Due Diligence Report Project Number: 41509-013 June 2016
PNG: Rural Primary Health Services Delivery Project (Loan 2785 and Grant 0259)
Prepared by the Department of Health for the Asian Development Bank.
This due diligence report is a document of the borrower. The views expressed herein do not necessarily represent those of ADB’s Board of Directors, Management, or staff, and may be preliminary in nature. Your attention is directed to the “terms of use” section of this website. 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 judgements as to the legal or other status of any territory or area. Papua New Guinea Rural Primary Health Services Delivery Project
DUE DILIGENCE REPORT FOR ACQUISITION of the AMAIRA CHP SITE
Eastern Highlands Province
June 2016 INDEX
Executive Summary Project and Community Health Post Description Amaira Community Health Post Site – Description and Area Scope of Land Use/Purchase Socioeconomic Information Information Disclosure, Consultations and Participation Grievance Redress Mechanism Applicable Policies and Laws Agreements on Land Use Compensation and Benefits Budget and Sources of Funds Institutional Arrangements Implementation Schedule Monitoring and Reporting
ANNEXURES (Available Upon Request)
Annex One: Reports of Community Consultations
Annex Two: Minutes of Aid Post Board meetings
Annex Three: Signed Customary Land Transfer Agreement
Annex Four: Land survey of site
Annex Five: Land Investigation Report
Annex Six: Valuation Report
Annex Seven: Approved Layout Plan for Community Health Post
Annex Eight: Environmental Management Plan
Annex Nine: Certificate of Alienability
Annex Ten: Deed of Release
EXECUTIVE SUMMARY
The Rural Primary Health Service Delivery Project (RPHSDP) is a collaboration between the Government of PNG represented by its National Department of Health and the Asian Development Bank, Australian Department of Foreign Affairs and Trade, the OPEC Fund for International Development, the World Health Organisation, the Japanese International Cooperation Agency and UNICEF.
The Project is operating in two (2) Districts of each of eight (8) Provinces and plans to build thirty-two (32) new Community Health Posts, ninety-six (96) new staff houses as well as providing medical equipment and small vehicles (cars, boats, or motorbikes) to support their operation. It will also install or upgrade sanitation facilities, provide waste management facilities and establish renewable energy supplies for selected health facilities.
The Community Health Post is deemed a Level 2 Health Facility under the PNG National Health “e i e “ta da ds, s ‘ole Deli eatio Mat i a d is e ui ed to p o ide ate al a d child primary health clinics. Provision is also made for birthing and postnatal inpatient care, short term paediatric and adult inpatient services and for triage, stabilisation and referral to highe le el fa ilities of iti all ill lie ts. A odest P o edu e ‘oo is p o ided to allo emergency care of trauma or serious medical conditions prior to referral and discrete consultation rooms are provided to ensure privacy for clients seeking care or advice for their conditions. The Amaira Community Health Post is expected to provide health services for up to forty (40) people per day.
Amaira Village is located about thirty (30) kilometres directly east of Okapa Station in the Okapa District of Eastern Highlands on the border with Obura Wonenara District. It is accessible by road from Kainantu, the nearest township, but can take up to one hour of travelling time dependent upon prevailing weather conditions.
The immediate catchment population for the proposed Amaira Community Health Post is 3248 persons. Demand for maternal and child health services to be offered by the Community Health Post will be derived from the 568 children less than 5 years of age and 698 women of child bearing age living in the area as identified through the 2011 Census. However, it is also anticipated that those living in villages further to the west will also access the new Amaira Community Health Post and that the true catchment population will be closer to 8000 people once the facility is constructed and commissioned.
Their nearest Hospital is the run down Okapa District Hospital which can only be reached by walking 30 kilometres in a westerly direction. They do have more timely access to the Kainantu District Hospital provided that they have access to a vehicle but there are very few vehicles operating in the immediate area due to poor road conditions.
The site at Amaira, acquired for the State by the Okapa District Development Authority, satisfies all of the P oje t s criteria required for construction of the proposed Community Health Post to proceed:
The land is in Okapa District of the Province The Chief Executive Officer of the Eastern Highlands Provincial Health Authority has endorsed the concept plan, the site plan and the final design of the Community Health Post after consulting with the local communities that it will serve. Landowners of the area have been consulted extensively about their healthcare needs and voluntarily offered land for the project in order to secure a Community Health Post within their village. The P o i e s “t ategi Health “e i e De elop e t Pla , e o e ds construction of a Level 2 Community Health Post in the village to serve the health needs of the 3248 people living in the immediate area. That Plan has been endorsed by the Board of the Provincial Health Authority. The Chief Executive Officer has entered a Memorandum of Agreement with the Secretary for Health confirming the availability of recurrent budget for operation of the facility The Chief Executive Officer has nominated the three staff members to be assigned to the facility and those staff have undergone extensive upskilling in maternal and child health service provision. The nominated Officer in Charge has completed the Rural Health Facility Management Course delivered by Divine Word University. The Community Health Post design has been certified by the Manager, Health Facilities Branch of the National Department of Health as consistent with the National Health Service Standards, 2011 The Environmental Management Plan was endorsed by the relevant officers of the Asian Development Bank on 10th June, 2016. The former customary owners of the land consented to sell their land to the State through the Land Investigation Report dated 27th February, 2015. The land offered is cleared, steeply sloping in opposite directions and well drained clay and loam. It is registered as Portion 336C Milinch of Okapa, Fourmil of Markham, Okapa District, Eastern Highlands Province. The Land Investigation Report indicates that there is sufficient land available and thus the o e s a affo d to sell the la d . The land was owned by members of the Kafiamapa (Avia) Clan and had been acquired through e e ship of the Cla . Their rights to the land are not contested.
