Tamil Nadu Health System Reform Program

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The development objective of the Tamil Nadu Health System Reform Program Project for India is to improve quality of care, strengthen management of non‐communicable diseases and injuries, and reduce inequities in reproductive and child health services in Tamil Nadu.The proposed Program contributes to the attainment of Sustainable Development Goal (SDG) 3 and the Health, Nutrition and Population Global Practice goal of ending preventable deaths and disability through Universal Health Coverage (UHC).The Government wants to enhance efficiency, effectiveness, and impact of its current health sector program, and using a Program‐for‐Results (PforR) instrument to support the proposed TNHSRP will provide a much greater focus on outputs and outcomes through better alignment of expenditures and incentives with results.As outlined in Vision 2023, this involves strengthening primary and secondary care centers and upgrading tertiary care hospitals. A special focus is given to Noncommunicable Disease (NCDs) using a two‐pronged strategy: (a) preventing NCDs through population‐based interventions to raise awareness and induce lifestyle changes and (b) improving the capacity for early screening, diagnosis, treatment, and follow‐up in health facilities.The Program has three key result areas with a combination of both technical interventions specific to each result area and cross‐cutting interventions that contribute to achieving results across the three result areas. These cross‐cutting interventions aim to strengthen institutions and state capacity and expected outputs or intermediate results in the Program theory of change.The first result area is recognizing that there is no single silver bullet in quality of care, the Program embraces a multipronged approach to quality improvement.The second result area focuses on enhancing the management of NCDs, associated risk factors and injuries.The third result area focus will be maintained in nine priority districts, which constitute the bottom quintile of the Reproductive and Child Health (RCH) indicators in the state and have a relatively large proportion of tribal populations.