The US$ 48 million Nagaland Health Project will empower village health committees to deliver better health service delivery across the state and strengthen existing health systems and public health facilities. This will include capacity-building and results-based financing for village health committees, who are responsible for local health services, to improve services as well as enhance the knowledge and awareness of their communities. The project will also invest in improving health services in 177 facilities, including through water and sanitation and off-grid electricity backup. The project will strengthen statewide health system components, including information, procurement and supply chain management, and human resource management systems.
The agreement for the project was signed by Raj Kumar, Joint Secretary, Department of Economic Affairs, Ministry of Finance, on behalf of the Government of India; L. Watikala, Principal Director, Department of Health and Family Welfare, Government of Nagaland; and Genevieve Connors, Program Leader and Acting Country Director, World Bank India, on behalf of the World Bank.
"The project will help the Government of Nagaland improve the efficiency, quality and accountability of its health services by strengthening the Health Department's management and systems capacity, its governance and accountability mechanisms, as well as its ability to engage effectively with health committees at the village level. This will be done by complementing existing activities of both the state and the National Health Mission," said Raj Kumar, Joint Secretary, Department of Economic Affairs, Ministry of Finance.
Apart from state-wide investments to improve health systems, the project will focus on building knowledge and skills of Village Health Committees, including fostering involvement of women's groups, to manage and oversee health services for their communities. An incentive strategy will be used whereby funding will be provided to communities on the basis of progress on defined indicators of improved health and nutrition-related services and practices. In turn, communities will use the grants for activities and investments that are important to them and which have impacts on health and nutrition.
"Strengthening health and nutrition service delivery systems both at the local and at the state level will go a long way in improving the quality of health care services in Nagaland," said Genevieve Connors, Program Leader and Acting Country Director for World Bank in India. "We also hope the project will benefit from the World Bank's experience over the years in financing health system development projects globally as well as across several Indian states."
Another key initiative of the project will be to improve the conditions of health facilities for both staff and patients. Frequent outages of power supply in health centers and lack of safe drinking water and inadequate sanitation are not only undermining the quality of health services in the state but also reduce patient demand for services while affecting the working conditions and motivation of health staff.
Sunlight, altitude, and temperature conditions in Nagaland make solar energy a cost-effective option to ensure reliable power supply for health services. The project will invest in off-grid electrical power solutions adapted to the needs of each targeted health facility. It will also support installation of solar water pumps and water heaters in these facilities. At least 100 health facilities are expected to benefit from improved power supply.
Existing water supply piping and storage facilities will be repaired and upgraded while rooftop water harvesting systems will be installed in targeted health facilities. At least 125 health facilities are expected to benefit from improved water and sanitation.
"The project will support both community-level and statewide capacity to improve delivery of essential health services in Nagaland," said Patrick Mullen, Senior Health Specialist, World Bank and World Bank's Task Team Leader for the project.
The credit is from the International Development Association (IDA) - the World Bank's concessionary lending arm - with a maturity of 25 years, including a 5-year grace period.