Mr. Korofe Muratai, Mr. Nuato Sandafe, Mr. Gilbert Kawa Muratai, Mr. Joseph Autua and Mr, Apse A is a e a ed i the “ hedule of O e s, “tatus a d ‘ights to the La d se tio of the La d I estigatio ‘epo t as ha i g full ights as the la d o e s. They have nominated Mr. Korofe Muratai, Mr. Nuato Sandafe, Mr. Gilbert Kawa Muratai, Ms. Hellen Gilberty Muratai and Mr. Yato Yarike Waina to be their representatives and agents for the purpose of executing a transfer to the Provincial Administrator. They fu the autho ised the a o e agents to accept, on behalf of all, moneys and considerations paid by the said Administrator i o e tio ith the p oposed t a sfe of the said pie e of la d .
The extent of the site was determined by the customary owners and the owners of adjoining land in the company of the Surveyor prior to survey and is quantified at 1.33 hectares by him. The boundaries are clearly marked and are consistent with the decision of the local landowners. The owners of contiguous land have also declared that they have no interest in or rights by native custom to the surveyed land.
The site was selected by the customary owners because it is central to the surrounding villages of Avia, Waisana, Nankona, Ponampa, Sinkura 1 and 2 and Waifina whose villagers have limited access to other health services and because of its proximity to the road leading to Kainantu.
The value of the land provided for the Community Health Post was assessed by the Valuer- General to be K93,000.00 and there are no capital improvements or planted crops on the site.
The Certificate of Alienability No. 28/11-2015 was issued by the Secretary of the Department of Provincial and Local Government Affairs on 30th November, 2015.
Payment of K93,000 was made to the authorised agents by the Okapa District Development Authority on behalf of the State in Amaira Village on ------. The Deed of Release and the Sale and Transfer documents were signed by ------in the presence of X other people.
The process of obtaining the Title on behalf of the State is now complete and tenders have been invited for construction of the proposed Community Health Post.
A. PROJECT AND COMMUNITY HEALTH POST DESCRIPTION
Background
1. The Rural Primary Health Service Delivery Project will strengthen the rural health system in PNG by increasing the coverage and quality of primary health care in partnership with State and non-state service providers by supporting the Government of PNG to implement the National Health Plan 2011-2020 as it relates to rural health. The Project operates in two districts in each of the following eight Provinces nominated by the Government of PNG: Eastern Highlands, East Sepik, Enga, Milne Bay, Western Highlands, West New Britain, Morobe and the Autonomous Region of Bougainville.
2. The Project will make health service improvements on both the supply and demand sides and strengthen the policy and legal framework for health services at all levels. The Project has six (6) clearly articulated outputs:
Output 1 – National policies and standards: assisting the National Department of Health in developing policies, standards, and strategies for new Community Health Posts and human resource strengthening of the rural health sector. This will result in the development of Provincial health service development plans and improvements in the National Health Information System.
Output 2 – Sustainable partnerships between provincial governments and non-state actors: Partnership Committees have been established to improve coordination and efficiency among providers, (churches and NGOs) and to increase consistency and accountability. Partnership arrangements have been formalized through Memoranda of Agreement with most non-state health service providers.
Output 3 – Human resource development in the health sector. The Project will increase the skills of health personnel in rural communities, focusing on the existing workforce. It will help provinces to address staff performance and retention issues.
Output 4 – Community health facility upgrading: The Project will build thirty-two (32) new Community Health Posts, with ninety-six (96) staff houses as well as providing medical equipment and small vehicles (cars, boats, or motorbikes). It will also install or upgrade sanitation facilities, provide waste management facilities, and establish renewable energy supplies for selected health facilities. The Community Health Post is deemed a Level 2 Health Fa ilit u de the PNG Natio al Health “e i e “ta da ds, s ‘ole Deli eatio Matrix and is required to provide maternal and child primary health clinics. Provision is also made for birthing and postnatal inpatient care, short term paediatric and adult inpatient services and for triage, stabilisation and referral to higher level facilities of critically ill lie ts. A odest P o edu e ‘oo is p o ided to allo e e ge a e of t au a o serious medical conditions prior to referral and discrete consultation rooms are provided to ensure privacy for clients seeking care or advice for their conditions. The Amaira Community Health Post is expected to provide health services for up to forty (40) people per day.
Output 5 – Health promotion in local communities: The Project will support village health olu tee s a d i ease o e s i ol e e t a d community engagement in delivering health se i es ased o the Health Isla ds f a e o k.
Output 6 - Project monitoring, evaluation and management: The Project has established a Project Support Unit (PSU) as part of the National Department of Health, which will be used by the National Department of Health as part of its health system strengthening activities.
3. Eastern Highlands Provincial Health Authority has selected Amaira in Okapa District as one of the sites to construct a new Community Health Post under Output 4 of the Project. The facility will have two (2) postnatal beds and three (3) general beds which are deemed sufficient to provide Level 2 health services to a catchment population of up to 8000 persons.
