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Primary Health Care For Ethnic Minorities Of Northern Lao PDR

Lao PDR's rural poor - especially in the north, where many ethnic minorities live - will have significantly more access to essential health care as a result of a US$20 million loan approved today by the Asian Development Bank.

In the remote and inaccessible northern provinces, the Primary Health Care Expansion Project will construct 41 new health centers and seven district hospitals and upgrade a further six health centers and 17 hospitals. The project will also improve the quality of health services by training local staff and providing vaccines and drugs to villages. In addition, the project will bring nationwide benefits by strengthening the institutional capacity for public health care through coordinating and standardizing management systems, training programs and innovative financing approaches.

The hill tribes in the north, where 60 percent of the population subsist below the poverty line, will be the main beneficiaries. Health in this region is generally poor. Life expectancy is only 53 years and infant and maternal mortality rates and fertility rates are among the highest in Asia. Common deadly - and preventable - diseases are malaria, tuberculosis, pneumonia, diarrhea and measles. The lack of essential micro-nutrients in the local diet is another killer. Lao PDR also faces an increasing risk of an HIV/AIDS epidemic.

"We're supporting the Government in helping especially poor women and children who live in isolated villages and have no access at all to essential services," says Vincent De Wit, an ADB health specialist. "Many of them die from diseases which can be easily prevented with the right treatment. We shall be collaborating with provincial governments and international NGOs to reduce this tragedy."

In Lao, isolated villages suffer from poor communications, lack of qualified staff, undesirable working conditions and financial constraints. In one province, nearly half the villages are four hours' travel from a hospital.

Specifically, the project will develop public health care in the provinces of Phongsali, Louang Namtha, Bokeo, Sayaburi, Oudomxai, Louang Phrabang, Houaphan and Xieng Khouang. Its focus on cost-effective measures for women and children will include health promotion, reproductive health care, the prevention and treatment of common infections and micronutrient deficiency, and first referral services.

The district hospitals will be equipped to provide reproductive care, including obstetric surgery, and to deal with emergency surgery, with laboratories for blood screening and transfusion. First referral services will also be expanded to these district hospitals. The health centers will provide outreach services to villages such as immunization and the supply of drug kits. Training programs include scholarships for postgraduate training in surgery and anesthesia.

The total project cost is US$25 million. The ADB is financing 80 percent, with the balance coming from the government. The ADB loan will be from its concessionary Asian Development Fund and is repayable over 32 years, including an eight-year grace period. The interest rate will be one percent per annum during the grace period and 1.5 percent per annum thereafter.

The Ministry of Health will be the executing agency for the project, which is scheduled for completion in June 2007.

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