How to Improve Public Health Systems : Lessons from Tamil Nadu

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dc.creatorDas Gupta, Monica
dc.creatorDesikachari, B.R.
dc.creatorSomanathan, T.V.
dc.creatorPadmanaban, P.
dc.date2012-03-19T19:12:53Z
dc.date2012-03-19T19:12:53Z
dc.date2009-10-01
dc.date.accessioned2026-07-01T01:00:33Z
dc.descriptionPublic 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.formatapplication/pdf
dc.formattext/plain
dc.identifierhttp://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.identifierhttps://hdl.handle.net/10986/4265
dc.identifier10.1596/1813-9450-5073
dc.identifier.urihttp://hdl.handle.net/123456789/414165
dc.languageEnglish
dc.relationPolicy Research working paper ; no. WPS 5073
dc.rightsCC BY 3.0 IGO
dc.rightshttp://creativecommons.org/licenses/by/3.0/igo/
dc.rightsWorld Bank
dc.subjectADMINISTRATIVE CONTROL
dc.subjectAGED
dc.subjectANTENATAL CARE
dc.subjectBASIC HEALTH
dc.subjectBIRD FLU
dc.subjectBLINDNESS
dc.subjectCANCER
dc.subjectCENTER FOR DEVELOPMENT
dc.subjectCHICKENPOX
dc.subjectCHIKUNGUNYA
dc.subjectCHILD DEVELOPMENT
dc.subjectCHILD HEALTH CARE
dc.subjectCHILD HEALTH SERVICES
dc.subjectCHILD MORTALITY
dc.subjectCHILD MORTALITY RATE
dc.subjectCHOLERA
dc.subjectCITIES
dc.subjectCITIZEN
dc.subjectCITIZENS
dc.subjectCLINICAL SERVICES
dc.subjectCOMMUNICABLE DISEASES
dc.subjectCOMMUNITY HEALTH
dc.subjectCONTROLLING POPULATION GROWTH
dc.subjectCROWDING
dc.subjectDEAD ANIMALS
dc.subjectDEAD BODIES
dc.subjectDEATHS
dc.subjectDENGUE
dc.subjectDEVELOPING COUNTRIES
dc.subjectDIABETES
dc.subjectDIARRHEAL DISEASES
dc.subjectDISASTERS
dc.subjectDISEASE
dc.subjectDISEASE CONTROL
dc.subjectDISEASE OUTBREAK
dc.subjectDISEASE OUTBREAKS
dc.subjectDISEASE PREVENTION
dc.subjectDISEASE PREVENTION AND CONTROL
dc.subjectDISEASE SURVEILLANCE
dc.subjectDISPENSARIES
dc.subjectDOCTORS
dc.subjectDRINKING WATER
dc.subjectEARLY DETECTION
dc.subjectEARTHQUAKE
dc.subjectECONOMIC CHANGE
dc.subjectECONOMIC GROWTH
dc.subjectEMERGENCIES
dc.subjectENDEMIC DISEASES
dc.subjectENVIRONMENTAL HEALTH
dc.subjectEPIDEMIC
dc.subjectEPIDEMICS
dc.subjectEXISTING RESOURCES
dc.subjectEXPENDITURES
dc.subjectFAMILY HEALTH
dc.subjectFAMILY PLANNING
dc.subjectFAMILY WELFARE
dc.subjectFINANCIAL RESOURCES
dc.subjectFOOD CONTROL
dc.subjectFOOD SAFETY
dc.subjectGI
dc.subjectGII
dc.subjectHAZARD
dc.subjectHAZARDS
dc.subjectHEALTH ACTIVISTS
dc.subjectHEALTH AUTHORITIES
dc.subjectHEALTH BUDGETS
dc.subjectHEALTH CARE INDICATORS
dc.subjectHEALTH CENTERS
dc.subjectHEALTH CENTRE
dc.subjectHEALTH CENTRES
dc.subjectHEALTH CONDITIONS
dc.subjectHEALTH EDUCATION
dc.subjectHEALTH EXPENDITURE
dc.subjectHEALTH EXPENDITURE PER CAPITA
dc.subjectHEALTH EXPENDITURES
dc.subjectHEALTH EXPERTS
dc.subjectHEALTH IMPACT
dc.subjectHEALTH IMPACT ASSESSMENTS
dc.subjectHEALTH INDICATORS
dc.subjectHEALTH INTERVENTIONS
dc.subjectHEALTH MANAGEMENT
dc.subjectHEALTH MANPOWER
dc.subjectHEALTH MANPOWER DEVELOPMENT
dc.subjectHEALTH NEEDS
dc.subjectHEALTH ORGANIZATION
dc.subjectHEALTH OUTCOMES
dc.subjectHEALTH PLANNING
dc.subjectHEALTH POLICY
dc.subjectHEALTH PROBLEMS
dc.subjectHEALTH PROFESSIONALS
dc.subjectHEALTH REGULATIONS
dc.subjectHEALTH RESOURCES
dc.subjectHEALTH SECTOR
dc.subjectHEALTH SERVICE
dc.subjectHEALTH SERVICE DELIVERY
dc.subjectHEALTH SERVICE PROVISION
