List of Hospitals to provide 24 hours CEmONC services

1	COIMBATORE	Coimbatore Medical College Hospital, Coimbatore
2	COIMBATORE	Dist HQ Hospital, Tiruppur
3	CUDDALORE	Dist HQ Hospital, Cuddalore
4	CUDDALORE	Govt Hospital, Virudhachalam
5	DHARMAPURI	Dist HQ Hosptial ,Dharmapuri
6	DHARMAPURI	Government Hospital . Harur
7	DINDIGUL	Dist HQ Hospital ,Dindigul
8	DINDIGUL	Government Hospital. Palani
9	ERODE	Dist HQ. Hospital, Erode
10	ERODE	Government Hospital, Gobichettypalayam
11	KANCHEEPURAM	Chengalpattu Medical College Hospital Chingleput
12	KANCHEEPURAM	Dist HQ Hospital Kancheepuram
13	KANYAKUMARI	Kanyakumari Medical College, Nagercoil
14	KANYAKUMARI	Govt Hospital Boothapandy
15	KANYAKUMARI	Govt Hospital Padmanabhapuram
16	KARUR	Dist HQ Hospital Karur
17	KARUR	Govt Hosptial, Kulithalai
18	KRISHNAGIRI	Govt Hospital, Hosur
19	KRISHNAGIRI	Dist HQ Hospital Krishnagiri
20	MADURAI	Govt. Rajaji Hospital Madurai
21	MADURAI	Govt Hospital, Usilampatty
22	NAGAPATTINAM	Govt Hospital Mayiladuthurai
23	NAGAPATTINAM	Dist HQ Hospital Nagapattinam
24	NAMAKKAL	Dist HQ Hospital Namakkal
25	NAMAKKAL	Govt Hospital ,Tiruchengode
26	THE NILGIRIS	Govt Hospital Gudalur
27	THE NILGIRIS	Dist HQ Hospital, Udhagamandalam
28	PERAMBALUR	Govt Hospital Ariyalur
29	PERAMBALUR	Dist HQ Hospital, Perambalur
30	PUDUKOTTAI	Dist HQ Hospital Puddukottai
31	PUDUKOTTAI	Govt Hospital Aranthangi

32	RAMANATHAPURAM	Govt Hospital. Paramakudi
33	RAMANATHAPURAM	Dist HQ Hosptial, Ramanathapuram
34	SALEM	Mohan Kumaramangalam Medical College Hospital, Salem
35	SALEM	Govt Hospital. Attur
36	SALEM	Dist HQ Hospital, Mettur Dam
37	SIVAGANGA	Govt Hospital, Karaikudi
38	SIVANGANGA	Dist HQ Hospital Sivaganga
39	THANJAVUR	Govt. RM Hospital, Thanjavur
40	THANJAVUR	Dist HQ Hospital, Kumbakonam
41	THANJAVUR	Govt Hospital Pattukottai
42	THENI	District HQ Hospital .Periyakulam
43	THENI	Theni Medical College Hospital, Theni
44	THOOTHUKUDI	Thoothukudi Medical College Hospital, Thoothukudi
45	THOOTHUKUDI	Dist HQ Hospital, Kovilpatty
46	TIRUNELVELI	Thirunelveli Medical College Hospital, Thirunelveli
47	TIRUNELVELI	Dist HQ Hospital .Tenkasi
48	THIRUVALLUR	Govt Hospital.Thiruthani
49	THIRUVALLUR	Dist HQ Hospital Tiruvallur
50	TIRUVANNAMALAI	Govt Hospital, Arani
51	TIRUVANNAMALAI	Dist HQ Hospital Tiruvannamalai
52	TIRUVARUR	Govt Hospital, Mannargudi
53	TIRUVARUR	Dist HQ Hospital, Thiruvarur
54	TRICHY	KAP. Viswanathan Medical College Hospital, Trichy
55	TRICHY	Dist HQ Hospital. Manapparai
56	VELLORE	Vellore Medical College Hospital, Vellore
57	VELLORE	Govt Hospital Gudiyatham
58	VELLORE	Govt Hospital Tirupattur
59	VILLUPURAM	Govt Hospital Kallakurichi
60	VILLUPURAM	Dist HQ Hospital, Villupuram
61	VIRUDHUNAGAR	Govt Hospital Rajapalayam
62	VIRUDHUNAGAR	Dist HQ Hospital, Virudhunagar

Public Private Partnership Packages

• Operationalisation of Emergency Ambulance Service in each of the 385 blocks in Tamil Nadu

• Health Care Waste Management training for health personnel.

