ADB is helping Viet Nam improve health and nutrition in the Central Highlands, in particular for women, children, the poor, and ethnic groups. The project will further reduce maternal and child mortality by addressing access to and quality gaps in commune health stations and hospitals and by strengthening provincial health management in five provinces.
|Project Name||Second Health Care in the Central Highlands Project|
|Project Type / Modality of Assistance||Loan
|Source of Funding / Amount||
|Strategic Agendas||Inclusive economic growth
|Drivers of Change||Gender Equity and Mainstreaming
Governance and capacity development
|Sector / Subsector||
Health / Health system development
|Gender Equity and Mainstreaming||Gender equity|
|Project Rationale and Linkage to Country/Regional Strategy|
|Impact||Improved health and nutrition in the central highlands, in particular for women, children, the poor, and ethnic groups|
|Description of Outcome||Increased use of health services, in particular maternal and child health services in district hospitals, ICPs, and CHSs|
|Progress Toward Outcome||Outcome indicators are one track and most indicators have already achieved their respective targets. Outpatient visits per person per year to district hospitals reached 0.74 from 0.47 in 2014, a 57% increase. Outpatient visits to CHSs declined from 0.67 per person per year (2014) to 0.56 in 2018, a 16% decrease. Inpatient visits per person per year to district hospitals and ICPs reached 0.083 per person per year, a 32% increase from 2014 baseline of 0.063. Proportion of ethnic women deliveries assisted by skilled staff reached 86.3%. Under-5 child malnutrition was reduced to 17.6% from 22.6% in 2014, a 22% reduction.|
|Description of Project Outputs||
1. Improved access and quality of community health care
2. Increased access and quality of hospital services
3. Strengthened provincial health system management
|Status of Implementation Progress (Outputs, Activities, and Issues)||STATUS OF OUTPUT INDICATORS (ACHIEVEMENTS): Output 1: Improved access and quality of community health care1a. Achieved. Proportion of CHSs meeting 80% of the national quality benchmarks to increase to 85% 1b. Achieved. Proportion of CHSs with at least one medical doctor to increase to 92%1c. Achieved. Number of female doctors in CHSs increased by 17% to 300 (2014 baseline: 255).1d. Achieved. Contracts to build or renovate 54 CHSs and 10 ICPs have been awarded. On track to complete all works by 31 Dec 2019.Output 2: Increased Access and Quality of Hospital Services2a. Achieved. Proportion of district hospitals meeting 80% of the national quality benchmark (national inventory checklist) increased by 130% to reach 26% (2014 baseline: 11.3%) 2b. Achieved. 460 level-1 specialists are posted in district hospitals or 8.67 specialists per hospital (27% of whom, or 125 specialists, are female) 2c. Achieved. Number of district hospital beds in the region increased by 1,726 (from 4,410 to 6,136), obstetrics and pediatric beds accounts for 43.6% (2,675). 2d. Partially achieved and on track. Hospital infection control systems that meet national quality benchmark put in place in 43% of hospitals. 2e. Likely to be partially achieved. One district hospital is under construction (Krung Buk), 5 district hospitals is being upgraded, 26 provincial and district hospitals will be equipped.Output 3: Strengthened Provincial Health System Management3a. Achieved. 88% of district senior managers achieving 80% of quality benchmark3b. Not likely to achieve. Proportion of women among district senior managers increased by 7% to 59 senior health managers. 3c. Achieved. 100% of provincial annual operation plans meeting 80% of minimum benchmarks, including funding for maintenance of buildings and equipment, and in-service training3d. Achieved. Provincial training systems put in place in each province (100%).OVERALL IMPLEMENTATION PROGRESS:Training activities. Progress on short-term training courses in 2018 is good, putting the project back on track to achieve its training targets. By 31 Dec 2018, the project had provided pre-service training for 326 VHWs and 36 VBAs, achieving 62.1% and 6.9% of targets, respectively. The project had also provided in-service training to 1069 VHWs and 248 VBAs, achieving 76.4% and 62% of the targets, respectively. CPMU will not train new VBAs in the remaining time because new government policy supports only one health staff at the village level (VHW or VBA) and all districts prefer to have VHWs, who can conduct a range of primary care activities. Safe motherhood training for midwives/VBAs, and doctors were given to 697 (87.1% of target) midwives/VBAs and 645 doctors (53.8% of target). Training in health center management, hygiene and quality assurance for CHS/ICP heads