2

HEALTH AND FAMILY WELFARE DEPARTMENT PERFORMANCE BUDGET 2004-2005 CONTENTS Page No
1 2 3 4 5 6 7 8 9 10 11 12 13 Medical Education Medical and Rural Health Services Primary Health Centres Public Health and Preventive Medicine Family Welfare Programme Drugs Control Administration Indian Medicine and Homeopathy DANIDA Assisted Tamil Nadu Area Health Care Project Reproductive and Child Health Project Tamil Nadu State AIDS Control Society Tamil Nadu State Blindness Control Society Tamil Nadu Medical Services Corporation Tamil Nadu State Health Transport Department 1 28 35 40 63 68 72 83 85 88 95 96 100

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) Revised Estimate 2003-2004 Non-Plan Plan Total (8) (9) (10)

Classification
I. (1) MEDICAL EDUCATION Medical Colleges Revenue Capital TEACHING HOSPITALS Revenue

Accounts 2002-2003 Non-Plan Plan Total (2) (3) (4)

Budget Estimate 2003-2004 Non-Plan Plan Total (5) (6) (7)

9041 24498 +14 1 1001 --

251 456 643 337 ---

9292 456 25141 +14 338 1001 --

11899 -28079 +18 -1182 --

201 2831 2937 207 ---

12100 2831 31016 +18 207 1182 --

10232 25728 +17 1 1137 --

229 1630 2204 311 ---

10461 1630 27932 +17 312 1137 --

II.

Capital III. TUBERCULOSIS CONTROL Revenue Capital IV. TRAINING Nurses Revenue Capital b. Other than Nurses Revenue Capital Revenue Total Capital V. King Institute , Guindy Revenue Capital a.

--54 -54 -543 --

8 ---8 ----

8 -54 -62 -543 --

--8 -8 -853 --

7 ---7 ----

7 -8 -15 -853 --

--52 -52 -708 --

17 ---17 ----

17 -52 -69 -708 --

(1) VI. DIRECTION, SUPERVISION AND POLICY FORMULATION Director of Medical Education Revenue Capital VII. CANCER CONTROL Revenue Capital VIII. FREE EYE CAMP Revenue Capital Control of Blindness Revenue Capital TOTAL Revenue Capital IX MISCELLANEOUS a) Medical Revenue Capital b) Aids Control Revenue Capital c) Social Welfare Revenue Capital Total Revenue Capital GRAND TOTAL Revenue Capital

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(9)

(10)

318 +9 -317 -77 --

--35 ----

318 +9 -352 -77 --

388 +1 -413 -108 --

-------

388 +1 -413 -108 --

364 +1 -352 -64 --

--200 ----

364 +1 -552 -64 --

--77 --

95 -95 --

95 -172 --

--108 --

-----

--108 --

--64 --

-----

--64 --

82 ---7 -89 -35938 +23 1

--5 ----5 -1037 793

82 -5 -7 -94 -36975 +23 794

114 1 --10 -124 1 43054 +19 1

-6 -----6 3145 3044

114 7 --10 -124 7 46199 +19 3045

102 1 --5 -107 1 38744 +18 2

-6 -----6 2650 1947

102 7 --5 -107 7 41394 +18 1949

Accounts 2002-2003 Classification (1) 01. Salaries 02. Wages 03. Dearness Allowance 04. Travel Expenses 05. Office Expenses 06. Rent, Rates and Taxes 08. Advertising and Publicity 09. Grants-in-aid 10. Contribution 12. Scholarship and Stipend 17. Minor works 18. Maintenance 19. Machinery & Equipment's 21. Motor Vehicles 24. Materials & Supplies 25. Interest 33. Payment of Professional and special services 34. Other Charges 42. Services or commitment charges 45. Petrol,oil and Lubricants 46. Clothing Non-Plan (2) 17066 +7 23 6912 +3 32 1501 359 6 237 59 1916 -16 1651 3 25 2 52 4 25 64 111 Plan (3) 107 -43 -2 --359 --95 1 385 ------1 1

OBJECT WISE CLASSIFICATION Budget Estimate 2003-04 Total (4) 17173 +7 23 6955 +3 32 1503 359 6 596 59 1916 95 17 2036 3 25 2 52 4 25 65 112 Non-Plan (5) 19822 +8 10 10423 +4 29 1676 320 8 287 51 2150 -23 1604 +1 5 30 -7 2 15 84 117 Plan (6) 123 -65 -9 --2479 -1 --393 ---1 ----Total (7) 19945 +8 10 10488 +4 29 1685 320 8 2766 51 2151 -23 1997 +1 5 30 -8 2 15 84 117

(Rupees in Lakhs) Revised Estimate 2003-04 Non-Plan (8) 17569 +8 146 8116 +4 21 1732 445 8 283 51 2147 -23 1635 5 28 4 106 2 15 92 155 Plan (9) 117 -52 -9 --1797 -1 --593 ------1 1 Total (10) 17686 +8 146 8168 +4 21 1741 445 8 2080 51 2148 -23 2228 5 28 4 106 2 15 93 156

47. 49. 01 02 51. 59. 66. 67. 68. 72. 74. 76. 99.

Classification (1) Stores and Equipments Festival Advances Festival AdvancesDebit Festival AdvancesCredit(-) Compensatory Charges Prizes & Awards Medicines Dietary Charges Cost of Text Books Training Purchase and upkeep of Animals Computer & Accessories Miscellaneous Total

Accounts 2002-2003 Non-Plan Plan Total (2) (3) (4) 947 -947

Budget Estimate 2003-2004 Non-Plan Plan Total (5) (6) (7) 1053 -1053

Revised Estimate 2003-2004 Non-Plan Plan Total (8) (9) (10) 1053 -1053

116 319

-2

116 321

150 150

---

150 150

163 163

1 1

164 164

9 2 4210 +4 763 138 6 10 -2 35938 +23

--8 -36 --1 -1037

9 2 4218 +4 763 174 6 10 1 2 36975 +23

1 8 4239 +5 947 117 1 22 1 3 43054 +19

--8 -16 --50 -3145

1 8 4247 +5 947 133 1 22 51 3 46199 +19

1 2 4279 +5 653 157 1 11 2 3 38744 +18

--8 -20 --51 -2650

1 2 4287 +5 653 177 1 11 53 3 41394 +18

SOURCE OF FINANCE (Rupees in lakhs) Revised Estimate 2003-2004 Non-Plan Plan Total (8) (9) (10)

Classification (1) Demand No. 18 - Health and Family Welfare Department 03. Directorate of Medical Education Voted Charged Total Demand No.38 2210-Medical (Buildings) 4210.Capital (Buildings) Total Budget Publication No: 51 2049.01.200.BT- Loan from HUDCO (Charged) Budget Publication No: 52 6003.00.109.BC - Loan from HUDCO

Accounts 2002-2003 Non-Plan Plan Total (2) (3) (4)

Budget Estimate 2003-2004 Non-Plan Plan Total (5) (6) (7)

35938 23 35961 1 -1

1037 -1037 -793 793

36975 23 36998 1 793 794

43054 19 43073 1 -1

3145 -3145 -3044 3044

46199 19 46218 1 3044 3045

38744 18 38762 2 -2

2650 -2650 -1947 1947

41394 18 41412 2 1947 1949

--

200

--

200

353

--

353

--

--

--

--

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
Sl. No. 1. 2. 3. 4. 5. 6. 7. 8. Name of the Institution (1) Madras Medical College, Chennai. Stanley Mecical College, Chennai. Kilpauk Medical College, Chennai. Chengalpattu Medical College, Changalpattu Madurai Medical College, Madurai. Thanjavur Medical College, Thanjavur. Coimbatore Medical College, Coimbatore. Govt. Mohan Kumaramangalam Medical College, Salem. Tirunelveli Medical College, Tirunelveli. Tamilnadu Govt.Dental College and Hosp.ital, Chennai Thoothukudi Medical College, Thoothukudi K.A.P.Viswanatham Medical College, Trichy. Total MBBS BDS B.Pharm (2) 165 150 100 50 155 150 110 75 (3) (4) 50 60 DGO (5) 38 12 8 16 6 6 DLO (6) 24 4 4 12 4 DO (7) 24 6 12 4 1 DMRT DMRD (8) 8 (9) 8 4 11 1 DA (10) 15 12 4 20 8 3 D. Orth (11) 8 4 8 6 4 DCH (12) 35 12 8 12 4 4 DTCD DDVL DCP DPH DIPM (13) 11 2 (14) (15) 20 8 4 2 (16) 10 (17) 3 DPM (18) 8 5 2 DIP in Diabetology (19) 3 ` -

9. 10

150 -

100

2 -

11. 12.

100 100 1305

100

110

86

48

47

24

62

30

77

13

20

14

10

15

DETAILS OF NUMBER OF SANCTIONED STRENGTH OF VARIOUS POST GRADUATE ( II ) DEGREE AND HIGHER SPECIALITY COURSES

Sl.No. Name of the Institution 1. Madras Medical College, Chennai 2. Tamil Nadu Government Dental College and Hospital, Chennai 3. Stanley Medical College, Chennai 4. Kilpauk Medical College, Chennai 5. Thanjavur Medical College, Thanjavur 6. Tirunelveli Medical College, Tirunelveli 7. Madurai Medical College, Madurai 8. Coimbatore Medical College, Coimbatore 9. Chengalpattu Medical College, Chengalpattu 10. GovernmentMohanKumaramangal am Medical College ,Salem. TOTAL

M.D. 123 47 19 18 5 49 21 2 284

M.S. 39 19 18 9 4 33 17 1 2 142

M.Ch. 22 6 6 1 8 2 45

D.M. 17 5 2 -4 28

M.D.S 18 18

M.Pharm 8 4 12

M.Sc. (N) 8 8

Total 217 18 77 45 28 9 98 40 1 4 537

PARA MEDICAL COURSES (SANCTIONED STUDENTS STRENGTH)

Sl. No. Basic Diploma Dental Dental B.Sc. Lab Diploma in E.C.G Physiotheraph Mechani Hygienist Nursing B.Sc. in D.Pharm C.R.A. D.R.A. Technicia Lab Optician Technicia y Nursing Nursing c * n Gr.I. Technician n 40 25 5 5 25 130 170 170 70 130 120 60 60 5 5 40 46 30 30 25 25 6 6 -

Name of the Institution

1. Madras Medical College, Chennai 2. Stanley Medical College, Chennai 3. Government Stanley Hospital, Chennai 4. Madurai Medical College, Madurai 5. Thanjavur Medical College, Thanjavur 6. Coimbatore Medical College, Coimbatore 7. Tamil Nadu Govt. Dental College & Hospital, Chennai 8. Institute of Rehabilitation Medicine, K.K. Nagar, Chennai 9. College of Physiotheraphy, Trichy 10. Government Ophthalmic Hospital, Chennai 11. King Institute, Guindy, Chennai 12. Government General Hospital, Chennai 13. Govt.Rajaji Hospital, Madurai 14. Government Kilpauk Medical College Hospital, Chennai 15. Government Mohan Kumaramangalam Medical College Hospital, Salem 16. Government Tirunelveli Medical College Hospital, Tirunelveli. 17. Government Thanjavur Medical College Hospital, Thanjavur.

130 125

18. Annal Gandhi Government Memorial Hospital , Trichy. 19. Government Mohan Kumaramangalam Medical College, Salem 20. Government Coimbatore Medical College Hospital, Coimbatore 21. Government Kasturba Gandhi Hospital for Women & Children, Chennai. 22. Government Chengalpattu Medical College Hospital, Chengalpattu 23. Government Thoothukudi Medical College Hospital, Thoothukudi 24. Government Kanyakumari Medical College Hospital, Nagercoil 25. Government Head Quarters Hospital, Kancheepuram 26. Government Head Quarters Hospital, Cuddalore 27. Government Head Quarters Hospital, Ramanathapuram 28. Government Head Quarters Hospital, Dindigul 29. Government Head Quarters Hospital, Udagamandalam 30. Government Head Quarters Hospital, Thiruppur 31. Government Head Quarters Hospital, Nagapattinam Total

130 -

10

140 50

50

50

50

40

50

50 50 50 50 50 50 50 1745

240

10

10

40

56

30

30

50

* for trained Nurses

PERSONNEL STRENGTH OF THE Sl. No. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12.

DIRECTORATE OF MEDICAL EDUCATION No. of Posts 1 2 1 1 8 1 1 1 1 9 223 39 288

Name of the Post Director of Medical Education Additional Director of Medical Education Joint Director of Medical Education (Pharmacy) Deputy Secretary to Government/Deputy Director of Medical Education (Administration) Deputy Director of Medical Education Deputy Secretary to Government/Financial Adviser & Chief Accounts Officer Senior Civil Surgeon Deputy Secretary to Government/Law Officer Manager Other Officers Ministerial Staff Basic Servants TOTAL

PERSONNEL STRENGTH OF THE COLLEGES Other than Ministerial 67 26 20 46 30 75 49 41 5 2 9 4 2 376

Sl.No. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13.

