Tamil Nadu Health System reform programme gets $287 mn loan from World Bank

The central government, Tamil Nadu and the World Bank have signed a $287 million loan agreement for the state's Health System Reform Programme that aims to improve the quality of health care, reduce the burden of non-communicable diseases (NCDs), and fill equity gaps in reproductive and child health services.
Tamil Nadu ranks third among all Indian states in the NITI Aayog Health Index. The state’s maternal mortality rate has declined from 90 deaths per 100,000 live births in 2005 to 62 deaths in 2015-16 while infant mortality has declined from 30 deaths per 1000 live births to 20 in the same period.

A key contribution to these achievements has been the establishment of emergency obstetric and neonatal care centres and 108 ambulance service with support from the World Bank. These have ensured that no mother has to travel more than 30 minutes to access emergency obstetric and neonatal care 24 hours a day, seven days a week.
Despite these impressive gains, certain challenges in health care remain, including quality of care and variations in reproductive and child health among districts. Tamil Nadu is also dealing with a growing burden of NCDs as they account for nearly 69 percent of deaths in the state.
The Tamil Nadu Health System Reform Program will support the state government to develop clinical protocols and guidelines; achieve national accreditation for primary, secondary, and tertiary-level health facilities in the public sector; strengthen physicians, nurses and paramedics through continuous medical education; strengthen the feedback loop between citizens and the state by making quality and other data accessible to the public.
Sameer Kumar Khare, Additional Secretary, Department of Economic Affairs, Ministry of Finance said that Tamil Nadu can serve as a model for how to take health system performance to the next level by investing in the public sector and offer lessons to other states. He said that it is a moment of happiness that the World Bank is helping the state in this journey.
The agreement for the Project was signed by Sameer Kumar Khare, Additional Secretary, Department of Economic Affairs, Ministry of Finance, on behalf of the Government of India, Beela Rajesh, Secretary, Health and Family Welfare Department, on behalf of the Government of Tamil Nadu and Hisham Abdo, Acting Country Director, World Bank India, on behalf of the World Bank.
“The programme supports interventions to strengthen institutional and state capacity to achieve results. Good practices and innovations from Tamil Nadu are being scaled up while others from around the world are being introduced through the programme to improve management of the state public health sector, increase transparency, and strengthen accountability,” said Hisham Abdo, Acting Country Director, World Bank.
The programme will promote population-based screening, treatment and follow-up for NCDs, and improve monitoring and evaluation. Patients will be equipped with knowledge and skills to self-manage their conditions. Lab services and health provider capacity will also be strengthened to address mental health. To tackle road injuries, the programme will improve in- hospital care, strengthen protocols, strengthen the 24x7 trauma care services and establish a trauma registry.
Another key aim of this programme is to reduce the equity gaps in reproductive and child health. Special focus will be given to nine priority districts, which constitute the bottom quintile of the RCH indicators in the state and have a relatively large proportion of tribal populations.
“This Programme focuses on results instead of inputs through a Programme-for-Results (PforR) lending instrument. This will provide a much greater focus on outputs and outcomes through better alignment of expenditures and incentives with results,” said Rifat Hasan, Senior Health Specialist, World Bank India, and the Task Team Leader for the programme. The use of the PforR instrument is a first for the health sector and will offer lessons for other states.

Tamil Nadu parties cry foul over national policy on language formula

Parties in Tamil Nadu including the DMK Saturday strongly opposed the three-language formula's continuation with add-on features proposed in the draft National Education Policy alleging it was tantamount to "thrusting" Hindi and wanted it junked.
The Tamil Nadu government said it would continue with the two-language formula, seeking to cool frayed tempers.

