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Viet Nam,Soc Rep of
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LOAN: VIE 37115-01
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Health Care in the Central Highlands
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Location
The Project will support the health system and improve the health status of people in the five provinces of the Central Highlands: Dak Lak, Dak Nong, Gia Lai, Kon Tum, and Lam Dong.
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Sector
Health, Nutrition, & Social Protection /Health Systems
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Initial Listing
7 March 2003
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Most Recent Update
8 February 2007
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Executing Agency(ies)
Ministry of Health
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- Missions
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| TA Fact-Finding |
Loan Fact-Finding |
Pre-Appraisal |
Appraisal |
| 8-15 Jan 2003 |
1-12 Sep 2003 |
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13-23 Oct 2003 |
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Loan Approval Date
9 January 2004
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Estimated Completion Date
December 2009
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- Cost and Financing Plan (in US$ million)
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| Source |
Foreign Cost |
Local Cost |
Total |
| Bank |
11.10 |
8.90 |
20.00 |
| Cofinancing |
0.40 |
5.20 |
5.60 |
| Borrower |
0.00 |
5.00 |
5.00 |
| Beneficiaries |
0.00 |
0.00 |
0.00 |
| Others |
0.00 |
0.00 |
0.00 |
| Project/Program Cost |
11.50 |
19.10 |
30.60 |
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OCR |
ADF |
Total |
| Loan Amount |
0.00 |
20.00 |
20.00 |
- Description
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The Project has a focus on providing curative health services to the poor and disadvantaged, including ethnic minorities, women, and children, by upgrading district health centers and enhancing the skills of health care service providers. The Project is supporting the effective implementation of the new Government initiative, Prime Minister's Decision 139, aimed at establishing the Health Care Funds for the Poor. The Project also emphasizes building the capacity of the provincial health departments for planning, financing, and managing health services.
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- Thematic Classification
- Human Development / Gender and Development
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- Target Classification
- Targeted Intervention
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- Rationale
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The Central Highlands region is one of Viet Nam's poorest regions with relatively poor health indicators. The main factors contributing to the poor health are (i) inadequate access to quality and culturally compatible health services, (ii) lack of appropriate skills among health care personnel, and (iii) demand-side issues such as the lack of affordability of health services and demand for public health services such as institution-based births. Health infrastructure needs significant strengthening. The quality of health services in public and private sectors is poor. Health care providers' skills need upgrading. Significant capacity building is required to effectively implement Decision 139.
- Objectives and Scope
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The Project is supporting the health system and improve the health status of people - especially the poor and disadvantaged - in the five provinces of the Central Highlands: Dak Lak, Dak Nong, Gia Lai, Kon Tum, and Lam Dong.
Specific objectives of the Project are to (i) improve availability of, and access to, quality health services, especially for the poor and disadvantaged; (ii) improve affordability and utilization of health services, especially for the poor; and (iii) strengthen the capacity of the health system to address effectively the health needs of the people. The Project has the following three components: (i) upgrading facilities and equipment, (ii) human resources development, and (iii) strengthening financing and management of health services.
- Policy Dialogue
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- Environment Category:
B
- Environment Impact and Mitigation
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The Project will have no significant adverse environmental effect and will improve considerably current waste management practices. Civil works will be small in scale and will not adversely affect any ecosystems. Design of civil works will address disposal of hazardous medical wastes. A major component is to improve waste management.