4. Sites selected by the Provinces, are required to satisfy the following criteria:
(i) The facility or site is located in a participating Province and participating District and is in a predominantly rural area;
(ii) The proposed works have been identified and designed by the relevant implementing agency in a participatory manner with input from the community;
(iii) Community consultation for selection of the site has been conducted;
(iv) The proposed works are integrated into a comprehensive provincial health plan;
(v) The proposed facility/site has available/earmarked budget for recurrent cost in the health functional grant;
(vi) The proposed facility/site has sufficient human resources/staff and supervision capacity;
(vii) Institutional and financial arrangements for construction, operation and maintenance of the facility and access to the facility have been agreed upon by the Partnership Committee/Provincial Health Authority Board;
(viii) The proposed works comply with all requirements of relevant National laws and regulations and ADB's Safeguard Policy Statement (2009), the Environment Management Plan, Environment Assessment and Review Framework, and Land Assessment Framework;
(ix) the Independent State of Papua New Guinea through the Eastern Highlands Provincial Health Authority has clear and unencumbered title to the associated land portion on which the Community Health Post is to be located, without claims of third parties, and the Province has supplied adequate written confirmation of the same from the relevant authorities and community participants, as applicable, including relevant Clan Land Use Agreement, Certificate of Alienability, Sale and Transfer of Land Deed and Deed of Release documentation; and
(x) access to and from the site for vehicles or other means of transport is in place. 5. Within each participating Province, the Districts to participate in the Project were required to satisfy the following criteria:
(i) The District is selected with a view to maximizing the delivery of health services for rural populations that are most underserved at the outset of the Project such as the percentage of the population accessible to health facilities within 2 hours traveling time.
(ii) The District is selected with due consideration for the ability to absorb and utilise the proposed investment of resources, taking into account levels of security, law and order, governance, and administrative capacity.
6. Each of the sites chosen for the construction of a new Community Health Post usually requires less than one hectare of land to accommodate the health facility and three staff houses. In the case of the Amaira site 1.33 hectares was provided as a g ee field site.
7. The P oje t s i pact is limited to compensable loss of land use, any existing structures on the site and, where applicable, crops and trees. The landowners and local communities are expected to benefit from improved access to health services and short-term employment opportunities from infrastructure construction and maintenance. The acquisition of small plots of land for the Community Health Posts is based on the laws, regulations, and policies of the Go e e t of PNG a d the ADB s “afegua d Poli “tate e t 9 . The Project will not finance Community Health Post construction that involves compulsory land acquisition and/or involuntary resettlement impacts. In all cases the Project is building on State land or church leased where there has been a previous aid post.
B. EASTERN HIGHLANDS PROVINCE – GEOGRAPHY, POPULATION DISTRIBUTION & ACCESS TO SERVICES
8. The follo i g aps of Easte Highla ds P o i e a e de i ed f o the PNG ‘u al De elop e t Ha d ook of de eloped LW Ha se , BJ Alle , ‘M Bou ke a d TJ McCarthy and published by the Land Management Group, Department of Human Geography of the Australian National University. The depiction of occupied and unoccupied lands for Eastern Highlands Province remains accurate and clearly indicates the concentration of the population in the arable valleys of the Province. Population density in those areas has increased by approximately 9% since the 2000 Census upon which these depictions relied. Access to services for residents of some areas has improved with better and more roads being provided in some areas. Real income levels have not improved significantly since the time of publication.
9. Eastern Highlands Province occupies 11,000 square kilometres in the PNG central highlands. Altitude varies from 3500m above sea level in the rugged Bismarck Range in the north to just 300 metres in the upper Ramu Valley in the northeast of the Province. Agriculture is conducted over an altitudinal range of 300-2400 metres. The Asaro, Benabena, Karmanuntina, Gafutina and upper Ramu Valleys have highly productive soils for gardening and support large concentrations of population. The southern half of the Province is more mountainous with more than 50% of the land unoccupied. Image 1: Occupied/Unoccupied Land in Eastern Highlands Province – 2001
AMAIRA
10. The total Provincial population reported at the time of the 2011 National Census was 578242 with the population heavily concentrated in the arable valleys which are some of the most densely populated and intensively cultivated areas in PNG. Amaira Village is located about thirty (30) kilometres directly east of Okapa Station in the Okapa District of Eastern Highlands on the border with Obura Wonenara District. It is only accessible by road from Kainantu, the nearest township, but can take up to one hour of travelling time dependent upon prevailing weather conditions. The distance from Kainantu is inexplicably recorded as 50 kilometres in a north westerly direction in the Land Investigation Report when it is actually south west of Kainantu.
The following image depicts the areas of greatest population density in Eastern Highlands Province a d that the populatio de sit i the A ai a a ea is ode ate with up to 60 persons/square kilometre.
Image 2: Population Density in Eastern Highlands Province, PNG
AMAIRA
The following image depicts the level of access to major centres and services for the people of Eastern Highlands. The people of Amaira area are considered to be within 4-8hours of Goroka, their nearest major service centre. The a ea h the Okapa “tatio , a Dist i t Headquarters, by walking for up to eight (8) hours in a westerly direction but the District Hospital at Okapa is rundown and service capacity is limited.
AMAIRA
11. The immediate catchment population for the proposed Amaira Community Health Post is 3248. Demand for maternal and child health services to be offered by the Community Health Post will be derived from the 568 children less than 5 years of age and 698 women of child bearing age. However, it is also anticipated that those living in villages further to the west will also access the new Amaira Community Health Post and that the true catchment population will be closer to 8000 people once the facility is constructed and commissioned. Their nearest Hospital is the run down Okapa District Hospital which can only be reached by walking 20 kilometres in a westerly direction. They do have better access to the Kainantu District Hospital provided that they have access to a vehicle but there are very few vehicles operating in the immediate area due to road conditions.
C. AMAIRA CHP SITE: DESCRIPTION AND AREA
12. Eastern Highlands Provincial Health Authority has selected Amaira in Okapa District as one of the sites to construct a new Community Health Post under Output 4 of the Project. The Amaira facility will have two (2) postnatal beds and four (4) general beds.