Senior Congress leader P Chidambaram in a series of tweets in Tamil said: "what is the meaning of three language formula in schools? The meaning is they will make Hindi a compulsory subject..."
In another tweet, he said "If Hindi language is a compulsory subject its import is imposition of Hindi." "The BJP government's real face is beginning to emerge..." he also tweeted.
Meanwhile, "#StopHindiImposition,#TNAgainstHindiImposition trended on the microblogging site Twitter.
The three-language formula which bats for Hindi from "pre-school to class 12 was a big shocker," and the recommendation would "divide" the country, DMK chief M K Stalin said.
The draft policy prepared by a panel led by eminent scientist K Kasturirangan was unveiled on Friday.
Recalling the anti-Hindi agitations beginning as early as 1937 in Tamil Nadu, the DMK leader in a statement here said since 1968 the State was following the two-language formula of learning only Tamil and English.
The DMK would never tolerate imposition of Hindi and strongly oppose it. "Still, I believe that the Central BJP government will not make way for another language stir," he said.
The Dravidian party also said recommendations like "Gurukula" mode of education, teaching Sanskrit and sending Hindi teachers from Hindi speaking States to non-Hindi speaking States would in due course cause a "big danger" to non-Hindi speaking people.
The recommendations, the DMK said rather than lifting the standards of education has led to doubts that it had "ulterior motives" like imposition of Hindi on non-Hindi speaking States and thrusting Sanskrit in schools.
Recalling Jawaharlal Nehru's assurance that English would continue to be in use till such time desired by non-Hindi speaking States, he also pointed out that the State had enacted years ago a Compulsory Tamil Learning Act.
Demanding the Centre to reject the draft recommendations which was "imposition," of Hindi under the garb of three-language formula, he said his party MPs would voice their strong opposition in Parliament as soon as the House was convened.
Taking potshots at the AIADMK for being what it called a "yes master," to the Centre, he wanted Chief Minister K Palaniswami to strongly oppose it and if not remove the words "Anna," and "Dravida," from his party's name.
The AIADMK is an abbreviation for All India Anna Dravida Munnetra Kazhagam.
The BJP must never even dream to implement three language formula in Tamil Nadu and such a "greedy dream," would lead to "catastrophic," consequences for them, he said.
Parties including the CPI and BJP's ally in the Lok Sabha polls, the PMK too alleged the recommendation on the three language formula was "imposition of Hindi" and wanted scrapping it.
Makkal Needhi Maiam chief Kamal Haasan said "be it language or a project, if we do not like that, it should not be forced on us." He said his party would pursue legal options against it.
Education Minister K A Sengottaiyan told Puthiya Thalaimurai Tamil news channel: "There will be no deviation from the two-language formula followed in Tamil Nadu. Only Tamil and English will continue to be taught in our State." The draft National Education Policy, 2019 available on the government website said the three-language formula will need to be implemented in its spirit throughout the country, promoting multilingual communicative abilities for a multilingual country.
Schools in Hindi speaking areas should also offer and teach Indian languages from other parts of India, it said.
The three language formula, followed since the adoption of the National Policy on Education 1968 and endorsed in subsequent years will be continued.
Since research now clearly showed that children picked up languages quickly between the ages of 2 and 8, and moreover that multilingualism has great cognitive benefits to students, children will now be immersed in three languages early on, starting from the foundational stage onwards, it said.
"...students who wish to change one of the three languages they are studying may do so in Grade 6, so long as the study of three languages by students in the Hindi-speaking states would continue to include Hindi and English and one of the modern Indian languages from other parts of India, ...while the study of languages by students in the non-Hindi-speaking states would include the regional language, Hindi and English."
Also, every student will take a fun course on "The Languages of India" sometime in Grades 6-8.
The draft policy said India also has "an extremely rich literature in other classical languages, including classical Tamil, as well as classical Telugu, Kannada, Malayalam, and Odia, in addition to Pali, Persian, and Prakrit; these classical languages and their literatures too must be preserved for their richness and for the pleasure and enrichment of posterity."
A choice of foreign languages like French and German, would be offered and available to interested students to choose as electives during secondary school.

Truckers' strike causes loss of Rs 70 bn worth of goods trade in Tamil Nadu

Due to the ongoing all-India strike by truck operators, Rs 70 billion worth of trade in goods has been affected in Tamil Nadu alone, said All India Motor Transport Congress' (AIMTC's) representatives.
Vegetable prices are also soaring in various parts of the state, especially in Chennai, due to the strike.

Truck operators are demanding the closure of toll plazas across the country. They are also pressing for the acceptance of a charter of demands, including a reduction in fuel prices and uniform national pricing with quarterly revision, among other things. They have been on strike for the past five days.
C Dhanaraj, secretary of the State Lorry Owners Federation – Tamil Nadu, which is spearheading the strike in the state, said that almost its entire 460,000-strong truck force was off the roads, causing a loss of Rs 3 billion every day.
G R Shanmugappa, south zone general secretary of the AIMTC, said that due to the strike, good worth Rs 70 billion were stuck in various parts of the state.
Meanwhile, the stock of textiles has piled up in the towns of Tirupur, Karur, and Erode and from other major textile production centres in the state.
Tirupur Exporters Association President Raja M Shanmugham said, "The ongoing indefinite lorry strike has created a major impact on Tirupur's knitwear exporting units as they could not transport the finished garments for shipment either through seaports at Thoothukudi, Chennai, Kochi, and Mumbai or through airports at Chennai, Bengaluru and Kochi."
He added that in the "season-conscious and design-driven export market", on-time supply is a major factor. Shanmugham said that any delay would not be appreciated by foreign buyers at a time when Indian exporters are competing with countries like Bangladesh, Cambodia, Myanmar, Sri Lanka, Pakistan, Vietnam, and China in the international market.
Shanmugham added that given the nature of production activities in the Tirupur cluster, the stoppage of vehicle movement from garment units to outside job working units -- like knitting, dyeing, compacting, printing, embroidery, checking, ironing, and packing -- will affect production. Further, he said that these job working units would not be in a position to provide work to their employees as a result.
Reports stated that tension prevailed at the goods yard in the Namakkal railway station. While rice meant for the public distribution system was being loaded onto lorries from the goods compartments, a group of truck operators arrived on the scene and entered into an argument with the Railway Goods Yard Lorry Owners Association and prevented the loading operation.
Vegetable prices at Chennai's Koyambedu market have gone up by 15-20 per cent due to the strike. Tomato prices have increased by Rs 5 to Rs 25 a kg, big onion prices have increased by Rs 5 to Rs 25 a kg, small onion prices have increased by Rs 25 to Rs 65 a kg, potato prices have increased by Rs 6 to Rs 25 a kg, green chilli prices have increased by Rs 5 to Rs 35 a kg, and carrot prices have increased by Rs 20-25 to Rs 50-55 a kg.
Around 300 lorries used to come to the market every day. However, due to the ongoing strike, lorries from other states are not coming to the market, which has led to the increase in prices.