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Improved Maternal and Child Health Through Connectivity (Financed by the Japan Fund for Poverty Reduction)

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Improved Maternal and Child Health Through Connectivity (Financed by the Japan Fund for Poverty Reduction) Grant Assistance Report Project Number: 46077 February 2013 Proposed Grant Assistance Republic of Tajikistan: Improved Maternal and Child Health through Connectivity (Financed by the Japan Fund for Poverty Reduction) CURRENCY EQUIVALENTS (as of 25 January 2013) Currency unit – somoni (TJS) TJS1.00 = $0.2099 $1.00 = TJS4.765 ABBREVIATIONS ADB – Asian Development Bank ADF – Asian Development Fund CAREC – Central Asia Regional Economic Cooperation IEE – initial environmental examination IMCI – Integrated Management of Childhood Illnesses IMR – infant mortality rate JFPR – Japan Fund for Poverty Reduction JICA – Japan International Cooperation Agency MCH – maternal and child health MMR maternal mortality ratio MOH – Ministry of Health MOT – Ministry of Transport PIU – project implementation unit U5MR – under-five mortality rate VIMF – village infrastructure maintenance fund NOTES (i) The fiscal year (FY) of the Government of Tajikistan and its agencies ends on 31 December. (ii) In this report, "$" refers to US dollars. Vice-President X. Zhao, Operations 1 Director General K. Gerhaeusser, Central and West Asia Department (CWRD) Director C.C. Yu, Tajikistan Resident Mission, CWRD Team leader F. Nuriddinov, Project Officer, CWRD Team members A. Chyngysheva, Portfolio Management Specialist, CWRD R. Idei, Transport Specialist, CWRD N. Kvanchiany, Associate Project Analyst, CWRD S. Roth, Senior Social Development Specialist (Social Protection), Regional and Sustainable Development Department Z. Wu, Transport Specialist, CWRD 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. JAPAN FUND FOR POVERTY REDUCTION (JFPR) JFPR Grant Proposal I. Basic Data Name of Proposed Activity Improved Maternal and Child Health through Connectivity Country Republic of Tajikistan Grant Amount Requested $2,500,000 Project Duration 3 years Regional Grant {Yes / z No Grant Type z Project / { Capacity building II. Grant Development Objective(s) and Expected Key Performance Indicators Grant Development Objectives: The primary objective of the project is to improve maternal and child health results for isolated rural communities of five jamoats1 in Rasht district, one of the poorest regions of the country with the highest rate of food insecurity. Health services are poor and knowledge of health- promoting behavior is limited. The situation has worsened since March 2009 when the only bridge connecting the communities to the district center was destroyed by flooding. Residents now have to make a 17-kilometer detour to access the road to the district center. This has seriously constrained access to social services, especially health-care facilities, for communities lacking adequate local health services. The project outcome will be improved access of the marginalized rural poor in five jamoats in Rasht district to strengthened health services. The project will support (i) rehabilitation of the bridge and improvement of the rural road, which is linked to Central Asia Regional Economic Cooperation (CAREC) corridors 3 and 5; and (ii) increased use of effective health services and nutrition practices in communities. About 40,000 villagers will benefit from these interventions. Expected Key Performance Indicators: (i) The 66-meter bridge over the Sarbog river rehabilitated, and 18 km of the rural road linking Navobod, Obi Mehnat, Tagoba, Boki Rahimzoda, and Nusratullo Makhsum jamoats and Rasht district center improved (ii) 90% of health workers in health facilities of the target area updated on obstetric and infant care, and Integrated Management of Childhood Illnesses (IMCI) (iii) 20,000 people in the target area covered by the public information campaign to improve health behavior at the household level (iv) The rural hospital in Navobod equipped with a safe and operating ambulance; and 75% of emergencies reported in the rural health centers referred to the central hospital III. Grant Categories of Expenditure, Amounts, and Percentage of Expenditures Amount of Grant Percentage of Category Allocated in $ Expenditures 1. Civil Works 1,400,000 56.0 2. Equipment and Supplies 131,900 5.3 3. Training, Workshops, Seminars, and Public 76,700 3.1 Campaigns 4. Consulting Services 518,230 20.7 5. Grant Management 128,800 5.1 6. Contingencies 244,370 9.8 Total 2,500,000 100.0 1 Jamoat is Tajik for village cluster, the lowest administration division. 