The World Bank has decided to extended the period of utilisation of Rs.595 crores loan granted to Karnataka Health Systems Development project (KHSDP) II for two more years from March 31, 2002.

In a progress review report dated November 11, 2002 submitted to the AKM Nayak, principal secretary, department of health and family welfare, government of Karnataka and Mahendra Jain, KHSDP administrator, the World Bank country director, Michael Cater said the extended period of the project should be used to consolidate several software components.

The Bank had asked the KHSDP officials to focus on issues such as strengthening institutional capacity for better service delivery, re-commissioning facilities created under the project, including installation and utilisation of equipment and addressing skills, mismatches and staff vacancies in different hospitals in an imaginative way.

An International Development Association (IDA) team comprising T Nawaz, mission leader, P Kudeia and S Rao Sheshadri reviewed the implementation of the KHSDP-II between September 25 and 29, 2002 and held discussions with Mahendra Jain and senior staff members of the KHSDP in Bangalore and New Delhi.

The progress report said, "Over the course of the past year, the implementation has been fully satisfactory and the project continues to make considerable progress to management and software areas." Under the KHSDP, civil works had been completed at 183 hospitals of the 204 hospitals in Bangalore, Mysore and Belgaum divisions. The project activities were being integrated with the programmes of the Directorate of Health and Family Welfare (DOHFW) in the areas of contracts for non-clinical services, disease surveillance and implementation of the yellow card scheme to make the project more sustainable, the Bank has suggested to the KHSDP staff to strengthen software components, particularly information, education and communication (IEC).

R. Maheswarappa, KHSDP officer, told pharmabiz.com that the project was commissioned in 1996-97 with the objective of improving the performance and quality of healthcare services at the district and the sub-districts level of the healthcare system. Till November 2002, the cumulative expenditure under the project was Rs. 543 crore, which is 89 per cent of the total cost, he said. Around 380 vehicles and 118 ambulances were provided to the secondary hospitals.

The Bank is less satisfied with the award of contracts for a set of non-clinical services and waste management. The World Bank report on "Raising the sights: Better health systems for India's poor 2001", said that for better performance and compliance, it would be necessary to strengthen the capacity of the hospitals staff to supervise work and provide training to those working in more complex areas of waste management.

R Rajashekar, chief administrative officer, KHSDP said that the staff members were aware of the problems in waste management and steps would be taken soon to solve them.