Development Projects : Tamil Nadu Health System Reform Program

Abstract*

The development objective of the Tamil Nadu Health System Reform Program Project for India is to improve quality of care, strengthen management of non‐communicable diseases and injuries, and reduce inequities in reproductive and child health services in Tamil Nadu.The proposed Program contributes to the attainment of Sustainable Development Goal (SDG) 3 and the Health, Nutrition and Population Global Practice goal of ending preventable deaths and... Show More

Development Objective

The Program Development Objective (PDO) is to improve quality of care, strengthen management of non-communicable diseases and injuries, and reduce inequities in reproductive and child health services in Tamil Nadu.

Key Details

Project Details

Project ID
P166373
Status
Closed
Team Leader
Dinesh Nair , Aarushi Bhatnagar, Rahul Pandey
Borrower 2
Government of India

Country
India
Disclosure Date
April 27, 2018
Approval Date
(as of board presentation)
March 19, 2019
Effective Date
July 29, 2019

Total Project Cost 1
US$ 5515.00 million
Implementing Agency
Department of Finance,Department of Health and Family Welfare, Government of Tamil Nadu
Region
South Asia
Fiscal Year 3
2019

Commitment Amount
US$ 287.00 million
Environmental Category
N/A
Last Update Date
May 14, 2024
Closing Date
May 31, 2024

Consultant Services required
No
Last Stage Reached
BANK APPROVED

Notes
1. Total project cost includes funding from World Bank and non-bank sources in US$ millions. Active and Closed projects show current commitments. Proposed (pipeline) and dropped projects show the forecast amount. The commitment amount for projects in the pipeline is indicative and may be modified during the project preparation.
2. Borrower refers to the Borrower of a Loan or Recipient of a Grant.
3. ”Fiscal Year” is the fiscal year in which the project was approved (or dropped if the status is dropped). The World Bank's fiscal year is from July 1 - June 30. For example, a fiscal year of 1996 corresponds to July 1, 1995 - June 30, 1996.

Sectors

Themes

FY17 - Environment and Natural Resource Management

FY17 - Climate change4%
- FY17 - Adaptation4%

FY17 - Human Development and Gender

FY17 - Disease Control30%
- FY17 - Non-communicable diseases30%
FY17 - Health Systems and Policies83%
- FY17 - Child Health20%
- FY17 - Health Service Delivery63%
- FY17 - Health System Strengthening63%
- FY17 - Reproductive and Maternal Health20%

FY17 - Social Development and Protection

FY17 - Social Inclusion5%
- FY17 - Participation and Civic Engagement5%

Project Map

Interactive Map

Finances

Financing Plan (US$ Millions)

Financier	Commitments
International Bank for Reconstruction and Development	287.00
Borrower/Recipient	4990.75

Total Project Financing (US$ Millions)

Product Line	IBRD/IDA
IBRD Commitment	287.00
IDA Commitment	N/A
IBRD + IDA Commitment	287.00

Lending Instrument
Grant Amount	N/A
Total Project Cost**	5515.00

Summary Status of World Bank Financing (US$ Millions) as of February 28, 2025

No data available.

Detailed Financial Activity as of February 28, 2025

Download:

