More than six months after its launch, the Tamil Nadu government’s flagship scheme, Makkalai Thedi Maruthuvam, reached out to its 50,00,000th beneficiary on Wednesday.
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In a State such as Tamil Nadu, where the three-tier healthcare system — primary, secondary, tertiary — is considered well-structured, Makkalai Thedi Maruthuvam is aimed at reaching the unreached, with the emphasis on bridging the gap in the treatment of non-communicable diseases (NCD).
Designed to take healthcare to the doorstep of people, the scheme encompasses services ranging from drug delivery for hypertension and diabetes to providing palliative care, physiotherapy and continuous ambulatory peritoneal dialysis (CAPD).
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Rolled out in August 2021, the scheme has not only taken healthcare services closer home but also made it affordable for beneficiaries like Bavin, 16, of Vizhuperundurai village in Cuddalore district, who is undergoing CAPD.
His father, Ramesh, a daily wage labourer, said, “He has had renal problems from childhood. He has been undergoing dialysis for the last four years. I used to spend ₹24,000 to ₹27,000 a month on dialysis bags. Now, we get them free under Makkalai Thedi Maruthuvam. In addition, doctors and nurses regularly visit him at home, and blood samples are also drawn at home for testing,” he said.
For Sangeetha, Makkalai Thedi Maruthuvam has helped in gaining greater mobility. The resident of Vandalur lost both legs in an accident in 2019, resulting in bilateral above knee amputation. The scheme fully funded the prosthesis and training for her early this year.
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On Wednesday, Chief Minister M.K. Stalin handed over the medicine kit to the 50,00,000th beneficiary at Sithalapakkam in Chengalpattu district.
“While many say that Universal Health Coverage is a utopian dream, Makkalai Thedi Maruthuvam has been a significant milestone towards making it attainable by addressing a critical gap for those unable to access health services. It ensures that accessible, free and thus affordable healthcare reaches the doorstep,” Health Secretary J. Radhakrishnan said.
He added, “While it has many benefits which are already known, I personally found this very useful to track and diagnose, and then treat persons who are in denial and claim they are hale and hearty. To cite an example, those who have not checked for diabetes and hypertension or both and their complications. Similar is the case of many who despite knowing their disease condition have stopped taking follow-up treatments due to their work or challenges in accessibility.”
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The official said Makkalai Thedi Maruthuvam had been a game changer in providing care to those who were elderly, immobile, recovering from paralysis, differently abled and required palliative care at the doorstep. “It has had a catalytic effect on improving access to free healthcare and more importantly helped in creating awareness of the health needs among people.”
T.S. Selvavinayagam, Director of Public Health and Preventive Medicine, said that among the unique features of the scheme was screening and CAPD. Women health volunteers — one per health sub-centre and who make house-to-house visits — are among the key human resources for Makkalai Thedi Maruthuvam. “Our mid-level health providers under the Universal Health Coverage programme and village health nurses are also engaged. While we are expanding the strength of women health volunteers, our target is 9,500 over a period of time,” he said.
“Tamil Nadu being a frontrunner in health, Makkalai Thedi Maruthuvam bridges the gap between hospitals and the people. The disconnect or gap that was existing despite a very well-established public health system in Tamil Nadu is bridged by Makkalai Thedi Maruthuvam,” said B. Baranidharan, Deputy Director Health Services, Chengalpattu.
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According to him, three gaps would be reduced — diagnostic gap (the undiagnosed getting diagnosed by house-to-house screening); therapeutic gap (diagnosed patients not on treatment or on irregular treatment is reduced by drug delivery at home); and control gap (those diagnosed on treatment but with poor control of hypertension/diabetes would be reduced by drug delivery and follow-up at home).
Adherence to drugs would in turn lead to a good control of hypertension and diabetes, ultimately reducing chronic diseases. “Burden of chronic diseases on hospitals has to come down. These were the basis on which Makkalai Thedi Maruthuvam was built,” he added.
A cross-section of healthcare workers said strengthening the workforce for the scheme was the need of the hour.