Bangladesh: Second Urban Primary Health Care Project

Sovereign Project | 36296-013 Status: Closed

Summary

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Project Name Second Urban Primary Health Care Project
Project Number 36296-013
Country Bangladesh
Project Status Closed
Project Type / Modality of Assistance Grant
Loan
Source of Funding / Amount
Grant 0008-BAN: Second Urban Primary Health Care Project
Asian Development Fund US$ 10.00 million
Grant 0009-BAN: Second Urban Primary Health Care Project
Government of Sweden US$ 5.00 million
Grant 0010-BAN: Second Urban Primary Health Care Project
Government of the United Kingdom US$ 25.00 million
Loan 2172-BAN: Second Urban Primary Health Care Project
Asian Development Fund US$ 30.00 million
Loan: Second Urban Primary Health Care Project
United Nations Population Fund US$ 2.00 million
Swedish International Dev. Cooperation Agency US$ 5.00 million
Strategic Agendas Inclusive economic growth
Drivers of Change Governance and capacity development
Private sector development
Sector / Subsector

Health - Health sector development and reform

Gender Equity and Mainstreaming Some gender elements
Description
Project Rationale and Linkage to Country/Regional Strategy
Impact

Project Outcome

Description of Outcome
Progress Toward Outcome Outcome indicators with regard to improved access, efficiency, effectiveness and quality of PHC services were generally achieved. UPHCP II had a target population of 9.41 million, which was around 23% of the urban population of Bangladesh. As of 26 September 2012, 10.22 million individual clients attended UPHCP II clinics from the start of the second phase in July 2005 to June 2012 (7 years). 78% of clients were female, and overall, the project saw an increase in cumulative service contacts as well as increase in utilization among the poor reaching 80% of all service contacts in the last four years.
Implementation Progress
Description of Project Outputs
Status of Implementation Progress (Outputs, Activities, and Issues)

Output 1.1. All the 24 partnership areas were operational until the service completion date of 30 June 2012. The PANGOs also provided interim services from July-December 2012.

Output 1.2. Supplementary nutrition delivered by the 24 PA NGOs. Further strengthening of this component is required in the next phase of the project.

Output 1.3. All are operational.

Output 1.4. BCCM end-line survey indicated increase from 63.4% to 81.3%, compared to baseline.

Output 2.1. The original scope of civil works was not feasible due to rapid cost escalations and issues such as land unavailability and the scope was revised in the Revised DPP as: 13 CRHCC, 28 PHCC, 1 up-gradation and 38 public toilet. Progress of civil works is CRHCC - 8 completed, 1 under construction (60% completion, 1 suspended due to problems and 3 not contracted; PHCC - 13 completed, 5 under construction, 7 suspended, and 3 not contracted; up-gradation - 1 (target achieved); public toilet - 38 - 27 completed, 8 suspended, and 3 not contracted

Output 2.2. Progress on this component was behind schedule. Out of the 38 revised target, 27 public toilets were completed and 8 were suspended due to land problems and 3 were not contracted.(A management model for public toilets that will ensure sustainability of operations and maintenance and active community engagement will be supported under operations research under the next project phase.)

Output 3.1 2,945 people (1,577 female) were trained in-country, mostly in clinical or management aspects. Fellowships and study tours not conducted. At least 1 elected official from each urban local body participated in project workshop.

Output 3.2. Gender composition of overseas training wasweak due to lack of more women in management positions.

Output 3.3. Under-achieved, but PAs generally received training in some thematic areas.

Output 3.4b. The number of women management personnel were very limited in PMU, PIUs, and PAs. Exact percentage to be verified with PMU.

Output 3.5. Achieved under local training conducted by MS&T firm.

Output 3.4a. Achieved for health providers. Exact percentage to be verified with PMU.

Output 4.2. Delayed but four firms hired within 2 years of Project (project performance monitoring and evaluations systems; construction supervision; behavior change communication; and management and training support firm).

Output 4.1. PMU and PIUs established and functioning.

Geographical Location All the six city corporations---Dhaka, Chittagong, Khulna, Rajshahi, Syllhet and Barisal---and five municipalities-Bogra, Comilla, Sirajgonj, Madhabdi and Savar.

Safeguard Categories

Environment B
Involuntary Resettlement
Indigenous Peoples

Summary of Environmental and Social Aspects

Environmental Aspects
Involuntary Resettlement
Indigenous Peoples
Stakeholder Communication, Participation, and Consultation
During Project Design During project preparation, discussions were held with beneficiaries, health staff, and officials through field studies, meetings, and workshops. These provided information on health service availability, health-seeking behaviors, and financing during disease episodes.
During Project Implementation During implementation, the beneficiaries provided advice on health services, health promotion activities, and access to the health services for the poor. They were also consulted through focus groups during project evaluation.

Business Opportunities

Consulting Services Consultants and consulting firms will be recruited under ADB's Guidelines on the Use of Consultants and other arrangements satisfactory to ADB for recruitment of local consultants. The consulting firms will provide (i) management support for the PMU and management training, (ii) quality assurance training and supportive supervision, (iii) health management information systems development and implementation, (iv) behavioral change communication and marketing, (v) financial management and performance auditing, (vi) project performance monitoring and evaluation, and (vii) design and supervisory engineering services for construction.
Procurement

Procurement of ADB-financed goods, related services, and civil works will be carried out in accordance with ADB's Guidelines for Procurement.

