Lao People's Democratic Republic : Improving the Quality of Health Care Project

Project Name

Improving the Quality of Health Care Project

Project Number

53291-001

Country / Economy

• Lao People's Democratic Republic

Project Status

Active

Project Type / Modality of Assistance

• Loan

Source of Funding / Amount

Loan 4337-LAO: Improving the Quality of Health Care Project

Source	Amount
Concessional ordinary capital resources lending	US$ 45.00 million

Operational Priorities

• OP1: Addressing remaining poverty and reducing inequalities
• OP2: Accelerating progress in gender equality
• OP3: Tackling climate change, building climate and disaster resilience, and enhancing environmental sustainability
• OP6: Strengthening governance and institutional capacity

Sector / Subsector

• Health / Health system development

Gender

Effective gender mainstreaming

Description

The proposed project will enhance the Ministry of Health (MOH)'s capacity to deliver high-quality health care, with a focus on expanding quality healthcare services in provincial and district health facilities. Quality health care is a key component of effective universal health coverage (UHC) under the Sustainable Development Goals (SDGs) and Lao Health Sector Reform (HSR), 2013-2030. Quality health care and responsiveness to patients' preferences encourages people to seek care, and results in enhanced health outcomes. The project will (i) help design and make operational a quality governance mechanism; (ii) enhance quality assurance for health professional education institutions (HPEIs) and health human resources (HHRs); (iii) upgrade existing district hospitals and HPEIs; and (iv) improve health facility management through management training, continuous quality improvement (CQI) cycles and health information systems. The project will be implemented in 16 districts in 10 provinces of the Lao PDR,3F and is expected to directly benefit 1.6 million inpatients and outpatients each year, particularly poor patients from rural districts, women, elderly people, people with a disability, and members of ethnic minorities, all of whom rely on public health care.4F It builds on previous Asian Development Bank (ADB) programs, and will support HSR Phase III (2021-2025) and Phase IV (2026-2030)

Project Rationale and Linkage to Country/Regional Strategy

The proposed project will contribute to the HSR's Phase III (2021-2025) and IV (2026-2030)'s thrust to expand quality essential health services in local facilities (district hospitals and below). The project aligns with the operational priorities (OP) of ADB's Strategy 2030; (i) addressing remaining poverty and reduce inequalities (OP1), by pursuing UHC and reducing health vulnerabilities; (ii) accelerating progress in gender equality (OP2), by enabling women to pursue health professional education opportunities, participate in QHC governance, and by addressing their unmet health needs; (iii) tackling climate change, building climate and disaster resilience, and by enhancing environmental sustainability (OP3) through climate-smart design of civil works; and (iv) strengthening governance and institutional capacity (OP6), by developing and operationalizing QHC, personnel, and hospital management policies. The project also contributes to priority 2 (enhanced human development) of ADB's 2017-2020 country partnership strategy for the Lao PDR and its extension.

Impact

Sustainable Development Goals related to the health sector achieved by 2030

Project Outcome

Description of Outcome

Foundations for high-quality health care strengthened and utilization of health services increased

Progress Toward Outcome

Implementation Progress

Description of Project Outputs

Governance mechanisms for quality assurance and CQI enhanced

HHRs to deliver quality health services strengthened

Quality and management of health facilities boosted

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

Geographical Location

Nation-wide

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 project includes 20 consulting services packages (19 individual consultant packages and 1 consulting firm packages). All packages will undergo OCB arrangement with prior review from ADB. The design and construction supervision consulting firm will be engaged using quality-cost-based selection (90:10 quality-cost ratio). Advance contracting is proposed for the national design and construction supervision firm, the accounting firm, the CTA, the international architect, the program manager/deputy CTA, the international procurement specialist, the national procurement specialist, the national project administrator, and the national planning, budgeting and M&E assistant.

Procurement

All advance contracting will be undertaken in accordance with the ADB Procurement Policy (2017, as amended from time to time) and the Procurement Regulations for ADB Borrowers: Goods, Works, Nonconsulting, and Consulting Services (2017, as amended from time to time). The issuance of invitations to bid under advance contracting and retroactive financing will be subject to ADB approval. The borrower and MOH have been advised that approval of advance contracting and retroactive financing does not commit ADB to finance the project.

Advance contracting will involve selection of key PMU consultants and the design and construction supervision firm for civil works up to, but not including, contract signing. Given the current capacity of the borrower, additional advance contracting support maybe required to enable timely mobilization of consultants and procurement.

The project includes 8 civil works packages, 15 goods packages, and 3 non-consulting service packages. Most of the civil works and goods packages, and all vehicles, will be rely on open competitive bidding (OCB), except for specific readily available, simple, low-risk goods and non-consulting service packages, which will be procured using RFQ. Prior review will be made on (i) the packages using OCB with international advertisement, (ii) first two works and first goods packages using OCB with national advertisement, and (iii) first package using RFQ. The rest of the works and goods packages will be under post-sampling review. Three packages for non-consulting services will be procured using RFQ.

Contact

Responsible ADB Officer

Esperato Martinez, Alexo R.

Responsible ADB Department

Sectors Group

Responsible ADB Division

Human and Social Development Sector Office (SG-HSD)

Executing Agencies

Ministry of Health

Timetable

Concept Clearance

07 Oct 2019

Fact Finding

08 Jun 2020 to 12 Jun 2020

MRM

17 Apr 2020

Approval

18 Aug 2023

Last Review Mission

-

Last PDS Update

22 Aug 2023

Funding

Loan 4337-LAO