Name of the Institution Madras Medical College, Chennai Stanley Medical College, Chennai Kilpauk Medical College, Chennai Chengalpattu Medical College, Chengalpattu Thanjavur Medical College, Thanjavur Madurai Medical College, Madurai Tirunelveli Medical College, Tirunelveli Coimbatore Medical College, Coimbatore Tamil Nadu Government Dental College and Hospital, Chennai Government College of Physiotheraphy, Tiruchirapalli Government Mohan Kumaramangalam Medical College, Salem K.A.P.Viswanatham Govt. Medical College, Tiruchirapalli Thoothukudi Medical College, Thoothukudi Total

Medical 578 274 242 243 177 301 232 239 41 1 98 145 75 2646

Para Medical 235 83 57 106 85 175 77 65 33 4 46 38 -1004

Ministerial 106 44 28 45 35 65 40 50 16 5 28 28 2 492

Basic Servants 208 124 60 78 96 139 66 127 25 9 32 35 -999

Total 1194 551 407 518 423 755 464 522 120 21 213 250 79 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 Government General Hospital, Chennai 1. 1. Madras Medical College, Chennai (including Peripheral Hospital, Periyar Nagar and City Police Hospital, 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 -doOphthalmic Hospital, Chennai Government Kasturba Gandhi Hospital for Women 3. -doand Children, Chennai Institute of Obstetrics and Gynaecology and 4. -doGovernment Hospital for Women and Children, Chennai Government Institute of Rehabilitation Medicine, 5. -doChennai Institute of Child Health and Hospital for Children, 6. -doChennai 7. Institute of Thoracic Medicine, Chennai-31 -do8. Institute of Mental Health, Chennai -do9. Tamilnadu Government Dental College -----------and Hospital , Chennai 10. Government Stanley Hospital, Chennai 2. Stanley Medical College, 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 11. Government RSRM Lying in Hospital, Chennai -do12. Government Hospital for Thoracic Medicine, -doTambaram, Chennai-47 3. Kilpauk Medical College, Chennai 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

Sl.No. Name of the Hospitals 14. Government Tiruvootteeswarar Hospital for Thoracic Medicine, Chennai-12 15. Government Royapettah Hospital, Chennai-14 (including Peripheral Hospital, K.K. Nagar) (i) Government Hospital, Saidapet, Chennai-15 (ii) Government Peripheral Hospital, Neelankarai 16. Government Chengalpattu Medical College Hospital, Chengalpattu 17. Government Tanjavur Medical College Hospital, Thanjavur 18. Government Raja Mirasdar Hospital, Thanjavur 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 20. Government Tirunelveli Medical College Hospital, Tirunelveli (including Frieda Monnier Government Hospital, Kalakkad, Tirunelveli) 21. Government Coimbatore Medical College Hospital, Coimbatore 22. Government Mohan Kumaramangalam Medical College Hospital, Salem 23. 24. 25. 26. Government Arignar Anna Memorial Cancer Institute, Kancheepuram Government Arignar Anna Memorial Cancer Hospital, Karapettai Kancheepuram King Institute of Preventive Medicine, Guindy, Chennai-32 Annal Gandhi Memorial Govt. Hospital, Tiruchirapalli (including) (i)Government College of Physiotherapy,Trichy. (ii) Government Rajaji T.B.Hospital, Tiruchi. 27. 28. 29. Thoothukudi Medical College Hospital, Thoothukudi Government Vellore Medical College Hospital, Vellore (including) Subsidiary Hospital, Vellore. Government Kanyakumari Medical College Hospital, Kanyakumari ( including ) Subsidiary Hospital, Nagercoil Government Theni Medical College Hospital, Theni @ Allinagaram

Medical College to which attached 3. Kilpauk Medical College, Chennai -do-

4. Chengalpattu Medical College, Chengalpattu 5. Thanjavur Medical College, Thanjavur -do6. Madurai Medical College, Madurai

7. Tirunelveli Medical College, Tirunelveli

8. Coimbatore Medical College, Coimbatore 9. Government Mohan Kumaramangalam Medical College, Salem 10. K.A.P. Viswanatham Govt. Medical College, Tiruchirapalli

11. Thoothukudi Medical College, Thoothukudi 12. Vellore Medical College, Vellore 13. Kanyakumari Medical College, Kanyakumari 14. Theni Medical College, Theni

30.

PERSONNEL STRENGTH OF THE HOSPITALS Name of the Institution Sl. No. 1. 2. 3. 4. Medical Nursing ParaMedical (4) 474 372 170 83 175 12 156 175 223 82 118 39 19 20 25 19 15 146 151 149 160 425 310 135 95 121 13 61 6 110 44 61 16 16 12 22 17 88 63 56 14 107 Ministerial Other than Ministerial (6) 212 78 57 45 57 1 73 69 87 44 54 20 14 9 9 8 20 43 34 62 33 326 286 84 72 164 5 89 104 124 21 323 31 9 2 5 3 6 57 90 177 38 Basic Servants and others (7) 791 308 217 119 260 20 268 311 237 180 214 70 23 43 35 32 33 189 167 158 170 Total

(1) Government General Hospital, Chennai Government Stanley Hospital, Chennai Government Kilpauk Medical College Hospital, Chennai Regional Institute of Ophthalmology and Government Ophthalmic Hospital, Chennai 5. Government Royapettah Hospital, Chennai (including Government Hospital, Saidapet, Chennai) 6. Government Kasturba Gandhi Hospital for Women and Children, Chennai 7. Institute of Obstetrics and Gynaecology and Government Hospital for Women and Children, Chennai 8. Institute of Child Health and Hospital for Children, Chennai 9. Government R.S.R.M. Lying Hospital, Chennai 10. Institute of Mental Health, Chennai 11. Government Tiruvotteswarar Hospital for Thoracic Medicine, Otteri, Chennai 12. Institute of Thoracic Medicine, Chetput, Chennai 13. Government Peripheral Hospital, K.K. Nagar, Chennai 14. Government Peripheral Hospital, Anna Nagar, Chennai 15. Government Peripheral Hospital, Tondiarpet, Chennai 16. Government Institute of Rehabilitation Medicine, K.K. Nagar, Chennai 17. Government Hospital for Thoracic Medicine, Tambaram, Chennai 18. Government Chengalpattu Medical College Hospital, Chengalpattu 19. Govt. Raja Mirasdar Hospital, Thanjavur 20. Government Thanjavur Medical College Hospital, Thanjavur

(2) 188 64 48 16 71 8 39 18 56 15 23 7 12 18 30 20 2 17 6 27 37

(3)

(5)

(8) 2416 1418 711 430 848 59 686 683 837 386 793 183 93 104 126 99 164 515 504 587 545

(1) 21. Government Peripheral Hospital, Periyar Nagar, Chennai 22. 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. Government Tirunelveli Medical College Hospital, Tirunelveli (including) (i) Frieda Monniar Government Hospital Kalakhad, Government Coimbatore Medical College Hospital, Coimbatore Government Arignar Anna Memorial Cancer Hospital, Karapettai, Kancheepuram Government Arignar Anna Memorial Cancer Institute, Kancheepuram King Institute, Guindy, Chennai-32 Government Mohan Kumaramangalam Medical College, Hospital, Salem Annal Gandhi Memorial Govt. Hospital, Tiruchirapalli (including) Government T.B Hospital, Tiruchirapalli Thoothukudi Govt.Medical College Hospital, Thoothukudi Government Vellore Medical College Hospital, Vellore (including) Subsidiary Hospital, Vellore. 32. Government Kanyakumari Medical College Hospital, Kanyakumari (including) Subsidiary Hospital, Nagercoil Total

(2) 17 81 7 10 2 2 66 2 105 25 11 58 83 24 3 38 51 3 42 10 1362

(3) 21 310 24 6 8 12 236 4 221 43 4 227 126 7 121 124 20 77 57 4431

(4) 18 388 15 11 1 7 180 3 156 32 13 190 66 144 4 54 54 14 38 18 3198

(5) 9 108 4 5 3 1 58 2 57 18 4 59 22 33 4 20 32 7 19 16 1510

(6) 8 86 1 7 1 14 4 133 38 10 85 36 38 2 24 36 3 46 25 2613

(7) 33 574 35 17 25 16 325 13 254 74 8 299 155 146 18 92 157 27 72 121 6306

(8) 106 1547 86 49 46 39 879 28 926 230 50 691 589 511 38 349 454 74 294 247 19420

23.

24. 25. 26. 27. 28. 29. 30. 31.

HOSPITALS AND DISPENSARIES - NUMBER OF BEDS Name of the Institution Sl.No. (1) 1. Government General Hospital, Chennai 2. Govt. Peripheral Hospital, Periyar Nagar 3. Government Stanley Hospital, Chennai (i) Government Peripheral Hospital, Tondiarpet, Chennai 4. Government Kilpauk Medical College Hospital, Chennai (i) Government Peripheral Hospital, Anna Nagar, Chennai 5. Government Royapettah Hospital, Chennai (i) Govt. Hospital, Saidapet, Chennai (ii) Government Peripheral Hospital, K.K. Nagar, Chennai Regional Institute of Ophthalmology and Govt. Ophthalmic Hospital, Chennai Government Kasthurba Gandhi Hospital for Women and Children, Chennai Institute of Obstetrics and Gynaecology and Government Hospital for Women and Children, Chennai Institute of Child Health and Hospital for Children, Chennai Government R.S.R.M. Hospital-in-Lying Hospital, Chennai Institute of Mental Health, Chennai-10 Government Thiruvotteeswar Hospital for Thoracic Medicine, Otteri, Chennai-12 Government Institute of Rehabilitation Medicine, K.K. Nagar, Chennai-83 Government Hospital for Thoracic Medicine, Tambaram, Chennai-47 Government Chengalpattu Medical College Hospital, Chengalpattu A.C.Room (2) 4 2 9 2 6 A Class Ward (3) 18 6 2 5 4 20 4 B Class Ward (4) 74 12 7 7 16 16 13 58 122 6 24 4 C Class Ward (5) 163 55 20 18 84 55 13 16 21 15 General Ward (6) 1770 100 1208 100 486 100 687 32 100 371 624 713 537 452 1658 200 60 725 605 Total (7) 2029 100 1281 100 515 100 712 32 100 478 695 752 537 510 1800 222 60 776 630

6. 7. 8. 9. 10. 11. 12. 13. 14. 15.

16. 17. 18.

19.

(1) Government Raja Mirasdar Hospital, Thanjavur Govt. Thanjavur Medical College Hospital, Thanjavur Government Rajaji Hospital, Madurai I)Government Hospital, Balarangapuram ii) Government Hospital for Thoracic Medicine, Thoppur iii) Government Hospital for Infectious diseases, Thoppur iv) Government Cholera Collection Centre, Thoppur Tirunelveli Medical College Hospital, Tirunelveli including Frieda Monnier Govt Hospiral, Kalakad Coimbatore Medical College Hospital, Coimbatore Government Arignar Anna Memorial Cancer Hospital, Karapettai, Kancheepuram Government Mohan Kumaramangalam Medical College Hospital, Salem Annal Gandhi Memorial Government Hospital, Tiruchirapalli (including) Government Rajaji T.B. Hospital, Tiruchirapalli Thoothukudi Govt. Medical College Hospital, Thoothukudi Government Vellore Medical College Hospital, V ellore (including) Subsidiary Hospital, Vellore. Government Kanyakumari Medical College Hospital, Kanyakumari (including) Subsidiary Hospital, Nagercoil Total

(2) 1 19 1 44

(3) 6 7 1

(4) 3 10 23 12 6 12 4 4 433

(5) 12 20 38 2 --

(6) 625 641 2131 40 207 50 28 1078 30

(7) 640 678 2218 40 207 52 28 1091 30 1020 270 711 621 100 612 541 148 402 400 21238

20. 21. 22. 23.

4 -18 95

16 14 10 20 592

993 270 679 609 100 598 541 148 402 376 20074

24. 25. 26.

STATEMENT SHOWING THE NUMBER OF IN-PATIENTS ADMISSIONS Sl. No

Name of the Hospitals

Total Number of In-patients Treated 2002-2003 (1) 556260 27576 419757 30430 274426 29974 224334 4586 100778 298001 403494 238320 164440 591075 65382 34305 14582 330384 260081 2003-2004 (2) 561540 30793 417994 20986 275943 31144 232957 5042 101023 258312 369520 234794 134450 561275 60150 33332 20481 295478 266583

Average Per Day 2002-2003 (3) 1524 76 1150 83 751 82 615 17 276 816 1105 653 451 1619 179 94 40 905 713 2003-2004 (4) 1538 84 1145 57 756 85 638 18 277 708 1012 643 368 1538 165 91 56 810 730

1. Government General Hospital, Chennai (i) Government Peripheral Hospital, Periyar Nagar 2. Government Stanley Hospital, Chennai (i)Government Peripheral Hospital, Tondiarpet, Chennai 3. Government Kilpauk Medical College Hospital, Chennai (i)Government Peripheral Hospital, K.K. Nagar, Chennai 4. Government Royapettah Hospital, Chennai (i)Government Hospital, Saidapet, Chennai-15 5. Regional Institute of Ophthalmology and Government Ophthalmic Hospital, Chennai-8 6. Government Kasthurba Gandhi Hospital for Women and Children, Chennai-5 7. Institute of Obstetrics and Gynaecology and Government Hospital for Women and Children, Chennai 8. Institute of Child Health and Hospital for Children, Chennai 9. Government R.S.R.M. Lying-in Hospital, Chennai 10. Institute of Mental Health, Chennai 11. Government Tiruvotteswarar Hospital for Thoracic Medicine, Otteri, Chennai-12 12. Govt. Peripheral Hospital, Arignar Anna Nagar, Chennai 13. Government Institute of Rehabilitation Medicine, K.K. Nagar, Chennai-83 14. Tamil Nadu Government Dental College and Hospital, Chennai 15. Government Hospital for Thoracic Medicine, Tambaram, 16. Government Chengalpattu Medical College Hospital, Chengalpattu

Total Number of Out-Patients Treated 2002-2003 2003-2004 (5) (6) 2037276 2063989 403433 416639 1966043 2019318 295279 327108 1559224 438475 915842 351187 182367 335706 220545 738821 105736 107185 113815 370808 125627 185437 263767 1077343 1560222 500544 945560 386305 186965 326830 176517 716601 109904 120579 95040 446501 123569 171502 292295 1083346

17. Government Raja Mirasdar Hospital, Thanjavur 18. Government Thanjavur Medical college Hospital, Thanjavur 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 20. Government Tirunelveli Medical College Hospital, Tirunelveli (i) Frieda Monniar Hospital, Kalakkad, Tirunelveli 21. Coimbatore Medical College Hospital, Coimbatore 22. Government Arignar Anna Memorial Cancer Hospital, Karapettai, Kanchipuram 23. Government Arignar Anna Memorial Cancer Institute, Kancheepuram 24. Government College of Physiotherapy, Tiruchirapalli 25. Government Mohan Kumaramangalam Medical College Hospital, Salem 26. Annal Gandhi Memorial Government Hospital, Tiruchirapalli (including) Government Rajaji T.B. Hospital,Tiruchirapalli. 27. Institute of Thoracic Medicine, Chetput, Chennai 28. Thoothukudi Govt.Medical College Hospital, Thoothukudi 29. Government Vellore Medical College Hospital, Vellore (including) Subsidiary Hospital, Vellore.. 30. Government Kanyakumari Medical College Hospital, Kanyakumari (including) Subsidiary Hospital,Nagercoil.

