Lao People's Democratic Republic: Developing Model Healthy Villages in Northern Lao People's Democratic Republic

Sovereign Project | 42143-012

Summary

The Project will develop Model Healthy Villages in Northern Lao PDR and improve the health of villagers, in particular mothers and children, through enhanced community participation in primary health care (PHC). The project has 4 major components: (i) strengthening village capacity in planning, implementing, and managing primary health care activities; (ii) improving village infrastructure for 'healthy environments', (iii) strengthening capacity of districts and health centers to support village-level primary health; and (iv) project management and coordination. A key thrust of the project is to test and further develop a coherent model for effective community participation in PHC and to propose a harmonized national approach for scale-up of model healthy villages nationwide.

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Project Name Developing Model Healthy Villages in Northern Lao People's Democratic Republic
Project Number 42143-012
Country Lao People's Democratic Republic
Project Status Closed
Project Type / Modality of Assistance Grant
Source of Funding / Amount
Grant 9137-LAO: Developing Model Healthy Villages in Northern Lao People's Democratic Republic
Japan Fund for Poverty Reduction US$ 3.00 million
Strategic Agendas Inclusive economic growth
Drivers of Change
Sector / Subsector

Health - Health sector development and reform

Gender Equity and Mainstreaming
Description The Project will develop Model Healthy Villages in Northern Lao PDR and improve the health of villagers, in particular mothers and children, through enhanced community participation in primary health care (PHC). The project has 4 major components: (i) strengthening village capacity in planning, implementing, and managing primary health care activities; (ii) improving village infrastructure for 'healthy environments', (iii) strengthening capacity of districts and health centers to support village-level primary health; and (iv) project management and coordination. A key thrust of the project is to test and further develop a coherent model for effective community participation in PHC and to propose a harmonized national approach for scale-up of model healthy villages nationwide.
Project Rationale and Linkage to Country/Regional Strategy ADB's strategy for its operations in the Lao PDR and in the Country Strategy and Program (CSP) for 2007-2011 is consistent with the Government?s Sixth Five Year National Socio-Economic Development Plan, 2006-2010 (NSEDP). Health continues to be one of the priority sectors for the Government. As a component of its overall assistance program for health sector development, ADB will continue providing support for primary health care, health sector financing, and human resource development. This includes a series of sector interventions aimed at improving the institutional framework, financing, human resource development, and governance in the health sector. The pipeline of the Country Operations Business Plan (COBP) 2009- 2011 includes a health project that will build on outputs provided so far in the health sector. ADB has supported the expansion of Primary Health Care (PHC) in 8 Northern provinces and strengthening institutional capacity for PHC management nationwide. In order to further improve the quality and use of services, the health system development project (HSDP) strengthened this further with a focus on Human Resource Development, and introduced the results-based approach and the health equity fund. Based on this successful approach, a Health Sector Development Program is planned starting 2010. The proposed Project will complement this Program and contribute to the CSP's objectives.
Impact Improved health status of rural population in Houaphan and Xiangkhouang provinces.
Project Outcome
Description of Outcome Target villages achieve model healthy village status.
Progress Toward Outcome - By 23 February 2013, a grant closing date, all 100 target villages achieved MHV status. The final workshop was on 30 Jan 2013, participated by health officials from the two target provinces, MOH, and the representative from Embassy of Japan to Lao PDR and ADB Lao PDR resident mission.
Implementation Progress
Description of Project Outputs

1. Strengthened Village Capacity for Participatory Planning and Management of Model Healthy Villages

2. Improved Village Infrastructure for Primary Health Care Delivery

3. Strengthened Capacity of Districts and Health Center teams to Support Model Healthy Villages

4. Project Management and Implementation Supported

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

1. Strengthened Village Capacity for Participatory Planning and Management of MHVs

- Village health committee members and village health volunteers in 100 target villages were trained.

- As targeted, a total of 679 village health committee (VHC) members (25% women; 13% non-Lao ethnic groups) and 192 village health volunteers (VHVs) (40% women ; 27% non-Lao ethnic groups) were trained on MHV concept, health education, participatory planning and monitoring of MHV activities

2. Improved Village Infrastructure for Primary Health Care Delivery

- All 100 villages have developed and completed implementation of village health plans, which include construction/rehabilitation of 82 gravity water systems (60 were rehabilitated and 22 were newly constructed), 6,887 latrines, 47 village billboards, 50 drainages, and 2 incinerators.

- Water user committee and operations and maintenance (O&M) funds were established in each village and operational.

- 492 out of 1590 (31%) participants of village meetings were women.

- 877 out of 1590 (55%) participants of village meetings were non-Lao ethnic groups

3. Strengthened Capacity of Districts and Health Centers to Support Model Healthy Villages

- 16 multidisciplinary district teams established in 2010 and received training on implementation of MHV, health education, MNCH services in early 2011.

- 41 out of 79 (51.8%) district mobile team members conducting outreach activities are women.

- Medical equipment, audio-video equipment and supplies were provided to the trained district teams.

4. Project Management and Implementation Support

- The PCU and PCCU teams were established in 2009 and supported by the implementation and procurement consultant

- Annual operational plan developed and implemeted.

- Monitoring tools and system is in place.

- BCC strategy was developed and existing IEC materials have been identified and a package for MHV finalized.

