World Bank Document
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MIZORAM HEALTH SYSTEMS Public Disclosure Authorized STRENGTHENING PROJECT (P173958) Public Disclosure Authorized Environmental and Social Management Framework (ESMF) Public Disclosure Authorized Draft Report Public Disclosure Authorized October 2020 Table of Content Executive Summary ............................................................................................................................. vi 1 Introduction ................................................................................................................................... 1 1.1 Background ............................................................................................................................. 1 1.2 Environmental Profile of Mizoram ......................................................................................... 1 1.3 Socio-Cultural and Demographic Profile of Mizoram ............................................................ 3 1.3.1 Demographic Profile ....................................................................................................... 3 1.3.2 Tribes of Mizoram .......................................................................................................... 4 1.4 Autonomous District Councils in Mizoram ............................................................................ 4 1.5 Protected Areas ....................................................................................................................... 4 1.6 Health Status in Mizoram ....................................................................................................... 5 1.7 Health Care Facilities in Mizoram .......................................................................................... 7 1.8 Purpose of the ESMF .............................................................................................................. 8 1.9 Approach and Methodology.................................................................................................... 8 2 Project Description ....................................................................................................................... 9 2.1 Project Components ................................................................................................................ 9 3 Legal and Regulatory Framework ............................................................................................ 14 3.1 Indian National Regulations and Standards .......................................................................... 14 3.2 Mizoram State Specific Laws and Regulations .................................................................... 23 3.3 The World Bank’s Environmental and Social Standards (ESS) ........................................... 25 3.4 Guidance Related to COVID19 ............................................................................................ 30 4 Environmental and Social Baseline ........................................................................................... 34 4.1 Key Health Sector Challenges in Mizoram ........................................................................... 34 4.2 Waste Management in Mizoram ........................................................................................... 34 4.2.1 Bio-Medical Waste Management .................................................................................. 34 4.2.2 Segregation and Collection of Waste ............................................................................ 35 4.2.3 Storage and Transportation of Bio-medical Waste ....................................................... 36 4.2.4 Treatment and Disposal of Bio-medical Waste ............................................................ 36 4.2.5 Occupational and Health Safety Measures ................................................................... 37 4.2.6 Other Environmental Aspects ....................................................................................... 38 4.2.7 Infrastructure Condition and Access ............................................................................. 38 4.3 Status of Women in Mizoram ............................................................................................... 39 4.3.1 Women work participation rate ..................................................................................... 40 4.3.2 Gender Based Violence ................................................................................................. 40 4.4 Current Information Education and Communication (IEC) Mechanism .............................. 41 5 Assessment of Environmental and Social Risks and Impacts ................................................. 43 ii 6 Environment and Social Management Plan (ESMP) .............................................................. 52 6.1 Negative list of Activities Under the Project ........................................................................ 77 7 Framework Procedures For Environmental And Social Management ................................. 78 7.1 Environmental and Social Management procedures ............................................................. 78 7.2 Sub-project Screening and Categorization ............................................................................ 80 7.3 Sub-project Implementation, Monitoring and Reporting ...................................................... 81 8 Stakeholder engagement and grievance redress mechanism .................................................. 82 8.1 Key Stakeholders .................................................................................................................. 82 8.2 Stakeholder Consultation During Preparation ...................................................................... 82 8.3 Stakeholder Engagement Plan (SEP) .................................................................................... 89 8.4 Grievance Redress Mechanism ............................................................................................. 89 8.5 Process of Disclosure ............................................................................................................ 90 9 Institutional Arrangements, Responsibilities and Capacity Building .................................... 91 9.1 Institutional Arrangement ..................................................................................................... 91 9.2 Training and Capacity Building ............................................................................................ 91 9.3 Indicative Budget .................................................................................................................. 91 Annexures ............................................................................................................................................ 93 Annex I: Sub-Project Screening Format .......................................................................................... 93 Annex-II: Labor Management Procedures (LMP) .......................................................................... 98 Annex-III: Generic Biomedical Waste Management Plan ............................................................ 105 Annex-IV: Stakeholder Consultations During Preparation ......................................................... 109 Annex-V: Draft ToR of Wastes Characterization Study ............................................................... 111 iii ABBREVIATIONS ADC Autonomous District Council ANC Antenatal care ANM Auxiliary nurse midwife ASHA Accredited social health activist BMW Bio-medical Waste Management BMWM Bio-medical Waste Management CBMWTF Common Bio-medical Waste Treatment Facility CERC Contingent Emergency Response Component CHC Community Health Centre CMO Chief Medical Officer CPCB Central Pollution Control Board CPHC Comprehensive Primary Health Care CTF Common treatment facility DH District Hospital DOHFW Department of Health and Family Welfare E&S Environmental and Social EIA Environmental Impact Assessment ESF Environmental and Social Framework of World Bank ESG Environmental, Health, and Safety Guidelines ESMF Environmental and Social management Framework ESMP Environmental and Social Management Plan ESS Environmental and Social Standard ETP Effluent Treatment plant FPIC Free, Prior, and Informed Consultation GBV Gender Based Violence GDP Gross Domestic Product GoI Government of India GoM Government of Mizoram GRM Grievance Redress Mechanism HCF Health Care Facility HR Human Resource HRH Health Human Resource HWC Health and Wellness Centre ICC Internal Complaints Committee ICT Information and communication technology IEC Information, Education, and Communication IMR Infant Mortality Rate IPA Internal performance agreement IPF Investment Project Financing IPM Internal Performance Management IT Information Technology JSSK Janani Shishu Suraksha Karyakaram LCC Local Complaints Committee LDHF Low-dose-high-frequency LMP Labor Management Procedure MH Maternal Health MHCS Mizoram Health Care Scheme MMR Maternal Mortality Rate iv MO Medical Officer MOHFW Ministry of Health and Family Welfare MS Medical Superintendent MSPCB Mizoram State Pollution Control Board NCD Non-communicable diseases NGO Non-governmental Organization NHM National Health Mission NQAS National Quality Assurance Standards OHS Occupation and Health Safety OOPE Out-of-pocket expenditure OSC One Stop Centre PDO Project Development Objective PHC Primary Health Centre PMU Project Management Unit PPE Personal Protective equipment PPP Public Private Partnership RKS