(1) 284998 299569 727008 10536 47450 1112 3009 305206 4513 428455 73920 284478 257123 23612 174720 192678 36597 191725 208740 7623634

(2) 285236 295471 741548 8304 59213 4037 1636 274547 7492 413604 78159 288025 258322 20210 184134 187836 31962 117708 58307 7227548

(3) 781 825 1992 29 130 3 8 836 12 1174 203 780 704 65 478 528 100 350 197 20344

(4) 781 810 2032 23 162 11 4 752 20 1133 214 789 708 55 504 515 88 322 160 19802

(5) 1028866 477148 3314347 252693 658370 43862 1534515 17324 32955 21852 1642315 1324655 30794 251511 864662 765482 21381 859397 7662 24943707

(6) 1060009 526838 3380633 248479 622274 44366 1437447 18347 25098 15596 1777807 1326156 32542 257325 948540 792299 21580 697169 15923 25317762

Total

Sl. No. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18.

Name of

STATEMENT SHOWING THE NUMBER OF OUT-PATIENTS AND ADMISSIONS Average Number of OutTotal Number of InPatients Per Day Patients Discharged the Institution 2002-2003 2003-2004 2002-2003 2003-2004 (2) 5582 5386 4271 501 2509 962 920 604 2388 290 294 312 689 1201 1016 808 364 863 2951 (3) 5655 5532 4275 512 2590 1058 895 484 1963 301 330 260 705 1371 1223 896 339 809 2968 (4) 53868 47051 38719 12623 29668 778 27091 36906 34517 20555 5636 4062 6092 9731 3021 483 27532 44191 (5) 53690 47957 38883 12824 30574 1066 26834 33731 35699 20095 5783 3838 4391 10380 3288 684 29137 46400

Average Length of Stay Per Patient (in days) 2002-2003 2003-2004 (6) 10 9 7 8 8 7 11 11 6 8 105 20 8 8 12 30 12 6 (7) 10 8 7 8 7 7 9 11 6 7 97 16 8 8 8 30 10 6

(1) Government General Hospital, Chennai Government Stanley Hospital, Chennai Government Kilpauk Medical College Hospital, Chennai Regional Institute of Ophthalmology and Government Ophthalmic Hospital, Chennai Government Royapettah Hospital, Chennai (i) Government Hospital, Saidapet, Chennai-15 Government Kasturba Gandhi Hospital for Women and Children, Chennai Institute of Obstetrics and Gynaecology and Government Hospital for Women and Children, Chennai Institute of Child Health and Hospital for Children, Chennai Government R.S.R.M. Lying-in Hospital, Chennai Institute of Mental Health, Chennai Government Tiruvotteswarar Hospital for Thoracic Medicine, Otteri, Chennai Institute of Thoracic Medicine, Chetput, Chennai Government Peripheral Hospital, K.K. Nagar, Chennai Government Peripheral Hospital, Anna Nagar, Chennai Government Peripheral Hospital, Tondiarpet, Chennai Government Institute of Rehabilitation Medicine, K.K. Nagar, Chennai Government Hospital for Thoracic Medicine, Tambaram, Chennai Government Chengalpattu Medical College Hospital, Chengalpattu

19. 20. 21. 22.

(1) Raja Mirasdar Hospital, Thanjavur Government Thanjavur Medical College Hospital, Thanjavur Tamil Nadu Government Dental College and Hospital, Chennai 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 Government Tirunelveli Medical College, Hospital, Tirunelveli (i) Frieda Monniar Government Hospital Kalakhad, Tirunelveli Government Coimbatore Medical College Hospital, Coimbatore Government Arignar Anna Memorial Cancer Hospital, Karapettai, Kancheepuram Government Arignar Anna Memorial Cancer Institute, Kancheepuram Government Peripheral Hospital, Periyar Nagar, Chennai Government College of Physiotheraphy, Tiruchirapalli Government Mohan Kumaramangalam Medical College Hospital, Salem Annal Gandhi Memorial Government Hospital, Tiruchirapalli (including) Government Rajaji T.B. Hospital, Tiruchirapalli Thoothukudi Govt.Medical College Hospital, Thoothukudi Government Vellore Medical College Hospital, Vellore (including) Subsidiary Hospital,Vellore. Government Kanyakumari Medical College Hospital, Kanyakumari (including) Subsidiary Hospital,Nagercoil. Total

(2) 2819 1307 510 9080 692 1804 64 4204 64 90 1105 95 4500 3629 84 2369 2097 59 1520 51 68054

(3) 2904 1443 469 9262 680 1705 121 3938 50 69 1141 45 4870 3633 89 2598 2170 59 1915 54 69381

(4) 50208 39672 85139 1372 6100 3009 910 37652 543 64085 3670 3359 55331 45775 2045 29120 49755 36597 18200 3326 938392

(5) 51360 40693 86841 982 6231 919 2615 35812 561 56780 4177 3532 68123 51266 1209 29616 48133 24775 18000 3423 940302

(6) 6 7 8 60 10 3 7 8 15 7 21 10 7 6 17 6 4 30 22 29 -

(7) 6 7 9 60 10 2 2 8 15 7 20 10 7 5 17 6 4 30 7 20 -

23. 24. 25. 26. 27. 28. 29. 30. 31 32. 33.

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

Sl.No. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16.

Name of the Institution

(1) Government General Hospital, Chennai Government Stanley Hospital, Chennai Government Kilpauk Medical College Hospital, Chennai Regional Institute of Ophthalmology and Government Ophthalmic Hospital, Chennai Government Royapettah Hospital, Chennai(including) (i) Government Hospital, Saidapet, Chennai-15 Government Kasturba Gandhi Hospital for Women and Children, Chennai Institute of Obstetrics and Gynaecology and Government Hospital for Women and Children, Chennai Govt.Inst. of Child Health and Hospital for Children, Chennai Government R.S.R.M. Lying-in Hospital, Chennai Government Institute of Mental Health, Chennai Govt. Tiruvotteswarar Hospital for Thoracic Medicine, Chennai Institute of Thoracic Medicine, Chetput, Chennai Government Peripheral Hospital, K.K. Nagar, Chennai Government Peripheral Hospital, Anna Nagar, Chennai Government Peripheral Hospital, Tondiarpet, Chennai Government Institute of Rehabilitation Medicine, K.K. Nagar, Chennai

Number of Operations Performed Major Minor Total (2) 15489 13550 15760 13663 5832 14 6669 14835 7859 7243 691 1319 278 7 (3) 32556 25705 4184 14539 24097 3017 13890 21432 8489 2870 1461 7136 222 16 (4) 48045 39255 19944 28202 29929 3031 20559 36267 16348 10113 2152 8455 500 23

Number of Laboratory Tests Conducted (5) 1087818 861062 534431 96877 570108 38030 327545 276461 743827 110096 93328 47888 26365 53936 99428 34347 2894

Number of Number of MRI /C T X-rays Scan Taken Taken (6) (7) 172151 2976/34 277 135048 1020 63820 3546 95451 6087 11640 11373 71479 3002 3984 10553 35819 5890 12877 2495 2848 7263 10346 11757 -

(1) 17. 18. 19. 20. 21. 22. Government Hospital for Thoracic Medicine, Tambaram, Chennai Government Chengalpattu Medical College Hospital, Chengalpattu Government Raja Mirasdar Hospital, Thanjavur Government Thanjavur Medical College Hospital, Thanjavur Tamil Nadu Government Dental College and Hospital, Chennai Government Rajaji Hospital, Madurai (i) Government Hospital, Balarangapuram, Madurai (ii) Government Hospital for Thoracic Medicine, Thoppur, Madurai Government Tirunelveli Medical College, Hospital, Tirunelveli (i) Frieda Monniar Government Hospital Kalakkad, Tirunelveli Government Coimbatore Medical College Hospital, Coimbatore Government Arignar Anna Memorial Cancer Hospital, Karapettai, Kancheepuram Government Peripheral Hospital, Periyar Nagar, Chennai Government Mohan Kumaramangalam Medical College Hospital, Salem Annal Gandhi Memorial Government Hospital, Tiruchirapalli (including) Government Rajaji T.B. Hospital, Tiruchirapalli Thoothukudi Govt. Medical College Hospital, Thoothukudi Arignar Anna Memorial Cancer Institute, Kancheepuram Government Vellore Medical College Hospital, Vellore (including) Subsidiary Hospital, Vellore. Government Kanyakumari Medical College Hospital, Kanyakumari (including) Subsidiary Hosital, Nagercoil. Total

(2) 12166 15017 4952 38553 22148 146 5564 10538 95 780 8414 8752 -6702 3668 2731 243435

(3) 5284 16446 11417 3419 180 43062 118 3984 141 9068 112 1015 23452 12108 -1351 6123 15979 45 312918

(4) 5284 28612 26434 8371 38773 65210 264 9548 141 19606 207 1795 31866 20860 -8053 9791 18710 45 556353

(5) 359172 372384 120705 328344 29923 1187903 22745 13103 425654 6063 514002 49683 60982 627754 325773 7155 288286 13413 191611 17408 370000 41085 10377589

(6) 95838 61919 16087 62376 37749 135287 1381 982 50815 642 61796 3350 5530 58552 31517 1362 23705 11244 748 13272 1322215

(7) -6684 7476 806/1225 2 8650 10296 9098 10111 -4859 5369 3037 3782 / 142495

23. 24. 25. 26. 27. 28. 29. 30. 31. 32.

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. 2.

Testing of food samples are carried out for VIPs on their visit to Chennai. 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. 2. 3. Virus isolation from cases of acute flaccid paralysis. Monitor the cold chain maintenance of Polio vaccine of potency testing. 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 2002-2003 Receipts 27.13 Expenditure 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. 2. 3 4. 5 6. 7 8 9 10 11

Director Additional Directors of Medical and Rural Health Services Additional Directors of Medical and Rural Health Services (Admn) Joint Director of Medical and Rural Health Services Joint Director of Medical and Rural Health Services (Admn) Deputy Directors of Medical Services (Leprosy) Deputy Director of Medical and Rural Services(Admn) Financial Advisor & Chief Accounts Officer Other A & B Group Staff Ministerial Staff Office Assistants and Others Total

1 6 1 3 1 3 1 1 39 153 89 298

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 1 2 3 4 5 6 7 8 9

Name of the Post Joint Director of Health Services Hospital Superintendent( in the cadre of Senior Civil Surgeon) Deputy Director of Medical and Rural Health Services ( in the cadre of Senior Civil Surgeon) Senior Civil Surgeons Senior Civil Surgeon Specialist District Leprosy Officer (now Deputy Director of Medical Services (Leprosy)) District T.B. Officer ( including one post of Superintendent, TB Hospital) Assistant Surgeon / Sr,Asst Surgeons / Civil Surgeons (including Dental) Nursing Staff

No. of Posts 28 30 24 165 176 25 22 1942 4759

10 11 12

Ministerial Staff Paramedical Staff Other Staff Total

2228 3516 4192 17107

DIRECTOR OF MEDICAL AND RURAL HEALTH SERVICES (MEDICAL WING)

OBJECTWISE CLASSIFICATION (Rs.in lakhs)

Sl 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Object Salaries Wages Dearness Allowance Travel Expenses Office Expenses R.R.T. Publicity Advertisement Grants Contribution Subsides Hospitality Major works Minor works Maintenance Machinery & Equipment Motor Vehicle Materials and Supplies Depreciation Inter Transfer Accounts PPSS Investments Other Charges Rewards Accounts 2002-03 10713.63 0.03 4568.98 52.76 599.14 16.78 1.29 37.52 2.22 Budget Estimate 2003-04 11467.20 0.05 6317.40 66.04 610.78 27.19 7.00 37.59 1.54 165.52 8.43 Revised Estimate 2003-04 11021.39 27.36 5311.12 61.58 670.18 42.88 7.00 37.59 1.54 216.98 9.15 1.12 826.00 0.48 783.00 0.02 0.43 783.00 0.02

1.72 213.57 85.49

25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44

Service Commit charge Ration Charges Petrol, Oil, Lubricant Clothing Stores and Equipments Foreign Allowance Festival Advance Compensation Conducted Tour Expdr Prizes and Awards T A for non Officials Lands Buildings Medicines Diet Books Procurement of Agri Inputs Computer & Accessories Training Deduct Recoveries (-)

60.65 46.91 416.08 97.87 1.20 0.38

73.08 117.15 468.87 136.73 1.46

63.68 113.87 465.81 133.52 53.24 2.01

4090.51 585.28 1.67 -116.15

4100.66 635.40 0.30 4.00 -136.73

4100.63 658.50 4.80 6.00 -133.52

DISTRICTWISE INSTITUTIONS-2003-2004

(ABSTRACT)
Sl.No 1 2 3 4 5 6 7 8 9 District Kancheepuram Vellore Tiruvannamalai Cuddalore Dharmapuri Salem Erode Coimbatore The Nilgiris H.Qrs 1 1 1 1 1 1 1 1 Taluk 6 6 5 5 4 6 6 6 5 Non-Taluk 1 4 1 2 2 3 8 Others 1 1 2 1 1 2 6 Total 9 10 7 9 7 10 11 17 12

10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29

Trichy Pudukottai Dindigul Madurai Virudhunagar Sivaganga Ramanathapuram Tirunelveli Tuticorin Kanniyakumari Nagapattinam Thanjavur Villupuram Karur Perambalur Tiruvallur Tiruvarur Theni Namakkal Krishnagiri Total

1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 26

7 8 6 4 7 5 6 6 6 4 7 6 7 3 5 7 6 4 3 4 160

2 3 5 1 1 4 3 6 2 5 4 6 2 2 1 3 1 2 4 1 79

1 1 2 1 1 7 1 1 3 1 1 1 35

10 13 14 7 10 17 10 14 9 9 13 13 13 6 7 12 9 7 8 7 300

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\

Year 20002001 20012002 20022003 20032004

New Sputum Positive TB Patients diagnosed Target Achievement 30890 31055 31055 31055 24533 23589 24346 36153 % 79 76 78

