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Ethnic Group Development Plan, Myanmar

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Ethnic Group Development Plan, Myanmar Greater Mekong Subregion Health Security Project RRP REG-48118-002 Ethnic Group Development Plan, Myanmar Project number: 48118-002 May 2016 Myanmar: Greater Mekong Subregion Health Security Prepared by the Ministry of Health and Sports for the Asian Development Bank. CURRENCY EQUIVALENTS (as of 7 April 2016) Currency unit – kyat (MMK) MMK1.00 = $0.00085 $1.00 = MMK1,170 ACRONYMS ADB – Asian Development Bank AH - Affected Household AHI – Avian Human Influenza AI – Avian Influenza AIDS – Acquired immunodeficiency syndrome AOP – Annual Operational Plan ANM -- Auxiliary Nurse Midwife APSED – Asia-Pacific Strategy for Emerging Diseases ARI – Acute Respiratory Infections BMA – Burma Medical Association BWM – Burmese Women Association CBO – Community-based Organization CDC – Communicable Diseases Control CDC1 – First GMS Regional Communicable Diseases Control Project CDC2 – Second GMS Regional Communicable Diseases Control Project CLMV – Cambodia, Lao PDR, Myanmar and Viet Nam CLV – Cambodia, Lao PDR and Viet Nam CTA -- Chief Technical Adviser DCDC – Department of Communicable Diseases Control DIHC – Department of International Health Cooperation DMF – Design and Monitoring Framework DMS – Department of Medical Services DPH – Department of Public Health EA – Executing Agency EHF – Ebola Hemorrhagic Fever EGDP – Ethnic Group development plan EHF – Ebola Hemorrhagic Fever EID – Emerging Infectious Diseases EMDP – Ethnic Minority Development Plan EG – Ethnic Minority Group GAP – Gender Action Plan GMS – Greater Mekong Subregion GSSS – Gender and Social Safeguards Specialist HEF – Health Equity Funds HIV – Human Immunodeficiency Virus HMIS – Health Management Information System HSP – Health Security Project IA – Implementing Agency IEC – Information, Education and Communication IHR – International Health Regulations ILO – International Labour Organization IMR – Infant Mortality Rate IOM – International Organization of Migration MDG – Millennium Development Goal MERS – Middle-east Respiratory Syndrome MEV – Migrants, Ethnic and other Vulnerable Groups MOHS – Ministry of Health and Sports MMR – Maternal Mortality Ratio MNCH – Maternal, Neonatal and Child Health MOF – Ministry of Finance MOLES – Ministry of Labour, Employment, and Social Security M&E – Monitoring and Evaluation NGO – Non-governmental Organization NHL – National Health Laboratory OD - Operational District PAM – Project Administration Manual PCR – Project Completion Report PDR – People’s Democratic Republic (Lao-) PHC – Primary Health Care PMU – Project Management Unit PRC – People’s Republic of China RCU – Regional Cooperation Unit RHU – Regional Health Office RSC – Regional Steering Committee SARS – Severe Acute Respiratory Distress Syndrome SDR – Special Drawings Right SPS – Safeguard Policy Statement S/RHO – State/Region Health Office S/RMU – State/Region Management Unit U5MR – Under-five Mortality Rate UNAIDS – United Nations Joint Program for the Control of HIV/AIDS UNDP – United Nations Development Program UNFPA – United Nations Fund for Population and Development UHC – Universal Health Coverage UNICEF – United Nations Children Fund VHW – village health worker WHO – World Health Organization NOTES (i) The fiscal year (FY) of the Government of Lao PDR and its agencies ends on 31 December (from 2016 onwards). “FY” before a calendar year denotes the year in which the fiscal year ends, e.g., FY2017 ends on 31 December 2017. (ii) In this report, "$" refers to US dollars. This ethnic group development plan 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 judgments as to the legal or other status of any territory or area. CONTENTS 1. EXECUTIVE SUMMARY .................................................................................................. 1 2. DESCRIPTION OF THE PROJECT ................................................................................. 4 3. SOCIAL IMPACT ASSESSEMNT ..................................................................................... 8 A. Legal and Institutional Framework ............................................................................... 8 B. Baseline Information .................................................................................................. 10 C. Stakeholders and Consultations ................................................................................. 12 D. Vulnerabilities, Risks, and Project Effects .................................................................. 