41505-012: Second Greater Mekong Subregion Regional Communicable Diseases Control Project | Asian Development Bank

Cambodia: Second Greater Mekong Subregion Regional Communicable Diseases Control Project

Sovereign (Public) Project | 41505-012 Status: Active

ADB is helping enhance communicable disease control systems in the Greater Mekong Subregion. The project, which includes Cambodia and the Lao People’s Democratic Republic, will expand surveillance and response systems, target the control of dengue and neglected tropical diseases, and include communicable disease control training for agencies and communities in border districts.

Project Details

Project Officer
Sato, Azusa Southeast Asia Department Request for information
Country
  • Cambodia
Sector
  • Health
 
Project Name Second Greater Mekong Subregion Regional Communicable Diseases Control Project
Project Number 41505-012
Country Cambodia
Project Status Active
Project Type / Modality of Assistance Grant
Source of Funding / Amount
Grant 0231-CAM: Second Greater Mekong Subregion Regional Communicable Diseases Control Project
concessional ordinary capital resources lending / Asian Development Fund US$ 10.00 million
Grant 0448-CAM: Second Greater Mekong Subregion Regional Communicable Diseases Control Project (Additional Cofinancing to Grant 231-CAM)
Regional Malaria and Other Communicable Disease Threats Trust Fund under the Health Financing Partnership Facility US$ 4.00 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
Description The project follows Strategy 2020, which realigns ADB's role in the health sector with emphasis on regional, intersector, and interagency cooperation, as also detailed in the operational plan for health. It is in line with ADB s Regional Cooperation and Integration Strategy, the GMS regional cooperation strategy and the country partnership strategies and country operations business plans of Cambodia, Lao PDR, and Viet Nam. The project supports regional public goods and capacity towards regional health and economic security and the Millennium Development Goals (MDGs) for reducing child mortality and malnutrition, halting the spread of communicable diseases, and others. In partnership with WHO, the Mekong Basin Disease Surveillance Cooperation, the Kenan Institute Asia and other partners, it addresses critical funding gaps for the roll-out of the International Health Regulations (2005) and APSED, as well as regional strategies for the control of dengue and NTDs. Under the leadership of WHO, regional and national aid coordination mechanisms are in place including regular meetings, surveys and publications for aid coordination, technical forums, community of practice groups, and websites.
Project Rationale and Linkage to Country/Regional Strategy Emerging infectious diseases such as severe acute respiratory syndrome (SARS), avian influenza, and swine flu have had major economic impacts on productivity, trade, and tourism in the GMS, and continue to pose a major public health concern. New diseases, mostly of animal origin, also pose a constant threat. Dengue, chikungunya, cholera, typhoid, and HIV/AIDS fueled by better connectivity, urban development, and social and environment changes continue to spread in the GMS. Controlling these diseases requires strong surveillance systems, community prevention and preparedness, and quick system response capacities.
Impact Improved regional health security of the population in the Greater Mekong Subregion (GMS).
Project Outcome
Description of Outcome Timely and adequate control of communicable diseases likely to have a major impact on the region's public health and economy.
Progress Toward Outcome

1. Proportion of suspected infectious disease outbreaks reported within 24 hours:

Among 69 event/outbreaks occurred in 2016, 35 events occurred in 11 CDC2 supported provinces and other 34 in non-supported provinces. 100% are timely reported.

2. Proportion of confirmed infectious diseases outbreaks in border provinces reported across borders within 24 hours:

There was no outbreak of regional or international concern occurred in 2016.

The public health events do not meet the criteria of the IHR (2005) to report, but according to the new agreement based on the SOP's development and endorsement in early December 2017 by the Steering Committee that all public health events with high and very high risk should be reported across the border within 24 hours.

3. Proportion of populations in targeted villages that conduct proper CDC prevention and care increased from 40% to 60%:

Indicator is measured by household survey. Post evaluation survey which is planned to conduct by 2017.

4. Annual parasite incidence in Preah Vihear province (plasmodium falciparum) (confirmed malaria cases/1,000 habitants):

The cumulative cases goes up to 593 cases resulting incidence rate of 7.29 per 1000 population.

Implementation Progress
Description of Project Outputs

1. Enhanced regional CDC systems

2. Improved CDC along borders and economic corridors

3. Integrated project management

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

Total is equal to 18ODs x 2villages x 5Years = 180 villages were selected in 2012 for the fact that combined operation would lead to cost efficiency and timely implementation of the community-based CDC.

In Q4-2016: (1) 3 Cambodia hosted Cross-border meeting in Kampot on 20-21 Oct 2016 involving 8 operational districts.

Q2 (2015): No joint Cross-border meetings conducted by CLV

No cross-border activity in Q2-2016.

Since 2013: 29% of newly selected volunteers are female, no new recruit in 2016.

