India: Supporting National Urban Health Mission

Sovereign Project | 47354-003 Status: Approved

Summary

ADB is reinforcing the efforts of Government of India to improve the health of people who live in cities, especially the poor. The project is strengthening broadly-defined urban health systems across cities and towns to deliver quality essential health services for all, with a particular focus on the poor and vulnerable. The project is improving the networks of primary health facilities in urban areas and introducing a quality assurance mechanism for them. It is also helping to improve planning, management, and innovation, in order to bring best practices to city clinics and health centers. The financing for the project is being disbursed based on the achievement of results, including more births in health facilities and higher childhood immunization rates.

Latest Project Documents

Consulting Notices See also: CMS

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Procurement Notices See also: Operational Procurement

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Procurement Documents

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Project Name Supporting National Urban Health Mission
Project Number 47354-003
Country India
Project Status Approved
Project Type / Modality of Assistance Loan
Technical Assistance
Source of Funding / Amount
Loan 3257-IND: Supporting National Urban Health Mission
Ordinary capital resources US$ 300.00 million
TA 8899-IND: Strengthening Capacity of the National Urban Health Mission
Japan Fund for Poverty Reduction US$ 2.00 million
Strategic Agendas Inclusive economic growth
Drivers of Change Governance and capacity development
Knowledge solutions
Partnerships
Private sector development
Sector / Subsector

Health - Health system development

Gender Equity and Mainstreaming Gender equity
Description ADB is reinforcing the efforts of Government of India to improve the health of people who live in cities, especially the poor. The project is strengthening broadly-defined urban health systems across cities and towns to deliver quality essential health services for all, with a particular focus on the poor and vulnerable. The project is improving the networks of primary health facilities in urban areas and introducing a quality assurance mechanism for them. It is also helping to improve planning, management, and innovation, in order to bring best practices to city clinics and health centers. The financing for the project is being disbursed based on the achievement of results, including more births in health facilities and higher childhood immunization rates.
Project Rationale and Linkage to Country/Regional Strategy India has made significant progress toward improving health services but more than 77 million poor and vulnerable people in cities still have limited access to basic health services such as child immunization. India's rapid urbanization has accompanied massive growth in the number of urban poor and large health disparities. For example, studies have found poor city children under the age of 5 are almost twice as likely to die as children in more prosperous situations. This is due to adverse living conditions and limited access to health services, despite the fact that these children may often live close to many hospitals. This vulnerable segment of the population cannot afford the private health providers that dominate urban areas and often incur out-of-pocket health expenses that drive them even deeper into poverty. There is also limited health promotion services.
Impact Improved health status of the urban population, particularly the poor and vulnerable, across India

Project Outcome

Description of Outcome Increased access to equitable and quality urban health system
Progress Toward Outcome HMIS strengthened to capture urban specific outcome indicators and intra-urban health disparities.
Implementation Progress
Description of Project Outputs

3. Capacity for planning, management, and innovation and knowledge sharing strengthened

2. Quality of urban health services improved

1. Urban primary health care delivery system strengthened

Status of Implementation Progress (Outputs, Activities, and Issues)

Output 1: cities are mapping slums, vulnerable populations, and health facilities to effectively plan infrastructure and pro-poor health services. Gap analysis of facilities ongoing to meet basic NUHM requirements for staffing and service package. Good progress in recruitment and training of urban ASHAs and strengthening community processes at the primary health level.

Output 2: QA guidelines for UPHCs issued in October 2015 and roll-out of QA mechanism underway. 31 states have set up SQAC and 18 states have SQAUs in place, and their capacity and functioning being assessed and further improved for ensuring quality at urban primary health facilities.

Output 3: NUHM capacity development framework has been developed, specifying priority areas for capacity development and implementation support; outputs and targets; modalities; and progress reporting mechanism. Bid document for establishing the pool of experts to support the national PMU is being finalized.

Geographical Location

Safeguard Categories

Environment B
Involuntary Resettlement C
Indigenous Peoples C

Summary of Environmental and Social Aspects

Environmental Aspects

An assessment is expected to ensure that the upgrading of urban primary health centers do not result in any adverse environmental impact.

