ADB Loan Supports Program to Improve Urban Health in India

The Asian Development Bank (ADB) has approved a $300 million loan to support India's National Urban Health Mission, the government program launched in May 2013 to strengthen health service delivery in urban areas of the country.

India has made good progress toward improving health services in rural areas, but over 77 million urban poor and vulnerable still have limited access to basic health services such as child immunization, said Sungsup Ra, Director of the South Asia Human and Social Development Division at ADB. The National Urban Health Mission is meant to change that.

India is urbanizing rapidly. This has caused massive growth in the number of urban poor and large health disparities.

For example, poor urban children under 5-years of age are almost twice as likely to die than their non-poor counterparts, according to India's latest National Family Health Survey, due to adverse living conditions and limited access to health services, despite living close to many hospitals. This vulnerable segment of the population cannot afford the private health providers that dominate urban areas and often incur out-of-pocket health expenses that drive them even deeper into poverty. There are also very few preventive and health promotion services.

The National Urban Health Mission aims to strengthen health systems across cities and towns to deliver quality health services for all, targeting the poor and vulnerable. The loan will support this government effort using results-based lending to enhance implementation and improve its systems.

Among other activities, the loan will help strengthen the networks of primary health facilities in urban areas and introduce a quality assurance mechanism for them. It will help improve planning, management, and innovation and knowledge sharing, aiming to replicate best practices in delivering urban health services. The program will also promote better coordination between health and other urban sectors, and explore opportunities for public-private partnerships.

The funds will be disbursed over the next 3 years subject to achievement of results, which include more births in health facilities and higher childhood immunization rates. The loan period is 25 years, with a grace period of 5 years. The loan will be complemented by a $2 million technical assistance grant provided by the Japan Fund for Poverty Reduction and administered by ADB to strengthen program implementation in selected states.

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