How to Improve Public Health Systems : Lessons from Tamil Nadu

Das Gupta, Monica; Desikachari, B.R.; Somanathan, T.V.; Padmanaban, P.

dc.creator	Das Gupta, Monica
dc.creator	Desikachari, B.R.
dc.creator	Somanathan, T.V.
dc.creator	Padmanaban, P.
dc.date	2012-03-19T19:12:53Z
dc.date	2012-03-19T19:12:53Z
dc.date	2009-10-01
dc.date.accessioned	2023-02-18T19:37:44Z
dc.date.available	2023-02-18T19:37:44Z
dc.identifier	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
dc.identifier	http://hdl.handle.net/10986/4265
dc.identifier.uri	http://localhost:8080/xmlui/handle/CUHPOERS/249765
dc.description	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.
dc.language	English
dc.relation	Policy Research working paper ; no. WPS 5073
dc.rights	CC BY 3.0 IGO
dc.rights	http://creativecommons.org/licenses/by/3.0/igo/
dc.rights	World Bank
dc.subject	ADMINISTRATIVE CONTROL
dc.subject	AGED
dc.subject	ANTENATAL CARE
dc.subject	BASIC HEALTH
dc.subject	BIRD FLU
dc.subject	BLINDNESS
dc.subject	CANCER
dc.subject	CENTER FOR DEVELOPMENT
dc.subject	CHICKENPOX
dc.subject	CHIKUNGUNYA
dc.subject	CHILD DEVELOPMENT
dc.subject	CHILD HEALTH CARE
dc.subject	CHILD HEALTH SERVICES
dc.subject	CHILD MORTALITY
dc.subject	CHILD MORTALITY RATE
dc.subject	CHOLERA
dc.subject	CITIES
dc.subject	CITIZEN
dc.subject	CITIZENS
dc.subject	CLINICAL SERVICES
dc.subject	COMMUNICABLE DISEASES
dc.subject	COMMUNITY HEALTH
dc.subject	CONTROLLING POPULATION GROWTH
dc.subject	CROWDING
dc.subject	DEAD ANIMALS
dc.subject	DEAD BODIES
dc.subject	DEATHS
dc.subject	DENGUE
dc.subject	DEVELOPING COUNTRIES
dc.subject	DIABETES
dc.subject	DIARRHEAL DISEASES
dc.subject	DISASTERS
dc.subject	DISEASE
dc.subject	DISEASE CONTROL
dc.subject	DISEASE OUTBREAK
dc.subject	DISEASE OUTBREAKS
dc.subject	DISEASE PREVENTION
dc.subject	DISEASE PREVENTION AND CONTROL
dc.subject	DISEASE SURVEILLANCE
dc.subject	DISPENSARIES
dc.subject	DOCTORS
dc.subject	DRINKING WATER
dc.subject	EARLY DETECTION
dc.subject	EARTHQUAKE
dc.subject	ECONOMIC CHANGE
dc.subject	ECONOMIC GROWTH
dc.subject	EMERGENCIES
dc.subject	ENDEMIC DISEASES
dc.subject	ENVIRONMENTAL HEALTH
dc.subject	EPIDEMIC
dc.subject	EPIDEMICS
dc.subject	EXISTING RESOURCES
dc.subject	EXPENDITURES
dc.subject	FAMILY HEALTH
dc.subject	FAMILY PLANNING
dc.subject	FAMILY WELFARE
dc.subject	FINANCIAL RESOURCES
dc.subject	FOOD CONTROL
dc.subject	FOOD SAFETY
dc.subject	GI
dc.subject	GII
dc.subject	HAZARD
dc.subject	HAZARDS
dc.subject	HEALTH ACTIVISTS
dc.subject	HEALTH AUTHORITIES
dc.subject	HEALTH BUDGETS
dc.subject	HEALTH CARE INDICATORS
dc.subject	HEALTH CENTERS
dc.subject	HEALTH CENTRE
dc.subject	HEALTH CENTRES
dc.subject	HEALTH CONDITIONS
dc.subject	HEALTH EDUCATION
dc.subject	HEALTH EXPENDITURE
dc.subject	HEALTH EXPENDITURE PER CAPITA
dc.subject	HEALTH EXPENDITURES
dc.subject	HEALTH EXPERTS
dc.subject	HEALTH IMPACT
dc.subject	HEALTH IMPACT ASSESSMENTS
dc.subject	HEALTH INDICATORS
dc.subject	HEALTH INTERVENTIONS
dc.subject	HEALTH MANAGEMENT
dc.subject	HEALTH MANPOWER
dc.subject	HEALTH MANPOWER DEVELOPMENT
dc.subject	HEALTH NEEDS
dc.subject	HEALTH ORGANIZATION
dc.subject	HEALTH OUTCOMES
dc.subject	HEALTH PLANNING
dc.subject	HEALTH POLICY
dc.subject	HEALTH PROBLEMS
dc.subject	HEALTH PROFESSIONALS
dc.subject	HEALTH REGULATIONS
dc.subject	HEALTH RESOURCES
dc.subject	HEALTH SECTOR
dc.subject	HEALTH SERVICE
dc.subject	HEALTH SERVICE DELIVERY
dc.subject	HEALTH SERVICE PROVISION
dc.subject	HEALTH SERVICES
dc.subject	HEALTH SPECIALIST