2 JAPAN FUND FOR POVERTY REDUCTION JFPR Grant Proposal Background Information A. Other Data Date of Submission of 11 October 2012 Application Project Officer Farrukh Nuriddinov, Project Officer Project Officer’s Tajikistan Resident Mission Division, E-mail, Phone Central and West Asia Department [email protected], +992 37 221 0558 Other Staff Who Will A. Chyngysheva, Portfolio Management Specialist, CWRD Need Access to Edit R. Idei, Transport Specialist, CWRD and/or Review the Report N. Kvanchiany, Associate Project Analyst, CWRD S. Roth, Senior Social Development Specialist (Social Protection), Regional and Sustainable Development Department Z. Wu, Transport Specialist, CWRD Sector Transport and ICT (primary) Health and social protection Subsector(s) Road transport (district and rural roads, road maintenance) Health systems (primary health care including village health care and first referral) Theme Social development Subtheme(s) Human development Targeting Classification Targeted interventions (TI–H) and MDGs TI (M4, M5) Name of Associated ADB Loan 2196-TAJ/Grant 0154-TAJ: Dushanbe–Kyrgyz Border Road Financed Operation(s) Rehabilitation Project (Phase 2) Loan 2359-TAJ/Grant 0085-TAJ: CAREC Regional Road Corridor Improvement Project Executing Agency Ministry of Transport through the Project Implementation Unit Contact: Mukhtor Negmatov, Executive Director, Project Implementation Unit Ayni 14, 73046 Dushanbe Tel: (992 37) 221 56 73 Fax: (992 37) 251 02 75 Email: [email protected] Grant Implementing Same as above Agency B. Details of the Proposed Grant 1. Description of the Components, Monitorable Deliverables and/or Outcomes, and Implementation Timetable Component A Component Name Improved and sustainable access for isolated communities through bridge and rural road rehabilitation Cost ($) $1,465,500 (excluding contingencies) Component Description The component will improve road access to Garm town, the Rasht 3 district center, for 58 rural communities of five jamoats affected by the flooding, and support establishment of a sustainable infrastructure maintenance mechanism. Civil works. The project will (i) rehabilitate an existing 66-meter (m) bridge over the Sarbog river and (ii) improve an 18 km road from the bridge to the Rasht district center access road. The bridge and road will link the communities to the main Dushanbe– Kyrgyz Republic border road currently being rehabilitated as part of CAREC corridors 3 and 5.2 This will enable the project to contribute to strengthening links with regional and local markets. Community-based infrastructure maintenance mechanism. Community capacity will be developed to maintain infrastructure sustainably by replicating and reinforcing the decentralized operation and maintenance (O&M) scheme established under JFPR 9111-TAJ and JFPR 9078-TA.3 The project will build the capacity of key local stakeholders (local government, community-based organizations, and contractors) to carry out community-based maintenance work through participatory planning and mobilizing local resources. The project will support in (i) forming road maintenance associations in the beneficiary jamoats; (ii) training the associations to build their technical and financial management skills so that properly kept; (iii) establishing village infrastructure maintenance funds (VIMFs) in all five jamoats to collect cash contributions from the community for O&M; 4 and (iv) providing essential road maintenance and safety equipment to the associations. This will ensure periodic maintenance is carried out after the defects liability period of civil works contracts for the bridge and road. Arrangements used for previous projects will be adopted to establish road maintenance associations. Community- based organizations should submit a clear statement of understanding and responsibilities to the Ministry of Transport 2 ADB. 2005. Report and Recommendation of the President to the Board of Directors: Proposed Loan and Asian Development Fund Grant to the Republic of Tajikistan for the Dushanbe–Kyrgyz Border Road Rehabilitation Project (Phase 2). Manila; ADB. 2007. Report and Recommendation of the President to the Board of Directors: Proposed Loan, Asian Development Fund Grants, and Technical Assistance Grant to the Kyrgyz Republic and the Republic of Tajikistan for the CAREC Regional Road Corridor Improvement Project. Manila; ADB. 2009. Report and Recommendation of the President to the Board of Directors: Proposed Supplementary Asian Development Fund Grant to the Republic of Tajikistan for the Dushanbe–Kyrgyz Border Road Rehabilitation Project (Phase 2). Manila. 3 ADB. 2007. Proposed Grant Assistance to the Republic of Tajikistan for the Sustainable Access for Isolated Rural Communities Tajikistan (financed by the Japan Fund for Poverty Reduction). Manila; ADB. 2005. Proposed Grant Assistance to the Republic of Tajikistan for the Community-Based Rural Road Maintenance Project (financed by
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