• Health Care Waste Management including operating common treatment facility in the districts.

• Mortuary Van services in the districts

• Mobile outreach clinical services in tribal areas

• Piloting of Cardio vascular disease risk factor management

• Cervical Cancer screening pilot

• Opening of counseling centres in the hospitals to improve the accessibility of poor to hospital services

• Community Based Health Insurance (CBHI) pilot

• Establishment of Accident Relief and Trauma Care Centres in highways

• Establishment of Blood Bank in Tribal areas

• Training for Tribal health Volunteers

• Bed grants to NGOs operating in tribal areas

• Training of staff on clinical, quality improvement, management etc.,

• Newer packages will be developed during the course of the project

STATUS OF NGOs SELECTION AS ON 12.09.2006

NGOs Selected Status

NGO SELECTION AND MOU STATUS AS ON 18.09.06

NGO SELECTION AND MoU STATUS

Applications are invited from the interested eligible candidates for the following posts in the world Bank supported Tamil Nadu health systems Project, Chennai - 600 006.

Advertisement No. 6 /TNHSP/ PMU /2006

Applications are invited from interested and eligible candidates for appointment to the following posts in the World Bank supported Tamil Nadu Health Systems Project, Chennai-600 006.

Advertisement No. 7 /TNHSP/PMU/2006

Applications are invited from eligible candidates for appointment to the following posts in the World Bank supported Tamil Nadu Health Systems Project, Chennai – 600 006.

Advertisement No.9/TNHSP/PMU/2007

Project Management Structure

Studies and Workshops

Studies Conducted:

• Social Assessment of Beneficiaries Study
• Informal private health sector study
• Burden of diseases study
• Rational use of drugs study
• Electronic Mapping of health facilities study (Public and Private)
• Facility survey study (all public hospitals in secondary care sector)
• Tribal development Plan
• Public Private Partnership
• Financial Management Study (sponsored by World Bank)

State level Workshops conducted:

• NGOs involved in Tribal Health Care activities

• Public Private Partnerships first consultative workshop

• Non Communicable diseases (sponsored jointly by World Bank and Government of Tamil Nadu)

• Workshop on Bio Medical Waste Management

• State level work shop and inauguration of CEmONC services and birth companion scheme.

Studies envisaged:

• Quality of care - hospital utilization and patient satisfaction survey at state level through private consultants

• Non Communicable Diseases ( NCD ) – especially Cardio Vascular Disease including Hypertension – Study on Risk factors

Social Assessment of Beneficiaries Study

The social assessment of beneficiaries study was undertaken by a team from Christian Medical College , Vellore . The study highlighted the health seeking behavior of the public, the facilities available in public sector and the satisfaction level of the patients as well as the role and method of traditional healers, quality of care in private health care facilities, levels of satisfaction and constraints of vulnerable groups in accessing health care facilities. It has also highlighted the gender differentials in health seeking behavior.

Informal Private Health Sector Study

This study was confined to the districts of Dharmapuri, Theni, Dindigul and Kanyakumari. There is no particular logic in the selection of these districts except that the first three are poorer districts with lower health status while the last one has the distinction of having a high literacy rate and better health status. The practitioners from alternative systems of medicine representing Ayurvedic, Homeopathic,Siddha and Unani medicines were considered for this study. In addition, practitioners with no recognition to practice any of the above mentioned systems were also included under this study. The study focused on the prevalence of informal private sector providers practicing in all parts of the state with varying degrees of questionable quality and cross practice. Some of the informal sector providers are eager to participate in government health programmes.

Burden of diseases
A study on burden of diseases was conducted by Christian Medical College Vellore to find out the causes of mortality and morbidity .The study was based on the following documents

• Medical Certification of Cause of Death (MCCD)
• Reports on comprehensive health camps conducted through out Tamil Nadu ( 96 lakhs patients ) during 2000- 01
• Reports on the speciality camps conducted ( 7,98,442 patients ) during 2002-03
• Other reports available with DPH&PM

Rational use of drugs

The essential drugs programme of the government of Tamil Nadu executed through TNMSC focused among other things on rational selection and use of drugs in government health facilities. A study on the extent of rational use of drugs in PHCs and FRUs in the state was conducted during 2003. The study had taken up both outpatient and inpatient treatment and was conducted through exit interviews of a scientifically selected sample of 7040 out patients and case sheets of 463 inpatients , supplemented with a perusal of the out patients prescription slips and drugs issued to the out patients. These provided the data base for the study. The patient contacts were established at 56 FRUs and 56 PHCs dispersed over Tamil Nadu . The study revealed the good and certain deficiencies in the rational use of drugs by the doctors in the PHC’s and FRU’s

Mapping of Health Facilities ( Public and Private )

The mapping exercise was undertaken for all healthcare facilities throughout Tamil Nadu . The out-patients attending all government hospitals and inpatient attending the hospital for one month were interviewed and the report analysed . The availability of private and public health care providers in the area was accounted for.

