Second Health Care in the Central Highlands Project in Kon Tum

Due Diligence Report

Project number: 44265-013 Stage: Final August 2016

VIE: Second Health Care in the Central

Prepared by the Ministry of Health, Socialist Republic of Viet Nam, for Asian Development Bank.

The 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.

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. CURRENCY EQUIVALENTS (as of March 2016)

Currency unit – Vietnamese Dong (VND)

$1.00 = VND 22,350

ACCRONYMS

ADB - Asian Development Bank

CHS - Commune Health Station

CPMU - Central Project Management Unit

EGP - Ethnic Group Plan

HICH - Health Care in the Central Highlands Project

IEC - Information, Education and Communication

ICP - Inter-communal Polyclinics

IMR - Infant Mortality Rate

MDG - Millennium Development Goal

MMR - Maternal Mortality Ratio

MOH - Ministry of Health

MOF - Ministry of Finance

NGO - Non-Government Organization

PAM - Project Administration Manual

PCR - Project Completion Report

PHC - Primary Health Care

PPMU - Provincial Project Management Unit

U5MR - Under-five mortality Rate

VHW - Village Health Worker

VSS - Vietnam Social Security System

Notes: The 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. 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.

I. INTRODUCTION 1. The Ministry of Health (MOH) is implementing the Second Health Care in the Central Highlands Project (HICH, or the Project) in the 5 provinces (Dak Lak, Lam Dong, Gia Lai, Kom Tum and Dak Nong) of Viet Nam, through Loan № 3038 – VIE (SF) from the Asian Development Bank (ADB). The objective of the Project is to increase use of maternal and child health services in district hospitals, inter-communal polyclinics (ICPs) and commune health stations (CHSs) by: (i) building new, upgrading some CHSs, ICPs and district hospitals including WWTPs; (ii) providing medical equipment and HMIS at the central, provincial, district, commune and village levels; (iii) developing human health resources through long-term and short-term training courses in professional and managerial skills; and (iv) service access support. 2. The Project comprises the following components in the Target Provinces: – Component A: Improved Access and Quality of Community Health Care – Component B: Increased Access and Quality of Hospital Services – Component C: Strengthened Provincial Health System Management 3. The safeguard categories for the Project is as below: – Environment category B:Anticipated disturbance during construction and generation of wastes during operation of hospitals. – Involuntary Resettlement category C: No resettlement issues have been identified or are expected. – Indigenous Peoples category B: The project includes a significant proportion of ethnic groups amongst its beneficiaries in the targeted provinces, who are among some of the poorest and most marginalized households in Viet Nam. 4. Kon Tum Province lies in the Central Highlands region of Vietnam and shares borders with Laos and Cambodia. It has an area of 9,934 square km and a population of approximately 432,865. The economy is primarily agricultural. Neighboring provinces are Quảng Nam to the North, Quảng Ngãi to the East and Gia Lai to the South. Ethnic groups in Kon Tum province include the Kinh, Ba Na, Brau, Giẻ Triêng, Jarai, Rơ Măm, and Xo Dang in which the Kinh accounts for 53%. 5. The Project shall finance for construction and upgrading of35Community Health Stations (CHSs)located in 35 communes, wards and towns of Kom Tum Province as Dak Glei, Dak To, Dak Ha, Sa Thay Towns; Ngoc Wang, Kroong, Dak Ro Wa, Dak Coi, Dak To Lung, Po E, Dak Long, Ngoc Tem, Dak To Re, Tan Lap, Hoa Binh, Doan Ket, Mo Ray, Sa Son, Ya Ly, Dak Ro Nga, Van Lem, Dak To Kan, Dak Sao, Te Xang, Tu Mo Rong, Dak Ui, Kon Dao, Dak Kan, Sa Loong, Dak Nong, Dak Su, Dak Man, Ngoc Linh Communes and Ngo May, Truong Chinh Wards 6. The objective of the DDR is to confirm if all the safeguards-related conditions in the Loan Agreement have been met by the respective stakeholders to allow the issuance of “no objection” for the award of civil works contract for the construction and upgrading works of the Project in Kom Tum province. Specifically, the DDR will: a. Verify if (i) DONRE has granted the final approval of the IEE, (ii) MOH and the PPMUs have incorporated relevant provisions from the EMP (including monitoring and reporting requirements) into the bidding documents and works contract, and (iii) DONRE has issued the required certificates of environmental protection or environmental impact assessment certificates for civil works contracts that involves environmental impacts; b. Verify if the proposed civil works (hospitals and community health centers) will not involve any land acquisition or involuntary resettlement impacts. In doing so, determine the current use, type and ownership of the land where the facilities will be constructed, sufficiency of available land for the civil works, including sites for temporary use during construction; c. Ascertain which ethnic minority groups are within the service-area of the proposed facilities, and assess how they are covered in the final ethnic minorities development plan (EMDP), which is also a requirement for awarding works contract; 7. While in the field, the consultant is also expected to advise the PPMU of the other safeguards-related requirements during project implementation as provided in the Loan Agreement to ensure their awareness of such requirements. 8. Prior to the field visit, the CPMU prepared the checklists for screening involuntary resettlement, environment and indigenous people impacts (see appendix 1). The checklists were sent to Kom Tum PPMU to assist the PPMU in verifying the status of safeguard issues of the subproject in Kom Tum. The field visits were undertaken by the safeguard specialist on 9 to 12 May and13 to16June 2016 to review the report prepared by the Kom Tum PPMU, consult the PPMU on the corrective and pending actions and collect necessary information and documents needed for the preparation of the DDR. During these trips, all the proposed works were visited. Meetings with the PPMU, the project owners were organized. Findings from the visit are presented in the succeeding sections.

II. THE PROPOSED WORKS 9. The proposed civil works in Kom Tum includes the construction and upgrading of35 CHSs in 35 communes, towns and wards. In June 2016, all technical designs for the said proposed works have been submitted toKom Tum People Committee for clearance and approval. A brief description on the existing CHSsthat are financed by the project is presented in Table 1. Table 1. Description of existing CHSs Commune/Ward Year of Current Existing physical facilities /Town operation Area (m2) Đắk Rơ Wa 2000 4852 A single-storey grade IV building with 6 rooms Commune (90m2), WC, Parking yard Kroong 2001 3600 A single-storey grade IV building with 5 rooms Commune (90 m2), WC, Parking yard Tu Mơ Rông n/a n/a N/a Commune Đắk Glei Town 2001 N/a Degraged, Can not used

Đắk Hà Town 2007 1445,5 A single-storey grade IV building with 4 rooms (80 m2), WC, Parking yard Đắk Ui 2001 1431,5 two single-storey grade IV buildings with 6 Commune rooms (110 m2), WC, Parking yard Ngọc Wang N/a N/a N/a Commune Đắk Rơ Nga 2004 1037,4 A single-storey grade IV building with 4 rooms commune (80 m2), WC, Parking yard Mô Rai 2001 502 A single-storey grade IV building with 4 rooms Commune (80m2), WC, Parking yard DắK Kôi 2001 550 A single-storey grade IV building with 4 rooms Commune (80m2), WC, Parking yard Ngô Mây Ward 2004 1217 A single-storey grade IV building with 5 rooms (90 m2), WC, Parking yard Trường Chinh 2004 620 A single-storey grade IV building with 4 rooms Ward (80m2), WC, Parking yard Đoàn Kết 2000 1510,4 A single-storey grade IV building with 5 rooms commune (90 m2), WC, Parking yard Hòa Bình 2000 1184,6 A single-storey grade IV building with 5 rooms commune (90 m2), WC, Parking yard Đăk Tô town 2001 932,4 A single-storey grade IV building with 5 rooms (90 m2), WC, Parking yard Kon Đào 2001 1649,8 A single-storey grade IV building with 5 rooms commune (90 m2), WC, Parking yard Văn Lem 2007 1329,9 A single-storey grade IV building with 5 rooms commune (90 m2), WC, Parking yard Đăk Sú 2001 532,4 A single-storey grade IV building with 4 rooms commune (80 m2), WC, Parking yard Đăk Kan 2004 2598 A single-storey grade IV building with 5 rooms commune (90 m2), WC, Parking yard Đăk Nông 2001 1550 A single-storey grade IV building with 4 rooms commune (75 m2), WC, Parking yard Sa Long 2001 1512 A single-storey grade IV building with 5 rooms commune (90 m2), WC, Parking yard Đắk Sao 2001 2314,6 A single-storey grade IV building with 5 rooms commune (90 m2), WC, Parking yard Tờ Kan 2001 648 A single-storey grade IV building with 4 rooms commune (80 m2), WC, Parking yard Tê Xăng 2001 790,6 A single-storey grade IV building with 4 rooms commune (80 m2), WC, Parking yard Đắk Man 2001 1286,4 A single-storey grade IV building with 5 rooms commune (90 m2), WC, Parking yard Ngọc Linh 2001 455,9 A single-storey grade IV building with 5 rooms commune (90 m2), WC, Parking yard Ngọc Tem 2001 1926,6 A single-storey grade IV building with 5 rooms commune (90 m2), WC, Parking yard Đắk Long 2004 2353,1 A single-storey grade IV building with 4 rooms commune (90 m2), WC, Parking yard Pờ Ê commune 2001 2612,6 A single-storey grade IV building with 5 rooms (90 m2), WC, Parking yard Ya Ly commune 2001 2220 A single-storey grade IV building with 5 rooms (90 m2), WC, Parking yard Sa Sơn 2001 1523,9 A single-storey grade IV building with 5 rooms commune (90 m2), WC, Parking yard Sa Thầy 2001 2127,8 A single-storey grade IV building with 5 rooms commune (90 m2), WC, Parking yard Đắk Tờ Lung 2001 990,5 A single-storey grade IV building with 5 rooms commune (90 m2), WC, Parking yard Đắk Tờ Re 2001 3761,7 A single-storey grade IV building with 5 rooms commune (70 m2), WC, Parking yard Tân Lập 2001 760,8 A single-storey grade IV building with 5 rooms commune (70 m2), WC, Parking yard

