New World Bank Project to Improve Healthcare Services in Mizoram, India
Washington: The World Bank Board of Executive Directors today approved a $32 million Mizoram Health Systems Strengthening Project to improve management capacity and quality of health services in Mizoram, situated in the North East region of India, particularly for the benefit of underserved areas and vulnerable groups.
The project will strengthen the governance and the management structure of the Department of Health and Family Welfare (DoHFW) and its subsidiaries, improve the quality and coverage of services delivered by the state government health systems, and invest in a comprehensive Quality Assurance program which would enable quality certification of health facilities.
A key focus will be to strengthen the effectiveness of the state health insurance program; build synergies with the Government of India’s Pradhan Mantri Jan Arogya Yojna (PMJAY); and thereby reduce financial barriers in accessing hospital services, prevent catastrophic out of pocket expenditure for health by poor families and expand coverage.
The Mizoram Health Systems Strengthening Project will benefit the people across all eight districts of the state. It will also benefit health sector staff, specifically at the secondary and primary levels, by strengthening their planning and management capacity along with building their clinical skills and competencies.
Mizoram’s performance on key health outcomes is mixed when compared to national averages, with significant urban-rural disparities and an increasing burden of non-communicable diseases (NCDs). In 2019-20, under-five mortality in Mizoram was 24 per 1,000 live births; and the prevalence of stunting among under-five children was 28.9 percent which increased marginally from the previous survey (2014-15). Non-Communicable Diseases in adults account for more than 50 percent of the disease burden in the state.
The Government of Mizoram has been steadily increasing its commitment to the health sector. Health expenditure as a share of total state government expenditure in 2015-16 was 8.3 percent, the highest among the North-Eastern states.
“While Mizoram performs better than the national average on many key health indicators, access to quality health services is a challenge, particularly in rural areas. The COVID-19 pandemic has also adversely impacted the delivery of essential health services,” said Junaid Ahmad, World Bank Country Director in India. “This project will support the state government’s efforts to deliver quality healthcare for the poor and vulnerable and those located in remote areas.”
As a key strategy, the project will move towards a performance-based financing system where Internal Performance Agreements (IPAs) between the DoHFW and its subsidiaries would foster more accountability at all levels. This is expected to go a long way in improving the management of the system to deliver quality health services. The project will also focus on promoting synergy between various schemes and augment the capacity of the state insurance agency.
Like other states in India, the COVID-19 pandemic has had adverse effects on the delivery and utilization of essential health services in the state. The project will invest in infection prevention and control for a more resilient response to future outbreaks, pandemics, and health emergencies.
Improved health services may also lead to an incremental increase in bio-medical waste. Any improper management of wastes including bio-medical waste and other hazardous wastes such as plastic waste and e-waste poses environmental risks. The project will invest in improving the overall ecosystem for bio-medical waste management (both solid and liquid waste). It will include segregation, disinfection, and collection while safeguarding the environment and improving the quality of health service and patient safety.
“Lack of investments in improving organizational structures and financing patterns coupled with weak management and accountability is severely affecting the quality of health services in Mizoram,” said Amith Nagaraj Bathula, Senior Operations Officer, and World Bank’s Task Team Leader for the project. “This project will help the state to improve quality certification at health facilities, enhance human resources, improve health insurance and other innovations.”
The $32 million loan from the International Bank for Reconstruction and Development (IBRD), has a maturity of 14.5 years, including a grace period of 5 years.