A path-breaking massive surveillance and intervention project, the Tamil Nadu government’s Makkalai Thedi Maruthuvam (MTM) is definitely an example of how a welfare state would take care of the health requirements of its people. No doubt, the scheme has made an impact, especially among patients of the rapidly growing non-communicable diseases (NCDs). Improving accessibility to healthcare services for many, early detection of diabetes and hypertension, and reduction in out-of-pocket expenditure are among its successes. But, as all massive, population-based projects go, there are some gaps and shortfalls, starting with human resources, accuracy of data and equipment, drug delivery, and a larger need to evaluate the outcomes so far, especially the hypertension and diabetes-control rates.
A tough task
Taking home-based screening and drug delivery to the doorstep of beneficiaries is no small exercise. MTM, which will complete two years in August, is a massive programme involving lakhs of beneficiaries and a nearly 20,000-strong workforce. The scheme was recently profiled by the World Health Organization (WHO) for its outreach. As of July 20, official data show around 5.50 crore individuals were screened — 1,00,55,514 first-time beneficiaries and 3,20,53,880 repeat-service beneficiaries — though it is reliably learnt that the actual line-list would be lesser.