10. The location, description of the proposed works, area required, current land use of the sites and land ownership statusof the proposed works sites in Kom Tum province are presented in table2.

Table 2. Description of the proposed works and sites in Kom Tum Province Location Proposed Work Description Const Current Land Use Holder of Area (m2) LURC Đắk Rơ Health station building 250 Proposed works are Dak Ro Wa Wa Auxiliary house 37 constructed within the Health Commune Parking yard 37 campus of existing CSH Station Wall, internal road, water 350 well, wastes burning hole Kroong Health station building 250 An Idle area managed by Kroong Commune Auxiliary house 37 Kroong Communeon Commune Parking yard 37 which a local household Wall, internal road, water 350 is growing cassava and well, wastes burning hole no housing on this area. Tu Mơ Health station building 250 Idle area with only Tu Mo Rong Rông Auxiliary house 37 bushes, No agricultural Commune Commune Parking yard 37 activities, no housing on this area. Wall, internal road, water 350 well, wastes burning hole Đắk Glei Health station building 250 Idle area with only Dak Glei Town Auxiliary house 37 bushes, No agricultural Town Parking yard 37 activities, no housing on Wall, internal road, water 350 this area. well, wastes burning hole Đắk Hà Health station building 250 Idle area with only Dak Town Auxiliary house 37 bushes, No agricultural HaTown Parking yard 37 activities, no housing on Wall, internal road, water 350 this area. well, wastes burning hole Đắk Ui Health station building 250 Proposed works are Dak Ui Commune Parking yard 37 constructed within the Health Wall, internal road, water 200 campus of existing CSH Station well, wastes burning hole Ngọc Health station building 250 An Idle area managed by Ngoc Wang Wang Auxiliary house 37 Ngoc Wang Commune on commune Commune Parking yard 37 which a local household is growing cassava and Wall, internal road, water 320 no housing on this area. well, wastes burning hole Đắk Rơ Health station building 250 Proposed works are Dak Ro Nga Nga Auxiliary house 37 constructed within the Health campus of existing CSH Station commune Parking yard 37 Wall, internal road, water 350 well, wastes burning hole Mô Rai Health station building 250 Idle area with Mô Rai Commune Auxiliary house 37 anabandoned single Commune Parking yard 37 storey building that was used for Mo Rai People Wall, internal road, water 460 Committee well, wastes burning hole DắK Côi Health station building 250 Idle area with only DắK Kôi Commune Auxiliary house 37 bushes, No agricultural Commune Parking yard 37 activities, no housing on Wall, internal road, water 360 this area. well, wastes burning hole Ngô Mây Upgrading health station 90 Proposed works are Ngo May Location Proposed Work Description Const Current Land Use Holder of Area (m2) LURC Ward building constructed within the Health Construction of a new a 160 campus of the CHS Station single-storey building Trường Upgrading health station 90 Proposed works are Truong Chinh building constructed within the Chinh Ward Construction of a new a 160 campus of the CHS Health single-storey building Station Đoàn Kết Upgrading health station 90 Proposed works are Doan Ket commune building constructed within the Health Construction of a new a 160 campus of the CHS Station single-storey building Hòa Bình Upgrading health station 90 Proposed works are Hoa Binh commune building constructed within the Health Construction of a new a 160 campus of the CHS Station single-storey building Đăk Tô Upgrading health station 90 Proposed works are Dak To town building constructed within the Health Construction of a new a 160 campus of the CHS Station single-storey building Kon Đào Upgrading health station 70 Proposed works are Kon Dao commune building constructed within the Health Construction of a new a 180 campus of the CHS Station single-storey building Văn Lem Upgrading health station 90 Proposed works are Van Lem commune building constructed within the Health Construction of a new a 160 campus of the CHS Station single-storey building Đăk Sú Upgrading health station 70 Proposed works are Dak Su commune building constructed within the Health Construction of a new a 180 campus of the CHS Station single-storey building Đăk Kan Upgrading health station 90 Proposed works are Dak Kan commune building constructed within the Health Construction of a new a 160 campus of the CHS Station single-storey building Đăk Nông Upgrading health station 70 Proposed works are Dak Nong commune building constructed within the Health Construction of a new a 180 campus of the CHS Station single-storey building Sa Long Upgrading health station 70 Proposed works are Sa Long commune building constructed within the Health Construction of a new a 180 campus of the CHS Station single-storey building Đắk Sao Upgrading health station 90 Proposed works are Dak Sao commune building constructed within the Health Construction of a new a 160 campus of the CHS Station single-storey building Dak Tờ Upgrading health station 90 Proposed works are Dak To Kan Kan building constructed within the Health commune Construction of a new a 160 campus of the CHS Station single-storey building Tê Xăng Upgrading health station 70 Proposed works are Te Xang commune building constructed within the Health Construction of a new a 180 campus of the CHS Station single-storey building Đắk Man Upgrading health station 70 Proposed works are Dak Man building constructed within the Health Location Proposed Work Description Const Current Land Use Holder of Area (m2) LURC commune Construction of a new a 180 campus of the CHS Station single-storey building Ngọc Linh Upgrading health station 180 Proposed works are Ngoc Linh commune building constructed within the Health campus of the CHS Station Ngọc Tem Upgrading health station 330 Proposed works are Ngoc Tem commune building constructed within the Health campus of the CHS Station Đắk Long Upgrading health station 90 Proposed works are Dak Long commune building constructed within the Health Construction of a new a 160 campus of the CHS Station single-storey building Pờ Ê Upgrading health station 282 Proposed works are Po E Health commune building constructed within the Station campus of the CHS Ya Ly Upgrading health station 90 commune building Proposed works are Ya Ly Construction of a new a 160 constructed within the Health single-storey building campus of the CHS Station Sa Sơn Upgrading health station 70 commune building Proposed works are Sa Son Construction of a new a 180 constructed within the Health single-storey building campus of the CHS Station Sa Thầy Upgrading health station 70 Town building Proposed works are Sa Thay Construction of a new a 180 constructed within the Health single-storey building campus of the CHS Station Đắk Tờ Upgrading health station 90 Lung building Proposed works are Dak To commune Construction of a new a 160 constructed within the Lung Health single-storey building campus of the CHS Station Đắk Tờ Upgrading health station 70 Re building Proposed works are Dak To Re commune Construction of a new a 180 constructed within the Health single-storey building campus of the CHS Station Tân Lập Upgrading health station 70 Proposed works are Tan Lap commune building constructed within the Health Construction of a new a 180 campus of the CHS Station single-storey building

