Bangladesh: Urban Primary Health Care Services Delivery Project

Sovereign Project | 42177-013

Summary

The Asian Development Bank (ADB) supported Urban Primary Health Care Project (UPHCP) is one of the largest public-private partnerships (PPP) in the delivery of primary health care (PHC) in South Asia. The Government of Bangladesh with the assistance of ADB implemented the First Urban Primary Health Care Project (UPHCP-I) from March 1998 to June 2005. The Second Urban Primary Health Care Project (UPHCP-II), supported by ADB and the Governments of the United Kingdom and Sweden, commenced in July 2005 and was completed in December 2012. A provision of $50 million has been made for the Bangladesh Urban Primary Health Care Services Delivery Project (UPHCSDP) in ADB's lending pipeline for 2012 in addition to $400,000 grant support for Supporting the Urban Primary Health Care Services Delivery Project in 2012. The UPHCSDP and the grant continue the provision of urban PHC, among others, through successful PPPs pioneered by UPHCP-I and II.

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Consulting Notices

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Procurement Documents


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Project Name Urban Primary Health Care Services Delivery Project
Project Number 42177-013
Country Bangladesh
Project Status Approved
Project Type / Modality of Assistance Loan
Technical Assistance
Source of Funding / Amount
Loan 2878-BAN: Urban Primary Health Care Services Delivery Project
Asian Development Fund US$ 50.00 million
TA 8118-BAN: Supporting the Urban Primary Health Care Services Delivery Project
Technical Assistance Special Fund US$ 400,000.00
Strategic Agendas Inclusive economic growth
Drivers of Change Governance and capacity development
Partnerships
Private sector development
Sector / Subsector

Health - Health sector development and reform - Health system development

Gender Equity and Mainstreaming Gender equity
Description

The Asian Development Bank (ADB) supported Urban Primary Health Care Project (UPHCP) is one of the largest public-private partnerships (PPP) in the delivery of primary health care (PHC) in South Asia. The Government of Bangladesh with the assistance of ADB implemented the First Urban Primary Health Care Project (UPHCP-I) from March 1998 to June 2005. The Second Urban Primary Health Care Project (UPHCP-II), supported by ADB and the Governments of the United Kingdom and Sweden, commenced in July 2005 and was completed in December 2012. A provision of $50 million has been made for the Bangladesh Urban Primary Health Care Services Delivery Project (UPHCSDP) in ADB's lending pipeline for 2012 in addition to $400,000 grant support for Supporting the Urban Primary Health Care Services Delivery Project in 2012. The UPHCSDP and the grant continue the provision of urban PHC, among others, through successful PPPs pioneered by UPHCP-I and II.

With a density of 2,756 people per square kilometer (km2) in urban areas and 843 people per km2 overall, Bangladesh is the most densely populated country in the world (excluding a few city-states). Bangladesh is urbanizing at a rapid pace and the country's urban population is expected to reach 89.5 million (from 39.5 million in 2005) by 2030. According to one estimate, by 2020 the urban poor figure could be as high as 40%-60% of the urban population. Notwithstanding higher economic growth in urban areas, the absolute number of poor households is increasing in urban Bangladesh due to migration of rural poor into urban areas. Studies have shown that the health indicators of the urban poor are as worse as those of the rural poor because of poorer living conditions, and limited urban PHC. Failure to provide urban PHC can have serious negative externalities - spread of communicable diseases, debilitating epidemics, reduction in economic productivity, among others.

Project Rationale and Linkage to Country/Regional Strategy The Project will build on the gains of UPHCP-II by strengthening the pro-poor focus, nutrition provision aspects, reproductive health services, and project implementation; and expand the service provision to other backward areas of Bangladesh. By strengthening and mainstreaming the PPP model of service delivery, the Project will encourage alternative ways of public services delivery and enable greater role for the private sector. Through its large focus on women's health, the Project will enable greater gender equity. Therefore, UPHCSDP is closely aligned with Bangladesh's National Strategy for Accelerated Poverty Reduction-II and ADB's Country Partnership Strategy. ADB is one of the lead development partners of the Government of Bangladesh in the domain of urban development, which involves a multidimensional approach - economic (roads), public health (water supply), environmental health (sewerage, solid waste management), and primary health care. This holistic approach to urban development also includes transforming institutions to prepare Bangladesh for the rapid urbanization process. The Project is built on the rationale of synergies (blending prevention and promotion with critical PHC) and driving more effective ways of delivering services (through PPPs). The Project continues the momentum gained by Bangladesh towards achieving child-, maternal health- and communicable diseases-related Millennium Development Goals (MDGs).
Impact Improved health of the urban population, particularly the poor, women, and children
Project Outcome
Description of Outcome Sustainable good quality urban PHC services are provided in the project areas and target the poor and the needs of women and children
Progress Toward Outcome

25 PANGOs has been engaged to provide primary health care services. However, at present, there are no PANGO in Sirajgonj and Gopalgonj municipality partnership areas. Engagement of replacement PANGOs for these 2 areas are ongoing.

