The Centre, Karnataka and the World Bank today signed a $70 million additional credit agreement for the ongoing Karnataka Health System Development and Reform Project to further support improvements in health service delivery, particularly for the underserved areas and vulnerable groups.
The project builds on the experience of the original $141.83 million project. Since 2006, the project has contributed to development of the state’s health system, including improving administrative capacity and planning, investing in maternal health services, contracting NGOs to run mobile health clinics, supporting community-level public health interventions and contributing to a state government scheme that purchases hospital services for poor beneficiaries from accredited public and private hospitals.
The project has contributed to progress in a number of health indicators — the proportion of births in a health facility has risen from 65 per cent in 2005-06 to 86 per cent in 2009; the proportion of children fully immunised has risen from 55 per cent in 2005-06 to 78 per cent in 2009; and 96 mobile health clinics are operational. According to a 2011 health facility survey, 83 per cent of public health centres (PHCs) had a doctor present at the time of the survey, compared to only 35 per cent in 2004; in 2011, 89 per cent of PHCs had a functional labor room, compared to 67 percent in 2004. Today, over 1,000 PHCs across the state function 24 hours a day.
To date, over 19,000 poor patients have benefited from tertiary-level hospital services they would otherwise have had great difficulty in accessing.
“Over the past two decades, Karnataka has made progress in the health sector. At the same time, socio-economic disparities in the utilisation of basic health services still exist. This project, we hope, will continue to contribute to the government’s efforts at improving health services for mothers and children, particularly among the poor and vulnerable populations,” said Michael Haney, World Bank Operations Advisor for India. “The World Bank looks forward to a continued and productive partnership with the government of Karnataka in the health sector, providing experience and models that can benefit other states in India as well as internationally,” he added.
Consequently, the project will continue support to improvements in the primary and maternal health services, notably upgrading facilities to provide 24-hour services and extending mobile health services to underserved communities. The project will continue to support and scale-up the state government’s programme to purchase hospital services for poor patients with a focus on further strengthening capacity for monitoring and verification.
A number of new strategies to address the emerging health problems will be piloted with support of the project, including a programme for non-communicable disease prevention and control, focusing on hypertension, diabetes, and cancer — diseases that are imposing a growing burden on the poor. The pilot will include, in particular, interventions to address cervical cancer, a highly-treatable disease that causes the death of thousands of women in the state. In close collaboration with another World Bank-financed project - the Second Karnataka State Highways Improvement Project - additional financing will support a comprehensive road safety strategy, focusing on improving ambulance and emergency healthcare services for road traffic injury victims.
“Since its start in 2006, the project has supported reforms and innovations in the health sector in Karnataka. Going forward, as government spending in health sector continues to increase, the project will focus on activities that can benefit from technical engagement with the World Bank; pilot programmes, which if successful, can be scaled up using government funds; and evaluations to inform such decisions,” said Patrick Mullen, Senior Health Specialist, World Bank, and the Project’s Task Team Leader.
The project will be financed by a credit from the International Development Association (IDA) - the World Bank’s concessionary lending arm - which provides interest-free loans with 25 years to maturity and a grace period of five years.