III. POTENTIAL SAFEGUARD ISSUES OF THE SUBPROJECT IN KOM TUM PROVINCE 11. Land Acquisition and Resettlement: after reviewing the technical design, taking site visits and collecting the documents related to land use rights, it is concluded that no resettlement issues have been identified or are expected. The details are presented as below  Dak Ro Wa Health Station – Dak Ro Wa commune, Kom Tum city: all construction works are in the campus of 4,852.8 m2 of the existing Health Station, the total construction area of 700 m2that is currently usedasyard and garden of the station. This area was under management of Dak Ro Wa Health Station based on an official land map excerpt issued by Dak Ro Wa commune people committee (CPC)in 2015. No land acquisition is required and no third-party user will be affected.  Kroong Health Station – Kroong commune, Kom Tum city: shall be relocated to new place that is, currently, an idle area on which an local household are growing cassava. This area of 1500 m2is under management of Kroong Commune People Committee planned as the location for Kroong Health Station according an official land map excerpt issued by Kroong Commune People Committee in 2012. During time of waiting for new health station construction, the CPC has made an agreement with a local household to allow this household to grow cassava on the said area. The cassava has been grown since Feb 2016 and expectedly will be harvested no later than the end of September 2016, and Kroong People Committee also has confirmed that after this cassava season, the proposed land shall be kept as an idle area until the commencement of health station construction as scheduled no sooner than December 2016. In view of that, there will be no impacts on the crops planted in such area. Both the PPMU and the CPC have been instructed to keep each other updated on the progress of subproject implementation thereby, local authorities and people can cooperate together in the good management of this land as well as support the project. It is recommended that the PPMU shall inform the CPC at least three months before carrying out the site clearance for the construction. No land acquisition is required and no third-party user will be affected.  Tu Mo Rong Health Station – Tu Mo Rong commune, Tu Mo Rong District: shall be constructed on an idle area of 900 m2 under management of Tu Mo Rong commune people committee based on the official minutes on Verification of Land for Basic Construction among agencies of Tu Mo Rong district as Department of Resources and Environment, District Health Center and Tu Mo Rong people committee on 20th November 2012. There are no agricultural activities or housings on this area, no land acquisition is required and no third-party user will be affected, no land acquisition is required and no third-party user will be affected.  Dak Glei Health station - Dak Glei Town, Dak Glei District: shall be constructed on an idle area of 1000 m2 under management of Dak Glei Town people committee based on the official announcement on the location for constructing Dak Glei health station issued by Dak Glei District People Committee on 28th March 2016. There are no agricultural activities or housings on this area, no land acquisition is required and no third-party user will be affected.  Dak Ha Health Station – Dak Ha Town, Dak Ha District: shall be constructed on an idle area of 1445,5 m2 under management of Dak Ha Town people committee based on the official announcement on the location for constructing Dak Ha health station issued by Dak Ha District People Committee on 18th November 2015. There are no agricultural activities or housings on this area, no land acquisition is required and no third-party user will be affected.  Dak Ui Health Station – Dak Ui commune, Dak Ha District: all construction works are in the campus of 1,431.5 m2 of the existing Health Station, the total construction area of 600 m2that is currently usedasyard and garden of the station. This area was under management of Dak Ui Health Station based on Land Use Right Certificate No BP540486 issued by Kom Tum Province People Committee on 31st March 2014. No land acquisition is required and no third-party user will be affected.  Ngoc Wang Health Station – Ngoc Wang commune, Dak Ha District: shall be constructed on an idle area on which an local household are growing cassava. This area of 8733 m2 is under management of Ngoc Wang Commune People Committee planned as the location for Ngoc Wang Health Station according an official announcement on the location for constructing Ngoc Wang health station issued by Dak Ha District People Committee on 21st December 2015. During time of waiting for new health station construction, the CPC has made an agreement with a local household to allow this local household to grow cassava on the said area. The cassava has been grown since Feb 2016 and expectedly will be harvested no later than the end of September 2016, and Ngoc Wang People Committee also has confirmed that after this cassava season, the proposed land shall be kept as an idle area until the commencement of health station construction as scheduled no sooner than December 2016. In view of that, there will be no impacts on the crops planted in such area. Both the PPMU and the CPC have been instructed to keep each other updated on the progress of subproject implementation thereby, local authorities and people can cooperate together in the good management of this land as well as support the project. It is recommended that the PPMU shall inform the CPC at least three months before carrying out the site clearance for the construction. No land acquisition is required and no third-party user will be affected.  Dak Ro Nga Health Station – Dak Ro Nga commune, Dak To district: all construction works are in the campus of 1.037,4 m2of the existing Health Station, the total construction area of 700 m2that is currently usedasyard and garden of the station. This areawas under management of Dak Ro Nga Health Station based on an official land map excerpt issued by Dak Ro Nga Commune People Committee. No land acquisition is required and no third-party user will be affected.  Mo Rai Health Station – Mo Rai Commune, Sa Thay district: shall be constructed on an idle area of 4,200 m2 under management of Mo Rai Commune people committee based on the official announcement on the location for constructing Mo Rai health station issued by Mo Rai Commune People Committee on 107thDecember 2012. On this area, there is an abandoned single storey building that was used as the commune official building. There are no agricultural activities on this area, no land acquisition is required and no third-party user will be affected.  Dak Coi Health Station – Dak Coi commune, Kon Ray District: shall be constructed on an idle area of 900 m2 under management of Dak Koi Commune people committee based on the official announcement on the location for constructing Dak Koi health station issued by Kon Ray District People Committee on 26th July 2016. There is no agricultural activities on this area, No land acquisition is required and no third-party user will be affected.  Ngo May Health Station – Ngo May Ward, Kom TumCity: all construction and upgrading works are in the campus1,217 m2 of the existing Health Station, the total construction area of 160 m2that is currently usedasyard and garden of the station. This area was under management of Ngo May Health Station based on Land Use Right Certificate No BP540838 issued by Kom Tum Province People Committee on 04thApril 2014. No land acquisition is required and no third-party user will be affected.  Truong Chinh Health Station – Truong Chinh Ward, Kom Tum City: all construction and upgrading works are in the campus588 m2 of the existing Health Station, the total construction area of 160 m2that is currently usedasyard and garden of the station. This area was under management of Truong Chinh Health Station based on Land Use Right Certificate No BP540554 issued by Kom Tum Province People Committee on 05th may 2014. No land acquisition is required and no third-party user will be affected.  Doan Ket Health Station – Doan Ket Commune, Kom Tum City: all construction and upgrading works are in the campus 1,510 m2 of the existing Health Station, the total construction area of 160 m2that is currently usedasyard and garden of the station. This area was under management of Doan Ket Health Station based on Land Use Right Certificate No BP54035 issued by Kom Tum Province People Committee on 05th may 2014. No land acquisition is required and no third-party user will be affected.  Hoa Binh Health Station – Hoa Binh Commune, Kom Tum City: all construction and upgrading works are in the campus 1,184.6m2 of the existing Health Station, the total construction area of 160 m2that is currently usedasyard and garden of the station. This area was under management of Hoa Binh Health Station based on Land Use Right Certificate No BP540551 issued by Kom Tum Province People Committee on 05thMay 2014. No land acquisition is required and no third- party user will be affected.  Dak To Health Station – Dak To Town, Dak to district: all construction and upgrading works are in the campus 932,4 m2 of the existing Health Station, the total construction area of 160 m2that is currently usedasyard and garden of the station. This area was under management of Dak To Health Station based on Land Use Right Certificate No BP540548 issued by Kom Tum Province People Committee on 16th May 2014. No land acquisition is required and no third-party user will be affected.  Kon Dao Health Station – Kon Dao Commune, Dak To District: all construction and upgrading works are in the campus 1,649.8 m2 of the existing Health Station, the total construction area of 180 m2that is currently usedasyard and garden of the station. This area was under management of Kon Dao Health Station based on Land Use Right Certificate No BP540549 issued by Kom Tum Province People Committee on 16th May 2014. No land acquisition is required and no third- party user will be affected.  