsidiary Hospital, Vellore.

- -

- -

- -

- -

541 148

541 148

26. Government Kanyakumari Medical College Hospital, Kanyakumari (including) Subsidiary Hospital, Nagercoil

- -

- -

- 4

- 20

402 376

402 400

Total 44 95 433 592 20074 21238

STATEMENT SHOWING THE NUMBER OF IN-PATIENTS ADMISSIONS

Total Number of In-patients Treated Average Per Day Total Number of Out-Patients Treated

2002-2003 2003-2004 2002-2003 2003-2004 2002-2003 2003-2004 Sl. No Name of the Hospitals

(1) (2) (3) (4) (5) (6) 1. Government General Hospital, Chennai

(i) Government Peripheral Hospital, Periyar Nagar 556260 27576

561540 30793

1524 76

1538 84

2037276 403433

2063989 416639

2. Government Stanley Hospital, Chennai (i)Government Peripheral Hospital, Tondiarpet,

Chennai

419757 30430

417994 20986

1150 83

1145 57

1966043 295279

2019318 327108

3. Government Kilpauk Medical College Hospital, Chennai(i)Government Peripheral Hospital, K.K. Nagar, Chennai

274426 29974

275943 31144

751 82

756 85

1559224 438475

1560222 500544

4. Government Royapettah Hospital, Chennai (i)Government Hospital, Saidapet, Chennai-15

224334 4586

232957 5042

615 17

638 18

915842 351187

945560 386305

5. Regional Institute of Ophthalmology and Government Ophthalmic Hospital, Chennai-8

100778 101023 276 277 182367 186965

6. Government Kasthurba Gandhi Hospital for Women and Children, Chennai-5

298001 258312 816 708 335706 326830


403494 369520 1105 1012 220545 176517


238320 234794 653 643 738821 716601

9. Government R.S.R.M. Lying-in Hospital, Chennai 164440 134450 451 368 105736 109904 10. Institute of Mental Health, Chennai 591075 561275 1619 1538 107185 120579 11. Government Tiruvotteswarar Hospital for Thoracic

Medicine, Otteri, Chennai-12 65382 60150 179 165 113815 95040

12. Govt. Peripheral Hospital, Arignar Anna Nagar, Chennai 34305 33332 94 91 370808 446501 13. Government Institute of Rehabilitation Medicine, K.K.

Nagar, Chennai-83 14582 20481 40 56 125627 123569


- - - - 185437 171502

15. Government Hospital for Thoracic Medicine, Tambaram,

330384 295478 905 810 263767 292295


260081 266583 713 730 1077343 1083346

(1) (2) (3) (4) (5) (6) 17. Government Raja Mirasdar Hospital, Thanjavur 284998 285236 781 781 1028866 1060009 18. Government Thanjavur Medical college Hospital,

Thanjavur 299569 295471 825 810 477148 526838

19. Government Rajaji Hospital, Madurai (i) Government Hospital, Balarangapuram, Madurai (ii) Government Hospital for Thoracic Medicine,

Thoppur, Madurai (iii) Government Infectious Diseases Hospital,

Thoppur, Madurai (iv) Government Cholera Collection Centre, Thoppur,

Madurai

727008 10536 47450 1112

3009

741548 8304

59213 4037

1636

1992 29

130 3

8

2032 23

162 11

4

3314347 252693

- -

-

3380633 248479

- -

-

20. Government Tirunelveli Medical College Hospital, Tirunelveli (i) Frieda Monniar Hospital, Kalakkad, Tirunelveli

305206 4513

274547 7492

836 12

752 20

658370 43862

622274 44366

21. Coimbatore Medical College Hospital, Coimbatore 428455 413604 1174 1133 1534515 1437447 22. Government Arignar Anna Memorial Cancer Hospital,

Karapettai, Kanchipuram 73920 78159 203 214 17324 18347


- - - - 32955 25098

24. Government College of Physiotherapy, Tiruchirapalli - - - - 21852 15596 25. Government Mohan Kumaramangalam Medical College

Hospital, Salem 284478 288025 780 789 1642315 1777807

26. Annal Gandhi Memorial Government Hospital, Tiruchirapalli (including) Government Rajaji T.B. Hospital,Tiruchirapalli.

257123 23612

258322 20210

704 65

708 55

1324655 30794

1326156 32542

27. Institute of Thoracic Medicine, Chetput, Chennai - - - - 251511 257325 28. Thoothukudi Govt.Medical College Hospital,

Thoothukudi 174720 184134 478 504 864662 948540

29. Government Vellore Medical College Hospital, Vellore (including) Subsidiary Hospital, Vellore..

192678 36597

187836 31962

528 100

515 88

765482 21381

792299 21580

30. Government Kanyakumari Medical College Hospital, Kanyakumari (including) Subsidiary Hospital,Nagercoil.

191725 208740

117708 58307

350 197

322 160

859397 7662

697169 15923

Total 7623634 7227548 20344 19802 24943707 25317762

STATEMENT SHOWING THE NUMBER OF OUT-PATIENTS AND ADMISSIONS Average Number of Out-

Patients Per Day Total Number of In-Patients Discharged

Average Length of Stay Per Patient (in days) Name of the Institution 2002-2003 2003-2004 2002-2003 2003-2004 2002-2003 2003-2004

Sl. No.

(1) (2) (3) (4) (5) (6) (7) 1. Government General Hospital, Chennai 5582 5655 53868 53690 10 10

2. Government Stanley Hospital, Chennai 5386 5532 47051 47957 9 8

3. Government Kilpauk Medical College Hospital, Chennai 4271 4275 38719 38883 7 7


501 512 12623 12824 8 8

5. Government Royapettah Hospital, Chennai (i) Government Hospital, Saidapet, Chennai-15

2509 962

2590 1058

29668 778

30574 1066

8 7

7 7


920 895 27091 26834 11 9


604 484 36906 33731 11 11

8. Institute of Child Health and Hospital for Children, Chennai 2388 1963 34517 35699 6 6

9. Government R.S.R.M. Lying-in Hospital, Chennai 290 301 20555 20095 8 7

10. Institute of Mental Health, Chennai 294 330 5636 5783 105 97

11. Government Tiruvotteswarar Hospital for Thoracic Medicine, Otteri, Chennai

312 260 4062 3838 20 16

12. Institute of Thoracic Medicine, Chetput, Chennai 689 705 - - - -

13. Government Peripheral Hospital, K.K. Nagar, Chennai 1201 1371 6092 4391 8 8

14. Government Peripheral Hospital, Anna Nagar, Chennai 1016 1223 9731 10380 8 8

15. Government Peripheral Hospital, Tondiarpet, Chennai 808 896 3021 3288 12 8

16. Government Institute of Rehabilitation Medicine, K.K. Nagar, Chennai

364 339 483 684 30 30

17. Government Hospital for Thoracic Medicine, Tambaram, Chennai

863 809 27532 29137 12 10


2951 2968 44191 46400 6 6

(1) (2) (3) (4) (5) (6) (7) 19. Raja Mirasdar Hospital, Thanjavur 2819 2904 50208 51360 6 6

20. Government Thanjavur Medical College Hospital, Thanjavur 1307 1443 39672 40693 7 7


510 469 - - - -

22. Government Rajaji Hospital, Madurai (i) Government Hospital for Thoracic Medicine,

Thoppur, Madurai (ii) Government Hospital, Balarangapuram, Madurai (iii) Government Cholera Collection Centre, Thoppur,

Madurai (iv) Government Infectious Diseases Hospital, Thoppur,

Madurai

9080 -

692 -

-

9262 -

680 -

-

85139 1372

6100 3009

910

86841 982

6231 919

2615

8 60

10 3

7

9 60

10 2

2

23. Government Tirunelveli Medical College, Hospital, Tirunelveli (i) Frieda Monniar Government Hospital Kalakhad,

Tirunelveli

1804

64

1705

121

37652

543

35812

561

8

15

8

15 24. Government Coimbatore Medical College Hospital,

Coimbatore 4204 3938 64085 56780 7 7


64 50 3670 4177 21 20


90 69 - - - -

27. Government Peripheral Hospital, Periyar Nagar, Chennai 1105 1141 3359 3532 10 10

28. Government College of Physiotheraphy, Tiruchirapalli 95 45 - - - - 29. Government Mohan Kumaramangalam Medical College

Hospital, Salem 4500 4870 55331 68123 7 7


3629

84

3633

89

45775

2045

51266

1209

6

17

5

17 31 Thoothukudi Govt.Medical College Hospital, Thoothukudi 2369 2598 29120 29616 6 6

32. Government Vellore Medical College Hospital, Vellore (including) Subsidiary Hospital,Vellore.

2097 59

2170 59

49755 36597

48133 24775

4 30

4 30

33. Government Kanyakumari Medical College Hospital, Kanyakumari (including) Subsidiary Hospital,Nagercoil.

1520 51

1915 54

18200 3326

18000 3423

22 29

7 20

Total 68054 69381 938392 940302 - -

NUMBER OF OPERATIONS PERFORMED, NUMBER OF X-RAYS TAKEN ETC. DURING THE YEAR 2003-2004

Number of Operations Performed

Name of the Institution Major Minor Total Number of Laboratory

Tests Conducted

Number of X-rays Taken

Number of MRI /C T

Scan Taken

Sl.No.

(1) (2) (3) (4) (5) (6) (7) 1. Government General Hospital, Chennai 15489 32556 48045 1087818 172151 2976/34

277 2. Government Stanley Hospital, Chennai 13550 25705 39255 861062 135048 1020

3. Government Kilpauk Medical College Hospital, Chennai 15760 4184 19944 534431 63820 7263


13663 14539 28202 96877 3546 10346

5. Government Royapettah Hospital, Chennai(including) (i) Government Hospital, Saidapet, Chennai-15

5832 14

24097 3017

29929 3031

570108 38030

95451 6087

11757 -


6669 13890 20559 327545 11640 -


14835 21432 36267 276461 11373 -

8. Govt.Inst. of Child Health and Hospital for Children, Chennai 7859 8489 16348 743827 71479 -

9. Government R.S.R.M. Lying-in Hospital, Chennai 7243 2870 10113 110096 3002 -

10. Government Institute of Mental Health, Chennai - - - 93328 3984 -

11. Govt. Tiruvotteswarar Hospital for Thoracic Medicine, Chennai - - - 47888 10553 -

12. Institute of Thoracic Medicine, Chetput, Chennai - - - 26365 35819 -

13. Government Peripheral Hospital, K.K. Nagar, Chennai 691 1461 2152 53936 5890

14. Government Peripheral Hospital, Anna Nagar, Chennai 1319 7136 8455 99428 12877 -

15. Government Peripheral Hospital, Tondiarpet, Chennai 278 222 500 34347 2495

16. Government Institute of Rehabilitation Medicine, K.K. Nagar, Chennai

7 16 23 2894 2848 -

(1) (2) (3) (4) (5) (6) (7)

17. Government Hospital for Thoracic Medicine, Tambaram, Chennai - 5284 5284 359172 95838 --

18. Government Chengalpattu Medical College Hospital, Chengalpattu 12166 16446 28612 372384 61919 6684

19. Government Raja Mirasdar Hospital, Thanjavur 15017 11417 26434 120705 16087 -

20. Government Thanjavur Medical College Hospital, Thanjavur 4952 3419 8371 328344 62376 7476

21. Tamil Nadu Government Dental College and Hospital, Chennai 38553 180 38773 29923 37749 -

22. Government Rajaji Hospital, Madurai (i) Government Hospital, Balarangapuram, Madurai (ii) Government Hospital for Thoracic Medicine, Thoppur,

Madurai

22148 146

-

43062 118

-

65210 264

-

1187903 22745 13103

135287 1381 982

806/12252 -

23. Government Tirunelveli Medical College, Hospital, Tirunelveli (i) Frieda Monniar Government Hospital Kalakkad, Tirunelveli

5564 -

3984 141

9548 141

425654 6063

50815 642

8650 -

24. Government Coimbatore Medical College Hospital, Coimbatore 10538 9068 19606 514002 61796 10296


95 112 207 49683 3350 -

26. Government Peripheral Hospital, Periyar Nagar, Chennai 780 1015 1795 60982 5530 -


8414 23452 31866 627754 58552 9098


8752 --

12108 --

20860 --

325773 7155

31517 1362

10111 --

29. Thoothukudi Govt. Medical College Hospital, Thoothukudi 6702 1351 8053 288286 23705 4859

30. Arignar Anna Memorial Cancer Institute, Kancheepuram - - - 13413 - -

31. Government Vellore Medical College Hospital, Vellore (including) Subsidiary Hospital, Vellore.

3668 6123 9791 191611 17408

11244 748

5369 -

32. Government Kanyakumari Medical College Hospital, Kanyakumari (including) Subsidiary Hosital, Nagercoil.

2731 -

15979 45

18710 45

370000 41085

13272 -

3037 -

Total 243435 312918 556353 10377589 1322215 3782 / 142495

King Institute of Preventive Medicine, Guindy, Chennai.

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. Anti-Toxin Section

This department is engaged in the manufacture of polyvalent Anti Snake venom. Immunisation of Horses for the production of anti-snake venom serum was commenced from June 2002. Anti Rabies Vaccine Section

The Neural tissue Rabies vaccine production from sheep brain is stopped as per Government order.

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 T.S.P. 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 in Micro students and Technicians on Blood Transfusions and Immuno Haematology is also carried out in this department.

5. Storage and supply of Aids kits to Government Blood Banks.

6. Quality control test of blood group reagents. 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. Testing of food samples are carried out for VIPs on their visit to Chennai. 2. Stool samples are received from PHCs for detection of vibro cholera.

Diptheria Toxoid Section

This department is engaged mainly in the manufacture of Diphtheria Toxoid on a pilot project. Necessary formalities laid down by the Central Research Institute, Kasauli to go for the regular production of dual antigen vaccinne have been completed . Government have been addressed for the production of this vaccinne and orders are awaited. Virology Section

Virology Section is recognised by W.H.O. as National Polio Laboratory to carry out:- 1. Virus isolation from cases of acute flaccid paralysis. 2. Monitor the cold chain maintenance of Polio vaccine of potency testing. 3. Arbo Viral Centre has been set up in 1999 for diagnosis of Encephalitis and Dangue.This Department also maintains and supplies cell lines

to other institutions. Serological investigation for viral diseases is undertaken. Potency of measles vaccines is maintained. The Research and Training programmes are undertaken for Post Graduate students.

Media Section

In the Media section, all types of Media required for the manufacturing sections are produced and supplied.

Central filling section:

This section mainly deals with the containerisation of all vaccines and sera manufactured in this Institute. Animal Section

In the Animal Section, small animals like mice, rat, guinea pigs, rabbits etc. are maintained and supplied for laboratory experimental purposes to major research institutions in this State. Department of Biological Control

This department functions as biological standardisation and Quality Control Laboratory for independent quality control of all products manufactured in this Institute. It also functions as a Laboratory for analysis of schedule C and C1 drugs for State under the Drugs and Cosmetics Act. The raw materials and Glasswares purchased for the production of Sera and Vaccines are also tested here. Drug samples received from Tamil Nadu Medical Services Corporation are analysed and reported on payment basis. Library

All the standard journals and reference books in Microbiology, Virology, Immunology, Bio-chemistry and its allied subjects are available. Bibliographic works and xerox facilities are also available in this Library. This is one of the Best Reference Libraries in our country. Teaching Activities 1. M.D. Microbiology

The King Institute of Preventive Medicine, Guindy is a recognised teaching centre in Bacteriology, Ph.D., Post Graduate and Under Graduate students in Medical Microbiology are being given one to two years training in various Departments.

2. School of Laboratory Technology

The Government of Tamil Nadu have issued orders for starting Diploma in Medical Laboratory Technician course for 2 years with the intake of 40 - 50 candidates per annum. This two years Diploma course has been started from 3.10.94. At present, 46 students are undergoing this training. Certificate course in Laboratory Technician Grade-I course sanctioned for Service candidates has commenced from 11-12-95 with an intake of 40 students.

Inoculation Centre, First Aid and Dispensary

This centre mainly deals with issue of International Vaccination Certificate to the Travellers particularly for Yellow Fever. It also offers first aid to the staff of this Institute whenever the need arises. Haj Pilgrims are inoculating with Meningococcal vaccine. Maintenance Section

1. Mechanical Section This section looks after operation and Maintenance of Pump houses to supply adequate water supply to the Institute and also operation

and maintenance of boilers to ensure steam supply to various stills and sterilisers. Maintenance of other mechanical equipments is also undertaken. 2. Electrical Section

This section is looking after operation and maintenance of transformers, Generator sets and all chemically operated equipments and

maintaining power supply to whole institute. 3. Refrigeration Section

This section is looking after operation and maintenance of all Cold storage, plant rooms, various Air-conditioning Plants, Freeze driers,

Deep freezers, Refrigerators and allied equipments.

Tetanus Toxoid Department

This department is engaged in the manufacture of Tetanus Toxoid vaccine. This vaccine is supplied to all Government hospitals through Tamil Nadu Medical Services corporation.

