Lao People's Democratic Republic: Health Sector Development Program (Program Grant)

Sovereign Project | 41376-022

Summary

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Procurement Documents


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Project Name Health Sector Development Program (Program Grant)
Project Number 41376-022
Country Lao People's Democratic Republic
Project Status Approved
Project Type / Modality of Assistance Grant
Source of Funding / Amount
Grant 0172-LAO: Health Sector Development Program (Program Grant)
Asian Development Fund US$ 10.00 million
Grant 0173-LAO: Health Sector Development Program (Project Grant)
Asian Development Fund US$ 10.00 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
Project Rationale and Linkage to Country/Regional Strategy
Impact Reduced maternal and infant mortality, and child malnutrition.
Project Outcome
Description of Outcome Improved use of Primary Health Care (PHC), in particular by the poor, women, children, and small ethnic groups.
Progress Toward Outcome

The project outcome indicators are being assessed by the projects endline survey. The data collection, data entry and analysis have been completed. reporting on the findings is under preparation by EA, which expects to complete by end June 2015.

According to findings of Lao Social Indicator survey 2011:

- The U5MR is 79/1,000 live births (the revised MDG 2015 target is 70; MDG Progress Report 2013)

- The MMR is 357/100,000 live births (CI: 269-446). ( the MDG 2015 target is unchanged at 260; MDG Progress Report 2013).

Implementation Progress
Description of Project Outputs

1. Strengthened planning and financing capacity.

2. Increased access to MNCH care.

3. Improved quality of HRH.

Status of Implementation Progress (Outputs, Activities, and Issues)

As of 30 March 2015, overall project progress is satisfactory and the project performance rating in e-ops is on track. Overall physical project progress is 99%, compared to the elapsed grant period of 91%. The project will be closed on 30 June 2015.

Output1:

(i) All 17 provinces have developed result-based AOPs from 2010/2011 to 2013-2014. The implementation of AOP is on progress; (ii) from 2010 to 2014, government budget allocated to operation has significantly increased as well as budget for maintenance of facilities and equipment; (iii) Health equity fund for the poor was expanded covering 62 districts in 8 northern provinces. Since HEF has been operated in Oct 2011, the cumulative number of poor patient-visits if about 109,000. (iv) The overall HEF assessment is being carried out by an international HEF specialist.

Output 2:

(i) Procurement and distribution of medical equipment for hospitals to improve MNCH standard are completed.

(ii) Construction of one district hospital, 10 health centers and renovation of 2 district hospitals and 13 health centers are completed;

(iii) MNCH teams from 6 out of 12 type A district hospitals have been trained and an assessment of training needs for type B district hospitals was completed. 8 out of 13 type A district hospitals in eight provinces are able to provide surgery and cesarean sections. A specific facility survey is being conducted to assess MNCH standards in type A district hospitals.

(iv) The revised standards for district hospital and health center design approved by Minister of health in March 2014 include standards for privacy needs of women: separate toilet for women, delivery and post- delivery rooms.

(v) 1,724 (42%) out of 4,035 villages were declared as MHV with direct support the program grant.

Output 3:

- 153 health staff (92% are female and 28% are ethnic people) were trained as community midwives.

- 138 health center staff (62% are female and 51 are ethnic people) completed the 2 month SBA training and Training on SBA for another 30 HC staff is ongoing.

- 57 health staff (98% are female) completed the Emonc training, and training on BemONC for 30 district hospital staff is ongoing.

- 112 health staff (58% were female) completed village health workers training.