Van Lem Health Station – Van Lem Commune, Dak to district: all construction and upgrading works are in the campus 1,329.9 m2 of the existing Health Station, the total construction area of 160 m2that is currently usedasyard and garden of the station. This area was under management of Van Lem Health Station based on Decision No 421/QD-UBND on land handover to Kom Tum Department of Health for construction of Van Lem health station issued by Kom Tum Province People Committee on 30th June 2015. No land acquisition is required and no third-party user will be affected.  Dak Su Health Station – Dak Su Commune, Ngoc Hoi District: all construction and upgrading works are in the campus 532,4 m2 of the existing Health Station, the total construction area of 180 m2that is currently usedasyard and garden of the station. This area was under management of Kon Dao Health Station based on Land Use Right Certificate No BX734035 issued by Kom Tum Province People Committee on 16th May 2014. No land acquisition is required and no third- party user will be affected.  Dak Kan Health Station – Dak Kan Commune, Ngoc Hoi District: all construction and upgrading works are in the campus 2598 m2 of the existing Health Station, the total construction area of 160 m2that is currently usedasyard and garden of the station. This area was under management of Dak Kan Health Station based on Land Use Right Certificate No BP540876 issued by Kom Tum Province People Committee on 18th September 2014. No land acquisition is required and no third-party user will be affected.  Dak Nong Health Station – Dak Nong Commune, Ngoc Hoi District: all construction and upgrading works are in the campus 1152.2 m2 of the existing Health Station, the total construction area of 180 m2that is currently usedasyard and garden of the station. This area was under management of Dak Nong Health Station based on Land Use Right Certificate No BP540877 issued by Kom Tum Province People Committee on 18th September 2014. No land acquisition is required and no third-party user will be affected.  Sa Long Health Station – Sa Long Commune, Ngoc Hoi District: all construction and upgrading works are in the campus 1512 m2 of the existing Health Station, the total construction area of 180 m2that is currently usedasyard and garden of the station. This area was under management of Sa Long Health Station based on Land Use Right Certificate No BP540879 issued by Kom Tum Province People Committee on 18th September 2014. No land acquisition is required and no third-party user will be affected.  Dak Sao Health Station – Dak Sao Commune, Tu Mo Rong District: all construction and upgrading works are in the campus2314,6m2 of the existing Health Station, the total construction area of 160 m2that is currently usedasyard and garden of the station. This area was under management of Dak Sao Health Station based on Land Use Right Certificate No BX734648 issued by Kom Tum Province People Committee on 04th November 2015. No land acquisition is required and no third-party user will be affected.  Dak To Kan Health Station – Dak To Kan Commune, Tu Mo Rong District: all construction and upgrading works are in the campus 648 m2 of the existing Health Station, the total construction area of 160 m2that is currently usedasyard and garden of the station. This area was under management of Dak To Kan Health Station based on Land Use Right Certificate No BX734601 issued by Kom Tum Province People Committee on 22th October 2015. No land acquisition is required and no third-party user will be affected.  Te Xang Health Station – Te Xang Commune, Tu Mo Rong District: all construction and upgrading works are in the campus 790 m2 of the existing Health Station, the total construction area of 180 m2that is currently usedasyard and garden of the station. This area was under management of Te Xang Health Station based on Land Use Right Certificate No BP540739 issued by Kom Tum Province People Committee on 18th July 2014. No land acquisition is required and no third-party user will be affected.  Dak Man Health Station – Dak Man Commune, Dak Glei District: all construction and upgrading works are in the campus 1,286.4 m2 of the existing Health Station, the total construction area of 180 m2that is currently usedasyard and garden of the station. This area was under management of Dak Man Health Station based on Land Use Right Certificate No BP540477 issued by Kom Tum Province People Committee on 10th April 2014. No land acquisition is required and no third- party user will be affected.  Ngoc Linh Health Station – Ngoc Linh Commune, Dak Glei District: only upgrading an existing building that is in the campus 455,9 m2 of the existing Health Station.This area was under management of Dak Man Health Station based on Land Use Right Certificate No BP540772 issued by Kom Tum Province People Committee on 10th April 2014. No land acquisition is required and no third- party user will be affected.  Ngoc Tem Health Station – Ngoc Tem Commune, Kon Plong District: only upgrading an existing building that is in the campus1,926.6m2 of the existing Health Station.This area was under management of Ngoc Tem Health Station based on Land Use Right Certificate No BX734209 issued by Kom Tum Province People Committee on 08th June 2015. No land acquisition is required and no third-party user will be affected.  Dak Long Health Station – Dak Long Commune, Kon Plong District: all construction and upgrading works are in the campus 1,286.4 m2 of the existing Health Station, the total construction area of 180 m2that is currently usedasyard and garden of the station. This area was under management of Dak Long Health Station based on Land Use Right Certificate No BX734203 issued by Kom Tum Province People Committee on 08th June 2015. No land acquisition is required and no third-party user will be affected.  Po E Health Station – Po E Commune, Kon Plong District: only upgrading an existing building that is in the campus 2,612.6 m2 of the existing Health Station.This area was under management of Po E Health Station based on Land Use Right Certificate No BX734207 issued by Kom Tum Province People Committee on 08th June 2015. No land acquisition is required and no third-party user will be affected.  Ya Ly Health Station – Ya Ly Commune, Sa Thay District: all construction and upgrading works are in the campus 2,220 m2 of the existing Health Station, the total construction area of 160 m2that is currently usedasyard and garden of the station. This area was under management of Ya Ly Health Station based on Land Use Right Certificate No BP540118 issued by Kom Tum Province People Committee on 15th August 2013. No land acquisition is required and no third-party user will be affected.  Sa Son Health Station – Sa Son Commune, Sa Thay District: all construction and upgrading works are in the campus 1,523.9 m2 of the existing Health Station, the total construction area of 180 m2that is currently usedasyard and garden of the station. This area was under management of Sa Son Health Station based on Land Use Right Certificate No BP540272 issued by Kom Tum Province People Committee on 29th November 2013. No land acquisition is required and no third- party user will be affected.  Sa Thay Health Station – Sa Thay Town, Sa Thay District: all construction and upgrading works are in the campus 2127,8 m2 of the existing Health Station, the total construction area of 180 m2that is currently usedasyard and garden of the station. This area was under management of Sa Thay Health Station based on Land Use Right Certificate No BP540113 issued by Kom Tum Province People Committee on 15th August 2013. No land acquisition is required and no third-party user will be affected.  Dak To Lung Health Station – Dak To LungCommune, Kon Ray District: all construction and upgrading works are in the campus990.5m2 of the existing Health Station, the total construction area of 160 m2that is currently usedasyard and garden of the station. This area was under management of Dak To Lung Health Station based on Land Use Right Certificate No BP540780 issued by Kom Tum Province People Committee on 18thJuly 2014. No land acquisition is required and no third-party user will be affected.  Dak To Re Health Station – Dak To Re Commune, Kon Ray District: all construction and upgrading works are in the campus 3,761.7 m2 of the existing Health Station, the total construction area of 180 m2that is currently usedasyard and garden of the station. This area was under management of Dak To Re Health Station based on Land Use Right Certificate No BP540782 issued by Kom Tum Province People Committee on 18th July 2014. No land acquisition is required and no third-party user will be affected.  Tan Lap Health Station – Tan Lap Town, Kon Ray District: all construction and upgrading works are in the campus 760,8 m2 of the existing Health Station, the total construction area of 180 m2that is currently usedasyard and garden of the station. This area was under management of Tan Lap Health Station based on Land Use Right Certificate No BP540778 issued by Kom Tum Province People Committee on 18th July 2014. No land acquisition is required and no third-party user will be affected. 12. Environment: The proposed works are expected to have positive impacts to the environment as these will support the construction, rehabilitation, and operation of health facilities, including improvement in water, sanitation, and waste management systems. However, the construction activities will cause disturbances. Such impacts which include generation of noise and dust, deterioration of water quality through sediment laden runoff or improper waste disposal, exacerbation of local flooding conditions, and disruption to property access or commercial activities, will be readily managed to acceptable levels through implementation of standard construction environmental management practices. The current environmental status is described in table 3.