- Social Aspects and Remedies
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The Project will make a significant contribution to reducing the poverty and vulnerability caused by poor health. Approximately 220,000 people will see their health care costs drop below 10% of total household expenditure. The pro-poor health financing system will make the health financing substantially less regressive. The Project fully integrates concerns of ethnic minority groups into subcomponent design and does not harm any specific group. An ethnic minority development plan has been prepared to highlight project benefits to ethnic minority communities and ensure they have access to affordable, high-quality health services in a more equitable health system. The Project fully mainstreams gender concerns into its design to ensure that women share proportionately to project benefits. The Project emphasizes women's health, particularly in the areas of reproductive health, obstetrics, gynecological care, and maternal and child health. The Project will help strengthen current efforts to prevent the spread of HIV/AIDS through the preventive health infrastructure and health promotion programs specifically targeted at HIV/AIDS. The level of involuntary resettlement is significant. Land acquired for new and relocated health facilities will total about 15.2 hectares. Civil works will affect an estimated 38 households, including shops, which will require relocation. Some affected households will also lose agricultural land. All losses will be compensated at full replacement cost and current market value. Transition allowances will be provided and rehabilitation measures will ensure restoration of income-generating activities.
- Benefits and Beneficiaries
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The Project will have a significant impact on the health and well being of the Central Highlands population. Since health is closely related to productivity, it will also help incomes. The Project will benefit 4.4 million people in the Central Highlands by improving quality of, and access to, health services. These benefits will target a rural population of 3.2 million, particularly the 1 million poorest and 1.5 million ethnic minorities. The Project will improve effectiveness and efficiency of the health system in the four provinces by upgrading health facilities, preventive health centers, strengthening training and management capacity, and increasing the quality of health service delivery. The Project will support Decision 139 to fully finance the cost of health insurance premium or reimbursement of health services for the poor in the Central Highlands.
- Public Consultation
- Arranged by Borrower, Bank and TA Consultants
- Date for Consultation : During the PPTA implementation (April-October 2003) and appraisal stages (2-13 November 2003).
- Groups Consulted : All stakeholders, including selected staff from the Ministry of Health; people's committees at different levels; and representatives from the poor and more vulnerable groups, including ethnic minorities, and resettlement-affected persons.
- Beneficiary Participation in Formulation
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The provincial health departments have carried out initial consultations with district authorities and civil society on the proposed civil works for district health centers. These consultations included discussions on potential resettlement and environmental impacts, as well as the proposed design to ensure that local needs are met. Affected persons have been informed about the Project and have been consulted during preparation of the resettlement plan.
- Beneficiary Participation in Implementation
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The Project places a strong emphasis on community involvement and the use of services by all community members. Special initiatives will be taken to involve people in health insurance schemes. Women's participation will be central to programs on maternal and child health. The community will work more closely in assessing health needs and identifying solutions. Additional public consultations will be held to discuss resettlement of affected people. Local authorities will also discuss with affected communities the site-specific environmental management plans and initial environmental examinations.
- Consulting Services
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About 32 person-months by international consultants and 573 person-months by domestic consultants will be required. Domestic consulting services comprise 119 person-months for services organized at the central level and 454 person-months for the services specific to provinces. The consultants will be recruited from consulting firms or as individual experts, depending on the need. Consulting firms will be selected using quality- and cost-based selection. Domestic consultants for provincial services will be engaged by the individual PPMUs. International consultants comprise an architect, an equipment and procurement specialist, a public health expert with background in quality of care, and a health economist.
- Procurement
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Civil works will generally be small and scattered and are unlikely to attract foreign bidders, hence, LCB procedures will be used unless they exceed $2 million equivalent, in which case ICB procedures will be followed. Procurement of medical equipment will be carried out using ICB procedures for packages exceeding $500,000 and IS procedures if they are below $500,000. LCB procedures will be used for contracts costing below $200,000 and direct procurement for contracts below $100,000.
- Contacts
- Bank
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Erik A. Bloom
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Economist
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EREA
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Tel. No.:
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(632) 632-6370
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E-mail:
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- Executing Agency
- Ministry of Health
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Contact Person
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Dr. Duong Huy Lieu, Director
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Tel. No.
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Fax. No.
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844-846-3703
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E-mail
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Contact Person
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Dr. Nguyen Van Thuong, Project Director
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Tel. No.
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Fax. No.
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844-8463056
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E-mail
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