Parthasarathi R, Sinha S P
Department of Community Medicine, Dhanalakshmi Srinivasan Medical College, Siruvachur, Tamil Nadu, India.
Indian J Community Med. 2016 Oct-Dec;41(4):302-304. doi: 10.4103/0970-0218.193344.
The Tamil Nadu model of public health is renowned for its success in providing quality health services at an affordable cost especially to the rural people. Tamil Nadu is the only state with a distinctive public health cadre in the district level and also the first state to enact a Public Health Act in 1939. Tamil Nadu has gained significant ground in the various aspects of health in the last few decades largely because of the significant reforms in its health sector which dates back to 1980s which saw rigorous expansion of rural health infrastructure in the state besides deployment of thousands of multipurpose health workers as village health nurses in rural areas. Effective implementation of Universal Immunization Programme, formation of Tamil Nadu Medical Services Corporation for regulating the drug procurement and promoting generic drugs, early incorporation of indigenous system of medicine into health care service, formulation of a health policy in 2003 by the state with special emphasis on low-income, disadvantaged communities alongside efficient implementation of The Tamil Nadu Health Systems Project (TNHSP) are the major factors which contributed for the success of the state. The importance of good political commitment and leadership in the health gains of the state warrants special mention. Moreover, the economic growth of the state, improved literacy rate, gender equality, and lowered fertility rate in the last few decades and contributions from the private sector have their share in the public health success of the state. In spite of some flaws and challenges, the Tamil Nadu Model remains the prototype health care delivery system in resource-limited settings which can be emulated by other states also toward a better health care delivery system.
泰米尔纳德邦的公共卫生模式以成功以可承受的成本提供优质医疗服务而闻名，尤其是为农村人口提供服务。泰米尔纳德邦是唯一一个在区级拥有独特公共卫生干部队伍的邦，也是1939年第一个颁布《公共卫生法》的邦。在过去几十年里，泰米尔纳德邦在卫生的各个方面都取得了显著进展，这主要归功于其卫生部门自20世纪80年代以来的重大改革，当时该邦大力扩展农村卫生基础设施，此外还在农村地区部署了数千名担任乡村保健护士的多用途卫生工作者。有效实施通用免疫计划、成立泰米尔纳德邦医疗服务公司以监管药品采购并推广通用药物、早日将本土医学体系纳入医疗服务、该邦在2003年制定特别强调低收入、弱势社区的卫生政策以及高效实施泰米尔纳德邦卫生系统项目（TNHSP）是该邦取得成功的主要因素。该邦在卫生方面取得的成就中，良好的政治承诺和领导力的重要性值得特别提及。此外，该邦过去几十年的经济增长、识字率提高、性别平等、生育率降低以及私营部门的贡献也在该邦的公共卫生成功中占有一席之地。尽管存在一些缺陷和挑战，但泰米尔纳德邦模式仍然是资源有限环境下的原型医疗服务提供系统，其他邦也可以效仿，以建立更好的医疗服务提供系统。