Overseas Section

Medical Stores

Administrative Office and Package Section

RECEIPT AND EXPENDITURE - KING INSTITUTE

(Rs. in lakhs)

Year Receipts Expenditure 2002-2003 27.13 548.11

CHAPTER - 2

MEDICAL AND RURAL HEALTH SERVICES

The Director of Medical and Rural Health Services is incharge of planning and execution of all programmes of Medical Services. He is responsible for rendering medical care services, through the grid of 26 District Headquarters Hospitals, 160 Taluk Hospitals, 79 Non Taluk Hospitals, 12 Dispensaries, 11 Mobile Medical Units, 7 Women and Children Hospitals, 2 TB Hospitals/Sanatorium, 2 TB Clinics and 1 Leprosy Rehabilitation Promotion Unit. The State has been divided into Twenty Nine Revenue Districts for the implementation of the Medical Services. The Joint Directors of Health Services in Districts are the overall controlling officers of all the Medical Institutions for the Implementation of medical services including family Welfare and supervising authority for all health programmes. The Deputy Directors of Medical Services (Thoracic Medicine) in every District look after the T B Control programme. Specialists in the rank of Civil Surgeons are also provided in the district Headquarters Hospitals. The Deputy Directors of Medical Services (Leprosy) in every District look after the Leprosy Eradication Programme. The Leprosy Programme has been integrated with the Department of Public Health in order to involve Leprosy Field staff in Public Health work and the Health Inspectors in Leprosy work. Improvements to District, Taluk, Non Taluk Hospitals and Dispensaries constitute an important development of plan of activities in the shape of expanded medical facilities, specialised services such as Medicine, Surgery, Obstetrics and Gynaecology, ophthalmology, ENT, Venerology, Orthopaedic Surgery, Anaesthesiology, Child Health, Dental, Psychiatric Clinics, Ambulatory services, Pathological Laboratory Services, Leprosy, T B, 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. In other Health Medical Programmes, such as Control of Blindness, medical facilities under Hill Area Development Programme and Adi Dravidar and Tribal Welfare Schemes, etc., the Medical Services Department is coordinating and implementing the Programmes through the Government Medical Institutions under this Department. Direction, Supervision and Policy Formulation: The Strength of various categories of staff is given below:

Sl No Staff Position No. of Posts 2003-2004

1. Director 1 2. Additional Directors of Medical and Rural Health Services 6 3 Additional Directors of Medical and Rural Health Services (Admn) 1 4. Joint Director of Medical and Rural Health Services 3 5 Joint Director of Medical and Rural Health Services (Admn) 1 6. Deputy Directors of Medical Services (Leprosy) 3 7 Deputy Director of Medical and Rural Services(Admn) 1 8 Financial Advisor & Chief Accounts Officer 1 9 Other A & B Group Staff 39 10 Ministerial Staff 153 11 Office Assistants and Others 89 Total 298

Hospital and Dispensaries: Each District has a District Headquarters Hospital, Taluk Headquarters Hospitals, Non-Taluk Hospitals and Dispensaries. The District level Administrative Control of the Medical Institutions including Family Welfare Programme is vested with the Joint Director of Health Services. The Strength of staff under District level Administration is given below: Sl. No Name of the Post No. of Posts

1 Joint Director of Health Services 28 2 Hospital Superintendent( in the cadre of Senior Civil Surgeon) 30

3 Deputy Director of Medical and Rural Health Services ( in the cadre of Senior Civil Surgeon) 24

4 Senior Civil Surgeons 165 5 Senior Civil Surgeon Specialist 176

6 District Leprosy Officer (now Deputy Director of Medical Services (Leprosy)) 25

7 District T.B. Officer ( including one post of Superintendent, TB Hospital) 22

8 Assistant Surgeon / Sr,Asst Surgeons / Civil Surgeons (including Dental)

1942

9 Nursing Staff 4759

10 Ministerial Staff 2228 11 Paramedical Staff 3516 12 Other Staff 4192

Total 17107 DIRECTOR OF MEDICAL AND RURAL HEALTH SERVICES (MEDICAL WING) OBJECTWISE CLASSIFICATION (Rs.in lakhs)

Sl Object

Accounts 2002-03

Budget Estimate 2003-04

Revised Estimate 2003-04

1 Salaries 10713.63 11467.20 11021.39 2 Wages 0.03 0.05 27.36 3 Dearness Allowance 4568.98 6317.40 5311.12 4 Travel Expenses 52.76 66.04 61.58 5 Office Expenses 599.14 610.78 670.18 6 R.R.T. 16.78 27.19 42.88 7 Publicity - 8 Advertisement 1.29 7.00 7.00 9 Grants 37.52 37.59 37.59

10 Contribution 2.22 - - 11 Subsides - - 12 Hospitality - - 13 Major works - - 14 Minor works - - 15 Maintenance 1.72 1.54 1.54 16 Machinery & Equipment 213.57 165.52 216.98 17 Motor Vehicle 85.49 8.43 9.15 18 Materials and Supplies 19 Depreciation - 20 Inter Transfer Accounts 21 P P S S 1.12 0.48 0.43 22 Investments 826.00 783.00 783.00 23 Other Charges 0.02 0.02 24 Rewards

25 Service Commit charge 26 Ration Charges 27 Petrol, Oil, Lubricant 60.65 73.08 63.68 28 Clothing 46.91 117.15 113.87 29 Stores and Equipments 416.08 468.87 465.81 30 Foreign Allowance 31 Festival Advance 97.87 136.73 133.52 32 Compensation 1.20 53.24 33 Conducted Tour Expdr 34 Prizes and Awards 0.38 1.46 2.01 35 T A for non Officials 36 Lands 37 Buildings 38 Medicines 4090.51 4100.66 4100.63 39 Diet 585.28 635.40 658.50 40 Books 41 Procurement of Agri Inputs 42 Computer & Accessories 1.67 0.30 4.80 43 Training 4.00 6.00 44 Deduct Recoveries (-) -116.15 -136.73 -133.52

DISTRICTWISE INSTITUTIONS-2003-2004

(ABSTRACT) Sl.No District H.Qrs Taluk Non-Taluk Others Total

1 Kancheepuram 1 6 1 1 9 2 Vellore - 6 4 - 10 3 Tiruvannamalai 1 5 1 - 7 4 Cuddalore 1 5 2 1 9 5 Dharmapuri 1 4 - 2 7 6 Salem 1 6 2 1 10 7 Erode 1 6 3 1 11 8 Coimbatore 1 6 8 2 17 9 The Nilgiris 1 5 - 6 12

10 Trichy - 7 2 1 10 11 Pudukottai 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 Sivaganga 1 5 4 7 17 16 Ramanathapuram 1 6 3 - 10 17 Tirunelveli 1 6 6 1 14 18 Tuticorin 1 6 2 - 9 19 Kanniyakumari - 4 5 - 9 20 Nagapattinam 1 7 4 1 13 21 Thanjavur 1 6 6 - 13 22 Villupuram 1 7 2 3 13 23 Karur 1 3 2 - 6 24 Perambalur 1 5 1 - 7 25 Tiruvallur 1 7 3 1 12 26 Tiruvarur 1 6 1 1 9 27 Theni 1 4 2 - 7 28 Namakkal 1 3 4 - 8 29 Krishnagiri 1 4 1 1 7

Total 26 160 79 35 300 Hill Area Development Programme: The following Schemes are now functioning under Hill Area Development Programme in the State.

Forty bedded ward at Government Headquarters Hospital, Udhagamandalam. Forty bedded ward at Government Hospital, Gudalur. Government Dispensary at Gudalur Bazaar.

Tribal Development Programme: Government have established the following Dispensaries to provide medical facilities to the Tribal Population especially living in remote areas.

Thoradipattu, Kalrayan Hills in Villupuram District.

Melnivalur, Kalrayan Hills, Villupuram District. Mobile Medical Unit at Valliamalai, (Kalvarayan Hills) Villupuram District. Kariyakoil, Kalrayan Hills, Salem District. Sempulichempatti, Trichy District.

T.B. CONTROL PROGRAMME: There are about 2 lakh TB patients in Tamil Nadu. Among them, 0.7 lakh are infectious. There are 10 TB Hospitals (2 Government Institutions under the control of Director of Medical and Rural Health Services, 6 Government Institutions under the control of Director of Medical Education and 2 Private Institutions) in the State. In all, there are 3,654 beds in the State exclusively for inpatient treatment of the acutely-ill TB patients, all the TB patients are on domiciliary (home) treatment in the nearest Medical or Health facility. As per RNTCP DOTS Programme Officer in the rank of Additional Director is at the State- level to co-ordinate and supervise the TB Control Programme activities. At the District-level, each District TB Centre is headed by a Deputy Director of Medical Services (TB). Central Assistance under the External Assistance Component is provided meeting 100% requirement of anti-TB drugs and the establishment cost of 29 Districts Societies. State Government meets the entire expenditure on running the TB institutions (towards staff, maintenance of TB Institutions, drugs, vehicles etc). In 2002-2003 about eighty thousand cases were diagnosed and fully cured. The Revised National Tuberculosis Control Programme (RNTCP) is implemented in all Districts now. 138 TB Units one for every 5 Lakh population, 627 Microscopy Centes one for every lakh population were created .Thus the Programme is completely decentralized upto the village level. With full coverage of the State under Revised National Tuberculosis Control Programme the incidence of Tuberculosis would be brought under control. NGOs, Private Practitioners, SHGs are being involved in RNTCP in a phased manner. Tamil Nadu will be is one of the best states in the country in implementing RNTCP. Achievement under the Revised National Tuberculosis Control Programme\

New Sputum Positive TB Patients diagnosed

Chest Symptomatics for whom sputum examination

was done Cure-rate Year

Target Achievement % Target Achievement % Target Achievement2000-2001 30890 24533 79 308880 384506 124 85% 37%

2001-2002 31055 23589 76 310550 380747 123 85% 81%

2002-2003 31055 24346 78 310550 376037 121 85% 84%

2003-2004 31055 36153 116 310550 596367 192 88% 192%

EXPENDITURE DETAILS UNDER TB CONTROL PROGRAMME (Rupees in Lakhs)

YEAR CENTRE 2000-2001 281.88 2001-2002 755.59 2002-2003 485.54 2003-2004 568.57

FINANCIAL REQUIREMENTS

DIRECTORATE OF MEDICAL AND RURAL HEALTH SERVICES (RUPEES IN LAKHS)

Accounts 2002-2003 Budget Estimate 2003-04 Revised Estimate 2003-04 Sl No Programme Activity Classification

Plan Non Plan Total Plan Non Plan Total Plan Non Plan Total 1. a Direction, Supervision 6.50 6.50 6.50 6.50

b Policy Formulation c Direction at Headquarters level 283.51 283.51 348.87 348.87 311.28 311.28 d Direction at District level 553.48 553.48 667.51 667.51 596.29 596.29

Total 836.99 836.99 6.50 1016.38 1022.88 6.50 907.57 914.07 2. Training Programme – Training for Para

Medical workers for Leprosy etc

Total

3.a Hospital & Dispensaries 26.67 18535.85 18562.52 134.66 2240.91 20375.57 161.33 19516.82 19678.15 b. Previnciliation of Panchayat Union

Dispensaries.

c. Ambulance and Mortuary van 43.58 43.58 51.73 51.73 48.58 48.58 d. Mobile Medical Unit 22.46 22.46 24.18 24.18 22.45 22.45

Total 4. Contract

a. Leprosy control 52.00 906.54 958.54 81.79 1256.38 1338.17 69.19 1071.86 1141.05 b. T.B.Control 11.94 613.61 625.55 15.14 870.76 885.90 13.60 677.97 691.57 c. AIDS 3.67 3.67 4.18 4.18 3.89 3.89 d Illness Assistance Society 0.01 0.01 0.01 0.01 Total

5. Grants 37.58 37.58 37.58 37.58 37.58 37.58 6. Laboratory Services 65.89 65.89 80.74 80.74 74.01 74.01 7. Control of Blindness 153.83 153.83 259.05 259.05 241.67 241.67 8. Mental Health 24.87 24.87 34.66 34.66 56.44 56.44 9. Regional Diagnostic Centres 826.00 826.00 783.01 783.01 783.01 783.01

PERFORMANCE REPORT FOR THE YEAR 2003-2004 (DISTRICT WISE).

SL NO

NAME OF THE DISTRICTS BEDS TOT.OP AVG.OP TOT.IP AVG.IP MAJOR

Operations MINOR

Operations EMER. CASES

1. Kancheepuram 793 3944367 10777 253898 694 5276 36269 125749 2. Vellore 972 2977849 8136 316382 864 14031 29579 61263 3. Tiruvannamalai 705 2530571 6914 241637 660 15424 46566 50114 4. Cuddalore 964 3533623 9655 331215 905 15280 33774 21302 5. Dharmapuri 926 2546417 6957 343072 937 7761 12884 30301 6. Salem 531 2113287 5774 167370 457 4652 15543 23874 7. Erode 1145 3569222 9752 418902 1145 10773 21557 53690 8. Coimbatore 1187 4097325 11195 373404 1020 10381 10902 39952 9. The Nilgris 795 918638 2510 90871 248 1849 4529 5259 10. Trichy 437 1859571 5081 146233 400 5073 28851 44290 11. Pudukkottai 937 2406954 6576 267189 730 7809 26084 21871 12. Dindigul 860 3358278 9176 215295 588 5902 45476 18300 13. Madurai 436 1852589 5062 131183 358 357 34124 10064 14. Virudhunagar 1030 2798966 7647 291727 797 7172 13746 10668 15. Sivaganga 706 1948393 5323 174784 478 7551 11325 24261 16. Ramanathapuram 938 2452967 6702 214541 586 7254 9448 7501 17. Tirunelveli 778 2925260 7993 218464 597 9572 10233 7533 18. Thoothukudi 495 1513723 4136 178855 489 2652 16683 21910 19. Kanyakumari 339 1648594 4504 118124 323 2686 18154 6675 20. Nagapattinam 963 1963967 5366 184519 504 7621 12626 116296 21. Thanjavur 831 2593414 7086 192336 526 2527 33780 17743 22. Villupuram 792 2720187 7432 385024 1052 4437 58392 94495 23. Karur 339 1179439 3223 106358 291 2760 3495 3672 24. Perambalur 368 1943130 5309 104049 284 4672 29896 12867 25. Tiruvallur 416 2310153 6312 79786 218 5903 2382 23684 26. Thiruvarur 591 1903254 5200 222454 608 1347 72379 53143 27. Theni 618 2234823 6106 218509 597 1352 10763 26629 28. Namakkal 659 2650075 7241 174033 476 4511 11430 58458

TOTAL 20551 68495036 187145 6160214 16832 176585 660870 991564

PERFORMANCE REPORT FOR THE YEAR 2002-2003 (DISTRICT WISE).

SL NO

NAME OF THE DISTRICTS

MLC PM LAB TESTS X-RAY ACCIDENT DELIVERIES CEASAREANS OTHER MATY

AVG. BIRTH.

1 Kancheepuram 13003 1190 597369 15465 10089 11129 1435 27149 30 2 Vellore 19667 1703 985389 10367 2590 15723 1181 2994 43 3 Tiruvannamalai 12204 604 1813626 9711 2643 8515 405 14554 23 4 Cuddalore 11969 1951 732582 20116 4224 11237 1296 14053 31 5 Dharmapuri 15512 967 648743 16909 4924 10932 927 271 30 6 Salem 7797 357 459481 7076 1719 4460 402 3979 12 7 Erode 10389 1284 1567019 20675 3586 12036 2166 1189 33 8 Coimbatore 10282 1342 1070493 14822 4856 14313 2405 13770 39 9 The Nilgris 3044 359 215876 8154 999 3469 253 1275 9

10 Trichy 4221 309 487249 8016 1107 4388 252 0 12 11 Pudukkottai 7780 341 488842 20143 3454 13153 1340 1476 36 12 Dindigul 9212 1025 1296958 13653 2234 8078 729 1487 22 13 Madurai 3199 257 205106 9030 2449 4563 351 0 12 14 Virudhunagar 5761 560 607964 23010 3912 7800 1277 8991 21 15 Sivaganga 5176 334 313797 13673 1042 6383 1143 1494 17 16 Ramanathapuram 3915 1422 669995 17743 2036 5631 1029 5520 15 17 Tirunelveli 3919 957 732105 13242 1429 8002 854 764 22 18 Thoothukudi 3249 426 287663 6702 1986 6096 1070 5026 17 19 Kanyakumari 3274 371 385628 11350 1405 1950 185 0 5 20 Nagapattinam 9096 441 909622 12327 2685 8174 760 1946 22 21 Thanjavur 8862 498 398464 13076 1795 10745 1502 2175 29 22 Villupuram 18233 757 584213 14761 5930 11645 431 5007 32 23 Karur 2537 417 192160 7978 1214 3541 469 806 10 24 Perambalur 6174 284 374657 5588 1527 3833 46 0 10 25 Tiruvallur 6675 365 181716 7322 2598 5716 672 686 16 26 Thiruvarur 5015 194 442408 12847 1863 6237 491 86 17 27 Theni 6428 433 330616 11842 1972 5119 1407 122 14 28 Namakkal 5253 437 831797 14064 1048 3493 481 406 10

TOTAL 221846 19585 17811538 359662 77316 216361 24959 115226 589

CHAPTER - 3

PRIMARY HEALTH CENTRES The administration of Primary Health Centres have been brought under the control of the

Director of Public Health and Preventive Medicine from the 1st March, 1996. Details of Primary Health Centres sanctioned and functioning:

1.1 Number of Primary Health Centres functioning at the end of VI Five Year Plan i.e. 1984- 85. 436

Number of Primary Health Centres sanctioned during 1985 - 86: a) By Converting Rural Dispensaries as Additional Primary Health Centres 1951.2 b) New Additional Primary Health Centres sanctioned 20Number of Primary Health Centres sanctioned during 1986-87 : a) By conversion of Non - Taluk Hospital as Community Health Centres (Upgraded Primary Health Centres) : 41

b) Newly sanctioned Additional Primary Health Centres 51.3

c) Newly sanctioned Primary Health Centre (Tribal) Nammiampattu 11.4 New Primary Health Centres established in 1987-88 (Additional) 140

1.5 Number of Primary Health Centres (Additional) sanctioned during 1988-89 (*) By wounding up of Mobile Health Unit in the PHCs and creation of Primary Health Centres.

(*)274

1.6 Number of New Additional Primary Health Centres sanctioned during 1988-89. 110

1.7 Number of New Additional Primary Health Centres during 1989-90 a) New Primary Health Centres : 123 b) Conversion of Panchayat Union Dispensaries : 41

164

1.8 Number of New Additional Primary Health Centres during 1990-91 (Conversion of Panchayat Union Dispensaries) 43

1.9 Number of New Additional Primary Health Centre sanctioned during 1991-92 (Perugonapalli in Dharmapuri District). 1

Total 1430 14 PHCs have been upgraded as Taluk Hospitals (-) 14 Total 14161.10 No. of PHCs sanctioned during 1993-94 11.11 No. of PHCs sanctioned during 1995-96 1

1.12 No. of PHCs sanctioned during 1996-97 a) New Primary Health Centre : 1 b) Conversion of Panchayat Union Dispensaries : 2

3

Total 14211.13 PHC Sankarapuram made as Taluk Hospital (-) 1 Total 14201.14 Conversion of Panchayat Union Dispensaries 11 Total 14311.15 23 PHCs have been upgraded as Taluk Hospital (-) 23 Total 14081.16 No. of PHCs Sanctioned during 1998-99 6 Total 14141.17 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 1.22 No. of PHC sanctioned during 2001-2002 1 TOTAL 1411 1.23 No. of PHCs sanctioned during 2003-2004 2 TOTAL 1413

Community Health Centres / Upgraded Primary Health Centres sanctioned and established:

No. of Upgraded PHCs 24 No. of Non-Taluk Hospitals converted as Community Health Centres 1986-87 35

Total 59 No. of PHCs upgraded during 2001-2002 21



Total 152 Existing staff pattern for Main Block Primary Health Centres:

1. Medical Officer 2 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

Additional Staff for Upgraded Primary Health Centres:

1. Medical Officer - Civil Surgeon 1 2. Medical Officer - (PG Qualified Civil Assistant Surgeon) 1 3. Staff Nurse 2 4. Pharmacist 1 5. Male Nursing Assistant 1 6. Female Nursing Assistant 1 7. Sweeper 1 8. Radiographer 1 9. Dark Room Assistant 1 10. Laboratory Technician Grade-II 1

Primary Health Centres Building Facilities:

1 Total No. of Primary Health Centres 1413 2 Primary Health Centres Functioning in Government buildings 1361 3 Primary Health Centres under construction at various stages 14 4 In Private/Panchayat Union Buildings 38 Total 1413 Availability of quarters 406

Tribal Welfare Scheme:

Under this scheme, nine blocks have been identified as Tribal areas in the State. All these Blocks have one Primary Health Centre. Among the nine Primary Health Centres one Primary Health Centre at Alangayam and Kariyalur has been upgraded. Adequate preventive, promotive and curative services and all National Health Programmes are being implemented through the network of Primary Health Centre/Health Sub Centre in the Tribal Sub Plan area for the welfare of Tribals.

The details of Primary Health Centres and Community Health Centres functioning in Tribal Areas as follows: Old Regular 7 Upgraded PHC 3 Under Tribal Sub-plan scheme 14 Dispersed Tribal Group 1 (Pechiparai in Kanyakumari District) PHC Uprgraded as Taluk Hospital 1

National Scheme for the Prevention of Visual Impairment and Control of Blindness:

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

c. To educate the school children and the rural masses on eye care and prevention of the common causes of blindness.

d. To conduct Mini eye camps at Main PHC’s wherever Operation Theatres are 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 PHC in the Block.