Geographical Location Lao PDR provinces of Houaphan and Xiangkhouang
Safeguard Categories
Environment C
Involuntary Resettlement C
Indigenous Peoples B
Summary of Environmental and Social Aspects
Environmental Aspects The proposed Project will pilot combining water supply and sanitation with primary health care activities to establish self-reliant and sustainable model healthy villages in the target area. To qualify for a model healthy village, a village should maintain a clean environment and practice basic hygiene principles-- having safe water, eating well cooked food and maintaining clean housing. In addition, primary health care from immunization, safe motherhood practices, medicine, etc. should be available for the village. Establishing model health villages not only provides health benefits, it also encourages neighboring villages to join the project. The proposed Project will target villages in priority poor districts and focus on women, children, and ethnic groups.
Involuntary Resettlement A resettlement framework has been prepared to address any impacts that may arise from small-scale investments. Limited, if any, impacts are expect
Indigenous Peoples The Project includes several strategies to ensure that small ethnic groups will also benefit, including targeted inclusion of these groups in village planning to increase their capacity and knowledge about common diseases and health care; participatory tools for mobilization and planning to ensure participation of all groups; and inclusion of women and poor and vulnerable groups in all stages of project implementation as criteria for qualifying for the second round of funding for village infrastructure, thus encouraging communities to involve all subgroups in health activities. All district and health center staff members will be trained in gender and participatory development, including consideration of ethnic groups. In addition, a national gender and social development consultant will be engaged for 6 person-months to support the Project.
Stakeholder Communication, Participation, and Consultation
During Project Design The proposed Project was designed following a participatory approach and involved consultations with provincial, district and village officials, residents in villages and key informants at the national, provincial and district levels. Activities included: (i) reconnaissance visits to villages to consult and inform district and village officials about the Project and conduct informal interviews with villagers; (ii) meetings to inform local officials and residents about the Project policies and procedures; (iii) meetings with representatives, Ministry of Health, and other donors and organizations involved in the health sector; and (iv) workshops with national and provincial stakeholders to review design issues.
During Project Implementation

During implementation, a Field Guide will be prepared which will detail the implementation arrangement and the use of participatory methods. The Project promotes participatory and consultative processes for all residents including women, ethnic groups, and poor households and seeks to maximize community participation and ownership by transferring control for decisions and actions to communities and aims to achieve (i) improved community representation in village development; (ii) community capacity to organize themselves for local improvements and plan, design, operate, supervise and maintain local infrastructure in coordination and partnership with local authorities and agencies; and (iii) improved knowledge and awareness of village residents in basic health, hygiene and sanitation. Efforts will be made to link project-related hygiene and clean environment activities to larger campaigns with the Lao youth in schools. Funding and technical assistance will be provided for communities to improve village and household health and sanitation facilities and undertake priority small-scale community improvements.

A participation strategy will be incorporated into the overall project design. Villagers, especially women, will participate in the strengthening of village health committees. Participation of the community will be an essential activity under the proposed Project to define a model healthy village and to plan the health activities accordingly.

Business Opportunities
Consulting Services A total of 401 person-months of consulting services will be recruited, 6 person-months international and 395 person-months national, including 300 person-months for district facilitators and 48 person-months for provincial financial specialists. Due to the specific needs for these specialists to be local and field-based as well as the variety of specialists needed, all consultants will be recruited on an individual basis to ensure that the most appropriate candidates are selected in the most cost-efficient manner. ADB, in consultation with the Ministry of Health, will recruit the international consultants, and the Ministry of Health will recruit the national consultants in accordance with ADB's Guidelines on the Use of Consultants by Asian Development Bank and its Borrowers (2007, as amended from time to time).
Procurement All goods and civil works will be procured in accordance with ADB's Procurement Guidelines (2007, as amended from time to time). National competitive bidding (NCB) and Shopping will be the procurement methods to be used. Goods and civil works equivalent to or below $100,000 will be procured using ADB's shopping procedure, and those above $100,000 will be procured using ADB's national competitive bidding procedure. No international competitive bidding is envisaged under the Project. The assets procured under this Project will be handed over to the Executing Agency upon project completion.
Responsible ADB Officer Phoxay Xayyavong
Responsible ADB Department Southeast Asia Department
Responsible ADB Division Lao Resident Mission
Executing Agencies
Ministry of HealthDr. Prasongsidh Bouphapheceppmo@etllao.comProject Management Unit, Ministry of Health, Lao PDR
Timetable
Concept Clearance 06 May 2008
Fact Finding 15 Mar 2008 to 20 Mar 2008
MRM -
Approval 14 Aug 2009
Last Review Mission -
PDS Creation Date 14 Jul 2008
Last PDS Update 27 Mar 2013

Grant 9137-LAO

Milestones
Approval Signing Date Effectivity Date Closing
Original Revised Actual
14 Aug 2009 23 Nov 2009 23 Nov 2009 23 Nov 2012 23 Feb 2013 26 Aug 2013
Financing Plan Grant Utilization
Total (Amount in US$ million) Date ADB Others Net Percentage
Project Cost 3.34 Cumulative Contract Awards
ADB 0.00 14 Aug 2009 0.00 3.00 100%
Counterpart 0.34 Cumulative Disbursements
Cofinancing 3.00 14 Aug 2009 0.00 3.00 100%

Safeguard Documents

See also: Safeguards
Title Document Type Document Date
Developing Model Healthy Villages in Northern Lao PDR Resettlement Planning Documents Mar 2009

Evaluation Documents

See also: Independent Evaluation

No documents found.


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