Facility Survey ( All public hospitals in secondary care sector )

A comprehensive facility survey was carried out in all secondary care hospitals in Tamil Nadu numbering 270 to find out the infrastructure facilities especially the buildings , equipments, human resources, vehicles and performance of the hospitals. The survey revealed in detail the infrastructure especially the civil works , water supply ,drainage and sanitation system, electrical works and repair status of the equipments ,vehicle and performance of the hospitals. The facility survey is being followed up to decide on the civil work needs , equipment supply and man power needs which will be provided by the project.

Tribal Health

A study on the tribal health has been instituted through a specialist in tribal health. The tribal population is around 53 lakhs. They are spread in the districts of Nilgiris , Coimbatore , Dharmapuri , Salem , Namakkal, Trichy , Dindigul Cuddalore and Vellore . No specific health plan for the tribals has been designed and implemented so far except for some out- reach camps and grant to some NGOs working in those areas.

Public- Private Partnership

In Tamil Nadu, many of the National programmes like Family welfare programme , Blindness Control programme ,Aids control programme and Immunisation Programmes are all carried out with active participation of the private sector health care providers. The private sector is growing at a fast pace and it is roughly estimated that around 80% of the first contact for out patients and 50 % of inpatient services are in the private sector. Hence it is imperative that various modalities of partnership among government , for–profit private sector and voluntary sector health care providers and institutions be explored to harness both public and private resources for meeting health sectors goals . A consultant is being nominated to study and recommend the PPP policy of the government and the action plan.

Financial Management Study ( Sponsored by World Bank )
The financial management study report recommends certain functional enhancements in areas like

• Budget
• Fund flow
• Accounting
• Management
• Audit – Internal and External
• Review Mechanism

It also recommends

• Computerisation
• Finance Integrated Management Information System

It also recommended certain points on system and staffing improvements

• Accountability of the institutions and individuals
• Performance Monitoring System
• Human Resource Management
• Revision of Job Descriptions

Comprehensive Emergency Obstetric & Newborn Care (CEmONC) Services

To ensure that the emergency obstetric and newborn care services are easily accessible, the Project has identified a minimum of two hospitals in each district to provide round the clock comprehensive emergency obstetric and newborn care services (CEmONC) in such a way that from anywhere in Tamil Nadu, antenatal mothers and newborn cases can access the CEmONC centers within one hour.In the next phase, more number of CEmONC centers will be established to ensure that the access will be within half hour. These hospitals will be equipped with adequate qualified manpower and equipments to provide uninterrupted services round the clock.

Each CEmONC centre will have

1. Labour Ward
   

2. Operation Theatre
   
3. Blood Bank
   
4. Diagnostic services
   
5. Ambulance services
   
6. Specialists services in O & G , Paediatrics , Anaesthesia & General Surgery

Grading of Hospitals

Grading	Bed Norms	Range
District Hospital Grade I	500 beds	350 and above
District Hospital Grade II	300 beds	350 and below
Sub District Hospital Grade I	200 beds	150 to 250 beds
Sub District Hospital Grade II	100 beds	75 to 150 beds
Sub District Hospital Grade III	50 beds	40 to 75 beds
Sub District Hospital Grade IV	30 beds	Less than 40 beds

Advertisement No:8/TNHSP/2006

	GOVERNMENT OF TAMIL NADU
	TAMIL NADU HEALTH SYSTEMS PROJECT

Advertisement No:8/TNHSP/2006

Applications are invited for appointment to the post of Architect in the World Bank supported Tamil Nadu Health Systems Project on a consolidated pay of Rs.15,000/- per month. The appointment is purely temporary on contract basis. The candidates should possess B.Arch degree. Preference will be given to those with experience in the design of hospital buildings.

Eligible candidates may send their applications with bio-data and copies of testimonials on or before 5.00 PM on 15.12.2006 to the address given below.

Visit us at www.tnhsp.org The Project Director,

www.tnhealth.org Tamil Nadu Health Systems Project,

7^th Floor, DMS Complex,

Visit us at: www.in.gov.in 359, Anna Salai, Teynampet,

DIPR/1160/DIS/2006 Chennai-600 006.