13. The site at Amaira, acquired for the State by the Okapa District Development Authority for the construction of a Community Health Post and three (3) staff houses satisfies all of the criteria required for construction of the proposed Community Health Post to proceed:
The land is in Okapa District of the Province The Chief Executive Officer of the Eastern Highlands Provincial Health Authority has endorsed the concept plan, the site plan and the final design of the Community Health Post after consulting with the local communities that it will serve. Landowners of the area have been consulted extensively about their healthcare needs and voluntarily offered land for the project in order to secure a Community Health Post within their village. The P o i e s “t ategi Health “e i e De elop e t Pla , e o e ds construction of a Level 2 Community Health Post in the area to serve the health needs of the 3248 people living in the immediate area. That Plan has been endorsed by the Board of the Provincial Health Authority. The Chief Executive Officer has entered a Memorandum of Agreement with the Secretary for Health confirming the availability of recurrent budget for operation of the facility The Chief Executive Officer has nominated the three staff members to be assigned to the facility and those staff have undergone extensive upskilling in maternal and child health service provision. The nominated Officer in Charge has completed the Rural Health Facility Management Course delivered by Divine Word University. The Community Health Post design has been certified by the Manager, Health Facilities Branch as consistent with the National Health Service Standards, 2011 The Environmental Management Plan was endorsed by the relevant officers of the Asian Development Bank on 10th June, 2016. The former customary owners of the land, registered as Portion 336C Milinch of Okapa, Fourmil of Markham, Okapa District, Eastern Highlands Province, consented to sell their land to the State through the Land Investigation Report dated 27th February, 2015. The area of the land acquired is 1.33 hectares and sits atop a narrow ridge which is used as a walking track between Amaira and Okapa. The entire area on which the Community Health Post and staff houses are to be constructed has been cleared of significant trees for many years.
E. SCOPE OF LAND USE/PURCHASE
14. The land offered voluntarily by the local people for acquisition by the State for the construction of the proposed Community Health Post is cleared, steeply sloping in opposite directions and well drained clay and loam. The Land Investigation Report indicates that there is sufficient land available a d thus the o e s a affo d to sell the la d . The land was owned by members of the Kafiamapa (Avia) Clan and had been acquired through e e ship of the Clan. Their rights to the land are not contested.
15. Mr. Korofe Muratai, Mr. Nuato Sandafe, Mr. Gilbert Kawa Muratai, Mr. Joseph Autua and Mr, Apsen Anis are a ed i the “ hedule of O e s, “tatus a d ‘ights to the La d section of the Land Investigatio ‘epo t as ha i g full ights as the la d o e s. The ha e nominated Mr. Korofe Muratai, Mr. Nuato Sandafe, Mr. Gilbert Kawa Muratai, Ms. Hellen Gilberty Muratai and Mr. Yato Yarike Waina to be their representatives and agents for the purpose of executing a transfer to the Administrator over that piece of land known as Amaira/Portion 336C containing approximately 1.33 hectares and situated near Okapa in the District of Okapa of Easte Highla ds . The fu the authorised the above agents to accept, on behalf of all, moneys and considerations paid by the said Administrator in connection with the proposed transfer of the said pie e of la d .
16. The extent of the site was determined by the customary owners and the owners of adjoining land in the company of the Surveyor, Mr. Ketiri Rahonimo, prior to survey and is quantified at 1.33 hectares by him. The boundaries are clearly marked and are consistent with the decision of the local landowners. The owners of contiguous land have also declared that they have no interest in or rights by native custom to the surveyed land.
17. The site chosen for the Community Health Post was selected by the customary owners because it is central to the surrounding villages of Avia, Waisana, Nankona, Ponampa, Sinkura 1 and 2 and Waifina whose villagers have limited access to other health services and because of its proximity to the road leading to Kainantu.
18. The value of the land provided for the Community Health Post was assessed by the Valuer-General to be K93,000.00 inclusive of planted crops.
19. The Certificate of Alienability No. 28/11-2015 was issued by the Secretary of the Department of Provincial and Local Government Affairs on 30th November, 2015.
20. Payment of K93,000 was made to the authorised agents by the Okapa District Development Authority on behalf of the State in Amaira Village on ------. The Deed of Release and the Sale and Transfer documents were signed by ------in the presence of X other people.
21. The process of obtaining the Title on behalf of the State is now complete and tenders have been invited for construction of the proposed Community Health Post.
22. Officers of the Provincial Health Authority, the Eastern Highlands Provincial Administration and the Rural Primary Health Service Delivery Project have followed both Government of PNG and standard ADB safeguards processes including extensive consultation with the local community, use of applicable National land laws and regulations, and due diligence to ensure that local people would not experience significant adverse impacts by relinquishing this land.
D. SOCIOECONOMIC INFORMATION
23. The people of Eastern Highlands Province are of Austronesian origin. Most Eastern Highlanders are fluent in Tok Pisin and many younger people also speak English. However, literacy rates, at just 43.9%, are amongst the lowest in the country.1
24. Life expectancy for people living in Eastern Highlands was just 54.6 years for males and 56.3 years for females in 2011. At the same time the total fertility rate was 4.4 and the infant mortality rate was 54/10002.
25. A o di g to the Natio al Depa t e t of Health s “e to Pe fo a e A ual Report for Okapa District 19.63% of children under 5 years of age were suffering some level of malnutrition which is just below the National average. Measles vaccination rates were just 35.30%, pentavalent vaccination coverage rates were just 19.68% and attendances for outpatient care at reporting health facilities were just 21.66% of what should be expected of a rural population.
26. When compared to accepted indicators of maternal health, Okapa District health services are performing very poorly. The supervised delivery rate is just 7.71% whilst the national average is 44% and the National target is 80%. Attendance for antenatal care is just 31.46% whilst the National average is 63%.
