From medicines to patient care: Meghalaya's health system shows major gains, says World Bank

ROOPAK GOSWAMI

SHILLONG, June 8: The World Bank has upgraded its assessment of the Meghalaya Health Systems Strengthening Project, citing marked improvements in health service delivery, management performance and healthcare utilisation across the state.

In its latest Implementation Status and Results Report, the World Bank raised the project’s rating for progress towards achieving its development objective from “Moderately Satisfactory” to “Satisfactory”, noting that all five key outcome indicators and all 13 intermediate result indicators had met or exceeded their Year-4 targets.

The $40 million project, implemented by the Meghalaya Department of Health and Family Welfare, aims to improve management capacity, quality and utilisation of health services across the state.

According to the report, overall implementation progress improved significantly during the past six months, with the World Bank describing the gains as “broad-based and sustained” across multiple areas of the health system.

Among the major achievements highlighted in the report is a sharp improvement in administrative performance. Average performance scores in targeted administrative units increased by nearly 44 percentage points, exceeding the project target of 20 percentage points. Similarly, quality scores for Community Health Centres and Primary Health Centres rose by more than 21 percentage points, surpassing project goals.

The report also found that patient satisfaction in targeted health facilities increased by more than 77 percentage points from the baseline. At the same time, the availability of essential medicines improved substantially, with stock-outs declining across targeted facilities.

Healthcare access and utilisation also showed notable gains. Government health facilities recorded 1.75 million outpatient visits, nearing the project’s end target of 1.8 million, while the number of women using inpatient services rose to more than 104,000. Health insurance coverage expanded to 88 per cent of households, exceeding the project’s target of 80 per cent.

Quality improvement measures have also advanced. Seven district hospitals have now achieved quality certification, and 95 per cent of doctors and nurses in targeted facilities have participated in clinical competency assessments, surpassing project benchmarks. Biomedical waste management scores and facility quality monitoring indicators also exceeded targets.

The World Bank noted that a key achievement has been the institutionalisation of reforms, particularly performance-based financing mechanisms, which are increasingly being embedded within government systems rather than operating solely as project-driven initiatives. This, the report said, is expected to help sustain improvements beyond the project’s scheduled closure in March 2027.

Financially, the project has disbursed $32.95 million, or more than 82 per cent of the approved funding, with less than a year remaining before completion.

The findings suggest Meghalaya’s efforts to strengthen public healthcare systems are yielding measurable results, even as the state enters the final phase of one of its largest externally supported health sector reforms.

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