[Potential environmental impacts of the program will not be significant or irreversible during the site specific activities, including construction and operations of the PHCs. The mitigation measures can be built into the program safeguard system. The program's initial categorization of environmental impacts is Category B.]

Involuntary Resettlement

An assessment is expected to ensure that the upgrading of urban primary health centers do not result in any adverse impact on involuntary resettlement or indigenous people.

[The program's initial categorization of social impacts is Category C. No adverse social impacts are expected or will be supported under the program.]

Indigenous Peoples

An assessment is expected to ensure that the upgrading of urban primary health centers do not result in any adverse impact on involuntary resettlement or indigenous people.

[The program's initial categorization of social impacts is Category C. No adverse social impacts are expected or will be supported under the program.]

Stakeholder Communication, Participation, and Consultation
During Project Design The development of National Urban Health Mission (NUHM) and Framework for Implementation by the Ministry of Health and Family Welfare involved extensive consultations across all levels of Government and civil society. The NUHM Technical Resource Group (TRG) further guided on key issues of reaching vulnerable sections of the society, main strategies and institutional design of NUHM, and organization of urban health service delivery and governance based on series of consultations with experts and a range of vulnerable urban poor groups and field visits to 30 cities. The ADB team also conducted stakeholder consultations and detailed field assessment of NUHM implementation in West Bengal, Madya Pradesh, and Tamil Nadu, which gave important insights into NUHM implementation challenges and capacity building requirements.
During Project Implementation For stakeholder participation, the NUHM emphasizes community participation and processes, reaching of vulnerable groups, and capacity building of stakeholders (urban local bodies, health workers, private providers, community structures, and functionaries of other related departments) in managerial, technical, and public health competencies

Business Opportunities

Consulting Services A total of 63 person-months, including 15 person-months of international and 48 person-months of national consultant are provided under the PPTA.
Procurement The procurement scope under the NUHM will include renovation of existing public health centers, construction of new public health centers, procurement of medicines, consumables, medical equipment, and ICT equipment and other office and laboratory facilities, engagement of consulting services for project and financial management, medical consultants, community workers, and NGOs. Procurement will be undertaken following the country procurement systems as spelt out in the General Financial Rules, 2005 (GFR) of the GOI and its amendments and the State Financial Rules/ Procurement Law/ Procurement Policy developed by the States within the frame work of the national GFR.

Responsible Staff

Responsible ADB Officer Hayman Win
Responsible ADB Department South Asia Department
Responsible ADB Division Human and Social Development Division, SARD
Executing Agencies
Ministry of Health and Family Welfare
150 A Nirman Bhawan
New Delhi - 110 011
India

Timetable

Concept Clearance 25 Aug 2014
Fact Finding 18 Sep 2014 to 24 Sep 2014
MRM 11 Dec 2014
Approval 28 May 2015
Last Review Mission -
Last PDS Update 26 Jan 2016

Loan 3257-IND

Milestones
Approval Signing Date Effectivity Date Closing
Original Revised Actual
28 May 2015 28 Jul 2015 01 Sep 2015 30 Sep 2018 - -
Financing Plan Loan Utilization
Total (Amount in US$ million) Date ADB Others Net Percentage
Project Cost 1,954.90 Cumulative Contract Awards
ADB 300.00 28 May 2015 40.00 0.00 13%
Counterpart 1,654.90 Cumulative Disbursements
Cofinancing 0.00 28 May 2015 40.00 0.00 13%

TA 8899-IND

Milestones
Approval Signing Date Effectivity Date Closing
Original Revised Actual
28 May 2015 30 Jul 2015 30 Jul 2015 30 Jun 2018 - -
Financing Plan/TA Utilization Cumulative Disbursements
ADB Cofinancing Counterpart Total Date Amount
Gov Beneficiaries Project Sponsor Others
0.00 2,000,000.00 0.00 0.00 0.00 0.00 2,000,000.00 28 May 2015 0.00

Safeguard Documents See also: Safeguards

Safeguard documents provided at the time of project/facility approval may also be found in the list of linked documents provided with the Report and Recommendation of the President.

Evaluation Documents See also: Independent Evaluation

None currently available.

Related Publications

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