Period	Financier	Transaction Type	Amount (US$)
Jun 17, 2022	IBRD-89340	Loan Disb	18,845,350.00
Feb 15, 2022	IBRD-89340	Loan Disb	23,750,000.00
Aug 30, 2022	IBRD-89340	Loan Disb	14,655,250.00
Jan 25, 2022	IBRD-89340	Loan Disb	40,497,000.00
Nov 15, 2022	IBRD-89340	Int Charges	1,610.64
Nov 15, 2022	IBRD-89340	Int Charges	5,966.48
Nov 15, 2022	IBRD-89340	Int Charges	173,652.67
Nov 15, 2022	IBRD-89340	Int Charges	2,199,080.50
Nov 15, 2022	IBRD-89340	Int Charges	362,083.84
Mar 22, 2023	IBRD-89340	Loan Disb	10,260,000.00
May 17, 2023	IBRD-89340	Loan Disb	11,187,000.00
Sep 13, 2023	IBRD-89340	Loan Disb	5,013,600.00
Jul 12, 2023	IBRD-89340	Loan Disb	13,228,000.00
May 15, 2023	IBRD-89340	Int Charges	225,543.52
May 15, 2023	IBRD-89340	Int Charges	152,271.10
May 15, 2023	IBRD-89340	Int Charges	4,327,180.00
Nov 7, 2023	IBRD-89340	Loan Disb	4,035,000.00
Nov 15, 2023	IBRD-89340	Int Charges	3,794.79
Nov 15, 2023	IBRD-89340	Int Charges	182,512.97
Nov 15, 2023	IBRD-89340	Int Charges	117,976.34
Nov 15, 2023	IBRD-89340	Int Charges	6,203,470.50
May 15, 2024	IBRD-89340	Int Charges	43,269.20
May 15, 2024	IBRD-89340	Int Charges	102,180.56
May 15, 2024	IBRD-89340	Int Charges	6,929,153.00
May 15, 2024	IBRD-89340	Loan Repay	7,210,234.00
May 15, 2024	IBRD-89340	Int Charges	221.09
Jun 28, 2024	IBRD-89340	Loan Disb	18,106,000.00
May 14, 2024	IBRD-89340	Loan Disb	5,157,000.00
Mar 19, 2019	IBRD-89340	Loan Commitment	287,000,000.00
Nov 15, 2019	IBRD-89340	Int Charges	7,473.17
Nov 15, 2019	IBRD-89340	Int Charges	203,767.38
Nov 4, 2019	IBRD-89340	Loan Disb	2,122,000.00
Jul 29, 2019	IBRD-89340	Loan Disb	717,500.00
Jul 29, 2019	IBRD-89340	Fee Charges	717,500.00
Apr 27, 2020	IBRD-89340	Loan Disb	49,901,500.00
May 15, 2020	IBRD-89340	Int Charges	159.88
May 15, 2020	IBRD-89340	Int Charges	2,070.57
May 15, 2020	IBRD-89340	Int Charges	347,374.16
May 15, 2020	IBRD-89340	Int Charges	40,338.24
Nov 15, 2020	IBRD-89340	Int Charges	6,135.43
Nov 15, 2020	IBRD-89340	Int Charges	63,976.18
Nov 15, 2020	IBRD-89340	Int Charges	294,423.88
Nov 15, 2020	IBRD-89340	Int Charges	423,217.22
Jun 30, 2021	IBRD-89340	Loan Disb	5,000,000.00
May 15, 2021	IBRD-89340	Int Charges	290,210.90
May 15, 2021	IBRD-89340	Int Charges	304,945.53
Nov 15, 2021	IBRD-89340	Int Charges	290,127.10
Nov 15, 2021	IBRD-89340	Int Charges	325,093.80
May 15, 2022	IBRD-89340	Int Charges	552,635.80
Aug 31, 2021	IBRD-89340	Loan Disb	725,000.00
May 15, 2022	IBRD-89340	Int Charges	236,719.73
Mar 28, 2022	IBRD-89340	Loan Disb	4,899,000.00

Footnotes

Ratings

IMPLEMENTATION RATINGS

Name	Review	Date
Monitoring and Evaluation	Satisfactory	2024-05-23
Overall Implementation Progress (IP)	Satisfactory	2024-05-23
Progress towards achievement of PDO	Satisfactory	2024-05-23

COMPLETION RATINGS

No data available.

INDEPENDENT EVALUATION RATINGS

No data available.

Results Framework

PROJECT DEVELOPMENT OBJECTIVE INDICATORS

INDICATOR		BASELINE	CURRENT	TARGET

Increased number of public facilities with quality certification (primary, secondary, and tertiary)	Value	(i) Tertiary facilities with entry level NABH accr	i) Tertiary facilities with entry level NABH accre	(i) Tertiary facilities with entry level NABH cert
	Date	November 1, 2018	May 10, 2024	July 1, 2024
	Comment

Improved scores in quality score card for primary, secondary, and tertiary level facilities	Value	NA – to be measured after quality dashboard is est	65	65
	Date	November 1, 2018	May 10, 2024	July 1, 2024
	Comment

Increased share of adults with hypertension or diabetes whose blood pressure or blood sugar are under control	Value	Hypertension under control:7.3%Diabetes under con	Hypertension under control:17%Diabetes under co	Hypertension under control: 3 percentage point inc
	Date	April 30, 2021	May 10, 2024	July 1, 2024
	Comment

Increased utilization of reproductive and child health services in priority districts	Value	(i) Full ANC: 28.8% (ii) Fully immunized: 57.9%	(i) Full ANC: 41.3%(ii) Fully immunized: 70.4% (	(i) Full ANC: 41.3% (ii) Fully immunized: 70.4%
	Date	November 1, 2018	May 10, 2024	July 1, 2024
	Comment