Chest Symptomatics for whom sputum examination was done Target Achievement % 308880 310550 310550 384506 380747 376037 596367 124 123 121 192

Cure-rate Target Achievement 85% 85% 85% 88% 37% 81% 84% 192%

116 310550

EXPENDITURE DETAILS UNDER TB CONTROL PROGRAMME

(Rupees in Lakhs) YEAR 2000-2001 2001-2002 2002-2003 2003-2004 CENTRE 281.88 755.59 485.54 568.57

FINANCIAL REQUIREMENTS

DIRECTORATE OF MEDICAL AND RURAL HEALTH SERVICES

(RUPEES IN LAKHS) Sl No 1. a b c d 2. Programme Activity Classification Plan Direction, Supervision Policy Formulation Direction at Headquarters level Direction at District level Total Training Programme Training for Para Medical workers for Leprosy etc Total Hospital & Dispensaries Previnciliation of Panchayat Dispensaries. Ambulance and Mortuary van Mobile Medical Unit Total Contract Leprosy control T.B.Control AIDS Illness Assistance Society Total Grants Laboratory Services Control of Blindness Mental Health Regional Diagnostic Centres 26.67 Union 43.58 22.46 52.00 11.94 3.67 906.54 613.61 43.58 22.46 958.54 625.55 3.67 37.58 65.89 153.83 24.87 826.00 81.79 15.14 4.18 0.01 51.73 24.18 1256.38 870.76 51.73 24.18 1338.17 885.90 4.18 0.01 37.58 80.74 259.05 34.66 783.01 69.19 13.60 3.89 0.01 48.58 22.45 1071.86 677.97 48.58 22.45 1141.05 691.57 3.89 0.01 37.58 74.01 241.67 56.44 783.01 Accounts 2002-2003 Non Plan 283.51 553.48 836.99 Total 283.51 553.48 836.99 Budget Estimate 2003-04 Plan 6.50 Non Plan 348.87 667.51 1016.38 Total 6.50 348.87 667.51 1022.88 Revised Estimate 2003-04 Plan 6.50 Non Plan 311.28 596.29 907.57 Total 6.50 311.28 596.29 914.07

6.50

6.50

3.a b. c. d. 4. a. b. c. d 5. 6. 7. 8. 9.

18535.85

18562.52

134.66

2240.91

20375.57

161.33

19516.82

19678.15

37.58 65.89 153.83 24.87 826.00

37.58 80.74 259.05 34.66 783.01

37.58 74.01 241.67 56.44 783.01

PERFORMANCE REPORT FOR THE YEAR 2003-2004 (DISTRICT WISE). SL NO 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. NAME OF THE DISTRICTS Kancheepuram Vellore Tiruvannamalai Cuddalore Dharmapuri Salem Erode Coimbatore The Nilgris Trichy Pudukkottai Dindigul Madurai Virudhunagar Sivaganga Ramanathapuram Tirunelveli Thoothukudi Kanyakumari Nagapattinam Thanjavur Villupuram Karur Perambalur Tiruvallur Thiruvarur Theni Namakkal TOTAL BEDS 793 972 705 964 926 531 1145 1187 795 437 937 860 436 1030 706 938 778 495 339 963 831 792 339 368 416 591 618 659 20551 TOT.OP 3944367 2977849 2530571 3533623 2546417 2113287 3569222 4097325 918638 1859571 2406954 3358278 1852589 2798966 1948393 2452967 2925260 1513723 1648594 1963967 2593414 2720187 1179439 1943130 2310153 1903254 2234823 2650075 68495036 AVG.OP 10777 8136 6914 9655 6957 5774 9752 11195 2510 5081 6576 9176 5062 7647 5323 6702 7993 4136 4504 5366 7086 7432 3223 5309 6312 5200 6106 7241 187145 TOT.IP 253898 316382 241637 331215 343072 167370 418902 373404 90871 146233 267189 215295 131183 291727 174784 214541 218464 178855 118124 184519 192336 385024 106358 104049 79786 222454 218509 174033 6160214 AVG.IP 694 864 660 905 937 457 1145 1020 248 400 730 588 358 797 478 586 597 489 323 504 526 1052 291 284 218 608 597 476 16832 MAJOR Operations 5276 14031 15424 15280 7761 4652 10773 10381 1849 5073 7809 5902 357 7172 7551 7254 9572 2652 2686 7621 2527 4437 2760 4672 5903 1347 1352 4511 176585 MINOR Operations 36269 29579 46566 33774 12884 15543 21557 10902 4529 28851 26084 45476 34124 13746 11325 9448 10233 16683 18154 12626 33780 58392 3495 29896 2382 72379 10763 11430 660870 EMER. CASES 125749 61263 50114 21302 30301 23874 53690 39952 5259 44290 21871 18300 10064 10668 24261 7501 7533 21910 6675 116296 17743 94495 3672 12867 23684 53143 26629 58458 991564

PERFORMANCE REPORT FOR THE YEAR 2002-2003 (DISTRICT WISE). SL NO 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 NAME OF THE DISTRICTS Kancheepuram Vellore Tiruvannamalai Cuddalore Dharmapuri Salem Erode Coimbatore The Nilgris Trichy Pudukkottai Dindigul Madurai Virudhunagar Sivaganga Ramanathapuram Tirunelveli Thoothukudi Kanyakumari Nagapattinam Thanjavur Villupuram Karur Perambalur Tiruvallur Thiruvarur Theni Namakkal TOTAL MLC 13003 19667 12204 11969 15512 7797 10389 10282 3044 4221 7780 9212 3199 5761 5176 3915 3919 3249 3274 9096 8862 18233 2537 6174 6675 5015 6428 5253 221846 PM 1190 1703 604 1951 967 357 1284 1342 359 309 341 1025 257 560 334 1422 957 426 371 441 498 757 417 284 365 194 433 437 19585 LAB TESTS 597369 985389 1813626 732582 648743 459481 1567019 1070493 215876 487249 488842 1296958 205106 607964 313797 669995 732105 287663 385628 909622 398464 584213 192160 374657 181716 442408 330616 831797 17811538 X-RAY 15465 10367 9711 20116 16909 7076 20675 14822 8154 8016 20143 13653 9030 23010 13673 17743 13242 6702 11350 12327 13076 14761 7978 5588 7322 12847 11842 14064 359662 ACCIDENT 10089 2590 2643 4224 4924 1719 3586 4856 999 1107 3454 2234 2449 3912 1042 2036 1429 1986 1405 2685 1795 5930 1214 1527 2598 1863 1972 1048 77316 DELIVERIES 11129 15723 8515 11237 10932 4460 12036 14313 3469 4388 13153 8078 4563 7800 6383 5631 8002 6096 1950 8174 10745 11645 3541 3833 5716 6237 5119 3493 216361 CEASAREANS 1435 1181 405 1296 927 402 2166 2405 253 252 1340 729 351 1277 1143 1029 854 1070 185 760 1502 431 469 46 672 491 1407 481 24959 OTHER MATY 27149 2994 14554 14053 271 3979 1189 13770 1275 0 1476 1487 0 8991 1494 5520 764 5026 0 1946 2175 5007 806 0 686 86 122 406 115226 AVG. BIRTH. 30 43 23 31 30 12 33 39 9 12 36 22 12 21 17 15 22 17 5 22 29 32 10 10 16 17 14 10 589

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 1.2 Number of Primary Health Centres functioning at the end of VI Five Year Plan i.e. 1984- 85. Number of Primary Health Centres sanctioned during 1985 - 86: a) By Converting Rural Dispensaries as Additional Primary Health Centres b) New Additional Primary Health Centres sanctioned Number of Primary Health Centres sanctioned during 1986-87 : a) By conversion of Non - Taluk Hospital as Community Health Centres (Upgraded Primary Health Centres) : b) Newly sanctioned Additional Primary Health Centres c) Newly sanctioned Primary Health Centre (Tribal) Nammiampattu New Primary Health Centres established in 1987-88 (Additional) 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. Number of New Additional Primary Health Centres sanctioned during 1988-89. Number of New Additional Primary Health Centres during 1989-90 a) New Primary Health Centres : 123 b) Conversion of Panchayat Union Dispensaries : 41 Number of New Additional Primary Health Centres during 1990-91 (Conversion of Panchayat Union Dispensaries) Number of New Additional Primary Health Centre sanctioned during 1991-92 (Perugonapalli in Dharmapuri District). Total 14 PHCs have been upgraded as Taluk Hospitals Total No. of PHCs sanctioned during 1993-94 No. of PHCs sanctioned during 1995-96 No. of PHCs sanctioned during 1996-97 a) New Primary Health Centre : 1 b) Conversion of Panchayat Union Dispensaries : 2 Total PHC Sankarapuram made as Taluk Hospital Total Conversion of Panchayat Union Dispensaries Total 23 PHCs have been upgraded as Taluk Hospital Total No. of PHCs Sanctioned during 1998-99 Total 5 PHCs have been upgraded as Taluk hospitals/ Non-Taluk Hospitals Total No. of PHCs upgraded as Taluk Hospitals Total No. of PHCs sanctioned during 99-2000 TOTAL 436 195 20 41 5 1 140 (*)274 110 164

1.3 1.4 1.5 1.6

1.7

1.8 1.9

43 1 1430 (-) 14 1416 1 1 3 1421 (-) 1 1420 11 1431 (-) 23 1408 6 1414 (-) 5 1409 (-) 12 1397 2 1399

1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 1.19

1.20 1.21 1.22 1.23

No. of PHCs sanctioned during 2000-2001 Upgradation of PHC Kurinjipadi, Cuddalore Dist. As Non Taluk Hospital TOTAL No. of PHC sanctioned during 2001-2002 TOTAL No. of PHCs sanctioned during 2003-2004 TOTAL

12 (-) 1 1410 1 1411 2 1413

Community Health Centres / Upgraded Primary Health Centres sanctioned and established: No. of Upgraded PHCs No. of Non-Taluk Hospitals converted as Community Health Centres 1986-87 Total No. of PHCs upgraded during 2001-2002 Total No. of PHCs upgraded during 2002-2003 Total No. of PHCs upgraded during 2003-2004 Total Existing staff pattern for Main Block Primary Health Centres: 1. 2. 3. 4. 5. 6. 7. 8. 9. Medical Officer Pharmacist Auxiliary Nurse Midwife Male Nursing Assistant Junior Assistant Driver Cook-cum-Waterman Sweeper Lab. Assistant Additional Staff for Upgraded Primary Health Centres: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Medical Officer - Civil Surgeon Medical Officer - (PG Qualified Civil Assistant Surgeon) Staff Nurse Pharmacist Male Nursing Assistant Female Nursing Assistant Sweeper Radiographer Dark Room Assistant Laboratory Technician Grade-II 1 1 2 1 1 1 1 1 1 1 2 1 1 1 1 1 1 1 1 24 35 59 21 80 37 117 35 152

Primary Health Centres Building Facilities: 1 2 3 4 Total No. of Primary Health Centres Primary Health Centres Functioning in Government buildings Primary Health Centres under construction at various stages In Private/Panchayat Union Buildings Total Availability of quarters 1413 1361 14 38 1413 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. b. c. d. e. To render treatment for minor eye ailments To prescribe glasses for the correction of refractive errors To educate the school children and the rural masses on eye care and prevention of the common causes of blindness. To conduct Mini eye camps at Main PHCs wherever Operation Theatres are available. 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. 2. 3. 4. 5. Construction of 100 HSCs under PMGY During the year 2000-2001, Construction of 100 HSCs availing NABARD loan Under RIDF VII during the year 2002-2003 Construction of 100 HSCs availing NABARD Loan under RIDF VII during the year 2002-2003 Construction of 100 HSCs availing NABARD loan under RIDF VII during the year 2002-2003 Construction of 5 HSCs under PMGY scheme during the Year 2003-2004 Total Construction of Health Sub Centres 100 100 100 98 5 403

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 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 DISTRICT Coimbatore Cuddalore Dharmapuri Dindigul Erode Kancheepuram Kanyakumari Karur Madurai Nagapattinam Namakkal Perambalur Pudukkottai Ramanathapuram Salem Sivaganga Thanjavur The Nilgiris Theni Thiruvallur Thiruvarur Thoothukudi Thiruchirapalli Thirunelveli Thiruvannamalai Vellore Virudhunagar Villupuram Total Total OP 2671524 2609664 2681922 2471644 2649420 2064145 1347118 1224778 2172540 1524165 1740173 1846730 1935379 1334413 3414942 1397747 3235851 546577 1308188 1784963 1714567 1615925 2100111 2858266 2639011 2869416 1446689 3067971 58273839 OP per Day 109.10 145.00 108.00 140.10 111.50 122.00 124.70 117.30 143.70 98.50 102.80 106.90 103.40 80.60 135.50 88.20 155.00 54.20 145.40 120.90 122.10 95.50 119.10 128.10 91.60 119.00 111.60 106.50 114.64 Total IP 9152 14059 25685 15244 9601 6577 5538 5592 13380 5080 6687 10751 8435 7079 7358 6286 5082 2444 8958 4857 10655 2601 10284 5269 15687 16773 4174 13101 256389 IP per Month 11.20 23.40 31.00 25.90 12.10 11.70 15.40 16.10 26.50 9.80 11.90 18.70 13.50 12.80 8.80 11.90 7.30 7.30 29.90 9.90 22.80 4.60 17.50 7.10 16.30 20.90 9.70 13.60 20.18

Objective Classification (PHC Wing)

