Project Name Health Services Sector Development Program, Subprogram 1
Project Number 51035-001
Country / Economy Papua New Guinea
Project Status Active
Project Type / Modality of Assistance Grant
Loan
Source of Funding / Amount
Loan 3664-PNG: Health Services Sector Development Program
Ordinary capital resources US$ 100.00 million
Loan 3665-PNG: Health Services Sector Development Program
Ordinary capital resources US$ 45.10 million
Loan 3666-PNG: Health Services Sector Development Program
Concessional ordinary capital resources lending US$ 49.90 million
Grant 0648-PNG: Health Services Sector Development Program, Subprogram 1 (Additional Financing)
Government of Australia US$ 38.00 million
Strategic Agendas Inclusive economic growth
Drivers of Change Gender Equity and Mainstreaming
Governance and capacity development
Partnerships
Sector / Subsector

Health / Health sector development and reform

Public sector management / Public expenditure and fiscal management

Gender Effective gender mainstreaming
Description The Health Services Sector Development Program (HSSDP) will help Papua New Guinea (PNG) strengthen health services through policy reforms and direct investments in health systems. A diagnostic assessment of the coverage, financing, and quality of health services is required to ensure that the interventions are designed for maximum impact.
Project Rationale and Linkage to Country/Regional Strategy The HSSDP will contribute to the achievement of the National Health Plan (NHP) (2011 to 2020) and the Development Strategic Plan (2010 to 2030). In particular, the HSSDP aims to improve national public expenditure management and strengthen health systems. The HSSDP builds upon ADB's long-term in-country engagement in both the health sector and public finance management (PFM).
Impact

Affordable, accessible, equitable, and high-quality health services for all citizens developed (National Health Plan 2011 to 2020).

Project Outcome
Description of Outcome

A more sustainable and efficient healthcare system achieved

Progress Toward Outcome

The individual Consultant and the Consulting Firm working on strategies to improve the reliability of the Medical Supplies Procurement and Distribution Service completed the drafting of a Master Plan for this purpose and the Plan has been considered and endorsed by the National Department of Healths Senior Executive Management (SEM) Group.

A standard Charter and Terms of Reference for the Partnership Committees have been developed in readiness and 11 PHAs were supported to establish Partnership Committees through the project.

eNHIS was developed and rolled-out in March 2020 and data collection and reporting has been implemented in several health facilities. Point of service data entry and reporting is now available from 840 health facilities in all 22 provinces.

Construction is completed at Ambunti Health Centre, Umba, Gaulim and Bitokara Community Health Posts. Completion of Stage 1 civil works for the Bogia District Hospital was achieved during October 2022. Contractors are expected to mobilize to Wirui, Cape Gloucester and Warasikau project sites in Q2 2023.

Implementation Progress
Description of Project Outputs

National frameworks and PFM enhanced

Subnational health system management strengthened

Health service delivery components strengthened

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

Revised Catalogue published and uploaded to mSupply

Publication of the Regulations for the Provincial Health Authorities Act, 2007 will enshrine the requirement for PHAs to form Partnership Committees to formally engage with other health service providers and stakeholders at the Provincial level. A standard charter and terms of reference has been developed. Nine PHAs were supported to establish partnership committees.

Contracts awarded for 1 Level 4 and 2 Level 3 facilities. Safeguards requirements well advanced for another Level 4 and 3 Level 3s

A review of the mSupply inventory management system and current procurement, warehousing and distribution processes has been completed. A comprehensive stocktake of all Area Medical Stores was conducted during March 2021 in order to establish a baseline for usable stock. Revision of Standard Operating Procedures (SOPs) has been completed.

EOC curriculum under revision

Contract negotiations were concluded with PNG Remote Sensing Centre for further rollout, development and maintenance of the eNHIS in early March 2020. Since that time data collection and reporting from the point of service has been implemented in all health facilities in Hela, East New Britain, Central, Manus, New Ireland, West Sepik, Chimbu, Gulf, East Sepik, Oro, Eastern Highlands, Jiwaka, Southern Highlands and Madang Provinces. Point of service data entry and reporting is now available from 840 health facilities in all 22 Provinces.

National Health Service Standards 2011 reviewed and revised edition endorsed by the NDoH SEM in April 2021 and by the National Health Board in June 2021; Clinical Governance Framework for provincial health authorities developed and endorsed by NDoH SEM, implementation in other provinces commenced in March 2022; Patient Referral Guidelines completed and being rolled-out; National Infection Prevention and Control Guidelines rewritten and endorsed by NDoH SEM, WHO funded its publication and officially launched on 21 July 2022; Strategic Health Service Development Plans developed; draft Manual for the Governance & Management of Provincial Health Authorities in PNG developed and was refined by PHA executives in Mar 2022 prior to seeking endorsement and presentation to Boards and management teams of the PHAs; Public Finance Management modules for PHAs drafted and endorsed by NDOH SEM.

The National Health Plan 2021-2030 has been developed and is now endorsed by the National Health Board and NEC, printed and published. Implementation costing was facilitated by the Nossal Institute through its contract with HSSDP and was completed on 28 May 2021. The cost of K42.7 million over the life of the Plan has now been accepted and endorsed by NEC.

