fbpx 49173-004: Improving Access to Health Services for Disadvantaged Groups Investment Program - Tranche 1 | Asian Development Bank

Mongolia: Improving Access to Health Services for Disadvantaged Groups Investment Program - Tranche 1

Sovereign (Public) Project | 49173-004 Status: Approved

Tranche 1 proposed for financing under the requested periodic financing request (PFR) aims to contribute to the investment program's impact of improving the health status of Mongolians.

The investment project comprises the following outputs:

(i) urban and rural primary health care strengthened,

(ii) district and aimag hospital services improved,

(iii) health financing system strengthened, and

(iv) capacity in procurement and financial management of relevant government entities for health strengthened.

Project Details

Project Officer
Najibullah Habib East Asia Department Request for information
Country
  • Mongolia
Sector
  • Information and communication technology
 
Project Name Improving Access to Health Services for Disadvantaged Groups Investment Program - Tranche 1
Project Number 49173-004
Country Mongolia
Project Status Approved
Project Type / Modality of Assistance Grant
Loan
Source of Funding / Amount
Grant 0672-MON: Improving Access to Health Services for Disadvantaged Groups Investment Program - Tranche 1
Japan Fund for the Joint Crediting Mechanism US$ 3.48 million
Loan 3843-MON: Improving Access to Health Services for Disadvantaged Groups Investment Program - Tranche 1
Ordinary capital resources US$ 66.14 million
Loan 3844-MON: Improving Access to Health Services for Disadvantaged Groups Investment Program - Tranche 1
concessional ordinary capital resources lending / Asian Development Fund US$ 10.00 million
Strategic Agendas Inclusive economic growth
Regional integration
Drivers of Change Gender Equity and Mainstreaming
Governance and capacity development
Partnerships
Sector / Subsector

Information and communication technology / ICT industries and ICT-enabled services

Gender Equity and Mainstreaming Effective gender mainstreaming
Description

Tranche 1 proposed for financing under the requested periodic financing request (PFR) aims to contribute to the investment program's impact of improving the health status of Mongolians.

The investment project comprises the following outputs:

(i) urban and rural primary health care strengthened,

(ii) district and aimag hospital services improved,

(iii) health financing system strengthened, and

(iv) capacity in procurement and financial management of relevant government entities for health strengthened.

Project Rationale and Linkage to Country/Regional Strategy

Sector background. Rapid urbanization in Mongolia over recent decades has increased the burden on the provision of health and social services in Ulaanbaatar and aimag centers. This has led to a shortage of human resources, funding, and equipment; and obsolete and poorly functioning health facilities that weaken the accessibility, quality, and equity of health care services. Poor urban infrastructure and weakened government capacity to provide basic social services have exacerbated the situation. Ulaanbaatar has been the main destination for migrants from Mongolia's rural areas, and now hosts more than 50% of the country's population. About 60% of Ulaanbaatar's population lives in ger areas, with limited access to running water, sanitation, and social services, including primary health care (PHC). Access to health care is challenging, especially for the poor. Out-of-pocket health expenses are high and account for 41% of total health expenditure; one-third of household out-of-pocket health expenses are for medicines because of high prices and the inappropriate use of drugs. Over 90% of the population has health insurance coverage, but the benefit package is limited to hospital services, with the result that the poor use health services 2.5 times less than the nonpoor. In 2015, government expenditure on health accounted for just 2.4% of gross domestic product, well below the 5% target of the World Health Organization. Addressing behavioral risk factors, particularly among men including obesity, alcohol and tobacco abuse, and gender-based violence and their associated health impacts remains a key challenge.

The Asian Development Bank (ADB) has been Mongolia's key health sector development partner since 1993, providing five loans totaling $84.90 million, seven grants totaling $37.00 million, and 15 technical assistance (TA) projects totaling $10.65 million. The projects achieved significant results through comprehensive health system support and strengthening, including for PHC reform and investments, information and communications technology, medicine and pharmaceutical procurement reforms, establishment of health insurance, health infrastructure, human resources for health, and sector governance. ADB has also strategically supported the drafting and enactment of key health policies and laws, including the Health Law (2016) and laws related to health insurance, medicines and medical devices, and medical care and services. With support from ADB, Mongolia was able to achieve its Millennium Development Goal targets of reducing under-5 child mortality and preventing the spread of HIV/AIDS. It also made significant progress toward the Millennium Development Goal targets of reducing poverty and malnutrition, and improving maternal health.

Despite these achievements, Mongolia faces a continuing burden from both communicable and noncommunicable diseases, resulting in premature mortality and high levels of disability, which prevent the nation from fulfilling its economic potential. Economic growth since 2001 has been strong, but one in five Mongolians still live below the national poverty line and face significant health care challenges that need to be addressed.