(Rupees in Thousands)
Budget Estimate 2003-04 Objects (1) Non-Plan (2) Plan (3) 50951 351 27 3101 0 2005 30 193 0 30061 335 10 49 1102 2180 135 0 0 0 0 1 54367 300 1 71 554 0 0 0 802 70 5081 692 -692 0 2 38794 15 0 0 17 190610 0 190610 C.S.S (4) 11885 108 2 43 0 538 4 37 0 7012 390 8 0 0 7 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 179 -179 0 0 1 0 0 0 1 20037 0 20037 Total (5) 870026 7418 69 32312 1 38008 1064 2407 200 513315 10760 398 1069 1242 7737 10135 150 75 1 45 1 54368 310 1 1081 554 0 15 0 6802 260 5266 12159 -12159 10 102 152758 1015 0 49 318 1719326 -10 1719316 NonPlan (6) 748295 6209 40 18109 1 33014 1175 1787 150 389115 10035 370 1020 140 5550 15000 100 75 1 44 0 0 10 0 602 0 0 15 0 6000 190 185 11024 -11024 10 100 143963 998 0 49 300 1382652 -10 1382642 Revised Estimate 2003-04 Plan (7) 225367 1878 40 6391 0 7658 40 794 0 117188 3086 62 699 1122 2230 1020 0 0 0 0 1 16189 300 17385 576 0 0 215 3010 2285 400 4505 689 -689 0 1 19530 15 600 9070 0 441657 0 441657 C.S.S (8) 12097 110 2 55 0 538 4 37 0 6290 390 8 0 0 7 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 179 -179 0 0 1 0 0 0 0 19540 0 19540 Total (9) 985759 8197 82 24555 1 41210 1219 2618 150 512593 13511 440 1719 1262 7787 16020 100 75 1 44 1 16190 310 17385 1178 0 0 230 3010 8285 590 4690 11892 -11892 10 101 163494 1013 600 9119 300 1843849 -10 1843839

01. Salaries 01. Pay 807190 02. Medl. Allowance 6959 03. Medical Charges 40 04. Other Allowances 29168 05. Interim Relief 1 06. H.R.A. 35465 07. Travel Concession 1030 08. C.C.A. 2177 02. Wages 200 03. Dearness Allowance 476242 04. Travelling Expenses 01. Tour T.A. 335 02. Transfer T.A. 370 03. F.T.A. 1020 05. Office Expenses 01. Telephone Charges 140 02. Other Contingencies 5550 03. Electric Charges 10000 06 Rent Rate Taxes 01 Rent 150 02 Property Tax 75 03 Water Charges 1 08. Advertisement & Pub 45 09. Grant-In-Aid 0 19 Machinery & Equipments 01. Purchase 0 03 Maintenance 10 21. Motor Vehicle 01. Purchase 0 02. Maintenance 1010 24. Materials and 0 Supplies 0 25 Interest 33. 01 Pleader fees 15 42. Service or 0 Commitment charge 45. P.O.L. 6000 190 46. C.T.S. 47. S & E 185 49. 01 FA Debit 11288 02 FA Credit -11288 51. Compensation 10 59. Prizes & Awards 100 66. Medicines 113963 1000 67. F.D.C. 71. Printing charges 0 72. Training 49 300 73. Transport Charges Total 1508689 Charged -10 TOTAL 1508679

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)
Objects 01 Salaries 02 Wages 03 Dearness Allowance 04 Travel Expenses 05 Office Expenses 06 Rent, Rates and Taxes 07 Publications 08 Advertising & Publicity 09 Grants-in-Aid Actual 2002-2003 Non-Plan Plan Total 3408.78 10215.43 13624.21 0.16 -0.78 -0.62 1457.41 4464.09 5921.50 110.71 490.85 601.56 45.51 211.12 256.63 9.17 66.86 76.03 0 1.22 1.22 1.71 40.49 42.20 14.77 0 14.77 Budget Estimate 2003-2004 Non-Plan Plan Total 4028.10 12772.85 16800.95 0.40 1.40 1.80 2235.15 7128.40 9363.55 133.01 540.64 673.65 56.78 257.36 314.14 7.66 106.84 114.50 0 2.00 2.00 1.11 48.10 49.21 17.00 0.01 17.01

11 Subsidies 12 Scholarship and Stipend 16 Major Works 17 Minor Works 18 Maintenance 19 Machinery & Equipment 21 Motor Vehicles 24 Materials & Supplies 25 Interest 33 PPSS 34 Other Charges 45 P.O.L. 46 Clothing, Tentage and Stores 47 Stores & Equipment 49 FA Debit 49 FA Credit 59 Prizes & Awards 66 Medicines 67 Feeding/Dietary Charges 68 Cost of Books 71 Printing Charges 72 Training 73 Transport 76 Computer & Maintenance Total

0 0.72 0 0.67 0 9.38 2.43 4.59 0.88 0.32 0.03 33.00 0.41 0.21 7.07 -19.83 0.14 324.33 0.02 1.75 48.99 12.52 0.50 0 5476.35

0 2.55 0 0 0.25 33.74 188.63 125.62 2.66 11.41 0 60.38 0.11 44.55 28.91 -22.86 0.68 245.84 0 0.92 0.04 65.63 0.87 2.80 16282.01

0 3.27 0 0.67 0.25 43.12 191.06 130.21 3.54 11.73 0.03 93.38 0.52 44.76 35.98 -42.69 0.82 570.17 0.02 26.70 49.03 78.15 1.37 2.80 21758.36

0 0.86 0 0.35 0 7.75 5.98 4.45 0 0.65 0.10 60.25 0.38 0.21 0 0 0.94 328.44 0.02 0.90 46.00 15.85 1.38 0 6953.72

0.01 18.00 0 0 0.01 37.52 5.79 470.16 0 33.76 0 103.67 0.02 44.23 0 0 1.62 418.56 0 1.20 0.11 30.97 3.85 0.40 22027.48

0.01 18.86 0 0.35 0.01 45.27 11.77 474.61 0 34.41 0.10 163.92 0.40 44.44 0 0 2.56 747.00 0.02 2.10 46.11 46.82 5.23 0.40 28981.20

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

46 Clothing, Tentage and Stores 47 Stores & Equipment 5900 Prizes & Awards 66 Medicines 67 Feeding/Diet Charges 68 Cost of Books 71 Printing Charges 72 Training 73 Transport Charges 76 Computer & Maintenance Total

0.19 0.21 0.44 328.44 0.02 1.00 46.00 17.75 1.38 0 6521.97

1.46 42.79 1.62 542.59 0 1.20 0.11 30.97 3.89 0.40 18069.65

1.65 43.00 2.06 871.03 0.02 2.20 46.11 48.72 5.27 0.40 24591.62

STATEMENT SHOWING THE FINANCIAL REQUIREMENT OF PUBLIC HEALTH SCHEMES (Rupees in lakhs)
Schemes Direction and Administration School Health Programme Tribal Sub Plan Health Sub Centres Prevention and Control of Diseases Prevention of Food Adulteration Prevention of Air and Water Pollution Health Statistics and Evaluation Health Education and Publicity Training Total Actual 2002-2003 Non-Plan Plan Total 249.24 541.67 0 0 3925.99 203.54 122.67 139.65 103.67 189.92 5476.35 869.24 0 63.72 9634.23 5518.11 1.46 12.04 0 2.71 180.50 16282.01 1118.48 541.67 63.72 9634.23 9444.10 205.00 134.71 139.65 106.38 370.42 21758.36 Budget Estimate 2003-2004 Non-Plan Plan Total 333.47 616.16 0 0 5069.70 227.53 144.38 179.79 146.18 1051.39 40.00 74.90 12590.41 7963.28 9.50 13.40 0 3.14 1384.86 656.16 74.90 12590.41 13032.98 237.03 157.78 179.79 149.32 517.97 28981.20 Revised Estimate 2003-2004 Non-Plan Plan Total 278.39 608.97 0 0 4793.63 224.14 125.87 161.09 120.05 209.83 6521.97 998.32 40.00 69.30 10267.85 6345.59 9.50 14.73 0 4.36 320.00 18069.65 1276.71 648.97 69.30 10267.85 11139.22 233.64 140.60 161.09 124.41 529.83 24591.62

236.51 281.46 6953.72 22027.48

DIRECTION AND ADMINISTRATION (Rupees in lakhs)

Scheme Actual 2002-2003 NonPlan Total Plan 178.60 70.64 0 0 0 0.51 178.60 70.64 0.51 Budget Estimate 2003-04 NonPlan Total Plan 242.99 90.48 0 0 0 1.00 242.99 90.48 1.00 Revised Estimate 2003-04 NonPlan Total Plan 200.51 77.88 0 0 0 1.00 200.51 77.88 1.00

2210-06-001-AA Headquarters Administration 2210-06-001-AG Directorate of Training & CE 2210-06-001-JAHeadquarters Administration 2211-00-001-SF Direction & Administration under CSSM & Sub Centres
Total

0 249.24

868.73

868.73

0 1050.39 1050.39 333.47 1051.39 1384.86

0 278.39

997.32 998.32

997.32 1276.71

869.24 1118.48

SCHOOL HEALTH PROGRAMME (Rupees in lakhs)

Scheme Actual 2002-2003 NonPlan Total Plan Budget Estimate 2003-2004 NonPlan Total Plan Revised Estimate 2003-2004 NonPlan Total Plan

2210-01-109-AA / JA School Medical Inspection 2210-01-109-AB Supply of Drugs through TNMSC Total

241.67 300.00 541.67

0 0 0

241.67 316.16 300.00 300.00 541.67 616.16

40.00 0 40.00

356.16 308.97 300.00 300.00 656.16 608.97

40.00 0 40.00

348.97 300.00 648.97

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 Number % Number % 40308 -40308 -37117 14092 1888 9297206 92.08 34.96 4.68 -35327 10786 1382 9297206 87.64 26.76 3.43

Sl.No. 1. 2.

Particulars Total Number of Schools to be covered Number of Schools covered so far I visit II visit III visit Total Number of Students to be examined

3.

4.

5. 6.

7.

Number of Students examined so far I visit II visit III visit Number of Students treated for minor ailments Morbidity Pattern a) Dental Carries b) Worm Infestation c) A.R.I. d) Anaemia e) Vitamin - A Deficiency f) Scabies g) Defective Vision h) Ottitis Media i) Leprosy j) Defective Hearing k) Rheumatic Heart Diseases l) T.B. m) Goiter Number of students referred to Taluk Hospitals or any other referral Hospitals

7246698 2403253 371148 4946396

77.94 25.85 3.99

6719807 2101292 291290 4695246

72.28 22.60 3.14

1047932 886818 1040153 325255 199080 145408 17568 38387 4565 4238 6190 8504 2093 72592

10.46 8.85 10.38 3.25 1.99 1.45 0.18 0.38 0.07 0.04 0.06 0.08 0.02 0.72

938014 878223 1152967 308389 174088 112248 14561 31789 4119 4617 3843 7998 4483 46503

1029 9.64 12.65 3.38 1.91 1.23 0.16 0.35 0.05 0.05 0.04 0.09 0.05 0.51

PREVENTION AND CONTROL OF DISEASES (Rupees in lakhs)

Schemes Plague Control Measures Epidemic Control Unit Epidemiological Unit Guineaworm Eradication Programme Cholera Combat Team Cholera Control Programme Malaria Rural and Urban, Japanese Encephalitis and Lab.Asst.in PHCs Filaria Control Leprosy Control Surveillance for Epidemic Preparedness Institute of Vector Control and Zoonoses, Hosur Immunization Maternity and Child Health Services Prevention and Control of Goitre Care Assisted Feeding Programme Mobile Health Care/ Specialty Camps Leptospirosis Dengue Control Total Actual 2002-2003 NonPlan Total Plan 26.19 0 26.19 52.52 0 52.52 14.02 0 14.02 3.85 0 3.85 17.98 0 17.98 0 19.63 19.63 0 4480.51 4480.51 342.54 3018.55 41.02 0 Budget Estimate 2003-2004 Revised Estimate 2003-2004 NonPlan Total NonPlan Total Plan Plan 26.68 0 26.68 26.39 0 26.39 71.52 0 71.52 151.16 0 151.16 19.42 0 19.42 15.13 0 15.13 2.81 0 2.81 4.24 0 4.24 20.76 0 20.76 19.59 0 19.59 0 23.39 23.39 0 22.09 22.09 0 6742.34 552.23 0 148.77 62.20 6742.34 0 5078.78 565.05 0 141.28 56.69 5078.78 966.96 3658.31 219.54 56.69 363.96 120.19 4.74 3.64 402.09 21.72 4.00 11139.22

407.38 749.92 412.42 0 3018.55 3889.53 111.53 50.79 152.55 50.79 49.92 0

964.65 401.91 3889.53 3658.31 198.69 62.20 78.26 0

292.79 5.77 298.56 420.72 49.24 113.07 0 113.07 152.07 0 0 4.06 4.06 0 5.83 3.46 0 3.46 3.85 0 0 423.46 423.46 0 354.40 0 14.98 14.98 0 22.38 0 0 0 0 2.50 3925.99 5518.11 9444.10 5069.70 7963.28

469.96 314.81 49.15 152.07 120.19 0 5.83 0 4.74 3.85 3.64 0 354.40 0 402.09 22.38 0 21.72 2.50 0 4.00 13032.98 4793.63 6345.59

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 90s 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 2000 2001 2002 2003

CASES IN THE STATE 43053 31551 34523 43396

CASES IN CHENNAI CITY 31861 23652 27205 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 2000 2001 2002 2003 CASES 118 119 126 180 DEATH. 17 18 29 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 1998 1999 2000 2001 2002 2003 01/04 to 3/04 No. of persons examined 1136072 1031604 1033093 1095717 1155566 1128494 273300 No. positive for Mf. 2254 789 1338 1007 775 417 47 Mf. Rate 0.19 0.07 0.12 0.09 0.07 0.04 0.02 No. of disease case 1715 2030 1590 1041 849 251 29 Disease Rate 0.15 0.20 0.14 0.09 0.07 0.02 0.01 Endemicity Rate 0.34 0.27 0.26 0.18 0.14 0.06 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 1997-98 1998-99 1999-2000 2000-01 2001-02 2002-2003 Round I II III IV V VI Target Population (in lakhs) 260.00 264.00 268.30 DEC 262 ALB 132 DEC 128.5 ALB 134.7 DEC 136.41 DEC+ALB 137.57 Population covered (in lakhs) 227.816 237.679 242.080 252 126 123.7 127.4 129.65 130.77 Coverage % 92.74 94.04 93.16 96.1 95.6 89.20 89.6 87.83 89.95 Mf. Rate 0.881 0.326 0.176 0.20 0.10 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 1. 2. 3. 4. 5. 6. 7. 8. 9 10 Year 1995 1996 1997 1998 1999 2000 2001 2002 2003 Jan04 to March04 Cases 651 606 1455 3006 1004 1801 2196 1232 3629 681 Deaths 6 11 10 3 3 8 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 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Year 1995 1996 1997 1998 1999 2000 2001 2002 2003 Jan04 to March04 Cases 549 491 264 128 135 81 816 376 1610 145 Deaths 6 16 21 5 2 1 8 1 9 -