Phone NO:044-24345996.

GOVERNMENT OF TAMIL NADU

TAMIL NADU HEALTH SYSTEMS PROJECT

From To

Thiru.T.Jacob, IAS., M/s Broadline Computers

Project Director, Systems Private Limited,

Tamil Nadu Health Systems Project, 7 Khader Nawaz Khan Road

7^th Floor, DMS Building Nungambakkam,

Teynampet, Chennai-600 006. Chennai-600 006(with enclosure)

Lr.No.2389/E1/HSP/2006 Dated:24.11.2006

Sir,

Sub: Tamil Nadu Health Systems Project – Advertisement for recruitment of staff for Engineering Cell – Hosting in the Web site – Request.

-------

I enclose a copy of the advertisement to be released calling for applications for appointment to the post of Architect in the Engineering Cell of the Tamil Nadu Health Systems Project. This advertisement is being released in media on 25.11.2006. I request that the text of the advertisement may be hosted in the Web site of Tamil Nadu Health Systems Project on 25.11.2006.

for Project Director.

Performance Indicators

The progress of the project will be monitored on the basis of a set of performance indicators. The indicators are classified into two broad groups:

• Process Indicators
• Outcome Indicators

Process Indicators: The project will initiate a series of activities under each component, such as civil works, service delivery, training, manpower recruitment and development, disease surveillance, HMIS, IEC, etc. The process indicators will judge the actual progress of each activity in quantitative terms against the project target.

Outcome Indicators: These indicators will measure the overall impact of the project due to expected changes in hospital outputs and improved efficiency of the system. These indicators include disease profile, morbidity and mortality rates, case fatality ratio, patient’s satisfaction, awareness of people regarding availability of services, and so on. The indicators will be assessed at regular intervals so that problems can be identified, solved, and necessary changes brought about during the implementation phase. These will also provide useful data for further analysis and studies.

Process Indicators:

• Number of centers providing comprehensive emergency obstetric care operationalized
  Declining trend of out-referrals in the CEmONC centers

• Number of centers providing neonatal care operationalized
  Declining trend of out-referrals in the CEmONC centres

• Number of counselors appointed in health facilities in tribal areas

• Number of facilities with staffing according to norms

• Number of counseling centers for NCD established at district hospitals

• Protocols developed for management for NCD

• Cases registered and managed as per protocol

• Increased number of women being screened for cervical cancer

• Number of identified trauma care centers operationalized

• Development of standard treatment protocols and recording/reporting forms

• Training in the use of protocols

• Carry out and evaluate (mid-term and end-line independent, before and after assessments) training in the following areas:

  • Rational use of drugs

  • Management training

  • Health care waste management

  • HMIS

  • Equipment maintenance

  • QOC

  • Referral

  • Service provider behavior change

• Number of MOUs with NGOs for facilitating service utilization by Below poverty line (BPL) population at project hospitals

• Increase in utilization by BPL of project facilities as measured by increases in:

  1. Out Patient(OP) and In Patient(IP)/month

  2. Bed Occupancy Rate(BOR)

  3. Bed Turn Over Rate(BTOR)

  4. Average Length of Stay(ALOS)

• Baseline survey of health service utilization, expenditure, and satisfaction

• Baseline quality of care evaluation

• Implementation of a field tested and coherent paper-based hospital HMIS

Outcome Indicators:

• Total in-patient utilization (considering both the public and private sector) by the poorest 40% of the population increased (as measured by an asset index).

• Improved quality of care in public hospitals, as measured by a series of indicators (including management of indicator conditions, patient outcomes, and quality control mechanisms) and implementation of a regulation / accreditation system to improve quality of care in private sector hospitals

• CEmONCs should handle more than 50% of complicated deliveries for women belonging to SC/ST concurrently meeting the standards of quality of care.

• Reduced case-fatality rate among the SC/ST population for maternal admissions in CEmONC hospitals

• Reduced ratio of neonatal deaths per total of neonatal admissions and hospital live births in CEmONC hospitals

• Increased utilization of primary and secondary services by tribal groups.