Civil Works/Goods: The Project will construct 50 PHC centers and 14 comprehensive reproductive health care (CRHC) centers, and upgrade 4 PHC centers to CRHC centers. The Project will support the purchase of 12 apartments or buildings for PHC centers in Dhaka. The Project will support, on a pilot basis, the construction and initial operation in each partnership area of at least four community toilets blocks with bathing and urinal facilities.

Partnership Agreements: The Project will continue to provide PHC services through performance-based contracting out of PHC services to NGOs. Two of the three partnership areas in Chittagong will be covered by the city corporation health department, while the remaining area will be contracted out to a partner NGO. It will use partnership agreements similar to those pioneered during UPHCP-I. The partner NGOs will provide essential services package plus (ESP+) services in the partnership agreement areas. These services will consist of (i) HIV/AIDS and STI control, (ii) other communicable disease control, (iii) other ESP services, and (iv) supplementary nutrition. The Project will finance 24 partnership agreements, each covering 200,000-300,000 people. Each partnership agreement area will consist of one CRHC center, at least one PHC center per 30,000-50,000 people, and at least one satellite or mini-clinic per 10,000 people. Satellite clinics will be operated from rented buildings in poor neighborhoods in the evening to cater to those who work during the day. PHC centers will provide a full range of essential services, including basic emergency obstetric care. The CRHC centers will provide comprehensive emergency obstetric care, newborn care, and specialized ESP+ services. The Project will support CRHC-center-based voluntary testing and counseling services for HIV/AIDS through grant financing.

Responsible Staff

Responsible ADB Officer Brian Chin
Responsible ADB Department South Asia Department
Responsible ADB Division Human and Social Development Division, SARD
Executing Agencies
Local Govt Div,Min of Local Govt Rural Devt & Coop
Mr. Jamal A. Naser Chowdhury
pduphcp@bangla.net
Nagar Palika Bhawan, Dhaka

Timetable

Concept Clearance 08 Mar 2002
Fact Finding 22 Aug 2004 to 09 Sep 2004
MRM 08 Oct 2004
Approval -
Last Review Mission -
PDS Creation Date 01 Feb 2007
Last PDS Update 30 Sep 2013

Grant 0008-BAN

Milestones
Approval Signing Date Effectivity Date Closing
Original Revised Actual
31 May 2005 07 Jun 2005 01 Jul 2005 30 Jun 2012 30 Jun 2013 22 Sep 2014
Financing Plan Grant Utilization
Total (Amount in US$ million) Date ADB Others Net Percentage
Project Cost 12.00 Cumulative Contract Awards
ADB 10.00 31 May 2005 8.17 0.00 89%
Counterpart 2.00 Cumulative Disbursements
Cofinancing 0.00 31 May 2005 8.17 0.00 89%
Status of Covenants
Category Sector Safeguards Social Financial Economic Others
Rating - Satisfactory - Unsatisfactory - Satisfactory

Grant 0009-BAN

Milestones
Approval Signing Date Effectivity Date Closing
Original Revised Actual
31 May 2005 07 Jun 2005 01 Jul 2005 30 Jun 2012 31 Dec 2012 31 Mar 2014
Financing Plan Grant Utilization
Total (Amount in US$ million) Date ADB Others Net Percentage
Project Cost 5.00 Cumulative Contract Awards
ADB 0.00 31 May 2005 0.00 3.36 67%
Counterpart 0.00 Cumulative Disbursements
Cofinancing 5.00 31 May 2005 0.00 3.36 67%

Grant 0010-BAN

Milestones
Approval Signing Date Effectivity Date Closing
Original Revised Actual
31 May 2005 07 Jun 2005 01 Jul 2005 30 Jun 2012 31 Dec 2012 10 Apr 2014
Financing Plan Grant Utilization
Total (Amount in US$ million) Date ADB Others Net Percentage
Project Cost 25.00 Cumulative Contract Awards
ADB 0.00 31 May 2005 0.00 18.11 72%
Counterpart 0.00 Cumulative Disbursements
Cofinancing 25.00 31 May 2005 0.00 18.11 72%

Loan 2172-BAN

Milestones
Approval Signing Date Effectivity Date Closing
Original Revised Actual
31 May 2005 07 Jun 2005 01 Jul 2005 30 Jun 2012 30 Jun 2013 16 Sep 2014
Financing Plan Loan Utilization
Total (Amount in US$ million) Date ADB Others Net Percentage
Project Cost 55.00 Cumulative Contract Awards
ADB 30.00 31 May 2005 21.19 0.00 100%
Counterpart 18.00 Cumulative Disbursements
Cofinancing 7.00 31 May 2005 21.19 0.00 100%
Status of Covenants
Category Sector Safeguards Social Financial Economic Others
Rating - Satisfactory - Satisfactory - Satisfactory
Title Document Type Document Date
Second Urban Primary Health Care Project: Project Completion Report Project/Program Completion Reports Sep 2014
Second Urban Primary Health Care Project: Spot Review Report Project Procurement-Related Reviews Dec 2012
Second Urban Primary Health Care Project Reports and Recommendations of the President May 2005

Safeguard Documents See also: Safeguards

Safeguard documents provided at the time of project/facility approval may also be found in the list of linked documents provided with the Report and Recommendation of the President.

Evaluation Documents See also: Independent Evaluation

Title Document Type Document Date
Bangladesh: Second Urban Primary Health Care Project Validations of Project Completion Reports Aug 2015

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