Consultant’s reports describe activities by a consultant or group of consultants related to preparing a technical assistance project.
This document dated June 2014 is provided for the ADB project 42177-013 in Bangladesh.
Technical assistance completion reports describe for technical assistance projects the expected impact, outcome and outputs; conduct of activities; evaluation and achievement of the expected outcomes; an assessment and rating; major lessons; and recommendations and follow-up actions.
This document dated September 2014 is provided for the ADB project 42177-013 in Bangladesh.
Validates the completion report’s assessment of the project, which aimed to improve the quality, higher rates of access, and more affordable primary health care in eight northern provinces in Lao PDR. IED overall assessment: Successful.
The Asian Development Bank partnered with the Blacksmith Institute in building capacity in Asian countries to develop a knowledge base on the location, toxicity, and health impacts of these sites.
Harnessing the expertise and resources of the private sector through partnerships can help broaden access to high-quality health care in Asia and the Pacific.
One of the challenges facing the public health sector in the Asia and Pacific region is how to improve access to lifesaving medicines, particularly in poor rural areas.
The problem is threefold. First, medicines can be expensive, especially for chronic and debilitating conditions that require long-term treatment like heart diseases, cancer, and diabetes. Second, there is a lack or absence of drugstores in areas where the pharmacy business is not considered profitable. Finally, publicly managed health facilities regularly have to deal with systemic problems - such as those related to procurement - that hinder the steady supply of medicines.
A promising solution is public-private partnerships (PPPs) in pharmacy services, which can provide safe and affordable medicines to many who would otherwise not have access to them.
PPPs are innovative, long-term contractual arrangements for developing infrastructure and providing public services by introducing private sector funds and expertise in areas that are normally the responsibility of the government. In the health sector, PPPs have the potential to help the government increase access, lower costs, and improve the quality of facilities and services.
PPPs in pharmacy services tap the private sector's expertise in efficiently dispensing safe and affordable medicines even in remote, underserved areas.
Health services from across Asia and the Pacific have already had positive experiences using PPPs to deliver pharmacy services.
In the Kyrgyz Republic, an ADB-supported early childhood development project which started in 2006 established rural pharmacy networks in remote areas through PPPs. The government was already subsidizing essential drugs based on doctors' prescriptions through the Mandatory Health Insurance Fund. However, patients in rural areas were benefitting less from the subsidy than urban patients because of the lack or absence of pharmacies in these areas.
The PPP program offered incentives to private drug retailers to open stores in rural villages. The government provided free rent for the pharmacies, while the project financed an initial supply of essential drugs, equipment, and staff training. The government regulated the prices of drugs covered by the public health insurance, yet it allowed the pharmacies to sell other medicines or toiletries to make a profit.
According to the project's completion report, majority of the population in the 12 of the poorest "raions" or districts covered by the project now have access to pharmacies, which have more than doubled in number. In 2005, there were less than 100 pharmacies in all 12 raions. By the time the project closed in 2008, there was an additional 123 pharmacies in nine raions, providing 90% of the population with access to a pharmacy, up from just 30% 5 years earlier. Moreover, prices of medicines have gone down, and the population also reported that they now trust the quality of the medicines.
"Rural pharmacy networks run by private pharmaceutical retailers in collaboration with the government have been profitable and drug prices have also dropped, and some companies are planning to expand to other villages on their own," said Rie Hiraoka, Country Director of ADB's Kyrgyz Republic Resident Mission.
In the Philippines, technical assistance from ADB has helped the provincial government of Northern Samar to develop its PPP in pharmacy model. The local government wanted to improve the operation of the pharmacy in its provincial hospital, which would run out of medicines and supplies because of the long and tedious procurement process in the public sector. After assessing the situation with the support of a technical assistance team, the local government decided to develop a PPP in pharmacy model and eventually bid out the management of the provincial hospital's pharmacy to the private sector.
ADB has also produced a step-by-step guidebook on how to develop PPPs in pharmacy in the Philippines based on the technical assistance team's experience in Northern Samar.
"The six steps in the guidebook capture what the local government of Northern Samar and the ADB technical team went through as they developed the PPP in pharmacy model - from the project design to the procurement phases. This highlights the importance of working together on the ground level, ensuring that every stakeholder's voice is heard," shared by Gerard Servais, health specialist at ADB's Southeast Asia Department.
The guidebook helps to determine the issues and concerns related to pharmacy services, identify stakeholders and their roles, and develop an implementation plan and a social marketing plan. It also outlines procurement requirements and procedures, and provides project implementation guideposts, including putting in place an effective monitoring and evaluation system.
The lessons learned in the Kyrgyz Republic and the Philippines are no doubt invaluable to developing countries cross the Asia and Pacific region and beyond.
Q&A: Narrowing the Development Gap: Follow-Up Monitor of the ASEAN Framework for Equitable Economic Development
A new ADB report finds that the path to recovery has proven uneven and diverse, yielding development gaps among member countries of ASEAN.
SEADS 2023: Call for Accelerated Climate Action Towards a Net-Zero ASEAN
SEADS 2023 amplified the urgent call for climate action to ensure Southeast Asia’s carbon neutrality by 2050, and highlighted the importance of partnerships to accelerate climate financing and decarbonization.
Ties That Bind: BIMP-EAGA and IMT-GT Are Vital Building Blocks for ASEAN
At their respective leaders’ summits in Indonesia, both subregional programs demonstrated their ongoing contribution to regional economic resilience, with key support from ADB and other development partners.
Seven Funding Innovations to Boost Climate Finance
Devastating floods, deadly heatwaves, and intense droughts in Asia and the Pacific over the past year confirm what scientists have been warning for years: the impacts of climate change are here and they’re getting worse.