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: Year 1998-99 1999-2000 2000-2001 2001-2002 2002-2003 2003-2004 A.D.D. Cases 77748 69,824 62405 58733 68528 61800 Deaths 384 164 172 160 187 63 Cases 1691 1858 1183 1442 1251 409 Cholera Deaths 1 1 1 0 3 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 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 District Ramanathapuram The Nilgiris Thiruvarur Salem Virudhunagar Villupuram Coimbatore Kanyakumari Dharmapuri Pudukkottai Namakkal Nagapattinam Erode Perambalur Tuticorin Thanjavur Chennai Thiruchirappalli Theni Thiruvannamalai Dindigul Vellore Kancheepuram Cuddalore Sivaganga Thiruvallur Thirunelveli Madurai Karur Year 2001 1999 1998 1999 2001 1999 2001 1999 1999 1998 1998 1998 1998 1999 2001 1998 1996 1999 1998 1999 1999 1997 1997 2000 2003 2003 2003 2000 2000 Total Examined 28821 19659 12496 46514 22369 44700 33475 25243 65792 24603 12789 14185 22342 25240 29245 16337 25483 33523 14549 48848 53719 36331 21301 45592 22511 28528 26825 42506 29614 Goitre Cases 3328 3273 1817 5802 1697 5376 3401 2966 7576 2741 1338 1471 2321 2636 2010 1659 2567 3362 1350 4563 4742 3085 1680 3547 1435 1584 1700 2687 1057 % 11.5 16.6 14.5 12.5 7.6 12.0 10.2 11.7 11.5 11.1 10.5 10.4 10.4 10.4 6.9 10.2 10.1 10.0 9.3 9.3 8.8 8.5 7.9 7.8 6.4 5.6 6.3 6.3 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 2001-2002 S.N Vaccine T A % T.T.M 1 12.73 13.41 105 2 D.P.T 11.58 12.52 108 3 Polio 11.58 12.53 108 4 B.C.G 11.58 12.77 110 5 Measles 11.58 12.18 105 Note: T - Annual Target, A - Achievement T* - Annual Target adopted as per G.O.I. P.T% - Proportionate percentage to target. 2002-2003 T A 12.87 13.05 11.7 12.08 11.7 12.09 11.7 12.2 11.7 12 (Fig in Lakhs) 2003-2004 T* A P.T % 12.81 12.55 98 11.64 11.87 102 11.64 11.88 102 11.64 11.99 103 11.64 11.52 99

% 101 103 103 104 103

REPORTED INCIDENCE OF V.P.D CASES IN TAMILNADU S.No. DISEASE 2001 C 1 0 1 4 0 757 488 D 0 0 0 2 0 8 0 C 1 0 3 2 0 262 512 2002 D 0 0 0 1 0 1 0 C 4 0 2 0 2 156 699 2003 D 2 0 2 0 0 0 4

1 DIPTHERIA 2 PERTUSIS 3 TETANUS(NEO) 4 TETANUS(OTH) 5 POLIO 6 TB(CHILD) 7 MEASLES 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. 1 2 3 4 5 Item Total No. of Samples received and tested in connection with the periodical examination of protected water supply Total Number of water samples received from Rural Water supply New Water supplies included under periodical examination Total Number of samples of Water etc. tested for Bacteriological Physical and Chemical examinations Number of field investigations etc. carried out 2001-2002 25426 98 5 27007 12 2002-2003 11033 349 15613 22 2003-2004 28740 669 10 18569 27

PREVENTION OF FOOD ADULTERATION (Rs. in lakhs) Actual 2002-2003 Scheme 2210-06-102-AA Food Analysis Laboratories 2210-06-102-JA & SA Food Analysis Laboratories Total NonPlan 203.54 0 203.54 Plan 0 1.46 1.46 Total 203.54 1.46 205.00 Budget Estimate 2003-04 NonPlan Total Plan 227.53 0 227.53 0 9.50 9.50 227.53 9.50 237.03 Revised Estimate 2003-04 Non-Plan 224.14 0 224.14 Plan 0 9.50 9.50 Total 224.14 9.50 233.64

PREVENTION OF AIR AND WATER POLLUTION Actual 2002-2003 Non-Plan Plan 0 122.67 122.67 12.04 0 12.04 Budget Estimate 2003-2004 Non-Plan Plan Total 0 144.38 144.38 13.40 0 13.40 13.40 144.38 157.78 (Rs. in lakhs) Revised Estimate 2003-04 Non-Plan Plan Total 0 125.87 125.87 14.73 0 14.73 14.73 125.87 140.60

Scheme 2210-06-107-JA Development of Public Health Lab. Services 2215-02-106-AA Water Analysis Laboratory Total

Total 12.04 122.67 134.71

HEALTH STATISTICS AND EVALUATION (Rs. in lakhs) Revised Estimate 2003-04 NonPlan Total Plan 1.70 0 1.70 14.81 0 14.81 19.48 121.75 3.35 161.09 0 0 0 0 19.48 121.75 3.35 161.09

S. No. 1 2 3 4 5

Actual 2002-2003 Scheme 2210-80-004-AA Research Work 2210-80-004-AB Nutrition Research 2210-80-004-AG Medical Statistical Cell 2210-80-004-AI Vital Statistical Registration 2210-80-004-AJ Strengthening of Surveillance Unit for Expanded and Immunization Programme Total NonPlan 1.93 15.27 16.69 100.58 5.18 139.65 Plan 0 0 0 0 0 0 Total 1.93 15.27 16.69 100.58 5.18 139.65

Budget Estimate 2003-2004 NonPlan Total Plan 3.22 0 3.22 24.44 0 24.44 20.45 127.03 4.65 179.79 0 0 0 0 20.45 127.03 4.65 179.79

HEALTH EDUCATION AND PUBLICITY Scheme 2210-06-112-AA Head Quarters Unit and RCAP Units in Districts 2210-06-112-AC Training Units 2210-06-113-AD Press 2210-06-113-AE Exhibition and Media Units 2210-06-113-JA Establishment of 10 Media Units Total Actual 2002-2003 Non-Plan Plan Total 77.83 7.85 7.48 10.51 0 103.67 0 0 0 0 2.71 2.71 77.83 7.85 7.48 10.51 2.71 106.38 Budget Estimate 2003-2004 Non-Plan Plan Total 108.89 10.87 11.65 14.77 0 146.18 0 0 0 0 3.14 3.14 108.89 10.87 11.65 14.77 3.14 149.32 (Rs. in lakhs) Revised Estimate 2003-2004 Non-Plan Plan Total 88.79 9.59 6.95 14.72 0 120.05 0 0 0 0 4.36 4.36 88.79 9.59 6.95 14.72 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 Recurring : Equipment and furniture Rs.33,000/: 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. 1. 2. 3. 4. 5. Details of MCH Components 2000-01 % 100.0 85.6 98.4 2.0 98.9 2001-02 % 99.2 87.9 98.8 1.2 99.0 2002-03 % 93.1 90.0 99.0 1.0 98.8 200304 % 93.4 92.3 99.3 0.7 99.1

Antenatal Registration Institutional Services Deliveries by trained staff Deliveries by untrained staff Birth weight taken for newborn babies.

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. 1. 2. Name of District Dharmapuri Salem Tribal Area Sitheri hill Yercaud hill Kolli hill Kalrayan hill. Health Sub-Centres 5 3 5 2

3. 4. 5.

Villupuram Vellore` Trichirapalli

Kalrayan hill Jawadhu hill Pachamalai hills Total

14 17 4 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. 1. 2. 3. 4. 5. 6. 7. Name of post Assistant Surgeon Laboratory Technician Pharmacist Auxiliary Nurse Midwife Attendant Driver Health Inspector No. of post 2 1 1 1 1 1 3

A majority of the women in Tamil Nadu and the adolescent girls in the age group 11 to 19 years are suffering from some form of anaemia. This contributes to low birth weight new born babies and maternal and Infant deaths. Hence as part of antenatal services package, the expectant mothers are given with 100 FST (Large) tablets. Identified anaemic pregnant mothers are administered with 200 tablets. To control the Iron deficiency anaemia among adolescent girls each girl is given with an IFA (Large) tablet weekly once. About 53 lakhs adolescent girls are benefited every week. The coverage stands at 57.8% at present. HEALTH SUB CENTRE (Rupees in lakhs)
Scheme 2210-03-101-JD P.U.HSCs 2211-00-101-SC Sub Centres 2211-00-793-SA Health SubCentres in Adi Dravidar Colonies Total Actuals 2002-2003 Budget Estimate 2003-2004 Revised Estimate 2003-04 NonPlan Total NonPlan Total NonPlan Total Plan Plan Plan 0 0.23 0.23 0 0 0 0 0 0 0 8006.16 8006.16 0 8980.16 8980.16 0 8473.23 8473.23 0 0 1627.84 1627.84 9634.23 9634.23 0 0 3610.25 12590.41 3610.25 12590.41 0 0 1794.62 10267.85 1794.62 10267.85

TRIBAL SUB PLAN (Rupees in lakhs)

Scheme Actuals 2002-2003 NonPlan Total Plan 0 9.40 9.40 Budget Estimate 2003-2004 NonPlan Total Plan 0 13.29 13.29 Revised Estimate 2003-2004 NonPlan Total Plan 0 12.69 12.69

2210-03-796-JC Mobile Medical Unit facilities at Kalrayan Hills 2211-00-796 SA Maternity Centres under Tribal Areas Total

0 0

54.32 63.72

54.32 63.72

0 0

61.61 74.90

61.61 74.90

0 0

56.61 69.30

56.61 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 1999 2000 2001 2002(Provisional) Birth Rate 19.3 19.3 19.1 18.5 Death Rate 8.0 7.9 7.7 7.7 Infant Mortality Rate 52.0 51.0 49.0 44.0

National Campaign to issue Birth Certificates: Registration of Births and Deaths are compulsory under the Registration of Birth and Death Act 1969. The Act also provides for issue of a certificate free of charge to the informant immediately after registration. The individual Birth Certificate is a vital document for getting admission to School, obtaining Passport Etc. In order to create awareness among the public and to know the importance of Registration a National Campaign to issue Birth Certificate is launched from. 14-11-2003 to 31-3-2004. 29 Lakhs of Birth Certificates have been issued during the campaign. To focus the Birth as a right of the child the National Campaign is launched. Multipurpose National Identity Card: The Government of India has decided to issue of Multi purpose National Identity Card to all citizens. In Tamil Nadu, Tiruvadanai Taluk of Ramanathapuram District has been selected as the pilot area for the Multi purpose National Identity Card Project. The Civil Registration System forms the basis for the implementation the Multipurpose National Identity Card Project. For this Project the Additional Secretary, Home Department has been nominated as State co-ordinator. The Director of Census Operation is overall incharge for this pilot project. Medical Certification of Cause of Death as per International Classification of Diseases X Revision: S. International Classification of Diseases % of Total Medically Certified Deaths No. 1999 2000 1. Infectious and Parasitic diseases 7.1 7.0 2. Neoplasms 4.3 4.2

3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20.

Nutritional metabolic diseases and Immunity disorders. Diseases of blood and blood forming organs. Mental disorders Diseases of Nervous system Diseases of circulatory system. Diseases of Respiratory system Diseases of digestive system Diseases of Genito Urinary System Complications of Pregnancy Diseases of skin Diseases of muscular skeletal system. Congenital Anomalies Certain conditions originating in the perinatal period Symptoms, signs and ill defined conditions. Injury and Poisoning Diseases of eye and adnexa Disease of the ear and mastoid Persons External Causes of morbidity and mortality

2.5 0.8 0.3 1.67 35.8 7.2 2.3 2.3 0.3 0.04 0.01 0.3 4.59 14.3 13.1 2.5

0.5 3.8 0.4 2.75 35.2 4.8 2.7 3.7 0.4 0.04 0.01 0.3 8.5 8.1 15.3 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. 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. 2. One week training at Anna Institute of Management. 3. 21 days at Anna Institute of Management. 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 have been trained, 15276 medical and paramedical staff 1.

