WASHINGTON, September 27, 2012 - The World Bank today approved a $70 million additional credit to the Karnataka Health System Development and Reform Project to further support development of the state’s health system, particularly in underserved areas and among vulnerable groups.
This Project builds on the successful experience of the original $ 141.83 million Karnataka Health System Development and Reform Project. The original Project has been contributing to the state’s health system by building capacities and systems to improve state and central government spending on health. It has made progress in a number of health indicators – the proportion of births delivered in a health facility has risen from 65 percent in 2005-06 to 86 percent in 2009; the proportion of children fully immunized has increased from 55 percent in 2005-06 to 78 percent in 2009 (against a target of 80 percent); and 96 mobile health clinics are operational (against a target of 97). According to a 2011 health facility survey done by the Project, 83 percent of public health centers (PHCs) had a doctor present at the time of the survey, compared to only 35 percent in 2004; in 2011, 89 percent of PHCs had a functional labor room, compared to 67 percent in 2004. Today over a 1000 PHCs across the state function 24 hours a day.
The Project has supported the state government in the areas of public health standards and health care waste management. It has also made significant contribution to the state government’s initiatives in health financing by purchasing hospital services for poor beneficiaries – to date, a total of 19,000 patients have benefited from services they would otherwise have had great difficulty in accessing.
The additional financing, approved today, will continue to support the state government’s strategy to improve health services in the areas of primary and maternal health care, quality assurance, public-private contracting, and purchasing of hospital services for the poor. The Project will also support new strategies for non-communicable disease control and road safety.
“Over the past two decades Karnataka has made significant progress in the health sector. At the same time, socio-economic disparities in the utilization 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 poor and vulnerable populations,” said Onno Rϋhl, World Bank Country Director 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, a primary focus of the Project will be on strengthening existing government health services, including upgrading health facilities for better maternal health care, supporting another 57 PHCs for providing 24 hour service, extending health services to underserved communities through mobile health clinics operated by contracted non-governmental organizations (NGOs), supporting NGO-run hospital help desks to improve access to hospital services for poor and vulnerable patients, scaling-up quality assurance strategies, and developing capacities of the health administration. The Project will continue to support scale-up of the state government’s program to purchase hospital services for poor patients, with a focus on monitoring and building their capacity for verification.
A number of new strategies to address emerging health problems that are growing in India will be piloted with support of the Project, including a program for non-communicable disease prevention and control that will include community outreach, diagnosis and treatment services, focusing on hypertension, diabetes, and cancer -- all diseases that are imposing a growing burden on the poor in India. The pilot program will include, in particular, interventions to address cervical cancer, a highly-treatable disease that is nevertheless causing 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 – the additional financing will support a comprehensive road safety strategy, focusing on improving ambulance and emergency health care services for road traffic injury victims.
“Since its start in 2006, this Project has always been focused on supporting reforms and innovations in the health sector in Karnataka. Going forward, as the government spending in the health sector will continue to increase, this Project will largely focus on activities that can benefit from technical engagement with the World Bank; pilot programs, 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.
