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India: Supporting Strategic Interventions in the Health Sector Towards Achieving Universal Health Coverage

Sovereign (Public) Project | 53355-001 Status: Active

The health sector in India is in a stage of transition. This presents both an opportunity and a challenge given the increasing demand for quality health services exacerbated by changing disease patterns. Health being under the state list of the constitution of India, the differential capabilities of the states to implement healthcare delivery becomes critical. Within this context and given our previous and continued engagement with the health sector, it is crucial that a strategic approach be adopted for expanding health sector engagement in India. This would draw upon the vision laid out in Strategy 2030 and align increased engagement identifying key areas of support including investment needs. It would also assess, document and support innovative practices, recognizing that India might need organic solutions developed which are scalable, yet draw from best practices.

Project Details

Project Officer
Khetrapal, Sonalini South Asia Department Request for information
Country
  • India
Sector
  • Health
 
Project Name Supporting Strategic Interventions in the Health Sector Towards Achieving Universal Health Coverage
Project Number 53355-001
Country India
Project Status Active
Project Type / Modality of Assistance Technical Assistance
Source of Funding / Amount
TA 9827-IND: Supporting Strategic Interventions in the Health Sector Towards Achieving Universal Health Coverage
Technical Assistance Special Fund US$ 225,000.00
Strategic Agendas Inclusive economic growth
Drivers of Change Gender Equity and Mainstreaming
Governance and capacity development
Knowledge solutions
Sector / Subsector

Health / Health sector development and reform

Gender Equity and Mainstreaming Some gender elements
Description The health sector in India is in a stage of transition. This presents both an opportunity and a challenge given the increasing demand for quality health services exacerbated by changing disease patterns. Health being under the state list of the constitution of India, the differential capabilities of the states to implement healthcare delivery becomes critical. Within this context and given our previous and continued engagement with the health sector, it is crucial that a strategic approach be adopted for expanding health sector engagement in India. This would draw upon the vision laid out in Strategy 2030 and align increased engagement identifying key areas of support including investment needs. It would also assess, document and support innovative practices, recognizing that India might need organic solutions developed which are scalable, yet draw from best practices.
Project Rationale and Linkage to Country/Regional Strategy India is home to more than 1.3 billion people, the second highest in the world after China. In the health sector, India has made some improvements, notably maternal mortality ratio (MMR) has reduced by 77%, from 556 per 100,000 live births in 1990 to 130 per 100,000 live births in 2016, which is below the MDG targets. Similarly, Infant Mortality Rate has also declined to 34 per 1000 Live Births in 2016 and the Life expectancy at Birth has increased from 49.7 years in 1970 75 to 68.3 years in 2011 15. Nonetheless, several persisting issues remain. Communicable diseases continue to be a challenge and account for 27.5% of all deaths in India. TB burden is disproportionately high with more than a quarter (27%) of global TB burden from India. Furthermore, emerging and re-emerging zoonotic diseases, foodborne and waterborne diseases and diseases caused by multi-resistant organisms constitute as major threats. Antimicrobial resistance is fast becoming one of biggest health challenges, and in 2010, India recorded a staggering 12.9 billion units of antibiotic consumption, which was one of the highest consumption globally. Exacerbating the situation, India is facing changing disease pattern, where noncommunicable diseases (NCDs) such as cardiovascular disease, diabetes, cancer, respiratory, and other chronic diseases, account for over 60% of total mortality. The top three causes of death for all ages in 2017 are related to NCDs which includes ischemic heart disease, chronic obstructive pulmonary disease, and stroke. More striking, the percentage change from 2007 to 2017 of causes of deaths related to NCDs (including diabetes and chronic kidney disease) have increased by around 40% or more (except asthma with a 6.2% increase). In terms of health systems, out of total 155,069 sub-centers in rural India, 86% do not meet the Indian Public Health Standards set up by the government. Further, India has low density of health workforce; with density of physicians (7 per 10,000 population) and nurses (17.1 per 10,000 population) as against the global average of 13.9 and 28.6 respectively. To add to the complexity, interstate and regional differences in health system capacity affects implementation and access to care.
Impact Universal Health Care (UHC) in India increased
Project Outcome
Description of Outcome Priority areas for ADB intervention in India health sector identified
Progress Toward Outcome
Implementation Progress
Description of Project Outputs

Assessment of priority areas for improved UHC in India completed

ADB strategy for health sector in India developed

Status of Implementation Progress (Outputs, Activities, and Issues)
Geographical Location Nation-wide
Summary of Environmental and Social Aspects
Environmental Aspects
Involuntary Resettlement
Indigenous Peoples
Stakeholder Communication, Participation, and Consultation
During Project Design
During Project Implementation
Business Opportunities
Consulting Services The TA will engage five individual consultants amounting to 22 person-months (4 person-months international and 18 person-months national). ADB will engage the consultants following the ADB Procurement Policy (2017, as amended from time to time) and its associated project administration instructions.
Procurement Not Applicable.
Responsible ADB Officer Khetrapal, Sonalini
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 -
Fact Finding -
MRM -
Approval 17 Oct 2019
Last Review Mission -
Last PDS Update 22 Oct 2019

TA 9827-IND

Milestones
Approval Signing Date Effectivity Date Closing
Original Revised Actual
17 Oct 2019 - 17 Oct 2019 31 Dec 2020 - -
Financing Plan/TA Utilization Cumulative Disbursements
ADB Cofinancing Counterpart Total Date Amount
Gov Beneficiaries Project Sponsor Others
225,000.00 0.00 0.00 0.00 0.00 0.00 225,000.00 17 Oct 2019 24,632.23

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Tenders

Tender Title Type Status Posting Date Deadline
Health System Assessment Expert Individual - Consulting Closed 27 Mar 2020 07 Apr 2020
Health System Assessment Expert Individual - Consulting Closed 14 Mar 2020 17 Mar 2020
Supporting Strategic Interventions in the Health Sector Towards Achieving Universal Health Coverage (Senior Health Systems Specialist) Individual - Consulting Closed 06 Nov 2019 12 Nov 2019

Contracts Awarded

No contracts awarded for this project were found

Procurement Plan

None currently available.