Construction of Health Sub Centres under NABARD & PMGY

1. Construction of 100 HSCs under PMGY During the year 2000-2001, 100

2. Construction of 100 HSCs availing NABARD loan Under RIDF VII during the year 2002-2003 100

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 2003-2004 5 Total Construction of Health Sub Centres 403

Out of 403 Health Sub Centres, Public Works Department Authorities have undertaken work for 392 Health Sub Centres

INPATIENTS AND OUT PATIENTS TREATED

DURING APRIL'2003 TO MARCH 2004 SNO DISTRICT Total OP OP per Day Total IP IP per Month

1 Coimbatore 2671524 109.10 9152 11.20

2 Cuddalore 2609664 145.00 14059 23.40

3 Dharmapuri 2681922 108.00 25685 31.00

4 Dindigul 2471644 140.10 15244 25.90

5 Erode 2649420 111.50 9601 12.10

6 Kancheepuram 2064145 122.00 6577 11.70

7 Kanyakumari 1347118 124.70 5538 15.40

8 Karur 1224778 117.30 5592 16.10

9 Madurai 2172540 143.70 13380 26.50

10 Nagapattinam 1524165 98.50 5080 9.80

11 Namakkal 1740173 102.80 6687 11.90

12 Perambalur 1846730 106.90 10751 18.70

13 Pudukkottai 1935379 103.40 8435 13.50

14 Ramanathapuram 1334413 80.60 7079 12.80

15 Salem 3414942 135.50 7358 8.80

16 Sivaganga 1397747 88.20 6286 11.90

17 Thanjavur 3235851 155.00 5082 7.30

18 The Nilgiris 546577 54.20 2444 7.30

19 Theni 1308188 145.40 8958 29.90

20 Thiruvallur 1784963 120.90 4857 9.90

21 Thiruvarur 1714567 122.10 10655 22.80

22 Thoothukudi 1615925 95.50 2601 4.60

23 Thiruchirapalli 2100111 119.10 10284 17.50

24 Thirunelveli 2858266 128.10 5269 7.10

25 Thiruvannamalai 2639011 91.60 15687 16.30

26 Vellore 2869416 119.00 16773 20.90

27 Virudhunagar 1446689 111.60 4174 9.70

28 Villupuram 3067971 106.50 13101 13.60

Total 58273839 114.64 256389 20.18

Objective Classification (PHC Wing) (Rupees in Thousands)

Budget Estimate 2003-04 Revised Estimate 2003-04 Objects Non-Plan Plan C.S.S Total Non-

Plan Plan C.S.S Total

(1) (2) (3) (4) (5) (6) (7) (8) (9) 01. Salaries 01. Pay 807190 50951 11885 870026 748295 225367 12097 985759 02. Medl. Allowance 6959 351 108 7418 6209 1878 110 8197 03. Medical Charges 40 27 2 69 40 40 2 82 04. Other Allowances 29168 3101 43 32312 18109 6391 55 24555 05. Interim Relief 1 0 0 1 1 0 0 1 06. H.R.A. 35465 2005 538 38008 33014 7658 538 41210 07. Travel Concession 1030 30 4 1064 1175 40 4 1219 08. C.C.A. 2177 193 37 2407 1787 794 37 2618 02. Wages 200 0 0 200 150 0 0 150 03. Dearness Allowance 476242 30061 7012 513315 389115 117188 6290 512593 04. Travelling Expenses 01. Tour T.A. 335 335 390 10760 10035 3086 390 13511 02. Transfer T.A. 370 10 8 398 370 62 8 440 03. F.T.A. 1020 49 0 1069 1020 699 0 1719 05. Office Expenses 01. Telephone Charges 140 1102 0 1242 140 1122 0 1262 02. Other Contingencies 5550 2180 7 7737 5550 2230 7 7787 03. Electric Charges 10000 135 0 10135 15000 1020 0 16020 06 Rent Rate Taxes

01 Rent 150 0 0 150 100 0 0 100 02 Property Tax 75 0 0 75 75 0 0 75 03 Water Charges 1 0 0 1 1 0 0 1

08. Advertisement & Pub 45 0 0 45 44 0 0 44 09. Grant-In-Aid 0 1 0 1 0 1 0 1 19 Machinery & Equipments

01. Purchase 0 54367 1 54368 0 16189 1 16190 03 Maintenance 10 300 0 310 10 300 0 310

21. Motor Vehicle 01. Purchase 0 1 0 1 0 17385 0 17385 02. Maintenance 1010 71 0 1081 602 576 0 1178 24. Materials and Supplies 0 554 0 554 0 0 0 0

25 Interest 0 0 0 0 0 0 0 0 33. 01 Pleader fees 15 0 0 15 15 215 0 230 42. Service or Commitment charge 0 0 0 0 0 3010 0 3010

45. P.O.L. 6000 802 0 6802 6000 2285 0 8285 46. C.T.S. 190 70 0 260 190 400 0 590 47. S & E 185 5081 0 5266 185 4505 0 4690 49. 01 FA Debit 11288 692 179 12159 11024 689 179 11892 02 FA Credit -11288 -692 -179 -12159 -11024 -689 -179 -11892 51. Compensation 10 0 0 10 10 0 0 10 59. Prizes & Awards 100 2 0 102 100 1 0 101 66. Medicines 113963 38794 1 152758 143963 19530 1 163494 67. F.D.C. 1000 15 0 1015 998 15 0 1013 71. Printing charges 0 0 0 0 0 600 0 600 72. Training 49 0 0 49 49 9070 0 9119 73. Transport Charges 300 17 1 318 300 0 0 300

Total 1508689 190610 20037 1719326 1382652 441657 19540 1843849 Charged -10 0 0 -10 -10 0 0 -10 TOTAL 1508679 190610 20037 1719316 1382642 441657 19540 1843839

CHAPTER - 4

PUBLIC HEALTH AND PREVENTIVE MEDICINE

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.

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.

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.

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 29 Revenue districts.

Government have re-organised the Department during January, 1991. A Joint Director of Health Services from the medical service cadre has been posted to each Revenue District to be incharge of all Medical, Public Health and Family Welfare Programmes at the District Level and supervise the Deputy Directors of Health Services. Statement Showing the Financial Requirements for Public Health Schemes - OBJECTIVE CLASSIFICATION

(Rs. in lakhs) Actual 2002-2003 Budget Estimate 2003-2004 Objects Non-Plan Plan Total Non-Plan Plan Total

01 Salaries 3408.78 10215.43 13624.21 4028.10 12772.85 16800.95 02 Wages 0.16 -0.78 -0.62 0.40 1.40 1.80 03 Dearness Allowance 1457.41 4464.09 5921.50 2235.15 7128.40 9363.55 04 Travel Expenses 110.71 490.85 601.56 133.01 540.64 673.65 05 Office Expenses 45.51 211.12 256.63 56.78 257.36 314.14 06 Rent, Rates and Taxes 9.17 66.86 76.03 7.66 106.84 114.50 07 Publications 0 1.22 1.22 0 2.00 2.00 08 Advertising & Publicity 1.71 40.49 42.20 1.11 48.10 49.21 09 Grants-in-Aid 14.77 0 14.77 17.00 0.01 17.01

11 Subsidies 0 0 0 0 0.01 0.01 12 Scholarship and

Stipend 0.72 2.55 3.27 0.86 18.00 18.86

16 Major Works 0 0 0 0 0 0 17 Minor Works 0.67 0 0.67 0.35 0 0.35 18 Maintenance 0 0.25 0.25 0 0.01 0.01 19 Machinery & Equipment 9.38 33.74 43.12 7.75 37.52 45.27 21 Motor Vehicles 2.43 188.63 191.06 5.98 5.79 11.77 24 Materials & Supplies 4.59 125.62 130.21 4.45 470.16 474.61 25 Interest 0.88 2.66 3.54 0 0 0 33 PPSS 0.32 11.41 11.73 0.65 33.76 34.41 34 Other Charges 0.03 0 0.03 0.10 0 0.10 45 P.O.L. 33.00 60.38 93.38 60.25 103.67 163.92 46 Clothing, Tentage and

Stores 0.41 0.11 0.52 0.38 0.02 0.40

47 Stores & Equipment 0.21 44.55 44.76 0.21 44.23 44.44 49 FA Debit 7.07 28.91 35.98 0 0 0 49 FA Credit -19.83 -22.86 -42.69 0 0 0 59 Prizes & Awards 0.14 0.68 0.82 0.94 1.62 2.56 66 Medicines 324.33 245.84 570.17 328.44 418.56 747.00 67 Feeding/Dietary

Charges 0.02 0 0.02 0.02 0 0.02

68 Cost of Books 1.75 0.92 26.70 0.90 1.20 2.10 71 Printing Charges 48.99 0.04 49.03 46.00 0.11 46.11 72 Training 12.52 65.63 78.15 15.85 30.97 46.82 73 Transport 0.50 0.87 1.37 1.38 3.85 5.23 76 Computer &

Maintenance 0 2.80 2.80 0 0.40 0.40

Total 5476.35 16282.01 21758.36 6953.72 22027.48 28981.20 Statement showing the Financial Requirements for Public Health Schemes -

OBJECTIVE CLASSIFICATION (Rs. in lakhs)

Revised Estimate 2003-2004 Subjects Non-Plan Plan Total 01 Salaries 3880.88 10652.34 14533.22 02 Wages 0.40 1.11 1.51 03 Dearness Allowance 1853.63 5150.95 7004.58 04 Travel Expenses 130.58 532.19 662.77 05 Office Expenses 63.86 269.67 333.53 06 Rent, Rates and Taxes 7.89 118.21 126.10 07 Books & Publications 0 2.00 2.00 08 Advertising & Publicity 2.31 59.10 61.41 09 Grants-in-Aid 17.00 10.17 27.17 11 Subsidies 0 17.78 17.78 12 Scholarship and Stipend 0.79 18.00 18.79 17 Minor Works 80.49 0 80.49 18 Maintenance 0 0.25 0.25 19 Machinery & Equipment 6.15 7.53 13.68 21 Motor Vehicles 7.98 7.23 15.21 24 Materials & Supplies 6.05 438.66 444.71 25 Interest 0.04 0.30 0.34 33 PPSS 8.15 33.76 41.91 34 Other Charges 0.09 0 0.09 45 P.O.L. 60.25 125.37 185.62

46 Clothing, Tentage and Stores 0.19 1.46 1.65 47 Stores & Equipment 0.21 42.79 43.00 5900 Prizes & Awards 0.44 1.62 2.06 66 Medicines 328.44 542.59 871.03 67 Feeding/Diet Charges 0.02 0 0.02 68 Cost of Books 1.00 1.20 2.20 71 Printing Charges 46.00 0.11 46.11 72 Training 17.75 30.97 48.72 73 Transport Charges 1.38 3.89 5.27 76 Computer & Maintenance 0 0.40 0.40 Total 6521.97 18069.65 24591.62

STATEMENT SHOWING THE FINANCIAL REQUIREMENT OF PUBLIC HEALTH SCHEMES

(Rupees in lakhs) Actual 2002-2003 Budget Estimate 2003-2004 Revised Estimate 2003-2004 Schemes

Non-Plan Plan Total Non-Plan Plan Total Non-Plan Plan Total Direction and Administration 249.24 869.24 1118.48 333.47 1051.39 1384.86 278.39 998.32 1276.71

School Health Programme 541.67 0 541.67 616.16 40.00 656.16 608.97 40.00 648.97Tribal Sub Plan 0 63.72 63.72 0 74.90 74.90 0 69.30 69.30Health Sub Centres 0 9634.23 9634.23 0 12590.41 12590.41 0 10267.85 10267.85Prevention and Control of Diseases 3925.99 5518.11 9444.10 5069.70 7963.28 13032.98 4793.63 6345.59 11139.22

Prevention of Food Adulteration 203.54 1.46 205.00 227.53 9.50 237.03 224.14 9.50 233.64

Prevention of Air and Water Pollution 122.67 12.04 134.71 144.38 13.40 157.78 125.87 14.73 140.60

Health Statistics and Evaluation 139.65 0 139.65 179.79 0 179.79 161.09 0 161.09

Health Education and Publicity 103.67 2.71 106.38 146.18 3.14 149.32 120.05 4.36 124.41

Training 189.92 180.50 370.42 236.51 281.46 517.97 209.83 320.00 529.83Total 5476.35 16282.01 21758.36 6953.72 22027.48 28981.20 6521.97 18069.65 24591.62

DIRECTION AND ADMINISTRATION

(Rupees in lakhs) Actual 2002-2003 Budget Estimate 2003-04 Revised Estimate 2003-04

Scheme Non-Plan

Plan Total Non-Plan

Plan Total Non-Plan

Plan Total

2210-06-001-AA Headquarters Administration

178.60 0 178.60 242.99 0 242.99 200.51 0 200.51

2210-06-001-AG Directorate of Training & CE

70.64 0 70.64 90.48 0 90.48 77.88 0 77.88

2210-06-001-JAHeadquarters Administration

0 0.51 0.51 0 1.00 1.00 0 1.00 1.00

2211-00-001-SF Direction & Administration under CSSM & Sub Centres

0 868.73 868.73 0 1050.39 1050.39 0 997.32 997.32

Total 249.24 869.24 1118.48 333.47 1051.39 1384.86 278.39 998.32 1276.71

SCHOOL HEALTH PROGRAMME (Rupees in lakhs)

Actual 2002-2003 Budget Estimate 2003-2004 Revised Estimate 2003-2004 Scheme Non-

Plan Plan Total Non-

Plan Plan Total Non-

Plan Plan Total

2210-01-109-AA / JA School Medical Inspection 241.67 0 241.67 316.16 40.00 356.16 308.97 40.00 348.97

2210-01-109-AB Supply of Drugs through TNMSC 300.00 0 300.00 300.00 0 300.00 300.00 0 300.00

Total 541.67 0 541.67 616.16 40.00 656.16 608.97 40.00 648.97

SCHOOL CHILDREN HEALTH CAMP PROGRAMME

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 in first to twelfth standards.

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 checkup to the students thrice a year.

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 specialised treatment are referred to higher medical institutions. The referred cases of students are treated in the referral centres 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 sum of Rs.14.00 lakhs have been released for a massive training programme to these teachers. 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.

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 SMI teams, other local bodies and for referral centres for treating the referred case of school children.

To facilitate easy mobility of school medical teams and transport of referred cases of students a sum of Rs.21.00 lakhs have been released for POL charges. 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. For the current year up to March 2004 9112389 students were examined. Of them, 4695246 students were treated for one or other Health Problems and 46503 students were referred to Higher Medical Institutions for further treatment Morbidity pattern of school children under School Children Health Camp programme is as follows:

Primary, Middle, High and Higher Secondary

Schools 2002-2003 2003-2004 Sl.No. Particulars

Number % Number % 1. Total Number of Schools to be covered 40308 -- 40308 --2. Number of Schools covered so far

I visit II visit III visit

37117140921888

92.0834.964.68

35327

10786 1382

87.6426.763.43

3. Total Number of Students to be examined 9297206 -- 9297206

4. Number of Students examined so far I visit II visit III visit

72466982403253371148

77.9425.853.99

6719807 2101292 291290

72.2822.603.14

5. Number of Students treated for minor ailments

4946396 4695246

6. Morbidity Pattern a) Dental Carries 1047932 10.46 938014 1029 b) Worm Infestation 886818 8.85 878223 9.64 c) A.R.I. 1040153 10.38 1152967 12.65 d) Anaemia 325255 3.25 308389 3.38 e) Vitamin - A Deficiency 199080 1.99 174088 1.91 f) Scabies 145408 1.45 112248 1.23 g) Defective Vision 17568 0.18 14561 0.16 h) Ottitis Media 38387 0.38 31789 0.35 i) Leprosy 4565 0.07 4119 0.05 j) Defective Hearing 4238 0.04 4617 0.05 k) Rheumatic Heart Diseases 6190 0.06 3843 0.04 l) T.B. 8504 0.08 7998 0.09 m) Goiter 2093 0.02 4483 0.05

7. Number of students referred to Taluk Hospitals or any other referral Hospitals

72592 0.72 46503 0.51

PREVENTION AND CONTROL OF DISEASES

(Rupees in lakhs) Actual 2002-2003 Budget Estimate 2003-2004 Revised Estimate 2003-2004

Schemes Non-Plan

Plan Total Non-Plan

Plan Total Non-Plan

Plan Total

Plague Control Measures 26.19 0 26.19 26.68 0 26.68 26.39 0 26.39Epidemic Control Unit 52.52 0 52.52 71.52 0 71.52 151.16 0 151.16Epidemiological Unit 14.02 0 14.02 19.42 0 19.42 15.13 0 15.13Guineaworm Eradication Programme 3.85 0 3.85 2.81 0 2.81 4.24 0 4.24Cholera Combat Team 17.98 0 17.98 20.76 0 20.76 19.59 0 19.59Cholera Control Programme 0 19.63 19.63 0 23.39 23.39 0 22.09 22.09Malaria Rural and Urban, Japanese Encephalitis and Lab.Asst.in PHCs 0 4480.51 4480.51 0 6742.34 6742.34 0 5078.78 5078.78

Filaria Control 342.54 407.38 749.92 412.42 552.23 964.65 401.91 565.05 966.96Leprosy Control 3018.55 0 3018.55 3889.53 0 3889.53 3658.31 0 3658.31Surveillance for Epidemic Preparedness 41.02 111.53 152.55 49.92 148.77 198.69 78.26 141.28 219.54

Institute of Vector Control and Zoonoses, Hosur 0 50.79 50.79 0 62.20 62.20 0 56.69 56.69

Immunization 292.79 5.77 298.56 420.72 49.24 469.96 314.81 49.15 363.96Maternity and Child Health Services 113.07 0 113.07 152.07 0 152.07 120.19 0 120.19Prevention and Control of Goitre 0 4.06 4.06 0 5.83 5.83 0 4.74 4.74Care Assisted Feeding Programme 3.46 0 3.46 3.85 0 3.85 3.64 0 3.64Mobile Health Care/ Specialty Camps 0 423.46 423.46 0 354.40 354.40 0 402.09 402.09Leptospirosis 0 14.98 14.98 0 22.38 22.38 0 21.72 21.72Dengue Control 0 0 0 0 2.50 2.50 0 4.00 4.00

Total 3925.99 5518.11 9444.10 5069.70 7963.28 13032.98 4793.63 6345.59 11139.22 VECTOR BORNE DISEASE CONTROL PROGRAMME The Programme for the control of Vector Borne Disease, Malaria, Filariasis, Guinea Worm Eradication and Japanese Encephalitis are under implementation in the State of Tamil Nadu. The Director of Public Health and Preventive Medicine, Chennai is the Programme Director. He is assisted by the Additional Director of Public Health and Preventive Medicine (Malaria & Filaria) and Joint Director (VBDC) in the implementation of the Programme.

MALARIA SITUATION IN TAMIL NADU In Tamil Nadu State, during 90’s a total of 1,20,029 cases were recorded out of which 59.6% were recorded from the Urban areas and 40.4% in Rural. The coastal villages of Ramanathapuram, Paramakudi, Nagapattinam and riverine villages of Dharmapuri, Krishnagiri and Tiruvannamalai were endemic for Malaria. Due to the intensive control measures like active and passive surveillance, Vector control measures etc., taken up by the Public Health Department, the malaria case incidence has been drastically brought down to 34510 in 2002. At present the coastal villages of Nagapattinam, which were once endemic are almost free from Malaria. The incidence of Malaria in Tiruvannamalai shows a decreasing trend. However, Malaria is emerging as a problem in Ramanathapuram. The factors contributing for the persistence of Malaria in rural areas are:-

1) Numerous breeding places in the river beds, puddles, rocky pits, sandy pits, casuarinas pits, etc.,

2) Migration of the population for fishing (Ramanathapuram), as labourers for construction and as quarry workers to other endemic states.

3) Non-acceptance for indoor residual spray. Out of the total Malaria cases reported in the State, 78% are occurring in Chennai City and another 6% in Tuticorin, Erode, Vellore, Dindigul, Salem, Tiruchengode, Tiruvallur and Tiruvottiyur. The following problems attribute for the increase of Malaria in Urban areas.

1) Population migration in search of employment. 2) Lack of adequate water supply leading to storage of water for use, creating breeding source

of Malaria Vector. 3) Developmental activities especially construction of Buildings, over-bridges etc., 4) Non closure of wells, cisterns, overhead tanks etc., 5) Inaccessible overhead tanks causing hindrance to the anti-larval work.

CONTROL STRATEGY: The control strategies adopted in the Public Health Department are:-

1) Malaria case detection is being carried-out by house to house visit by collection of blood smears from fever cases and giving treatment for those who are found positive for Malaria.

2) Two rounds of residual insecticidal spray during transmission period using synthetic pyrethroids in Malaria endemic areas.

3) Passive surveillance and anti-larval work in Urban. 4) Creating awareness among the community for their participation. 5) Whenever imported cases are recorded, the same is cross notified by the concerned Medical

Officer to the respective Health Authorities of State for further remedial action at their end. 6) Mass and contact Blood survey are being carried out to prevent the occurrence of Secondary

cases in the low risk areas. 7) Whenever necessary, focal spray is being carried out.

