Public Health and Governance in Tamil Nadu: An Overview

2016 ◽  
Author(s):  
Subramaniam Chandran
Keyword(s):  
2021 ◽  
Vol 3 (1) ◽  
pp. 57-64
Author(s):  
Saumya Pandey

Introduction: Infertility is a global public health problem; cost-effective patient-friendly treatment modalities along with psychosexual intervention strategies are essential for infertility control/prevention/management among ethnically disparate populations. Objectives: This study aimed to assess differential in vitro fertilization (IVF) success trends among infertile women of South Indian ethnicity. Materials and Methods: Prospective, observational study designed in a hospital-based setting with active enrollment of infertile women undergoing IVF/intracytoplasmic sperm injection (ICSI) at Indira IVF Center, Chennai, Tamil Nadu, India (April-September 2019); inclusion criteria: age >35 years, South Indian ethnicity, married >1 year, absence of full-term clinical pregnancy, endometrial thickness <6 mm/thin endometrium; exclusion criteria: prior ≥2 IVF failures, fibroids/adenomyosis/cervical cancer/endometriosis. IVF success was determined by evaluating total frozen embryos transferred/month, average oocyte yield/donor, oocyte quality, M-II oocytes, biochemical/clinical pregnancy (beta-human chorionic gonadotropin positivity/fetal cardiac activity). Mycobacterium tuberculosis positivity was assessed by GeneXpert polymerase chain reaction-based technology, and psychosexual intervention-incorporated marital relationship counseling sessions/therapy, referrals for psychiatric assessments (cognitive impairment/schizophrenia/depression). Written informed consent of participants was taken and study was approved by Institutional Review Board. Results: Mean age and endometrial thickness of study participants were 33.3 years (SD ±1.9) and 8.7 mm (SD ±0.5), respectively; average Body Mass Index (BMI) and anti-müllerian hormone (AMH) levels were 28.4 kg/m2 and 4.7 ng/mL, respectively. Embryos transferred/month: 7 in April/13 in May/24 in June/36 in July/24 in August/30 in September, and pregnancies: 4/8/17/26/20/22 for the months of April, May, June, July, August, and September 2019, respectively. Subgroup stratification demonstrated M-II vs total oocytes retrieved were 76%, 73%, 60%, 71%, 77%, and 77%. Overall IVF success rates were 57% in April/62% in May/71% in June/72% in July/83% in August/73% in September; frozen embryo transfer success was 0 in April-May/67% in June/73% in July/89% in August/100% in September 2019. English/Tamil-speaking infertile women self-reported treatment-related satisfaction rates of 80% to 100%. Conclusion: M-II oocytes’ yield, sociodemographics of infertile women, and increasing age/aberrant AMH/BMI profiles/endometrial receptivity/diminished ovarian reserve are promising predictors of IVF/ICSI success in genetically distinct patient population subset(s). Future multicentric gene epidemiology studies with larger sample size and precision-based psychiatric assessments/interventions are warranted for development of predictive biomarkers in infertility management.


