The World Bank Thursday approved a credit of 110,83 million US dollar (605 mio. DKR) to help the Indian state of Tamil Nadu improve the effectiveness of its health system, both public and private.
The World Banks involvement in the Tamil Nadu Health Systems Project will help introduce new approaches in the way the health sector functions in the state, such as promoting collaboration with the private sector, adopting quality assurance mechanisms, and addressing the growing burden of non-communicable diseases.
While the health system in Tamil Nadu has been fairly effective in providing basic health needs to its people, it is expected that the goals sought in this project will demonstrate the impact of cutting-edge reforms.
Tamil Nadu in Southern India has successfully delivered preventive services, like immunization, with the result that there has been considerable improvement over time in its infant mortality rate (IMR) and the under-five mortality rate.
From 1992 to 1999, IMR declined from 71 to 48 per thousand, and the under-five mortality rate dropped from 97 to 63 per thousand. However, these rates are still much higher than those in Sri Lanka and the neighboring State of Kerala, where, for example, IMRs are 12 and 16, respectively.
– Tamil Nadu has made significant progress in improving the health status and increasing access to health care services in the last decades, says Preeti Kudesia, a Senior Public Health Specialist at the World Bank adding:
– Nonetheless, the State continues to face major challenges such as stagnating infant and maternal mortality rates, a growing burden of non-communicable diseases, poor quality of care, equity issues, and low levels of health financing in the state.”
To respond to these challenges the Government of Tamil Nadu developed a Health Policy in 2003.
his strategy focuses on improving the health status of the general population, with special emphasis on the health of low-income communities and families, over the next two decades. The project will support implementation of this strategy.
The project has four components:
1) Increasing access to and utilization of health services, particularly for poor, disadvantaged, and tribal groups;
2) Developing and pilot testing effective interventions to address key health challenges, specifically non-communicable diseases and traffic accidents;
3) Improving health outcomes, access and quality of service delivery through strengthened oversight of the public sector health systems, and greater engagement of the nongovernmental sector;
4) Increasing the effectiveness and efficiency of public sector hospital services, primarily at district and sub-district levels.
The project seeks development impact by supporting public-private partnerships in the implementation of all its components. Risk factor prevention for non-communicable diseases will be implemented across the state, while pilot strategies for prevention and management of hypertension and cervical cancer will be rigorously tested for effectiveness in selected districts.
The project will also ensure comprehensive emergency obstetric and neonatal care in an aggressive strategy to reduce infant and maternal mortality rates, and worse-off areas that are remote or inhabited by tribal people will receive support first.. Infrastructure improvements and improved quality of care will be implemented simultaneously in a phased manner.
The project is expected to contribute to achieving broader India Country Strategy objectives such as improving governance, expanding access and upgrading effectiveness and quality of services, and enhancing community participation and empowerment.
The credit, from the International Development Association (IDA), the World Banks concessionary lending arm, carries a 0,75 percent service charge, a 10-year grace period, and a 35-year maturity.
For more information on World Bank activities in India, visit:
www.worldbank.org/in
Kilde: www.worldbank.org
