Lao People's Democratic Republic: Health System Development Project

Sovereign Project | 32313-022 Status: Closed

Project Details

Project Officer
Lochmann, Barbara Southeast Asia Department Request for information
  • Lao People's Democratic Republic
  • Grant
  • Health
Project Name Health System Development Project
Project Number 32313-022
Country Lao People's Democratic Republic
Project Status Closed
Project Type / Modality of Assistance Grant
Source of Funding / Amount
Grant 0079-LAO: Health System Development Project
concessional ordinary capital resources lending / Asian Development Fund US$ 13.00 million
Strategic Agendas Inclusive economic growth
Drivers of Change
Sector / Subsector

Health - Health sector development and reform

Gender Equity and Mainstreaming
Project Rationale and Linkage to Country/Regional Strategy

Project Outcome

Description of Outcome
Progress Toward Outcome The project was effective in achieving its desired outcome, which was to improve PHC delivery for vulnerable groups in the eight northern provinces and strengthen pro-poor health system development nationwide. Improvement to vulnerable groups was promoted through investments in upgrading staff competency, equipment, construction and renovation at the provincial, district and community level.
Implementation Progress
Description of Project Outputs
Status of Implementation Progress (Outputs, Activities, and Issues) Targeted outputs in capacity development were delayed and ultimately scaled back, while in-service training focused mainly on management and planning and less on clinical skills development, although it was widely acknowledged that these were rather limited . While educational barriers still exist among non-Lao ethnic groups, more appropriate bridging courses for health workers and more time could have helped to recruit staff from ethic groups in health centers. Overall health care utilization of the poor increased from 43% in 2006 to 46.7% in 2010. It is not evident whether targeting mechanisms were appropriate to reach the most vulnerable including non-Lao ethnic groups and if out-of pocket expenditures were reduced. Specific project outputs will be available in the Project Completion Report by Q3 2013.
Geographical Location 8 Northern provinces for PHC delivery Natonawide for capacity building and system development

Summary of Environmental and Social Aspects

Environmental Aspects The Project's environmental impacts were reviewed through rapid environmental assessment; no significant adverse impacts were identified. The Project will support the construction of district hospitals and health centers based on MOH guidelines for the construction of health facilities developed under the PHCEP. Environmentally sound medical waste treatment will be included in the design of the new as well as upgraded health facilities. Site selection, design, construction, replacement work, and facility operation will conform to the relevant regulations and standards of the Government, international good practices, and ADB's Environment Policy (2002). No activities resulting from the Project will cause pollution, health hazards, or soil erosion. The Project is classified as Category C.
Involuntary Resettlement Replacement of 11 existing health centers and upgrading of three district hospitals under the Project will not require any new land. Construction of new provincial hospitals in Houaphan and Louang Namtha and 10 new health centers will, as a priority, be carried out on vacant and idle land owned by the Government that is free from all encumbrances, habitation, dispute, or controversy. Since the final site for each subproject has not been agreed yet, a resettlement framework has been prepared.
Indigenous Peoples The project design is built around the needs of ethnic groups and includes several strategies to ensure that ethnic groups benefit from the Project. The specific actions are included in the main text of this report and recommendation of the President.
Stakeholder Communication, Participation, and Consultation
During Project Design A stakeholder analysis as part of the project design dentified key stakeholders, to understand their related roles and interests, and to make a preliminary assessment of capacity for Project implementation. A variety of stakeholders were consulted including the relevant ministries, other national agencies, provincial and district health officials, managers and staff of hospitals and health centers, village health volunteers. Discussions were held with development partners (e.g., the World Bank) to ensure synergies and complementarities with their ongoing initiatives in the health sector, and with the private sector (Amanresorts International Private Limited) to seek out possible partnerships.
During Project Implementation A participation strategy is incorporated into the overall project design. The Project supports the MOH efforts to strengthen the decentralization of the health sector in the Lao PDR. It will also build MOH's capacity to coordinate among donors as the health sector gradually moves toward a program approach. It supports consultation and coordination activities among departments within MOH, between MOH and other line ministries, between the central and administrative levels, and in the districts and villages. The use of participatory approaches is critical for the design and introduction of HEFs. Villagers, especially women, will participate in the identification of candidates for PHC officer training. Health committees at different levels will perform various roles in the management of health facilities and of health programs, including the expansion of the village health program under the Project.

