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India - Second Reproductive and Child Health Project (Inglês)

Ratings for the Second Reproductive and Child Health (RCH) Project for India were as follows: outcomes were moderately satisfactory, the risk to development outcome was low or negligible, the Bank performance was moderately satisfactory, and the Borrower performance was also moderately satisfactory. Some lessons learned included: one key learning from the project was that demand-side interventions (such as Janani Suraksha Yojana - JSY) are important and possibly necessary, but not sufficient conditions for quality enhancement. Going forward, additional efforts are needed to strengthen the quality of the RCH services, in addition to those already underway (such as accreditation, third party review, quality improvements at clinic level, team based training and reviews, strengthened skill trainings such as SBA (Skilled Birth Attendance) and IMNCI (Integrated Management of Neonatal and Childhood Illness), etc). Despite the fact that health is a state subject in decentralized India, the financing model followed by RCH II and NRHM (National Rural Health Mission), whereby federal budget allocations were tied to specific reforms and strengthening state and district-level capacities, greatly enabled wide-spread policy reforms. Further, the provision of some flexible funds went a long way in enabling innovations at state and district levels. The project enabled countless innovations in service delivery models, especially at state and district-levels. This is one of the key success factors for the project, and it will not have been possible without the flexible funds at decentralized levels. Future projects may benefit from a similar approach. Since most of the program targets were achieved well before the end of the project and many were surpassed, the question remains whether the targets could have been set higher and whether these could have been adjusted upwards at the time of restructuring? However, at the time of restructuring, data from Third District Level Household Survey (DLHS 3) was only available, which had shown modest improvements given that it measured only the first 2 years of progress. This highlights the need for timely and accurate datasets to be available for target setting and results monitoring.


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    India - Second Reproductive and Child Health Project

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    Governance and Accountability Action Plan;Reproductive and Child Health;millennium development goal;maternal and child health;children fully immunized;unmet need for contraception;expanding public private partnerships;annual population growth rate;Maternal and Child Mortality;united nations population fund;integrated management;sanitation committee;population and reproductive health;access to family planning;gaps in service provision;economic and financial analysis;quality of care;assessment of risk;financial management capacity;cold chain equipment;acute flaccid paralysis;family planning targets;Financial Management System;financial management manual;power and water;choice of service;number of beneficiaries;supervision of state;pool of fund;procurement and distribution;lack of competition;quality of audit;delay in procurement;providing universal access;review of allegations;cash transfer scheme;lack of authority;assessment of outcome;behavior change communication;Rural Health Care;innovation in service;family planning program;social and gender;series of workshops;adoption of contraception;promotion of health;accountability for outcomes;infant mortality rate;outputs by components;reproductive age group;Exchange Rates;emergency obstetric care;Sexually transmitted diseases;public health service;maintaining gender balance;polio eradication;vulnerable group;procurement procedure;state ownership;field visits;



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