Increased screening in public sector facilities for cervical and breast cancers	Value	Cervical cancer: 15.8%Breast cancer: 19.5%	Cervical cancer: 17%Breast cancer: 23%	Cervical cancer: 16%Breast cancer: 19%
	Date	November 1, 2018	May 10, 2024	July 1, 2024
	Comment

Tertiary facilities with entry level NABH certification Value 0 3 4
Date November 1, 2018 May 10, 2024 July 1, 2024
Comment
Hypertension under control Value 7.3% 17% 3 percentage point increase from baseline - 10.3%
Date April 30, 2021 May 10, 2024 July 1, 2024
Comment
Full ANC Value 28.80 41.30 41.30
Date November 1, 2018 May 10, 2024 July 1, 2024
Comment
Cervical cancer Value 15.80 17.00 16.00
Date November 1, 2018 May 10, 2024 July 1, 2024
Comment
Secondary facilities with NQAS certification Value 3 75 out of which 15 are in the priority districts 70 of which 14 are in the priority districts
Date November 1, 2018 May 10, 2024 July 1, 2024
Comment
Diabetes under control Value 10.8% 16.7% 6 percentage point increase from baseline - 16.8%
Date April 30, 2021 May 10, 2024 July 1, 2024
Comment
Fully immunized Value 57.90 70.40 70.40
Date November 1, 2018 May 10, 2024 July 1, 2024
Comment
Breast cancer Value 19.50 23.00 19.00
Date November 1, 2018 May 10, 2024 July 1, 2024
Comment

Improved provision of quality trauma care services	Value	(i) # of trauma centers using trauma registry: 0(	i) # of trauma centers using trauma registry: 54(	(i) # of trauma centers using trauma registry: 54
	Date	November 1, 2018	May 10, 2024	July 1, 2024
	Comment

Primary facilities with NQAS certification Value 4 300 out of which 60 are in priority districts 300 of which 60 are in the priority districts
Date November 1, 2018 May 10, 2024 July 1, 2024
Comment
mCPR Value 38.50 43.50 43.50
Date November 1, 2018 May 10, 2024 July 1, 2024
Comment
# of trauma centers using trauma registry Value 0 54 54
Date November 1, 2018 May 10, 2024 July 1, 2024
Comment
% of surgical ED admissions Value 45.9% 85% 55%
Date March 31, 2021 May 10, 2024 July 1, 2024
Comment

INTERMEDIATE RESULTS INDICATORS

INDICATOR		BASELINE	CURRENT	TARGET

Implementation of quality improvement interventions in primary, secondary, and tertiary care facilities	Value	(i) Number of primary, secondary, and tertiary lev	(i) Number of primary, secondary, and tertiary lev	(i)Number of facilities implementing at least 1 en
	Date	November 1, 2018	May 10, 2024	July 1, 2024
	Comment

Strengthened content, quality, accessibility, and use of data for decision making	Value	Conceptual Model and Operational Plan for a streng	Population health registry under roll out in 1 dis	Population health registry developed and rolled ou
	Date	November 1, 2018	May 10, 2024	July 1, 2024
	Comment

Implementation of updated social and behavior change communication (SBCC) strategy Value No Yes Yes
Date November 1, 2018 May 10, 2023 July 1, 2024
Comment
Piloting of patient experience questionnaire for secondary & tertiary care facilities Value 0.00 5.00 5.00
Date November 1, 2018 May 10, 2024 July 1, 2024
Comment

Strengthened coordination, integration, performance-based management, learning, and other cross-cutting functions for better results	Value	Policies/Strategies: NoInstitutional systems: No	(i) Process for call for proposal and award for ye	(i) 1 annual call for research proposals issued an
	Date	November 1, 2018	May 10, 2024	July 1, 2024
	Comment

People who have received essential health, nutrition, and population (HNP) services Value 0.00 4082246.00 3600000.00
Date March 29, 2019 May 10, 2024 July 1, 2024
Comment
Increased share of primary & secondary facilities with at least one staff trained on mental health Value 0.00 41.05 40.00
Date November 1, 2018 May 10, 2024 July 1, 2024
Comment

Increased transparency and accountability through citizen engagement (voice, agency, and social accountability)	Value	Districts conducting Health Assembly: 0%.State He	DHA for 63% districts and 1 SHA completed	Districts conducting Health Assembly: 60%.State H
	Date	November 1, 2018	October 30, 2023	July 1, 2024
	Comment