Public Health Administration. Management Foundation "B" training course

TRAINING (Rs. in lakhs)

Actual 2002-2003 Scheme 1. 2. 3. 4. 5. 6 7 8 9 10 2210-06-003-AA Orientation Training Centre, Poonamallee 2210-06-003-AB Training of Health Visitor 2210-06-003-AD Nutrition Training 2210-06-003-JE Establishment of Computer Training Centre @ Salem & Madurai 2210-06-003-AF Establishment of Regional Institute of Public Health for in-service Training 2211-06-003-SG Schools for Training in Multi Purpose Health Workers (Female) 2211-00-003-SA Health and Family Welfare Training Centres 2211-00-003- SF Grants 2211-00-003-JA DANIDA Health Care Absorption NonPlan 140.85 28.85 11.24 0 8.98 0 0 0 0 0 189.92 Plan 0 0 0 0 0 81.90 60.01 0 36.96 1.63 180.50 Total 140.85 28.85 11.24 0 8.98 81.90 60.01 0 36.96 1.63 370.42

Budget Estimate 2003-04 NonPlan 184.37 29.64 13.00 0.02* 9.48 0 0 0 0 0 236.51 Plan 0 0 0 49.40 0 125.90 67.68 0.01 35.99 2.48 281.46 Total 184.37 29.64 13.00 49.42 9.48 125.90 67.68 0.01 35.99 2.48 517.97

Revised Estimate 2003-04 NonPlan 156.22 30.70 11.72 0 11.19 0 0 0 0 0 209.83 Plan 0 0 0 16.40 0 125.20 64.36 10.17 101.39 2.48 320.00 Total 156.22 30.70 11.72 16.40 11.19 125.20 64.36 10.17 101.39 2.48 529.83

2211-00-104-SD Motor Vehicle Total * 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 MLEC I MLEC II MLEC III MLEC IV 4039 3886 2525 1432 PB 7533 6785 5950 4018 MB 1058 1932 1662 701 Total 12630 12603 10137 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 1998-99 1999-2000 2000-2001 2001-2002 2002-2003 2003 04 (upto Dec 03) New Case Detection Achieve Target % ment 40000 45862 114.7 30000 62812 209.4 15000 47350 315.7 15000 32251 215.0 13470 24767 183.9 * 13289 Cases Brought Under Trt Achieve Target % ment 40000 46005 115 30000 62911 209.7 15000 47327 315.5 15000 32274 215.2 13470 24767 183.9 * 13703 Cases Cured Achieve ment 51632 56234 54216 32990 28977 16414

Target 43000 50000 34000 43000 27395 *

% 120.1 112.5 159.5 76.72 105.8 -

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

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 peoples programme involving the active cooperation 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 Sl. No. 1. 2. 3. 4. 5. INDICATORS CURRENT LEVEL TAMIL NADU INDIA 6,24,05,679 102,70,15,247 11.72 21.35 987 933 480 324 44.04 27.78 82.33 75.85 64.55 54.16

Population Decennial Growth Rate (%) Sex Ratio (female per 1000 males) Density of population (per sq. K.M.) Percentage of Urban population Male 6. Literacy Rate (%) Female Source: 2001 Census 7. Crude Birth Rate (per 1000 population) 8. Crude Death Rate (per 1000 population) 9. Infant Mortality Rate (per 1000 live births) 10. Natural Growth Rate (%) Source: SRS 2002

18.5 7.7 44 1.08

25.0 8.1 64 1.69

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 2 3 4 5 6 7 8 Primary Health Centres Health Sub-centres Rural Family Welfare Centres Post Partum Centres Urban Family Welfare Centres Urban Health Posts Voluntary Organisations Private Approved Surgeries 1413 8682 382 118 101 198 27 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. 2. 3. 4. 5. Couple Protection Rate (as on 31 March 2003) Sterilisation acceptors with two and less than two living children 2003-2004 Percentage of Higher Order Births (2002) Mean age at acceptance of sterilisation (2002-03) Mean number of living children to the sterilisation acceptors (2002-03)
st

50.3 % 67.8 % 20.2 % 26.9 Years 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. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 District Chennai Coimbatore Cuddalore Dharmapuri Dindigul Erode Kancheepuram Kanyakumari Karur Madurai Nagapattinam Namakkal Perambalur Pudukkottai Ramanathapuram Salem Sivagangai Thanjavur The Nilgiris Theni Thiruchirapalli Thirunelveli Thiruvallur Thiruvannamalai Thiruvarur Thoothukudi Vellore Sterilisation 54402 26218 17096 20489 15380 17583 15879 10437 4775 20255 6745 9286 6252 8311 7607 23455 7550 14289 4750 8566 12088 18409 12096 16044 6955 10932 24739 I.U.D. 55379 23147 18290 15753 14786 15696 13138 11273 7350 19942 11912 11777 6817 12740 8692 19051 7247 18254 4525 7131 14492 19569 11661 15938 10063 10732 18768 O.P.Users 15477 9386 9250 8333 6275 6541 4714 5258 2947 8276 4065 4272 2843 5009 5404 5341 4081 7838 1194 2598 4130 7708 4806 5737 4444 5128 7847 C.C.Users 32667 13598 11408 8037 6064 9300 5154 5263 2425 10112 4336 6590 2633 5550 5573 7569 4858 7251 1608 2598 3375 9341 5809 6185 4351 3849 8618

28 29

Villupuram Virudhunagar Total

16742 12120 429450

21227 12223 437573

7571 5343 171813

10621 6896 211636

PERFORMANCE UNDER MEDICAL TERMINATION OF PREGNANCY S.No. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 Name of the District Chennai Coimbatore Cuddalore Dharmapuri Dindigul Erode Kancheepuram Kanyakumari Karur Madurai Nagapattinam Namakkal Perambalur Pudukkottai Ramanathapuram Salem Sivagangai Thanjavur The Nilgiris Theni Thiruchirappalli Thirunelveli Thiruvallur Thiruvannamalai Thiruvarur Thoothukudi Vellore Villupuram Virudhunagar Total 2003 - 2004 No. of Institutions Performance 94 13395 49 2969 33 3815 44 2590 34 3882 54 1661 78 2093 37 1542 19 1308 66 3912 18 167 19 2609 5 418 37 1049 33 731 25 6910 45 763 19 2493 9 684 18 893 37 2706 77 3977 52 1375 22 1262 18 856 27 1122 46 3046 23 1945 55 858 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 1. District Level activities 2. State Level activities Rs. in Lakhs 94.70 111.46

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. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

Details of activities For dissemination of FW & RCH Messages through Prasar Bharathi, Private For settlement of pending bills for the dissemination of FW & RCH messages during the period from March03 to October03 For capacity building on BCC activities through Regional family Welfare Training centres For participating in Exhibitions at State & District levels For organising Workshops, Seminars and Conferences etc. at State & Dist. Levels For having observed World Population day on 11.7.03 For dissemination of Family Welfare & RCH Messages through traditional Media like drama, Folk songs etc. For creation of Proto type danglers table top calendars conversion of VHS into CD and Purchase of VCD/Players printed materials etc. For Evaluation of IEC activities Miscellaneous Total

Allotted amounts in Lakhs (Rupees) 40.00 20.00 10.00 5.00 5.00 2.46 10.00 11.00 3.00 5.00 111.46

FAMILY WELFARE PROGRAMME - OBJECTIVE CLASSIFICATION Sl.No Details STATE PLAN 01 03 04 05 06 08 09 10 17 19 21 33 42 45 46 49 51 59 66 72 Salaries D.A Travel Expenses Office Expenses Rent Rates&Taxes Advertising Grants-in Aid Insurance Premium Minor works Machinery and Equipments Maintenance of functional vehicles Payments for Professional and Special Services Service Commitment Charges Petrol oil & Lubricants Clothing,Tentage & Stores Festival Advances Compensation Prizes and Awards Medicines Training 267725 115690 8900 1963 95239 50 119 679 2940 3723 365 5 6125 101 16 2 4 4 92239 2501 2 2 2 2 2 6125 81528 38586 402 558 92239 6300 0 2501 220 4 1446 136 860 44 5 6125 Actual 2002-2003 Budget Estimate 2003-2004 (Rs. In thousands) Revised Estimate 2003-2004

76 77

Purchase Deduct Recoveries Total

503624

-2 100899

-860 230094

FAMILY WELFARE PROGRAMME - OBJECTIVE CLASSIFICATION (Rs. In thousands) Sl.No Details CENTRALLY SPONSORED 01 03 04 05 06 08 09 10 19 21 24 33 42 45 46 49 51 59 66 67 72 73 77 Salaries D.A Travel Expenses Office Expenses Rent Rates&Taxes Advertising Grants-in-aid Contribution Machinery and Equipments Maintenance of functional vehicles Materials & Supplies Payments for Professional and Special Services Service or Commitment Charges Petrol oil & Lubricants Clothing, Tentage & Stores Festival Advances Compensation Prizes and Awards Medicines Diet charges Training Transport charges Deduct Recoveries Total 48879 20734 2174 2565 471 7433 111264 3755 0 215 55115 154 885 2419 330 0 86313 3 45981 0 0 0 0 388690 72590 40653 2314 2943 560 1 138300 4500 0 330 50000 35 2 2677 145 682 124154 27 132678 0 0 0 -682 571909 53811 24835 2316 3095 560 20829 138300 4500 0 330 50000 35 26 2846 142 679 124230 27 97126 0 0 0 -679 523008 Actual 20022003 Budget Estimate 2003-2004 Revised Estimate 2003-2004

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 1 2 3 4 5 6 7 8 9 10 11 12 13 Name of the Post Director of Drugs Control Joint Director of Drugs Control Deputy Director of Drugs Control Assistant Director of Drugs Control Assistant Director of Drugs Control (Administration) Senior Drugs Inspector Drugs Inspectors Legal Adviser Assistant Accounts Officer Ministerial Staff Office Assistant Driver Telephone Operator TOTAL No. of Posts 01 01 03 14 01 10 74 01 01 117 79 04 01 307

Drugs Testing Laboratory, Chennai has the following Staffs: Sl No 1 2 3 4 5 6 7 8 9 10 11 12 13 Name of the Post Government Analyst Deputy Government Analyst Senior Analyst Junior Analyst Junior Administrative Officer Technician Grade-I Technician Grade-II Gas Mechanic Electrician Grade-I Plumber Laboratory Attendant Animal Attendant Ministerial Staff No. of Posts 01 02 15 24 01 04 04 01 01 01 04 01 10

05 01 01 TOTAL 76 The King Institute, Guindy, Chennai has the following Staffs for the purpose of testing Schedule 'C' & 'C1' Drugs: Sl No 1 2 3 4 5 6 7 8 9 Name of the Post Deputy Director Assistant Professor Chief Chemist Chemical Assistant Junior Assistant Typist Technician Grade-I Technician Grade-II Office Assistant TOTAL 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 No. of Posts 01 01 01 02 01 01 02 01 03 13

14 15 16

Office Assistant Sweeper Sweeper-cum-Watchman

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) Sl Sub-Head of Account Revised Estimate for 2003-2004 No 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, 13.20 13.20 Guindy. 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. 1. 2. 3. 20 00 20 01 40193 2708 591 20 02 20 03 20 36355 1980 521 24961 1533 503 3396 8307 162 563 49 3130 6039 106 174 20 4149 3798 351 34099 3341 2996 345 35729

Details of Inspection Number of Inspections of Sales Concerns No. of Inspections of Manufacturing Concerns No. of Inspections of Hospitals and Medical Stores.

42692 2405 617

1. 2. 3. 4. 5. 6.

Details of Licences Issued/Renewed/Cancelled Sales Licences Granted 3023 3140 Sales Licences Renewed 11460 11745 Manufacturing Licences Granted 191 173 Manufacturing Licences Renewed 550 588 Licences Granted for Manufacturing Ayurvedic, 47 44 Siddha and Unani. Homoeopathic Licences Granted 2 1 Details of Samples Tested (as on 31-01-2004) No. of Samples Tested 3828 3959 No. of Samples declared as Standard Quality 3313 4607 No. of Samples declared as Not of Standard Quality. 515 352 No. of Sales Concerns (as on 31-01-2004) 33354 32345

1. 2. 3.

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

Allopathic Medicine a. Regular Licences 668 b. Loan Licences 334 c. Repackers Licences 20 TOTAL 1022 Details of Prosecution Launched:

Type of Licences

Indian Medicine 558 35 593

Homeopathic Medicine 7 7

Cosmetics 183 2 185

2000-2001

2001-2002

2002-2003 194 192 02 -

Details of Inspection

1. Total No. of Prosecutions sanctioned (a) No. of Prosecutions sanctioned under the Drugs & Cosmetics Act 1940. (b) No. of Prosecutions sanctioned under the Drugs & Magic Remedies (Objectionable Advertisements) Act 1954. (c) No. of Prosecutions under Drugs Price Control Order. (d) No. of Prosecutions under Narcotic Drugs & Psychotrophic Substances Act. Blood Bank Licences as on 31-03-2004 .. .. 214

106 103 01 02 -

70 65 05 -

OBJECTWISE CLASSIFICATION: B.E.2003-04 Non-Plan Plan Total 289.33 289.33 0.10 0.10 153.30 153.30 5.45 5.45 8.65 8.65 10.89 10.89 0.02 0.02 2.00 9.25 11.25 0.10 0.10 4.50 4.50 0.05 0.05 0.69 3.26 -3.26 0.06 2.01 0.46 477.61 2.00 11.25 0.69 3.26 -3.26 0.06 2.01 0.46 2.00 488.86 (Rs. in Lakhs) R.E.2003-04 Non-Plan Plan Total 277.40 - 277.40 0.10 0.10 127.97 - 127.97 5.45 5.45 11.80 11.80 11.17 11.17 0.02 0.02 3.50 9.25 12.75 0.10 0.10 4.50 4.50 0.05 0.05 0.69 3.31 - 3.31 0.06 2.01 0.46 445.28 2.00 11.25 0.69 3.31 - 3.31 0.06 2.01 0.46 2.00 456.53

Detailed Head 01 Salaries 02 Wages 03 Dearness Allowances 04 Travel Expenses 05 Office Expenses 06 Rent, Rates & Taxes 08 Advertising & Publicity 19 Machinery & Equipments 21 Motor Vehicles 24 Materials & Supplies 33 Payment for Professional & Special Service 45 Petroleum, Oil & Lubricants 49 Festival Advance - Credit 49 Festival Advance - Debit 59 Prizes & Awards 66 Medicines 68 Cost of Books/Note Books/Slates etc., 76 Computer & Accessories TOTAL

2003-2004 (upto 31-032004) 150 146 04 -

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 2 3 4 5 6 Medical Personnel Nursing Personnel Pharmacists Ministerial Staff Nursing Asst./Hospital Worker Others Total 969 91 632 225 674 444 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. 1. 2. Name of the Course UG - BSMS PG- MD (Siddha) Distribution for MD (S) 1. General Category 2. Special Category i. Central Pool ii. Union Territory (other than Delhi) iii. Refugee studentwho is not native of Tamil Nadu iv. Son/Daughter of Central Govt. Employee Service in the State of Tamil Nadu v. Foreign candidate like Sri Lanka, Singapore, Malaysia Total No.of seats 100 60 51 seats 1 1 1 1 Under Graduate 100 Post Graduate 60 Total 100 60

5 60

Distribution of branches in MD (Siddha): Sl.No. 1 2 3 4 5 6 Name of the Branches Gunapadam Maruthuvam Sirappu Maruthuvam Kuzhanthai Maruthuvam Noi Nadal Nanju Noolum Maruthuva Neethi Noolum Total No.of seats allotted 12 14 7 7 10 10 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 MD (Siddha) Gunapadam Maruthuvam Sirappu Maruthuvam Total No.of Students as on 1.1.04 Female Total 9 20 24 34 10 16

