Dr. DAREZ AHAMED, IAS.

,
MISSION DIRECTOR,
NATIONAL HEALTH MISSION,
TAMIL NADU.
 POPULATION
India 1210 Million
Tamil Nadu 72.10 Million
32 Districts in Tamilnadu
 ABOUT TAMIL NADU
 Population- 7.21 crores.

 Decadal growth rate 15.60% (2001-2011).

 Seventh most populous state in India.

 6% of country’s population.

 Lowest TFR of 1.7 in the country.

 One of the most urbanised states (48.45%) in India

 Consists 1.1 crore Eligible Couples.

% OF HIGER ORDER OF BIRTH (3 & ABOVE)
Current Use of Family Planning Methods in
Tamil Nadu (NFHS-IV) - Acceptors 53.2 %
% OF P.S. IN TOTAL STERILISATION
TRENDS IN PPIUCD PERFORMANCE
 METHOD WISE PERMANENT
STERILISATION PERFORMANCE 2015-16
TRENDS IN PPIUCD PERFORMANCE
METHOD-WISE PPIUCD PERFORMANCE
GRAVIDA WISE MATERNAL DEATH
ANALYSIS 2015-2016
 Why strategy had to be changed:

 MMR 25, IMR 10 by 2023 is target set by our vision document.

 High risk Non acceptors had to be brought in to the system , shift
from population stabilization strategy to RMNCH +A strategy. The
DFW needs this fundamental reorientation to shift from target
based to maternal and child health related interventions.
 7.9 % HOB contributes 25% of MMR
 Lack of spacing directly contributing to MMR, IMR and other
morbidities.
 The best way to tackle high risk non acceptors is to counsel them
when they are in the health facilities. (99.9% institutional
deliveries). The most receptive period in non acceptors is during this
period.
 Strategy contd..

Imparting tubectomy training and life saving skill in

anaesthesia trained MBBS doctors which has been a key
strategy in implementation of PPS even at the level of
CHC .
PPIUCD doesn’t require repeat visit to the facility, and
state is looking at strengthening MVA/MMA as a logical
corollary to PPIUCD as an RMNCH+A strategy. Over the
counter abortifacients has been a signifanct contributor
to MMR about 1%.
100 block strategy is being implemented by having
specific action plans for blocks. (Reasons were as varied
as unmet , religious , etc)
 HOB blocks.
No of
Sl. Name of the Name of the % of HOB Maternal
No. District Blocks 2014 Deaths
2014-15
1 Namakkal Kolli Hills 24.4 1
2 Tiruvannamalai Jawad Hills 21.7 0
3 Tiruvannamalai Chengam 21.5 1
4 Villupuram Kalrayan Hills 19.6 1
5 Tiruvannamalai Thiruvannamalai 19.2 4
6 Tiruvannamalai Thandrampattu 19.2 0
7 Karur Thogamalai 18.2 2
8 Tiruvannamalai Pudupalayam 17.9 3
9 Vellore Pernampet 17.6 2
10 Vellore Alangayam 17.3 1
 No of Maternal
Sl. % of HOB
Name of the District Name of the Blocks Deaths 2014-
No. 2014
15

11 Villupuram Mugaiyur 1
17.3
12 Tiruvannamalai Kalasapakkam 3
17.1
13 Sivagangai V.Pudur 0
16.7
14 Vellore Jolarpet 1
16.6
15 Villupuram Thirukoilur 1
16.5
16 Tiruvallur R.K. Pet 0
16.5
17 Thoothukudi Alwarthirunagari 2
16.3
18 Thoothukudi Udankudi 0
16.2
19 Salem Tharamangalam 0
16.1
20 Dharmapuri Pennagaram 1
15.8
INSTITUTIONS PERFORMING PPIUCD
No. of institution
Name of the Institution performing PPIUCD
2016-17
MEDICAL COLLEGE
21
HOSPITALS

GOVERNMENT HOSPITALS 214

PRIMARY HEALTH CENTRES 239

URBAN HEALTH POSTS 24

TOTAL 498
 POSITIVE ATMOSPHERE FOR
POST PARTUM STERILISATION AND PPIUCD
 Universal awareness of post partum services

 99.6 % of deliveries are institutional

 All the pregnant mothers are registered for

antenatal care and tracked using PICME

 Easy accessibility of post partum sterilisation and

PPIUCD services

 Motivation by medical and para medical staff

during hospitalisation
 POSITIVE ATMOSPHERE FOR
POST PARTUM STERILISATION AND PPIUCD

 Follow up visits at Village level by VHN, SHN, AGW

etc

 Confidence on the Survival of the baby – IMR has

come down to 20/1000 live births

 100% Antenatal, Natal & Postnatal Care resulted in

increasing safe delivery practice

 Reduction in visits to facilities in PPIUCD

 POSITIVE ATMOSPHERE FOR
POST PARTUM STERILISATION AND PPIUCD
 Health Education & Behavioural Change
Communication have helped in removing the Social
Taboos to some extent & creating awareness

 Constant Post Operative visit, early recognition of

complication & Prompt management of
complications have resulted in reduction in
morbidities & mortalities in Sterilisation

 Periodic review of failures by the quality assurance

committee and updating the knowledge of Service
Providers
 POSITIVE ATMOSPHERE FOR
POST PARTUM STERILISATION AND PPIUCD

 State Level review on sterilisation deaths by the

panel of experts

 This leads to early redressal of problems associated

with such incidence

 Prompt Payment of all Financial assistance to the

acceptors and service providers
 a n k
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