27. The need for a local Community Health Post to serve the population of the Amaira area is clearly demonstrated by these very low access/take up rates for basic maternal and child health care.
28. Per capita annual average incomes vary significantly across the Eastern Highlands Province. Some people living in close proximity to Goroka derive relatively high cash incomes from the sale of fresh foods at local markets and others living in areas where coffee can be grown derive very high incomes. However, on average, the people are generally poor with
1 National Health Plan 2011-2020, Volume 2 2 National Health Plan 2011-2020, Volume 2 average annual cash incomes of less than K200 per person.
29. Most people living in the Amaira area are reliant upon subsistence gardening of sweet potatoes, e glish potatoes, ea s, a s, corn, cabbage and broccoli. Local farmers also raise pigs, goats and chickens for local consumption to provide the majority of their protein requirements.
30. The following image 4 indicates that average annual cash incomes per capita for people living throughout the Okapa District are relatively low with the District having the highest p opo tio of populatio ith e lo i o es a d a s all p opo tio ha i g high cash income. The people living in the immediate Amaira area have moderate incomes due to their ability to grow and harvest coffee beans.
Image 4: Average Annual Cash Income per capita for people living in Eastern Highlands Province - 2001.
AMAIRA
31. There are only small areas of land in the Province which are considered to have high agricultural potential and most of the arable land in the Province is already under strong or very strong agricultural pressure. Continuing and rapid population growth since 2001 has further increased the pressure with fallow periods necessarily reducing. As a result of rapid population growth, 4.56% per annum as measured between to 2000 and the 2011 Census, when coupled with changing climatic conditions, there is increasing pressure on the arable land. The following image 5 shows that the land in the Amaira area is of low potential due mainly to its mountainous terrain.
Image 5: Map of Eastern Highlands Province depicting areas of Agricultural Pressure
AMAIRA
32. However, the Land Investigation Report records that the former customary owners of the land provided for the Community Health Post at Amaira own sufficient land and that the provision of the land will not be detrimental to the interest of the customary owners or of their descendants either now or in the foreseeable future.
E. INFORMATION DISCLOSURE, CONSULTATIONS, AND PARTICIPATION
P o i ial Health Autho it Offi e s, the P oje t s Health Me to , Co u i atio “pe ialist and the Safeguards Officer first visited Amaira from 18th to 22nd November, 2013 to gauge support for and to promote awareness of the proposed Community Health Post. They o du ted o u it o sultatio , a a e ess a d a health eeds a al sis th oughout the 2 Wards of the catchment area. Villagers representing Kafanumampa, Ainampipa, Amaira, Ofumpina, Waifina 1, Nagona, Wainompa (Avia) Sisiompa (Avia) and Avia villages participated enthusiastically.
The health issues consistently identified were diarrhoea/typhoid, malaria, coughs and colds/pneumonia, tuberculosis and joint pain (arthritis). The social problems consistently identified were alcohol and drug consumption, domestic violence, personal security and fear of rape and lack of access to family planning services. The absence of a clean and reliable water supply was acknowledged as a major issue for all communities with complaints about contamination of the creeks and that the water is dirty during times of heavy rain. However, there a few viable opportunities to provide reticulated water supplies since many of the villages are located high on ridges.
33. In November, 2013, Mr. Ketiri Rahonimo, Consultant Surveyor, visited the site in conjunction with Officers of the Provincial Health Authority and conducted cadastral and topographic surveys with the assistance of local customary landowners who identified the proposed boundaries and extent of the land to be provided for the Community Health Post.
34. There were other visits and discussions with local landowners by Provincial Lands Officers, the P oje t s “afegua ds Offi e a d P o i ial Offi e s du i g to dis uss acquisition of the land for the proposed Community Health Post.
35. I O to e , the P oje t s A hite t atte ded the site ith the P oje t s Geotechnical Surveyor to undertake soil testing and to discuss the proposed site plan with the villagers and landowners.
36. In March, 2015 Mr. Immanuel Soer, ILG Officer with the Regional Office of the Department of Lands & physical Planning visited the site and met with customary landowners in order to prepare the Land Investigation Report after further consultation with local people and confirmation of their genealogy.
37. Communities and affected people visited by the Project staff have been encouraged to discuss any issues of concern to them. All staff working on the various components have consistently stressed that the tender and contracting process will be conducted in an open and transparent way, so that all eligible firms can bid for the work provided that they qualify according to the tender criteria.
F. GRIEVANCE REDRESS MECHANISM (GRM)
38. The Project will establish a GRM, which will be accessible (considering literacy levels), predictable (known procedures, within a set timeframe), and transparent. The Provincial Safeguards Officer (PSO), Mr. Phillip Wanua, will be the grievance redress focal point to address Project related concerns that may arise during implementation. Through public meetings, communities and affected people have been informed by the Rural Primary Health Service Delivery Project that they have a right to grievance resolution, and are told how they can have access to the GRM. Complaints and grievance procedures will be based on those outlined in the Land Assessment Framework. These will be adapted slightly to ensure communities are easily able to register any complaints at the local level, and that there is a publicly acceptable forum to deal with them. A Grievance Registration book will be established to be held and administered by the local Health Facility Management Committee which has been formed. Anyone can approach this Committee to lodge a complaint or grievance. After the tender is awarded and before construction starts the Rural Primary Health “e i e Deli e P oje t s health p o otio a d ge de tea ill isit o u ities to conduct HIV/AIDS awareness training for community members and contracting staff. During this, the Grievance Registrar will be identified and trained as part of the Health Committee.
