Program Components & Activities

Component I: Improved Quality of Care

Sub Components


  1. Gap analysis /agency/ on the spot verification
  2. Implementation plan development based on gap analysis
  3. Implementation of facility improvement plan (infra - no major civil works), training, HR, equipment & supplies, licenses, regulatory clearances, protocols, guidelines etc.
  4. Primary facilities with NQAS certification: 4 to 300 of which 60 are in the priority districts
  5. Secondary facilities with NQAS certification: 3 to 70 of which 14 are in the priority districts
  6. Tertiary facilities with entry level NABH certification:0 to 7
  7. additional priority district incentive
  8. Certification process - fee, assessment and monitoring etc.
  9. IQAS and EQAS for all diagnostic services
  10. Networking of all Labs in hub and spoke model through LIMS for 5 years
  11. Renovation and replacement of Toilet block after gap assessment
  12. Repair and replacement of cots and mattresses etc after gap assessment
  13. Colour washing and branding of all PH facilities/li>
  1. Identification of quality improvement initiative from the list of evidence-based interventions
  2. Quality of Care (QoC) Strategy (Technical part) / manual developed, adopted and printed
  3. A quality dashboard (Technology part) will be developed for primary, secondary, and tertiary level facilities in Year 1 and launched and Government order issued.
  4. Training the facilities for reporting and implementing on the quality dashboard quarterly
  5. Strengthening of Institutions implementing quality improvement initiativesin primary, secondary and tertiary level facilities
  1. The baseline and target scores will be established once the dashboard is developed.
  2. Number of primary, secondary, and tertiary level facilities implementing at least 1 endorsed quality improvement initiative from the list of evidence-based interventions specified in the QoC Strategy: 0
  3. Number of primary, secondary, and tertiary facilities reporting on quality dashboard quarterly: 0 to 570 primary and 248 in secondary and tertiary care
  4. Improved scores in quality dashboard for primary, secondary, and tertiary level facilities
  5. Tracking of Indicators to measure quality of care along the three dimensions of quality: structural inputs, clinical processes, and patient outcomes.
  6. Strengthening better performing DME, DMS and DPH institutions
  7. Strengthen public hospitals after gap analysis
  1. Development of detailed patient experience questionnaire
  2. Integration with the concept of the MeraAspatal survey
  3. Piloting of patient experience questionnaire for secondary & tertiary care facilities from 0 to 10%
  1. Guidelines on district and state health assemblies developed and adopted
  2. State Health Assembly: 1 per year
  3. Districts conducting Health Assembly: 0 to 60%
  1. Development of Conceptual Model and Operational Plan for a strengthened Health Management Information System (HMIS)
  2. Design completed-Electronic medical records and Patient tracking for NCDs
  3. Inputs including hardware for Integrated system implemented to pilot all modules developed in at least one primary,one secondary and one tertiary care facility
  4. Inputs including hardware for Integrated system implemented in all the health facilities of at least one district
  5. Inputs including hardware for Integrated system implemented in all the health facilities in 9 districts
  1. Development and Adoption of TN Health Policy/ Strategy for Vision 2030
  2. Operational research program developed, adopted and awarded on annual basis
  3. Updated policy for CME program developed and adopted
  4. Development & adoption of performance-based incentive strategy for PHCs
  5. Assessment of programmaticgaps and adoption ( provider and beneficiary perspective)
  6. Performance based financial incentive for screening & confirmation ( Development of design, costing & piloting)
  7. Development and adoption of an Environment Strategy for the Health Sector in Tamil Nadu
  8. Operational research program launched with annual call for research proposals issued and selected proposal awarded
  9. Annual call for research proposals issued and selected proposal awarded
  10. Deploying e-procurement system in TNMSC and 20% of value of total contracts of TNMSC under the Program done through e-procurement
  11. Skill training in BMWM including refresher
  12. Secondary care services at Suburban Chennai
  13. State specific activities as PIP for quality and cross cutting activities for reaching the result areas
  14. Development and Adoption for provider mapping and implementation of CEA
  15. Develop public health information system with health observatory, research, health museum
  16. Ensuring Legal compliance for every public facility
  17. International conference on HSS
  18. Emergency preparedness and disaster management including training
  19. Integrated IT solution for real time monitoring of 108,JSSK, RBSK, MMU, and Hearse vehicles etc.
  20. Strengthen Equipment's inventory and maintained system
  21. establishment of health news channel and media unit
  22. Developing HDUs in major hospitals
  23. Strengthen MRB for HR training
  24. PFMS, gap analysis, concurrent audit