Table 3. The current environmental status of the proposed works in Kom Tum province Proposed Waste Solid waste treatment Required environmental reports The EMP is works water and approval for proposed works incorporated water into bidding documents Đắk Rơ Currently Solid wastes of the An environmental protection plan The Wa using station mostly plastic has been registered by the PPMU subproject is Commune septic tank syringe, packings of and confirmed by Kom Tum under Design for WC medicine are collected DONRE (the official letter issued by phase, house. each day and then are Kom Tum DONRE on register bidding burned in a solid wastes confirmation of Environmental documents collection hole Protection Plan is enclosed in have not appendix 4) been Kroong Currently Solid wastes of the An environmental protection plan prepared yet. Commune using station mostly plastic has been registered by the PPMU septic tank syringe, packings of and confirmed by Kom Tum for WC medicine are collected DONRE (the official letter issued by house. each day and then are Kom Tum DONRE on register burned in a solid wastes confirmation of Environmental collection hole Protection Plan is enclosed in appendix 4) Tu Mơ Not Not applicable An environmental protection plan Rông applicable has been registered by the PPMU Commune and confirmed by Kom Tum DONRE (the official letter issued by Kom Tum DONRE on register confirmation of Environmental Protection Plan is enclosed in appendix 4) Đắk Glei Not Not applicable An environmental protection plan Town applicable has been registered by the PPMU and confirmed by Kom Tum DONRE (the official letter issued by Kom Tum DONRE on register confirmation of Environmental Protection Plan is enclosed in appendix 4) Đắk Hà Currently Solid wastes of the An environmental protection plan Town using station mostly plastic has been registered by the PPMU septic tank syringe, packings of and confirmed by Kom Tum for WC medicine are collected DONRE (the official letter issued by Proposed Waste Solid waste treatment Required environmental reports The EMP is works water and approval for proposed works incorporated water into bidding documents house. each day and then are Kom Tum DONRE on register burned in a solid wastes confirmation of Environmental collection hole Protection Plan is enclosed in appendix 4) Đắk Ui Currently Solid wastes of the An environmental protection plan Commune using station mostly plastic has been registered by the PPMU septic tank syringe, packings of and confirmed by Kom Tum for WC medicine are collected DONRE (the official letter issued by house. each day and then are Kom Tum DONRE on register burned in a solid wastes confirmation of Environmental collection hole Protection Plan is enclosed in appendix 4) Ngọc Not Not Applicable An environmental protection plan Wang Applicable has been registered by the PPMU Commune and confirmed by Kom Tum DONRE (the official letter issued by Kom Tum DONRE on register confirmation of Environmental Protection Plan is enclosed in appendix 4) Đắk Rơ Currently Solid wastes of the An environmental protection plan Nga using station mostly plastic has been registered by the PPMU commune septic tank syringe, packings of and confirmed by Kom Tum for WC medicine are collected DONRE (the official letter issued by house. each day and then are Kom Tum DONRE on register burned in a solid wastes confirmation of Environmental collection hole Protection Plan is enclosed in appendix 4) Mô Rai Not Not Applicable An environmental protection plan is Commune Applicable required to register according to Decree18/2015/ND-CP. This plan has not prepared yet DắK Côi Currently Solid wastes of the An environmental protection plan is Commune using station mostly plastic required to register according to septic tank syringe, packings of Decree18/2015/ND-CP. This plan for WC medicine are collected has not prepared yet house. each day and then are burned in a solid wastes collection hole Ngô Mây Currently Solid wastes of the An environmental protection plan Ward using station mostly plastic has been registered by the PPMU septic tank syringe, packings of and confirmed by Kom Tum for WC medicine are collected DONRE (the official letter issued by house. each day and then are Kom Tum DONRE on register burned in a solid wastes confirmation of Environmental collection hole Protection Plan is enclosed in appendix 4) Trường Currently Solid wastes of the An environmental protection plan Chinh using station mostly plastic has been registered by the PPMU Ward septic tank syringe, packings of and confirmed by Kom Tum for WC medicine are collected DONRE (the official letter issued by house. each day and then are Kom Tum DONRE on register burned in a solid wastes confirmation of Environmental collection hole Protection Plan is enclosed in appendix 4) Đoàn Kết Currently Solid wastes of the An environmental protection plan Proposed Waste Solid waste treatment Required environmental reports The EMP is works water and approval for proposed works incorporated water into bidding documents commune using station mostly plastic has been registerd by the PPMU septic tank syringe, packings of and confirmed by Kom Tum for WC medicine are collected DONRE (the official letter issued by house. each day and then are Kom Tum DONRE on register burned in a solid wastes confirmation of Environmental collection hole Protection Plan is enclosed in appendix 4) Hòa Bình Currently Solid wastes of the An environmental protection plan commune using station mostly plastic has been registered by the PPMU septic tank syringe, packings of and confirmed by Kom Tum for WC medicine are collected DONRE (the official letter issued by house. each day and then are Kom Tum DONRE on register burned in a solid wastes confirmation of Environmental collection hole Protection Plan is enclosed in appendix 4) Hòa Bình Currently Solid wastes of the An environmental protection plan commune using station mostly plastic has been registered by the PPMU septic tank syringe, packings of and confirmed by Kom Tum for WC medicine are collected DONRE (the official letter issued by house. each day and then are Kom Tum DONRE on register burned in a solid wastes confirmation of Environmental collection hole Protection Plan is enclosed in appendix 4) Đăk Tô Currently Solid wastes of the An environmental protection plan town using station mostly plastic has been registered by the PPMU septic tank syringe, packings of and confirmed by Kom Tum for WC medicine are collected DONRE (the official letter issued by house. each day and then are Kom Tum DONRE on register burned in a solid wastes confirmation of Environmental collection hole Protection Plan is enclosed in appendix 4) Kon Đào Currently Solid wastes of the An environmental protection plan commune using station mostly plastic has been registered by the PPMU septic tank syringe, packings of and confirmed by Kom Tum for WC medicine are collected DONRE (the official letter issued by house. each day and then are Kom Tum DONRE on register burned in a solid wastes confirmation of Environmental collection hole Protection Plan is enclosed in appendix 4) Văn Lem Currently Solid wastes of the An environmental protection plan commune using station mostly plastic has been registerd by the PPMU septic tank syringe, packings of and confirmed by Kom Tum for WC medicine are collected DONRE (the official letter issued by house. each day and then are Kom Tum DONRE on register burned in a solid wastes confirmation of Environmental collection hole Protection Plan is enclosed in appendix 4) Đăk Sú Currently Solid wastes of the An environmental protection plan commune using station mostly plastic has been registered by the PPMU septic tank syringe, packings of and confirmed by Kom Tum for WC medicine are collected DONRE (the official letter issued by house. each day and then are Kom Tum DONRE on register burned in a solid wastes confirmation of Environmental collection hole Protection Plan is enclosed in appendix 4) Đăk Kan Currently Solid wastes of the An environmental protection plan Proposed Waste Solid waste treatment Required environmental reports The EMP is works water and approval for proposed works incorporated water into bidding documents commune using station mostly plastic has been registered by the PPMU septic tank syringe, packings of and confirmed by Kom Tum for WC medicine are collected DONRE (the official letter issued by house. each day and then are Kom Tum DONRE on register burned in a solid wastes confirmation of Environmental collection hole Protection Plan is enclosed in appendix 4) Đăk Nông Currently Solid wastes of the An environmental protection plan commune using station mostly plastic has been registered by the PPMU septic tank syringe, packings of and confirmed by Kom Tum for WC medicine are collected DONRE (the official letter issued by house. each day and then are Kom Tum DONRE on register burned in a solid wastes confirmation of Environmental collection hole Protection Plan is enclosed in appendix 4) Sa Long Currently Solid wastes of the An environmental protection plan commune using station mostly plastic has been registered by the PPMU septic tank syringe, packings of and confirmed by Kom Tum for WC medicine are collected DONRE (the official letter issued by house. each day and then are Kom Tum DONRE on register burned in a solid wastes confirmation of Environmental collection hole Protection Plan is enclosed in appendix 4) Đắk Sao Currently Solid wastes of the An environmental protection plan commune using station mostly plastic has been registerd by the PPMU septic tank syringe, packings of and confirmed by Kom Tum for WC medicine are collected DONRE (the official letter issued by house. each day and then are Kom Tum DONRE on register burned in a solid wastes confirmation of Environmental collection hole Protection Plan is enclosed in appendix 4) Tờ Kan Currently Solid wastes of the An environmental protection plan commune using station mostly plastic has been registered by the PPMU septic tank syringe, packings of and confirmed by Kom Tum for WC medicine are collected DONRE (the official letter issued by house. each day and then are Kom Tum DONRE on register burned in a solid wastes confirmation of Environmental collection hole Protection Plan is enclosed in appendix 4) Tê Xăng Currently Solid wastes of the An environmental protection plan commune using station mostly plastic has been registered by the PPMU septic tank syringe, packings of and confirmed by Kom Tum for WC medicine are collected DONRE (the official letter issued by house. each day and then are Kom Tum DONRE on register burned in a solid wastes confirmation of Environmental collection hole Protection Plan is enclosed in appendix 4) Đắk Man Currently Solid wastes of the An environmental protection plan commune using station mostly plastic has been registered by the PPMU septic tank syringe, packings of and confirmed by Kom Tum for WC medicine are collected DONRE (the official letter issued by house. each day and then are Kom Tum DONRE on register burned in a solid wastes confirmation of Environmental collection hole Protection Plan is enclosed in appendix 4) Ngọc Linh Currently Solid wastes of the An environmental protection plan Proposed Waste Solid waste treatment Required environmental reports The EMP is works water and approval for proposed works incorporated water into bidding documents commune using station mostly plastic has been registerd by the PPMU septic tank syringe, packings of and confirmed by Kom Tum for WC medicine are collected DONRE (the official letter issued by house. each day and then are Kom Tum DONRE on register burned in a solid wastes confirmation of Environmental collection hole Protection Plan is enclosed in appendix 4) Ngọc Tem Currently Solid wastes of the An environmental protection plan commune using station mostly plastic has been registerd by the PPMU septic tank syringe, packings of and confirmed by Kom Tum for WC medicine are collected DONRE (the official letter issued by house. each day and then are Kom Tum DONRE on register burned in a solid wastes confirmation of Environmental collection hole Protection Plan is enclosed in appendix 4) Đắk Long Currently Solid wastes of the An environmental protection plan commune using station mostly plastic has been registered by the PPMU septic tank syringe, packings of and confirmed by Kom Tum for WC medicine are collected DONRE (the official letter issued by house. each day and then are Kom Tum DONRE on register burned in a solid wastes confirmation of Environmental collection hole Protection Plan is enclosed in appendix 4) Pờ Ê Currently Solid wastes of the An environmental protection plan commune using station mostly plastic has been registered by the PPMU septic tank syringe, packings of and confirmed by Kom Tum for WC medicine are collected DONRE (the official letter issued by house. each day and then are Kom Tum DONRE on register burned in a solid wastes confirmation of Environmental collection hole Protection Plan is enclosed in appendix 4) Ya Ly Currently Solid wastes of the An environmental protection plan commune using station mostly plastic has been registered by the PPMU septic tank syringe, packings of and confirmed by Kom Tum for WC medicine are collected DONRE (the official letter issued by house. each day and then are Kom Tum DONRE on register burned in a solid wastes confirmation of Environmental collection hole Protection Plan is enclosed in appendix 4) Sa Sơn Currently Solid wastes of the An environmental protection plan commune using station mostly plastic has been registered by the PPMU septic tank syringe, packings of and confirmed by Kom Tum for WC medicine are collected DONRE (the official letter issued by house. each day and then are Kom Tum DONRE on register burned in a solid wastes confirmation of Environmental collection hole Protection Plan is enclosed in appendix 4) Sa Thầy Currently Solid wastes of the An environmental protection plan commune using station mostly plastic has been registered by the PPMU septic tank syringe, packings of and confirmed by Kom Tum for WC medicine are collected DONRE (the official letter issued by house. each day and then are Kom Tum DONRE on register burned in a solid wastes confirmation of Environmental collection hole Protection Plan is enclosed in appendix 4) Đắk Tờ Currently Solid wastes of the An environmental protection plan Proposed Waste Solid waste treatment Required environmental reports The EMP is works water and approval for proposed works incorporated water into bidding documents Lung using station mostly plastic has been registered by the PPMU commune septic tank syringe, packings of and confirmed by Kom Tum for WC medicine are collected DONRE (the official letter issued by house. each day and then are Kom Tum DONRE on register burned in a solid wastes confirmation of Environmental collection hole Protection Plan is enclosed in appendix 4) Đắk Tờ Currently Solid wastes of the An environmental protection plan Re using station mostly plastic has been registered by the PPMU commune septic tank syringe, packings of and confirmed by Kom Tum for WC medicine are collected DONRE (the official letter issued by house. each day and then are Kom Tum DONRE on register burned in a solid wastes confirmation of Environmental collection hole Protection Plan is enclosed in appendix 4) Tân Lập Currently Solid wastes of the An environmental protection plan commune using station mostly plastic has been registered by the PPMU septic tank syringe, packings of and confirmed by Kom Tum for WC medicine are collected DONRE (the official letter issued by house. each day and then are Kom Tum DONRE on register burned in a solid wastes confirmation of Environmental collection hole Protection Plan is enclosed in appendix 4) 17. The Loan Agreement requires that no works contract which involves environmental impacts will be awarded until DONRE has granted the final IEE approved by ADB in Sep 2013, relevant provisions of the EMP are integrated into the Works contract, and DONRE has issued the certificates of environmental protection or environmental impact assessment certificates. 18. At the time of the review, the IEE have not been approved by DONRE, however, the PPMU have been aware of this requirement and it is expected that this mission shall be complete no later than September 2016 before starting bidding process as scheduled. In addition, two CHSs (Dak Coi, Mo Ray Heath Stations) of 35 proposed works of Kom Tum have not obtained the proper environmental certificate, as mentioned in table 3. 19. Indigenous peoples: Kom Tum province has 25 ethnic groups, accounting for about 47% (229,413 people) of the province's population (432,856people) in which Xơ Đăng, Bana, Giẻ-Triêng, Gia Rai, Brâu và Rơ Mămare in place or the local peoples, and other ethnic groups have migrated during the last 30 years, such as Tay, Nung, Muong, Dao, Thai and Mong. Located in 35 communes, towns and wards, the service areas of the proposed works and the status of indigenous peoples in these areas are presented in table 4.

