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World Bank Document Public Disclosure Authorized World Bank-financed Hainan Health Sector Reform Project (P171064) Public Disclosure Authorized Stakeholder Engagement Plan (SEP) Public Disclosure Authorized Public Disclosure Authorized Hainan Provincial Health Commission (HPHC) December 2019 Contents 1 Project Introduction .................................................................................. …….1 1.1 PROJECT BACKGROUND ....................................................................................... 1 1.2 PURPOSE, SCOPE AND IMPLEMENTATION PATH................................................... 1 2 Stakeholder Analysis ........................................................................................ 3 2.1 STAKEHOLDER IDENTIFICATION ..................................................................... 3 2.2 OVERALL ATTITUDE OF STAKEHOLDERS TO THE PROJECT .............................. 4 2.3 STAKEHOLDER DEMAND ANALYSIS ................................................................ 4 2.4 VULNERABLE GROUPS .................................................................................. 4 2.4.1 IDENTIFICATION OF VULNERABLE GROUPS ........................................ 4 2.4.2 DEMAND ANALYSIS OF VULNERABLE GROUPS ................................. 5 3 Stakeholders Engagement ............................................................................... 9 3.1 STARTED INFORMATION DISCLOSURE ACTIVITIES ........................................... 9 3.2 INFORMATION DISCLOSURE ACTIVITIES TO BE STARTED ................................ 10 3.3 STARTED PUBLIC CONSULTATION ACTIVITIES ............................................... 11 3.4 PUBLIC CONSULTATION ACTIVITIES TO BE STARTED ..................................... 11 4 Grievance Mechanism .................................................................................... 17 4.1 FOR RESIDENTS .......................................................................................... 17 4.2 FOR PRIMARY MEDICAL INSTITUTIONS ......................................................... 17 5 Resources and Responsibilities .................................................................... 18 6 Monitoring and Reporting ............................................................................... 18 Appendix 1 List of FGDs ....................................................................................... 19 Appendix 2 Ethnic Minority Engagement Framework ......................................... 20 Appendix 3 Summary of First Round of Public Consultation ............................. 29 Appendix 4 Implementation and Operation Stages ............................................. 34 Appendix 5 Field work Photos .............................................................................. 40 Abbreviations EAC - Ethnic Affairs Commission FDT - Family Doctor Team FGD - Focus Group Discussion HC - Health Commission HHDRC - Hainan Health Development Research Center HHSA - Hainan Healthcare Security Administration HPHC - Hainan Provincial Health Commission HSA - Healthcare Security Administration PAO - Poverty Alleviation Office PHC - Primary Healthcare PMO - Project Management Office SEP - Stakeholder Engagement Plan WF - Women’s Federation Units Currency unit = Yuan (CNY) USD1.00 = CNY6 1 hectare = 15 mu 1 Project Introduction 1.1 Project Background The overall goal of the Hainan Health Sector Reform Project (HHSRP) is to strengthen the quality of primary health care (PHC) services and efficiency of the health system. Focusing on primary health care (the foundation for people-centered integrated care), the Project takes an integrated health system approach to deliver improved health outcomes for the people of Hainan. Recognizing that there is no silver bullet to achieve this goal, the project adopts a two-pronged approach: 1） The project supports the strengthening of primary care delivery system to address several key gaps that plague the health system in Hainan, including: a) poor preventive and promotive care, particularly in the context of the rising incidence of NCDs and an ageing population; b) the routine bypassing of PHC facilities in favor of hospital care; c) the declining quality of PHC, largely due to a lack of rigorously applied standards of service quality and shortage of appropriately qualified human resources; and d) inefficiencies in financing that disproportionately affect service utilization and health outcomes of the poor and most vulnerable. The central focus for PHC strengthening will be (i) to build health sector stewardship of People Centered Integrated Care (PCIC) through better integration of different levels of care and alignment of public health functions such as disease surveillance and emergency response with PHC service delivery; and (ii) to improve the performance of Family Doctor Teams (FDTs) operating in township health clinics, village clinics and community health centers through targeted strengthening of front-line service delivery , rigorous measurement of performance outputs and outcomes, supportive supervision and targeted incentives driving forward a strong/high capacity PHC system that is delivered through team-based approaches and responds efficiently to population health needs. 2）This is supported with deeper institutional, human resource, and information technology reform to create a sustainable and efficient service delivery system. At the operational level this will mean providing technical and financial support for strategic and results-oriented planning and management, evidence-based decision-making and adoption of e-governance platforms for greater coordination and efficiency. The Project will also streamline strategic purchasing of services through insurance programs in order to drive the system towards the Project goals of improving quality of primary care and efficiency of the health system. At the individual provider level, the Project will leverage incentives to change provider-level behavior and improve care for the growing burden of NCDs. Component 1: Reforming Institutions and Strengthening Stewardship for People-Centered Integrated Care (PCIC): • Reducing institutional fragmentation in primary care services • Increasing coordination between HPHC and HPHSA • Developing a collaborative approach in which providers and patients work together to improve the self-management of health and, eventually, health outcomes Component 2: Strengthening Primary Health Service Delivery with appropriate support system: • to strengthen Family Doctor Team (FDT) performance through a mix of approaches involving a) capacity building, b) strengthened performance management and targeted incentives and c) supportive demand and supply side measures. Component 3: Strengthening Information Technology • Supporting the Provincial Health Commission IT Capacity • Supporting the Provincial Health Security Agency IT Capacity Component 4: Strategic purchasing for quality services Component 4: Technical Assistance and Project Management 1.2 Purpose, Scope and Implementation Path 1.2.1 Purpose This SEP aims to ensure that stakeholder consultation, communication and engagement is conducted continuously and effectively throughout the Project, and relevant design and measures are optimized and improved continually by collecting reasonable comments and suggestions from stakeholders, thereby benefiting all stakeholders to the greatest extent. In addition, since the Project A4-1 involves some minority areas, this SEP includes a special Ethnic Minority Engagement Framework (EMEF) to ensure that minority residents are engaged throughout the Project to maximize the local benefits of the Project. Specifically, this includes: Establishing and maintaining constructive relationships among all stakeholders; Considering opinions of stakeholders in project design, and environmental and social management; Maintaining adequate, equal and effective engagement at the implementation and operation stages to control project impacts and risks, and adjust and optimize relevant measures timely; Ensuring timely and accessible information disclosure to stakeholders, including appropriate project information on environmental and social risks and impacts; and Providing appropriate and inclusive ways to stakeholders, so that opinions, issues and appeals of stakeholders (especially vulnerable groups and ethnic minorities) are collective and handled effectively. 1.2.2 Scope This SEP applies to the 4 components, and the project area is the entity of Hainan Province. 1.2.3 Basic path This SEP will identify stakeholders, analyze interest correlations and engagement needs, and draft an engagement mechanism and plan across the design, implementation and operation stages. Since the Project was at the preparation stage when this SEP was prepared, and project activities at the implementation and operation stages may be further adjusted, detailed stakeholder identification and demand analysis is not fully carried out at this stage. This SEP is an ongoing living document, it will analyze stakeholder engagement activities started and to be started at the preparation stage and plan such activities for the implementation and operation stages, focusing on mechanism set up, design and monitor, thereby to ensure that all stakeholders are engaged as in a good manner. This will be further tracked by monitoring. A4-2 2 Stakeholder Analysis 2.1 Stakeholder Identification According to the Feasibility Study Report, the Project has 4 components, which involve different stakeholders. Therefore, stakeholders
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