How to Improve Public Health Systems : Lessons from Tamil Nadu
Public health systems in India have weakened since the 1950s, after central decisions to amalgamate the medical and public health services, and to focus public health work largely on single-issue programs - instead of on strengthening public health...
| Main Authors: | , , , |
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| Language: | English |
| Published: |
2012
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| Subjects: | |
| Online Access: | http://www-wds.worldbank.org/external/default/main?menuPK=64187510&pagePK=64193027&piPK=64187937&theSitePK=523679&menuPK=64187510&searchMenuPK=64187283&siteName=WDS&entityID=000158349_20091013150143 http://hdl.handle.net/10986/4265 |
| Summary: | Public health systems in India have
weakened since the 1950s, after central decisions to
amalgamate the medical and public health services, and to
focus public health work largely on single-issue programs -
instead of on strengthening public health systems broad
capacity to reduce exposure to disease. Over time, most
state health departments de-prioritized their public health
systems. This paper describes how the public health system
works in Tamil Nadu, a rare example of a state that chose
not to amalgamate its medical and public health services. It
describes the key ingredients of the system, which are a
separate Directorate of Public Health - staffed by a cadre
of professional public health managers with deep firsthand
experience of working in both rural and urban areas, and
complemented with non-medical specialists with its own
budget, and with legislative underpinning. The authors
illustrate how this helps Tamil Nadu to conduct long-term
planning to avert outbreaks, manage endemic diseases,
prevent disease resurgence, manage disasters and
emergencies, and support local bodies to protect public
health in rural and urban areas. They also discuss the
system s shortfalls. Tamil Nadu s public health system is
replicable, offering lessons on better management of
existing resources. It is also affordable: compared with the
national averages, Tamil Nadu spends less per capita on
health while achieving far better health outcomes. There is
much that other states in India, and other developing
countries, can learn from this to revitalize their public
health systems and better protect their people s health. |
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