Geographical Location Vientiane and 17 Provinces of Laos, with focus on 8 Northern provinces
Safeguard Categories
Environment B
Involuntary Resettlement C
Indigenous Peoples C
Summary of Environmental and Social Aspects
Environmental Aspects The project environmental impacts were reviewed through rapid environmental assessment. The project will support the upgrading of four hospitals and upgrading or replacement of 20 health centers based on MOH guidelines for the construction of health facilities development under the Primary Health Care Expansion Project. No significant adverse impact were identified; the investment will have positive impacts on the environment. The main concern is medical waste management. Most health facilities separate waste but the subsequent handling is inadequate. The project will not cause any significant pollution, health hazards or soil erosion. No negative environmental impacts are anticipated.
Involuntary Resettlement The four hospitals and 20 health centers will be upgraded, renovated, or replaced on existing government land free of encumbrances. No resettlement issue has been identified or are expected. However, if any land acquisition or other action is required that effects private persons and/or users of the land, a land acquisition and resettlement framework has been prepared in according with ADB's Involuntary Settlement Policy (1995) to guide the preparation of a land acquisition and resettlement plan (Appendix 11 of RRP). In case of changes in scope, the new site will be also inspected for any possible resettlement issue.
Indigenous Peoples The project design is built around the needs of ethnic groups and includes several strategies to ensure that ethnic group benefit. Specific actions have been incorporated into project design. A gender and ethnic group action plan has been prepared to help ensure that health personnel and consumers from small ethnic groups benefit from policy reforms and related investment.
Stakeholder Communication, Participation, and Consultation
During Project Design Extensive consultations were held at national level (MOH departments, other ministries and partners; provincial level (governors, administrators); sub-provincial level (district officers and health staff); and potential beneficiaries (village health committees, volunteers, and clients). Several field studies have been conducted during the PPTA to appraise planning and budgeting, financial management, safe motherhood, quality of care, and civil works including public consultation on any resettlement or environmental issues.
During Project Implementation The MOH Steering Committee is to review program progress each quarter. The provincial health offices are being consulted weekly and all provinces are visited every quarter. The mechanism to incorporate feedback of beneficiaries is well developed under the model healthy villages but needs to be mainstreamed in general for the annual planning process and supervision.
Business Opportunities
Procurement The program grant proceeds will be used to finance the foreign exchange cost of items produced and procured in ADB member countries, excluding items included on a list of ineligible items and imports financed by other bilateral and multilateral sources. The grant recipient will certify that the volume of eligible imports exceeds the amount of ADB's projected disbursements under the program grant in a given period. ADB will have the right to audit the use of grant proceeds and to verify the accuracy of the recipient's certification.
Responsible ADB Officer Phoxay Xayyavong
Responsible ADB Department Southeast Asia Department
Responsible ADB Division Lao Resident Mission
Executing Agencies
Ministry of HealthDr. Prasongsidh Bouphahsdpadm10@gmail.comPlanning and Budgeting Department, Ministry of Health, Vientiane Lao PDR
Timetable
Concept Clearance 21 Jul 2009
Fact Finding 01 Jun 2009 to 12 Jun 2009
MRM 31 Jul 2009
Approval 10 Nov 2009
Last Review Mission -
PDS Creation Date 23 Jul 2009
Last PDS Update 31 Mar 2015

Grant 0172-LAO

Milestones
Approval Signing Date Effectivity Date Closing
Original Revised Actual
10 Nov 2009 23 Nov 2009 17 Dec 2009 30 Jun 2012 - 31 Aug 2012
Financing Plan Grant Utilization
Total (Amount in US$ million) Date ADB Others Net Percentage
Project Cost 10.00 Cumulative Contract Awards
ADB 10.00 10 Nov 2009 10.00 0.00 100%
Counterpart 0.00 Cumulative Disbursements
Cofinancing 0.00 10 Nov 2009 10.00 0.00 100%
Status of Covenants
Category Sector Safeguards Social Financial Economic Others
Rating - - - - - Satisfactory

Grant 0173-LAO

Milestones
Approval Signing Date Effectivity Date Closing
Original Revised Actual
10 Nov 2009 23 Nov 2009 17 Dec 2009 30 Jun 2014 30 Jun 2015 -
Financing Plan Grant Utilization
Total (Amount in US$ million) Date ADB Others Net Percentage
Project Cost 10.80 Cumulative Contract Awards
ADB 10.00 10 Nov 2009 10.00 0.00 100%
Counterpart 0.80 Cumulative Disbursements
Cofinancing 0.00 10 Nov 2009 9.89 0.00 99%
Status of Covenants
Category Sector Safeguards Social Financial Economic Others
Rating - - - - - Satisfactory

Safeguard Documents

See also: Safeguards
Title Document Type Document Date
Health Sector Development Program Resettlement Frameworks Sep 2009
Health Sector Development Program Environmental Assessment and Measures Sep 2009

Evaluation Documents

See also: Independent Evaluation

No documents found.


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