dc.subject	HEALTH SPENDING
dc.subject	HEALTH STATUS
dc.subject	HEALTH SYSTEM
dc.subject	HEALTH SYSTEMS
dc.subject	HEALTH WORKERS
dc.subject	HEALTH WORKFORCE
dc.subject	HOSPITAL
dc.subject	HOSPITAL CARE
dc.subject	HOSPITALS
dc.subject	HUMAN DEVELOPMENT
dc.subject	HYGIENE
dc.subject	ILLNESS
dc.subject	IMMUNIZATION
dc.subject	INCOME
dc.subject	INFANT
dc.subject	INFANT DEATH
dc.subject	INFECTION
dc.subject	INFECTIOUS DISEASES
dc.subject	INSECTICIDES
dc.subject	INTERVENTION
dc.subject	IODINE DEFICIENCY
dc.subject	JOB TRAINING
dc.subject	LATRINES
dc.subject	LAWS
dc.subject	LEPROSY
dc.subject	LEPTOSPIROSIS
dc.subject	LOCAL GOVERNMENTS
dc.subject	LOCAL PUBLIC HEALTH
dc.subject	MALARIA
dc.subject	MALARIA CASES
dc.subject	MALARIA CONTROL
dc.subject	MALE HEALTH
dc.subject	MALE HEALTH WORKERS
dc.subject	MANAGING POPULATION
dc.subject	MASS GRAVES
dc.subject	MATERNAL AND CHILD HEALTH
dc.subject	MATERNAL CARE
dc.subject	MATERNAL DEATH
dc.subject	MEASLES
dc.subject	MEAT
dc.subject	MEDICAL CARE
dc.subject	MEDICAL CENTERS
dc.subject	MEDICAL COLLEGE
dc.subject	MEDICAL DOCTORS
dc.subject	MEDICAL EDUCATION
dc.subject	MEDICAL OFFICER
dc.subject	MEDICAL OFFICERS
dc.subject	MEDICAL PRACTICE
dc.subject	MEDICAL PRACTITIONERS
dc.subject	MEDICAL RESEARCH
dc.subject	MEDICAL SERVICES
dc.subject	MEDICAL SPECIALISTS
dc.subject	MEDICINES
dc.subject	MIDWIFE
dc.subject	MINISTRY OF HEALTH
dc.subject	MORBIDITY
dc.subject	MORTALITY
dc.subject	MORTALITY RATE
dc.subject	NATIONAL EFFORTS
dc.subject	NATIONAL HEALTH
dc.subject	NATURAL DISASTER
dc.subject	NATURAL DISASTERS
dc.subject	NURSE
dc.subject	NURSES
dc.subject	NURSING
dc.subject	NUTRITION
dc.subject	OCCUPATIONAL DISEASES
dc.subject	OUTPATIENT CARE
dc.subject	OUTREACH WORKERS
dc.subject	PATIENT
dc.subject	PATIENTS
dc.subject	PERSONAL COMMUNICATION
dc.subject	PLAGUE
dc.subject	POISONING
dc.subject	POLICY RESEARCH
dc.subject	POLICY RESEARCH WORKING PAPER
dc.subject	POLIO
dc.subject	PREGNANCY
dc.subject	PREGNANCY COMPLICATIONS
dc.subject	PREVENTION ACTIVITIES
dc.subject	PREVENTIVE HEALTH SERVICES
dc.subject	PREVENTIVE MEDICINE
dc.subject	PRIMARY HEALTH CARE
dc.subject	PRIMARY HEALTH CARE SERVICES
dc.subject	PRIVATE HOSPITALS
dc.subject	PROGRESS
dc.subject	PUBLIC EXPENDITURE
dc.subject	PUBLIC EXPENDITURE ON HEALTH
dc.subject	PUBLIC HEALTH
dc.subject	PUBLIC HEALTH ADMINISTRATION
dc.subject	PUBLIC HEALTH CONCERNS
dc.subject	PUBLIC HEALTH INTERVENTIONS
dc.subject	PUBLIC HEALTH LAWS
dc.subject	PUBLIC HEALTH PROGRAMS
dc.subject	PUBLIC HEALTH SERVICES
dc.subject	PUBLIC HEALTH SYSTEM
dc.subject	PUBLIC HEALTH WORKERS
dc.subject	PUBLIC SERVICES
dc.subject	QUARANTINE
dc.subject	RODENTS
dc.subject	RURAL AREAS
dc.subject	RURAL DEVELOPMENT
dc.subject	SANITARY CONDITIONS
dc.subject	SANITATION
dc.subject	SMALLPOX
dc.subject	SOCIAL DEVELOPMENT
dc.subject	SOCIAL MOBILIZATION
dc.subject	SOCIAL WELFARE
dc.subject	T.V.
dc.subject	TB
dc.subject	TEACHING HOSPITALS
dc.subject	TERTIARY LEVELS
dc.subject	TREATMENT
dc.subject	URBAN AREAS
dc.subject	URBANIZATION
dc.subject	VACCINATION
dc.subject	VECTOR BORNE DISEASES
dc.subject	VECTOR CONTROL
dc.subject	VECTORS
dc.subject	WASTE
dc.subject	WORKERS
dc.subject	WORLD HEALTH ORGANIZATION
dc.subject	YAWS
dc.subject	ZOONOSES
dc.subject	ZOONOTIC DISEASES
dc.title	How to Improve Public Health Systems : Lessons from Tamil Nadu
dc.type	Publications & Research :: Policy Research Working Paper
dc.coverage	The World Region
dc.coverage	The World Region