$328 m WB loan for AP’s health project.

The health sector in Andhra Pradesh received a major boost with the World Bank giving its consent to financing the AP Health Systems Strengthening Project involving an estimated $ 328 million, approximately ₹2,290 crore.

The project, to be implemented in three stages, would focus on improving quality of care, improve responsiveness of public health services and increase access to an expanded package of primary health services. The bank had agreed to release

$ 36.16 million in 2020, $ 71.01 million in 2021, $ 84.74 million in 2022, $ 73.34 million in 2023, $ 39.58 million in 2024 and $ 23.17 million in 2025, the last year of its implementation.

The key project developments include increasing the number of the community and primary health centres with quality certification and increase average patient reported experience score. In addition, it aims at increasing the percentage of patients diagnosed with and at risk of hypertension and diabetes as per protocol at the sub-centre or PHC levels while it would focus on increasing the percentage of pregnant women receiving full antenatal care.

Project appraisal

In the project appraisal document, the World Bank said Maternal Mortality Ratio (MMR) significantly declined in the State from 154 per one lakh live births to 74 as also the Infant Mortality Ratio which dropped from 54 per 1,000 live births to 35 in the past few years. These trends, while being positive, however, mask the emerging and last mile challenges faced by the State.

The bank said the public health system in the State was not currently well positioned to address the increasing burden of non-communicable diseases which had gone up by 60% in 2016 while communicable, maternal, neonatal and nutritional diseases had declined in the State.

Additionally, as NCD screening and care was currently available only at secondary level and above, it often resulted in poorer access.

There were also disparities in the coverage of maternal and child health (MCH) services and outcomes within the State as well as in the quality of the MCH service delivery. For instance, IMR ranges from 48 per 1,000 live births in Srikakulam to 25 per 1,000 live births in Krishna district. Gaps in the quality of service provision remained.

Besides, poor quality of care in public health facilities was contributing to the lack of confidence in public health services.

The State had requested the World Bank’s assistance to scale up these efforts, address gaps in quality, improve the focus on results and enhance the pace of the State’s achievement in strengthening its public health system.

THE HINDU