By: Mariko Rasmussen, Program Assistant at Women Deliver
Tamil Nadu lies in the southernmost part of the Indian Peninsula. The state faces major challenges in improving and increasing access to health care services, but they are making significant strides. The Government of Tamil Nadu developed a Health Policy in 2003 with a focus on the health of low-income communities and families. The Tamil Nadu Health Systems Project supports this strategy through several interventions, especially those aimed at reducing infant and maternal mortality. The World Bank recently provided more funds, in addition to the original financing in 2004, to further improve health services quality and access while supporting state-wide management systems implementation.
The Project has utilized several innovative and effective measures. To increase access to necessary maternal and neonatal health services, 80 comprehensive emergency obstetrics and neonatal centers have been established and strengthened, leading to improved quality of care for women and infants. This care includes health education, nutritional support, and HIV/AIDS testing and counseling. In addition, 385 ambulances have been provided under the project, managed under a public private partnership, increasing emergency transport services in rural areas. These public private partnerships have also provided mobile out-reach health services as well as other services.
The Project also launched a pilot program that includes ensuring women’s reproductive health through cervical cancer screenings. The pilot program has had great success with 84% of women in the target age group of 30 – 60 years being screened in the Theni and Thanjavur districts and the scheme could be extended to the whole of Tamil Nadu.
To ensure that women’s and infants’ health visits are recorded, an electronic health management system was established and is now operational in 38 secondary level hospitals, with plans to extend to all 270, and to 18 medical colleges. These electronic records prove invaluable in maintaining and monitoring a woman’s and her infants’ health throughout the continuum of care.
From these interventions and more, Tamil Nadu has seen improvements in both maternal and infant health. Infant mortality has decreased by 35%. The state’s maternal mortality ratio has decreased 50% from 167 deaths per 100,000 live births in 1999 to 111 in 2006, while India's MMR in 2008 was 230. While this is exciting progress, it is still 25 times higher than in developed countries. But with further improvements to quality of care and strengthened comprehensive emergency obstetric and neonatal care, Tamil Nadu is on the right track.