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India - Reproductive and Child Health

Volume 449: debated on Monday 11 September 2006

I have approved support of £252 million over five years for the second phase of the Government of India’s nationwide Reproductive and Child Health Programme. DFID will disburse £10 million in financial assistance plus a further £700,000 in technical assistance in 2006-07. Thereafter, annual disbursements will be subject to satisfactory reports on progress.

This programme will support the Government of India in tackling India’s huge burden of maternal and infant mortality. One fifth (136,000) of all maternal deaths in the world, and one quarter (1.8 million) of all infant deaths occur in India. Globally we will not reach the Millennium Development Goals to reduce these deaths unless we succeed in India. The Reproductive and Child Health Programme is the Indian Government’s single biggest response to meet this challenge. The programme aims to reduce the Maternal Mortality Ratio from 407/100,000 live births in 1998 to 100/100,000 in 2015, and the Infant Mortality Rate from 70/1000 live births in 1998 to 30/1000 in 2015. If the programme achieves all its targets, over one million lives will be saved each year.

The programme will introduce new measures to tackle concerns about procurement irregularities in the first phase of the Reproductive and Child Health Programme, which was not funded by DFID. An action plan will help strengthen competitive tendering procedures and increase transparency for the purchasing of drugs and equipment, and new standards will be introduced to improve the quality of products. Until these measures take effect, all procurement contracts over $200,000 will be handled by international agents.

The total cost of this second phase of the Reproductive and Child Health Programme is around £5 billion, which the Indian central and state Governments will meet the bulk of. External aid will be around 15 per cent. of the overall budget, with the single largest contribution coming from DFID. Our aid is being fully coordinated with other development partners, including the World Bank.

The Reproductive and Child Health Programme is universal in coverage, and it will provide care through pregnancy, childbirth and childhood. But resources will be targeted on India’s poorest states, including Uttar Pradesh, Bihar, Orissa, and Madhya Pradesh and will especially target women and children among the poorest and most marginalised families, in Scheduled Castes and Scheduled Tribes.

DFID’s financial support will be used for upgrading maternity facilities; increasing skilled attendance at birth; the purchase of essential drugs, equipment, supplies and contraceptives; staff training; communications; the piloting of new ideas; and assessing the impact of the programme. DFID technical assistance will finance a National Health Systems Resource Centre, which will provide overall technical assistance to the Programme at central and state level, and strengthen health sector procurement.

This second phase of the programme is ambitious and will require a huge expansion in the delivery of public sector health services, to tackle some of the country’s biggest health problems. It also includes a number of additional accountability and financial management safeguards to strengthen the Government’s anti-corruption systems. The programme will be monitored closely by the Indian Government and development partners, through reviews every six months. A copy of the Project Memorandum for the DFID contribution has been deposited in the Library of the House.