39. The Grievance Registration book will record who is making the complaint, the substance of the complaint, to whom it has been referred for action, and the date. Grievance procedures may address benefits, contractor compliance, social and environmental concerns and other issues, apart from disputes relating to legally contestable land ownership rights. These will be referred to the District or Provincial Land Officers, who will institute a process to resolve land disputes and grievances based on accepted procedures of mediation. As required, the participation of appointed and traditional leaders will be facilitated to achieve a satisfactory resolution of any land issues at the local level. Every attempt will be made to ensure that women as affected persons, irrespective of traditional constraints, are included in the mediation processes. Any disputes arising over alienated land or compensation will follow procedures set out in the Land Disputes Settlement Act 2000, (explained in Section G, paragraph 35), and if mediation fails, will be referred to an appropriate court of law.
40. The Grievance Registrar in the village will, in the first instance, contact the Provincial Safeguards Officer, whose key function in relation to the GRM is (i) to record, categorize and prioritize the grievances and inform the Project Support Unit; (ii) in consultation with the Project Coordinating Committee and complainant, settle the grievances; (iii) to inform the aggrieved parties about the solution or, if a solution is not found (iv) to forward unresolved ases to the ‘u al P i a Health “e i e Deli e P oje t s P oje t Ma age o to highe authorities.
41. The Grievance Registrar will forward any complaint to the Provincial Safeguards Officer within five days of receiving it. The Provincial Safeguards Officer will discuss with the Project Coordinating Committee members and endeavor to find a solution within two weeks of receiving the complaint. For unresolved complaints, the Project Manager will consider the complaint and within one month will convey a decision to the Affected Persons. The Project Support Unit staff, along with local health officials, will assist the Project Manager in reviewing and addressing the complaint. If the Affected Person(s) are not satisfied with the Project “uppo t U it s de isio , the a the take the g ie a e to the PNG judi ial s ste .
G. APPLICABLE POLICIES AND LAWS
42. The PNG Constitution adopts customary law as part of the underlying law of the country and recognizes the property rights attached to customary land. According to the 2000 Underlying Act, customary law comprises the rules, rights and obligations pertaining to an individual or group by custom and tradition. Customary law applies and the courts recognize it where it is not inconsistent with written law. The Constitution also guarantees the right of the citizens to protection from unjust deprivation of property. No land or interest in land may be acquired compulsorily by the Government, except as it is required for public purposes or other justifiable reasons. In the event of expropriation of land, just compensation must be made, by the expropriating authority.
43. While the Constitution does allow for compulsory acquisition for building infrastructure for health, the Rural Primary Health Service Delivery Project has stipulated that no land will e a ui ed ithout the la do e s full ag ee e t. Mo eo e , this ag ee e t ust e secured through a transparent process following the FPIC principles (free, prior and informed consent). To ensure that these principles are adhered to, the Project Safeguards staff have made joint field visits with the Department of Lands and Physical Planning staff to the proposed CHP sites. The Government has recently introduced a new policy requiring that all land for building new state infrastructure should be bought outright, rather than, as in the past, being built on gifted customary land, or through leasing land from landowners.
44. The Land Act (1996) deals with ownership and use rights of customary land.3 It also sets out the procedures for the government to acquire customary land required for public purposes. The key provisions of the Act are (i) the government may acquire land, including improvements on land; (ii) usually the government negotiates agreements with the customary landowners for purchase of required land, but it can also compulsorily acquire the land; and (iii) the acquisition process involves several steps, including initial investigation, land survey, land investigation report (including genealogies of owner groups), determination of compensation value of land and any improvements, payment of compensation, registration of land for state ownership and transfer of title.
45. This process is being followed by the Rural Primary Health Service Delivery Project, working closely with the Department of Lands and Physical Planning, who are required to do the initial investigation including documenting genealogies of clans, valuing the land and its assets, registering the surveys and providing file numbers. Once this is done and approved, the file is sent to the Department of Provincial and Local Government so that a Certificate of Alienability can be issued for the title to be registered as state land. At the same time as the Government land acquisition process is proceeding, the Project is preparing standard safeguard documents for ADB approval.
46. The Land Disputes Settlement Act (2000) sets out the procedures for resolution of disputes involving customary land. The Act provides for a land disputes committee at provincial level and land courts at local, district and provincial levels. The committee can appoint land mediators. The Act promotes resolution of disputes through mediation based on the principles of traditional dispute settlement. If mediation fails, it is followed by appeal to the courts. The registration of customary landowners as an Incorporated Land Group (ILG) has been used a lot in private sector projects in PNG. While it is not a mandatory requirement for acquisition of land in case of public sector projects, registration of ILGs may be helpful in dispute resolution and negotiation with landowners. On the other hand, ILGs in the past have often been fraudulently used for the interests of a small group, rather than the whole clan. The Rural Primary Health Service Delivery Project will not insist on registration of landowners into an ILG, unless there is a specific reason why it may be necessary to secure land.