In Tamil Nadu I.E.C. activities have made a great impact on surveillance, that more number of cases are being identified under passive surveillance than Active Surveillance. Geographical information system (GIS) is being developed in Tamil Nadu for carrying-out epidemiological mapping of the villages and for identifying vulnerable areas and seasonal pattern of disease outbreak. The incidence of Malaria for the past 4 years are furnished below:

YEAR CASES IN THE STATE CASES IN CHENNAI CITY 2000 43053 31861 2001 31551 23652 2002 34523 27205 2003 43396 29058

CONDUCTING ANTI MALARIA MONTH. It is necessary to intensify Malaria control activities. As part of effort on Malaria control activities, Anti-Malaria Month is observed every year with the object of: 1. Creating awareness among the Public

a. Educating the Mass on Malaria, its prevention and control. b. Develop intersectional co-ordination.

JAPANESE ENCEPHALTIS CONTROL PROGRAMME Japanese Encephalitis Control Programme has emerged as an important Public Health Problem in the State during the last few years. The incidence for the past 4 years are furnished below:

YEAR CASES DEATH. 2000 118 17 2001 119 18 2002 126 29 2003 180 24

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. J.E. Vector monitoring is being carried out regularly in the endemic districts. Residual insecticidal spray is being carried out in Villages where suspected J.E.,. cases reported along with fogging operations.

NATIONAL FILARIA CONTROL PROGRAMME

The National Filaria Control Programme is being implemented in Tamil Nadu since 1957. The filaria 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 filaria survey unit for delimitation of endemic areas after survey district by district. The scheme is financed by the Centre to the extent of 50% of the cost of larvicides, materials and equipments. 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 persons examined

No. positive for Mf.

Mf. Rate No. of disease case

Disease Rate

Endemicity Rate

1998 1136072 2254 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 417 0.04 251 0.02 0.06

01/04 to 3/04

273300 47 0.02 29 0.01 0.03

SINGLE DOSE MASS DEC DRUG ADMINISTRATION PROGRAMME: Initially Mass Chemotherapy Programme was conducted during 1996 in Cuddalore District. Under this Programme DEC tablets have been distributed to the people (except pregnant women and children below one year of age) of endemic districts viz., Cuddalore, Thanjavur, Tiruvannamalai, Vellore, Kancheepuram, Tiruvallur, Villupuram, Tiruvarur, Pudukottai, Nagapattinam, Tiruchirapalli and Kanyakumari and they have been encouraged to consume the tablets so as to prevent filaria. Based on this success, the programme was launched on a large scale during the year 1997-98. The single dose Mass DEC Programme was conducted in 12 endemic districts viz., Cuddalore, Thanjavur, Tiruvannamalai, Vellore, Kancheepuram, Tiruvallur, Villupuram, Tiruvarur, Pudukottai, Nagapattinam, Tiruchirapalli and Kanyakumari. A total of 239.21 lakhs population were covered under this programme by administration of DEC tablets. The second round of single dose Mass DEC Programme was implemented during 1998-99 in the same endemic 12 Revenue Districts covering a population of 252.74 lakhs for administration of DEC tablets. The third round of Mass Chemotherapy was implemented in the same 12 endemic districts covering 250 lakhs population during 1999-2000 and fourth round was conducted in March, 2001 in the above districts covering 260 lakhs population.

During the fifth round, Government of Tamil Nadu came forward to launch this COMBI

(Communication for Behavioural Impact), strategy of World Health Organisation, in all the thirteen endemic districts in order to improve the consumption level. However, due to financial constraints, the World Health Organisation came forward to assist Tamil Nadu only in the six districts where DEC and Albendazole are co-administered. During the sixth round in 2002 WHO provided Rs. 49.00 lakhs IEC materials, Rs.14.40 lakhs worth Albendazole tablets, for the six districts viz., Kancheepuram, Vellore, Tiruvannamalai, Tanjore, Nagapattinam and Tiruvarur.

The year wise achievements of the MDA Programme is furnished below:

Year Round Target Population (in lakhs)

Population covered (in lakhs)

Coverage %

Mf. Rate

1997-98 I 260.00 227.816 92.74 0.881 1998-99 II 264.00 237.679 94.04 0.326

1999-2000 III 268.30 242.080 93.16 0.176 2000-01 IV DEC 262

ALB 132 252 126

96.1 95.6

0.20

2001-02 V DEC 128.5 ALB 134.7

123.7 127.4

89.20 89.6

0.10

2002-2003 VI DEC 136.41 DEC+ALB

137.57

129.65 130.77

87.83 89.95

0.08

The VII round of DEC Mass Drug Administration will be held during September 2004. This

programme is to benefit approximately 29 million people (except pregnant women and children under 2 years of age)

INSTITUTE OF VECTOR CONTROL AND ZOONOSES, HOSUR

For Plague Surveillance activities,the Institute of Vector Control and Zoonoses,Hosur is made as Nodal agency.There exist of foci of sylvatic plague among rodents in wild animals in certain forest areas.Thereby posing a threat for possible spread to human beings.Therefore surveillance system is organised to catch 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 animals.

The infrastructure available at this institute is also utilized to conduct various training programmes,workshops and seminars.The institute is conducting P.G.Diploma course in Public

Health Entomology for 12 candidates in each batch every year,conduct pre-service and inservice training courses for Field Assistants /Lab.Assistants for about 80 candidates each year.

Recently, an Arbovirus antigen production laboratory is established at this Institute under part II schemes 1998-99 to prepare antigen required for the diagnosis of Arbovirus diseases such as Japanese Encephalitis and Dengue. In the GO Ms No.225/Health and Family Welfare Department dated 28/11/2002,Govt have accorded sanction for Rs.1.05 lakhs for starting M. Sc. (Medical Entomology) course at Institute of Vector Control and Zoonoses, Hosur in affiliation with Dr.M.G.R. Medical University from coming year onwards.

LEPTOSPIROSIS CONTROL PROGRAMME: Under part II schemes 2000-2001, Government have established seven leptospirosis clinics in the taluk and district headquarters hospitals of Madurai and Thiruvallur districts. For the early diagnosis ,treatment and control measures ,test kits have been procured and supplied to the above clinics and other districts reporting cases. The staff involved in the programme have been trained. The incidence of leptospirosis in Tamil Nadu from 1995 to 2003 are furnished below:

S.No Year Cases Deaths 1. 1995 651 - 2. 1996 606 - 3. 1997 1455 6 4. 1998 3006 11 5. 1999 1004 10 6. 2000 1801 3 7. 2001 2196 3 8. 2002 1232 - 9 2003 3629 8 10 Jan04 to March04 681 0

DENGUE CONTROL PROGRAMME: Government have issued orders for the establishment of 12 dengue clinics in the taluk and district head quarters hospitals of Nagercoil,Vellore,Dharmapuri and Coimbatore. But amendment is awaited for the functioning of these clinics. Special IEC activities are under progress in Chennai city under Malaria free chennai project to control dengue fever in chennai city.Necessary guidelines are communicated to all the health unit districts to avert outbreaks. The case details of dengue fever in Tamil Nadu from 1995 toMarch 04 are furnished below:

S.No Year Cases Deaths 1. 1995 549 6 2. 1996 491 16 3. 1997 264 21 4. 1998 128 5 5. 1999 135 2 6. 2000 81 1 7. 2001 816 8 8. 2002 376 1 9. 2003 1610 9

10. Jan04 to March04 145 -

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. The following are the preventive and control measures taken during 2003-2004 are furnished below:

WATER SOURCES CHLORINATED 54372

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 6 years:

A.D.D. Cholera Year Cases Deaths Cases Deaths 1998-99 77748 384 1691 1

1999-2000 69,824 164 1858 1 2000-2001 62405 172 1183 1 2001-2002 58733 160 1442 0 2002-2003 68528 187 1251 3 2003-2004 61800 63 409 1

National Iodine Deficiency Disorders Control Programme The National Iodine Deficiency Disorders Control Programme is implemented in Tamil Nadu State from 1991 and the State IDD Cell started functioning from 1.7.94 onwards. The objective of the programme is to identify the areas with Iodine Deficiency Disorders 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, 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 are being done to access 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 2003-2004 1489 non-statutory samples were lifted and analysed in the Food Analysis Laboratories. The result shows 3% samples confirmed Nil Iodine, 48% confirmed less than 15ppm Iodine and 49% confirmed more than 15 PPm Iodine. The Government have issued orders for sale of iodised salt through fair price shops by both Tamil Nadu Civil Supplies Corporation and Co-operatives in public distribution system at Rs.2.50 per kilo in pouches in all districts. A Workshop has been conducted on 5.6.2003 to disseminate the finding of the survey Conducted during 2002 to the state holders for awareness generation and preparation of plan of action for control of Iodine Deficiency Disorder in Tamil Nadu.

“Global IDD Day” has been celebrated on 21.10.2003 throughout Tamil Nadu for creating awareness among the community regarding Iodine Deficiency Disorder control in Tamil Nadu. In Tuticorin also IDD day was celebrated on 31.10.2003 involving the Salt Department, District Oficials and Unicef representatives and Salt Manufactures etc., to crate Awareness on the importance of usage of iodised salt.

GOITRE SURVEY: Details of Goitre Survey conducted in 29 Districts in Tamil Nadu as below:-

Sl.No District Year Total Examined Goitre Cases %

1 Ramanathapuram 2001 28821 3328 11.5 2 The Nilgiris 1999 19659 3273 16.6 3 Thiruvarur 1998 12496 1817 14.5 4 Salem 1999 46514 5802 12.5 5 Virudhunagar 2001 22369 1697 7.6 6 Villupuram 1999 44700 5376 12.0 7 Coimbatore 2001 33475 3401 10.2 8 Kanyakumari 1999 25243 2966 11.7 9 Dharmapuri 1999 65792 7576 11.5

10 Pudukkottai 1998 24603 2741 11.1 11 Namakkal 1998 12789 1338 10.5 12 Nagapattinam 1998 14185 1471 10.4 13 Erode 1998 22342 2321 10.4 14 Perambalur 1999 25240 2636 10.4 15 Tuticorin 2001 29245 2010 6.9 16 Thanjavur 1998 16337 1659 10.2 17 Chennai 1996 25483 2567 10.1 18 Thiruchirappalli 1999 33523 3362 10.0 19 Theni 1998 14549 1350 9.3 20 Thiruvannamalai 1999 48848 4563 9.3 21 Dindigul 1999 53719 4742 8.8 22 Vellore 1997 36331 3085 8.5 23 Kancheepuram 1997 21301 1680 7.9 24 Cuddalore 2000 45592 3547 7.8 25 Sivaganga 2003 22511 1435 6.4 26 Thiruvallur 2003 28528 1584 5.6 27 Thirunelveli 2003 26825 1700 6.3 28 Madurai 2000 42506 2687 6.3 29 Karur 2000 29614 1057 3.6

PREVENTION OF FOOD ADULTERATION

Tamil Nadu State is implementing the measures to control the adulteration of food by implementing the prevention of Food Adulteration Act 1954 and Tamil Nadu Prevention of Food Adulteration Rules, 1955. The whole state is notified for the purpose of implementation of Food adulteration Act and Rules and at present 481 Local Bodies are implementing the act. Food samples collected from the Local Bodies are analysed in 7 Food Analysis Laboratories situated at King Institute (Guindy), Coimbatore, Madurai, Thanjavur, Salem Palayamcottai and at Chennai Corporation. During the year 2003-2004 upto 4277 samples were analysed out of which 761 samples were found adulterated. The percentage of adulteration is 17.79 Prosecution were launched in 206 cases of adulteration. During the year 2003-2004 82 cases were convicted out of which 10 were fined and 72 were fined with imprisonment.

IMMUNISATION PROGRAMME

After Eradication of Small pox, World Health organisation launched Expanded Programme of Immunisation (EPI) against six Childhood diseases namely Diptheria, Pertusis (Whooping Cough), Tetanus, Measles, Poliomyelitis and childhood Tuberculosis.

Tamil Nadu started Immunisation programme against these six Vaccine Preventable

Diseases during 1978. Annually, around 13 Lakh pregnant women and 12 Lakh infants have been benefited by

Immunisation programme. Because of effective implementation of Immunisation Services, there is a drastic reduction in the incidence of vaccine preventable diseases.

The reported cases of Diptheria, Pertussis, Neonatal Tetanus and poliomyelitis are negligible. The incidence of measles is reduced less than thousand cases per year.

PULSE POLIO CAMPAIGNS:

As part of polio eradication activities, the state had conducted nine series of Pulse Polio

Immunisation campaigns during the period from 1995-96 to 2003-2004. Around 65 to 75 lakhs of under five year children, are covered with additional doses of Oral Polio Vaccine in each campaign involving various Departments and Voluntary Organisations.

In order to wipeout the circulation of wild poliovirus completely from the environment, the

State has planned to conduct an additional rounds of PPI on 4.4.2004 & Around 73 lakhs children were benefitted in that round campaign.

HEPATITIS B VACCINATION

During the current year, Hepatitis –B vaccination programme is being implemented in

Chennai Slum area and four districts namely, Virudhunagar, Ramnad, Madurai and Nilgiris. Around 2.20 lakhs infants will be benefited. The programme will be extended to other districts in a phased manner for protecting the children from Hepatitis B virus.

MMR & RUBELLA VACCINATION

MMR & Rubella vaccination programme is launched as a pilot project in 5 blocks namely

Anna Gramam (Cuddalore District), Jayakondam (Perambalur District), Anadipatti (Theni District), Kellpennathur (Thiruvannamalai District) and Anaicut (Vellore District). 25,000 children of 2 to 5 years and 20,000 adolescent girls of 10-15 years will be given MMR & Rubella vaccination respectively. This vaccination helps to prevent congenital deformity in newborn babies.

TAMIL NADU – IMMUNISATION PERFORMANCE 2001-2002 To 2003-04

(Fig in Lakhs) 2001-2002 2002-2003 2003-2004

S.N Vaccine T A % T A % T* A P.T % 1 T.T.M 12.73 13.41 105 12.87 13.05 101 12.81 12.55 98 2 D.P.T 11.58 12.52 108 11.7 12.08 103 11.64 11.87 102 3 Polio 11.58 12.53 108 11.7 12.09 103 11.64 11.88 102 4 B.C.G 11.58 12.77 110 11.7 12.2 104 11.64 11.99 103 5 Measles 11.58 12.18 105 11.7 12 103 11.64 11.52 99

Note: T - Annual Target, A - Achievement T* - Annual Target adopted as per G.O.I. P.T% - Proportionate percentage to target.

REPORTED INCIDENCE OF V.P.D CASES IN TAMILNADU

2001 2002 2003 S.No. DISEASE C D C D C D 1 DIPTHERIA 1 0 1 0 4 2 2 PERTUSIS 0 0 0 0 0 0 3 TETANUS(NEO) 1 0 3 0 2 2 4 TETANUS(OTH) 4 2 2 1 0 0 5 POLIO 0 0 0 0 2 0 6 TB(CHILD) 757 8 262 1 156 0 7 MEASLES 488 0 512 0 699 4

C- Cases D- Death Activities of Water Analysis Laboratories at Guindy and Coimbatore: 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 collector visit all the protected water supply systems and collects 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. Special field investigations are also carried out wherever problems in water supplies arise like 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 three years from 2000-2001 to 2002-2003(upto January 2003) is furnished below: Physical achievement for the past Three Years

Sl. No. Item 2001-2002 2002-2003 2003-2004

1 Total No. of Samples received and tested in connection with the periodical examination of protected water supply

25426 11033 28740

2 Total Number of water samples received from Rural Water supply 98 349 669

3 New Water supplies included under periodical examination 5 - 10

4 Total Number of samples of Water etc. tested for Bacteriological Physical and Chemical examinations

27007 15613 18569

5 Number of field investigations etc. carried out 12 22 27

PREVENTION OF FOOD ADULTERATION (Rs. in lakhs)

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)

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) 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)

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

Maternal and Child Health Services: Maternity and Child Health Services in the rural area are rendered through a network of 8682 Health Sub-Centres attached to 1412 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. The following recurring and non-recurring expenditure are sanctioned towards the running of each Health Sub-Centre besides the salary of Village Health Nurse as per Government scale of pay. 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.

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

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

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) 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 02211-00-101-SC Sub Centres 0 8006.16 8006.16 0 8980.16 8980.16 0 8473.23 8473.232211-00-793-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) Actuals 2002-2003 Budget Estimate 2003-2004 Revised Estimate 2003-2004Scheme

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

STATE BUREAU OF HEALTH INTELLIGENCE 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:

% 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)

Actual 2002-2003


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 Achieve ment % Target Achieve

ment % Target Achieve ment %

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.

CHAPTER - 5

FAMILY WELFARE PROGRAMME

Tamil Nadu is the forerunner in the implementation of Family Welfare Programme all over the country. Family Welfare Programme is implemented as a people’s programme involving the active co-operation and participation of the community at large. The main aim of the programme is to bring down the fertility through improving maternal and child health care by bringing down Maternal and Infant Mortality Rate in the State. Under “community needs Assessment Approach” followed now the needs of the community have to be assessed based on the requirements of the people in the implementation of Family Welfare and Maternity Child Health Programmes. Demographic Scenario: The Demographic Scenario of Tamil Nadu compared with India is as follows

CURRENT LEVEL Sl. No. INDICATORS

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

7. Crude Birth Rate (per 1000 population) 18.5 25.0 8. Crude Death Rate (per 1000 population) 7.7 8.1 9. Infant Mortality Rate (per 1000 live births) 44 64 10. Natural Growth Rate (%) 1.08 1.69

Source: SRS 2002 The Infrastructure facilities under Family Welfare programme:-

The Family Welfare and Maternity & Child Health Services are provided to the Eligible couples in the state, both rural and urban areas, through the following Governmental, Voluntary and Private Medical Institutions.

1 Primary Health Centres 1413 2 Health Sub-centres 8682 3 Rural Family Welfare Centres 382 4 Post Partum Centres 118 5 Urban Family Welfare Centres 101 6 Urban Health Posts 198 7 Voluntary Organisations 27 8 Private Approved Surgeries 1308

The Directorate of Family Welfare is incharge of implementing the Family welfare Programme in

this State. At the District level, the Deputy Director of Medical and Rural Health Services and Family welfare is implementing the Family welfare Programme with the co-ordination of Deputy Director of Health Services in the overall supervision of Joint Director of Health Services.

Impact of Family Welfare Programme: 1. Couple Protection Rate (as on 31st March 2003) 50.3 %

2. Sterilisation acceptors with two and less than two living children 2003-2004 67.8 %

3. Percentage of Higher Order Births (2002) 20.2 %

4. Mean age at acceptance of sterilisation (2002-03) 26.9 Years

5. Mean number of living children to the sterilisation acceptors (2002-03) 2.5

Physical performance:-

The district wise Performance on Family Welfare in Tamil Nadu for 2003-2004 is furnished below.