A hydropower energy project in Central Viet Nam has disrupted the lives of an isolated ethnic minority, but offers better health care and educational opportunities for a bright future.
Source: Report and Recommendation to the President 2008.
Pa Pang, Central Viet Nam - Arat Thin gazes at the ultrasound images on the computer, and hangs onto the doctor's every word as he explains how she and her soon-to-be-born baby are faring. It is 22-year-old Thin's second pregnancy, but it is the first time she has received a pregnancy check-up in her own village in Viet Nam's remote central region.
The first time she was pregnant, Thin had to walk an entire day along muddy mountain paths to visit a doctor at the nearest health center.
Today, she is receiving modern prenatal attention due - indirectly at least - to the construction of the Song Bung 4 hydropower project. Pa Pang, where Thin grew up, is a host community that has provided land for people who relocated from Thon 2 village to make way for the hydropower project. Today, thanks to the project, the village (now called Pa Pang-Thon 2), has a health center, among other modern amenities that are making life more convenient - and safer.
"I learned that I shouldn't work so hard in the fields while I'm pregnant, which I didn't know when I was pregnant with my first child."
- Arat Thin, 22, ethnic minority villager
"I'm very happy to be able to talk to the doctor," says Thin. "I learned that I shouldn't work so hard in the fields while I'm pregnant, which I didn't know when I was pregnant with my first child."
When it is completed in 2014, the Song Bung 4 hydropower dam will help supply Viet Nam's growing need for energy. ADB has supplied $196 million from ordinary capital resources for Song Bung 4, the first hydropower project it has supported in Viet Nam.
The project is crucial in terms of meeting power-generation demand for Central Viet Nam, but ADB has also focused on avoiding adverse impacts during the project's implementation. For the more than 1,000 Co Tu ethnic minority members who have had to resettle, that has meant ensuring that their new homes in Pa Pang, or in one of three other villages, are improvements on their old ones.
Most of the villagers affected by the project have traditionally earned their livings through selling forest products, and through slash-and-burn agriculture. Most struggle on incomes below the national poverty line.
To ensure that the villagers who have been relocated have a better quality of life than they did before, the Song Bung 4 project has subsidized sturdy, new, wooden homes designed and built by the families themselves. The houses have toilets, electricity, and clean water. Pa Pang-Thon 2 - the first of the resettlement sites - has a primary school, a public road connecting it to other towns, along with the healthcare center. The other resettlement centers will also have the same amenities.
In Pa Pang, the new health center promotes growing awareness of the importance of staying healthy and preventing illness. The center bustles with visitors - children receiving regular vaccinations, the elderly coming for check-ups and consultations, and villagers dropping by to seek help from a health worker assigned by the local government.
"In addition to making regular visits to the health center in the village, I see more people visiting the district health center too, as it is much easier to reach with the new access road."
- Pham Hong Ha, vice head, district health center
"In addition to making regular visits to the health center in the village, I see more people visiting the district health center too, as it is much easier to reach with the new access road. If villagers have any problems, they seek our advice and get a check-up," says Pham Hong Ha, vice head of the district health center.
Some older Co Tu villagers do not speak Vietnamese fluently, but that is not an obstacle to benefiting from the new facilities. With the assistance of a grant from the Japan Fund for Poverty Reduction for the Song Bung 4 project, selected locals have trained to become village health workers and medical go-betweens.
These go-betweens provide basic services and checkups, and help villagers who need to visit the village or district health centers.
The Japan Fund for Poverty Reduction has also provided critical medical equipment and furniture at the Pa Pang-Thon 2 health center.
Just across from the health center, dozens of children from Pa Pang-Thon 2 Village are studying at a new primary school, which is also a byproduct of the hydropower project. The airy classrooms - equipped with previously unfamiliar essentials, such as chairs and desks - are a significant improvement on their former study environment. Po Loong Trim, a teacher at the school, says the classrooms have made a huge difference for neighborhood children.
"Students are much more motivated to come to school and learn. They are very happy to attend school and there's no more need for me to go looking for them at home anymore," he says.
Moving to a new home can be disruptive but the Song Bung 4 project is committed to ensuring that resettlement means better lives. "It's critical that even as we look to meet the country's electricity needs, that those affected by the new hydropower dam are given better facilities and the opportunity to make better lives for themselves," says Tomoyuki Kimura, ADB country director for Viet Nam.
One thing is for certain: with care from the local health center, Arat Thin's new baby will have a much better start in life now that the family is in the new village.
How a Mongolian Company is Providing Jobs and Hope for People with Disabilities
In this landlocked country of 3.4 million people, 42% of households with people with disabilities live in poverty, compared with 18% of households with persons without disabilities.
Improving Bengaluru’s Livability Through Transit-Oriented Development
Bengaluru, capital of the southern state of Karnataka, is India’s fourth most populous and economically productive city. It is also the world’s fourth largest technology cluster.
In Bangladesh, ADB Helped Build A Safer and Healthier Workplace for Women Garment Workers
In recent decades, Bangladesh has emerged as a leading textile exporter globally due to its low labor cost and high-quality products.
Roads Enhance Connectivity and Create Opportunities in Isolated Hills in Nepal
For landlocked Nepal, roads are a critical lifeline that transport 90% of passengers and goods.
Information and communication technology facilitates the efficient delivery of health-care services to rural communities.
Provides a set of lessons from a sector-wide, reform-based health program in Indonesia going through a process of decentralizing government services since 1999. Findings will feed into future higher-level evaluations.
Validates the completion report's assessment of the project, which aimed to improve the management capacity and system efficiency of the health sector in Tajikistan. IED overall assessment: Successful
This sector synthesis integrates the major findings and lessons learned from the experience of ADB-assisted projects in the health and population sector to improve project design, implementation and operations of future projects.