Village Health Support Groups (VHSG) are official village health workers of health system. 100% of them are trained in CDC within 5 years.

Additional volunteers Village Management Group (VMG) are recruited for Community-based CDC (MHV).

In 2016, 1075 Village health workers are refresher trained on community CDC/Malaria.

Accumulatively in 2016: 879 among trained 1075 volunteers reached 80% competency.

Indicator is measure and reported in 2014:

(i)Percent of people received Praziquantel in endemic area (Kratie: 86.87% and Stung Treng: 88.10% ),

(ii) Percent of women of child-bearing age who received Mebendazole (77% only one round),

(iii)Percent of pre-school aged children 1-5 years (12 to 59 months) received Mebendazole (R1: 93.94%, R2: 95.35% ).

Project stopped supporting MDA since 2015.

100% of RRT trained in CDC since 2013.

In 2016, 1498 CDC staff are trained and refresher trained on Emerging disease and malaria surveillance and investigation outbreak, risk communication to deal with media for emerging disease and malaria, Basic epidmiology and biostatistic, malaria and CDC 10 diseases, Index Case Investigation and Response for Malaria and CDC.

100% of CDC staff trained on CDC since 2013.

In 2016: 282 female among 1498 health staff are refresher trained on Emerging disease and malaria surveillance and investigation outbreak, risk communication to deal with media for emerging disease and malaria, Basic epidmiology and biostatistic, malaria and CDC 10 diseases, Index Case Investigation and Response for Malaria and CDC.

754 staff trained by project provinces are tested post-training, 603 staff got competency

MOH National Focal Point is functioning.

MOH-WHO joint press release:

Y2011: 7 (100%) on AI

Y2012: 3 (100%) on AI

Y2013: 18 on AI

Y2014: 12 (100%) on AI, Ebola, MERSK, Rabies and HIV in Roka village, Roka commune, Sangke district, Battambang province

Y2015:5 on Measles elimination in Cambodia, World Health Day 2015: From Farm to Plate: Make Food Safe, Preventive information about MERS-CoV, Confirmation of one measles case after elimination of measles, Measles cases found negative during confirmatory test.

-Project conducted simulation exercise on joint outbreak investigation in Stung Treng Province (December, 2014) with Champasack and Attapeu (Lao PDR). SOP for joint outbreak investigation and response WS planned to conduct by 22-23 September 2016. Agenda and Concept note of the workshop have been shared with Lao PDR, Vietnam, RCU, ADB and WHO.

- Cambodia hosted the regional workshop to finalize SOP for joint outbreak investigation and response, conducted in Siem Reap on 22-23 September 2016.

- Cambodia hosted Malaria Technical Forum on 31 October - 1 November, 2016 in Siem Reap;

- Cambodia participated Cross-border meeting on 16-17 August 2016 in Champasak Lao PDR, to strengthening surveillance and response system to response emerging infectious disease outbreak including malaria, of the two countries along the border;

- Cambodia also participated in CED in Ho Chi Minh.

CDC website is maintained and updated, Project webpage is integrated with CDC website.

CDC department posts several meaasges and CDC actiities in website. PCU also regularly shares project progress report with stakeholders and public through uploading in project webpage, CDC website.

CDC website links with other website such as MoH, US-CDC, RCU, WHO. Lesson and best practice in implementing community-based CDC is in draft. It will be endorced by project director and posted in project webpage.

In average, 500 visitors per month have accessed the website

- 100% of diseases outbreaks information exchanged as per IHR with sex-disaggregated data.

All of 11 Outbreaks information shared in Q1-2015

All of 7 Outbreaks information shared in Q2-2015

3 measles cases in first semester 2016 have been joint press released with WHO. It is not gender disaggregated.

Project provinces are applying but still limited and need to improve (will be evaluated at the end of project). Joint External Evaluation (JEE) is being piloted at country level. There is no evaluation on compliance with IHR/APSED at provincial level. Some key capacities already complied.

-Cambodia participated Cross-border meeting on 16-17 August 2016 in Champasak Lao PDR, to strengthening surveillance and response system to response emerging infectious disease outbreak including malaria, of the two countries along the border

- Provinces shared information exchange (Stung Treng, Kampong Cham, Kampot and Takeo) using MBDS cross border information format.

Cambodia developed Web based for sharing information on weekly CDC surveillance report.

Gender Mainstreaming Strategy and Action Plan for MOH Cambodia 2014-2018 for strengthenning CD and Non-CD services and advocate the inclusion of gender dimension in communicable and non-communicable diseases. Health workforce development plan 2016-2020 endorsed by MOH on 01 March 2016 included gender-related content.

All training curriculum and IEC materials includes gender contents.