ACHIEVEMENT UNDER FAMILY WELFARE PROGRAMME FOR 2003-2004

SI.No. District Sterilisation I.U.D. O.P.Users C.C.Users 1 Chennai 54402 55379 15477 32667

2 Coimbatore 26218 23147 9386 13598 3 Cuddalore 17096 18290 9250 11408 4 Dharmapuri 20489 15753 8333 8037 5 Dindigul 15380 14786 6275 6064 6 Erode 17583 15696 6541 9300 7 Kancheepuram 15879 13138 4714 5154 8 Kanyakumari 10437 11273 5258 5263 9 Karur 4775 7350 2947 2425 10 Madurai 20255 19942 8276 10112 11 Nagapattinam 6745 11912 4065 4336 12 Namakkal 9286 11777 4272 6590 13 Perambalur 6252 6817 2843 2633 14 Pudukkottai 8311 12740 5009 5550 15 Ramanathapuram 7607 8692 5404 5573 16 Salem 23455 19051 5341 7569 17 Sivagangai 7550 7247 4081 4858 18 Thanjavur 14289 18254 7838 7251 19 The Nilgiris 4750 4525 1194 1608 20 Theni 8566 7131 2598 2598 21 Thiruchirapalli 12088 14492 4130 3375 22 Thirunelveli 18409 19569 7708 9341 23 Thiruvallur 12096 11661 4806 5809 24 Thiruvannamalai 16044 15938 5737 6185 25 Thiruvarur 6955 10063 4444 4351 26 Thoothukudi 10932 10732 5128 3849 27 Vellore 24739 18768 7847 8618

28 Villupuram 16742 21227 7571 10621 29 Virudhunagar 12120 12223 5343 6896

Total 429450 437573 171813 211636 PERFORMANCE UNDER MEDICAL TERMINATION OF PREGNANCY

2003 - 2004 S.No. Name of the District No. of Institutions Performance 1 Chennai 94 13395 2 Coimbatore 49 2969 3 Cuddalore 33 3815 4 Dharmapuri 44 2590 5 Dindigul 34 3882 6 Erode 54 1661 7 Kancheepuram 78 2093 8 Kanyakumari 37 1542 9 Karur 19 1308 10 Madurai 66 3912 11 Nagapattinam 18 167 12 Namakkal 19 2609 13 Perambalur 5 418 14 Pudukkottai 37 1049 15 Ramanathapuram 33 731 16 Salem 25 6910 17 Sivagangai 45 763 18 Thanjavur 19 2493 19 The Nilgiris 9 684 20 Theni 18 893 21 Thiruchirappalli 37 2706 22 Thirunelveli 77 3977 23 Thiruvallur 52 1375 24 Thiruvannamalai 22 1262 25 Thiruvarur 18 856 26 Thoothukudi 27 1122 27 Vellore 46 3046 28 Villupuram 23 1945 29 Virudhunagar 55 858 Total 1093 71031

Information, Education and Communication: Govt. of India has released a sum of Rupees206.16 lakhs for implementation of IEC/BCC (Behaviour Change Communication) activities in Tamil Nadu for the year 2003-2004. Based on the allocation of funds by the Govt. of India it has been decided to spend/proposed to be spend as follows:

Activities Rs. in Lakhs 1. District Level activities 94.702. State Level activities 111.46 Under District level activities the amount is apportioned for Maintaining MSS and other IEC activities, Observance of World Population Day in all the Districts, Local BCC in Rural and Urban areas. Following is the action Plan for State Level IEC.

S.No. Details of activities Allotted amounts in Lakhs (Rupees)

1. For dissemination of FW & RCH Messages through Prasar Bharathi, Private 40.00

2. For settlement of pending bills for the dissemination of FW & RCH messages during the period from March’03 to October’03 20.00

3. For capacity building on BCC activities through Regional family Welfare Training centres 10.00

4. For participating in Exhibitions at State & District levels 5.00

5. For organising Workshops, Seminars and Conferences etc. at State & Dist. Levels 5.00

6. For having observed World Population day on 11.7.03 2.46

7. For dissemination of Family Welfare & RCH Messages through traditional Media like drama, Folk songs etc. 10.00

8. For creation of Proto type danglers table top calendars conversion of VHS into CD and Purchase of VCD/Players printed materials etc.

11.00

9. For Evaluation of IEC activities 3.00 10. Miscellaneous 5.00

Total 111.46 FAMILY WELFARE PROGRAMME - OBJECTIVE CLASSIFICATION

(Rs. In thousands)

Sl.No Details Actual 2002-2003


Revised Estimate2003-2004

STATE PLAN 01 Salaries 267725 16 81528 03 D.A 115690 2 38586 04 Travel Expenses 8900 4 402 05 Office Expenses 1963 4 558 06 Rent Rates&Taxes - - - 08 Advertising - - - 09 Grants-in Aid 95239 92239 92239 10 Insurance Premium - - 6300 17 Minor works 50 - 0 19 Machinery and Equipments 119 2501 2501 21 Maintenance of functional vehicles 679 2 220

33 Payments for Professional and Special Services - - 4

42 Service Commitment Charges 2940 - - 45 Petrol oil & Lubricants 3723 2 1446 46 Clothing,Tentage & Stores 365 2 136 49 Festival Advances - 2 860 51 Compensation - - 44 59 Prizes and Awards 5 2 5 66 Medicines 6125 6125 6125 72 Training 101 - -

76 Purchase - - - 77 Deduct Recoveries - -2 -860 Total 503624 100899 230094

FAMILY WELFARE PROGRAMME - OBJECTIVE CLASSIFICATION

(Rs. In thousands)

Sl.No Details Actual 2002-2003


Revised Estimate2003-2004

CENTRALLY SPONSORED 01 Salaries 48879 72590 53811 03 D.A 20734 40653 24835 04 Travel Expenses 2174 2314 2316 05 Office Expenses 2565 2943 3095 06 Rent Rates&Taxes 471 560 560 08 Advertising 7433 1 20829 09 Grants-in-aid 111264 138300 138300 10 Contribution 3755 4500 4500 19 Machinery and Equipments 0 0 0 21 Maintenance of functional vehicles 215 330 330 24 Materials & Supplies 55115 50000 50000

33 Payments for Professional and Special Services 154 35 35

42 Service or Commitment Charges 885 2 26 45 Petrol oil & Lubricants 2419 2677 2846 46 Clothing, Tentage & Stores 330 145 142 49 Festival Advances 0 682 679 51 Compensation 86313 124154 124230 59 Prizes and Awards 3 27 27 66 Medicines 45981 132678 97126 67 Diet charges 0 0 0 72 Training 0 0 0 73 Transport charges 0 0 0 77 Deduct Recoveries 0 -682 -679 Total 388690 571909 523008

CHAPTER - 6

DRUGS CONTROL ADMINISTRATION

The Director of Drugs Control is the Head of Department and he is the Controlling and Licensing Authority for the Drugs Manufacturing Units in Tamil Nadu. He is assisted by One Joint Director, Three Deputy Directors and One Assistant Director (Administration) in the Directorate, in matters relating to General Administration, Monitoring the activities of enforcement wing, issue of Licences to Drugs and Cosmetics Manufacturing Units in Tamil Nadu. There is a Legal-cum-Intelligence Wing to process legal matters and for taking up special investigations. It is headed by a Deputy Director of Drugs Control who is assisted by a Legal Adviser.

The State has been divided into 13 Zones and each zone is headed by an Assistant Director of Drugs Control who is the Licensing Authority for the Grant and Renewal of Sales Licences in their Zones. A Mobile Squad at Madurai headed by an Assistant Director of Drugs Control is functioning for attending to the complaints relating to Spurious Drugs. A Drugs Testing laboratory is functioning at Chennai for testing the samples of Drugs and Cosmetics drawn by Drugs Inspectors.

The Department of Drugs Control Administration has the following Staffs:

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 Inspectors 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

Drugs Testing Laboratory, Chennai has the following Staffs: Sl No Name of the Post No. of Posts

1 Government Analyst 01 2 Deputy Government Analyst 02 3 Senior Analyst 15 4 Junior Analyst 24 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

The King Institute, Guindy, Chennai has the following Staffs for the purpose of testing Schedule 'C' & 'C1' Drugs:

Sl No Name of the Post No. of Posts

1 Deputy Director 01 2 Assistant Professor 01 3 Chief Chemist 01 4 Chemical Assistant 02 5 Junior Assistant 01 6 Typist 01 7 Technician Grade-I 02 8 Technician Grade-II 01 9 Office Assistant 03 TOTAL 13

ACHIEVEMENTS DURING 2003-2004:

This directorate has drawn number of samples of drugs and specific instructions were also issued

to the Inspectors for the drawal of samples with reference to antibiotics etc., The samples drawn were sent for analysis as per the provision of Drugs and Cosmetics Act and based on analytical reports both administrative and legal action have been taken against the persons, based on the merit of each case. Accordingly this directorate has given sanction to prosecute 10 manufacturers / dealers for having manufactured and supplied Not of Standard Quality Drugs.

Further, this directorate has also cancelled the licence in respect of the product of two manufacturers, which have been reported as Not of Standard Quality. The drug licences of 37 manufacturers were suspended for the product reported as Not of Standard Quality.

This directorate is carrying out surprise inspections of manufacturing units by the Inspectors of

the intelligence wing and based on the inspection report the licences of five licensee's were directed to stop production and distribution of drugs as per Rule 85(2) of Drugs and Cosmetics Rules 1945.

Based on specific pattern of drawal of samples, by the Inspectors, this directorate was able to detect the movement of spurious drugs in the market and was able to limit the supply of such drugs in the market. This detection was carried out at an early stage itself and almost entire stock manufactured and supplied have been seized, further investigation is under process.

This directorate has also detected manufacture of drugs without licence by two manufacturers and legal action is being initiated against them. This directorate is also closely watching the activities of the Blood Bank and in the process one Hospital running a Blood Bank without licence was detected and sanction has been accorded for the prosecution of the same. Further the sale of CPD Blood Bags required to operate a Blood Bank was also monitored and accordingly one Stockiest of Blood Bag was prosecuted for contravention of Drugs & Cosmetics Act 1940.

Four cases under Drugs and Magic Remedies (Objectionable Advertisement) Act have been detected for having caused objectionable advertisement (1) for the treatment of Asthma, Sinus, Smoke and Dust Allergy; (2) for the treatment of crambs, Menses too late; (3) for the cure of disorder of Mensterual Flow and for having advertised for the treatment of Sexual Potency and (4) for having

stocked material with objectionable advertisement attracting the provisions of Drugs and Magic Remedies (Objectionable Advertisement) Act.

This directorate is also conducting surprise inspections of all the Sales Concerns to detect (1) the

sale of habit forming drugs (i.e.) Calmpose, Fortwin, Altrox; (2) to detect the sale of Physician Samples; (3) to detect the sale of date expired drugs; (4) to detect the sale of drugs without bills; (5) to detect the sale of drugs without licence; (6) to detect the sale of drugs without the supervision of qualified person and from these above categories this directorate has given sanction of prosecution to prosecute 150 Individuals / Concerns. Thus this directorate is taking every steps to enforce the Drugs & Cosmetics Act and Rules in public interest

Financial requirements: (Rupees in Lakhs)

Revised Estimate for 2003-2004 Sl No

Sub-Head of Account Non-Plan Plan TOTAL

2210-06-104

1 AA - Administration of Drugs Act 1940 344.67 - 344.67 2 AB - Administration of Drugs Act 1940 King Institute,

Guindy. 13.20 - 13.20

3 AC - Establishment of Drugs Testing Laboratory. 76.70 - 76.70 4 AD - Intelligence Wing of the Drugs Control Administration. 10.71 - 10.71 5 JA - Establishment of Drugs Testing Laboratory. - 9.25 9.25 6 JB - State Drug Control Administration - 2.00 2.00 TOTAL 445.28 11.25 456.53

Summary of work carried out by the Drugs Control Administration in Tamil Nadu during the period

from 2000-2001 to 2003-2004 (Upto 31-01-2004)

Sl. No.

Details of Inspection 20 00 - 20 01 - 20 02 - 20 03 - 20

1. Number of Inspections of Sales Concerns 42692 40193 36355 249612. No. of Inspections of Manufacturing Concerns 2405 2708 1980 15333. No. of Inspections of Hospitals and Medical

Stores. 617 591 521 503

Details of Licences Issued/Renewed/Cancelled

1. Sales Licences Granted 3023 3140 3396 31302. Sales Licences Renewed 11460 11745 8307 60393. Manufacturing Licences Granted 191 173 162 1064. Manufacturing Licences Renewed 550 588 563 1745. Licences Granted for Manufacturing Ayurvedic,

Siddha and Unani. 47 44 49 20

6. Homoeopathic Licences Granted 2 1 - -

Details of Samples Tested (as on 31-01-2004) 1. No. of Samples Tested 3828 3959 4149 33412. No. of Samples declared as Standard Quality 3313 4607 3798 29963. No. of Samples declared as Not of Standard Quality. 515 352 351 345

No. of Sales Concerns (as on 31-01-2004) 33354 32345 34099 35729

List of Manufacturers in Tamil Nadu as on 31-01-2004

Type of Licences Allopathic Medicine

Indian Medicine

Homeopathic Medicine

Cosmetics

a. Regular Licences 668 558 7 183 b. Loan Licences 334 35 - 2 c. Repackers Licences 20 - - -

TOTAL 1022 593 7 185 Details of Prosecution Launched:

Details of Inspection

2000

-200

1

2001

-200

2

2002

-200

3

2003

-200

4 (u

pto

31-0

3-20

04)

1. Total No. of Prosecutions sanctioned 106 70 194 150(a) No. of Prosecutions sanctioned under the Drugs & Cosmetics Act 1940.

103 65 192 146

(b) No. of Prosecutions sanctioned under the Drugs & Magic Remedies (Objectionable Advertisements) Act 1954.

01 05 02 04

(c) No. of Prosecutions under Drugs Price Control Order. 02 - - -

(d) No. of Prosecutions under Narcotic Drugs & Psychotrophic Substances Act.

- - - -

Blood Bank Licences as on 31-03-2004 .. .. 214

OBJECTWISE CLASSIFICATION: (Rs. in Lakhs)

B.E.2003-04 R.E.2003-04 Detailed Head Non-Plan Plan Total Non-Plan Plan Total

01 Salaries 289.33 - 289.33 277.40 - 277.4002 Wages 0.10 - 0.10 0.10 - 0.1003 Dearness Allowances 153.30 - 153.30 127.97 - 127.9704 Travel Expenses 5.45 - 5.45 5.45 - 5.4505 Office Expenses 8.65 - 8.65 11.80 - 11.8006 Rent, Rates & Taxes 10.89 - 10.89 11.17 - 11.1708 Advertising & Publicity 0.02 - 0.02 0.02 - 0.0219 Machinery & Equipments 2.00 9.25 11.25 3.50 9.25 12.7521 Motor Vehicles 0.10 - 0.10 0.10 - 0.1024 Materials & Supplies 4.50 - 4.50 4.50 - 4.5033 Payment for Professional & Special Service

0.05 - 0.05 0.05 - 0.05

45 Petroleum, Oil & Lubricants 0.69 - 0.69 0.69 - 0.6949 Festival Advance - Credit 3.26 - 3.26 3.31 - 3.3149 Festival Advance - Debit -3.26 - -3.26 - 3.31 - - 3.3159 Prizes & Awards 0.06 - 0.06 0.06 - 0.0666 Medicines 2.01 - 2.01 2.01 - 2.0168 Cost of Books/Note Books/Slates etc.,

0.46 - 0.46 0.46 - 0.46

76 Computer & Accessories - 2.00 2.00 - 2.00 2.00TOTAL 477.61 11.25 488.86 445.28 11.25 456.53

CHAPTER - 7

INDIAN MEDICINE AND HOMOEOPATHY

The Indian Systems of Medicine & Homoeopathy continue to be widely used due to their accessibility, efficacy and affordability. The Indian medicine system is also embedded in the beliefs of a wide section of the public and continues to be an integral and important part of their lives and for some, it is also a way of life. Complementary and Alternative Medicine or Traditional Medicine is rapidly growing worldwide. In India also, there is resurgence of interest in Indian Systems of Medicine. People are becoming concerned about the adverse effects of chemical based drugs and the escalating costs of conventional health care. Longer life expectancy and life style related problems have brought with them an increased risk of developing chronic, debilitating diseases such as heart disease, cancer, diabetes and mental disorders. Although new treatments and technologies for dealing with them are plentiful, nonetheless more and more patients are now looking for simpler, gentler therapies for improving the quality of life and avoiding problems of toxicity. Ayurveda, Homoeopathy, Siddha, Unani, Yoga and Naturopathy offer a wide range of preventive, promotive and curative treatments that are both cost effective and efficacious. There is a need for ending the long neglect of these systems in our health care strategy. Budgetary support has been augmented

The department is dealing with (a) Teaching in UG and PG course and (b) providing health care in District, taluk and Non-taluk and Primary Health Centre level in Siddha, Ayurveda, Unani, Homoeopathy, Naturopathy & Yoga (c) Research (d) Production, Standardization and quality control of drugs and (e) Production Standardization and quality control of herbs. Staff Strength The total number of personnel employed under the Indian Medicine and Homoeopathy Department is furnished below:

1 Medical Personnel 969 2 Nursing Personnel 91 3 Pharmacists 632 4 Ministerial Staff 225 5 Nursing Asst./Hospital Worker 674 6 Others 444 Total 3035

Old age Pension to Hereditary Siddha Medical Practitioners:

Old age pension of Rs.500/- per mensem is being sanctioned to the Hereditary Siddha Medical Practitioners who have attained the age of 60 years whose annual income is less than Rs.6000/-. About 840 persons have been benefited under this scheme and an amount of Rs.38.00 lakhs has been allotted for the purpose during 2004- 2005. District Siddha Medical Offices at District Level: District Siddha Medical Office has 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 Centres, 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. MEDICAL EDUCATION Government Siddha Medical College and Hospital, Palayamkottai The Government Siddha Medical College at Palayamkottai was started in the year 1964. The following courses are offered in the Government Siddha Medical College with its 250-bedded Hospital facility.

Sl. No.

Name of the Course No.of seats

Under Graduate

Post Graduate

Total

1. UG - BSMS 100 100 - 100 2. PG- MD (Siddha) 60 - 60 60 Distribution for MD (S) 1. General Category 51 seats 2. Special Category i. Central Pool 1 ii. Union Territory

(other than Delhi) 1

iii. Refugee studentwho is not native of Tamil Nadu

1

iv. Son/Daughter of Central Govt. Employee Service in the State of Tamil Nadu

1

v. Foreign candidate like Sri Lanka, Singapore, Malaysia

5

Total 60

Distribution of branches in MD (Siddha):

Sl.No. Name of the Branches No.of seats allotted 1 Gunapadam 12 2 Maruthuvam 14 3 Sirappu Maruthuvam 7 4 Kuzhanthai Maruthuvam 7 5 Noi Nadal 10 6 Nanju Noolum Maruthuva Neethi Noolum 10 Total 60

BSMS COURSE:

In BSMS Course 1925 candidates ( M - 1118; F - 807) have successfully completed the course so far. Total strength in BSMS course as on 1.1.2004 is 467 (M- 127 & F- 340)

MD (Siddha)

Total strength in M.D (S) Course as on 1.1.2004 is as follows:

Name of the Course Total No.of Students as on 1.1.04 MD (Siddha) Male Female Total Gunapadam 11 9 20 Maruthuvam 10 24 34 Sirappu Maruthuvam 6 10 16

Kuzhanthai Maruthuvam 9 9 18 Noi Nadal 12 15 27 Nanju Noolum Maruthuva Neethi Noolum 13 14 27

of the abvoe, the following 2 Post Graduate courses are implemented under Centrally Sponsored Scheme from the academic year 1996-97.

1. Sirappu Maruthuvam 2. Kuzhanthai Maruthuvam

M.D (Siddha)

The details of candidates who have completed the course as on 1.1.2004 are given below:

Name of the Course Male Female Total Maruthuvam 79 58 137 Gunapadam 79 32 111 Sirappu Maruthuvam 23 10 33 Kuzhanthai Maruthuvam 25 11 36 Noi Nadal 17 15 32 Nanju Noolum Maruthuva Neethi Noolum 4 8 12

Total 227 134 361 Hostel:

The number of inmates in the College Hostel for last six years are as follows:

Year No.of rooms available

Male No.of rooms available

Female Total

1998-1999 68 88 60 276 364 1999-2000 68 103 60 294 397 2000-2001 68 140 60 294 434 2001-2002 68 99 60 263 362 2002-2003 68 110 67 256 366 2003-2004 68 95 67 255 350

Government Siddha Medical College, Chennai:

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 1.1.2004 is 281. (63 Boys and 218 Girls). 642 students (M- 256; F-386) have passed out in BSMS Degree course from the College as on 1.1.2004. The Government have sanctioned the starting of 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) were 28 (15 Male and 13 Female) in Maruthuvam and 25 (12 Male and 13 Female) in Gunapadam as on 1-1-2004.

