India - Andhra Pradesh Health Systems Strengthening Project

Overview & Synopsis

Ratings of Andhra Pradesh Health Systems Strengthening Project for India were as follows: outcome was satisfactory, Bank performance was satisfactory, and monitoring and evaluation quality was substantial. Some of the lessons learned include: the extent to which private sector engagement is used to help achieve health sector goals is a policy decision that can change over time; Lagging projects can be turned around by consistent focus, supportive supervision, and strong commitment to project targets; Innovations in recruitment and policies to boost staff retention are possible if decision-makers have the courage and tenacity to reject long-accepted limitations; Telemedicine physician consultations as one element of digital health systems can be rolled out effectively and efficiently, providing consistent access to specialist physician advice down to the primary level of a health system, provided there is reliable power and connectivity; the PEF system was a significant innovation, going well beyond conventional patient satisfaction feedback mechanisms, and took much longer to design, test, and roll-out than had been expected; and Insights from innovative, complex projects can usefully and quickly inform the design of other projects on which the team members work.