9 CRHCC constracts and 14 PHCCC contracts have been signed.

Construction is ongoing for 8 comprehensive reproductive health care centers (CRHCCs) and 4 Primary Health Care Centers (PHCCs); and 7 Maintenance packages for CRHCCs and PHCCs are in various stages of progress.

Implementation Progress
Description of Project Outputs

1. Strengthened institutional governance and local government capacity to sustainably deliver urban PHC services

2. Improved accessibility, quality, and utilization of urban PHC services, with a focus on the poor, women, and children, through PPP

3. Effective support for decentralized project management

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

Output 1:

To date, a total BDT41.45 million has been deposited to the Urban Health Sustainability Fund.

Urban Health Strategy has been approved. A Consultant has been engaged to prepare draft Operational Plan.

Recruitment of ICT and HMIS, and Operational Research firms are ongoing.

Output 2

25 PANGOs has been engaged to provide primary health care services. However, at present, there are no PANGO in Sirajgonj and Gopalgonj municipality partnership areas. Engagement of replacement PANGOs for these 2 areas are ongoing.

9 CRHCC constracts and 14 PHCCC contracts have been signed.

Construction is ongoing for 8 comprehensive reproductive health care centers (CRHCCs) and 4 Primary Health Care Centers (PHCCs); and 7 Maintenance packages for CRHCCs and PHCCs are in various stages of progress.

Poverty survey is completed in 24 partnership areas. RIC in RCCPA1 is preparing for survey.

Indicators to be monitored by QA team and soon-to-be recruited PPME firm.

Output 3:

PMU staff recruitment process completed.

Recruitment for Urban Primary Health Care Specialist, Procurement Specialist, Quality Assurance Specialist, Financial Management Specialist, Training Management Specialist, Resource Management Specialist, Urban Health Strategy, Gender Specialist and Environment Specialist had been completed.

The Financial Management Specialist will improve the staff capacity and develop financial management information system of PMU and PIUs.

A new dynamic website is developed and being operated. An accounting software (Tally) is in use.

Recruitment for ICT and HMIS firm is ongoing.

The training plan has been finalized.

The following trainings were conducted:

In country: Newborn and Child Health Care; Purchase and Store Management; Technical Issues to Improve the Quality of Service Delivery; Workshop on Essential Services Delivery Package; Workshop on Strengthening Adolescent Sexual Reproductive Health; and Workshop of Gender Equity Mainstreaming.

Overseas: Community-based Urban Primary Health Care System (Indonesia)

Geographical Location
Safeguard Categories
Environment B
Involuntary Resettlement C
Indigenous Peoples C
Summary of Environmental and Social Aspects
Environmental Aspects
Involuntary Resettlement
Indigenous Peoples
Stakeholder Communication, Participation, and Consultation
During Project Design Primary stakeholders include selected staff from the Ministry of Local Government, Rural Development, and Cooperatives; Ministry of Health and Family Welfare; project implementation unit of the UPHCSDP; NGOs involved in the UPHCSDP; donor consortium; community-based organizations; representatives and officers of city corporations and municipalities; and representatives of the poor and of vulnerable groups. Stakeholders include relevant line ministries and other private providers of health services. A stakeholder analysis will be conducted as part of the feasibility study. The study will identify key project stakeholders and to plan the project activities. During project implementation, participatory processes will be incorporated into mapping target beneficiaries from urban slum and low-income areas, and into monitoring health services through the neighborhood and ward health committees at the health facilities. Citizen score cards and routine display of up-to-date public information about staffing, stock, facilities, and fee rates will be examined to improve accountability of the service providers and facilitate participation of service users in monitoring services. The communication, participation and consultation process will be done through a number of workshops, involving NGOs, CBOs and other stakeholders.
During Project Implementation Ongoing consultations with primary and secondary stakeholders will continue during implementation.
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 & CoopBangladesh Secretariat
Dhaka
Timetable
Concept Clearance 16 Nov 2012
Fact Finding 27 Feb 2012 to 08 Mar 2012
MRM 04 Apr 2012
Approval 18 Jul 2012
Last Review Mission -
Last PDS Update 26 Feb 2015