• Decreased road traffic accident case fatality rate

• Improving trend in indicators of quality of care

• Increased patient satisfaction with care

• Short and medium term measures for health care waste management implemented at project facilities

• PPP with NGO/private partners for transportation and final waste disposal

• Rigorous evaluation of 14 PPPs completed in terms of measured gains in access, quality and cost- effectiveness

• Upgradation and repairs of project facilities completed according to plan

• Increased number of laboratory tests, x-rays and other diagnostics at project facilities

• Reduction in equipment downtime

• Availability of staff according to norms at project facilities

• Reduction in doctor absenteeism as recorded in supervisor’s logbook

Significant Interventions

• Infrastructure improvement in all the 29 district and 241 sub district hospitals in Tamil Nadu

• Human Resource Development to develop a dedicated team of trained professionals with the necessary technical skills for effective health care delivery

• Computerization of Hospital Management Information System

• Establishment of 24 hours Comprehensive Emergency Obstetric & New Born Care (CEmONC) services

• Emergency Ambulance Services @ one ambulance per block for all 385 blocks in Tamil Nadu to be operated by NGOs through PPP mode

• Implementation of Bio-Medical Waste Management system in all public and private hospitals in Tamil Nadu

• Interventions in Tribal areas

• Pilot Projects for the control of Coronary artery disease and hypertension & cervical cancer in four districts

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Advertisement No. 6 /TNHSP/ PMU /2006

GOVERNMENT OF TAMIL NADU

TAMIL NADU HEALTH SYSTEMS PROJECT

Advertisement No. 6 /TNHSP/ PMU /2006

Applications are invited from the interested eligible candidates for the following posts in the world Bank supported Tamil Nadu health systems Project, Chennai – 600 006.

Sl.No	Name of the Post	No. of posts	Place of posting	Consolidated Salary Per month	Period of appointment
1	Cancer Control Officer	2	Theni and Kumbakonam	Rs.20,000	30 months
2	Officer Communication & Field Operation (Health Promotion)	1	Project office, Chennai	Rs.20,000	Three years (likely to be extended by 2 years)
3	Chartered Accountant	1	Project office, Chennai	Rs.15,000	Three years (likely to be extended by 2 years)
4	System Analyst	1	Project office, Chennai	Rs.10,000	Three years (likely to be extended by two years)

Qualifications

1. Cancer Control Officer

MBBS & PG degree / diploma in oncology / Obstetrics and Gynaecology /

Public Health Two years experience in cancer control programme
or any other Public Health programme is desirable

2. Officer Communications & Field Operation (Health Promotion)

A Masters degree / Bachelor degree / Diploma in mass communication or equivalent With two years experience in health promotion campaign / projects

3. Chartered Accountant

CA / ICWA , experience of two years is desirable

4. System Analyst

B.E / MCA / Allied PG degree in computer science Expert knowledge in MS project. Experience in designing and developing software / compilation and analysis of health project reports, surveys and mapping.

All the above appointments are purely temporary on contract basis for the period mentioned or till the necessity for the post ceases.

The interested candidates are requested to send their applications to the address given below in writing along with their Bio-data and other credentials clearly superscribed on the envelope “Application for the post of ………………………(name of the post)” the application shall reach the office in the address given below before 5.00 pm on 18.09.2006. The candidates will be selected on the basis of their qualifications, experience and performance in the interview.

The Project Director,

The Tamil Nadu Health Systems Project

7^th Floor, DMS Complex,

359, Anna Salai, Teynampet, Chennai – 6

Phone : 044 – 24345996

Visit us at www.tnhsp.org

www.tnhealth.org

Hospital Management Information System

Landmarks

15 Nov 2001 to 27 Jun 2004:
Studies, Workshops, Project Planning Activities, Various World Bank missions

28 Jun 2004 to 08 Jul 2004:
Project appraisal

03 Nov 2004 to 06 Nov 2004:
Negotiations

16 Dec 2004:
World Bank Board meeting and approval of the Project

20 Dec 2004:
First advertisement for consultancies released

05 Jan 2005:
Signing of agreement

Events

1.Interview for the post advertised

             1. Field Communication & Operation
             2. System Analyst
             3. Cancer Control Officer

              Venue :  6th Floor, Conference Hall, DMS Complex, Teynampet, Chennai
              Date :  10/10/06
              Time :  10:30 am

The communication for the individual concerned have been dispatched.

2. Sensitisation Workshop on Operationalisation of CEmONC Services ( Coimbatore Zone )

Venue : Hotel Surya International, Coimbatore
Date : 21 /10/05
Time : 9.30 AM

3. Sensitisation Workshop on Operationalisation of CEmONC Services ( Chennai Zone)

Venue : Chennai
Date : 24 /11/05

4. Sensitisation Workshop on Operationalisation of CEmONC Services ( Madurai Zone )

Venue : Madurai
Date : 26 /11/05

5. Consultation on 'Organ Transplant in Tamilnadu - The Future'

Venue: Anna Institute of Management, Greenways Road, Chennai.
Date: 02.03.2007
Time: 09:45 AM