Viet Nam: Health Care in the Central Highlands

Sovereign Project | 37115-013

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Project Name Health Care in the Central Highlands
Project Number 37115-013
Country Viet Nam
Project Status Closed
Project Type / Modality of Assistance Loan
Source of Funding / Amount
Loan 2076-VIE: Health Care in the Central Highlands
Asian Development Fund US$ 20.00 million
Strategic Agendas Inclusive economic growth
Drivers of Change Governance and capacity development
Sector / Subsector

Health - Health sector development and reform

Gender Equity and Mainstreaming Gender equity
Description 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.
Project Rationale and Linkage to Country/Regional Strategy

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.

The Government has a strong policy and institutional structure to support primary health care, which has evolved over the last few years to pay greater attention to the needs of the poor and disadvantaged. The Government has a major policy initiative called Decision 139 (Health Care Funds for the Poor) which is designed to ensure access to basic health care for the poor. The project is supporting MOH and the provincial departments of health to effectively implement Decision 139, and improve the management information system (MIS) and surveillance of communicalbe and noncommunicable diseases.

Project Outcome
Description of Outcome
Progress Toward Outcome The Project has achieved the expected outcomes of improving access to health services, increasing the affordability and utilization of services and strengthening health systems to address the health needs of the population. Results of the Viet Nam household living standard survey in 2004, 2006 and 2008 were compared for the Project provinces and for a set of control provinces. Control provinces had similar UNDP human development index scores to those of the Project provinces just prior to project implementation. Mortality in children has been reduced and government facilities are being used to a greater extent by women and poorer people (quintiles 4 and 5) using outpatient services. The total population's use of inpatient services at government hospitals increased more in project provinces. Those suffering from illness - measured over the previous 4 weeks - have decreased to a greater extent in Project provinces.
Implementation Progress
Description of Project Outputs
Status of Implementation Progress (Outputs, Activities, and Issues) The project has been completed successfully. PCR has been submitted for printing and circulation.
Geographical 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.
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 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.
During Project Implementation 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.
Business Opportunities
Consulting Services 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 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.
Responsible ADB Officer Tuyen Nhat Nguyen
Responsible ADB Department Southeast Asia Department
Responsible ADB Division Viet Nam Resident Mission
Executing Agencies
Ministry of Health
Mr. Ha Van Thuy
138A Giang Vo St, Hanoi
Concept Clearance 07 Mar 2003
Fact Finding 01 Sep 2003 to 12 Sep 2003
MRM 24 Sep 2003
Approval 09 Jan 2004
Last Review Mission -
PDS Creation Date 05 Dec 2006
Last PDS Update 01 Feb 2012

Loan 2076-VIE

Approval Signing Date Effectivity Date Closing
Original Revised Actual
09 Jan 2004 08 Apr 2004 30 Aug 2004 30 Jun 2010 - 05 Dec 2011
Financing Plan Loan Utilization
Total (Amount in US$ million) Date ADB Others Net Percentage
Project Cost 25.00 Cumulative Contract Awards
ADB 20.00 09 Jan 2004 18.17 0.00 98%
Counterpart 5.00 Cumulative Disbursements
Cofinancing 0.00 09 Jan 2004 18.54 0.00 100%
Title Document Type Document Date
Health Care in the Central Highlands Project Project/Program Completion Reports Jan 2012
Health Care in the Central Highlands Project Summary Poverty Reduction and Social Strategies Dec 2003
Health Care in the Central Highlands Project Reports and Recommendations of the President Dec 2003

Safeguard Documents

See also: Safeguards
Title Document Type Document Date
Health Care in the Central Highlands: Ethnic Minority Development Plan Indigenous Peoples Planning Frameworks/Indigenous Peoples Development Frameworks Aug 2004

Evaluation Documents

See also: Independent Evaluation
Title Document Type Document Date
Viet Nam: Health Care in the Central Highlands Project Validations of Project Completion Reports Oct 2014

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