LUCKNOW: Sore with the “unsatisfactory” performance of the Uttar Pradesh Health System Development Project (UPHSDP), its funding body the World Bank (WB) has effected a major re-structuring of the project whose five-year tenure ended on December 31.The WB has now restricted the project scope from 28 districts to a two-year pilot venture comprising four districts imitating National Rural Health Mission in terms of strategies and objectives.

Significantly, the next two years will be testing for the UPHSDP as its performance in execution of the pilot project would decide its extension to a full five-year term.

The decision of the WB to tone down the working of the project, appears justified in the light of facts mentioned in the performance assessment report, based on the observation of its experts who visited the state capital in September.

The marking was done on the basis of several pre-decided indicators which were examined by an expert group headed by B Sarenson at some health facilities visited by the team.

According to the report, the UP unit had disbursed only 43.4 per cent of the amount credited to the project. Significantly, the original amount credited to UP and Uttaranchal from its inception date July 26, 2000, was $91.5 million.

After the bifurcation of the state, the amount was revised to $76.2 million, of which only $33.1 million were disbursed.Another significant indicator was “improved health facility, quality and efficiency”, for which the report says, “there was a small increase in the number of inpatient and out-patient visits to the renovated facilities.

But the share of female patients was declining and that the number of institutional deliveries was also going down.” The team concluded, “the project progress remains unsatisfactory and the objective of is unlikely to be achieved.”

The report identified tardy pace of civil work as the major tumbling block. “Of all the 91 facilities constructed under the project, not a single could be completed within the allocated time,” said the report.

Providing equipments for these health facilities was another major responsibility undertaken by the project. But other than procurement, nothing was done. “A quality audit of the equipments delivery and use was planned but is yet to be carried out,” revealed the report.

When contacted, project director Shailesh Krishna defended his team. “The rating is biased. It is largely based on disbursement of funds which is overshadowing our work,” he complained. He admitted that the team had been slow initially with regard disbursement of the funds.

“There were some basic problems in the execution of the schemes and plans during the first three years but corrective measures were taken soon after and the loss has been made up,” he claimed.

A senior official in the health department, who attended the review meeting, told TOI that the biggest reason for the poor performance was “hiccuped implementation of the plans and schemes at the primary level”.

“The work at the district level was coordinated by a district project manager (DPM), equal in rank with a deputy-chief medical officer.

But he found it practically difficult to “direct” a chief medical superintendent (CMS) at the district hospital because he/she was senior to him. The working could not synchronise and therefore suffered,” he explained.

By Anupama

Leave a Reply

Your email address will not be published. Required fields are marked *