were completed for 761 CHS/ICP heads (76.1% of target). The project is likely to achieve all of its long-term and short-term targets. IEC and community outreach. In 2018, the project implemented community health care for 40% total communes (including 20% target from 2017) in each province. The training courses on IEC techniques and behavior change communication for ICP, CHS staff and district hospital staff were conducted by PPMUs in 5 provinces. In 2018, the project had held 33 classes for 943 staff. By 31 Dec 2018, the project had completed 53 classes for 1,505 staff, including 1,006 females (66.84%) and 352 ethnic minority staff (23.38%). All five provinces have completed their IEC campaigns in villages, with a total of 4,843 participants (79% were female and 75.5% were ethnic minorities). IEC small group meetings were conducted 180 times, on track to achieve the target.Civil works. The following civil works construction have been completed: (i) new district hospitals in Krong Buk (Dak Lak) Lot 1 (CW1), (ii) WWTP in Buon Me Thuot (Dak Lak) and in Dak R'Lap (Dak Nong) (CW3.2 and 3.3); (iii) inter-polyclinic in Eakly-Krong Pak District (CW4), (iii) upgrade of district hospitals in Dak R'lap and construction of district hospital in Dak R'lap, Cu Jut, and Krong No Dak Nong Province (CW5); (iv) 10 new CHS in Dak Nong (CW6); 35 CHS in Kon Tum (new and upgraded) (CW9); and (v) 8 new CHS in Dak Nong (CW12, except for CW12.5 in Kien Duc). During the field visit in Lam Dong, PPMU advised that civil works construction for upgrading of 2 district hospitals in Lam Dong (CW10), 9 new ICPs in Lam Dong (CW11), and WWTP in Da Hoai (Lam Dong) (CW3.5) will be completed in August 2019. Completion of Krong Buk district hospital (CW1 Lot 2) is delayed and slowing down due to land acquisition issues.Goods. Since the midterm review in July 2018, the project awarded contracts for: (i) the procurement of medical equipment and wastewater and sanitation repairs in Dak Nong Province (E6.1, E14.5, E15.9); (ii) procurement of medical equipment by CPMU (for Emergency & Intensive Care, Otorhinolaryngology & Maxillo-Facial-Stomatology, Laboratories [E8]; Infection control, OB/GYN and Pediatrics [E9]; Imaging Diagnostics Departments [E10]; and operating rooms [E11]) with more than 80% of the procured equipment have been delivered; and (iii) procurement of medical equipment for commune health stations and inter-polyclinics and hospital sanitation equipment repairs in Kon Tum Province (E6.3, E6.5, E6.6, E14.8, E14.9, E14.10; and E15.12). Provincial procurement of medical equipment (for New and upgraded CHS and ICPs), Sanitation equipment repairs in hospitals, and IEC materials for village communities is being prepared and ongoing.Consulting Recruitment. A consulting firm for conducting health surveys (CS32) was engaged in July 2018. Audit firm for FY 2018-2019 is currently being recruited and expected to commence service in April 2019. IEC service provider to broadcast and promote IEC video clips (regarding maternal and child health, child nutrition and personal hygiene) in Vietnam television will be engaged.|
|Geographical Location||Dak Nong, Gia Lai, Kon Tum, Tinh Dak Lak, Tinh Lam Dong|
|Summary of Environmental and Social Aspects|
|Environmental Aspects||As reported in the Semiannual Monitoring Reports (January-June 2018 and July-December 2018), the environmental management system of the project has been well established given all environmental requirements from both ADB and the government have been addressed and respective corrective action plans have been proposed and implemented. In general, the contractors for commune health stations have paid little attention to the environmental mitigation and safety measures such almost contractors do not have enough fence system, warning sign boards or guard rail, safety net for the sites at height. Other non-compliance issues that have been noted during this period, include limited provision of personal protective equipment (PPE) to workers, workers not enjoined to wear PPE, improper management of petroleum products and waste oil, etc. The contractors are trying to comply with the required environmental management measures. The PPMUs, with assistance from Construction Supervision Consultants (CSC) is continually conducting discussions and reminding the contractors to improve the implementation of environmental measures. The CSCs are regularly monitoring the contractors' performance through their daily site inspections. The CSCs have already included a more detailed section using the report template and the checklists on the contractors' environmental management activities and performance in monthly progress reports.|