Total 132 staff officially nominated as member of PMU, IA, and PIU; all Provincial staff prepared result based planning in accordance with MOH planning guideline. (Unchange n 2016)

Baseline survey was fully completed in 2014. The endline is expended to End-project survey and expected to be conducted by 2017.

Each year, 14 IA/PIAs AOPs met minimal standard as planning guideline of MOH; and approved by MOH and ADB.

AOP 2016 included cross-border collaboration, in-service training. AOP 2017 include gender-related advocacy on CDC as planned in the gender mainstreaming strategy and action plan for the ministry of health 2014-2018. 5 Provincial AOP 2017 have also included IP activities.

Updated Gender and IP action plan is being implemented. Tool for data collection is finalized and used to measure progress. Review workshop planned to be conducted early 2017.

Geographical Location
Safeguard Categories
Environment C
Involuntary Resettlement C
Indigenous Peoples B
Summary of Environmental and Social Aspects
Environmental Aspects The project is assessed category C for environment.
Involuntary Resettlement The project is assessed category C for involuntary resettlement.
Indigenous Peoples Ethnic groups constitute 31% of the population in the targeted border districts, most of them in the Lao PDR. They suffer disproportionately from common communicable diseases, and have less access to health care because of physical, financial, language, and cultural barriers. The project is assessed category B for indigenous people and is expected to have positive impacts on ethnic groups. The accrual of benefits to ethnic groups is discussed in the ethnic groups plan, and included in the project design. Under the sub-output for community based CDC, the aim is that 50% of 1,160 targeted villages belong to ethnic groups. This includes training of village health workers and support for healthy village development. The project will also provide scholarships for ethnic group members to become health workers.
Stakeholder Communication, Participation, and Consultation
During Project Design Included: (i) group discussions with potential beneficiaries, village health workers, and community-based organizations; (ii) consultation of health staff, provincial and district health managers, provincial governments, central ministries and partners; and (iii) workshop with ministries, partners, and NGOs.
During Project Implementation Level of consultation and participation envisaged are information sharing, Consultation,Collaborative decision making and empowerment. Existing organizational structures down to the village level will be used, no need for a separate system. However, participation will be monitored.
Business Opportunities
Consulting Services All consultants will be recruited according to ADB's Guidelines on the Use of Consultants. Four consulting firms and 17 individual consultants will be provided for the duration of 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). Government international competitive bidding starts at $300,000 for goods, national competitive bidding starts at $100,000, and shopping is below $100,000.
Responsible ADB Officer Sato, Azusa
Responsible ADB Department Southeast Asia Department
Responsible ADB Division Human and Social Development Division, SERD
Executing Agencies
Ministry of Health
No. 151-153, Avenue Kampuchea Krom
1537 Phnom Penh
Kingdom of Cambodia
Timetable
Concept Clearance 30 Mar 2010
Fact Finding 06 Apr 2010 to 23 Apr 2010
MRM 30 Apr 2010
Approval 22 Nov 2010
Last Review Mission -
PDS Creation Date 15 Apr 2010
Last PDS Update 31 Mar 2017

Grant 0231-CAM

Milestones
Approval Signing Date Effectivity Date Closing
Original Revised Actual
22 Nov 2010 27 Jan 2011 22 Mar 2011 30 Jun 2016 31 Dec 2017 -
Financing Plan Grant Utilization
Total (Amount in US$ million) Date ADB Others Net Percentage
Project Cost 11.00 Cumulative Contract Awards
ADB 10.00 22 Nov 2010 9.86 0.00 99%
Counterpart 1.00 Cumulative Disbursements
Cofinancing 0.00 22 Nov 2010 10.16 0.00 102%
Status of Covenants
Category Sector Safeguards Social Financial Economic Others
Rating - - - - - Satisfactory

Grant 0448-CAM

Milestones
Approval Signing Date Effectivity Date Closing
Original Revised Actual
26 Oct 2015 10 Nov 2015 04 Jan 2016 31 Dec 2017 - -
Financing Plan Grant Utilization
Total (Amount in US$ million) Date ADB Others Net Percentage
Project Cost 4.20 Cumulative Contract Awards
ADB 0.00 26 Oct 2015 0.00 2.84 71%
Counterpart 0.20 Cumulative Disbursements
Cofinancing 4.00 26 Oct 2015 0.00 4.25 106%
Status of Covenants
Category Sector Safeguards Social Financial Economic Others
Rating - - - - - 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.

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
Second Greater Mekong Subregion Regional Communicable Diseases Control Project: Ethnic Groups Plan Indigenous Peoples Plans/Indigenous Peoples Development Plans Jul 2015
Second Greater Mekong Subregion Regional Communicable Diseases Control Project (Cambodia) Indigenous Peoples Plans/Indigenous Peoples Development Plans Sep 2010

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.