Y

1. Dr. DAREZ AHAMED, IAS.,
MISSION DIRECTOR,
NATIONAL HEALTH MISSION,
TAMIL NADU.

2. POPULATION
India 1210 Million
Tamil Nadu 72.10 Million
32 Districts in Tamilnadu

3.  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.
ABOUT TAMIL NADU

4. % OF HIGER ORDER OF BIRTH (3 & ABOVE)

5. Current Use of Family Planning Methods in
Tamil Nadu (NFHS-IV) - Acceptors 53.2 %

6. % OF P.S. IN TOTAL STERILISATION

7. TRENDS IN PPIUCD PERFORMANCE

8. METHOD WISE PERMANENT
STERILISATION PERFORMANCE 2015-16

9. TRENDS IN PPIUCD PERFORMANCE

10. METHOD-WISE PPIUCD PERFORMANCE

11. GRAVIDA WISE MATERNAL DEATH
ANALYSIS 2015-2016

12. 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.

13. 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)

14. HOB blocks.
Sl.
No.
Name of the
District
Name of the
Blocks
% of HOB
2014
No of
Maternal
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

15. 11 Villupuram Mugaiyur
17.3
1
12 Tiruvannamalai Kalasapakkam
17.1
3
13 Sivagangai V.Pudur
16.7
0
14 Vellore Jolarpet
16.6
1
15 Villupuram Thirukoilur
16.5
1
16 Tiruvallur R.K. Pet
16.5
0
17 Thoothukudi Alwarthirunagari
16.3
2
18 Thoothukudi Udankudi
16.2
0
19 Salem Tharamangalam
16.1
0
20 Dharmapuri Pennagaram
15.8
1
Sl.
No.
Name of the District Name of the Blocks
% of HOB
2014
No of Maternal
Deaths 2014-
15

16. INSTITUTIONS PERFORMING PPIUCD
Name of the Institution
No. of institution
performing PPIUCD
2016-17
MEDICAL COLLEGE HOSPITALS 21
GOVERNMENT HOSPITALS 214
PRIMARY HEALTH CENTRES 239
URBAN HEALTH POSTS 24
TOTAL 498

17.  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

18.  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

19.  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

20.  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
POSITIVE ATMOSPHERE FOR
POST PARTUM STERILISATION AND PPIUCD