2016 ◽  
Vol 5 (1) ◽  
pp. 12
Author(s):  
K Ramu

The present study has estimated the willingness to pay (WTP) for secondary health care services (SHCS) in rural and urban environment of three districts in the state of Tamil Nadu during 2009-2011. Since the governments are struggling to mobilise additional financial        resources to provide essential health care services to the deprived population in the country, assessing the WTP for utilising the public health care services are realised as very important at this juncture. In realizing the importance of augmentation of resources, it has been decided to introduce contingent valuation method (CVM) for WTP of SHCS. A disproportionate systematic random sampling method has been adopted for the selection of 720 households; representing 240 respondents from each of the three districts represent 120 from rural and 120 from urban. A major portion (92%) of the surveyed respondents’ gender was male, literacy was high (90%) and they belonged to productive age group. They generally involve themselves in the farm and non - farm activities and avail employment. Their per capita income is Rs.17871, and it is lower than the India’s PCI. The SHCS are classified into 26 categories as per the guidelines provided by public health medical officers in the state of Tamil Nadu. The different health care services started with entry fee to dental problem. The 98.6 per cent of the total surveyed respondents are ready to pay for SHCS in a public hospital and the remaining 2.4 per cent of them are not willing to pay for the same. The range of WTP for 26 SHCS is Rs. 2 - 7000; the range of mean value is Rs. 6 - 5008 and the range of SD is 2 - 2854. Considering the view of majority of the respondents, this study prescribes to introduce the range of user fee for the identified major public health care services. Since the range is differed significantly, it is suggested to follow the minimum amount initially and in a phased manner, the policy makers may prescribe to enhance the user fee after assessing the ground realities and loopholes. The estimated R2 value for SHCS is 20 per cent, which indicates that the selected 12 independent variables have low influence on WTP for SHCS. The study reports that the other exogenous factors like intensity of disease, accessibility of services, quality, urgency, need and perception are the predominant determinants of WTP for SHCS. The present research contends that constitution of district level co-ordination committee for fixing and implementing user fee for SHCS. Introduction of nominal fee (user fee) for SHCS may be fixed for affordable population, free services for BPL population and it would improve the efficiency and equity of the public health care services for the marginalised population. Finally, it is of utmost importance for health professionals to follow ethics in their profession.


2012 ◽  
Vol 33 (2_suppl1) ◽  
pp. S71-S92 ◽  
Author(s):  
Usha Ramakrishnan ◽  
Alyssa Lowe ◽  
Sheila Vir ◽  
Shuba Kumar ◽  
Rani Mohanraj ◽  
...  

Background Inadequate nutrient intake, early and multiple pregnancies, poverty, caste discrimination, and gender inequality contribute to poor maternal nutrition in India. While malnutrition is seen throughout the life cycle, it is most acute during childhood, adolescence, pregnancy, and lactation. Although nutrition policies are on the books and interventions are in place, child malnutrition and maternal undernutrition persist as severe public health problems. Objective To evaluate the implementation of maternal nutrition programs in India. Methods The research was conducted in two phases. Phase 1 consisted of a desk review of national and state policies pertinent to maternal nutrition and national-level key informant interviews with respondents who have a working knowledge of relevant organizations and interventions. Phase 2 utilized in-depth interviews and focus group discussions at the state, district, and community levels in eight districts of two states: Tamil Nadu and Uttar Pradesh. All data were analyzed thematically. Results India has a rich portfolio of programs and policies that address maternal health and nutrition; however, systematic weaknesses, logistical gaps, resource scarcity, and poor utilization continue to hamper progress. Conclusions Elevating the priority given to maternal nutrition in government health programs and implementing strategies to improve women's status will help to address many of the challenges facing India's nutrition programs. Programs can be strengthened by promoting integration of services, ensuring effective procurement mechanisms for micronutrient and food supplements, establishing regional training facilities for improved program implementation, and strengthening program monitoring and evaluation.


2014 ◽  
Vol 16 (4) ◽  
pp. 489-507 ◽  
Author(s):  
Rajkishor Meher ◽  
Rajendra Prasad Patro

Health is an essential component of economic development and there is a strong correlation between health of human population and societal well-being. We cannot just think of the development of the human capital without the development of health and education of the people. However, it is found that although India has made large gains on the health front of its population, there exist wide variations between and within states. While states such as Kerala, Punjab and Tamil Nadu have a very developed health sector and the health indicators of these states are comparable to those of developed middle-income countries, states such as Bihar, Jharkhand, Madhya Pradesh, Chhattisgarh, Uttar Pradesh, Odisha, etc., are almost at the level of Sub-Saharan Africa. By using a few of the key health indicators the present article makes a critical analysis of the health status of people in the 17 major states of India, the ongoing health development programmes and the present state of public health care services in different parts of the country. The article further delves into an arena of specific policy intervention measures that are required to be undertaken in order to increase the health status of people.


2020 ◽  
Vol 13 (2) ◽  
pp. 222-230
Author(s):  
R. Shome ◽  
M. Nagalingam ◽  
R. Priya ◽  
S. Sahay ◽  
T. Kalleshamurthy ◽  
...  

