Makkalai Thedi Maruthuvam

Overview

An Evaluation of the NCD Care Cascade under “Makkalai Thedi Maruthuvam” in Tamil Nadu. The Makkalai Thedi Maruthuvam Scheme is a flagship programme of the Government of Tamil Nadu offering a comprehensive set of “Home-based health care services’ to ensure a continuum of care and meet the health needs of beneficiaries in the family.

The State Planning Commission, as a part of the evaluation of various schemes of government, conducted an evaluation study on the Non-Communicable disease care cascade under “Makkalai Thedi Maruthuvam in Tamil Nadu” – a cross-sectional study to assess the impact of the scheme in controlling NCDs and to capture the perception of the beneficiaries about the scheme.

The objectives of the study are 

  1. Overall screening coverage
  2. Screening through MTM
  3. Screening through field functionaries 
  4. Screening through Institutional Services

The Institute of Community Medicine (ICM), Madras Medical College, in association with the ICM of all medical colleges, assisted the State Planning Commission in conducting the study.

Key Insights

  • 73% of the survey participants had been benefited by the MTM door-to-door services
  • Diabetes Screening and treatment 
    • 2/3rd of newly diagnosed DM detected through MTM in the last year.
    • More than half of diabetics receive treatment through MTM.
    • One-third of diabetics received treatment through MTM field functionaries.
    • 10% of diabetics had good glycemic control.
  • Hypertension Screening and treatment
    • 3/4th of newly diagnosed HTN detected through MTM in the last year
    • 63% of hypertensives received treatment through MTM
    • 45% of hypertensives received treatment through MTM field functionaries.
    • 35% of hypertensives had good blood pressure control.
  • Cancer Screening 
    • 3.7% ever screened for oral cancer
    • 11.06 % of women ever screened for cervical cancer
    • 14.2 % of women ever screened for breast cancer
  • Other services 
    • 40% of those requiring palliative care are covered by MTM -field staff.

The results show that MTM has reached out to the most vulnerable groups, like women, rural areas, and the SC/ST category.  Among the various services offered, diabetes and hypertension screening and treatment coverage has reached the highest.  This indicates the de-professionalization of health care by involving women Health volunteers have made a major impact in reaching out to the most vulnerable population.  While the MTM is enabling universal coverage for NCD, the thrust areas include reaching out to urban areas and devising strategies for improving overall cancer screening.