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Chapter - 3 DIRECTORATE OF MEDICAL AND RURAL HEALTH SERVICES The Directorate of Medical and Rural Health Services is providing Medical Care Services, through the grid of 25 District Headquarters Hospitals, 162 Taluk Hospitals, 79 Non-taluk Hospitals, 12 Dispensaries. The Directorate is implementing various Medical Services Programmes such as TB Control, Mental Health, HIV, Blood Bank. The Non Taluk and Taluk Hospitals are the First Referral Units in the Chain of Medical Services in the State and the 25 District Headquarters Hospitals are the second referral units In each district, Headquarters hospital supervise and implement all the Medical and Health Programmes. The Joint Directors of Health Services in all Districts except Chennai are responsible for Supervision in implementation of all the Medical Health Programmes including Family Welfare. They also coordinate with the other departments to implement the programmes such as control of Blindness, AIDS, Hill Area Development Programme, Schemes for Adidravida and Tribal Welfare. The Hospitals under the control of the Director of Medical and Rural Health Services are having a total bed strength of 21,389. The daily average is 17,315 and average Out patient is 1,69,800. I. PRE-NATAL DIAGNOSTIC TECHNIQUES Pre-Natal Diagnostic Techniques (Regulation and Prevention of Misuse) Act 1994, came into force in Tamil Nadu with effect from 01.01.1996. For effective implementation of this Act, State, District and Taluk level Advisory Committees have been formed. The Director of Medical and Rural Health Services, the Joint Director of Health Services and Senior Civil Surgeon / Medical Officer of the Government Taluk Hospitals have been nominated as respective Appropriate Authorities to implement the Act. The total number of Scan Centres registered so far is 1625. Due to constant vigil, 61 unregistered scan centres have been seized and sealed. Cases have been filed against 6 scan centres. II. DISTRICT MENTAL HEALTH PROGRAMME Mental ill-health is an issue of Public Health importance requiring proactive, sensitive intervention particurly in rural setting. Hence a District Mental Health Programme is being implemented. The scheme outlay is of Rs.1 Crore for a Programme period of five years. The objectives of the programme are early identification of mental illnesses in the community and mental health care. Training of medical, para-medical and non-medical personnel, mental health care delivery and awareness programmes are different components of the programme. Director of Medical and Rural Health Services is the controlling authority and Institute of Mental Health is the Nodal Agency for implementation of the programme. At present the District Mental Health Programme is being implemented in Trichy, Madurai and Ramanathapuram Districts. III. TB CONTROL PROGRAMME There are about 10 lakh TB patients in Tamil Nadu. Among them, about one fourth (2.5 lakh cases) are infectious. There are 10 TB Sanatoria and TB Hospitals (5 Government Institutions under the control of Director of Medical and Rural Health Services, 3 Government Institutions under the control of Director of Medical Education and 2 Private Institutions) in the State. In all, there are 3,654 beds in the State exclusively for inpatient treatment of the acutely-ill TB patients, A vast majority of the TB patients are on domiciliary (home) treatment in the nearest medical or health facility. A full-time State TB Officer in the rank of Additional Director is at the State-level to co-ordinate and supervise the TB Control Programme activities. At the District-level, each District TB Centre is headed by a Deputy Director of Medical Services (TB) i.e., District TB Officer. Central Assistance under the External Assistance Component is provided (in kind) meeting about 50% of the requirement of anti-TB drugs. State Government meets the entire expenditure on running the TB institutions (towards staff, maintenance of TB Institutions,. drugs, vehicles etc). The Revised National Tuberculosis Control Programme (RNTCP) which was operated in 17 districts only has been extended to all the districts in December 2001. With full coverage of the State under Revised National Tuberculosis Control Programme the incidence of Tuberculosis would be brought under control. IV. TRAUMA CARE CENTRES Increasing number of road accidents in the State is of great concern. Hence it has been proposed to strengthen the Accident and Trauma Care facilities in the six Government Hospitals situated on the National / State Highways. It has been proposed to provide equipments like X-ray Unit, Ultra Sound Scanner and Semi Auto Analyser to the above mentioned Hospitals. V. TAMIL NADU STATE ILLNESS ASSISTANCE SOCIETY The Government of Tamil Nadu has constituted the Tamil Nadu State Illness Assistance Society which administers a "Revolving Fund" with an initial corpus fund of Rs.15 crores. The funding pattern will be in the ratio of 2:1 between State Government and Government of India. The affairs of the Tamil Nadu State Illness Assistance society is administered by the Executive Committee under the Chairmanship of the Secretary to Government, Health and Family Welfare Department and the Director of Medical and Rural Health Service as the Member Secretary. The society provides financial assistance for medical treatment in notified hospitals. ACTION PLAN FOR 2002-2003 1. Seven Regional Diagnostic Centres will be set up at a cost of Rs.21 crores at District Headquarters Hospitals. 2. Six Trauma Care centres at a total cost of Rs.4.45 crores will be established in Government Hospitals located on National / State Highways. 3. Strengthening of non-taluk and taluk hospitals. 4. Involve NGO's and private practitioners in Revised National Tuberculosis Control Programme. |
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