T.N.’s health sector: successes and challenges

Tamil Nadu’s Health System
• Despite its robust public health system, Tamil Nadu faces a health sector crisis due to high vacancies, strained workforce, and a lackadaisical attitude towards long-pending doctor demands.
• The state has made significant strides in expanding its health infrastructure and improving health outcomes through focussed initiatives and innovative programs.
• Key initiatives include ‘Makkalai Thedi Maruthuvam’ (MTM), which provides screening and drug delivery for conditions like diabetes and hypertension, and community-based cancer screening programs.
• The Tamil Nadu Medical Services Corporation streamlines drug procurement and supply for government hospitals.

Gains and Challenges
• The Maternal Mortality Ratio stands at 39.4 per 1,00,000 live births (2024-2025).
• The State’s Village Health Nurses (VHN) play a crucial role in maternal and child healthcare, but 2,013 posts of VHNs and 1,251 posts of Auxiliary Nurse Midwives are vacant.
• Government doctors have been asking for an increase in their workforce as per patient strength, and the Infant Mortality Rate fell from 8.2 per 1,000 live births (2023-2024) to 7.7 in 2024-2025.
• The MTM has demonstrated improvement in the management of hypertension and diabetes in the State.

Unmet Needs and Gaps
• Despite exponential growth in health infrastructure, there has been no proportionate expansion in the workforce.
• There is a growing concern about the shortage and skewed distribution of specialists in the State.
• The State recruited some 3,500-odd medical officers to its primary healthcare in the last four years but is yet to address specialist shortfalls at the secondary and tertiary care levels.
• Contractual recruitments and proposed models for public private partnership in service delivery are facing stiff opposition among the existing workforce.