Grant 0298-BAN

Milestones
Approval Signing Date Effectivity Date Closing
Original Revised Actual
18 Jul 2012 26 Sep 2012 03 Dec 2012 31 Dec 2017 - -
Financing Plan Grant Utilization
Total (Amount in US$ million) Date ADB Others Net Percentage
Project Cost 0.00 Cumulative Contract Awards
ADB 0.00 18 Jul 2012 0.00 17.22 86%
Counterpart 0.00 Cumulative Disbursements
Cofinancing 0.00 18 Jul 2012 0.00 7.62 38%

Loan 2878-BAN

Milestones
Approval Signing Date Effectivity Date Closing
Original Revised Actual
18 Jul 2012 26 Sep 2012 03 Dec 2012 31 Dec 2017 - -
Financing Plan Loan Utilization
Total (Amount in US$ million) Date ADB Others Net Percentage
Project Cost 61.00 Cumulative Contract Awards
ADB 50.00 18 Jul 2012 33.12 0.00 71%
Counterpart 11.00 Cumulative Disbursements
Cofinancing 0.00 18 Jul 2012 14.86 0.00 32%
Status of Covenants
Category Sector Safeguards Social Financial Economic Others
Rating - - - Satisfactory - -

TA 8118-BAN

Milestones
Approval Signing Date Effectivity Date Closing
Original Revised Actual
18 Jul 2012 02 Oct 2012 02 Oct 2012 31 Dec 2013 30 Jun 2014 -
Financing Plan/TA Utilization Cumulative Disbursements
ADB Cofinancing Counterpart Total Date Amount
Gov Beneficiaries Project Sponsor Others
400,000.00 0.00 0.00 0.00 0.00 0.00 400,000.00 18 Jul 2012 261,211.65
Status of Covenants
Category Sector Safeguards Social Financial Economic Others
Rating - - - Satisfactory - -
Title Document Type Document Date
Urban Primary Health Care Services Delivery Project: Audited Project Financial Statements (30 June 2013-20 June 2014) Audited Project Financial Statements Dec 2014
Supporting the Urban Primary Health Care Services Delivery Project: TA Completion Report TA Completion Reports Sep 2014
Supporting Urban Primary Health Care Services Delivery Project: Simple Poverty Scorecard for Identification of the Ultra Poor and Poor Consultants' Reports Aug 2014
নগর প্রাথমিক স্বাস্থ্য সেবা প্রদান প্রকল্প : প্রকল্প তথ্যপত্র Translated PDS Jul 2014
Supporting Urban Primary Health Care Services Delivery Project: Behaviour Change Communication Strategy Consultants' Reports Jun 2014
Supporting Urban Primary Health Care Services Delivery Project: Training and Capacity Development Strategy Consultants' Reports Jun 2014
Urban Primary Health Care Services Delivery Project: Audited Project Financial Statements (For the Year Ended 30 June 2013) Audited Project Financial Statements Nov 2013
Urban Primary Health Care Services Delivery Project Procurement Plans Mar 2013
Loan Agreement (Special Operations) for Urban Primary Health Care Services Delivery Project Loan Agreement (Special Operations) Sep 2012
Project Agreement for Urban Primary Health Care Services Delivery Project Project/Program Agreement Sep 2012
Grant Agreement (Externally Financed) for Urban Primary Health Care Services Delivery Project Grant Agreement Sep 2012
Proposed Loan, Technical Assistance Grant, and Administration of Grant: Urban Primary Health Care Services Delivery Project Reports and Recommendations of the President Jun 2012
Urban Primary Health Care Services Delivery Project Project/Program Administration Manual Jun 2012
Urban Primary Health Care Services Delivery Project Gender Action Plans Jun 2012

Safeguard Documents

See also: Safeguards
Title Document Type Document Date
Urban Primary Health Care Services Delivery Project Environmental Assessment and Review Framework Apr 2012
Urban Primary Health Care Services Delivery Project Resettlement Frameworks Apr 2012

Evaluation Documents

See also: Independent Evaluation

No documents found.


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