Introduction

To increase access for tribals, women and the general population who do not have access to essential and life saving services, TNHSP has conceived and implements the following programmes:

• Tribal Health
• CEmONC Centres
• Chief Minister's Comprehensive Health Insurance Scheme
• Poison Treatment Centres

Tribal Healthcare

Tribal communities constitute less than one per cent of the total population in the State (population around 6.25 lakh). These communities are spread throughout the State, but there is a higher concentration in 12 districts which are referred to as the Tribal districts.

Historically, tribal communities in Tamil Nadu have not enjoyed adequate healthcare services. Inaccessibility and cultural factors are some of the reasons for this. Tribal communities are spread both in the plains and hilly terrain, and communities located in remote areas pose a challenge when it comes to providing healthcare services.

Thus, one of the goals of the TNHSP is to create better access for the state's tribal populations to healthcare.

Comprehensive Emergency Obstetric and New born Care services (CEmONC)

Analysis of the maternal and infant mortality data revealed that 75% of maternal deaths occured during intra partum (during delivery) and post partum (just after delivery) and 25% occured in ante partum (before childbirth).

One common issue was that of referral. When the hospital where the pregnant woman accessed for care did not have adequate facilities, she had to be referred to another hospital elsewhere. Covering the distance between two hospitals at such a critical stage could prove fatal, as it was usually the complicated cases that were referred to other hospitals especially in the rural areas. Hence, it was decided to strengthen the obstetric and new born services in the
hospitals which led to the creation of the ‘Comprehensive Emergency Obstetric and Neonatal Care’ Centres.

Chief Minister's Comprehensive Health Insurance Scheme

Quality healthcare which comes at a cost, many a time turns out to be an unbearable burden for the economically weaker sections of the society. One way to address this is to provide free healthcare in Government hospitals. But what about treatments and diseases not feasible in district and sub-district hospitals and also the long waitlisted situations for emergency and life saving surgeries due to pile up of cases? How to ensure that economically weaker sections are not deprived of required healthcare?

For addresing this situation the Government of Tamilnadu introduced a massive welfare scheme called “Chief Minister Kalaignar Insurance Scheme for life saving treatments” on 23rd July 2009, for the poorest of the poor/low income/unorganised groups who cannot afford costly treatment, as a supplementary facility for getting free treatment in empanelled Government and private hospitals for such serious ailments.

On January 11, 2012, the Chief Minister's Comprehensive Health Insurance Scheme was introduced. Under the scheme, the sum assured for each family would be Rs.1 lakh every year for a total period of four years and for a total value of Rs. 4 lakh. In the case of certain procedures, the ceiling would be raised to Rs.1.5 lakh per annum. No fewer than 250 hospitals would be empanelled under the scheme. At least six hospitals in each district would be covered. There would be more hospitals in cities such as Chennai, Coimbatore and Madurai.

The new scheme would cover 1,016 procedures, 113 follow up procedures and 23 diagnostic procedures. The cost of tests required for treatment would also be part of the insurance cover.

Poison Treatment Centres

As it was found that there were many incidences of snake bites, organo phosphorous compound poisoning cases in the state and resultant high death rates it was decided to establish poison treatment centers throughout
the State. Totally, 34 Poison treatment centres were established in 29 district headquarters hospitals and 5 taluk hospitals.