A transforming emergency care in Tamil Nadu: a narrative review of the Innuyir Kappom Thittam - Nammai Kakkum 48 Scheme

Abstract

In 1956, the WHO Advisory Group defined accidents as unpremeditated events resulting in recognizable damage. Road traffic injuries (RTIs) remain a global public health challenge, with 1.19 million deaths reported in 2021, equating to 15 deaths per 100,000 population. RTIs are now the leading cause of death among individuals aged 5-29 years. In India, estimates of road traffic accidents (RTAs) largely rely on indirect reporting systems such as the National Crime Records Bureau (NCRB) and the Ministry of Road Transport and Highways (MoRTH). According to NCRB 2022, Tamil Nadu recorded 17,884 fatalities, with Chennai reporting the highest number of RTAs among metropolitan cities. Reducing road traffic deaths is critical to achieving Sustainable Development Goal (SDG) 3.6, which aims to halve global traffic deaths and injuries by 2030. Recognizing the burden of RTAs and associated financial strain, the Government of Tamil Nadu launched the “Innuyir Kappom Thittam: Nammai Kakkum - 48” scheme on December 18, 2021. This initiative ensures cashless trauma care during the first 48 hours, golden period covering 81 treatment modalities up to ₹1 lakh per individual under the Chief Minister’s Comprehensive Health Insurance Scheme. Between December 2021 and March 2023, 1,53,091 victims benefited, with ₹135.01 crore spent. By January 2024, 2,09,561 individuals had received treatment. The scheme continues under assurance mode and justified to raise the ceiling to ₹2 lakhs. High utilization and strong public‑private collaboration mark IK:NK‑48; independent evaluations could establish scalable, equitable trauma care models globally.