The Rs 150 crore project has been sponsored by the German government with financing from the German development bank, GTZ, amounting to Rs 120 crore and the remaining Rs 30 crore to come from the Central government corpus. The programme will cover the seven districts of Bankura, Birbhum, Cooch Behar, Darjeeling, Jalpaiguri, Midnapur and Purulia, where the primary health care system needs to be boosted. ``The German participation will be restricted to five of these seven districts (Bribhum and Darjeeling being excluded),'' says Heide Richter-Airijoki, head of the joint Indo-German venture, the West Bengal Health Systems Development Project. ``Large inter- and intra-state disparities exist in healthcare infrastructure, and improvements in coverage and quality of services have not matched the optimal level. The funding from the German government will help close gaps and contribute to quantitative and qualitative expansion of the primary health care infrastructure,'' says Richter-Airijoki.

The aim of the project is to decentralise need-based primary health services at the district, block and community level, says Dr Siraj, director of the project. ``The primary health care centres will have user-required medicines, equipment and transport facilities,'' he says. Systems for waste disposal and maintenance will also be improved. The West Bengal government has involved community representatives, NGOs, private service providers and various population groups in the project. These representatives will be involved in the planning, implementation, financing and monitoring of healthcare services as well as adminis- trative and financial decision processes at the district, block and community levels. ``This way, the control will be exercised by the people and the access to these services will be better,'' says Siraj. The West Bengal government has already got a system of employing doctors on a contract basis, especially in rural areas.

The seven districts on the project list have been chosen for upgraded facilities because they cover large tribal and scheduled caste belts where the poorest live, says Siraj. ``The upgraded system will include simple tests like malaria detection, which were earlier unavailable,'' says Richter-Airijoki. Malaria, which is prevalent in many rural belts, can be detected through a simple test, but since this facility is not available at the sub-centre level, most people have to travel to district level centres for test facilities. ``With the inclusion of simple tests like these, the primary health centres will be better,'' feels Richter-Airijoki.

Other simple measures will include transportation facilities for the ill, especially mothers with complicated pregnancies, to the nearest hospital. ``We will give some volunteers in the villages cycle rickshaws for transport, which they can use to vend vegetables or other such things when they are not in use for healthcare,'' explains Richter-Airijoki.

The work of expanding and building fresh infrastructure in these seven districts will begin later this year and the project is slated to be completed in the next four years.

``If each village has access to a primary health centre close by, the World Health Organization aim of `Health for All' will be met soon,'' says Richter-Airijoki.