Makkalai Thedi Maruthuvam scheme hits the mark by improving hypertension, diabetes control in T.N.

The Hindu

27-04-2025

By taking healthcare directly to the people's doorsteps, Tamil Nadu's flagship scheme - 'Makkalai Thedi Maruthuvam' (MTM) - has demonstrated an improvement in the management of hypertension and diabetes in the State. Among adults with hypertension, the proportion with blood pressure control rose to 17%, whereas for diabetes, the proportion with blood sugar control rose to 16.7%.
This finding from Tamil Nadu STEPS (World Health Organization STEPwise approach to NCD risk factor surveillance) Survey 2023-2024, which was taken up by the Indian Council of Medical Research-National Institute of Epidemiology (ICMR-NIE), comes as an early indicator of MTM's reach. The scheme was rolled out in August 2021.
Survey findings
T. S. Selvavinayagam, director, Directorate of Public Health and Preventive Medicine, said that the survey reflected community-level control among the population. 'This survey substantiates the efforts taken by the State government under MTM to achieve the Disbursement-Linked Indicators (DLI) set by the World Bank. It is a great achievement considering our population and number of years since we took up intensive efforts across the State,' he said.
To evaluate the progress of initiatives in line with theProgram for Results basis, the World Bank laid down DLIs of six percentage points for improvement in the control rate of diabetes and three percentage points for hypertension. In the baseline survey (TN STEPS Survey 2019-20), the control rate was 7.3% for hypertension and 10.8% for diabetes, Archana Ramalingam, scientist-E (Medical), Division of NCD Epidemiology, ICMR-NIE, said.
'We started the second survey (TN STEPS Survey 2023-24) in November 2023 and completed it by the end of March 2024. We had 8,114 participants across the State. We found that among adults with hypertension, the proportion with blood pressure control rose to 17%. Similarly, for diabetes, the proportion with blood sugar control rose to 16.7%,' she added.
Improved disease control
Dr. Archana said that the survey results showed a clear improvement in terms of the proportion diagnosed, initiated for treatment and blood pressure control for hypertension. 'There was a significant improvement in the percentage of patients diagnosed with hypertension - from 32% in the baseline survey to about 47% in the second survey. In the case of diabetes, the baseline survey showed that 53% had already been diagnosed, and 44% were receiving treatment. While the second survey did not show much improvement in the percentage diagnosed due to a high baseline, the proportion with blood sugar control improved to 16.7%,' she added.
Post-MTM, there has been a definite improvement in the management of hypertension and diabetes, she said. 'Improving regular medication access through Women Health Volunteers has borne results. Task-sharing interventions like MTM are bound to help in a State like TN that has invested in healthcare, and this is likely to lead to improvements in the future,' she said.
Implementation concerns and way forward
While task-sharing interventions have helped improve hypertension and diabetes control, she said that field visits showed that there can be significant challenges in implementing them in urban settings. 'In the rural areas, we saw greater acceptance and impact of the initiatives. However, people in the urban parts, especially cities like Chennai and Coimbatore, are still largely using private facilities for hypertension and diabetes care,' she said.
With the early implementation results of the MTM showing promise, the Health department should take steps to identify the gaps in implementation and opt to continuously improve the quality of services to improve the control rate further, she stressed.
Dr. Selvavinagayam said there is still a long way to go. 'We will now focus on the individual control level, which is essential for preventing any complications,' he said.