The No.of students passed out in PG Course is given below:

Branch Male Female Total Maruthuvam 11 7 18 Gunapadam 15 7 22

Total 26 14 40

The No. of inmates in the Govt.Siddha Medl.College Hospital, Chennai are furnished as follows:

Year No.of rooms available

Male No.of rooms available

Female Total

1999-2000 10 38 30 138 176 2000-2001 10 38 30 156 194 2001-2002 10 43 30 154 197 2002-2003 10 36 30 161 197 2003-2004 10 38 35 189 227

Government Homoeopathy Medical College and Hospital, Thirumangalam

The Government Homoeoathy Medicla College had been started at Madras in 1975 and subsequently it was transferred to thirumangalam.Five and half years duration of BHMS Degree course including one year internship is offered at Government Homoeopathy Medical College, Thirumangalam from1985-86 with an annual intake of 50 students. 20 acres of land in Maravankulam Village near Thirumangalam in Madurai District has been assigned by Government for the purpose of construction of buildings for this College and Hospital in August’96.

(a) The total strength of the College as on 1.1.2004 is 275 in BHMS course (77 boys and 198 girls). (b) 218 DHMS candidates and 307 BHMS candidates (M-118; F-189) have passed out from the

college as on 1-1-2004. (c) The number of women inmates accommodated in the College Hostel as on 1.1.2004 is 57.

Government Unani Medical College, Chennai: The Government Unani medical College was started in 1977 at Madras. Five and half years duration of BUMS Degree course including One year internship is being offered at Government Unani Medical College, Chennai from 1986-87 with an annual intake of 16 students. The number of seats have been increased from 16 to 26 from the academic year 1998-99. The College continues to function in the campus of Arignar Anna Government Hospital of Indian Medicine, Chennai. Its total strength is 117 (Boys 62 and Girls 55). The number of candidates passed out of the College as on 1-1-2004 is 262 (M-115; F-147).

The Govt.of India had released an amount of Rs.15.00 lakhs for construction of the 1st Floor as the 2nd instalment. The building will be completed. Government Yoga and Naturopathy Medical College, Chennai:. The Govt. Yoga and Naturopathy Medical College is functioning at the campus of the Arignar Anna Govt. Hospital of Indian medicine, Chennai with an annual intake of 10 students from the academic year 2000-2001. The total strength of students of the college as on 1.1.2004 is 35 (16-Male; 19-Female).

Admission for BSMS, BAMS, BHMS & BNYS Courses at Private Indian System of Medicine Colleges: There are 3 Siddha Private Medical Colleges, 5 Ayurveda Private Medical Colleges and 8 Homoeopathy Private Medical Colleges and 3 Private Yoga and Naturopathy Colleges functioning in this State and the annual intake of the colleges is as follows:

I.SIDDHA

Sl.No. Name of the Institution Annual intake 1 Sri Sairam Siddha Medical College, Poonthandalam, Sriperumpudur. 30 2 Akila Thiruvithancore Siddha Vaidya Kalloori, Munchirai 30 3 Velumail Siddha medical College & Hospital, Sriperumpudur 30 TOTAL 90

II.AYURVEDA

Sl.No. Name of the Institution Annual intake 1 The Venkataramana Ayurveda College, Korattur, Chennai 30 2 Dharma Ayurveda Medical College at Sriperumpudur 30 3 Ayurveda College, Coimbatore , Coimbatore 30 4 Sri Sankara College of Ayurveda, Thirucuirappalli 30 5 Sri Sairam Ayurveda Medical College and Research Centre, Poonthandalam,

Sriperumbudur 30

Total 150 III. HOMOEOPATHY

Sl.No. Name of the Institution Annual intake 1 White Memorial Homoeopathy Medical College, Attoor, Kanyakumari

Distric 50

2 Dr. Hanemam, Homoeopathy Medical College & Research Centre, Rasipuram, Salem District

50

3 Venkateswara Homoeopathy Medical College, Porur, Chennai 50 4 Saradha krishna Homoeopathy Medical College, Kulasekaram, Kanyakumar

District 50

5 Nethra Homoeopathy Medical College, Kalapatti village, Coimbatore 50 6 Sri Sairam Homoeopathy Medical College and Research Centre,

Poonthandalam, Sriperumbudur 50

7 R.V.S.Homoeopathy Medical College, Sulur, Coimbatore 50 8 Tamil Nadu Homoeopsthy Medical College, Salem 50 TOTAL 400

IV. YOGA AND NATUROPATHY

Sl.No. Name of the Institution Annual intake 1 Sri Rama Krishna Yoga & Naturopathy College,

Kulasekaram, Kanyakumari. 50

2 J.S.S.College, udagamandalam offering BNYS Course 60 3 Tamil Nadu College of Naturopathy & Yoga Research Institute, Salem 40 TOTAL 150 TOTAL SEATS (Siddha, Ayurveda, Homeopathy and Yoga 790

The Government have also given permission for starting the following Siddha, Ayurveda and

Homoeopathy Medical Colleges. These colleges are yet to be recognised by the Councils concerned.

Sl. No.

Name of the College Imparted Course

Duration of the course

Annual Intake

1 Siddha R.V.S. Siddha Medical College, Sulur, Coimbatore

B.S.M.S

5 ½ years

30

2

Ayurveda R.V.S. Ayurveda Medical college, Sulur, Coimbatore

B.A.M.S

5 ½ years

30

3

HOMOEOPATHY Thai Mookabigai Homoeopathy Medical College, Mugappaier, Chennai.

B.H.M.S.

5 ½ years

50

4

Yoga & Naturopathy Dr.C.Anbarasu Yoga and naturopathy Medical College, Goodapakkam village, Poonthamallee.

B.N.Y .S.

5 ½ years

20

The Government have declared White Memorial Homoeopathy MedicalCollege, Attoor, Kanyakumari District as Minority Institution for admission purposes. The Government have brought the admission of students in the private Siddha, Ayurveda, Homoeopathy and Yoga & Naturopathy Medical Colleges within the purview of the Government for BSMS, BAMS, BHMS and BNYS courses under both free seat and payment seat categories as per the direction of the Supreme Court of India. The Government have also regulated and prescribed fee structure for BSMS, BHMS, BAMS & BNYS courses for free seat and payment seat categories in the private Siddha, Ayurveda, Homoeopathy and Yoga & Naturopathy Medical Colleges. 60% of the total seats in self Financing Non Minority ISM Medical Colleges and 40% of the total seats in self Financing Minority ISM Medical Colleges will be filled by the Selection Committee through single window System.

Diploma course in Siddha Physiotherophy: Government have also permitted the Saseedharan Institute for Development of Herbs and Marmum for starting two years Diploma course in siddha Physiotheraphy of Thokkanam and Varmam at Mecode, Kaliakavillai,Kanyakunmari District with an annual intake of 40 students. MEDICL RELIEF: Arignar Anna Government Hospital of Indian Medicine, Chennai: The Out Patient and In Patient treatment facilities in four systems of medicine i.e., Siddha, Ayurveda, Unani and Homoeopathy is available at Arignar Anna Government Hospital of Indian Medicine, Chennai with 120 Siddha, 55 Ayurveda and 54 Unani beds under one roof. This Institution serves as teaching hospital for Government Siddha Medical College, Chennai and Government Unani Medical College, Chennai. 7 Government Siddha Dispensaries attached to Arignar Anna Govt.Hospital of Indian Medicine, Chennai are functioning in Chennai City.

The Government have sanctioned an amount of Rs.30.00 lakhs for construction of Special ward at Arignar Anna Government Hospital of Indian Medicine, Chennai under Part II Scheme 2003-04. The work is under Progress. A separate Department with 25 beds for Varma and 10 beds for Thokkanam is functioning at Arignar Anna Government Hospital of Indian medicine. A Yoga & Naturopathy clinic is also functioining in Arignar Anna Govt.Hospital. Siddha wings attached to District Headquarters Hospitals, Taluk Hospitals, Non-Taluk Hospitals and Primary Health

Centres etc.

Siddha Wings are functioning in 26 District Headquarters Hospitals, 160 Taluk Headquarters Hospitals, 75 Non-Taluk Hospitals, 326 Primary Health Centres and 9 Medical College Hospitals. Besides, 32 Government independent Siddha dispensaries are also functioning in the State. Buildings for Out Patients block and In Patients ward in Government Headquarters Hospitals, Dharmapuri, Ramanathapuram, Cuddalore and Medical College Hospital Toothukudi with 15 beds, Government Headquarters hospitals, Erode, Nagapattinam, Kancheepuram, Dindigul Tiruppur and Medical College Hospital, Vellore with 25 beds, and Medical College Hospital, Tiruchirapalli and Nagercoil, District head Quarters Hospital Namakkal, Villupuram, Virudhunagar, Kumbakonam, Thiruvarur, Karur, Mettur and Sivagangai with 16 beds, Taluk Headquarers Hospital, Chidambaram with 15 beds and16 bedded siddha ward with Out-patient block at Government Hospital, Kadayanallur was completed and the out-pstient department is functioning now.

Ayurveda wings attached to Medical College Hospital, District Headquarters Hospitals and Government Ayurveda Dispensaries: Five Ayurveda Dispensaries are functioning in the districts. Ayurveda wings with Panchakarma treatment are functioning in the District Headquarters Hospitals, Dindigul, Nagapattinam and Kumbakonam, and Medical College Hospital, Trichy, Tuticorin and Nagerciol and in One Non Taluk Hospital and 2 Primary Health Centres. Unani Wings attached to District Headquarters Hospital and Primary Health Centres: The Unani wings at Medical College & Hospital, Vellore, District Headquarters Hospitals, Nagapattinam, Ramanathapuram, Tiruvarur and Dindigul and at 4 Non Taluk Hospitals and at three Primary Health Centres are functioning in the State. Homoeopathy wings attached to District Headquarters Hospitals, Taluk Hospitals and Government Homoeopathy Dispensaries: Homoeopathy Wings are functioning at the Medical College Hospitals at Salem, Tiruchirapalli, Vellore, Tuticorin and Nagercoil. 23 District Headquarters Hospitals, 8 Taluk Hospitals and in 5 Government Homoeopathy Dispensaries.

Government Siddha Dispensaries and Mobile Medical Unit under Tribal Sub-Plan: The Government opened 7 Siddha Dispensaries in Hill area and one Mobile Medical Unit at Powerkadu in Kolli Hills of Salem District under Tribal Sub-Plan. All these Dispensaries and Mobile Medical Unit are functioning. The Government have sanctioned Siddha wings on 25 Primary Health Centres under Part II Scheme during the year 2003-2004. 25 Assistant Medical Officers are being selected by the Tamil Nadu Public Service Commission. This will be opened shortly. Details of Patients treated during the year 2003 (From January - December 2003)

Name of System No. of Patients treated during the year 2003

Out-Patients In-Patients Total a. Siddha 1,40,69,138 1,83,554 1,42,52,692 b. Ayurveda 3,46,448 13,191 3,59,639 c. Unani 1,73,010 22,840 1,95,850 d. Homoeopathy 12,62,144 29,551 12,91,695 e. Naturopathy & Yoga 20,656 20,656 Total 1,58,71,396 2,49,136 1,61,20,532

Daily Average 43,483 683 44,166

Patients Census for 2003 1,61,20,532 Patients Census for 2002 1,37,73,795 Increase of census 23,46,737

Increase of percentage with reference to last year patient census is 17%.

Action Plan during the year 2004-05: Government of India have sanctioned Rs.160 lakhs including the amount of Rs.46.00 lakhs towards the supply of medicines and towards the establishment of Speciality Clinic in 4 District Headquarters Hospitals and Six Taluk Hospitals as follows and same will be implemented during 2004-05.

District Head Qrs.Hpl 1. Kancheepuram 2. Tiruppur 3. Trichy 4. Virudhunagar

Taluk Hospital 1. Andipatti 2. Palani 3. Paramakudi 4. Gandarvakottai 5. Boothapandi 6. Thirumangalam

During the year 2003-04 the supply of essential drugs at a cost of Rs.58.50 lakhs has been sanctioned by Govt.of India for 234 Primary Health Centres and the scheme is to be continued till the 10th Five-year Plan period. PHARMACIES Pharmacy attached to Arignar Anna Government Hospital of Indian Medicine, Chennai: This Pharmacy is preparing medicines in Siddha, Ayurveda and Unani. The medicines prepared in this pharmacy are used in Arignar Anna Government Hospital of Indian Medicine, Chennai and the seven Siddha dispensaries attached to it in Chennai city. In addition, this Pharmacy is supplying 43 items of medicines to the Siddha Hospital/Wings in the following 6 districts i.e., (1) Kancheepuram, (2) Villupuram, (3) Thiruvallur, (4) Vellore, (5) Tiruvannamalai and (6) Cuddalore. Pharmacy attached to Govt. Siddha Medical College, Palayamkottai: This pharmacy is preparing and supplying all required medicine in Siddha to cater to the needs of patients at Government Siddha Medical College Hospital, Palayamkottai. This Pharmacy has also supplying 22 items of medicines to the Siddha Hospitals / Wings in the following 5 districts i.e. (1) Tirunelveli, (2) Virudhunagar, (3) Thoothukudi, (4) Kanyakumari, (5) Ramanathapuram.

Regional Pharmacy Vannarpet: A Regional Pharmacy has been established in the old Men’s Hostel buildings, Vannarpet at Tirunelveli. This Pharmacy is manufacturing and supplying the 32 items of Medicine to the Siddha wings / Siddha dispensaries in 5 districts i.e. (1) Tirunelveli, (2) Toothukudi (3) Kanyakumari, (4) Virudhunagar and (5) Ramanathapuram. In addition to the supply of Medicine by the Government Pharmacies, the following Government undertaking & Co-operative Institutions are supplying the Siddha Medicine to the Siddha wings / Dispensaries in this State.

1. TAMPCOL, Chennai 2. Lakshmi Seva Sangam, Dindigul.

Drug Testing Laboratory In order to improve the quality of drugs medicine under Indian Systems of Medicine, the State Government have decided to establish the Drug Testing Laboratory at Chennai. The Government of India have sanctioned the Grant-in-aid amount of Rs.85 lakhs to strengthen the State Drug Testing Laboratory, out of which a sum of Rs.50 lakhs has been released as 1st instalment for constructin of building and purchase of the equipments during the year 2001-2002 and the purchase of the equipments and construction of the building was completed during 2002-03. Further Government of India had released an amount of Rs.35.00 lakhs for purchase of equipment and Staff component. The purchase will be completed during 2004-05. National Institute of Siddha: The Government of Tamil Nadu has taken necessary steps to expedite the establishment of National Institute of Siddha at Tambaram, Chennai. The capital expenditure has to be shared between the State and the Central Government in the ratio of 40: 60. As a part of the State Government share, the land measuring 14.78 acres at a cost of Rs.6.64 lakhs as alreadybeen given at free of cost. The Government of India had so far released an amount of Rs.14.00 Crores for construction of building upto the year 2003-04. The State Government has released Rs.4.00 crores during the year 2003-04. The construction work at an area of 14242.14 Sq.mts. is expected to be completed during this year and the academic session of National Institute of Siddha will start from August 2004. Medicinal Plants Board: The Government have constituted the Tamil nadu Medicinal Plants Board to address the issues connected with conservation and sustainable use of Medicinal Plants, cultivation of Medicinal Plants and export of such products. The Government of India had released an amount of Rs.10.00 lakhs for this purpose as Grant in aid. One day State Level Seminar on commercial cultivation and marketing of medicinal plants in Tamil nadu was conducted at World University Service Centre on 23.1.04. More than 500 Scientists, Non Governmental Organisations and Farmers & Traders were participated. Pilot Scheme of Home Remedies Kits: The Government of India have sanctioned a sum of Rs.8.03 lakhs to implement the Pilot Scheme of Home Remedies exclusively for Theni District. Under this scheme, simple home remedies based on the Indian Systems will be distributed to rural people free of cost after identifying the service providers i.e. Trained Village Health Nurses. The above Pilot Scheme is implemented in 100 villages in Theni District and 21,959 persons were benefited through this scheme. Memorandum of Understanding: Memorandum of Understanding has signed between the Commissioner of Indian Medicine & Homoeopathy and Madras University to have collaborative work. The scope of the Memorandum of Understanding includes

A. Documentation:

i. Documentation of Siddha books in English and Hindi, if possible ii. Development of data base iii. Digitilisation of ancient Palm leaves

B. Research & Development: Research & Developoment on validating claims of Siddha medicines in the area of Jaundice, AIDS, Arthiritis, Diabetes etc. adopting internationally accpeted scientific methodology. C. Teaching programmes on herbal sciences D. In service Training for academic and research personnel E. Any other programmes in relation to anyone or more of the above said broad areas of collaboration which the

parties feel approprate under this Agreement. Research Unit at Government Siddha Medical College, Palayamkottai and Arignar Anna Government Hospital of Indian Medicine, Chennai: To test the medicines prepared by the Hereditary Siddha Medical Practitioners and to treat the patients suffering from cancer and AIDS, a Research wing in cancer and AIDS in Siddha system of medicine has been started both at Government Siddha Medical College, Palayamkottai and Arignar Anna Government Hospital of Indian Medicine, Chennai. The research work is in progress. Research Units in Diabetes, Fracture and Infertility are functioning at Arignar Anna Government Hospital of Indian Medicine, Chennai. Tamil Nadu Board of Indian Medicine and Board of Integrated Medicine, Chennai.

The number of Indian Medicine Practitioners registered with the Tamil Nadu Board of Indian Medicine as on 31.12.2003 was as follows:

Sl.No. Name of the course Naturopathy Ayurveda Unani Total

1 BUMS (Unani) - - 318 318 2 LIM/LAM etc. - 290 37 327 3 BSAM/BAMS (Ayurveda) - 1360 - 1360 4 DAM (Ayurveda) - 193 - 193 5 GCIM - 160 24 184 6 Tabib-Kamil - - 25 25 7 B2 Class - 1889 628 2517 8 Enlistment - 856 198 1054 9 Naturopathy Diploma 16 - - 16

10 B.N.Y.S 116 116 Total 132 4748 1230 6110

Tamil Nadu Siddha Medical Council, Chennai: The Number of siddha Medical Practitioners registered with Tamil Nadu Siddha Medical Council as on 31.12.2003 is as follows.

Class No.of Practitioners Registered BIM & BSMS 2487 LIM, LAM etc. 6 GCIM 3

B.Class 2245 C.Class 24 Enlistment 2409

Total 7174 Board of Integrated Medicine:

Name of the Course Ayurveda Unani Total GCIM 214 22 236 L.I.M. 217 24 241 Total 431 46 477

Tamil Nadu HomoeopathtyMedical Council, Chennai:

A Class

BHMS 992 DHMS 520 Others 95

B Class 14,125 C Class 1,050

Total 16,782

Naturopathy and Yoga System of Medicine:

The Government have recognised Naturopathy and Yoga as Systems of Medicine in Tamil Nadu. The Government of Tamil Nadu has made the provision for registration of the qualified persons in Naturopathy System at the Tamil Nadu Board of Indian Medicine, Chennai. The Tamil Nadu Government has recognised the following private Yoga institutions to conduct the Diploma courses.

1. Krishnamacharya Yoga Mandiram, Chennai

2. Yogasana Alayam, Chennai.

3. Asana Andiappan Yoga and Natural Living Development Trust, Tirunelveli.

4. Gandhi Institute of Yoga and Naturopathy, Yelagiri Hills, Thirupattur Taluk, Vellore District.

5. Sri Sankara College of Yoga and Naturopathy, Thiruchirappalli.

6. Savanandha Yogasana Mantrum Iarrkai Nala Vazhvu Abiviruthi, Arakkatallai, Tuticorin.

7. The Asian Social Welfare Natura; Health Trust, Sripathanallur, Vellore

8. Swamy Sivananda Yoga Research Centre, Palanganatham, Madurai. Yoga and Naturopathy Clinic at Arignar Anna Government Hospital of Indian Medicine, Chennai is functioning from 1997-98.