Impact Health status of Mongolians improved
Project Outcome
Description of Outcome Access to affordable quality primary and secondary health servicesb in Khovd and Uvs aimags (provinces), Ulaanbaatar ger (traditional tent) areas, and selected soums (aimag subdistricts) improved
Progress Toward Outcome
Implementation Progress
Description of Project Outputs

Urban and rural primary health care strengthened

District and aimag hospital services improved

Health financing system strengthened

Procurement and financial management capacity of government health entities strengthened

Status of Implementation Progress (Outputs, Activities, and Issues)
Geographical Location Ulaanbaatar
Safeguard Categories
Environment B
Involuntary Resettlement C
Indigenous Peoples C
Summary of Environmental and Social Aspects
Environmental Aspects
Involuntary Resettlement
Indigenous Peoples
Stakeholder Communication, Participation, and Consultation
During Project Design
During Project Implementation
Business Opportunities
Consulting Services The MOH is responsible for selecting, engaging, and supervising consultants. Eight packages for consulting services will be tendered and Consulting firms will be recruited following a quality and cost-based selection (QCBS) procedure with a quality / cost ratio of 90:10. International and national individual consultants (excluding PIU staff) will be engaged using individual consultant's selection procedure.
Procurement

All procurement of goods and works will be undertaken in accordance with ADB Procurement Policy (2017, as amended from time to time) and established commercial practice to obtain optimal results (quality / price ratio). The implementing agencies will also ensure that goods and services to be financed by project funds are procured from ADB member countries. Relevant sections of the ADB Anticorruption Policy (1998, as amended to date) will be included in all procurement documents and contracts.

A 10-year MFF procurement plan indicating thresholds and review procedures, describing contract packages for goods, works, and consulting services as well as national competitive bidding guidelines is presented in Section C. Prior review and approval by ADB of the OCB and RFQ procurement documents (advertisements and invitations, bidding documents, draft contract) are required for the first three procurements, while for the remainder a post review will be used.

Responsible ADB Officer Najibullah Habib
Responsible ADB Department East Asia Department
Responsible ADB Division Urban and Social Sectors Division, EARD
Executing Agencies
Ministry of Health (formerly Ministry of Health and Sports)
[email protected]
1st Floor, Government Building VIII
Olympic Street 2, Ulaanbaatar
Mongolia
Timetable
Concept Clearance -
Fact Finding -
MRM 18 Dec 2018
Approval 24 Oct 2019
Last Review Mission -
Last PDS Update 28 Oct 2019

Grant 0672-MON

Milestones
Approval Signing Date Effectivity Date Closing
Original Revised Actual
24 Oct 2019 - - 30 Jun 2025 - -
Financing Plan Grant Utilization
Total (Amount in US$ million) Date ADB Others Net Percentage
Project Cost 3.48 Cumulative Contract Awards
ADB 0.00 24 Oct 2019 0.00 0.00 0%
Counterpart 0.00 Cumulative Disbursements
Cofinancing 3.48 24 Oct 2019 0.00 0.00 0%

Loan 3843-MON

Milestones
Approval Signing Date Effectivity Date Closing
Original Revised Actual
24 Oct 2019 - - 30 Jun 2025 - -
Financing Plan Loan Utilization
Total (Amount in US$ million) Date ADB Others Net Percentage
Project Cost 66.96 Cumulative Contract Awards
ADB 66.14 24 Oct 2019 0.00 0.00 0%
Counterpart 0.82 Cumulative Disbursements
Cofinancing 0.00 24 Oct 2019 0.00 0.00 0%

Loan 3844-MON

Milestones
Approval Signing Date Effectivity Date Closing
Original Revised Actual
24 Oct 2019 - - 30 Jun 2025 - -
Financing Plan Loan Utilization
Total (Amount in US$ million) Date ADB Others Net Percentage
Project Cost 10.00 Cumulative Contract Awards
ADB 10.00 24 Oct 2019 0.00 0.00 0%
Counterpart 0.00 Cumulative Disbursements
Cofinancing 0.00 24 Oct 2019 0.00 0.00 0%

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 Access to Information Policy (AIP) 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.

None currently available.

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.

None currently available.

Evaluation Documents See also: Independent Evaluation

None currently available.

Related Publications

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.

Tenders

Tender Title Type Status Posting Date Deadline
Improving Access to Health Services for Disadvantaged Groups Investment Program - Tranche 1: Ground Source Heat Pump Expert Individual - Consulting Closed 25 Jul 2019 31 Jul 2019

Contracts Awarded

No contracts awarded for this project were found

Procurement Plan

None currently available.