Table 4. Indigenous peoples in the service areas of proposed works in Kom Tum province Proposed Population Percentage Number of Note work locations of Indigenous Indigenous peoples peoples Đắk Rơ Wa 3772 94.1 3550 Ro Ngao and Ba Na are acount for Commune 50% and 48%, respectively, of indigenous people Kroong 4672 43% 2053 99% of indigenous peoples is the Commune Ro Ngao, Tu Mơ Rông 1350 97% 1310 95% of indigenous peoples is the Commune Xe Dang, Đắk Glei 6800 66% 4488 Gie Trieng 19%, Xê Đăng 1%, Hà Town Lăng 43%, Kinh 37% Đắk Hà Town 15768 5% 711 90% of indigenous peoples is the Ro Ngao, the others as Thai, Muong Đắk Ui 5794 79% 4925 90% of indigenous peoples is the Commune So Ra, 5% Gie Trieng Ngọc Wang 4838 82% 3967 75% of indigenous peoples is the Commune So Ra, and others as the Ba Na, Tay, Ro Ngao, Muong Đắk Rơ Nga 3426 96% 3254 93% of indigenous peoples is the commune Se Dang, and others as the Mong, Thai Mô Rai 1986 90% 1787 98% of indigenous peoples is the Commune Ro Mam, DắK Côi 2561 98% 2510 96.7% of indigenous peoples is the Commune Xe Dang; 3% is the Tay, Ngô Mây 4267 16.94% 723 Ba Na and Gie Trieng are acount for Ward 52% and 48%, respectively, of indigenous people Trường Chinh 9333 14% 1341 85% of indigenous peoples is the Ward Ro Ngao, and others as the Tay, Nung Đoàn Kết 4115 28.3% 1176 Ba Na and Jarai are acount for 49% commune and 51%, respectively, of indigenous people Hòa Bình 6921 24.4% 2349 Ba Na and Jarai are acount for 20% commune and 80%, respectively, of indigenous people Đăk Tô town 13706 30% 2350 80% of indigenous peoples is the Xo Dang, and others as the Mong, Thai Kon Đào 4066 52.8% 2048 88% of indigenous peoples is the commune Xo Dang, Văn Lem 2404 95.5% 95.5% of indigenous peoples is the commune 2296 Xo Dang, Đăk Sú 7280 57.1% 4116 52% of indigenous peoples is the commune Se Dang, and others as the Tay,Dao ,Nung, Thai Đăk Kan 5317 45% 2134 40% of indigenous peoples is the commune Muong, and others as the Xe Dang, Tay Đăk Nông 3729 84.1% 3137 75% of indigenous peoples is the commune Gie Trieng,the others as the Nung Tay Sa Long 5575 82% 4572 59% of indigenous peoples is the commune Xe Dang, and others as the Muong, Thai, Tay Đắk Sao 3136 97% 3042 95% of indigenous peoples is the commune Se Dang Tờ Kan 3366 97% 3265 95% of indigenous peoples is the commune Se Dang Tê Xăng 1517 97% 1471 95% of indigenous peoples is the commune Se Dang Đắk Man 1237 97.4% 1206 98% of indigenous peoples is the commune Xe Dăng, Ngọc Linh 32633 98% 2581 98% of indigenous peoples is the commune Xe Dăng, Ngọc Tem 4456 75% 3342 80% of indigenous peoples is the commune Ba Na, and others as the Tay, Nung, Muong Đắk Long 4279 70% 3001 98% of indigenous peoples is the commune Mo Nong, Pờ Ê 2980 90% 2682 90% of indigenous peoples is the commune Ro Mam, Ya Ly 1963 84.7% 1633 90% of indigenous peoples is the commune Gie Trieng, 7% is Dao and 3% Hre Sa Sơn 2330 27.08% 631 99% of indigenous peoples is the commune Gia Rai, Sa Thầy 10636 29.8% 3177 99% of indigenous peoples is the commune Gia Rai Đắk Tờ Lung 2297 98% 2251 Sơ rá 33,3%, Jơ Lơng 65,53%, commune Mường 1,52% Đắk Tờ Re 6023 80.05% 4822 90% of indigenous peoples is the commune Ba Na, Tân Lập 4181 24% 1004 98% of indigenous peoples is the commune So Ra,