CHAPTER - 8

DANIDA ASSISTED TAMIL NADU AREA HEALTH CARE PROJECT - PHASE III

Introduction:

The III phase of the centrally sponsored externally aided DANIDA Tamil Nadu Area Health Care Project has been implemented from 24.12.1996 to 31.12.2003 at a total revised outlay of Rs. 70.76 crores (including direct funding of Rs. 7.89 crores) to improve the health and family welfare status of the rural population in the project area. The project was implemented in the districts of Dharmapuri, Thanjavur, Nagapattinam and Thiruvarur for most of the activities, extended some of the activities to the old districts of Salem, Namakkal, Cuddalore & Villupuram and supported some state level activities like training, drug supply logistics etc. The funding was on reimbursement basis with 85% share by DANIDA, 5% by Government of India and 10% by Government of Tamil Nadu. Achievements during 2003-04: Construction activities: • Decentralized preventive maintenance and cleaning up campaign has been done in all the PHCs and

HSCs, which are functioning in government building in the project districts. Improving Awareness (IEC): • School health competitions were conducted and prices were distributed to the winners in all the

schools in the new project districts. • Health messages were propagated to the community in the forms of Social Marketing Modal in

Salem, Namakkal, Dharmapuri and Krishnagiri districts by conducting 300 awareness programmes in each district.

• Mass Media campaign on health IEC has been done through AIR in the form of jingles and Doordharshan & cable TVs in the form TV serials.

• Exhibition panels, portable photographic posters were supplied to all DDHSs in the project districts and exhibitions were conducted in about 400 schools in each health district.

Improved Technical Knowledge & Skills of Service Providers (Training): • Indian Systems of Medicine training manuals has been prepared, mass printed and supplied to all

female health functionaries in the state. Health Services Management: • The existing HMIS registers and records for PHCs, FRUs and GHs have been simplified, mass

printed and supplied to all the PHCs, FRUs and GHs in the state. • Computers were provided to all the 87 block PHCs of Dharmapuri, Krishnagiri, Thanjavur, Thiruvarur,

Nagapattinam, Cuddalore, Villupuram and Kallakurichi health districts. Computer training has also been imparted to about 2100 staff of PHCs in the new project districts.

• The new HMIS registers and records for HSCs have been reprinted and supplied to all HSCs in the state.

• About 4000 nurses of FRUs including ANMs of block PHCs in the state has been given training on new born care.

Improvement of Medical Supplies: • Equipment were supplied to all the 23 CDWs of TNMSC. • About 10,000 staffs in the category of VHNs / SHNs /CHNs have been trained in basic treatment

procedures on both ASM and ISM drugs. • All VHNs / ANMs in the state have been given equipment kit. Budget performance 2003-04:

(Rs. in lakhs) Sl. No

Scheme Code/Name/ Activity

B.E 2003-04

R.E 2003-04

Actual Expenditure

* (upto 31.12.03)

a. Centrally Sponsored Scheme 1 In-service Training and Manpower

Development under DANIDA Project (SB) 52.32 5.23 5.09

2 Construction of Community Supported Health Subcentres under DANIDA Project (TF)

0.02 0.00 0.00

3 Project Organisation by State and District level establishment under DANIDA Project (SY)

30.41 22.49 19.71

4 Monitoring and Evaluation under DANIDA Project (SC)

24.06 313.47 182.81

5 Construction Cell under DANIDA Project (TJ)

0.03 0.00 0.00

6 Communication Component under DANIDA Project (SE)

0.08 104.72 104.48

7 Improvement of drug supplies under DANIDA Project (TE)

0.03 0.00 -26.75

Total 106.95 445.91 285.34 b. State Scheme 1 Infrastructure development under DANIDA

project – Grants for capital expenditure (JD)

0.01 0.0 0.00

Grand Total (a+b) 106.96 445.91 285.34 * The project was closed with effect from 31.12.2003.

CHAPTER - 9

REPRODUCTIVE AND CHILD HEALTH PROJECT Reproductive and Child Health (RCH) Programme:

Government of Tamil Nadu health policy 2003 focuses on greatly improving access, equity and quality of care and reforming health care financing.

The IMR of the State is almost stagnant and some districts like Theni, Salem, Namakkal and

Dharmapuri had high IMR. Various initiatives have been taken by Government to address the issue of stagnant IMR &MMR. With a view to strengthen the existing Maternal and Child health activities in Tamil Nadu, the Reproductive and Child Health project was formulated and commenced during the year 1997-

98 for implementation over a period of 6 year with a financial outlay of 23.14 crores It is a World Bank aided 100% centrally sponsored project. It has the following two major components

National Component for implementation in all districts of Tamil Nadu. This component is to

strengthen the infrastructure needs of districts excluding Madurai and Theni districts.

Sub-project covering the districts of Madurai and Theni both urban and rural excluding Madurai Corporation, with financial outlay of Rs.15.24 crores for rural and Rs. 7.9 crores for urban. Sub-Project:

The following activities were carried out under Sub-Project from 1997 - 98 to March 2004. Rural:

In addition to construction of 21 new HSCs in Madurai and Theni districts, additional constructions were provided in the selected 40 PHCs where more number of deliveries are conducted. The minor repairs were also carried out in 77 HSCs, which had encouraged the VHNs to provide quality services. An amount of Rs. 486.74 lakhs have been spent for improving the infrastructure facilities in the HSCs and PHCs during the project period.

Considering the non availability of essential equipments in the HSCs and PHCs in the Sub Project districts, the RCH Project procured and supplied maternity, paediatric and operation theatre equipments for the PHCs at a cost of Rs.125 lakhs. The availability of essential equipments to the PHCs have improved the institutional deliveries and the tubectomy performance in Madurai and Theni districts. The Maximum number of deliveries are conducted in the state per PHC per month in Madurai district. The number of deliveries have increased by100% in Madurai and Theni districts.

To improve the outreach services and strengthen the referral services 30 vehicles have been supplied to the PHCs at cost of Rs. 108 lakhs.

To mobilize the community against the social evil of female infanticide and to empower the women, moving street theatre “Kalaipayanam” programme was conducted in Theni District by using the services of Arivoli Iyakkam volunteers at a cost of Rs.25.64 lakhs.

Computer Systems with its accessories had been installed in all PHCs and Government Hospitals in Madurai and Theni districts and the RCH directorate at Chennai to improve the health management

information system at a cost of Rs.145 lakhs. The staff of Madurai and Theni districts were trained on the use of computer.

To empower the field health functionaries with communication skills and to develop skills in driving the mopeds, mobility cum communication skills training was organized in Madurai and Theni districts. All the field health functionaries were given loan to purchase mopeds at lower interest rate.

Selected IEC health messages have been was broadcast through AIR to create awareness on various RCH activities.

To meet the Emergency Transport needs of complicated deliveries and accident victims a pilot initiative was started under which two vehicles equipped with life saving equipments were given to NGO by name Sevanilayam at Theni district. Prior to the commencement of this initiative hardly one emergency case was transported per month by the PHC vehicle. The NGO supported emergency transport services are now transporting nearly 30- 45 emergency cases per month per vehicle.

The RCH outreach services in Madurai and Theni Sub Project District has been strengthened with a block level team consisting of lady medical officer, VHN, HI, BEE and hired lab technician who visit various villages on a fixed day schedule. The total cost for the conduct of one round of camps is Rs.16,76,150/- . In Madurai 1238 Camps and in Theni 648 camps were completed. In these camps large number of antenatal cases were examined, post natal care, new born care, family welfare services were provided. Lab services were also provided to screen various communicable diseases by hiring the services private lab technician. Ultrasonogram was used to screen pregnant mothers for any risk factors. All complicated cases needing higher level of care were referred to referral institutions.

A programme for Capacity Building of adolescent girls in order to empower them as link persons in the community for health programme has been implemented in the Districts of Madurai and Theni Districts at a cost of Rs.73,05,020. The adolescent girls were selected at the rate of two per habitation and they were trained in various RCH issues. These trained girls will take care of pregnant women, provide support services and act as link person between the health worker and the community.

Using the services of talented health functionaries street theatre troupe has been formed in Madurai district to perform street plays during the weekend period in the villages. These activities have been carried out at a cost of Rs.25.64 lakhs.

To eliminate the female infanticide, HSC level committees have been formed to target the high-risk mothers. The family of high-risk mothers are periodically counselled about the value of the girl child and the various benefits provided by the Government for the girl child. The family is also apprised about the penal provisions of the law if the family resort to female infanticide. Urban:

Urban Health Post buildings have been constructed in Theni, Cumbum, Chinnamanur, Melur, Thirumangalam, Bodi and Usilampatti and major renovation work at Periyakulam at a cost of Rs.126.88 lakhs. In addition Furniture, Maternity Instruments, Cots, Mattress and Pillows etc. worth Rs.30 lakhs were supplied to 8 Urban Health Posts. Drugs worth Rs.10.80 lakhs per annum were also supplied to 8 Urban Health Posts.

The Sub-project came to a closure on 31.3.04.

State Implementation Plan (National Component):

Under the National component Major Civil Works i.e. construction / Repairs to Operation Theatre / Labour Room, provision of water supply and electricity are being provided at a cost of Rs.9.40 Crores in PHCs, HSCs and FRUs through Public Works Department. In addition minor Civil Works have been carried out in selected PHCs at a cost of Rs.220 lakhs. The renovation / provision of additional buildings, major repairs have helped to improve the quality of services in the health facilities.

To provide round the clock delivery care in the PHCs, a pilot initiative in which 3 staff nurses, one driver and 2 sanitary workers are provided to 90 PHCs in Thanjavur, Thiruvarur, Nagapattinam, Dharmapuri, Krishnagiri, Madurai and Theni. Districts.

The maternal mortality has to be reduced to less than 1 per 1000 live births from the present level of 1.4 per 1000 live births. Hence under RCH project funds have been provided to Joint Director of Health services and Deputy Director of health services to hire the services of private anesthetists and obstetricians to provide emergency obstetric care and tubectomy services. Nearly 2600 caesareans were performed during the project period in addition to tubectomies and major gynecological surgeries. The PHCs are also permitted to hire private anesthetists and by hiring their services and nearly 44,533 tubectomies were performed.

RTI/STI clinics have been established to treat Reproductive Tract Infections / Sexually Transmitted Infections in selected 70 PHCs in the Districts viz., Thanjavur, Thiruvarur, Nagapattinam, Dharmapuri, Krishnagiri, Madurai, Theni, Cuddalore, Kallakurichi, Villupuram, Salem, Namakkal, Pudukottai and IPH Poonamallee.

The Drug Kits ‘A’, ‘B’, Essential Obstetric Care Kits, Emergency Obstetric Kits, RTI/STI Drug Kits

worth Rs.1496 lakhs were procured and supplied to HSCs / PHCs / FRUs by Tamil Nadu Medical Services Corporation out of RCH funds.

Medical Equipment Kits are supplied by Government of India for use of PHCs / FRUs /

Headquarters Hospitals to provide newborn care, emergency obstetric care. Training under RCH Programme:

The following trainings for all the categories of Medical and Paramedical have been completed in co-ordination with National Institute of Health and Family Welfare, New Delhi. Awareness Generation Training (about RCH, Population Indicators of the country) completed Integration Skill Development Training (Skills under essential Obstetric Care and New Born Care) Specialized Skill Development Training (Skill training on MTP, Tubectomy and IUD) Communication Training Management Training for the District Health Administrators MVA training (Manual Vacuum Aspiration) at Dindigul and Salem Districts

The Sub Project component part of the first phase of the RCH Project has come to a close by

March, 2004. The National component of the RCH Project is being continued beyond March 2004.

The planning for the second phase of the RCH Project is under progress.

CHAPTER - 10

TAMIL NADU STATE AIDS CONTROL SOCIETY

Introduction: The State AIDS Project Cell formed in 1993 was re-constituted as Tamil Nadu State AIDS Control Society (TNSACS) in 1994, with the Secretary, Health and Family Welfare Department, as the President of this Society and a senior I.A.S. Officer as the Member Secretary cum Project Director, to tackle the problem of AIDS in a more effective manner with the guidance and support of various committees and sub-committees, comprising of experts from different Fields. Model State in AIDS Control:

TNSACS was the first AIDS Control Society formed in the country HIV/AIDS Awareness level among the people is very high

Number of individuals availed testing and care facilities is high.

First State, which has notified and cared large number of HIV/AIDS, affected.

Activities of TNSACS :

The main components, strategies and interventions implemented by TNSACS under the AIDS Control Programme are as follows:

Information, Education and Communication activities

Targetted Intervention Programmes through NGOs

Institutional and infrastructural Strengthening

Training and Capacity Building activities

STD / RTI Care and also Out-reach Service

Condom Promotion activities

Blood Safety and Voluntary Blood donation activities

Advocacy and Sensitization Programmes

Testing, Surveillance and Impact Assessment Studies

Low cost AIDS care and support for people living with HIV / AIDS (PLWHA)

Legal and General Counselling and also Help line Services

Voluntary Counselling and Testing Centres to identify HIV affected & to provide counselling.

Prevention of Parent To Child Transmission.

Information, Education and Communication: Awareness is the key to the prevention and control of HIV / AIDS. Fear is not likely to solve any of

the problems, neither is ignorance. The electronic, print and other media are fully exploited, optimising the use of the resources of TNSACS. The first phase of the IEC campaign has been a resounding success, as independent surveys of professional agencies have indicated. The campaign is already being hailed as a model for other states in the country. The emphasis has now shifted towards interpersonal communication and behaviour change communication (BCC) to ensure positive behavioural changes among the people. The multi pronged strategy comprises of multi-media campaigns, advocacy programmes, Inter Sectoral Collaboration with all departments like Education, Mahalir thittam, Social welfare, Local panchayat elected Representatives etc and social mobilization activities are implemented centrally and at decentralized level to create an awareness on HIV/AIDS. The following IEC activities were carried out during the year 2003/2004.

• Village Talk AIDS programme through Nehru Yuva Kendra Sangathan throughout Tamilnadu by involving Youth Clubs.

• Two days State Level Conference HIV/AIDS awareness programme were conducted at Loyola College for the College Students for the formation of Red Ribbon Clubs in all the Colleges of Tamilnadu.

• International Candle Light Memorial Day 2003 was observed for the remembrance of people died of HIV/AIDS & to provide care and support for people living with HIV/AIDS.

• To reach the Rural community TANSACS has conducted Street Play/Drama in association with Song & Drama Division in 5 High Risk Districts of Tamilnadu namely Salem, Namakkal, Madurai, Trichy and Tirunelveli.

• One Life One Partner programme rally was conducted to create awareness among Youths.

• World AIDS Day 2003 was observed on 1st December 2003 on the topic of "Rights of People Living with HIV/AIDS".

• To create awareness among Tribal community, Puppet Show programmes were conducted at Kolli Hills, Namakkal District by involving professionally trained teams.

• One day awareness programme on HIV/AIDS among Aravanis was conducted during Koovagam Festival to create awareness among Aravanis Community.

• Necessary funds were released to all Districts to carry out and implement IEC activities for the General Community.

• Motor Cycle expedition from Chennai to Kanyakumari was done by NCC Students for creating awareness and also Dramas and distribution of IEC materials such as Posters and Handbills to the General Public was done by No.1 NCC (T) wing.

• Main focus was given to Care & Support, and demand generation for VCTC.

• Media Campaign was conducted at Kumbakonam, Mahamagam Festival to create awareness on HIV/AIDS for the devotees and General Community by using different types of IEC activities.

• TANSACS conducted HIV/AIDS & TB co-infection awareness throughout Tamilnadu in co-ordination with State TB Control Society.

Partnership with NGOs to reach High Risk Groups:

The involvement of NGOs in HIV/AIDS Prevention and Control Programmes aims at prevention of HIV/AIDS among Marginalised and Vulnerable Population who are at high risk. As Tamil Nadu reached highest awareness level among General Public during the last couple of years, focus has now been shifted towards bringing behavioural changes through Targetted Interventions involving grass root level NGOs and peer educators/outreach workers/counsellors.

The Tamil Nadu State AIDS Control Society funds 621 NGOs so far. Currently, there are 107 programmes as under in the State for different risk groups such as Sex Workers, Truckers, Industrial Workers, Prisoners, MSM, Migrant Workers, Networking with people Living with HIV/AIDS, Youth & Adolescents, Tribals & Research Studies. Monitoring and evaluation of NGO Programmes is being given top priority to facilitate positive behavioural changes. Awareness, condom promotion and demonstrations, STD Care, Counselling are the important sub-components of these interventions.

Sl. No. Name of the Interventions No. of Interventions

CSW 20 Truckers 15 Industrial Workers 16 Migrant Workers 15 MSM 2 Prisoners 3 Tribals 3 Youth Adolescents 1

I. Targeted Intervention

Research Studies 2 PLWHA Network 7 II. Network Drop in centre 7 Community Care Centre 4 III Care & Support Institutional Care Centre 12

Total 107

Blood Safety and Voluntary Blood Donation:

HIV can be transmitted through unscreened blood and blood products. Therefore adequate measures have been taken for the supply of safe and tested blood. There are 79 Government Blood Banks and also 123 Blood Banks under various sectors such as Quasi-Governmental organisations, Voluntary organisations and Private sector. These Blood Banks are testing the donor blood for HIV, Hepatitis B, Hepatitis C, Syphilis and Malarial infections. Tamil Nadu State AIDS Control Society supplies Test kits, consumables and certain equipments to all Government Blood Banks at free of cost. Lab Technicians and Counsellors support to Government Blood Banks are also provided by TNSACS, besides imparting training to personnel handling Blood and Blood products.

The Tamil Nadu State Blood Transfusion Council (TNSBTC) closely monitors the activities of

Blood Banks with the association of Drug Control authorities and State Health authorities. Professional Blood donation has been banned since 1998. Therefore all the necessary measures are taken by TNSACS to promote voluntary blood donation and ensure safe and adequate blood. TNSACS has taken several measures for the same such as dissemination of the messages popularising the concept of Voluntary Blood Donation, provision of funds to Universities, District administration, Corporations, Directorates of Collegiate and School Education, Voluntary organisations & Non-Governmental Organisations for promotional activities. Blood Donor Clubs were formed in the Colleges with the involvement of Universities. Financial Assistance is extended to Government Blood Banks towards refreshments to donars and conduction of camps, processing of Blood components and its usage are being promoted.

Blood Collection data in Tamil Nadu:

The numbers of Voluntary Blood Donors have gone up and consequently HIV Positivity among

blood donors has come down to 0.18% which is less than national average. About 64.05% of Blood is collected from Voluntary Blood donors and proposed to increase further. Control of Sexually Transmitted Diseases (STD):

The risk of transmission and spread of HIV/AIDS among STD patients is much higher than the general population. Therefore priority is given to STD/RTI Care and outreach activities. There are 57 STD clinics in various Institutions including Medical College Hospitals (11), District Headquarter Hospitals (26) and Taluk Hospitals (20). All these STD clinics are strengthened with necessary equipment and laboratory support, including Counselling facilities. The Drugs are supplied for the effective treatment of the patients attending these STD clinics. Counselling is provided to the attendees in outreach camps and also at STD clinics. Condoms are supplied to the clinic attendees free of cost. Partners of the patients are notified for improving effectiveness of the treatment and follow up services and to reduce the risk of transmission.

Condom Promotion:

Top Priority is being given to promote condom usage among people, both high-risk and low risk,

to prevent transmission of HIV through sexual route of transmission and unprotected sex. Three different strategies are adopted by TNSACS as indicated below:

Distribution of Free condoms (Nirodh) to the people through Health Care Institutions,

STD clinics, Outreach camps and also through Non-Governmental Organisations. (NGOs)

Promotion of subsidised or low priced condoms (Deluxe Nirodh) among the people in

Targetted Intervention areas and non-intervention areas with the support of Non-Governmental Organisations.