Business Opportunities

Consulting Services The Project will require five international consultants for a total of 47 person months, five national consultants for a total of 90 person months, and architect, engineering, and accounting services. The international PHC systems expert (21 person months), the international health policy and planning expert (6 person months) and the international health economist (8 person months) will be hired as individual consultants in accordance with ADB s Guidelines on the Use of Consultants (2007, as amended from time to time). The architect, engineering, and accounting services will be hired through separate firms according to ADB s Guidelines on the Use of Consultants, using the biodata technical proposal and consultant qualification selection or least cost selection method. Other consultants will be contracted through one firm according to ADB s Guidelines on the Use of Consultants, using the fixed budget selection method and biodata technical proposal. This package includes an international HRD expert (9 person months), and social development expert (3 person months) and a national health information expert (24 person months), health policy and planning expert (12 person months), HRD expert (24 person months), health care financing expert (24 person months), and social development expert (6 person months).
Procurement All ADB financed procurement will be in accordance with ADB Procurement Guidelines. Procurement of goods and services $100,000 and above and all civil works will follow national competitive bidding procedures. Vehicles will be procured through the United Nations system, which uses procurement procedures acceptable to ADB. Minor goods and services other than civil works and vehicles costing less than $100,000 may be procured by shopping.

Responsible Staff

Responsible ADB Officer Lochmann, Barbara
Responsible ADB Department Southeast Asia Department
Responsible ADB Division Lao Resident Mission
Executing Agencies
Ministry of Health
Dr. Prasongsidh Boupha
[email protected]
Vientiane, Lao PDR


Concept Clearance -
Fact Finding -
Approval -
Last Review Mission -
PDS Creation Date 28 Feb 2006
Last PDS Update 22 Mar 2013

Grant 0079-LAO

Approval Signing Date Effectivity Date Closing
Original Revised Actual
29 Jun 2007 15 Aug 2007 01 Oct 2007 31 Mar 2012 30 Jun 2012 07 Mar 2013
Financing Plan Grant Utilization
Total (Amount in US$ million) Date ADB Others Net Percentage
Project Cost 15.00 Cumulative Contract Awards
ADB 13.00 29 Jun 2007 12.99 0.00 100%
Counterpart 2.00 Cumulative Disbursements
Cofinancing 0.00 29 Jun 2007 12.99 0.00 100%
Status of Covenants
Category Sector Safeguards Social Financial Economic Others
Rating Satisfactory - - - - Satisfactory

Project Data Sheets (PDS) contain summary information on the project or program. Because the PDS is a work in progress, some information may not be included in its initial version but will be added as it becomes available. Information about proposed projects is tentative and indicative.

The Public Communications Policy (PCP) recognizes that transparency and accountability are essential to development effectiveness. It establishes the disclosure requirements for documents and information ADB produces or requires to be produced.

The Accountability Mechanism provides a forum where people adversely affected by ADB-assisted projects can voice and seek solutions to their problems and report alleged noncompliance of ADB's operational policies and procedures.

In preparing any country program or strategy, financing any project, or by making any designation of, or reference to, a particular territory or geographic area in this document, the Asian Development Bank does not intend to make any judgments as to the legal or other status of any territory or area.

Title Document Type Document Date
Health System Development Project Project/Program Completion Reports Jul 2013
Grant Agreement for Health System Development Project between Lao People's Democratic Republic and Asian Development Bank dated 15 August 2007 Grant Agreement Jul 2007
Health System Development Project Procurement Plans Jun 2007
Health System Development Project Reports and Recommendations of the President Jun 2007
Health Sector Development Project Design and Monitoring Frameworks Jan 2007

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.

Title Document Type Document Date
Health Sector Development Project Resettlement Planning Documents Jan 2007

Evaluation Documents See also: Independent Evaluation

None currently available.

Related Publications

None currently available.

The Public Communications Policy (PCP) establishes the disclosure requirements for documents and information ADB produces or requires to be produced in its operations to facilitate stakeholder participation in ADB's decision-making. For more information, refer to the Safeguard Policy Statement, Operations Manual F1, and Operations Manual L3.

Requests for information may also be directed to the InfoUnit.


No tenders for this project were found.

Contracts Awarded

No contracts awarded for this project were found

Procurement Plan

Title Document Type Document Date
Health System Development Project Procurement Plans Jun 2007