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Download 2.21 MB Due Diligence Report Project Number: 41509-013 August 2016 PNG: Rural Primary Health Services Delivery Project (Loan 2785 and Grant 0259) Prepared by the Department of Health for the Asian Development Bank. This 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. Your attention is directed to the “terms of use” section of this website. In preparing any country program or strategy, financing any project, or by making any designation of or reference to a particular territory or geographic area in this document, the Asian Development Bank does not intend to make any judgements as to the legal or other status of any territory or area. Papua New Guinea Rural Primary Health Services Delivery Project DUE DILIGENCE REPORT Taul Community Health Post Site AUGUST, 2016 1 INDEX Executive Summary 3 Project and Community Health Post Description 5 Taul Community Health Post Site - Description and Area 7 Scope of Land Use/Purchase 8 Socioeconomic Information 9 Information Disclosure, Consultations and Participation 13 Grievance Redress Mechanism 15 Applicable Policies and Laws 16 Agreements on Land Use 17 Compensation and Benefits 19 Budget and Sources of Funds 20 Institutional Arrangements 20 Implementation Schedule 22 Monitoring and Reporting 22 Annex One: Site Plan 23 Annex Two: Land Survey 24 Annex Three: Land Investigation Report 25 Annex Four: Valuation Report 40 Annex Five: Voluntary Land Use Agreement 42 Annex Six: Certificate of Alienability 46 Annex Seven: Deed of Release 47 Annex Eight: Sale & Transfer of Land 49 Annex Nine: Third Party Verification of Land Acquisition Process 52 2 EXECUTIVE SUMMARY The Turubu Rural Local Level Government area of Wewak District in East Sepik Province, in which Taul Village is situated, had a population of 11,727 at the time of the 2011 census. There were 101 males for every 100 females with an average of 5.5 persons per household. In 2010, the Provincial mortality rates were estimated to be 79/1000 for infants under one year and 115/1000 for children under five years of age. (National Research Institute Health Report, 2010). The 2015 Health Sector Performance Annual Review (SPAR) records that only 58.35% of expectant mothers accessed antenatal care at a health facility in the Wewak District. The supervised delivery rate for the rural population is also well below the National target of 80% and probably reflects the poor access to health facilities within the Wewak District. The 2015 SPAR also records that 10.73% of infants delivered in a health facility in the Wewak District had a birth weight of less than 2.5 kilograms and that 22.37% of children under the age of 5 years examined in Wewak District health facilities were suffering some level of malnutrition. Immunisation rates for measles amongst children less than 5 years of age were just 36.89% and pentavalent immunisation rates were 57.62% which are both well below the National target of 90%. In 2015 Wewak District health facilities only provided an average of 1.21 occasions of service per capita which is barely half of the National target of 2.4. These very poor indicators of health care accessibility make a compelling case for the development of additional, more accessible health facilities within Wewak District. The proposed Community Health Post at Taul will be classified as a Level 2 Health Facility under the PNG Natioal Health “eie “tadads, s ‘ole Delieatio Mati ad will be required to provide maternal, child and general primary health clinics. Provision will be made for birthing and postnatal inpatient care, short term paediatric and adult inpatient services and for triage and stabilisation of critically ill patients prior to referral to higher level facilities. A modest Procedure Room is also provided to allow emergency care of trauma or serious medical conditions prior to referral. Discrete consultation rooms are provided to ensure privacy for clients seeking care or advice for their conditions. The Taul Community Health Post will have five (5) inpatient beds and is expected to provide health services for up to forty-five (45) persons per day. The Community Health Post staff will also have a major role in health education and promotion in the area and will coordinate the activities of Village Health Volunteers working in the catchment area to generate demand for antenatal care, supervised deliveries, family planning and immunisation. The site provided for the Community Health Post by the customary landowners is known officially as Kauaa No. (Portion 567C, Milinch of Muschu, Fourmil of Wewak and District of Wewak) and consists of 1.12 hectares of sloping coastal foreshore covered by indigenous growth interspersed with a few mature coconut trees and other fruit and nut bearing trees. There are no structural improvements on the site. The land is fronted by the main Wewak/Munjun Village Road and has now been cleared and levelled by the former landowners in anticipation of early commencement of construction. The land was formerly owned by the Yangana Clan consisting of six (6) extended families totaling fifty-six (56) living members at the time that the Land Investigation Report was compiled on 30th January, 2015. The land was inherited by them from their forefathers. 3 The Land Investigation Report for the Kanumanar No. 1 site also records that the former owners derive their livelihood from subsistence farming, fishing, hunting and seasonal cash crop income and it affirms that they have retained ample land for gardens. The landowning Yangana Clan members agreed initially to give their land voluntarily for the building of the Community Health Post. However, ultimately, permanent use of the land was obtained through negotiated purchase following the Land Act and the Rural Primary Health Service Delivery Pojets Lad Assesset Faeok LAF). This is in accordance with GoPNG policy that all new State infrastructure should be built on State land. Kanumanar No. 1 was acquired by the State only after extensive consultation with the customary landowners and other community members confirmed through a Memorandum of Agreement. The Deed of Release and the Sale & Transfer of Land documents were signed and the land formally acquired through purchase by the Wewak District Development Authority on behalf of the State on 16th August, 2016 at a cost of K53,400.00. Following completion, the land acquisition process has been reviewed and verified by an independent third party consultant contracted by the PSU for this purpose. She has provided verification that (i) the local community and landowners support the Community Health Post construction and have agreed to provide their land; (ii) consultations and negotiations with landowners have been undertaken meaningfully, freely and in good faith and the landowners have made informed decisions on use of the land, and (iii) terms and conditions of the agreements have been explained, understood and agreed to by the landowners. A copy of the verification evidence is provided in Annex 9. 4 A. PROJECT AND COMMUNITY HEALTH POST DESCRIPTION Background 1. The Rural Primary Health Services Delivery Project will strengthen the rural health system in PNG by increasing the coverage and quality of primary health care in partnership with State and non-State service providers to support the Government of PNG to implement the National Health Plan as it relates to rural health. The Project covers two (2) Districts in each of the following eight (8) Provinces selected by the Government of PNG: Eastern Highlands, East Sepik, Enga, Milne Bay, Western Highlands, West New Britain, Morobe and the Autonomous Region of Bougainville. 2. The Project will make improvements in both the supply and demand sides, and strengthen the policy and legal framework for health services at all levels. There are six outputs: Output 1 – National policies and standards. Assisting the National Department of Health (National Department of Health) to develop policies, standards, and strategies for new Community Health Posts, and human resource strengthening of the rural health sector. This will result in the development of provincial health service plans, and improvements in the health information systems. Output 2 – Sustainable partnerships between Provincial governments and non-State actors. Partnership Committees have been established to improve coordination and efficiency among providers, (churches and NGOs) and to increase consistency and accountability Output 3 – Human resource development in the health sector. The Project will increase the skills of health personnel in rural communities, focusing on the existing workforce. It will help Provinces to address performance and retention issues. Output 4 – Community health facility upgrading. The Project will build 32 new Community Health Posts with 96 staff houses as well as providing medical equipment and small vehicles (cars, boats, or motorbikes). It will also provide sanitation facilities, waste management facilities and establish renewable energy supplies for those health facilities Output 5 – Health promotion in local communities. The Project will support village health olutees ad iease oes ioleet ad ouit egageet i delieig health seies ased o the health islads faework. Output 6 - Project monitoring, evaluation and management. The Project has established a Project Support Unit (PSU) as part of the National Department of Health which will be used as part
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