Zeroing Stage 3 - The Health Sector

We can now look at what the MDB Health Sector lending commitments consist of - the content of those 653 health projects, in the knowledge that the profile of these projects has been well established, and, while it may change in the future, is unlikely to veer off its current course. This will be your starting point for further marketing, if some of these contents are of real interest.

The content of the 653 projects in the MDB Health Database (MHD), with a combined loan value of $37 billion and approved or planned from FY 1990 through 2008, has a number of salient features. The MHD was assembled and copyrighted by Development Bank Associates (DBA) through 2004.

The following top examples of thematic text from projects in the MHD give an picture of the complex and often overlapping content of these MDB health projects. Altogether there were 104 topics, of which the top ten are given here with indicative text, excerpted from the project data of the MDBs (copyrighted by the MDBs). To see the full list of content topics, by frequency of inclusion in MDB health projects, click here:

Capacity Building – Training (included in at least 38 percent of projects) “Capacity building activities at district and sub-district level will focus on training of DHMBs, Hospital Management Boards and Rural Health Facility Committees and focus on financial management, ensuring access to health care by the poor, drug management, community involvement, transparency and results oriented health delivery management.”

Disease Prevention and Control (22 percent) “The objectives of the project are to help in the shift from a centrally driven, vertically organized disease surveillance system to one coordinated by the center and implemented by the states, districts and communities. The project's components will: Coordinate and decentralize disease surveillance activities; Integrate and strengthen disease surveillance at the state and district levels; Improve laboratory support; and Provide training for disease surveillance and action.”

Hospital and Other Health Infrastructure (22 percent) “The project includes Strengthening of FW service delivery, including extension and upgrading of infrastructure through construction of sub-centers and Primary Health Centers and upgrading of Community Health Centers to serve as first referral units for obstetric emergencies, and strengthening of outreach and community linkages through setting up of mobile clinics and establishment of community volunteer networks.”

Health Care Services and Delivery (21 percent) “Improving Clinical Service Quality – This is to improve the quality of clinical practices by improving the skills of health providers, introducing quality assurance systems, utilizing appropriate facilities, equipment, drugs and medical supplies. A system for monitoring improvements in the quality of clinical services will be established through the adoption of a quality assurance program. At health facilities, quality assurance plans will be developed to address patient satisfaction, systematic review of medical records and referrals, clinical protocols, and technical quality assurance schemes for laboratories and equipment.”

Health Care for the Poor (17 percent) “Improving access in specially disadvantaged districts and cities will focus additional investments in 24 districts and cities where health and social indicators are much below the state's average. Investments will finance strengthening infrastructure and community mobilization. A package of essential RCH services has been defined for: Prevention and management of unwanted fertility; Management of pregnancy and childbirth; Child survival (including immunization, diarrheal and acute respiratory illness, and newborn care); and Reproductive tract infection.”

HIS/HMIS - Health Management Information Systems (14 percent) “A well-functioning HMIS will be established to improve program performance and ensure effective monitoring, regular information flows and timely feedback mechanisms by bringing together information collected under different health programs. The focus of the program will be on: accurate identification of community needs; empowering of hospital management in expansion or deletion of services based on available data; strengthening the referral system; keeping enhancing capacity and quality of data analysis; establishing a system of rapid feedback; and strengthening operational research. The HMIS will gather data on: civil works; equipment; drugs; communicable diseases; hospital activity; and financial management.”

IEC - Information, Education, Communication (17 percent) “IEC campaigns focusing on behavior modeling; commissioning and distribution of EEC materials; distribution of condoms within ministry offices at national, provincial, and district levels; distribution to all staff of information regarding available benefits; and referral to health and social services.”

MCH – Maternal and Child Health (21 percent) “The project's objectives are to improve the nutrition and health status of children under 6 years of age, with special emphasis on those 0-3 years old, and pregnant and nursing women. It will also help to improve the capacity of the Integrated Child Development Services (ICDS) to deliver services, including to tribal people, over the longer term.”

PHC – Primary Health Care (15 percent) “The project will: (1) Focus on an improved access to, and quality of health, through the refurbishment of primary health care facilities, phasing out civil works, and equipment costs over a five year period. Medical equipment will be replaced, and, additionally required equipment will be procured, such as X-ray equipment, particularly for those communities in need of diagnostic care.”

Prevention and Control of HIV/AIDS (34 percent) “Activities supported under this component include interventions intended to expand and intensify the response to the HIV/AIDS epidemic and aimed at advocacy and awareness, preventing new infections (behavior change interventions, condom use, blood safety, school education programs, voluntary counseling and testing) and mitigating the impact of the epidemic by supporting those infected and affected.”

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Last updated October 11, 2006