Document of
                    The World Bank


                                                 Report No: 71706 v1




                 RESTRUCTURING PAPER

                         ON A

            PROPOSED PROJECT RESTRUCTURING
                          OF
KARNATAKA HEALTH SYSTEM DEVELOPMENT AND REFORM PROJECT

                      JULY 15, 2006


                        TO THE

                 GOVERNMENT OF INDIA


                      JULY 31, 2012
  INDIA: KARNATAKA HEALTH SYSTEM DEVELOPMENT AND REFORM PROJECT

                              RESTRUCTURING PAPER



1.      The closing date for the Karnataka Health System Development and Reform
Project (KHSDRP) (Credit No. 4229-IN) (P071160) will be extended from September
30, 2012 to March 31, 2013.

2.      The Project Development Objective (PDO) is to increase utilization of essential
health services (curative, preventive and public health), particularly in underserved areas
and among vulnerable groups. The project combines capital investment activities with
support for policy reforms and innovative health financing and service delivery
mechanisms. Project performance is satisfactory and objectives continue to be
achievable. PDO indicators have shown significant progress: the proportion of births
delivered in a health facility has risen from 65% in 2005-06 to 86% in 2009 (with an end-
project target of 90%); the proportion of children fully immunized has increased from
55% in 2005-06 to 78% in 2009 (against a target of 80%); 96 mobile health clinics are
operational (against a target of 97); and the number of claims paid by a health insurance
pilot program benefiting poor households is 19,199 (far exceeding the target of 7,500).

3.       The proposed extension is necessary to allow time for processing and clearances
of the government’s request for additional financing and extension of the project. Project
activities will continue during this period.

4.     This will be the second extension of the project, with the total extension period
being 12 months.




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