20. The project includes a significant proportion of ethnic groups amongst its beneficiaries in the targeted provinces, who are among some of the poorest and most marginalized households in Vietnam. The ethnic group settlements are often situated in remote areas and have comparatively less access to basic services. Ethnic groups have higher infant mortality rates and maternal mortality ratio. Based on that fact, the project will prioritize interventions in areas with high ethnic group populations and hence have positive impact on ethnic group peoples (category B). 21. According to item 8, Schedule 4 of the Loan Agreement 3038 VIE, the CPMU shall prepare and submit to ADB the final EGDP prior awarding any Works contract. To comply with this requirement, afinal EGDP has been prepared for the project and approved by ADB in March 2016

IV. GRIEVANCE REDRESS MECHANISM AND IMPLEMENTATION ARRANGEMENT 22. APs can send any questions to implementation agencies about their rights in relation with land acquisition, environmental problems, compensation. Furthermore, APs will not be ordered to pay any fee for resolving their grievance and complaints at local levels and court. The following steps for grievance redress are established based on the Complaint Law no. 02/2011/QH13, dated 11/11/2011 and Degree No75/2012/NĐ-CP on November 20, 2012. A complaint can be handled maximum through three stages, if not solved, it can be sent to court as a final level.  First Stage: Commune Peoples’ Committee (CPC) - An aggrieved AP may lodgehis/her complaint before any member of the CPC through the residential groupleader or directly to the CPC, in written or verbal form. It is incumbent upon thevillage chief to notify the CPC about the complaint. The CPC will meet personallywith the aggrieved AP and will have 15 days to resolve the complaint. The CPCsecretariat is responsible for documenting and keeping file of all complaints that ithandles.  Second Stage: District/Town People’s Committee (DPC) - If after 15 days theaggrieved AP does not hear from the CPC, or if the AP is not satisfied with thedecision taken on his/her complaint, the AP may bring the case, either written orverbal, to any member of DPC. DPC has 15 days to resolve the case. The DPC isresponsible for documenting and keeping files of all complaints that it handles  Third Stage: City People’s Committee (City PC) - If 15 days the aggrieved APdoes not hear from the DPC, or if the AP is not satisfied with the decision taken onhis/her complaint, the AP may bring the case, either in writing or verbal, to anymember of the City PC. The City PC has 15 days within which to resolve thecomplaint to the satisfaction of all concerned. The City PC secretariat is responsiblefor documenting and keeping file of all complaints that it handles.  Final Stage: People’s Court - If after 15 days following the lodging of the complaintwith the City PC, the aggrieved AP does not hear from the City PC, or if he/she is notsatisfied with the decision taken on his/her complaint, the case may be brought to thepeople’s court. Subproject Implementation arrangement 23. Subproject implementation arrangement is related to many key agencies from national to localities. See the arrangement below: A. National Level 24. MOH is the Executing Agency for the Project and assures overall coordination, planning, implementation, and reporting. 25. During the implementation of the subproject, the CPMU under MOH has the following responsibilities: (i) providing overall planning, coordination, and supervision of the safeguard policies implementation; (ii) guiding the Land Fund Development Centre (LFDC) and the PPMUs to implement resettlement activities in accordance with the Loan Agreement; (iii) establishing a database of APs for each component, as well as for the Project as a whole; (viii) establishing procedures for ongoing internal monitoring and review of subprojectlevel progress reports and for tracking compliance to project policies; (ix) establishing procedures for monitoring coordination between contractors and local communities and for ensuring prompt identification and compensation for impacts occurring during construction; (x) establishing procedures for the prompt implementation of corrective actions and the resolution of grievances; B. Province Level 26. Kon Tum’s PPC is responsible for resettlement, environmental and minorities people activities within its administrative jurisdiction. The main responsibilities of PPC include: (i) issuing decisions approving land valuations applied for compensation rates, allowances and other supports to APs, especially vulnerable groups, based on the principles of the RPs; (ii) Issuing decisions approving environmental certificates(iii) directing and supervising relevant provincial departments to implement effectively the environmental requirements (iv) authorize the district-level PCs to approve compensation, assistance and resettlement plans; (vi) directing the relevant agencies to settle APs’ complaints, grievances related to compensation, assistance and resettlement, environmental problems according to their law- prescribed competence; and (vi) directing the relevant agencies to examine and handle the violations in the compensation, assistance and resettlement domain. 27. The Kon Tum PPMU is responsible for safeguard implementation and internal monitoring. The main tasks of the PPMU include: (i) preparing, updating, and supervising safeguard requirement implementation; (ii) guiding the LFDC to implement all resettlement activities in compliance with the Project policy; and resolving any mistakes or shortcomings identified by internal monitoring to ensure that the objectives of the safeguard policies are met; and otherwise, to provide appropriate technical, financial and equipment support to the LFDC and Commune-level Inventory Working Groups; (iii) conducting, in combination with the LFDC and CPCs, information campaigns and stakeholder consultation in accordance with established project guidelines; (iv) implementing internal safeguard monitoring, establishing and maintaining AP databases in accordance with established project procedures and providing regular reports to the CPMU; and (vi) implementing prompt corrective actions in response to internal monitoring. C. District Level 28. The district PCs undertakes comprehensive management on compensation, assistance and resettlement. The DPCs are responsible to the PPC to report on progress, and the results of land acquisition. The DPC’s primary task includes: (i) approving the schedule and monitoring the progress of land acquisition and resettlement implementation in compliance with the Project Policy; (ii) establishing the subproject’s LFDC and Resettlement team and directing the LFDC and relevant district departments to appraise and implement the detailed compensation, assistance and resettlement; (iii) approving and taking responsibility before the law on the legal basis, and accuracy of the detailed compensation, assistance and resettlement options in the local area; approving cost estimates on implementation of compensation, assistance and resettlement work; (iv) taking responsibility for acquiring LURC, certificate on land owning rights of the AHs and individuals who will lose land and/or house; adjusting LURC for AHs and individuals who will lose land and/or house in accordance with the relevant authorization; (v) directing CPCs and relevant organizations on various resettlement activities; and (vii) resolving complaints and grievances of APs. 29. Land Fund Development Centers (LFDC), The main responsibilities of the LFDC are the following: (i) organizing, plan and carrying out compensation, assistance and resettlement activities; (ii) conducting the (Detailed Measurement Survey) DMS, consultation and disclosing project information, implementing income restoration program in coordination with various stakeholders; (iii) preparing the compensation plan and submiting it to the DPCs for approval; implementing compensation, assistance and resettlement alternatives; taking responsibility for providing the legal basis for the compensation, assistance and resettlement policy following the Project policy; (iv) leading and coordinating with the DPCs in the timely delivery of compensation payment and other entitlements to AHs; and (v) assisting the resolution of grievances. D. Commune Level 30. The CPC will assist the LFDC in their resettlement tasks. Specifically, the CPC will be responsible for the following: (i) in cooperation with district and commune level local mass organizations, mobilizing people who will be acquired to implement the compensation, assistance and settlement policy according to the Project policy; (ii) cooperating with the LFDC and working groups to communicate the reason for the acquisition to the people whose land is to be acquired; notifying and publicizing all resettlement options on compensation, assistance and resettlement which are approved by the DPCs; (iii) signing the Agreement Compensation Forms along with the AHs; (iv) assisting the resolution of grievances; and (v) actively participating in all resettlement, environmental activities and concerns.

V. CONCLUSIONS AND RECOMMENDATIONS 31. As a result of the review of available documents, plans, technical designs and references provided by Kon Tum PPMU and other related agencies, this due diligence review concludes and recommends the following:  The Subproject in Kon Tumwould not have any involuntary resettlement impacts, all within the meaning of the ADB SPS, so no corrective action is needed related to land acquisition or resettlement.  Kon Tum Department of Natural Resources and Environment has not granted the final approval of the IEE. However, Kon Tum PPMU has been aware of this requirement and the corrective actions to fulfill the requirement have been prepared by the PPMU with the support from the CPMU. It is expected that the required approval letter shall be issued no later than the end of September 2016. It is also recommended that the CPMU should do strictly monitoring to assure that the requirement shall be complied before awarding any works contract and should take responsibility of reporting to ABD when this requirement is done.  Two of 35 proposed works of Kom Tum subproject has not obtained the environmental certificates as requirement of Vietnamese regulations. The certificates shall be granted no later than the end of August 2016. It is also recommended that the CPMU should do strictly monitoring to assure that the requirement shall be complied before awarding any works contract and should take responsibility of reporting to ABD when this requirement is done.  The final a final EGDP updating the activities related to ethnic minority that set forth in the draft EGDP has been prepared for the project and approved by ADB in March 2016  At time of the DDR, not all conditions for awarding of civil works contracts have been meet that include (i) the environmental certificates for 02 CHSs and (ii) the approval of IEE by Kom Tum DONRE. The review and acceptance of these submissions by ADB shall be a condition of “No objection” of ADB for the award of civil works contracts.