Background and Aim: Brucellosis caused by bacteria belongs to the genus Brucella is an important zoonosis and constitutes a serious public health hazard worldwide including India. The present study aimed to estimate the knowledge of veterinarians on brucellosis, its public health threat, diagnosis, and vaccination. Materials and Methods: This cross-sectional study was conducted during 2013-2015 and 453 veterinarians representing 11 states/Union Territories (UT) of India (Assam, Tripura, Meghalaya, Goa, Karnataka, Madhya Pradesh, Uttar Pradesh, Delhi, Jammu and Kashmir, Tamil Nadu, and Punjab) were interviewed using self-administered questionnaire. Results: Out of 453 veterinarians, 71.74% stated handling of the animals on day-to-day basis and 28.25% were engaged in administration activities. The veterinarians ranked foot-and-mouth disease and brucellosis at the first and fourth ranks among the list of ten economic impacted diseases in the country. A significant association was observed between laboratory confirmation with those who handled brucellosis-suspected cases (p=0.000). Similarly, significant association was noted for the availability of vials/slides (p=0.114), vacutainers (p=0.008), icebox (p=0.103), and refrigerator (p=0.106) for those who preferred laboratory diagnosis. Only 20% of the veterinarians recommended vaccination against bovine brucellosis, and 17% obtained laboratory confirmation for the brucellosis-suspected cases. Conclusion: The study highlighted the need for awareness programs, laboratory facilities, veterinary doctors, and protective measures for the veterinarians for combating brucellosis through the control program in the country.


Author(s):  
R. Sudharsan ◽  
V. Saravanabavan

Health is a common theme in most cultures. Among the definitions still used, probably the oldest is that health is not the absence of disease. Contemporary developments in social sciences reveal that health is not only a biomedical phenomenon, but one which is influenced by social, psychological, cultural, economic and political factors of the people concerned. Thanjavur District lies on the east of Tamil Nadu. It is situated between 90 50’and 110 25’ of the northern latitude and between 780 45’and 790 25’ of the eastern longitude. It extends to an area of 3411 sq. kms. Our sample in Thanjavur, we found more people depending upon the public health facilities than on the private health facilities. Almost 74% people went to public health facilities and only 26% went to the private health facilities. The health status of various blocks of the district in relation to other blocks with reference to socio-economic living, environment, family structure and health care utilization but also emphasized the intra regional variation that exists among different bocks in the health status of the population.


2021 ◽  
pp. 96-118
Author(s):  
Pascale Hancart Petitet

This chapter documents the local and global processes of construction, legitimization and delegitimization, and the political uses of the knowledge of traditional birth attendants—TBAs. Based on four years’ ethnographical investigation in Tamil Nadu, this chapter discusses the issue from various points of view. It looks at the debates of actors involved in the national and international public health agendas, Indian movements promoting ‘Natural Childbirth’, and movements in favour of the preservation of traditional systems of medicine. TBAs are variously perceived as wicked mothers whose archaic practices must be controlled, the archetypal ambassadors of traditional knowledge, or as relevant actors bringing together ideal elements of any development activity—locality, community, and low cost. This careful reading of the contemporary social representations of TBAs and of their role reconfigurations offers a lens to examine authoritative knowledge’s social forms, practices, and paradoxes.


2019 ◽  
pp. 90-113
Author(s):  
Jean Drèze

This chapter discusses the dismal state of health care in India and the scope for change. Drawing on a wealth of survey data, it brings out the gaping deficiencies of public health facilities as well as India's poor health outcomes. In fact, India's health indicators do not compare favourably with those of Bangladesh or even Nepal, in spite of India's much higher per‐capita GDP and faster GDP growth. Of course, some Indian states (notably Kerala, Tamil Nadu, and Himachal Pradesh) have made health care a priority and, correspondingly, forged ahead in terms of health indicators. Recent evidence also suggests significant progress in this field in other states, including some—like Bihar—that have a long record of poor governance.


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