The proposed S-PPTA will reconfirm NUHM's relevance, rationale, and its linkage with GOI's development goals and sector strategy for urban health. The TA will examine the program's effectiveness, efficiency and economy, and sustainability. Specifically, it will review soundness of the NUHM's implementation framework and the proposed state-level program implementation guidelines. It will analyze the extent to which NUHM, with some strengthening in its design and implementation arrangements, can achieve its desired outcomes of serving health care needs of the urban poor in a sustainable manner. It will review the key components and result indicators. The S-PPTA will analyze the organizational set-up at central, state, and urban local body levels, staff capacity, and mechanisms for stakeholder consultations and grievance redressal. It will also initiate a review of NUHM's expenditure framework and financing plan, and assess the planning and budgeting process.
|Project Name||Supporting National Urban Health Mission|
|Project Type / Modality of Assistance||Technical Assistance
|Source of Funding / Amount||
|Strategic Agendas||Inclusive economic growth
|Drivers of Change||Governance and capacity development
|Sector / Subsector||
Health - Health system development
|Gender Equity and Mainstreaming||Effective gender mainstreaming|
|Description||The proposed S-PPTA will reconfirm NUHM's relevance, rationale, and its linkage with GOI's development goals and sector strategy for urban health. The TA will examine the program's effectiveness, efficiency and economy, and sustainability. Specifically, it will review soundness of the NUHM's implementation framework and the proposed state-level program implementation guidelines. It will analyze the extent to which NUHM, with some strengthening in its design and implementation arrangements, can achieve its desired outcomes of serving health care needs of the urban poor in a sustainable manner. It will review the key components and result indicators. The S-PPTA will analyze the organizational set-up at central, state, and urban local body levels, staff capacity, and mechanisms for stakeholder consultations and grievance redressal. It will also initiate a review of NUHM's expenditure framework and financing plan, and assess the planning and budgeting process. The coverage, level, and distribution of budget allocation will also be reviewed. The S-PPTA will assess predictability and sustainability of financing, such as timeliness, amount of budget release, and capacity for budget execution.|
|Project Rationale and Linkage to Country/Regional Strategy||The initial assessment of NUHM, based on the two missions and a review of the NUHM documents, shows that the concept is relevant and sound, and the delivery approach is innovative. The project team assesses that the results-based lending (RBL) modality will be most suitable for supporting the NUHM for the following reasons. First, this is a government-owned program which already has a program and implementation framework, detailed organizational arrangements, key result indicators, and an expenditure framework. Second, GOI's strong preference is for external assistance to support the whole program, rather than creating multiple projects with ring-fenced external funding. Third, the multi-disciplinary nature of the program that has a diverse range of activities requires an extensive inter-sectoral convergence and coordination. This calls for a modality that strengthens accountability for results rather than focusing only on transactions. A project loan modality will not be appropriate since the transaction costs of directly monitoring each transaction would be very high. The S-PPTA will, therefore, support loan design in accordance with the RBL policy and staff guidance.|
|Impact||Sustainable urban health delivery system targeted to urban poor established|
|Description of Outcome||RBL for "Supporting National Urban Health Mission" conceptualized and initial loan design developed|
|Progress Toward Outcome|
|Description of Project Outputs||Scope of RBL program for NUHM assessed|
|Status of Implementation Progress (Outputs, Activities, and Issues)|
Summary of Environmental and Social Aspects
|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.|
|Consulting Services||The executing agency is MOH, GOI. The implementing agency is the Urban Health Division, Department of Health & Family Welfare. A total of 63 person-months, including 15 person-months of international and 48 person-months of national consultant are provided under the PPTA. Individual consultants are engaged in accordance with ADB''s Guidelines on the Use of Consultants (2013, as amended from time to time). Disbursements will be made in accordance with ADB's Technical Assistance Disbursement Handbook (2010, as amended from time to time). The S-PPTA, which commenced in January 2014 will be implemented be completed in March 2016.|
|Responsible ADB Officer||Win, Hayman Kyaw|
|Responsible ADB Department||South Asia Department|
|Responsible ADB Division||Human and Social Development Division, SARD|
Ministry of Health
Department of Family Welfare
New Delhi, India
|Approval||16 Dec 2013|
|Last Review Mission||-|
|Last PDS Update||30 Mar 2015|
|Approval||Signing Date||Effectivity Date||Closing|
|16 Dec 2013||-||16 Dec 2013||31 Oct 2014||31 Aug 2016||-|
|Financing Plan/TA Utilization||Cumulative Disbursements|
|825,000.00||0.00||0.00||0.00||0.00||0.00||825,000.00||16 Dec 2013||749,331.91|
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