Tamil Nadu claims to have one of the best public health systems in the country, but it records an overwhelming number of deaths post-sterilisation.

The death in Chhattisgarh of more than a dozen women in a sterilisation camp has captured the nation’s attention. But the death of more than 130 women in Tamil Nadu between 2008 and 2012 alone has hardly received any scrutiny. The fatality count in the State is the highest in the country, according to data released by the Ministry of Health and Family Welfare.

One reason for Tamil Nadu’s poor performance is that the Union Ministry counts a death only after compensation is disbursed. Perhaps, a few States do not release any money or under-report deaths. Or, the death takes years to be recorded because of the delay in giving compensation to the family. This is why Tamil Nadu’s death count drops to 5 during 2012-13, as reported in 2014.

Despite these shortfalls in data accuracy, Tamil Nadu consistently records more deaths due to sterilisation every year than the national average of 11. “Though Tamil Nadu is more urbanised, there are still pockets with indicators worse than Bihar or Chhattisgarh,” says S. Elango, former Director of Public Health. There is also a significant gender-divide in the State’s sterilisation campaign, with women accounting for 99.4 per cent of all procedures.

The District Level Health Survey for 2012-13 shows that little more than half of the State’s population use family planning methods. An overwhelming proportion is attributed to female sterilisation.