13 E. People’s Perceptions ................................................................................................. 14 F. Proposed Measures ................................................................................................... 15 4. INFORMATION, DISCLOSURE, CONSULTATION AND PARTICIPATION ................... 15 5. BENEFITS, IMPACT AND MITIGATING MEASURES .................................................... 16 A. Mitigating Measures ................................................................................................... 17 6. CAPACITY BUILDING .................................................................................................... 17 7. INSTITUTIONAL ARRANGEMENTS .............................................................................. 18 8. GRIEVANCE REDRESS MECHANISM .......................................................................... 18 9. MONITORING, REPORTING, AND EVALUATION ........................................................ 18 10. BUDGET AND FINANCING .......................................................................................... 19 ANNEX 1: INFORMATION ON MIGRANTS, ETHNIC AND OTHER VULNERABLE GROUPS ............................................................................................................................ 20 ANNEX 2: EGDP CONSULTATION .................................................................................... 27 ANNEX 3: ETHNIC GROUP DEVELOPMENT PLAN .......................................................... 32 1. EXECUTIVE SUMMARY 1. This Ethnic Group Development Plan (EGDP) presents the Myanmar-specific ethnic group analysis, strategy, and plan for the GMS Health Security Project based on the Government’s and ADB’s policy on indigenous people.1 Ethnic groups (EGs)2 are the majority population in several of Myanmar’s States, and elsewhere are also fully mainstreamed in Myanmar society. 3 It would be more practical to focus on EGs that may not have access to services, are being displaced, or lack citizen rights and empowerment. In the context of the Project, this EGDP focuses on the first group, including remote ethnic groups, and internal and external migrants over half of whom are EGs. The challenges of control of infectious diseases of regional relevance in these two subgroups are quite different. 2. The proposed GMS Health Security Project for Cambodia, the Lao PDR, Myanmar and Viet Nam aims to improve regional public health security by strengthening health security systems and Communicable Diseases Control (CDC) in border areas, particularly for migrants, youth, and ethnic minorities. Three components or outputs4 are proposed: : (i) improved GMS cooperation and CDC in border areas; (ii) strengthened national disease surveillance and outbreak response systems; and (iii) improved laboratory services and hospital infection prevention and control. 3. The project will cover a total of 5 states and 1 region in Myanmar, 13 provinces in Cambodia, 12 provinces in the Lao PDR, and 36 provinces in Viet Nam. In Myanmar, approximately 2m people (two thirds of those living in target project areas) are classed as EGs, living in diverse socio-economic settings with different customs and languages. In Myanmar, the targeted states and region5 are Shan North, Shan East, Kayah, Kayin, and Mon States, and Tanintharyi region bordering China and Thailand. Tanintharyi region has a high poverty rate of over 30%. All provinces have substantial populations of EGs, for example the Shan, Kayin, Rakhine, Chinese, Mon, Kachin, Indians and Kayah as well as others. 4. According to ADB’s 2009 Safeguard Policy Statement (SPS), the Borrower is required to ensure benefits for EMGs affected by the Project. According to the Indigenous Peoples Safeguards Sourcebook6: “The borrower/client is responsible for assessing projects and their environmental and social impacts, preparing safeguard plans, and engaging with affected communities through information disclosure, consultation, and informed participation following all policy principles and safeguard requirements.” According to the Sourcebook, “IP safeguards are triggered when a project affects either positively or negatively and either directly or indirectly the indigenous people (para 8).” Furthermore, “the project is expected to have only limited impact and is accordingly categorized as B (para 67).” 5. As per the ADB SPS, “if [ethnic groups] are the sole or the overwhelming majority of direct project beneficiaries and when only positive impacts are identified, the elements of an [EGDP] could be included in the overall project design in lieu of preparing a separate 1 As described
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