dc.subjectHEALTH SERVICES
dc.subjectHEALTH SPECIALIST
dc.subjectHEALTH SPENDING
dc.subjectHEALTH STATUS
dc.subjectHEALTH SYSTEM
dc.subjectHEALTH SYSTEMS
dc.subjectHEALTH WORKERS
dc.subjectHEALTH WORKFORCE
dc.subjectHOSPITAL
dc.subjectHOSPITAL CARE
dc.subjectHOSPITALS
dc.subjectHUMAN DEVELOPMENT
dc.subjectHYGIENE
dc.subjectILLNESS
dc.subjectIMMUNIZATION
dc.subjectINCOME
dc.subjectINFANT
dc.subjectINFANT DEATH
dc.subjectINFECTION
dc.subjectINFECTIOUS DISEASES
dc.subjectINSECTICIDES
dc.subjectINTERVENTION
dc.subjectIODINE DEFICIENCY
dc.subjectJOB TRAINING
dc.subjectLATRINES
dc.subjectLAWS
dc.subjectLEPROSY
dc.subjectLEPTOSPIROSIS
dc.subjectLOCAL GOVERNMENTS
dc.subjectLOCAL PUBLIC HEALTH
dc.subjectMALARIA
dc.subjectMALARIA CASES
dc.subjectMALARIA CONTROL
dc.subjectMALE HEALTH
dc.subjectMALE HEALTH WORKERS
dc.subjectMANAGING POPULATION
dc.subjectMASS GRAVES
dc.subjectMATERNAL AND CHILD HEALTH
dc.subjectMATERNAL CARE
dc.subjectMATERNAL DEATH
dc.subjectMEASLES
dc.subjectMEAT
dc.subjectMEDICAL CARE
dc.subjectMEDICAL CENTERS
dc.subjectMEDICAL COLLEGE
dc.subjectMEDICAL DOCTORS
dc.subjectMEDICAL EDUCATION
dc.subjectMEDICAL OFFICER
dc.subjectMEDICAL OFFICERS
dc.subjectMEDICAL PRACTICE
dc.subjectMEDICAL PRACTITIONERS
dc.subjectMEDICAL RESEARCH
dc.subjectMEDICAL SERVICES
dc.subjectMEDICAL SPECIALISTS
dc.subjectMEDICINES
dc.subjectMIDWIFE
dc.subjectMINISTRY OF HEALTH
dc.subjectMORBIDITY
dc.subjectMORTALITY
dc.subjectMORTALITY RATE
dc.subjectNATIONAL EFFORTS
dc.subjectNATIONAL HEALTH
dc.subjectNATURAL DISASTER
dc.subjectNATURAL DISASTERS
dc.subjectNURSE
dc.subjectNURSES
dc.subjectNURSING
dc.subjectNUTRITION
dc.subjectOCCUPATIONAL DISEASES
dc.subjectOUTPATIENT CARE
dc.subjectOUTREACH WORKERS
dc.subjectPATIENT
dc.subjectPATIENTS
dc.subjectPERSONAL COMMUNICATION
dc.subjectPLAGUE
dc.subjectPOISONING
dc.subjectPOLICY RESEARCH
dc.subjectPOLICY RESEARCH WORKING PAPER
dc.subjectPOLIO
dc.subjectPREGNANCY
dc.subjectPREGNANCY COMPLICATIONS
dc.subjectPREVENTION ACTIVITIES
dc.subjectPREVENTIVE HEALTH SERVICES
dc.subjectPREVENTIVE MEDICINE
dc.subjectPRIMARY HEALTH CARE
dc.subjectPRIMARY HEALTH CARE SERVICES
dc.subjectPRIVATE HOSPITALS
dc.subjectPROGRESS
dc.subjectPUBLIC EXPENDITURE
dc.subjectPUBLIC EXPENDITURE ON HEALTH
dc.subjectPUBLIC HEALTH
dc.subjectPUBLIC HEALTH ADMINISTRATION
dc.subjectPUBLIC HEALTH CONCERNS
dc.subjectPUBLIC HEALTH INTERVENTIONS
dc.subjectPUBLIC HEALTH LAWS
dc.subjectPUBLIC HEALTH PROGRAMS
dc.subjectPUBLIC HEALTH SERVICES
dc.subjectPUBLIC HEALTH SYSTEM
dc.subjectPUBLIC HEALTH WORKERS
dc.subjectPUBLIC SERVICES
dc.subjectQUARANTINE
dc.subjectRODENTS
dc.subjectRURAL AREAS
dc.subjectRURAL DEVELOPMENT
dc.subjectSANITARY CONDITIONS
dc.subjectSANITATION
dc.subjectSMALLPOX
dc.subjectSOCIAL DEVELOPMENT
dc.subjectSOCIAL MOBILIZATION
dc.subjectSOCIAL WELFARE
dc.subjectT.V.
dc.subjectTB
dc.subjectTEACHING HOSPITALS
dc.subjectTERTIARY LEVELS
dc.subjectTREATMENT
dc.subjectURBAN AREAS
dc.subjectURBANIZATION
dc.subjectVACCINATION
dc.subjectVECTOR BORNE DISEASES
dc.subjectVECTOR CONTROL
dc.subjectVECTORS
dc.subjectWASTE
dc.subjectWORKERS
dc.subjectWORLD HEALTH ORGANIZATION
dc.subjectYAWS
dc.subjectZOONOSES
dc.subjectZOONOTIC DISEASES
dc.titleHow to Improve Public Health Systems : Lessons from Tamil Nadu

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