The World Bank’s Board of Directors today approved two complementary loans of $500 million each to support and improve India’s health sector. With this combined $1 billion financing, the Bank will support India’s flagship Pradhan Mantri-Ayushman Bharat Health Infrastructure Mission (PM-ABHIM), launched in October 2021, to improve public health infrastructure across the country. In addition to national level interventions, one of the loans will prioritize seven states including Andhra Pradesh, Kerala, Meghalaya, Odisha, Punjab, Tamil Nadu and Uttar Pradesh.
India’s health performance has improved over time. According to World Bank estimates, life expectancy in India – at 69.8 years in 2020, up from 58 in 1990 – is above average for the country’s income level. The under-five mortality rate (36 per 1,000 live births), infant mortality rate (30 per 1,000 live births) and maternal mortality rate (103 per 100,000 live births) are all close to the India’s average income level, reflecting significant achievements in access to skilled birth attendants, immunizations and other priority services.
Despite these advances in the health of the Indian population, COVID-19 has underscored the need to revitalize, reform and develop capacity for essential public health functions, as well as improve the quality and comprehensiveness of service delivery. health services.
“The outbreak of COVID-19 has again underscored the urgency of significant reforms to improve the performance of India’s health sector,” said Hideki Mori, the World Bank’s Acting Country Director for India. “India’s decision to invest early and significantly to strengthen its health system even as it emerges from the pandemic, is a pioneering choice and we are happy to support this important program.”
The two loans, Public Health Systems for Pandemic Preparedness Program (PHSPP) and Enhanced Health Service Delivery Program (EHSDP), are designed to have a complementary and transformational impact, supporting the Government of India’s reform agenda to accelerate universal coverage, improve quality and increase the resilience and preparedness of the Indian health system.
“Both programs leverage the unique strengths of the center and the states to support the development of more accessible, high-quality, and affordable health services,” said Lynne Sherburne-Benz, World Bank Regional Director of Human Development for the World Bank. ‘South Asia. “This strengthening of health systems, combined with the focus on a strong disease response, will improve preparedness and response to future epidemics.”
The PSSPN will support government efforts to:
prepare India’s surveillance system to be ready to detect and report outbreaks of potential international concern, ensure rapid response and prevent the emergence of pathogens;
enhance India’s capacity to detect pathogens, including zoonotic diseases, to inform India’s biosecurity response and the commercialization of new technologies to prevent, detect or treat infectious diseases; and
strengthen coordination and build institutional capacity of key public health institutions to implement the program and deliver high quality results.
The EHSDP will support the Government’s efforts to:
strengthen service delivery through a redesigned primary health care model, which includes improved household access to primary health care facilities, stronger links between each household and its primary care facility through regular visits to home and a non-communicable disease risk assessment;
improve quality of care by supporting certification of national quality assurance standards in health and wellness centers (HWCs), implementing quality of care measurement tools, including the experience of patients, and strengthening the health workforce by adopting state-specific human resource strategies for public health care facilities; and
transform health sector governance and accountability by strengthening implementation capacity, improving performance measurement and rewards at the district level, and fostering learning and knowledge exchange across states.
Both the PHSPP and the EHSDP use the results-based program funding instrument that emphasizes the achievement of results rather than inputs. International Bank for Reconstruction and Development (IBRD) PHSPP and EHSDP loans have a final maturity of 18.5 years, including a 5-year grace period.