|Involuntary Resettlement||Involuntary Resettlement is recategorized to _B_. As of November, 2018, 72 out of 74 sub-projects were found to be involved in land acquisition. These 72 sub-projects have been granted with land use right certificates or land allocation decisions, and 2 sub-projects were not granted certificate of land use right, which includes Krong Buk district hospital of Dak Lak province and the health center of Kien Duc town, Dak R'Lap district of Dak Nong province. Construction of health station in Kien Duc town changed its construction site, and thus no issue on resettlement. However, for Krong Buk, the land acquisition for the additional land required for auxiliary facilities of the hospital is yet to be completed. Internal disagreement on the eligibility of compensation for the affected land and crops for 7 affected households needs to be solved between provincial and district's people committee. A decision on whether the additional land that required compensation will be included in the project site is expected to be resolved by early April 2019. A resettlement plan or a due diligence report is being prepared.|
|Indigenous Peoples||The Ethnic Group Development Plan (EGDP) is being implemented. EGDP report is currently being revised and will be disclosed. Findings of EGDP implementation report will also be included in the semiannual social safeguard monitoring reports.|
|Stakeholder Communication, Participation, and Consultation|
|During Project Design||Consultation and participation during PPTA or project processing were seminars and workshops conducted such as: (i) inception, midterm, and final seminars involving all the project stakeholders; and (ii) a workshop involving decision makers, planners, managers, and representatives from the provinces and districts on specific policy and regulatory framework.|
|During Project Implementation||Continuous dialogue and consultation with government, development partners and relevant stakeholders.|
All procurement of goods and works will be undertaken in accordance with ADB Procurement Guidelines (2013, as amended from time to time). MOH will advertise all consulting opportunities through the Consultant Management System at www.adb.org. EA will obtain user login credentials from ADB.
The project has completed recruitment of international individual consultants and national individual
consultants. Engagement of consulting firms will be undertaken for (i) information, education and communication (IEC); (ii) training program and health care quality insurance; (iii) civil works detail design and supervision (four firms); and (iv) financial audit. Consulting firms will be hired under Quality- and Cost-Based Selection (QCBS), Quality-Based Selection (QBS), Least Cost Selection (LCS).
International competitive bidding (ICB) procedures will be used for civil work contracts estimated to cost $5,000,000 or more; national competitive bidding (NCB) procedures will be used for civil work contracts below $5,000,000. For Goods, ICB procedures will be used for goods valued at $3,000,000 or above; NCB procedures will be used for goods valued below $3,000,000; Civil works contracts and goods costing $100,000 or less will be procured through shopping.
Civil works procurement packages and other equipment will be awarded based on local competition and will be managed by the five PPMUs with supervision by the Central level and ADB when they are below $1,000,000. Above this level the CPMU will take a leading role and the bidding methodology will be international and national but the bidding process will be launched locally in the provinces.
Medical equipment and supplies packages will be procured by CPMU on basis of ICB, NCB, shopping or direct purchase.
Vehicles (hospital ambulances and district outreach vehicles) will be procured through ICB.
|Responsible ADB Officer||Ye Xu|
|Responsible ADB Department||Southeast Asia Department|
|Responsible ADB Division||Human and Social Development Division, SERD|
Ministry of Health
138A Giang Vo Str.
Hanoi, Viet Nam
|Concept Clearance||05 Dec 2011|
|Fact Finding||21 Jan 2013 to 02 Feb 2013|
|MRM||08 Apr 2013|
|Approval||30 Sep 2013|
|Last Review Mission||-|
|Last PDS Update||27 Mar 2019|
|Approval||Signing Date||Effectivity Date||Closing|
|30 Sep 2013||08 Nov 2013||23 Jun 2014||31 Dec 2019||30 Jun 2020||-|
|Financing Plan||Loan Utilization|
|Total (Amount in US$ million)||Date||ADB||Others||Net Percentage|
|Project Cost||76.60||Cumulative Contract Awards|
|ADB||70.00||30 Sep 2013||43.54||0.00||67%|
|Cofinancing||0.00||30 Sep 2013||35.30||0.00||54%|
|Status of Covenants|
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.
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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.
Evaluation Documents See also: Independent Evaluation
None currently available.
None currently available.
