Search :   
“Sharing innovative solutions to common health management problems”
»  Information about HS-PROD
»  HS-PROD Report
»  List of Entries
»  Entries by State/UT
»  Entries by Subject Area
»  FAQ

Mini Health Centre scheme, Tamil Nadu
Post your Comments
Subject Area="Public / private partnership (including NGOs)." Objective="Improved outreach services."
Details for Reform Option "Mini Health Centre scheme, Tamil Nadu"
Summary

Background: Community health outreach in partnership with the community is the core vision of Voluntary Health Services (VHS) for the healthcare of the rural underprivileged. The model of outreach services through Mini Health Centres (MHCs) found recognition as early as 1969 and served as a forerunner for primary healthcare in India. The aim of the MHCs is to render comprehensive, continuous and co-operative community care. Action: The MHC model was introduced in the in St Thomas block of Kancheepuram district of Tamil Nadu by VHS as a pilot project in 1968 -70 for a population of 10,000. The population was later scaled down to 5000 per MHC. To establish an MHC in an area, the community is involved in several ways. At the execution stage it participates by providing constructed building for accommodation and minimal furniture. Recurring cost is subsidised by grants both from government and private donations. Financial participation by the community is also encouraged through the Medical Aid Plan (MAP), the health insurance scheme run by VHS. At MHC level subscribers to the MAP are entitled to free treatment throughout the year and inpatient services at tertiary level are either subsidized or free. (For details of the MAP scheme see PROD entry No 127: Medical Aid Plan for voluntary health insurance, Tamil Nadu). Each MHC model is staffed by two fulltime Multi Purpose Workers (MPWs), one male, one female and a Medical Officer (MO). They are assisted by Lay First Aiders (LFAs) for every 1000 population. After a short and intensive training LFAs provide first aid services and impart health education to the community. They are in direct contact with the families and are constantly available, helping the people and understanding the need for health services and advising them accordingly. A regular medical officer, residing in an urban or semi urban area, attends the clinic for three hours a day, three times a week. The availability of the medical officer is imperative since he or she guides and leads the team of health workers. To improve the capability and resources of the MHC core staff, additional provisions are provided in the form of supervisory staff (one male and one female) for every four MHCs and a referral link where specialised care could be provided. The referral hospital is also expected to provide technical support and manage a cluster of MHCs through supervisory staff. All the above categories of workers, including the doctors, undergo compulsory prescribed training and on the job training while working at VHS. Services provided include: i) Medical examination of every family and preparation of ‘at risk’ register; ii) Nutritional assessment of each family member; iii) Maintenance of records; iv) Maternal services including antenatal and post natal care. Each mother is visited approximately once a month during the period of pregnancy and lactation; v) Child welfare services, including maintenance of growth cards, immunisation, nutritional assessment and treatment; vi) School health services; vii) Family welfare and planning; viii) Medical care; ix) Domiciliary treatment for tuberculosis and leprosy; x) Laboratory investigation for screening of preventable diseases; xi) Referral of cases for specialist consultation or admission to a referral hospital. Results: In 14 MHCs in 2004 the following results were achieved: Maternal care: 89.3% of women registered for ANC services 89 % of women received three ANC check ups 75.4% of women received immunisation 58.2% of deliveries were institutional Nutritional care to children: 69%% of children (0-5 years) registered Expected malnourishment was 13%

Cost The Government by their G.O. Ms. No. 437 dated 13th March’84 have sanctioned a budget of INR 27,000 per annum for each of the MHC run by VHS. The cost to be share on 1:1:1 basis by the Central Government, State Government and Voluntary organisation.
Place Kancheepuram district,Tamil Nadu
Time Frame Six -8 months
Advantages

Community partnership: Making the community provides the accommodation and minimum furniture free of cost and motivating the community to become member of the MAP scheme. Efficient functioning of the referral services: MHCs have well-established linkage with VHS hospital for the referrals. Government has also issued clear instructions in G.O. No. 94890/P&D I/ 78-SI dated 27.5.78 to Directors of Medical education and medical services to give special attention to the referred cases from MHCs and maintaining its records. Increased utilisation rate: Facility used more frequently due to availability of continuous and comprehensive services to the community on permanent basis rather than sporadic visits or camp drive Strengthened curative care at peripheral level: Provision of medical officer at the peripheral level strengthens the delivery of curative services on continuous basis.

Challanges

Continued need of co-operation from the community: Sustained motivation of the community to participate in the MAP scheme and ensuring their involvement in the health care activities. High turn over of the medical officers due to lack of motivation to serve in rural area.

Prerequisites

Local action committee consisting of local leaders, panchayat members, officials and other residents. It helps to generate awareness of ownership of the MHCs by the people. Community participation in providing free accommodation and minimal furniture for accommodating the MHC. Identification and linkage with the referral hospital for specialized services as Hospital and Medical Centre under VHS.

Who needs to be consulted

Local leaders, PRI members, NGO, State Government and Hospital for referral linkage.

Risks

Sustainability

Sustainable, but depends upon the raising of funds from the community through their continued involvement as subscribers in the MAP.

Chances of Replication

. Results have shown its success in terms of improved health indicators. . The model was adopted in 1977 by TN government as a prototype for the voluntary bodies to assist the government functioning. Since June 1993- 261 MHCs are running in the TN by various voluntary organizations. Out of them 14 are under VHS in Kancheepuram district.

Comments

The mini health centre scheme was started in 1970 when the concept of primary health centres was very new in India. The core idea was to involve the community in their own healthcare activities, which there is much need of today owing to resource constraints. But its success depends upon the continued involvement of the community.

Contact

Submitted By

Dr. Anuradha Davey, Research Consultant, IRMS, July 2005

Status Active
Reference Files
health-Lok Satta.pdf Ensuring a Healthy Future - Lok Satta
MHC-TN.jpg
Reference Links
 
No Record Updated
Read More
 
 
 
» Comparable Databases
» State/UTs Government
» UN Organisations
» Bilateral Organisations
» NGO's
» Miscellaneous
Read More