Promotion of condom usage and popularising the concept of safe sex and condom use

through awareness and behavioural change communication.

Condoms are available in all the fair price shops in the state. Training and Capacity Building:

In order to have better service delivery system and to have institutional strengthening in private

and public sector, training activities has been given due importance by making adequate provision in Action Plan to impart training on HIV/AIDS to Medical, Para-medical and personnel of different sectors

No. of units collected Year Voluntary

Donors Replacement

Donors Total % of Voluntary Blood Donation

1999 1,10,939 1,32,080 2,43,019 45.7% 2000 1,51,006 1,52,091 3,03,097 49.7% 2001 1,54,533 1,52,080 3,06,613 50.4% 2002 2,28,902 1,56,455 3,85,357 59.4% 2003 2,79,647 1,56,947 4,36,594 64.05%

and departments. This will positively bring capacity building among the various stake holders for a better performance in AIDS Control efforts and also to face challenges in future.

Training Performance During 2003-2004:

1. Joint Director of Medical Services 30 2. Nodal Officers 40 3. Trainer Training (Nurses) 40 4. Nurses 450 5. Medical Officers/Para Medical of AIDS Wards 60 6. Faculty Member ITI - 7. NSS Co-ordinate pilot training of Trainers NSS Co-ordinators - 8. Refresher Training to Medical Officers in PHCs 450 9. Village Health Nurses 600 10. Multipurpose Health Workers 180 11. Sector Health Nurses 210 12. ESI Medical Officers Training 120 13. ESI Nurses 160 14. ESI Para Medical Staff 210 15. Blood Bank Medical Officers 80 16. Private Medical Practioners 930

Facilities to Find out HIV Infection:

Screening of HIV status of any individual is important to assess the case load in the community. Informed consent, pre test - counselling and post test counselling, confidentiality etc. are important conditions insisted upon before the results are made known to the individuals. For this purpose, there are 43 VCTCs centres established in all Government Head Quarters Hospital and Government Medical Colleges.

Year No. of persons availed Testing facilities Found Positive for HIV

2002 - 2003 35521 4976 2003 - 2004 85801 20590

Surveillance System to assess Trends:

Surveillance system is essential to assess the trend in the spread of HIV infection among both High risk and low risk population and the same is being strengthened every year. There are 79 sentinel surveillance survey sites in the State during 2003. The latest survey reveals that the HIV sero-positivity among STD patients is 9.2% and among antenatal mothers it is 0.75%. HIV prevalence among Injecting Drug Users (IDUs) and Homosexuals are 63.8% and 4.4% respectively. In order to obtain more reliable information about the trend of infection in all the areas the number of sentinel sites will be increased further during this year with the requisite supply of equipment. Behavioural Surveillance Survey done by TNSACS reveals increased condom usage, increased risk perception and reduced sexual risk behaviour. Care and Support for HIV/AIDS affected: The Government accords high priority for making quality medical care and treatment accessible for opportunistic infections to the People Living with HIV/AIDS in the State. The society is conducting training programmes for the medical and para-medical staff to sensitise them to the needs of PLWHAs and also on the need to adopt universal precautions. The Society extends financial support for the purchase of drugs for opportunistic infections and for Post Exposure Prophylaxis (PEP) drugs. Apart from

this, Private Sector has also been involved in providing care and support to PLWHAs. At present, these Private Hospitals have been extended support from the Society. The Society also assists the associations of People Living with HIV/AIDS with a view to provide them access to care and psycho-social support.

The Government hospital for Thoracic Medicine, is catering to a large number of patients

suffering from HIV/AIDS. The Centres for Disease Control and Prevention, Atlanta, USA has come forward to upgrade this Institution as a Regional Institute for Treatment and Research for HIV/AIDS Related Diseases. The Government has signed a Memorandum of Understanding (MoU) with CDC, Atlanta for improving laboratories, upgrading the information systems and providing additional training facilities at the Hospital at a cost of Rs. 4.7 crores. Programmes for Youth/adolescence and Vulnerable:

1. School AIDS Education Programme is conducted with the objective of creating an awareness of HIV/AIDS among School students and Teachers. All the students studying in 9th and 11th standard are covered under the School AIDS Education Programme.

2. Peer Educators from 9th and 11th standard students were selected and given training to educate

other students in the Schools.

3. During last year (2003-04), 5216 Government and Government aided High Schools and Higher Secondary Schools and 3201 Matriculation Schools were covered under the School AIDS Education Programme.

4. Teachers Training modules and Flip Charts were supplied to all the Schools. Student’s booklets

were distributed to all the Students studying in 9th and 11th standards.

5. More than 15 lakhs students were benefited out of this School AIDS Education Programme. Family Health Awareness Campaigns: TNSACS has implemented 4th round of Family Health Awareness Campaign (FHAC) in the State with the support from NACO, Govt. of India to identify the STD and RTI cases and to treat them with syndromic management, basically to eliminate aggravating factors such as STD and RTI which contributes for faster spread of HIV/AIDS. The campaign mode approach adopted by TNSACS to reach the needy at their doorsteps has paved a way for identifying the vulnerable groups in rural and urban areas. Total No. of STD cases identified and treated from round 1 to round 4 are given below: Family Health Awareness Campaign:

Total Number of STDs treated Phase Male Female Total I 1,14,318 7,60,466 8,74,784 II 97,292 5,14,488 6,11,780 III 1,36,355 5,26,975 6,63,330 IV 2,73,061 8,31,986 11,05,047

TOTAL 6,21,026 26,33,915 32,54,941

Voluntary Counselling and Testing Centres: There are 43 Voluntary Counselling and Testing Centres (VCTCs) established in all Government Headquarters Hospitals and Government Medical Colleges. They serve as Entry point for prevention and care. Counselling and testing facilities are made available with qualified Counsellors. Lab Technicians and these centres are under the control of Medical Officers. Clients are encouraged to seek the facility of Counselling and Testing for HIV through NGO networks. Post test counselling facilities are also provided. Prevention of Parent To Child Transmission Programme:

The Prevention of Parent to Child Transmission of HIV Programme (PPTCT) is being implemented in 65 centres in Tamil Nadu including 14 Government Medical Colleges, 6 Private Medical Colleges, 28 District Government Head Quarters Hospitals, 8 Private Hospitals and 9 Corporation MCH Centres.

The goals of the PPTCT Programme are

1. Prevention of HIV among young people. 2. Prevention of unwanted pregnancies in general and especially among positive women or

women whose husbands are positive. 3. Prevention of transmission of HIV infection from mother to her infant. 4. Care and support of HIV affected families.

PPTCT Programme Training is imparted to PPTCT team members in all the centres and in-house training was also given to all the hospital staff. Counselling services are provided through Group Education, Group Counselling and individual Pre-test and Post-test counselling. Single Window System is followed in relation to laboratory facilities for all AN where PPTCT services are available. The beneficiaries are nearly almost 1500 mothers with HIV positive and information on Primary prevention of HIV was given to nearly 4.5 lakh mothers and almost 1.25 lakhs spouse s in our 65 PPTCT centres. Financial Performance: The Grant in aid received from National AIDS Control Organisation, Ministry of Health & Family Welfare and expenditure incurred are given below.

Year Budget Approved (Rs. in Lakhs)

Grant in aid received (Rs. in Lakhs)

Expenditure incurred (Rs. in Lakhs)

1995 - 96 650.00 577.44 731.55 1996 - 97 1743.94 2110.00 1329.34 1997 - 98 2000.00 1700.00 1672.90 1998 - 99 1595.13 1100.00 1383.89

1999 - 2000 1571.99 885.57 1408.27 2000 - 2001 1000.00 1027.00 771.75 2001 - 2002 1300.88 1480.65 1624.26 2002 - 2003 1500.67 1295.50 1349.15 2003 - 2004 1708.35 1225.00 1215.28

Component-wise expenses during 2003 - 04 are given below: (Rs. in Lakhs)

Sl. No. Component Expenditure up to March

2004 1 Priority Targetted Intervention against HIV/AIDS 310.69 2 Preventive Intervention for the General Community 673.98 3 Low Cost AIDS Care 83.42 4 Institutional Strengthening 142.69 5 Intersectoral Collaboration 4.50

TOTAL 1215.28

CHAPTER - 11

TAMIL NADU STATE BLINDNESS CONTROL SOCIETY Introduction:

Tamil Nadu State Blindness Control Society is functioning under the Chairmanship of Health Secretary to Government of Tamil Nadu with a Project Director and Deputy Director for the implementation of World Bank Assisted Cataract Blindness Control Project till 30.6.2002 and subsequently under National Programme for Control of Blindness from 1.7.2002. It monitors the activities of District Blindness Control Societies (DBCS) functioning in all Districts under the Chairmanship of District Collectors.

The main activity of DBCS is to achieve the target fixed by Government of India for free cataract surgery

with IOL implantation by the active involvement of NGOs and Government sector. The other activities are School Eye Screening, IEC, Eye donation campaign etc.

Performance on Cataract operations:

Year Target Achievement

2003-04 4,20,000 4,50,654 School Eye Screening:

Year Target No. of Children Screened

Target for free spectacles provided

No. of Spectacles provided

2003-2004 14,85,000 23,46,028 29,700 38,550 Functioning of Eye Bank:

Year Target for Eyes collection

Eyes Collected

Eyes Utilised

2003-2004 3000 4707 2678

Manpower training: Fourteen Ophthalmic Surgeons from Government Hospitals were trained in Modern techniques of Cataract Operation with Intra-ocular lens implantation at Regional Institute of Ophthalmology & Government Ophthalmic Hospital, Chennai.

CHAPTER - 12

TAMIL NADU MEDICAL SERVICES CORPORATION LIMITED Organisation:

The Tamil Nadu Medical Services Corporation Limited, which was incorporated on 01.07.1994

under the Companies Act 1956, has successfully completed the 9th year of its operation. It is an ISO 9001:2000 Certified Organization. The activities of the Corporation has expanded from the procurement and supply of drugs to the medical institutions to that of 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 maintenance of Pay Ward & medical equipments. Purchase of Drugs and Medicines:

During the year 2003-04, Tamil Nadu Medical Services Corporation Limited has purchased drugs

and medicines worth of Rs. 119.65 Crores through transparent and open tender process. The availability of drugs for the distribution to the various Government medical institutions through the 24 warehouses in the State is ensured by closely monitoring the stock position and the procurement process. The stock position in all the warehouses at any point of time is available on the website and in Tamil Nadu Medical Services Corporation Limited Head Office which can be easily accessed by the medical institutions.

The details of purchase and distribution of drugs and medicines during the year

2002-03 and 2003-04 are given below: (Rs. in Crores)

2003-2004 (Tentative)

2002-2003

I Opening stock 23.38 23.74 II Purchase made during the year. 119.65 108.92 III Distribution during the year. 120.91 109.29 IV Closing stock 22.12 23.38

Storage:

The Corporation has scientifically designed and constructed 23 Drug warehouses at convenient

locations in the state for quick movement of the drugs to the medical institutions. Action is being taken to construct remaining one Drug warehouse also at Sivaganga.

Distribution:

The medical institutions are provided with passbooks for drawl of medicines, surgical and suture

items on the basis of the financial allocation made by their respective Head of the Departments from the warehouses to which they are attached. Quality Control:

The Corporation ensures distribution of quality medicines to the Government medical institutions

by rigorous quality testing process in reputed analytical laboratories empanelled through open tender system. The samples from each batch of supply is drawn and sent to the approved laboratories after codification. Only the drugs, which pass the quality test, are issued to the hospitals.

Computerization: The success of the Tamil Nadu Medical Services Corporation Limited is mainly due to the well-designed Computer Network System. The Tamil Nadu Medical Services Corporation Limited has established a well knit Computer Network with all the Warehouses. The information from Warehouses are transferred to the Head Office daily through floppies. This has enabled the Corporation to have full control over the stocks available at different Warehouses and also to make available the required medicines to the needy warehouse from the warehouse where it is in surplus. Daily monitoring of the stock position is being 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 Hardwares have been upgraded with higher configuration and models. The softwares have also been upgraded from FoxPro to ORACLE for handling high volume of data.

Advanced Diagnostic facilities:

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 very nominal charges. The Corporation is maintaining 2 MRI Scan Centres one each at GGH, Chennai and GRH, Madurai and nominal charges are collected from the public for Scanning.

The Corporation is maintaining 35 CT Scan Centres in Government Hospitals and thereby at

least 1 CT Scanner is available in each District to serve the public. The Corporation is charging nominal amount for scanning.

Procurement of Equipments for the hospitals:

The Tamil Nadu Medical Services Corporation Limited has been procuring and supplying Medical

Equipments to all the Government hospitals / institutions including Veterinary institutions. During the year 2002-03, the Corporation has procured and supplied medical equipments to various Government hospitals and institutions valuing Rs.16.60 Crores and during the year 2003-04, the Corporation has taken action to procure and supply the following equipments to the various Government hospitals and institutions sanctioned by the Government under Part II Schemes 2003-04.

(i) Auto analyzer, Calposcope and Cell counter for Aringnar Anna

Memorial Cancer Hospital, Kancheepuram Rs. 20 Lakhs

(ii) Haemodialyser units for Government Rajaji Hospital, Madurai & Government Medical College Hospital Coimbatore

Rs.24 Lakhs

(iii) Echo Cardiogram with colour Doppler for Tirunelveli Medical college Hospital

Rs.24 Lakhs

(iv) Haemodialysis & Plasma separation Unit for Annal Gandhi Memorial Hospital, Trichy

Rs.24 Lakhs

(v) Provision of equipments for increasing 315 MBBS seats at Tirunelveli, Coimbatore, Salem, Chegalpet and Kilpauk Medical College Hospital, Chennai

Rs.100 Lakhs

(vi) C - Arm with Image Intensifier for Government Rajaji Hospital, Madurai Rs.25 Lakhs (vii) 500 mA X-Ray unit with Image Intensifier and basic equipments for

Bernaurd Institute of Radiology, Government General Hospital, Chennai Rs.50 Lakhs

(viii) Soft Tissue Mammography unit (one each) for 7 District Head Quarters Hospitals

Rs.224 Lakhs

(ix) Haemo Dialysis Unit (Two each) for 7 District Head Quarters Hospitals Rs.126 Lakhs (x) 100 mA X-Ray unit for 14 Taluk Head Quarters Hospitals Rs.30 Lakhs (xi) Echo Cardiogram with Colour Doppler (One each) for 7 District Head

Quarters Hospital Rs.168 Lakhs

Special Wards: (i) GI Bleed and Hepato Biliary Centre; Government Stanley Hospital, Chennai

ISO 9001 certified GI Bleed and Hepato Biliary Centre (special ward) maintained by Tamil Nadu

Medical Services Corporation Limited is functioning as a separate unit under the Surgical Gastroentrology Department in Government Stanley Hospital, Chennai. Necessary additional infrastructure facilities are provided by Tamil Nadu Medical Services Corporation Limited out of the funds generated by the Centre. (ii) Institute of Obstetrics and Gynaecology, Chennai Tamil Nadu Medical Services Corporation Limited is maintaining a Paying Maternity Ward in Institute of Obstetrics & Gynaecology and Government Hospital for Women and Childrens, Egmore, Chennai on a very nominal fee fixed by the Government. Paramedical and Housekeeping Staff are engaged through outsourcing agencies and the salary is met out of revenue generated in the ward. (iii) Government Kasturba Gandhi Hospital for Women and Children, Chennai Providing infrastructure facilities to establish a Paying Special Class Maternity Ward was taken up by Tamil Nadu Medical Services Corporation Limited as directed by the Government and has commenced functioning on 03.05.2004. Construction Activity: (i) Implementation of RCH Project: Tamil Nadu Medical Services Corporation Limited has also implemented World Bank assisted Reproductive and Child Health Project in Tamil Nadu. Under this project, construction of buildings for Rs.6.00 Crores has been undertaken by Tamil Nadu Medical Services Corporation Limited and completed. Drugs worth Rs.7.00 Crores was purchased by TNMSC and issued to the Medical Institutions. (ii) Regional Diagnostic Centre: Tamil Nadu Medical Services Corporation Limited has constructed 7 Regional Diagnostic Centres in the state at Thiruvannamalai, Villupuram, Pudukottai, Virudhunagar, Ramanathapuram, Namakkal and Tirupur and the equipments for the above centers are under installation at a total cost of Rs.21.00 Crores funded under Eleventh Finance Commission, Government of India (iii) Accident and Emergency Ward (Trauma Care Centre ): Construction and purchase of equipments for Accident and Emergency Ward at Tindivanam, Ambur, Krishnagiri, Sriperumpudur and Kovilpatti has been taken up at a total cost of Rs.2.93 Crores funded by Home Department. CPC Rate Contract: Tamil Nadu Medical Services Corporation Limited, under Central Purchase Committee System by adopting open tender system has finalized rate contract for 3078 Nos. of equipments required for 14 departments in Government Medical Institutions for the period 2002 - 2004.

Maintenance of Medical Equipments available in Government Hospitals: Government of Tamil Nadu has entrusted the responsibility of maintaining Medical Equipments available in all the Government Hospitals in the State. Tamil Nadu Medical Services Corporation Limited is in the process of putting a proper system in place for taking over the maintenance of medical Equipments in all the Government Hospitals in the State. Consultancy Services:

The Tamil Nadu Medical Services Corporation Limited is a role model on Drug Logistics and

warehousing for the whole of the country. Many states in the country are emulating the principles followed by this Corporation. The Feasibility Study Report on Drug Logistics to Warehousing for the Health and Family Welfare Department, Government of Andrapradesh has been finalized and furnished. Health and Family Welfare Department, Government of Rajasthan has approached Tamil Nadu Medical Services Corporation Limited, for undertaking the Feasibility Study on Drug Logistics and Warehousing. The consultancy work is under progress.

Tamil Nadu 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. to 6.00 p.m. daily. The site also has a Bulletin Board where public can access the Medical Specialists for getting expert opinion. The Website is maintained by Tamil Nadu Medical Services Corporation Limited.

CHAPTER - 13

TAMILNADU STATE HEALTH TRANSPORT DEPARTMENT Introduction:

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 pattern of works are got executed in this type of Workshops namely 27 Mobile Workshops. 9 District Workshops and 7 Regional Workshops. The percentage of fleet in operation which was 72.6% at the beginning of the formation of this Department in 1981, has been progressively improved and now it is 96% Sanctioned staff strength:

SL.NO NAME OF THE POST NO OF POST AS ON 1.1.2003

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

TOTAL 669

Units functioning:

Head Quarters of 7 Regional Workshops.

Headquarters of 9 District Workshops.

Headquarters of 27 Mobile Maintenance Units.

Chennai Chengalpattu Chennai (S) Chennai (N) Chengalpattu and Kancheepuram Tiruvellore

Vellore Villupuram Vellore Cuddalore Villupuram and Tiruvannamalai

Salem Dharmapuri Salem and Dharmapuri.

Coimbatore Udhagamandalam and Erode

Tiruppur Erode and Udhagamandalam

Tiruchirappalli Thanjavur and Pudukkottai Tiruchirappalli, Thanjavur Perambalur and Nagappattinam.

Madurai Virudhunagar Madurai (S) Madurai (N) Theni Ramnad Sivaganga Dindigul

Tirunelveli Nagercoil Tirunelveli (N) Tirunelveli (S) Sankarankoil Nagercoil. Tuticorin

Directorate wise fleet strength maintained by this Department is given hereunder:

S.No DIRECTORATE NO. OF VEHICLES

1. Public Health and Preventive Medicine 1078 2. Medical and Rural Health Services 541 3. Family Welfare 720 4. Medical Education 239 5. Tamil Nadu State Health Transport Department 52 6. DANIDA Health Care Project 20 7. Indian Medicine and Homeopathy 10 8. Drugs Control 3 TOTAL 2663

pb-health-2003-04

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