Male 11 10 6

Kuzhanthai Maruthuvam Noi Nadal Nanju Noolum Maruthuva Neethi Noolum

9 12 13

9 15 14

18 27 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 Maruthuvam 79 58 Gunapadam 79 32 Sirappu Maruthuvam 23 10 Kuzhanthai Maruthuvam 25 11 Noi Nadal 17 15 Nanju Noolum Maruthuva Neethi Noolum 4 8 Total 227 134 Hostel: The number of inmates in the College Hostel for last six years are as follows: Year 1998-1999 1999-2000 2000-2001 2001-2002 2002-2003 2003-2004 No.of rooms available 68 68 68 68 68 68 Male 88 103 140 99 110 95 No.of rooms available 60 60 60 60 67 67 Female 276 294 294 263 256 255 Total 364 397 434 362 366 350

Total 137 111 33 36 32 12 361

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 Maruthuvam Gunapadam Total Male 11 15 26 Female 7 7 14 Total 18 22 40

The No. of inmates in the Govt.Siddha Medl.College Hospital, Chennai are furnished as follows: No.of rooms Male No.of rooms available available 1999-2000 10 38 30 2000-2001 10 38 30 2001-2002 10 43 30 2002-2003 10 36 30 2003-2004 10 38 35 Government Homoeopathy Medical College and Hospital, Thirumangalam Year Female 138 156 154 161 189 Total 176 194 197 197 227

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 August96. (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 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. 1 2 3 Name of the Institution Sri Sairam Siddha Medical College, Poonthandalam, Sriperumpudur. Akila Thiruvithancore Siddha Vaidya Kalloori, Munchirai Velumail Siddha medical College & Hospital, Sriperumpudur TOTAL Annual intake 30 30 30 90 from the

II.AYURVEDA Sl.No. 1 2 3 4 5 Name of the Institution The Venkataramana Ayurveda College, Korattur, Chennai Dharma Ayurveda Medical College at Sriperumpudur Ayurveda College, Coimbatore , Coimbatore Sri Sankara College of Ayurveda, Thirucuirappalli Sri Sairam Ayurveda Medical College and Research Centre, Poonthandalam, Sriperumbudur Total Annual intake 30 30 30 30 30 150

III. HOMOEOPATHY Sl.No. 1 2 3 4 5 6 7 8 Name of the Institution White Memorial Homoeopathy Medical College, Attoor, Kanyakumari Distric Dr. Hanemam, Homoeopathy Medical College & Research Centre, Rasipuram, Salem District Venkateswara Homoeopathy Medical College, Porur, Chennai Saradha krishna Homoeopathy Medical College, Kulasekaram, Kanyakumar District Nethra Homoeopathy Medical College, Kalapatti village, Coimbatore Sri Sairam Homoeopathy Medical College and Research Centre, Poonthandalam, Sriperumbudur R.V.S.Homoeopathy Medical College, Sulur, Coimbatore Tamil Nadu Homoeopsthy Medical College, Salem TOTAL Annual intake 50 50 50 50 50 50 50 50 400

IV. YOGA AND NATUROPATHY Sl.No. 1 2 3 Name of the Institution Sri Rama Krishna Yoga & Naturopathy College, Kulasekaram, Kanyakumari. J.S.S.College, udagamandalam offering BNYS Course Tamil Nadu College of Naturopathy & Yoga Research Institute, Salem TOTAL TOTAL SEATS (Siddha, Ayurveda, Homeopathy and Yoga Annual intake 50 60 40 150 790

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. 1 2 3 4 Name of the College Siddha R.V.S. Siddha Medical College, Sulur, Coimbatore Ayurveda R.V.S. Ayurveda Medical college, Sulur, Coimbatore
HOMOEOPATHY

Imparted Course B.S.M.S B.A.M.S B.H.M.S. B.N.Y .S.

Duration of the course 5 years 5 years 5 years 5 years

Annual Intake 30 30 50 20

Thai Mookabigai Homoeopathy Medical College, Mugappaier, Chennai. Yoga & Naturopathy Dr.C.Anbarasu Yoga and naturopathy Medical College, Goodapakkam village, Poonthamallee.

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 Ayurveda Dispensaries:

Headquarters Hospitals and Government

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 a. Siddha b. Ayurveda c. Unani d. Homoeopathy e. Naturopathy & Yoga Total Daily Average Patients Census for 2003 Patients Census for 2002 Increase of census No. of Patients treated during the year 2003 Out-Patients 1,40,69,138 3,46,448 1,73,010 12,62,144 20,656 1,58,71,396 43,483 In-Patients 1,83,554 13,191 22,840 29,551 2,49,136 683 1,61,20,532 1,37,73,795 23,46,737 Total 1,42,52,692 3,59,639 1,95,850 12,91,695 20,656 1,61,20,532 44,166

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 Mens 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. 2. TAMPCOL, Chennai 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. ii. iii. Documentation of Siddha books in English and Hindi, if possible Development of data base 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: Naturopathy Name of the course BUMS (Unani) LIM/LAM etc. BSAM/BAMS (Ayurveda) DAM (Ayurveda) GCIM Tabib-Kamil B2 Class Enlistment 16 Naturopathy Diploma 116 B.N.Y.S 132 Total Tamil Nadu Siddha Medical Council, Chennai: Sl.No. 1 2 3 4 5 6 7 8 9 10 Ayurveda 290 1360 193 160 1889 856 4748 Unani 318 37 24 25 628 198 1230 Total 318 327 1360 193 184 25 2517 1054 16 116 6110

The Number of siddha Medical Practitioners registered with Tamil Nadu Siddha Medical Council as on 31.12.2003 is as follows. Class BIM & BSMS LIM, LAM etc. GCIM No.of Practitioners Registered 2487 6 3

B.Class C.Class Enlistment Total Board of Integrated Medicine: Name of the Course GCIM L.I.M. Total Ayurveda 214 217 431 Unani 22 24 46

2245 24 2409 7174

Total 236 241 477

Tamil Nadu HomoeopathtyMedical Council, Chennai: A Class BHMS DHMS Others B Class C Class Total 992 520 95 14,125 1,050 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. 2. 3. 4. 5. 6. 7. 8. Krishnamacharya Yoga Mandiram, Chennai Yogasana Alayam, Chennai. Asana Andiappan Yoga and Natural Living Development Trust, Tirunelveli. Gandhi Institute of Yoga and Naturopathy, Yelagiri Hills, Thirupattur Taluk, Vellore District. Sri Sankara College of Yoga and Naturopathy, Thiruchirappalli. Savanandha Yogasana Mantrum Iarrkai Nala Vazhvu Abiviruthi, Arakkatallai, Tuticorin. The Asian Social Welfare Natura; Health Trust, Sripathanallur, Vellore 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. Scheme Code/Name/ Activity No

B.E 2003-04

R.E 2003-04

Actual Expenditure * (upto 31.12.03) 5.09 0.00

a. 1 2

4 5 6 7

Centrally Sponsored Scheme In-service Training and Manpower Development under DANIDA Project (SB) Construction of Community Supported Health Subcentres under DANIDA Project (TF) Project Organisation by State and District level establishment under DANIDA Project (SY) Monitoring and Evaluation under DANIDA Project (SC) Construction Cell under DANIDA Project (TJ) Communication Component under DANIDA Project (SE) Improvement of drug supplies under DANIDA Project (TE)
Total

52.32 0.02

5.23 0.00

30.41

22.49

19.71

24.06 0.03 0.08 0.03 106.95 0.01

313.47 0.00 104.72 0.00 445.91 0.0

182.81 0.00 104.48 -26.75 285.34 0.00

b. 1

State Scheme Infrastructure development under DANIDA project Grants for capital expenditure (JD) 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 199798 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 highrisk 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 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. use of PHCs / FRUs /

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 coordination 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. I. Name of the Interventions CSW Truckers Industrial Workers Migrant Workers MSM Prisoners Tribals Youth Adolescents Research Studies Network PLWHA Network Drop in centre Care & Support Community Care Centre Institutional Care Centre Total Targeted Intervention No. of Interventions 20 15 16 15 2 3 3 1 2 7 7 4 12 107

II. III

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: No. of units collected Replacement Total Donors 1,32,080 2,43,019 1,52,091 3,03,097 1,52,080 3,06,613 1,56,455 3,85,357 1,56,947 4,36,594

Year 1999 2000 2001 2002 2003

Voluntary Donors 1,10,939 1,51,006 1,54,533 2,28,902 2,79,647

% of Voluntary Blood Donation 45.7% 49.7% 50.4% 59.4% 64.05%

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 NonGovernmental 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

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

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 2002 - 2003 2003 - 2004 No. of persons availed Testing facilities 35521 85801 Found Positive for HIV 4976 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 psychosocial 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 th th HIV/AIDS among School students and Teachers. All the students studying in 9 and 11 standard are covered under the School AIDS Education Programme. 2. Peer Educators from 9 and 11 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. Students booklets th th were distributed to all the Students studying in 9 and 11 standards. 5. More than 15 lakhs students were benefited out of this School AIDS Education Programme. Family Health Awareness Campaigns: TNSACS has implemented 4 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: Phase I II III IV TOTAL Total Number of STDs treated Female 7,60,466 5,14,488 5,26,975 8,31,986 26,33,915
th th th

Male 1,14,318 97,292 1,36,355 2,73,061 6,21,026

Total 8,74,784 6,11,780 6,63,330 11,05,047 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 1995 - 96 1996 - 97 1997 - 98 1998 - 99 1999 - 2000 2000 - 2001 2001 - 2002 2002 - 2003 2003 - 2004 Budget Approved (Rs. in Lakhs) 650.00 1743.94 2000.00 1595.13 1571.99 1000.00 1300.88 1500.67 1708.35 Grant in aid received (Rs. in Lakhs) 577.44 2110.00 1700.00 1100.00 885.57 1027.00 1480.65 1295.50 1225.00 Expenditure incurred (Rs. in Lakhs) 731.55 1329.34 1672.90 1383.89 1408.27 771.75 1624.26 1349.15 1215.28

Component-wise expenses during 2003 - 04 are given below: Sl. No. 1 2 3 4 5 Component Priority Targetted Intervention against HIV/AIDS Preventive Intervention for the General Community Low Cost AIDS Care Institutional Strengthening Intersectoral Collaboration TOTAL (Rs. in Lakhs) Expenditure up to March 2004 310.69 673.98 83.42 142.69 4.50 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 2003-04 School Eye Screening: Year 2003-2004 Target 14,85,000 No. of Children Screened 23,46,028 Target for free spectacles provided 29,700 No. of Spectacles provided 38,550 Target 4,20,000 Achievement 4,50,654

Functioning of Eye Bank: Year 2003-2004 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. Target for Eyes collection 3000 Eyes Collected 4707 Eyes Utilised 2678

CHAPTER - 12 TAMIL NADU MEDICAL SERVICES CORPORATION LIMITED

Organisation: The Tamil Nadu Medical Services Corporation Limited, which was incorporated on 01.07.1994 th under the Companies Act 1956, has successfully completed the 9 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 2002-2003 (Tentative) 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 welldesigned 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) (ii) (iii) (iv) (v) (vi) (vii) (viii) (ix) (x) (xi) Auto analyzer, Calposcope and Cell counter for Aringnar Anna Memorial Cancer Hospital, Kancheepuram Haemodialyser units for Government Rajaji Hospital, Madurai & Government Medical College Hospital Coimbatore Echo Cardiogram with colour Doppler for Tirunelveli Medical college Hospital Haemodialysis & Plasma separation Unit for Annal Gandhi Memorial Hospital, Trichy Provision of equipments for increasing 315 MBBS seats at Tirunelveli, Coimbatore, Salem, Chegalpet and Kilpauk Medical College Hospital, Chennai C - Arm with Image Intensifier for Government Rajaji Hospital, Madurai 500 mA X-Ray unit with Image Intensifier and basic equipments for Bernaurd Institute of Radiology, Government General Hospital, Chennai Soft Tissue Mammography unit (one each) for 7 District Head Quarters Hospitals Haemo Dialysis Unit (Two each) for 7 District Head Quarters Hospitals 100 mA X-Ray unit for 14 Taluk Head Quarters Hospitals Echo Cardiogram with Colour Doppler (One each) for 7 District Head Quarters Hospital Rs. 20 Lakhs Rs.24 Lakhs Rs.24 Lakhs Rs.24 Lakhs Rs.100 Lakhs Rs.25 Lakhs Rs.50 Lakhs Rs.224 Lakhs Rs.126 Lakhs Rs.30 Lakhs 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
1 2 3 4 5 6 7 8 9 10 11 12 13 14 Director

NAME OF THE POST

NO OF POST AS ON 1.1.2003 1 1 1 1 1 1 1 7 7 9 10 87 448 94 669

Deputy Director (Technical) Deputy Director (Administration) Accounts officer Automobile Engineer Technical Officer

Material Manager Workshop Superintendent Assistant Accounts Officer Assistant Engineer General Foreman Ministerial Staff Technical Staff Office Assistant, Sweeper and Watchman
TOTAL

Units functioning: Head Quarters of 7 Regional Workshops. Chennai Headquarters of 9 District Workshops. Chengalpattu Headquarters of 27 Mobile Maintenance Units. Chennai (S) Chennai (N) Chengalpattu and Kancheepuram Tiruvellore Vellore Cuddalore Villupuram and Tiruvannamalai Salem and Dharmapuri. Tiruppur Erode and Udhagamandalam Tiruchirappalli, Thanjavur Perambalur and Nagappattinam. Madurai (S) Madurai (N) Theni Ramnad Sivaganga Dindigul Tirunelveli (N) Tirunelveli (S) Sankarankoil Nagercoil. Tuticorin

Vellore

Villupuram

Salem Coimbatore

Dharmapuri Udhagamandalam and Erode Thanjavur and Pudukkottai

Tiruchirappalli

Madurai

Virudhunagar

Tirunelveli

Nagercoil

Directorate wise fleet strength maintained by this Department is given hereunder: S.No 1. 2. 3. 4. 5. 6. 7. 8. DIRECTORATE Public Health and Preventive Medicine Medical and Rural Health Services Family Welfare Medical Education Tamil Nadu State Health Transport Department DANIDA Health Care Project Indian Medicine and Homeopathy Drugs Control TOTAL NO. OF VEHICLES 1078 541 720 239 52 20 10 3 2663