Model Districts as a Roadmap for Public Health Scale-up in India

Abstract

While India has experienced some improvements in health indicators in recent years in terms of Millennium Development Goals 1, 4, and 5, the country still has some of the lowest indicators for reproductive and child health in the world. Public investment in primary health care must increase to achieve health targets, and the health system needs to be reformed to ensure efficient and effective delivery of high quality health services. While the Government of India's National Rural Health Mission (NRHM), launched in 2005, has made great strides in improving access to quality primary healthcare in rural areas, significant gaps remain. The Model Districts project is a joint initiative between the Earth Institute, Columbia University, and the Ministry of Health and Family Welfare, Government of India. Its goal is to demonstrate which health and nutrition interventions are required to narrow policy practice gaps in the NRHM in five regionally representative districts across India. The project's strategy is to target interventions and additional public health spending at the intersection of the six building blocks of health systems strengthening (infrastructure, data management, governance, financing, supply chain management, and frontline health worker capacity) and five areas along the continuum of care for mothers and children (antenatal care, safe delivery, immediate postnatal care, early childhood development and nutrition, and routine and sick child care). The Model Districts scale‐up model is supported by a robust baseline and monitoring and evaluation plan, pilot interventions at the block level, growth and expansion to the district level based on learning exchanges within and across districts, and finally national level scale‐up through policy adaptation and replication. This working paper signifies the beginning of the Model Districts project's contribution to research on the health system strengthening requirements for rural India, and is intended for use in policy making and health programming

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