Component II: Enhanced Management of Non Communicable Diseases and injuries


  1. STEPS Survey – Implement 2 rounds of WHO STEPS Survey including optional modules for NCDs, Mental Health / Suicide, Cervical Cancer, Oral Health and Violence / Injury
  2. Increased Screening in Public Sector facilities in Cervical and Breast Cancer
  3. STEPS implemented in 2019, 2021 and 2023
  4. Analysis, report and dissemination workshop
  5. TN NCD Strategy developed and adopted
  6. Hypertension under control: 3 percentage point increase from baseline
  7. Strengthen and provision of services for Hypertension including follow up in all public facilities
  8. Diabetes under control: 6 percentage point increase from baseline
  9. Strengthen and provision of services for Diabetes including follow up in all public facilities
  10. State specific PIPs for NCD activities
  11. Piloting UCS model of Thailand in primary care through modified capitation and incentive mechanism as part of UHC TN including outreach services
  • a. Strengthen food safety measures to control NCD risk factors
  • b. Strengthen AAT with incentive to public hospital team at graded level based on performance
  • c. Creation of community service groups for NCD
  • d. Creation of Drug disbursement centers for NCD in addition to free drugs HSC PHC GHs on payments using TNMSC drugs
  • e. Strengthen Drug inventory management up to HSC
  • f. Strengthen geriatric service units
  • g. Promotion of self monitoring of NCDs with incentivisation.
  • h. Strengthen Dialysis services in all facilities
  • i. Strengthen Ayush wellness centers for NCD
  • j. Strengthen Palliative care services
    1. Development of SBCC & CM ( CommunityMobilization) strategy ( consultations & workshops)
    2. Development of content & tool for SBCC & CM and testing
    3. Development of annual work plans for comprehensive SBCC Strategy after gap assessment and feed back
    4. Implementation of SBCC & CM strategy ( mass media, mid media, social media & IPC)
    1. 1. Increased share of primary and secondary facilities with at least one staff trained on mental health 0 to 40%
    2. i. Develop the content and strategy for the mental health training
    3. ii. Implementation of training including refresher training
    4. 2. Establishment of suicide hotline
    5. 3. Analysis of existing services and plan strategy/li>
    6. 4. A hotline linked to the 104 health helpline or separate line will be developed for counseling
    7. 5. Strengthen IMH and 3 regional centers for handling referral mental health services
    8. Counseling services to out of school children, educational stress, adolescent etc
    1. 1. Trauma registry developed and established
    2. 2. Inputs to trauma centers using trauma registry: 0 to 54 based on HMIS and 108 data
    3. 3. Protocols for requesting IFTs developed
    4. 4. Additional inputs like protocol, vehicles etc. to reduce the % of IFT calls as a % of total 108 system calls: 41.1% to 30% based on HMIS and 108 data
    5. 5. Inputs to increase the % of surgical ED admissions: 6.7% to 15% based on HMIS and 108 data
    6. 6. Improved capacity of trauma care providers - number of emergency department providers that received Level 3 (BTLS) and Level 4 training (ATLS)
    7. i. BLS SN 165 to 9000 and Doctors 100 to 6000
    8. ii. ALS SN 16 to 900 and Doctors 0 to 600
    9. iii. BLS training for every citizen
    10. 7. Better equipped ambulance system to improve pre-hospital care - number of ATLS ambulances providing Level 1 care 64 to 164
    11. Asses the needed areas
    12. Purchase, fabrication and equipping the ambulances

    Component III: Reduced Equity Gaps in Reproductive and Child Health


    1. Plan, Identify agency for Household survey (based on NFHS)
    2. Implementation of Household survey (based on NFHS) in year 1,3, and 5
    3. Analysis and dissemination workshop
    4. Strengthen MCH services in all public health facilities to ensure Full ANC: 28.8% to 41.3%
    5. Strengthen MCH services in all public health facilities to ensure Fully immunized: 57.9% to 70.4%
    6. Strengthen MCH services in all public health facilities to ensure mCPR: 38.5% to 43.5%
    7. Develop and Update State FR to ensure all are covered
    8. Birth preparedness package/services
    9. Strengthen 500 HWC after gap assessment
    10. Strengthening services at Taluk hospitals including MCH
    11. Provision of individual health cards
    12. Effective use of CHCs for managing minor ailments-in patient care
    13. Strengthen PICU based on performance