Bangladesh: Urban Primary Health Care Sector Development Project

Sovereign Project | 42177-012

Summary

The Asian Development Bank's (ADBs) engagement in the subsector since 1998 (through first and second Urban Primary Health Care Projects [UPHCP-I and UPHCP-II]) and Urban Public and Environmental Health Sector Development Program (UPEHSDP) indicate a high degree of prior experience in the subsector for ADB to support the proposed Urban Primary Health Care Sector Development Project (UPHCSDP). However, for the reasons listed below, a project preparatory technical assistance (PPTA) is certainly warranted. Primary health care subsector consists of a number of stakeholders. More than a dozen development partners support the primary health care in rural areas through the Ministry of Health and Family Welfare (MOHFW), while some of them support primary health care in urban areas under the Local Government Division (LGD) of the Ministry of Local Government, Rural Development and Cooperatives (MOLGRDC) in partnership with ADB (DFID, SIDA, UNFPA).

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Project Name Urban Primary Health Care Sector Development Project
Project Number 42177-012
Country Bangladesh
Project Status Closed
Project Type / Modality of Assistance Technical Assistance
Source of Funding / Amount
TA 7655-BAN: Urban Primary Health Care Sector Development Project
Technical Assistance Special Fund US$ 700,000.00
Strategic Agendas Inclusive economic growth
Drivers of Change Governance and capacity development
Private sector development
Sector / Subsector

Health - Health care finance - Health system development

Water and other urban infrastructure and services - Urban policy, institutional and capacity development

Gender Equity and Mainstreaming Gender equity
Description

The Asian Development Bank's (ADBs) engagement in the subsector since 1998 (through first and second Urban Primary Health Care Projects [UPHCP-I and UPHCP-II]) and Urban Public and Environmental Health Sector Development Program (UPEHSDP) indicate a high degree of prior experience in the subsector for ADB to support the proposed Urban Primary Health Care Sector Development Project (UPHCSDP). However, for the reasons listed below, a project preparatory technical assistance (PPTA) is certainly warranted. Primary health care subsector consists of a number of stakeholders. More than a dozen development partners support the primary health care in rural areas through the Ministry of Health and Family Welfare (MOHFW), while some of them support primary health care in urban areas under the Local Government Division (LGD) of the Ministry of Local Government, Rural Development and Cooperatives (MOLGRDC) in partnership with ADB (DFID, SIDA, UNFPA). The relationship between the MOHFW, which has the overall mandate for health policy and setting standards in urban areas) and urban local bodies who are mandated to deliver primary health care services in urban areas under the overall stewardship of LGD is complex. The positions of various stakeholders, and creating a synergy within the legal framework of the country is a major task for the proposed PPTA.

The proposed Project will continue to be executed under the tested and acknowledged public-private partnership (PPP) model. However, there is scope further fine tuning of the PPP model to enhance its effectiveness, improve the pro-poor targeting, reduce red tape and provide adequate flexibility to the private sector. However, accountability to results, mitigation of fiduciary risks, strengthening of financial management systems, strengthening the social safeguards, empowering the poor and adolescent girls, addressing emerging challenges including climate change, among others, would need further due diligence. The proposed Project has to absorb the lessons learnt, and build on the strengths of the past designs while effectively address the design flaws noticed during the implementation of UPHCP-II. Greater value for the money should be achieved through a better thought through design. Another challenge of the proposed Project will be to conclude the contracting-out of primary health care services to private sector in a timely, transparent and efficient manner. Bridging technical assistance support will be required for setting in more effective systems to track results, especially pro-poor targeting related. All the above mentioned reasons provide strong justification for the project preparatory technical assistance.

Project Rationale and Linkage to Country/Regional Strategy The Government of Bangladesh approved the second National Strategy for Accelerated Poverty Reduction (NSAPR-II) in December 2009 covering the period FY09 to FY11. The NSAPR-II reaffirms the commitment that reducing poverty and accelerating the pace of inclusive growth are the priorities of the country including halving the poverty rate by 2015 and achieving substantial improvements in all aspects of human development consistent with the MDGs. The poverty reduction strategy framework of NSAPR II is based on multidimensionality of poverty and consists of five strategic blocks and five supportive strategies. The strategic blocks are: (i) macroeconomic environment for pro-poor growth; (ii) critical areas for pro-poor growth; (iii) essential infrastructure for pro-poor growth; (iv) social protection for the vulnerable; and (v) human development. The supporting strategies are (i) ensuring participation, social inclusion, and empowerment; (ii) promoting good governance; (iii) ensuring efficient delivery of public services; (iv) caring for environment and tackling climate change; and (v) enhancing productivity and efficiency through science and technology. The government has also taken a long term vision for the country?s development. The long term Perspective Plan (2011-2021) is under preparation by the government which would provide goals for the future and chart out the course of action to achieve the goals by 2021. The key targets based on Vision 2021 pertaining to the proposed project are reduction in the maternal mortality to 1.5%, raise the use of birth control methods to 80%, and bring down infant mortality to 15 per thousand live births by 2021; and eliminate all kinds of contagious diseases and increase life expectancy of citizens to 70 years by 2021. The proposed project is consistent with the country partnership strategy, which support continuation of the innovative public private partnership (PPP) for the delivery of urban primary health care, and considers the project as important contributor to the gender equity agenda of the Country Partnership Strategy (CPS).
Impact tbd
Project Outcome
Description of Outcome tbd
Progress Toward Outcome
Implementation Progress
Description of Project Outputs tbd
Status of Implementation Progress (Outputs, Activities, and Issues)
Geographical Location Bangladesh
Summary of Environmental and Social Aspects
Environmental Aspects
Involuntary Resettlement
Indigenous Peoples
Stakeholder Communication, Participation, and Consultation
During Project Design
During Project Implementation
Business Opportunities
Consulting Services tbd
Responsible ADB Officer Hayman K. Win
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 & CoopBangladesh Secretariat
Dhaka
Timetable
Concept Clearance -
Fact Finding 16 Aug 2010 to 23 Aug 2010
MRM -
Approval 19 Nov 2010
Last Review Mission -
PDS Creation Date 06 Oct 2010
Last PDS Update 31 Jan 2011

TA 7655-BAN

Milestones
Approval Signing Date Effectivity Date Closing
Original Revised Actual
19 Nov 2010 07 Jul 2011 07 Jul 2011 30 Jun 2012 30 Nov 2012 -
Financing Plan/TA Utilization Cumulative Disbursements
ADB Cofinancing Counterpart Total Date Amount
Gov Beneficiaries Project Sponsor Others
700,000.00 0.00 125,000.00 0.00 0.00 0.00 825,000.00 19 Nov 2010 678,766.46

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Safeguard Documents

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Evaluation Documents

See also: Independent Evaluation

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