Since 2012, Asian Development Bank (ADB) has been in collaboration with the Government of West Bengal for increasing the total efficiency in public expenditure and ensuring that these expenditures are directly linked to the desired outcomes and achieve better service delivery.

ADB’s Second West Bengal Development Finance Programme supported the introduction of medium-term expenditure framework (MTEF) in the Health and Family Welfare Department of West Bengal.

MTEF is a transparent planning and budget formation process which allocates public resources according to their strategic priorities and desired outcomes while ensuring overall fiscal discipline. With adequate medium-term planning, West Bengal was able to establish outpatient department services in 41 hospitals, and provide free medical care, medicines, diagnostic tests and implants.

In addition, the government implemented schemes to cover expenses on all surgeries performed on children and provide health insurance to cover hospitalisation costs of up to $7,000 per family per annum for 15 million families.

ADB plans to further support the adoption of MTEFs by other departments as part of its proposed West Bengal Public Finance Management Reforms Programme.