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World Bank Documents on Similar Projects in Other Countries 41457 Document of The World Bank FOR OFFICIAL USE ONLY Public Disclosure Authorized Report No: 41457-KZ PROJECT APPRAISAL DOCUMENT ON A Public Disclosure Authorized PROPOSED LOAN IN THE AMOUNT OF US$117.7 MILLION TO THE REPUBLIC OF KAZAKHSTAN FOR A HEALTH SECTOR TECHNOLOGY TRANSFER AND INSTITUTIONAL REFORM PROJECT December 13, 2007 Public Disclosure Authorized Human Development Sector Unit Central Asia Country Unit Europe and Central Asia Region Public Disclosure Authorized This document has a restricted distribution and may be used by recipients only in the performance of their official duties. Its contents may not otherwise be disclosed without World Bank authorization. CURRENCY EQUIVALENTS (Exchange Rate Effective December 1, 2007) Currency Unit = Kazakh Tenge (KZT) KZT 120.7 = US$1 US$ = SDR 1 FISCAL YEAR January 1 – December 31 ABBREVIATIONS AND ACRONYMS AIDS Acquired Immune Deficiency Syndrome ISQUA International Society for Quality BTS Blood Transfusion Service IT Information Technology CAC Codex Alimentarius Commission JERP Joint Economic Research Program CCT Core Coordination Team JSC Joint Stock Company CDC Centers of Disease Control KZT Kazakhstan Tenge CEO Chief Executive Officer MCH Maternal and Child Health CFAA Country Financial Accountability Assessment MHI Mandatory Health Insurance CIS Commonwealth of Independent States MIT Ministry of Industry and Trade CME Continuous Medical Education MOA Ministry of Agriculture CPD Curative and Preventive Department MOEBP Ministry of Economy and Budget Planning CPG Clinical Practice Guidelines MOF Ministry of Finance DEF Department of Economic and Finance MOH Ministry of Health DRG Diagnosis-Related Group MOLSP Ministry of Labor and Social Policy DSDIC Department for Strategic Development and MSA Medical Savings Account International Cooperation NCD Non-Communicable Diseases EBM Evidence based Medicine NHIC National Health Information Center EC Expert Council NPV Net Present Value ECA Europe and Central Asia OFD Oblast Finance Department EPC Economic Policy Council OHD Oblast Health Departments FAO Food and Agriculture Department PAD Project Appraisal Document FMS Financial Management System PAF Project Accelerating Funds FSU Former Soviet Union PHC Primary Health Care GDP Gross Domestic Product PIST Project Implementation Support Team GFATM Global Fund to fight AIDS, TB and Malaria PMO Prime Minister’s Office GOK Government of Kazakhstan POM Project Operational Manual GOSO State General Mandatory Education Standard PPP Public Private Partnership HACCP Hazard Analysis and Critical Control Points QCBS Quality and Cost-Based Selection HALE Healthy Life Expectancy RBC Republican Budget Commission HCDI Health Care Development Institute SARS Severe Acute Respiratory Syndrome HCSCC Health Care Services Control Committee SES Sanitary and Epidemiological Surveillance HDI Health Development Institute SOE Statement of Expenditure HiT Health Systems in Transition SPS Sanitary and Phytosanitary HIV Human Immunodeficiency Virus SPU State Procurement Unit HMIS Health Management Information System TA Technical Assistance HPC Health Policy Council TB Tuberculosis HTA Health Technology Assessment TBD To be determined HYLG Healthy Years of Life Gained UHIS United Health Information System IBRD International Bank for Reconstruction and UN United Nations Development UNAIDS Joint United Nations Program on HIV/AIDS ICB International Competitive Bidding UNICEF United Nations Children’s Fund ICPPC Internal Control and Public Procurement USI Universal Salt Iodization Committee VHI Voluntary Health Insurance ILO International Labor Organization WFME World Federation of Medical Education IMR Infant Mortality Rate WTO World Trade Organization IRR Internal Rate of Return Vice President: Shigeo Katsu Country Director: Annette Dixon Country Manager Sergei Shatalov Sector Manager: Armin H. Fidler Task Team Leader: Peyvand Khaleghian FOR OFFICIAL USE ONLY KAZAKHSTAN Health Sector Technology Transfer and Institutional Reform Project CONTENTS Page I. STRATEGIC CONTEXT AND RATIONALE...............................................................................6 A. Country and sector issues.................................................................................................................6 B. Rationale for Bank involvement ......................................................................................................6 C. Higher level objectives to which the project contributes.................................................................8 II. PROJECT DESCRIPTION ..............................................................................................................8 A. Lending instrument ..........................................................................................................................8 B. Project development objective and key indicators...........................................................................9 C. Project components..........................................................................................................................9 D. Lessons learned and reflected in the project design.......................................................................14 E. Alternatives considered and reasons for rejection .........................................................................17 III. IMPLEMENTATION .................................................................................................................18 A. Partnership arrangements...............................................................................................................18 B. Institutional and implementation arrangements.............................................................................18 C. Monitoring and evaluation of outcomes/results.............................................................................20 D. Sustainability .................................................................................................................................20 E. Critical risks and possible controversial aspects............................................................................21 F. Loan/credit conditions and covenants............................................................................................25 IV. APPRAISAL SUMMARY ..........................................................................................................27 A. Economic and financial analyses...................................................................................................27 B. Technical........................................................................................................................................27 C. Fiduciary ........................................................................................................................................27 D. Social .............................................................................................................................................28 E. Environment...................................................................................................................................29 F. Safeguard policies..........................................................................................................................29 G. Policy Exceptions and Readiness...................................................................................................29 This document has a restricted distribution and may be used by recipients only in the performance of their official duties. Its contents may not be otherwise disclosed without World Bank authorization. Annex 1: Country and Sector or Program Background .......................................................................31 Annex 2: Major Related Projects Financed by the Bank and/or other Agencies ...............................49 Annex 3: Results Framework and Monitoring.......................................................................................51 Annex 4: Detailed Project Description....................................................................................................61 Annex 5: Project Costs .............................................................................................................................80 Annex 6: Implementation Arrangements ...............................................................................................81 Annex 6: Implementation Arrangements ...............................................................................................81 Annex 7: Financial Management and Disbursement Arrangements ...................................................87 Annex 8: Procurement Arrangements ....................................................................................................96 Annex 9: Economic and Financial Analysis .........................................................................................104 Annex 10: Safeguard Policy Issues........................................................................................................110 Annex 11: Project Preparation and Supervision .................................................................................111 Annex 12: Documents in the Project File..............................................................................................112 Annex 13: Statement of Loans and Credits..........................................................................................113 Annex 14: Country at a Glance .............................................................................................................114
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