Target achieved

There is at least 1 woman representing women's groups on every Board; some have 2 or 3

All 22 PHAs established by January 2020.

Clinical upskilling for maternal and child health staff in rural health facilities commenced in February 2022 and the Project will meet the deliverable from the Project Design Monitoring Framework to have upskilled 220 health workers by December 2022. At the end of this reporting period 260 midwives, nurses and community health workers have been upskilled in either Emergency Obstetric Care (EmOC) or Primary Mother and Baby Care.

PFM Consultant engaged since February, 2020. Currently developing PFM modules for PHA Manual and training materials in conjunction with DoF and NDoH Officers.

Geographical Location Nation-wide
Safeguard Categories
Environment B
Involuntary Resettlement C
Indigenous Peoples C
Summary of Environmental and Social Aspects
Environmental Aspects

An environmental assessment and review framework for the sector

Project will be developed and at least one environmental assessment of a subproject identified during preparation. The framework will comply with the Safeguard Policy Statement (SPS) 2009, as well as national laws and requirements relating to environmental assessment, to facilitate compliance with environmental requirements during project implementation.

Involuntary Resettlement The project will have minimal or no adverse social impacts.
Indigenous Peoples The project will have minimal or no adverse social impacts.
Stakeholder Communication, Participation, and Consultation
During Project Design

Stakeholder and beneficiary consultations will be initiated during TRTA, which will lead to stakeholder engagement

and participation plan(s).

During Project Implementation A program and reform steering committee will bring together key stakeholders from government institutions and development partners. Project component designs and individual policy reforms are based on or will incorporate feedback from consultations with identified stakeholder groups, led by the responsible implementing agencies. Participatory capacity, human resource development, and training needs assessments will be conducted at the institutional level.
Business Opportunities
Consulting Services All consultants are recruited according to ADB's Guidelines on the Use of Consultants.
Procurement Any procurement of equipment or consulting services conforms with ADB's Procurement Guidelines.
Responsible ADB Officer Mikkelsen-Lopez, Inez
Responsible ADB Department Sectors Group
Responsible ADB Division Human and Social Development Sector Office (SG-HSD)
Executing Agencies
Department of Treasury
Timetable
Concept Clearance 31 May 2017
Fact Finding 05 Dec 2017 to 13 Dec 2017
MRM 02 Mar 2018
Approval 31 May 2018
Last Review Mission -
Last PDS Update 20 Apr 2023

Grant 0648-PNG

Milestones
Approval Signing Date Effectivity Date Closing
Original Revised Actual
14 Jun 2019 21 Jun 2019 12 Aug 2019 30 Sep 2025 30 Sep 2027 -
Financing Plan Grant Utilization
Total (Amount in US$ million) Date ADB Others Net Percentage
Project Cost 38.00 Cumulative Contract Awards
ADB 0.00 02 May 2024 0.00 21.15 56%
Counterpart 0.00 Cumulative Disbursements
Cofinancing 38.00 02 May 2024 0.00 14.33 38%
Status of Covenants
Category Sector Safeguards Social Financial Economic Others
Rating - Satisfactory Satisfactory Satisfactory - Satisfactory

Loan 3664-PNG

Milestones
Approval Signing Date Effectivity Date Closing
Original Revised Actual
31 May 2018 13 Jun 2018 18 Jul 2018 30 Oct 2018 - 03 Apr 2019
Financing Plan Loan Utilization
Total (Amount in US$ million) Date ADB Others Net Percentage
Project Cost 100.00 Cumulative Contract Awards
ADB 100.00 02 May 2024 100.00 0.00 100%
Counterpart 0.00 Cumulative Disbursements
Cofinancing 0.00 02 May 2024 100.00 0.00 100%
Status of Covenants
Category Sector Safeguards Social Financial Economic Others
Rating - Satisfactory Satisfactory Satisfactory - Satisfactory

Loan 3665-PNG

Milestones
Approval Signing Date Effectivity Date Closing
Original Revised Actual
31 May 2018 13 Jun 2018 18 Jul 2018 30 Nov 2025 30 Sep 2027 -
Financing Plan Loan Utilization
Total (Amount in US$ million) Date ADB Others Net Percentage
Project Cost 54.60 Cumulative Contract Awards
ADB 45.10 02 May 2024 28.88 0.00 64%
Counterpart 9.50 Cumulative Disbursements
Cofinancing 0.00 02 May 2024 20.06 0.00 44%
Status of Covenants
Category Sector Safeguards Social Financial Economic Others
Rating - Satisfactory Satisfactory Satisfactory - Satisfactory

Loan 3666-PNG

Milestones
Approval Signing Date Effectivity Date Closing
Original Revised Actual
31 May 2018 13 Jun 2018 18 Jul 2018 30 Nov 2025 30 Sep 2027 -
Financing Plan Loan Utilization
Total (Amount in US$ million) Date ADB Others Net Percentage
Project Cost 49.90 Cumulative Contract Awards
ADB 49.90 02 May 2024 26.95 0.00 54%
Counterpart 0.00 Cumulative Disbursements
Cofinancing 0.00 02 May 2024 19.97 0.00 40%
Status of Covenants
Category Sector Safeguards Social Financial Economic Others
Rating - Satisfactory Satisfactory Satisfactory - Satisfactory
 
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