New World Bank project to improve health services in Meghalaya, India


WASHINGTON, September 30, 2021 – The Board of Directors of the World Bank today approved a $ 40 million project, which will improve the quality of health services and strengthen the state’s capacity to manage future health emergencies, including the pandemic of COVID-19.

The Meghalaya Health Systems Strengthening Project strengthen the management and governance capacities of the State and its health establishments; expand the design and coverage of the state health insurance program; improve the quality of health services through certification and better human resource systems; and enable efficient access to drugs and diagnostics.

All 11 districts of the state will benefit from the project. It will also benefit health sector staff at primary and secondary levels by strengthening their planning and management capacities and developing their clinical skills. The project will enable women to make better use of health services at the community level.

Under-five mortality in Meghalaya was 40 deaths per 1,000 live births in 2019-2020. Stunting among those under five was 47% – a marginal increase from the previous survey (2015-16). Some districts perform better than others and there are differences between rural and urban areas, with urban areas performing better on most health indicators. Meanwhile, NCDs (including hypertension, diabetes, heart disease and cancer) account for more than half of the disease burden in the state.

The project will help strengthen the effectiveness of the Meghalaya health insurance program known as Megha Health Insurance Plan (MHIS) – which currently only covers 56% of households. With its merger with Pradhan Mantri Jan Arogya Yojna (PMJAY), MHIS now plans to offer a more complete offer and cover 100% of households. This will reduce barriers to accessing hospital services and prevent catastrophic out-of-pocket expenses for poor families.

“The Meghalaya has the distinction of performing better than the national average on many key health indicators. However, access to quality health services remains a challenge, especially in rural areas. The COVID-19 pandemic has put further strain on the state’s health systems, impacting the delivery of essential services ”, noted Junaid Ahmad, World Bank Country Director in India. “This project will support the efforts of the state government to provide quality health care to poor and vulnerable people, women and people in remote areas.

As a key strategy, the project will evolve towards a performance-based financing system where internal performance agreements (IPAs) between the DoHFW and its subsidiaries would promote greater accountability at all levels. This should go a long way in improving the management of the system in order to provide quality health services. The project will also focus on promoting synergy between different schemes and increasing the capacity of the state insurance agency.

The project will invest in infection prevention and control for a more resilient response to future epidemics, pandemics and health emergencies.

Improving health services can also lead to a gradual increase in biomedical waste. Any mismanagement of waste, including biomedical waste and other hazardous waste such as plastic waste and electronic waste, presents environmental risks. The project will invest in improving the overall ecosystem for the management of biomedical waste (both solid and liquid). It will include segregation, disinfection and collection while preserving the environment and improving the quality of health services and patient safety.

“The weak management capacity leads to a series of shortcomings affecting the quality and use of health services in Meghalaya”, noted Amith Nagaraj Bathula, Senior Operations Manager and World Bank Task Team Leader for the project. “This project will help the state to improve management capacity, quality certification in health facilities, improvement of human resources, strengthening of health insurance and other innovations.”

The $ 40 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.

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