Tamil Nadu's new Rs 2,857 cr health programme aims to meet global norms

Scheme aims to improve quality of care, strengthen management of non-communicable diseases and injuries, and reduce inequities in reproductive and child health services

Tamil Nadu Chief Minister Edappadi K Palaniswami today launched the Tamil Nadu Health System Reform Programme (TNHSRP) in Chennai. The Rs 2,857.03 crore scheme will be implemented with funding support from the World Bank.

The programme aims at achieving result-oriented outcomes in healthcare delivery. It has set a five-year target of improving quality of care, strengthening the management of non-communicable diseases (NCD) and injuries, and reducing inequities in reproductive and child health services. 

Of the total programme cost, about Rs 1,999.90 crore is being funded by the World Bank via loan.

Palaniswami said through the project, the State wants to enhance the healthcare system and bring them on par with developed nations. Facilities in government hospitals and primary health centres will be augmented, ambulance services upgraded and a suicide prevention hotline will be set up. 

“By 2030 we want to reduce maternal mortality rate in the State, which is already low compared to the rest of the country, to 30,” said the Chief Minister.

In his address, Tamil Nadu's Deputy Chief Minister O Panneerselvam said with the implementation of the TNHSRP, government hospitals will be able to provide health services on par with the best private hospitals. Health Minister C Vijayabaskar explained some of the features of the Programme.

Junaid Kamal Ahmed, Country Director, World Bank, said this was the first Program-for-Results (PforR) project for the Bank in India and the first for Tamil Nadu as well.

“We hope Tamil Nadu becomes the lighthouse for supporting health reforms across India. The biggest partner for World Bank for all projects across India is Tamil Nadu,” he added.

The proposed activities under the Programme include improving quality of care in all government health institutions, including interventions to address quality of care in primary, secondary and tertiary-level facilities, NQAS and NABH quality accreditation of select hospitals and primary health centres, interventions for screening, diagnosis, treatment and management of NCDs, an improved mental health programme, reduction of deaths due to road traffic accidents and strengthening of reproductive and child health programmes.

Department officials said that Tamil Nadu can serve as a model for how to take health system performance to the next level by investing in the public sector and offer lessons to other states. Another key aim of this programme 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, said the offical.

“This Programme focuses on results instead of inputs through a Programme-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,” said Rifat Hasan, Senior Health Specialist, World Bank India, and the Task Team Leader for the programme. 

The use of the PforR instrument is a first for the health sector and will offer lessons for other states.

The programme 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 programme to improve management of the state public health sector, increase transparency, and strengthen accountability, says industry experts..

The programme 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 programme will improve in- hospital care, strengthen protocols, strengthen the 24x7 trauma care services and establish a trauma registry.