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4th March 2023 (8 Topics)

World Bank lends for Health Sector in India

Context

The World Bank is lending up to $1 billion to help India with preparedness for future pandemics as well as to strengthen its health infrastructure.

About

  • The lending will be divided into two complementary loans of $500 million each.
  • The bank will support India’s flagship Pradhan Mantri-Ayushman Bharat Health Infrastructure Mission (PM-ABHIM), launched in October 2021, to improve the public healthcare infrastructure across the country.
  • In addition to the national-level interventions, one of the loans will prioritise health service delivery in seven States including Andhra Pradesh, Kerala, Meghalaya, Odisha, Punjab, Tamil Nadu, and Uttar Pradesh.
  • The $500-million Public Health Systems for Pandemic Preparedness Program (PHSPP) will support the government’s efforts to prepare India’s surveillance system to detect and report epidemics of potential international concern.
  • Another portion of funds will also be allocated for Enhanced Health Service Delivery Program (EHSDP), which will support government’s efforts to strengthen service delivery through a redesigned primary healthcare model.
    • It includes improved household access to primary healthcare facilities, stronger links between each household and its primary care facility through regular household visits and risk assessment of non-communicable diseases.

Both the PHSPP and the EHSDP utilise the Program-for-Results financing instrument that focuses on achievement of results rather than inputs.

Both the PHSPP and EHSDP loans from the International Bank for Reconstruction and Development (IBRD) have a final maturity of 18.5 years including a grace period of five years.

Need of the initiative:

  • COVID-19 has underscored the need for developing capacity for core public health functions, as well as for improving the quality and comprehensiveness of health service delivery.

India’s Health sector:

  • In India, the Health care sector is one of the largest sectors in terms of both revenue and employment.
  • In India, the health care sector can be categorized into public and private.
  • Public health care hospitals comprise secondary and tertiary care institutions in urban areas while primary basic facilities are focused in rural areas.
  • Private health care sectors provide secondary, tertiary, and quaternary services in metro cities.
  • India’s performance in health has improved over time.
  • According to World Bank estimates, India’s life expectancy has increased from 58 in 1990 to 69.8 in 2020.
  • This is higher than average for the country’s income level.
  • Other indicators:
    • The under-five mortality rate (36 per 1,000 live births),
    • Infant mortality rate (30 per 1,000 live births), and
    • Maternal mortality ratio (103 per 100,000 live births) is all close to the average for India’s income level.

Pradhan Mantri-Ayushman Bharat Health Infrastructure Mission:

Key features:

  • Free diagnostics at district level: Under PMASBY, 134 different types of testing will be done free at district level, which will not only save costs but also reduce unnecessary inconvenience to poor people.
  • Mobile Hospitals: For the first time in Asia, two container-based hospitals with complete medical facilities will be maintained at all times under PMASBY.
  • One mobile unit will have 22 containers with 100 beds each.
  • The mobile hospitals will be set up in New Delhi and Chennai. These hospitals can be quickly assembled by train or air to respond to any disaster or disaster in the country.
  • Strengthening NCDC: The existing National Centres for Disease Control (NCDC), which has the mandate to stop outbreaks, will be strengthened under PMASBY by adding three new phases.
  • This will be the Climate Change Unit, the Occupational Health Unit, and the Disaster Management Unit. Five branches of the NCDC region - one north, south, east, west, and central - will be established. General diagnostic services will also be improved.

 

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