The Access to Information Policy (AIP) 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.
|Contract Title||Approval Number||Contract Date||Contractor||Contractor Address||Executing Agency||Contract Description||Total Contract Amount (US$)||Contract Amount Financed by ADB (US$)|
|MEDICAL EQUIPMENT FOR INFECTION CONTROL DEPTS PACKAGE E9.1||Loan 3038||06 Sep 2018||BMS MEDICAL TECHNOLOGY JSC||LOT NV B56 TRUNG HOA NHAN CHINH BOROUGH THANH XUAN DISTRICT VIET NAM,SOC REP OF||Ministry of Health||SUPPLY OF GOODS||1,221,890.00||1,221,890.00|
|MEDICAL EDQUIPMENT FOR INPATIENT-OB/GYN PEDIATRICS PACKAGE E9.2||Loan 3038||06 Sep 2018||MEDINSCO MEDICAL EQUIPMENT JOINT STOCK COMPAN||1ST FLOOR N4A-B BUILDING LE VAN LUONG STREET NHAN CHINH WARD THAN XUAN DISTRIC VIET NAM,SOC REP OF||Ministry of Health||SUPPLY OF GOODS||2,238,311.00||2,238,311.00|
|EQUIPMENT FOR IMAGING DIAGNOSTICS DEP -PACKAGE E10||Loan 3038||06 Sep 2018||TAI LOC TECHNOLOGY SERVICES AND VIETNAM-KOREA||NO.7 ALLEY 128 HOANG VAN THAU KHUONG MAI WARD THANH XUAN DISTRICT HANOI VIET NAM VIET NAM,SOC REP OF||Ministry of Health||SUPPLY OF GOODS||2,161,260.00||2,161,260.00|
|PROCUREMENT OF MEDICAL EQUIPMENT FOR OPERATING ROOMS (PACKAGE E11)||Loan 3038||15 Aug 2018||JV ARMYPHARM JSC AND HA CAO MEDICAL EQUIPMENT||NO. 55 CUM TRAM LONG BIEN WARD LONG BIEN DISTRICT HANOI VIET NAM VIET NAM,SOC REP OF||Ministry of Health||SUPPLY OF GOODS||2,650,000.00||2,650,000.00|
|PROCUREMENT OF MEDICAL EQUIPMENT FOR EMERGENCY AND INTENSIVE CARE DEPARTMENT (PACKAGE E8 LOT 1)||Loan 3038||15 Aug 2018||HDN INVESTMENT JSC||NO 19 LANE 61 HOAN CAU STREET O CHO DUA WARD DONG DA DISTRICT HANOI VIETNAM VIET NAM,SOC REP OF||Ministry of Health||SUPPLY OF GOODS||1,741,278.00||1,741,241.00|
|PROCUREMENT OF MEDICAL EQUIPMENT FOR LABORATORIES (PACKAGE E8 LOT 3)||Loan 3038||15 Aug 2018||THANH HOA MEDICAL MATERIALS EQUIPMENT JSC||109 NGUYEN TRAI STR. BA DINH WARD THAN HOA PROVINCE VIET NAM VIET NAM,SOC REP OF||Ministry of Health||SUPPLY OF GOODS||1,193,952.00||1,193,952.00|
|PROCUREMENT OF SOLID WASTE MANAGEMENT EQUIPMENT||Loan 3038||13 Jan 2018||TAY BAC A TECHNOLOGY JOINT STOCK COMPANY||6TH FLR, 25T2 BLDG. HOANG DAO THUY ST. TRUNG HOA WARD, CAU GIAY DIST., HANOI VIET NAM,SOC REP OF||Ministry of Health||SUPPLY OF GOODS||1,402,844.00||1,402,844.00|
|SIGNED CONTRACT FOR INFORMATION EDUCATION AND COMMUNICATION (CS-4/QBS)||Loan 3038||27 Oct 2017||CENTER FOR ENVIRONEMNT HEALTH STUDIES||4TH FLOOR, N8A8, NGUYEN THI THAP THANH XUAN, HANOI VIET NAM,SOC REP OF||Ministry of Health||251,409.00||251,276.00|
|SIGNED CONTRACT FOR RECRUITMENT OF QUALITY ASSURANCE OF HEALTH CARE AND TRAINING FIRM (CS-5/ QBS)||Loan 3038||27 Oct 2017||HEALTH ECONOMICS RESEARCH & CONSULTING CENTER||NO.13 HOUSE E, MIN.OF HEALTH COLLECTIVE 138 GIANG VO, BA DINH, HANOI VIET NAM,SOC REP OF||Ministry of Health||272,226.00||272,083.00|
|SIGNED CONTRACT FOR PROCUREMENT OF AMBULANCES||Loan 3038||01 Aug 2017||SHANXI XINHUAXIANG SCIENCE AND TECHNOLOGY||FLOOR 4, BUILDING 1, JIHUA INDUSTRIAL& LOGISTICS ZONE, YUNCHENG CITY, SHANXI CHINA,PEOPLE'SREP.OF||Altay Prefecture Government||SUPPLY OF GOODS||1,104,350.00||1,104,350.00|
