Mongolia: Fifth Health Sector Development Project

Sovereign Project | 45009-002 Status: Active


ADB is helping Mongolia improve the safety of patients and health workers in hospitals. The project will assist the Ministry of Health in setting up a national blood transfusion center and an improved central medical waste management facility in Ulaanbaatar. It will provide equipment for hospital sterilization and microbiology laboratories to prevent and control hospital-acquired infections.

Latest Project Documents

Consulting Notices See also: CMS

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Procurement Notices See also: Operational Procurement

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Procurement Documents

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Project Name Fifth Health Sector Development Project
Project Number 45009-002
Country Mongolia
Project Status Active
Project Type / Modality of Assistance Grant
Source of Funding / Amount
Grant: Fifth Health Sector Development Project
World Health Organization US$ 480,000.00
German Federal Ministry of Health US$ 186,000.00
Loan 2963-MON: Fifth Health Sector Development Project
Asian Development Fund US$ 30.00 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 Effective gender mainstreaming
Project Rationale and Linkage to Country/Regional Strategy

Project Outcome

Description of Outcome
Progress Toward Outcome New National Transfusiology Center (NTC) is fully constructed in accordance with the initial drawings. The actual completion of the construction requires additional budget of about $210,000. The need for additional funding is raised as a result of the additional constructions requirements identified during the design qualification carried-out in January 2014 (ventilation system, radiation room, cold storage room, special flooring and use of paint), which were not part of the initial drawings. ADB approved the request for additional financing in November 2015.
Implementation Progress
Description of Project Outputs
Status of Implementation Progress (Outputs, Activities, and Issues)

Component 1: Safe Blood Transfusion

Output 1. The procurement of medical and non-medical equipment for NTC is completed.

Output 2. Procurement of medical equipment for aimag and model blood bank is completed.

Component 2: Medical Waste Management

Output 3. Current operator of the central waste facilities was not yet compensated as planned. MOHS plans to cancel the current operator's contract at the end of 2015. Preparation of drawings is delayed.

Component 3: Hospital Hygiene and Infection Prevention and Control

Output 5. The working group on IPC is discussing the current guidelines.

Output 8. National consultant on KAP survey on IPC among healthcare workers is recruited.

All outputs will be assessed at project completion.

Geographical Location

Safeguard Categories

Environment B
Involuntary Resettlement C
Indigenous Peoples C

Summary of Environmental and Social Aspects

Environmental Aspects

The project is classified as category B. An initial environmental examination including an environmental management plan (EMP) was prepared in compliance with ADB's Safeguard Policy Statement (2009) and the Mongolia regulatory framework, and was posted on the ADB website on 21 August 2012. The initial environmental examination assesses and addresses environment impacts and risks related to (i) the Ulaanbaatar central medical waste management facility; (ii) the new National Transfusiology Center; (iii) smaller blood safety, infection prevention and control, medical waste facility installations in project aimags; and (iv) project associated facilities. The main adverse impacts and risks during the construction and operation phase include limited standard construction impacts, and risks related to unsafe collection, storage, treatment, and disposal of medical and chemical liquid waste generated by health facilities. These impacts and risks will be addressed through the implementation of the EMP that includes adequate mitigation and monitoring arrangements, responsibilities for EMP implementation and supervision, environmental training and capacity building, and budgets for implementation of EMP.

The EMP will be updated based on final design and will be submitted to ADB for review and approval prior to awarding the civil works contract. Contractors during construction, and facility operators as well as MOH during operation will implement these measures. The effectiveness of these measures will be regularly evaluated in the framework of the environmental monitoring program, and corrective actions defined as required. The Government of Mongolia, through MOH, is committed to manage identified environmental risks and agreed on a comprehensive set of loan covenants. Relevant environment information was disclosed to potentially affected people, and the results and findings of the consultation process were used to modify the initial environmental examination and the project design. Consultation and participation will continue throughout project implementation and any environmental complaints or disputes will be handled in accordance with the grievance redress mechanism established for the project. The project will have significant environment, health, and safety benefits. Mongolia's medical waste management system, including liquid hazardous waste, will be significantly strengthened by improving medical waste management systems within health care facilities, by upgrading the central medical waste management facility in Ulaanbaatar to meet internationally accepted standards.

