Healthcare scheme will cost T.N. ₹257 crore

‘Makkalai Thedi Maruthuvam’ under the National Health Mission, meant to address non-communicable diseases among the citizens, is aimed at bringing every listed beneficiary under the population health registry, forming a common denominator to ensure continuous monitoring and follow-up.

The goal is to achieve better compliance and control for non-communicable diseases. Apart from detection, treatment and follow-up, the beneficiaries will be given medicines at their doorstep. Field workers will provide healthcare services. The population-based screening programme will cover all aged above 18 for 10 common conditions: hypertension, diabetes, tuberculosis, leprosy, chronic kidney disease, oral, breast and cervical cancers, chronic obstructive pulmonary disease and mental health.

Those who are aged above 45 and registered with the population health registry will receive their drugs for hypertension and diabetes from women health volunteers. Home-based palliative care, physiotherapy, services to deliver peritoneal dialysis bags and monitoring of dialysis at home have been included in the scheme.

A total of 1,172 health sub-centres, 189 primary health centres and 50 community health centres in 50 universal health coverage blocks will be covered. The scheme will be rolled out in one zone in three corporations of Tirunelveli and Coimbatore districts, and in the Greater Chennai Corporation. By the year-end, it will cover the entire State, costing ₹257,15,78,350. This amount is apart from what is being spent on the ongoing non-communicable disease prevention programmes.

District nodal officers, community health officers, city health officers and block medical officers will monitor the scheme. The field workers include non-communicable disease staff nurses, pharmacists, physiotherapists, palliative care nurses, community health nurses and health inspectors, besides public health managers at the zonal level.

The medical officers, the non-communicable disease nurses, the pharmacists, the sector health nurses and health inspectors have been assigned the responsibility at primary health centres. At the health sub-centres, the village health nurses, urban health nurses, mid-level healthcare providers and woman health volunteers will be made responsible.

The Directorate of Medical and Rural Health Services and the Directorate of Medical Education will designate a nodal officer to monitor the scheme and linkages.

Renal dialysis

The scheme includes continuous ambulatory peritoneal dialysis (CAPD) as an alternative to haemodialysis to overcome such issues as infrastructure requirement and biomedical waste. The CAPD will be brought under the Chief Minister’s Comprehensive Health Insurance Scheme.

The State Health System Reform Programme will monitor the coverage. Medical college hospitals and district headquarters hospitals will be the hub for the CAPD scheme, while the block primary health centres will be the spokes. A palliative nurse will be deployed to provide the bags for dialysis, educate the patients on self-care, and to monitor them. The home-based outreach support will be given to all, whether or not they are covered under the Chief Minister’s Comprehensive Health Insurance Scheme.

The guidelines will be developed by the Mission Health Director in coordination with the State Nodal Officer, Renal Health, Peritoneal Dialysis Services. In each district, a nodal officer, who is either a nephrologist or a physician, will be appointed. The district-level officer in charge of the Chief Minister’s Comprehensive Health Insurance Scheme will look after logistics.

The government order signed by Health Secretary J. Radhakrishnan put the total cost of the scheme in rural areas at ₹195,69,51,050. In urban areas, it will cost ₹61,46,27,300.