This document provides information about family planning strategies and performance in Tamil Nadu, India. It notes that Tamil Nadu has a population of over 72 million people and has shifted its strategy from population stabilization to reducing maternal and child mortality. Key aspects of the new strategy include counseling high-risk non-acceptors of family planning during facility deliveries, training more doctors to perform postpartum sterilization, and strengthening postpartum intrauterine device insertion. The document lists the top 20 blocks with the highest rates of higher order births and associated maternal deaths. It also provides data on institutions providing postpartum intrauterine devices and factors contributing to a positive atmosphere for postpartum sterilization and intrauterine device services

1. Dr. DAREZ AHAMED, IAS.,
MISSION DIRECTOR,
NATIONAL HEALTH MISSION,
TAMIL NADU.

2. POPULATION
India 1210 Million
Tamil Nadu 72.10 Million
32 Districts in Tamilnadu

3.  Population- 7.21 crores.
 Decadal growth rate 15.60% (2001-2011).
 Seventh most populous state in India.
 6% of country’s population.
 Lowest TFR of 1.7 in the country.
 One of the most urbanised states (48.45%) in India
 Consists 1.1 crore Eligible Couples.
ABOUT TAMIL NADU

4. % OF HIGER ORDER OF BIRTH (3 & ABOVE)

5. Current Use of Family Planning Methods in
Tamil Nadu (NFHS-IV) - Acceptors 53.2 %

6. % OF P.S. IN TOTAL STERILISATION

7. TRENDS IN PPIUCD PERFORMANCE

8. METHOD WISE PERMANENT
STERILISATION PERFORMANCE 2015-16

9. TRENDS IN PPIUCD PERFORMANCE

10. METHOD-WISE PPIUCD PERFORMANCE

11. GRAVIDA WISE MATERNAL DEATH
ANALYSIS 2015-2016

12. Why strategy had to be changed:
 MMR 25, IMR 10 by 2023 is target set by our vision document.
 High risk Non acceptors had to be brought in to the system , shift
from population stabilization strategy to RMNCH +A strategy. The
DFW needs this fundamental reorientation to shift from target
based to maternal and child health related interventions.
 7.9 % HOB contributes 25% of MMR
 Lack of spacing directly contributing to MMR, IMR and other
morbidities.
 The best way to tackle high risk non acceptors is to counsel them
when they are in the health facilities. (99.9% institutional
deliveries). The most receptive period in non acceptors is during
this period.

13. Strategy contd..
 Imparting tubectomy training and life saving skill in
anaesthesia trained MBBS doctors which has been a key
strategy in implementation of PPS even at the level of
CHC .
 PPIUCD doesn’t require repeat visit to the facility, and
state is looking at strengthening MVA/MMA as a logical
corollary to PPIUCD as an RMNCH+A strategy. Over the
counter abortifacients has been a signifanct contributor
to MMR about 1%.
 100 block strategy is being implemented by having
specific action plans for blocks. (Reasons were as varied
as unmet , religious , etc)

14. HOB blocks.
Sl.
No.
Name of the
District
Name of the
Blocks
% of HOB
2014
No of
Maternal
Deaths
2014-15
1 Namakkal Kolli Hills 24.4 1
2 Tiruvannamalai Jawad Hills 21.7 0
3 Tiruvannamalai Chengam 21.5 1
4 Villupuram Kalrayan Hills 19.6 1
5 Tiruvannamalai Thiruvannamalai 19.2 4
6 Tiruvannamalai Thandrampattu 19.2 0
7 Karur Thogamalai 18.2 2
8 Tiruvannamalai Pudupalayam 17.9 3
9 Vellore Pernampet 17.6 2
10 Vellore Alangayam 17.3 1

15. 11 Villupuram Mugaiyur
17.3
1
12 Tiruvannamalai Kalasapakkam
17.1
3
13 Sivagangai V.Pudur
16.7
0
14 Vellore Jolarpet
16.6
1
15 Villupuram Thirukoilur
16.5
1
16 Tiruvallur R.K. Pet
16.5
0
17 Thoothukudi Alwarthirunagari
16.3
2
18 Thoothukudi Udankudi
16.2
0
19 Salem Tharamangalam
16.1
0
20 Dharmapuri Pennagaram
15.8
1
Sl.
No.
Name of the District Name of the Blocks
% of HOB
2014
No of Maternal
Deaths 2014-
15

16. INSTITUTIONS PERFORMING PPIUCD
Name of the Institution
No. of institution
performing PPIUCD
2016-17
MEDICAL COLLEGE HOSPITALS 21
GOVERNMENT HOSPITALS 214
PRIMARY HEALTH CENTRES 239
URBAN HEALTH POSTS 24
TOTAL 498

17.  Universal awareness of post partum services
 99.6 % of deliveries are institutional
 All the pregnant mothers are registered for
antenatal care and tracked using PICME
 Easy accessibility of post partum sterilisation and
PPIUCD services
 Motivation by medical and para medical staff
during hospitalisation
POSITIVE ATMOSPHERE FOR
POST PARTUM STERILISATION AND PPIUCD

18.  Follow up visits at Village level by VHN, SHN, AGW
etc
 Confidence on the Survival of the baby – IMR has
come down to 20/1000 live births
 100% Antenatal, Natal & Postnatal Care resulted in
increasing safe delivery practice
 Reduction in visits to facilities in PPIUCD
POSITIVE ATMOSPHERE FOR
POST PARTUM STERILISATION AND PPIUCD

19.  Health Education & Behavioural Change
Communication have helped in removing the Social
Taboos to some extent & creating awareness
 Constant Post Operative visit, early recognition of
complication & Prompt management of
complications have resulted in reduction in
morbidities & mortalities in Sterilisation
 Periodic review of failures by the quality assurance
committee and updating the knowledge of Service
Providers
POSITIVE ATMOSPHERE FOR
POST PARTUM STERILISATION AND PPIUCD

20.  State Level review on sterilisation deaths by the
panel of experts
 This leads to early redressal of problems associated
with such incidence
 Prompt Payment of all Financial assistance to the
acceptors and service providers
POSITIVE ATMOSPHERE FOR
POST PARTUM STERILISATION AND PPIUCD