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The Government of India, Government of Tamil Nadu (GoTN) and the World Bank have signed a $287 Million Loan Agreement for the Tamil Nadu Health System Reform Program.
  • Tamil Nadu ranks third among all Indian States in the NITI Aayog Health Index which is reflected in vastly improved health outcomes.
  • The State’s maternal mortality rate has declined from 90 deaths per 100,000 live births in 2005 to 62 deaths in 2015-16.
  • Infant mortality has declined from 30 deaths per 1000 live births to 20 in the same period.
  • A key contribution to these achievements has been the establishment of Emergency Obstetric and Neonatal Care Centers and the 108 ambulance service with previous support from the World Bank.
  • These have ensured that no mother has to travel more than 30 minutes to access emergency obstetric and neonatal care 24 hours a day, seven days a week.
Despite these impressive gains, certain challenges in health care remain, including quality of care and variations in reproductive and child health among districts. Tamil Nadu is also dealing with a growing burden of NCDs as they account for nearly 69 per cent of deaths in the State. The Tamil Nadu Health System Reform Program will support the State Government to:
  • Develop clinical protocols and guidelines
  • Achieve national accreditation for primary, secondary, and tertiary-level health facilities in the public sector
  • Strengthen physicians, nurses and paramedics through continuous medical education
  • Strengthen the feedback loop between citizens and the state by making quality and other data accessible to the public
  • The Program supports interventions to strengthen institutional and state capacity to achieve results.
  • Good practices and innovations from Tamil Nadu are being scaled-up while others from around the world are being introduced through the program to improve management of the State's Public Health Sector, increase transparency, and strengthen accountability.
  • The Program will promote population-based screening, treatment and follow-up for NCDs, and improve monitoring and evaluation.
  • Patients will be equipped with knowledge and skills to self-manage their conditions.
  • Lab services and health provider capacity will also be strengthened to address mental health.
  • To tackle road injuries, the program will improve in-hospital care, strengthen protocols, strengthen the 24x7 trauma care services and establish a trauma registry.
  • Another key aim of this Program is to reduce the equity gaps in reproductive and child health.
  • Special focus will be given to nine priority districts, which constitute the bottom quintile of the RCH indicators in the State and have a relatively large proportion of tribal populations.
This Program focuses on results instead of inputs through a Program-for-Results (PforR) lending instrument. This will provide a much greater focus on outputs and outcomes through better alignment of expenditures and incentives with results. The use of the PforR instrument is a first for the health sector and will offer lessons for other States. Also read: Both Financial And Non-Financial Factors Matter For ASHAs Indian Navy Environment Conservation Roadmap (INECR) Source: Tamil Nadu Health System Reform Program