47. The Fairness of Transaction Act of 1993 relates to the effect of certain transactions, to
3 The customary land includes land owned, used or occupied by a person or community in accordance with current customary usage. Access to land and resources is embedded in social relationships and expressed as customary land rights to utilize resources. Small clan-based groups live in the villages, managing their own resources, and exercising the right to utilize them. These groups (matrilineal or patrilineal clans which are composed of sub-clans, lineage groups, and at the lowest level extended households) are typically made up of “primary rights holders” – the recognized traditional leaders of the group – who collectively have the authority to allocate secondary use rights through their spokesperson(s). Different cultures have different ways of allocating land between primary and secondary rights holders.
ensure that they operate fairly without causing undue harm to, or imposing too great a burden on, any person, and in such a way that no person suffers unduly because he is economically weaker than, or is otherwise disadvantaged in relation to, another person. The purposes of this Act are to (a) ensure the overall fairness of any transaction which (i) is entered into between parties in circumstances where one party is for reasons of economic or other advantage predominant and the other is not able to exercise a free choice; or (ii) for one reason or another, without attaching any evil design or bad faith, appears to be manifestly unfair or not to be genuinely mutual; and (b) allow for the re-opening and review of any transaction irrespective of fault and validity, enforceability or effect of any agreement; and (c) ensure the fair distribution and adjustment of rights, benefits, duties, advantages and disadvantages arising out of a transaction. Transaction means any contract, promise, agreement, dealing or undertaking of an economic or commercial nature whether supported by consideration or not entered into between parties, and includes (a) an informal, complete or incomplete transaction; and (b) a transaction governed by customary law.
48. Land Group Incorporation (Amendment) Act (2009) and Land Registration (Amendment) Act (2009). These Acts were brought into effect in 2011, following recommendations from the National Land Development Taskforce. The Acts recognize the corporate nature of customary groups and allow them to hold, manage and deal with land in their customary names, and for related purposes. These also facilitate the voluntary egist atio of usto a la d, to e k o as egiste ed la la d , a d akes that land available for development through the use of Incorporated Land Groups (ILGs). These laws encourage (a) greater participation by local people in the national economy by the use of the land; (b) better use of such land; (c) greater certainty of title; (d) better and more effectual settlement of certain disputes; (e) legal recognition of the corporate status of certain customary and similar groups, and (f) conferring on them, as corporations, of power to acquire, hold, dispose of and manage land, and of ancillary powers; and (g) encouragement of the self-resolution of disputes within such groups.
49. As noted above, the Rural Primary Health Service Delivery Project does not require landowners to register as an ILG, but may negotiate with these groups, where they exist, or encourage groups to register if they want to further develop their land in future.
H. AGREEMENTS ON LAND USE
The series of consultations, which were held with landowners and affected people regarding the land at Amaira has been described in Section E. The teams visiting emphasized the benefits the community would gain by having a fully functioning Level 2 health service in the area, in return for providing land to the State. Environmental and social impacts were discussed, and the measures to control these were explained.
50. The process to acquire the land followed that laid out in the Land Assessment Framework which consists of the following steps for land purchase through negotiated agreement4:
4 Land Assessment Framework (Revised), 11 September 2013, PNG: Rural Primary Health Services Project, prepared by the National Development of Health, GoPNG, p.11
National Department of Health/Project Support Unit requested the Department of Lands and Physical Planning to issue an official land file number for the site to be purchased The Provincial Health Authority/Project Support Unit requested the Provincial Surveyor to undertake both cadastral and topographic surveys to identify the boundaries, location, size and area of the land to be purchased in consultation with customary landowners. The cadastral survey was then lodged with the Office of the Surveyor-General for registration and the topographic survey was provided to the Project Support Unit to allow preparation of site plans and structural design. Once the surveys were lodged the Provincial Health Authority and the Project Support Unit requested the Valuer-Ge e al s Offi e to se d a egiste ed Value to alue the la d and any improvements (for example, garden crops, food trees, timber trees, structures). His/her report was sent directly to the Office of the Valuer-General. The Provincial Health Authority and Project Support Unit then requested the District Lands Officer to prepare a Lands Investigation Report including ownership genealogy, rights and interest held in the land, and, estimated value of improvements to land in consultation with the landowners, the Valuer-General and other relevant government offices. The Land Investigation Report was then endorsed by the Provincial Administrator and forwarded to the Department of Lands and Physical Planning to progress the process to obtain a Certificate of Alienability as a prerequisite for purchase by the State. The Department of Lands and Physical Planning prepared a comprehensive file consisting of the Land Investigation Report, Valuation and Cadastral Survey and forwarded it to the Secretary, Department for Provincial and Local Level Government Affairs (DPLGA) who issued a Certificate of Alienability confirming that there was no impediment to acquisition by the State. The Certificate of Alienability was issued on 30th November, 2015 and returned to the Department of Lands and Physical Planning to prepare the purchase documents including the Deed of ‘elease to e sig ed, upo e eipt of the pu hase fu ds, the usto a landowners. The sum of K93,000.00 was released to the customary landowners on xxxxxxx. The land was deemed formally purchased on xxxxx after the expiration of the required 21 da s oti e as pu lished i the Go e e t Gazette a d e ui ed la .
The project at Amaira includes construction of the standard six-bed design for a Community Health Post and will include provision of equipment, drugs, and allocation of three (3) staff. The Province has committed to providing the required staff and the Project has ensured that they received the relevant training to ensure that the facility operates at the required standards for Level 2 health facilities in PNG. A plan of the proposed CHP is attached.
Following completion, the land acquisition process has been reviewed and verified by an independent third party consultant contracted by the Project Support Unit for this purpose. She has provided verification that (i) the local community and landowners support the Community Health Post construction and have agreed to provide their land; (ii) consultations and negotiations with landowners have been undertaken meaningfully, freely and in good faith and the landowners have made informed decisions on use of the land, and (iii) terms and conditions of the agreements have been explained to and understood and agreed by the landowners. A copy of the verification report is appended. I. COMPENSATION AND BENEFITS
46. The Amaira landowning clan agreed to permanent use of the land through negotiated purchase following the Land Act and Land Assessment Framework. Once the Government of PNG land acquisition process had been completed and the title transferred to the State the landowners received compensation from the State for the value of the land.