Appendix 1 Involuntary Resettlement Impact Categorization Checklist Project: The second health care in the central highland project (HICH) CATEGORY: C

Probable Involuntary Resettlement Effects Yes No Not Remarks Known

Involuntary Acquisition of Land Will there be land acquisition?

Upgrading 25 CHSs X

New Construction of 10 CHSs X

Is the site for land acquisition known? Upgrading 25 CHSs X The sites for construction were all identified within the existing CHS

New Construction of 10 CHSs X Idle areas managed by Government Agency

Is the ownership status and current usage of land to be acquired known?

Upgrading 25 CHSs X LURCs

New Construction of 10 CHSs X Official letters issued by Government agencies

Will easement be utilized within an existing Right of Way (ROW)?

Upgrading 25 CHSs X

New Construction of 10 CHSs X

Will there be loss of shelter and residential land use to land acquisition?

Upgrading 25 CHSs X

New Construction of 10 CHSs X

Will there be loss of agricultural and other productive assets due to land acquisition? Upgrading 25 CHSs X

New Construction of 10 CHSs X

Will there be loss of crops, trees, and fixed assets due to land acquisition? Upgrading 25 CHSs X Only small trees, wild brushes and no compensation required for these trees New Construction of 10 CHSs X Only small trees, wild brushes and no compensation required for these trees Will there be loss of business or enterprises due to land acquisition? Probable Involuntary Resettlement Effects Yes No Not Remarks Known Upgrading 25 CHSs X

New Construction of 10 CHSs X

Will there be loss of income sources and means of livelihoods due to land acquisition? Upgrading 25 CHSs X

New Construction of 10 CHSs X

Involuntary Restrictions on land use or on access to legally designated parks and protected areas

Will people lose access to natural resources, communal facilities and services?

Upgrading 25 CHSs X

New Construction of 10 CHSs X

If land use is changed, will it have an adverse impact on social and economic activities?

Upgrading 25 CHSs X

New Construction of 10 CHSs X

Will access to land and resources owned by the communally or by the state be restricted? Upgrading 25 CHSs X

New Construction of 10 CHSs X

Information on Displaced Persons

Any estimate of the likely number of persons that will be displaced by the Project? x No  Yes  Not applicable If yes, approximately how many? . Are any of the poor, female-headed households, or vulnerable to poverty risks? x No  Yes  Not applicable

Are any displaced persons from indigenous or ethnic minority groups? x No  Yes  Not applicable Appendix 2 Indigenous Peoples Impact Screening Checklist Project: The second health care in the central highland project (HICH) CATEGORY: B

KEY CONCERNS YES NO NOT Remarks (Please provide elaborations KNOWN on the Remarks column)

A. Indigenous Peoples Identification Are there socio-cultural group present in or use the project areas who may be considered as “tribes” (hill tribes, schedules tribes, tribal peoples), “minorities” (ethnic or national minorities) or “indigenous communities” in the project area? Upgrading 25 CHSs X

New Construction of 10 CHSs X

Are there national or local laws or policies as well as anthropological researches/studies that consider these groups present in or using the project area as belonging to “ethnic minorities”, scheduled tribes, tribal peoples, national minorities, or cultural communities? Upgrading 25 CHSs X

New Construction of 10 CHSs X

Do such groups self-identity as taking part of a distinct social and cultural group?

Upgrading 25 CHSs X

New Construction of 10 CHSs X

Do such groups maintain collective attachments to distinct habitats or ancestral territories and/or to the natural resources in these habitats and territories?

Upgrading 25 CHSs X

New Construction of 10 CHSs X

Do such groups maintain cultural, economic, social, and political institutions distinct from the dominant society and culture?

Upgrading 25 CHSs X Such groups maintain cultural, economic, social, and political institutions distinct from the dominant society and culture New Construction of 10 CHSs X Such groups maintain cultural, economic, social, and political institutions distinct from the dominant society and culture

Do such groups speak a distinct language or dialect?

Upgrading 25 CHSs X

New Construction of 10 CHSs X

KEY CONCERNS YES NO NOT Remarks (Please provide elaborations KNOWN on the Remarks column)

Has such groups been historically, socially and economically marginalized, disempowered, excluded, and/or discriminated against?

Upgrading 25 CHSs X

New Construction of 10 CHSs X

Are such groups represented as “Indigenous Peoples” or as “ethnic minorities” or “scheduled tribes” or “tribal populations” in any formal decision-making bodies at the national or local levels?

Upgrading 25 CHSs X

New Construction of 10 CHSs X

B. Identification of Potential Impacts Will the project directly or indirectly benefit or target Indigenous Peoples?

Upgrading 25 CHSs X

New Construction of 10 CHSs X

Will the project directly or indirectly affect Indigenous Peoples’ traditional socio-cultural and belief practices? (e.g. child- rearing, health, education, arts, and Governance?

Upgrading 25 CHSs X The people from indigenous communities will directly benefit from the Project in terms of improved quality of health cares New Construction of 10 CHSs X The people from indigenous communities will directly benefit from the Project in terms of improved quality of health cares Will the project affect the livelihood systems of Indigenous Peoples? (e.g. food production system, natural resource management, crafts and trade, employment status) Upgrading 25 CHSs X New Construction of 10 CHSs X Are there socio-cultural group present in or use the project areas who may be considered as “tribes” (hill tribes, schedules tribes, tribal peoples), “minorities” (ethnic or national minorities) or “indigenous communities” in the project area? Upgrading 25 CHSs X New Construction of 10 CHSs X

Appendix 3. List of people met and consulted

Name Location Position Tran Ai Kom Tum PPMU Head ofthe PPMU Do Hoang An Kom Tum PPMU Officer of PPMU Ha Van Luc Kom Tum PPMU Officer of PPMU Tran Van Moi Đắk Rơ Wa Commune Head of Administration Department of City Heath Center Y Lan Đắk Rơ Wa Commune Deputy of the station A Khuoc Kroong Commune Head of the station Ly Minh Tam Kroong Commune Land officer of CPC Nguyen Trong Hao Tu Mơ Rông Commune Deputy of the Center Nghiem Minh Hieu Đắk Glei Town President of the town Nguyen Thi Hang Đắk Hà Town Head of the station Tran Thi Bich Van Đắk Ui Commune Officer of the station Le Thi Bich Thuy Ngọc Wang Commune Head of the station A Viet Ngọc Wang Commune Land officer of CPC Vo Van Hung Đắk Rơ Nga commune Head of the station Nguyen Thi Tam Mô Rai Commune Officer of the station Bui Cong Trang DắK Côi Commune Officer of the station Trinh Minh Hoa Ngô Mây Ward Officer of the station Le Thi Cong Trường Chinh Ward Officer of the station Hoang Van Binh Đoàn Kết commune President of the town Tran Thi Minh Tu Hòa Bình commune Head of the station Van Thi La Đăk Tô town Officer of the station Do Hoang Hieu Kon Đào commune Head of the station Nguyen Thi Minh Thu Văn Lem commune Officer of the station A Kin Đăk Sú commune Officer of the station Le Thi Hang Đăk Kan commune Officer of the station Vu Thi Hong Đăk Nông commune Officer of the station Ho Thi Minh Ha Sa Long commune Head of the station Nguyen Thi Thanh Đắk Sao commune Officer of the station Ta Thanh Dak Tờ Kan commune Head of the station Tran Duc Tê Xăng commune Deputy of the station Dao Van Đắk Man commune Head of the station Nguyen Thi Ngọc Linh commune Officer of the station Le Van Cang Ngọc Tem commune Officer of the station Dinh Thuy Hang Đắk Long commune Head of the station Ho Thi Ly Pờ Ê commune Officer of the station Nguyen Thi Viet Ya Ly commune Head of the station Đỗ Thi Sa Sơn commune Officer of the station Bun So Sa Thầy Town Head of the station Hoang Thi Ha Đắk Tờ Lung commune Deputy of the station Nguyen Thi Thanh Tuyet Đắk Tờ Re commune Head of the station Nguyen Thi Kieu Van Tân Lập commune Deputy of the station