Establishment of suicide hotline Value No Yes Yes
Date November 1, 2018 May 10, 2024 July 1, 2021
Comment
Better equipped ambulance system to improve pre-hospital care -number of ATLS ambulances providing Level 1 care Value 64.00 205.00 164.00
Date November 1, 2018 May 10, 2024 July 1, 2024
Comment
Number of children immunized Value 0.00 4082246.00 3600000.00
Date March 29, 2019 May 10, 2024 July 1, 2024
Comment
Districts conducting Health Assembly Value 0% 63% ( 24 districts) 60%
Date November 1, 2018 May 10, 2024 July 1, 2024
Comment

Improved capacity of trauma care providers - number of emergency department providers that received Level 3 (BTLS) and Level 4 training (ATLS)	Value	Level 3: Nurses - 165; Doctors - 100.Level 4: Nur	Level 3: Nurses - 6909; Doctors - 4537.Level 4: N	Level 3: Nurses - 6120; Doctors - 4313.Level 4: N
	Date	November 1, 2018	May 10, 2024	July 1, 2024
	Comment

State Health Assembly Value 0 1 1
Date November 1, 2018 May 10, 2024 July 1, 2024
Comment

Hypertension under control	Value	7.3%	17%	3 percentage point increase from baseline - 10.3%
	Date	April 30, 2021	May 10, 2024	July 1, 2024
	Comment

Full ANC	Value	28.80	41.30	41.30
	Date	November 1, 2018	May 10, 2024	July 1, 2024
	Comment

Cervical cancer	Value	15.80	17.00	16.00
	Date	November 1, 2018	May 10, 2024	July 1, 2024
	Comment

Secondary facilities with NQAS certification	Value	3	75 out of which 15 are in the priority districts	70 of which 14 are in the priority districts
	Date	November 1, 2018	May 10, 2024	July 1, 2024
	Comment

Diabetes under control	Value	10.8%	16.7%	6 percentage point increase from baseline - 16.8%
	Date	April 30, 2021	May 10, 2024	July 1, 2024
	Comment

Fully immunized	Value	57.90	70.40	70.40
	Date	November 1, 2018	May 10, 2024	July 1, 2024
	Comment

Breast cancer	Value	19.50	23.00	19.00
	Date	November 1, 2018	May 10, 2024	July 1, 2024
	Comment

Primary facilities with NQAS certification	Value	4	300 out of which 60 are in priority districts	300 of which 60 are in the priority districts
	Date	November 1, 2018	May 10, 2024	July 1, 2024
	Comment

mCPR	Value	38.50	43.50	43.50
	Date	November 1, 2018	May 10, 2024	July 1, 2024
	Comment

% of surgical ED admissions	Value	45.9%	85%	55%
	Date	March 31, 2021	May 10, 2024	July 1, 2024
	Comment

Piloting of patient experience questionnaire for secondary & tertiary care facilities	Value	0.00	5.00	5.00
	Date	November 1, 2018	May 10, 2024	July 1, 2024
	Comment

Establishment of suicide hotline	Value	No	Yes	Yes
	Date	November 1, 2018	May 10, 2024	July 1, 2021
	Comment

Better equipped ambulance system to improve pre-hospital care -number of ATLS ambulances providing Level 1 care	Value	64.00	205.00	164.00
	Date	November 1, 2018	May 10, 2024	July 1, 2024
	Comment

Number of children immunized	Value	0.00	4082246.00	3600000.00
	Date	March 29, 2019	May 10, 2024	July 1, 2024
	Comment

Districts conducting Health Assembly	Value	0%	63% ( 24 districts)	60%
	Date	November 1, 2018	May 10, 2024	July 1, 2024
	Comment

State Health Assembly	Value	0	1	1
	Date	November 1, 2018	May 10, 2024	July 1, 2024
	Comment

Abstract*

Development Objective

Key Details

Project Details

Sectors

Themes

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Project Map

Finances

Financing Plan (US$ Millions)

Total Project Financing (US$ Millions)

Summary Status of World Bank Financing (US$ Millions) as of February 28, 2025

Detailed Financial Activity as of February 28, 2025

Ratings

IMPLEMENTATION RATINGS

COMPLETION RATINGS

INDEPENDENT EVALUATION RATINGS

Results Framework

PROJECT DEVELOPMENT OBJECTIVE INDICATORS

INTERMEDIATE RESULTS INDICATORS