Madras ENT Research Foundation Private Limited

A Scheme That Changed the Meaning of Access

(Cochlear Implant and Auditory Brainstem Implant Programme)

The Tamil Nadu Chief Minister’s Comprehensive Health Insurance Scheme for Cochlear Implantation stands as an example of how advanced medical technology can be translated into meaningful public health impact when vision, policy and clinical systems work together.

The enduring contribution of Prof. Mohan Kameswaran lies in seeing this possibility before it became policy — and in helping shape a system through which children from economically challenged families could receive the same life-changing technology that was once available only to a few.

At a time when cochlear implantation was still viewed with caution by many, Prof. Mohan Kameswaran persistently placed before successive political leadership the clinical, ethical and social need for such a scheme, through evidence-based advocacy and sustained dialogue with formidable Chief Ministers. The case was made that early hearing restoration could transform not only the life of a child, but also the destiny of the family. This farsighted approach helped Tamil Nadu become one of the pioneering states in India to support cochlear implantation for eligible children through a government-funded pathway.

For MERF, the scheme is a carefully built pathway through which children with severe to profound hearing loss are identified, evaluated, implanted, habilitated and followed up. The result is not only the restoration of hearing, but the possibility of speech, schooling, independence and dignity.

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MERF’s Role in TNCMCHIS

The Tamil Nadu Chief Minister’s Comprehensive Health Insurance Scheme has enabled approximately 6,000 cochlear implantations across Tamil Nadu, making it one of the most significant state-supported hearing restoration initiatives in the country. A large part of this movement was initiated and nurtured through the vision and sustained efforts of Prof. Mohan Kameswaran, who actively reached out to Government medical colleges across 28 districts of Tamil Nadu. These are the Government medical colleges where the program has been started:

1. Government Madras Medical College, Chennai

2. Government Stanley Medical College, Chennai

3. Government Kilpauk Medical College, Chennai

4. Government Chengalpattu Medical College, Chengalpattu.

5. Government Coimbatore Medical College, Coimbatore

6. Government Dharmapuri Medical College & Hospital, Dharmapuri

7. Government Medical College, Dindigul

8. Government Medical College & Hospital, Karur

9. Government Medical College, Kallakurichi

10. Government Medical College & Hospital, Krishnagiri

11. Government Rajaji Madurai Medical College, Madurai

12. Government Kanyakumari Medical College, Nagercoil

13. Government Medical College, Namakkal.

14. Government Mohan Kumaramangalam Medical College, Salem.

15. Government Sivagangai Medical College & Hospital, Sivagangai

16. Government Medical College & Hospital, Pudukkottai

17. Government Thanjavur Medical College, Thanjavur

18. Government Medical College, Theni

19. Government Tirunelveli medical college & Hospital, Tirunelveli

20. Government Tiruvannamalai Medical College & Hospital, Tiruvannamalai

21. Government KAP Viswanatham Medical College, Trichy

22. Government Thiruvarur Medical College & Hospital, Thiruvarur

23. Government Thoothukudi Medical College, Thoothukudi

24. Government Vellore Medical College, Vellore

25. Government Villupuram Medical College & Hospital, Villupuram

 

Through these visits, he helped build awareness, encourage referrals, guide programme development and establish cochlear implantation as an accessible and life-changing intervention for children with severe to profound hearing loss.

Madras ENT Research Foundation Private Limited has been one of the leading centres for cochlear implantation under TNCMCHIS. Since 2013, MERF has completed more than 1,500 cochlear implants under the scheme. Since 2017, MERF has also performed 50 Auditory Brainstem Implants under TNCMCHIS.

MERF continues to serve as a key centre for complex implantable hearing solutions, particularly in children with cochlear nerve deficiency, cochlear malformations and other anatomical conditions where conventional cochlear implantation may not be feasible. The inclusion of Auditory Brainstem Implantation under TNCMCHIS represents an important advancement in making highly specialised hearing restoration accessible to children who would otherwise have had no effective implantable hearing option.

 

A Public Health Model Built Around the Child

The strength of the Tamil Nadu model lies not only in funding the implant, but in creating a complete continuum of care. A cochlear implant is meaningful only when it is supported by early diagnosis, careful candidacy assessment, safe surgery, switch-on, mapping, auditory verbal habilitation and long-term follow-up.

This comprehensive approach distinguishes the Tamil Nadu experience. While national programmes such as ADIP (Assistance to Disabled Persons for Purchase/Fitting of Aids/Appliances) have expanded access to cochlear implantation across India, the Tamil Nadu model has evolved as a closely monitored state pathway, with strong emphasis on timely intervention, specialist evaluation, parental counselling and structured post-operative habilitation.

 

Habilitation: The Core of Success

The Tamil Nadu model recognised an important reality: surgery alone does not complete the child’s journey into hearing. After implantation, the child must learn to listen, attach meaning to sound, develop speech and gradually enter the world of communication.

For many families, repeated travel to Chennai for therapy would be financially and practically difficult. The development of a hub-and-spoke model, with satellite habilitation support closer to families, helped improve continuity of care. This approach reduced the burden of travel, strengthened attendance for habilitation and made the programme more sustainable for children from different parts of Tamil Nadu.

 At MERF, habilitation includes parent counselling, auditory verbal therapy, speech and language monitoring, mapping, troubleshooting, device guidance and long-term outcome review. Parents are treated as active partners in the child’s rehabilitation, because the home environment plays a decisive role in the development of listening and spoken language.

 

Eligibility for Cochlear Implant / Auditory Brainstem Implant under TNCMCHIS

Children may be considered under the scheme based on the prevailing Tamil Nadu Chief Minister’s Comprehensive Health Insurance Scheme criteria.

At present, the commonly listed eligibility includes:

• Children below 6 years of age with profound hearing loss who are not benefiting with hearing aids

• Children from below poverty line families

• Children who fulfil the required audiological, radiological, medical and scheme-related criteria

• Children requiring cochlear implantation or, in selected complex cases, auditory brainstem implantation

 

Documents Required

The following documents are usually required for eligibility verification:

• Birth certificate

• Ration card with the child’s name

• Smart card in the parent’s name

• Aadhaar card

Families are advised to bring all available medical records, previous hearing tests, hearing aid trial details and imaging reports, if already done elsewhere.