47. Affected persons at Amaira will benefit from the cash payment for land and by having access to some short-term employment opportunities (mainly unskilled work) as a result of the project during the construction phase. The requirement to hire local labour, where possi le, ill e pa t of the o t a to s o t a tual o ligatio s. While su h e plo e t opportunities on their own do not ensure sustainable livelihoods, being paid at least the minimum wage, and enjoying working conditions as per ILO Core Labour Standards (a recognized requirement for ADB financing of the Project), the Project Support Unit is confident that affected persons will be better off financially as a result of the project, and certainly better off in terms of access to health services.
48. The Rural Primary Health Services Delivery Project recognizes that gender considerations apply to all public infrastructure projects. In conducting this due diligence exercise, women who will be affected by this project have been consulted, both in mixed groups with men and exclusive groups of women. Measures proposed to ensure gender equitable practices and outcomes include:
Iterative consultations with women throughout all stages of the project cycle when preparing for and constructing the CHP That women clan members be recorded in the Land Investigation Report and valuation processes conducted by the Valuer-Ge e al s Offi e a d i luded i a su se ue t benefits Women being informed about how they can lodge grievances with the Project (and ultimately ADB) if they are dissatisfied with any aspects of the Project Ensuring that women affected persons are offered priority waged employment during construction, and are afforded equal pay and opportunities Addressing concerns women affected persons might have with safety and security issues, in contexts where they have to relocate their gardening activities Ensuring that all socio-economic data collected for the project is gender disaggregated in order to analyse the differential impacts at intra-household, intra-inter clan, and community level. Social risks associated with HIV/AIDS and other STIs will be mitigated to a large extent by employing as many local people on construction activities as possible and by awareness and prevention programmes designed to empower women and inform both women and men of the risks. All contracted staff will undertake a Rural Primary Health Service Delivery Project course designed for the purpose.
J. BUDGET AND SOURCES OF FUNDS
49. The Government of PNG has declared its intention to increase the proportion of land o ed the “tate th ough its Visio pla a d has provided funds to pay for the land needed for public service infrastructure. In the case of the Amaira Community Health Post project the State has paid for the land through the Eastern Highlands Provincial Government.
Item Costs (Kina) Value of land to be acquired 93000.00 Value of Existing Buildings Not Applicable Value of planted improvements Not Applicable FINAL VALUATION 93,000.00
K. INSTITUTIONAL ARRANGEMENTS
50. The National Department of Health is the Executing Agency for this Project and the participating Provinces are the Implementing Agencies. The day-to-day implementation activities related to land acquisition are undertaken by the Province with support from the Project Support Unit of the Rural Primary Health Service Delivery Project. These activities include:
Collaboration with and assistance to the Provincial/District Land Officer at the Community Health Post site to undertake their work and comply with Go e e t p o edu es, the P oje t s poli ies a d ADB e ui e e ts
Provision of resources to allow Provincial staff to accompany Project Support Unit (PSU) safeguards staff to sites
Collaboration with and assistance to the Provincial/District Land Officer, Provincial Safeguards Officer, and PSU Safeguards consultants in consulting and negotiating agreements with affected landowners and users
Facilitation of consultations with Ward Development Committees and affected communities and ensuring that all stakeholders are informed about the Project, its policies and procedures
Ensuring the requirements concerning public disclosure of the provisions for land acquisition and compensation are followed
Informing communities about the grievance redress mechanism, and overseeing and monitoring the process
Signing a Memorandum of Agreement with the National Department of Health agreeing to manage, operate, support, staff, and provide budgets and supplies for the new facility.
Ensuring that cadastral land surveys and Land Investigations Reports are completed and registered with the Surveyor-General and Department of Lands and Physical Planning in a timely manner.
51. Provincial Safeguards Officers, and other Government staff who are involved in implementing the P oje t s la d poli ies ha e ee p o ided ith t ai i g i the ADB s social safeguard policies and procedures
52. The Provincial Safeguards Officer is also responsible for monitoring of land acquisition activities, and will be the focal point for the Grievance Redress Mechanism. He is assisted a d suppo ted the P oje t “uppo t U it s “afegua ds “pe ialists.
L. IMPLEMENTATION SCHEDULE
53. The implementation schedule for land access and facility design processes at Amaira was as follows:
LAND ACCESS/ACQUISITION DATE
Community Consultation/Community Health Post and GRM November, 2013 advocacy completed Cadastral and Topographic Surveys undertaken with March, 2014 Landowner participation and endorsement Land Portion Number issued by Department of Lands & 3rd April, 2014 Physical Planning Land Investigation Report and Valuation completed and February, 2015 Lodged Certificate of Alienability issued 30th November, 2015
Land Payment settled XXXXX
Deed of Release received XXXXX
M. MONITORING AND REPORTING:
54. The ‘u al P i a Health “e i e Deli e P oje t s “afegua ds staff ill su it all La d Screening, Environmental Management Plans and Due Diligence reports to ADB detailing the land acquisition processes. The Provincial Safeguards Officer will be responsible for on-going monitoring of the land activities, supported by Project Support Unit staff, including assisting in the monitoring of contractor compliance with the Environmental Management Plan. The Project Support Unit will prepare semi-annual progress reports for ADB as part of project performance monitoring. An external consultant has been appointed to undertake third-party monitoring and verification of the land acquisition processes.
ANNEXURES (Available Upon Request)
Annex One: Reports of Community Consultations Annex Two: Land survey of site Annex Three: Land Investigation Report Annex Four: Valuation by the Office of the Valuer-General Annex Five: Certificate of Alienability Annex Six: Sale & Transfer of Land Annex Seven: Deed of Release Annex Eight: Approved Layout Plan for Community Health Post
ANNEXURES (Available Upon Request)