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Download/75287 (Accessed 12 April 2020) MINISTRY OF HEALTH Environmental and Social Management Framework for Uganda COVID-19 Response and Public Health Emergencies Systems Strengthening Project (P174041) July 2020 P a g e | i Acronyms ACT Artemisinin Combination Therapies iHIRS Integrated Human Resource Information System ART Anti -retroviral Therapy IMR Infant Mortality Rate ARVs Antiretroviral Drugs IPD In -Patient Department BOR Beds Occupancy Rate (BOR) IPT Intermittent Preventive Treatment CHEW Community Health Extension Workers MoH Ministry of Health COVID -19 Coronavirus disease 2019 NECOC National Emergency Coordination and Operations Centre CRVS Civil Registration and Vital Statistics NEMA National Environment Management Authority DHT District Health Team NIRA National Identification and Registration Authority DLI Disbursement Linked Indicators NCD Non -communicable diseases DRC Democratic Republic of Congo OPD Out Patients Department EAPHLNP East Africa Public Health Laboratory OPM Office of Prime Minister Networking Project EEP Eligible Expenditure Programs PHE Primary Health Emergency ESIA Environmental and Social Impact Assessment PMDU Prime Minister’s Delivery Unit ESMF Environmental and Social Management PNFP Private Not for Profit Framework ESMP Environmental and Social Management Plan PWD People with Disabilities GDP Gross Domestic Product RRH Regional Referral Hospital GBV Gender based violence RRH Uganda Peoples Defense Forces HAART Highly Active Anti -Retroviral Therapy SEA Sexual exploitation and abuse SOP Standard Operating Procedure HCIV Health Center Type Four SUO Standard Unit of Output HCW Healthcare Waste HCWM Health Care Waste Management TB Tuberculosis HMIS Health Management Information System TSR Treatment Success Rate HNP Health Nutrition and Population UBOS Uganda Bureau of Statistics HPAC Health Policy Advisory Committee URMCHIP Uganda Reproductive, Maternal, Neonatal and Child Health Improvement Project HRH Human Resources for Health HRHMIS Human Resources for Health Management VHT Village Health Teams Information System WB World Bank HSDP Health Sector Development Plan WHO World Health Organization ICD International Classification of Diseases ICT Information and Communication Technologies ICU Intensive care unit IDA International Development Association P a g e | ii Contents ACRONYMS ...................................................................................................................................................................................... I EXECUTIVE SUMMARY ................................................................................................................................................................. VI 1 BACKGROUND....................................................................................................................................................................... 1 1.1 RATIONALE OF THE WORLD BANK SUPPORT ...................................................................................................................... 1 1.2 PROJECT CONTEXT .......................................................................................................................................................... 1 1.3 AMOUNT OF FINANCING AND NATURE OF BANK SUPPORT .................................................................................................... 2 1.4 RATIONALE OF USING A FRAMEWORK INSTEAD OF SUBPROJECT-SPECIFIC PLANS .................................................................. 2 2 PROJECT DESCRIPTION ...................................................................................................................................................... 3 2.1 DEVELOPMENT OBJECTIVES ............................................................................................................................................. 3 2.2 DESCRIPTION OF PROJECT COMPONENTS ......................................................................................................................... 4 2.3 PROJECT BENEFICIARIES .................................................................................................................................................. 7 2.4 ENVIRONMENTAL AND SOCIAL RISK CLASSIFICATION OF THE PROJECT .................................................................................. 8 2.5 PROJECT BUDGET ............................................................................................................................................................ 9 2.6 SUMMARY OF PROJECT CHARACTERISTICS ........................................................................................................................ 9 3 POLICY, LEGAL AND REGULATORY FRAMEWORK ........................................................................................................ 12 3.1 POLICY FRAMEWORK IN UGANDA .................................................................................................................................... 12 3.1.1 The National Environment Management Policy, 1994 ............................................................................... 12 3.1.2 The National Health Policy, 1999 .................................................................................................................. 12 3.1.3 The National Medical Equipment Policy, 2009 ............................................................................................ 12 3.1.4 National Health Care Waste Management Plan (2009/2010–2011/2012) ............................................... 13 3.1.5 National Technical Guidelines for Integrated Disease Surveillance and Response, 2012 .................... 13 3.2 LEGAL FRAMEWORK IN UGANDA ..................................................................................................................................... 13 3.2.1 Constitution of the Republic of Uganda, 1995 ............................................................................................. 13 3.2.2 National Environment Act, 2019 .................................................................................................................... 13 3.2.3 Land Act, Cap 227 ........................................................................................................................................... 14 3.2.4 Local Governments Act, Cap 243 ................................................................................................................. 14 3.2.5 Public Health Act, Cap 281 ............................................................................................................................ 14 3.2.6 National Environment (Standards for Discharge of Effluent in Water or on Land) Regulations, 1999 . 14 3.2.7 National Environment (Waste Management) Regulations, 1999 .............................................................. 15 3.2.8 Employment Act, 2006 .................................................................................................................................... 15 3.2.9 Occupational Safety and Health Act (2006) ................................................................................................. 15 3.3 INSTITUTIONAL FRAMEWORK IN UGANDA ......................................................................................................................... 15 3.3.1 National Environment Management Authority (NEMA) .............................................................................. 15 3.3.2 Ministry of Health (MoH) ................................................................................................................................. 16 3.3.3 Ministry of Gender, Labor & Social Development ....................................................................................... 16 3.3.4 District Local Administration Structures ........................................................................................................ 16 3.4 WORLD BANK ENVIRONMENTAL AND SOCIAL FRAMEWORK ............................................................................................... 17 3.4.1 Environmental and Social Standards (ESS) ................................................................................................ 17 3.4.2 World Bank Group Environmental, Health and Safety Guidelines ............................................................ 22 3.4.2.1 WBG EHS Guidelines: “Air emissions and ambient air quality” .................................................................... 23 3.4.2.2 WBG EHS Guidelines: “Waste management” ............................................................................................... 24 3.4.2.3 Industry Specific WBG EHS Guidelines for “Healthcare facilities” ................................................................ 24 3.4.2.4 WBG EHS Guidelines: “Hazardous materials management” ........................................................................ 26 3.4.2.5 WBG EHS Guidelines: “Construction and decommissioning” ....................................................................... 27 P a g e | iii 3.5 WHO GUIDELINES ......................................................................................................................................................... 28 4 ENVIRONMENTAL AND SOCIAL BASELINE CONDITIONS .............................................................................................. 30 4.1 TRANSPORT INFRASTRUCTURE IN UGANDA ...................................................................................................................... 31 4.2 HEALTHCARE SERVICES AND FACILITIES
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