Involuntary Resettlement No involuntary resettlement effects are foreseen and is classified as a category C project. The National Transfusiology Center will be established on existing government land and will not affect local residents or residential buildings. A resettlement plan and framework are therefore not required. Should there be any change in scope or other changes with unanticipated resettlement impacts during project implementation, land acquisition and resettlement activities will be implemented in accordance with ADB's Safeguard Policy Statement (2009).
Indigenous Peoples The project is classified as category C for indigenous peoples. The assessment determined that there will not be any negative impact on indigenous peoples. The project will carry out an assessment of and implement effective ways to design and deliver information, education, communication activities to the public to ensure social inclusiveness and effective communication.
Stakeholder Communication, Participation, and Consultation
During Project Design Three workshops were held with related governmental departments, beneficiaries, environment protection bureau, local governments, etc., to inform the project design. The poverty and social analysis involved focus group and key informant interviews with health care workers, patients, and the general public. Development of the environmental impact assessments and environmental management plan (EMP) involved two rounds of public consultations. The gender action plan (GAP) has been prepared and discussed with the Ministry of Health. The GAP and EMP set out detailed ongoing public participation plans.
During Project Implementation Public disclosure of all project documents was made at the project management office and on the ADB website, including the project information document, design and monitoring framework, consolidated environmental impact assessment, report and recommendation of the President, public sector legal agreement, project administration memorandum, and environmental monitoring reports. The GAP and EMP indicate how consultation will continue throughout implementation.

Business Opportunities

Consulting Services The Borrower is responsible for selecting, engaging, and supervising consultants engaged under the loan funded by ADB. All consultants will be recruited according to ADB's Guidelines on the Use of Consultants (2010, as amended from time to time). A consultant firm to provide a total of 129 person-months of consulting services (37 international, 92 national) is recruited to support the executing agency in project implementation and capacity development for all project components. Three consulting firms will be engaged under lump sum contracts using consultants' qualification selection (CQS) for facilitating international accreditation of the National Transfusiology Center, architectural support for project facilities and environmental assessment of the central medical waste management facility. In total, 33 person-months of national consultants will be recruited for all three components following individual consultant selection procedure for providing safeguards, social, technical, legal, and monitoring support to the project.
Procurement All procurement of goods and works will be undertaken in accordance with ADB's Procurement Guidelines (2010, as amended from time to time). International competitive bidding will be applied to goods contracts estimated to cost $2,000,000 or more and works contracts estimated to cost $5,000,000 or more. Goods contracts with values less than $2,000,000 and works contracts with values less than $5,000,000 will follow national competitive bidding. Works and goods contracts with values less than $100,000 will be procured using ADB's shopping procedure.

Responsible Staff

Responsible ADB Officer Altantuya Jigjidsuren
Responsible ADB Department East Asia Department
Responsible ADB Division Mongolia Resident Mission
Executing Agencies
Ministry of Health and Sports
1st Floor, Government Building VIII
Olympic Street 2, Ulaanbaatar


Concept Clearance 07 Oct 2011
Fact Finding 03 Jul 2012 to 06 Jul 2012
MRM 07 Sep 2012
Approval -
Last Review Mission -
Last PDS Update 13 Apr 2016

Loan 2963-MON

Approval Signing Date Effectivity Date Closing
Original Revised Actual
10 Dec 2012 07 Feb 2013 14 Jun 2013 31 Dec 2018 - -
Financing Plan Loan Utilization
Total (Amount in US$ million) Date ADB Others Net Percentage
Project Cost 38.38 Cumulative Contract Awards
ADB 30.00 10 Dec 2012 12.35 0.00 45%
Counterpart 7.71 Cumulative Disbursements
Cofinancing 0.67 10 Dec 2012 6.40 0.00 24%
Status of Covenants
Category Sector Safeguards Social Financial Economic Others
Rating - - - - Satisfactory -

Safeguard Documents See also: Safeguards

Safeguard documents provided at the time of project/facility approval may also be found in the list of linked documents provided with the Report and Recommendation of the President.

Evaluation Documents See also: Independent Evaluation

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Related Publications

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