|Signed Contracts for Construction of Krong Buk District Hospital (Lot 1: Sand Filling; Lot 2: Construction of Main Building, Etc.)||Loan 3038||25 May 2017||Dak Lak Construction Joint Stock Company||25 Le Duan, Buon Me Thuot City Dak Lak Province, Viet Nam, Soc Rep of||Ministry of Health||Construction||3,651,483.00||3,085,310.00|
|Improvement/Strengthening of Roads under Package C4J in Almora District||Loan 3038||24 Apr 2017||Various||Various United States||Ministry of Health||Others||225,000.00||225,000.00|
|Various Contracts under WA 00012||Loan 3038||20 Mar 2017||Various||Various Viet Nam||Ministry of Health||Others||212,364.18||212,364.18|
|Signed Contracts for International Consultants: 1. Civil Works ($180,000); 2. Medical Equipment ($45,000)||Loan 3038||06 Mar 2017||Dak Lak Construction Investment and Housing||29A Nguyen Cong Tru, Buon Me Thuot City Dak Lak Province Viet Nam||Ministry of Health||Construction||296,705.40||253,534.63|
|Procurement of Office Equipment Gia Lai; Additional Equipment for CHSS and ICPS-GIA Lai and Wastewater and Sanitation Equipment Gia Lai; Signed Contract for Construction/Upgrade of ICP 719||Loan 3038||06 Mar 2017||Various||Various Viet Nam||Ministry of Health||Others||219,373.41||219,373.41|
|Various Contracts under WA 0010||Loan 3038||22 Feb 2017||Various||Various Viet Nam||Ministry of Health||Others||312,767.59||312,767.59|
|Signed Contract for Upgrade of District Hospital in Dakrlap||Loan 3038||20 Jan 2017||Ngu Hanh Son Construction and Trading Co.||76 To Huu, Khanh Xuan, Buon Ma Thuot City, Dak Lak Viet Nam||Ministry of Health||Construction||1,114,610.26||938,231.38|
|Signed Contract for Construction of Wastewater Treatment Plant in Dakrlap Hospital (CW3.3)||Loan 3038||20 Jan 2017||Gia Viet Architecture Joint Stock Company||59 Hoang Van Thu, Quang Ngai City Quang Ngai Province Viet Nam||Ministry of Health||Construction||195,956.40||164,947.74|
|Signed Contract for Construction of Oxygen Supply System in District Hospitals of Dakrlap, Krong No and Cu Jut||Loan 3038||20 Jan 2017||Central Highlands Medical Equipment Trading||32 Tran Huu Duc, Tan Loi Buon Ma Thuot City, Dak Lak Viet Nam||Ministry of Health||Construction||873,872.67||735,585.78|
|Signed Contract for Supervision Firm for Construction of District Hospitals and Wastewater Treatment Plants (F01/QCBS)||Loan 3038||10 Jan 2017||Thang Long Construction Architecture Design||02 House A8A Thanh Xuan Bac Collective Zone, Than Xuan Bac Ward, Hanoi, Viet Nam||Ministry of Health||Consultancy||585,896.57||—|
|Signed Contract for Provision of Teaching/Training Equipment (Package E4) Lot 1: Medical Equipment||Loan 3038||09 Jan 2017||Professional Technology of Medicines Co., Ltd.||72 Thai Thinh 1 Lane, Dong Da Hanoi Viet Nam||Ministry of Health||Supply of Goods||159,673.20||159,077.67|
|Signed Contract for Provision of Teaching/Training Equipment (Package E4) Lot 2: Office Equipment||Loan 3038||09 Jan 2017||Cinema-Broadcast Joint Stock Company||65 Tran Hung Dao, Hoan Kiem Hanoi Viet Nam||Ministry of Health||Supply of Goods||286,203.66||285,136.20|
|Title||Document Type||Document Date|
|Second Health Care in the Central Highlands Project: Procurement Plan||Procurement Plans||Jul 2019|