Public Healthcare Infra: India Gets $1 Billion from World Bank

Context

The Centre and the World Bank have signed two $500 million complementary loans to support and enhance the country’s health sector development.

Relevance:

GS Paper-2: Bilateral, regional and global groupings and agreements involving India and/or affecting India’s interests, India and its neighborhood- relations

Mains Question

How will World Bank loans help and improve India’s health sector development, particularly the Pradhan Mantri-Ayushman Bharat Health Infrastructure Mission (PM-ABHIM)? Comment (150 words).

Key Highlights

• The World Bank will provide $1 billion in joint financing to India’s flagship Pradhan Mantri-Ayushman Bharat Health Infrastructure Mission (PM-ABHIM).
• The Ayushman Bharat mission, which will be launched in October 2021, aims to improve public healthcare infrastructure across the country.
• The two loans are from the International Bank for Reconstruction and Development (IBRD) and have a total maturity of 18.5 years, including a 5-year grace period.

Service in 7 States

• In addition to national-level initiatives, the World Bank stated that one of the loans would prioritise healthcare service delivery in Andhra Pradesh, Kerala, Meghalaya, Odisha, Punjab, Tamil Nadu, and Uttar Pradesh.
• The two projects support India’s decision to strengthen the country’s health-care systems’ resilience and preparedness for future pandemics.
  • This will benefit the populations of the states participating in the projects and will have a positive spillover effect on other states.

Ayushman Bharat Health Infrastructure Mission of the Government of India

• On February 1, 2021, the ‘Atmanirbhar Swasth Bharat Yojana’ (PMASBY) scheme was renamed the ‘PM-Ayushman Bharat Health Infrastructure Mission’ (PM-ABHIM) for a six-year period, until fiscal year 2025-2026).
• The scheme’s measures are aimed at strengthening health systems and institutions at all levels of care, including primary, secondary, and tertiary care, as well as preparing health systems to respond effectively to current and future pandemics/disasters.

The PM-ABHIM scheme includes the following components:

o Centrally Sponsored Components:

1. Support for 17,788 rural Health and Wellness Centers in 10 High Focus States.
2. Creating 11,024 urban Health and Wellness Centers across all states.
3. There are 3382 Block Public Health Units in 11 High Focus states. Support for other states/UTs is available through the XV Finance Commission Health Sector Grants and NHM.
4. Establishment of Integrated Public Health Laboratories in all districts.
5. Creating Critical Care Hospital Blocks in all districts with a population of more than 5 lakh people.
   1. Central Sector Components: 1. 12 Central Institutions as training and mentoring sites, with 150-bed Critical Care Hospital Blocks; 2. Strengthening of the National Center for Disease Control (NCDC), 5 New Regional NCDCs, and 20 Metropolitan Health Surveillance Units;
6. 3. Expansion of the Integrated Health Information Portal to all States/UTs to connect all public health labs; 4. Operationalization of 17 new Public Health Units and strengthening of 33 existing Public Health Units at Points of Entry, which includes 32 airports, 11 seaports, and 7 land crossings; 5. Establishment of 15 Health Emergency Operation Centers and 2 container-based mobile hospitals; and 6. Establishment of a national institution for One Health, 4 New National Institutes

Life Expectancy

• According to the World Bank, India’s life expectancy has increased from 58 in 1990 to 69.8 in 2020, which is higher than the average for its income level.
• Additionally, the under-five mortality rate (36 per 1,000 live births), infant mortality rate (30 per 1,000 live births), and maternal mortality ratio (103 per 100,000 live births) are all in line with India’s income level.
• The COVID-19 pandemic has highlighted the importance of revitalising, reforming, and developing capacity for critical public health functions, as well as improving the quality and breadth of health services.

Two Programmes:

• The Public Health System for Pandemic Preparedness Programme, which has a budget of $500 million, will aid the government’s initiatives to equip the country’s surveillance system to effectively identify and report “epidemics of potential international concern”.
• In contrast, the Enhanced Health Service Delivery Programme, with a $500 million budget, will bolster the government’s efforts to improve healthcare service delivery through a restructured primary healthcare model that improves household access to primary healthcare facilities. o The programme will also improve the quality of care by supporting certification.

Conclusion

• The COVID-19 pandemic served as a stark reminder that pandemic preparedness is a global public good, highlighting the critical need for pandemic preparedness and health system improvement around the world.
• The two projects are assisting India in its decision to strengthen the health system’s capacity to withstand potential pandemics.
• This decision will have a significant positive impact on the individuals in the participating states as well as positive spillover effects on other states.