The government of India, government of Karnataka and the World Bank have inked a $70 million additional credit agreement for the ongoing Karnataka Health System Development and Reform Project (KHSD&RP) to further support improvements in health service delivery, particularly for the benefit of underserved areas and vulnerable groups.

The project builds on the successful experience of the original $141.83 million project. Since 2006, the project has contributed to development of the state’s health system, including improving administrative capacity and planning, investing in maternal health services, contracting non-governmental organisations (NGOs) to run mobile health clinics, supporting community-level public health interventions, and contributing to a state government scheme that purchases hospital services for poor beneficiaries from accredited public and private hospitals.

The project is financed by a credit from the International Development Association (IDA) which is the World Bank’s concessionary lending arm offering interest-free loans with 25 years to maturity and a grace period of five years.

The agreement for the Karnataka Health System Development and Reform Project was signed by Prabodh Saxena on behalf of the government of India, Vishal R, Project Administrator, on behalf of the government of Karnataka and Onno Ruhl, World Bank Country Director for India on behalf of the World Bank.

The project has contributed to progress in a number of health indicators including the proportion of births delivered in a health facility has risen from 65 per cent in 2005-06 to 86 per cent in 2009. The proportion of children fully immunized has increased from 55 per cent in 2005-06 to 78 per cent in 2009 apart from 96 operational mobile health clinics.

According to a 2011 health facility survey, 83 per cent of public health centres (PHCs) had a doctor present at the time of the survey, compared to only 35 per cent in 2004; in 2011, 89 per cent of PHCs had a functional labour room, compared to 67 per cent in 2004.  Currently, over 1000 PHCs across the state function 24 hours a day.

Currently, 19,000 poor patients have benefited from tertiary-level hospital services.“The additional financing will continue to support the state government’s strategy to improve health services in the areas of primary and maternal health care, quality assurance, public-private contracting, and purchasing of hospital services for the poor,” said Prabodh Saxena, joint secretary, Department of Economic Affairs, Ministry of Finance.

“The project will also support new strategies for non-communicable disease control and road safety,” he added.

“Over the past two decades Karnataka has made significant progress in the health sector but disparities in basic health services still exist. “This project, we hope, will continue to contribute to the government's efforts at improving health services for mothers and children, particularly among poor and vulnerable populations,” said Onno Ruhl, World Bank Country Director for India.