Fourth Health Sector Development Project – Additional Financing (RRP 41243) INITIAL ENVIRONMENTAL EXAMINATION April 2019 MON: Fourth Health Sector Development Second Additional Financing Prepared by the Ministry of Health of Mongolia for the Asian Development Bank. i Fourth Health Sector Development Project – Additional Financing (RRP 41243) CURRENCY EQUIVALENTS (as of 19 March 2019) Currency Unit – togrog (MNT) MNT1.00 = $0.00037 $1.00 = MNT2,632 ABBREVIATIONS ADB – Asian Development Bank DI – Design Institute DIA – District Inspection Agency (Ulaanbaatar) DRA – Drug Regulatory Agency EA – Executing Agency ED – Environmental Department (cities and aimags) EIA – Environmental impact assessment EMC – Environmental Management Consultant EMP – Environmental Management Plan EMS – Environmental Monitoring Station FGP – Family group practice FHSDP – Fourth Health Sector Development Project GASI – General Agency for Specialized Inspection GIEC – Grant Implementation Environmental Consultant GDP – Gross Domestic Product GOM – Government of Mongolia GRM – Grievance Redress Mechanism HCF – Health care facilities HRD – Human resources development HSMP – Health Sector Master Plan HSUM – Health Sciences University of Mongolia IA – Implementing Agency IEE – Initial Environmental Examination LIEC – Loan Implementation Environmental Consultant MDG – Millennium Development Goals MOF – Ministry of Finance MET – Ministry of Environment and Tourism MOH – Ministry of Health MSWL – Ministry of Social Welfare and Labor NCB – National competitive bidding RP – Resettlement Plan PHC – Primary health care PIU – Project implementation unit PMO – Project Management Office PPMS – Project performance monitoring system PSC – Project steering committee SHC – Soum health center SPS – Safeguard Policy Statement SS – Suspended Solids THSDP – Third Health Sector Development Project WHO – World Health Organization ii Fourth Health Sector Development Project – Additional Financing (RRP 41243) WEIGHTS AND MEASURES dB(A) – decibel (weighted average) ha – hectare kg/d – kilogram per day km – kilometer km2 – square kilometer m – meter m2 – square meter m3 – cubic meter m3/d – cubic meters per day m3/s – cubic meters per second mg/m3 – milligrams per cubic meter mm – millimeter GLOSSARY aimag – administrative unit (province) bagh – administrative unit (village) feldsher – community-based health nurse providing services in the bagh soum – administrative subunit of the aimag/province (district) NOTE In this report, "$" refers to US dollars. This initial environmental examination 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 judgments as to the legal or other status of any territory or area. iii Fourth Health Sector Development Project – Additional Financing (RRP 41243) Contents 1. EXECUTIVE SUMMARY ..................................................................................................... 7 2. INTRODUCTION ............................................................................................................... 12 2.1. Introduction and Purpose ............................................................................................... 12 2.2. Environmental Categorization, ADB and MON Approval of IEE ..................................... 14 2.3. Structure of this IEE Report ........................................................................................... 15 3. POLICY, LEGAL, AND ADMINISTRATIVE FRAMEWORK ............................................... 16 3.1. Mongolia’s Environmental Policy .................................................................................... 16 3.2. Environmental Assessment Requirements ..................................................................... 20 3.2.1. Environmental Assessment Requirements of ADB .................................................. 20 3.2.2. Environmental Assessment Requirements of Mongolia .......................................... 22 3.3. Other International Environmental Requirements ........................................................... 23 3.4. Mongolia HCF Environmental Infrastructure................................................................... 23 4. DESCRIPTION OF THE PROJECT .................................................................................. 24 4.1. Overview ........................................................................................................................ 24 4.2. Component 1: Songinohairkhan District Hospital ........................................................... 26 5. DESCRIPTION OF THE ENVIRONMENT (BASELINE DATA) .......................................... 35 5.1. Physical Environment .................................................................................................... 35 5.2. Ecological Resources .................................................................................................... 42 5.3. Socio-Economic Conditions ........................................................................................... 42 5.4. Sensitive Receptors Within The Project’s Area Of Influence .......................................... 44 5.4.1. Songinokhairkhan Hospital ..................................................................................... 44 6. ANALYSIS OF ALTERNATIVES ....................................................................................... 46 7. ANTICIPATED ENVIRONMENTAL IMPACTS AND MITIGATION MEASURES ................ 46 7.1. Screening and Avoidance of Environmental Impacts ..................................................... 46 7.2. Positive Impact and Environmental Benefits .................................................................. 47 7.3. Environmental Impacts and Mitigation Measures During Construction ........................... 47 7.3.1. Physical Impacts ..................................................................................................... 48 7.3.2. Biological Impacts ................................................................................................... 51 7.3.3. Socio-economic Impacts ......................................................................................... 51 7.4. Environmental Impacts and Mitigation Measures during Operation ................................ 54 7.4.1. Component 1: Songinohairkhan District Hospital .................................................... 54 7.5. Unanticipated Impacts During Construction and Operation ............................................ 57 8. INFORMATION DISCLOSURE, CONSULTATION, AND PARTICIPATION ...................... 57 8.1. Consultation and Participation During Project Preparation ............................................. 57 8.2. Public Consultation for the new Songinohairkhan Hospital Component ......................... 57 8.3. Future Information Disclosure and Public Consultation Program .................................... 59 9. GRIEVANCE REDRESS MECHANISM............................................................................. 60 9.1. Introduction .................................................................................................................... 60 9.2. Proposed GRM for MON: Fourth Health Sector Development Project – Second Additional Financing ....................................................................................................................... 60 10. ENVIRONMENTAL MANAGEMENT PLAN ....................................................................... 64 11. CONCLUSIONS AND RECOMMENDATIONS .................................................................. 64 11.1. Project Benefits .............................................................................................................. 64 11.2. Anticipated Impacts and Risks ....................................................................................... 64 11.3. Overall Conclusions ....................................................................................................... 65 12. REFERENCES .................................................................................................................. 66 13. ANNEXES ......................................................................................................................... 67 Annex 1. Environmental Management Plan .............................................................................. 67 Annex 2. Comparison of WB EHS for HCFs and MON: Fourth Health Sector Development Project – Second Additional Financing Components ...................................................... 89 Annex 3. Management Principles For Handling And Removal Of Asbestos .............................. 91 Annex 4. IEE - Project Design and Monitoring Framework Versus Positive/Negative Impacts .. 92 Annex 5. GRM related Forms ................................................................................................... 95 iv Fourth Health Sector Development Project – Additional Financing (RRP 41243) List of Tables Table 1. International Environmental Conventions Signed by Mongolia ......................................... 17 Table 2: Key Mongolian Environmental Legislation .......................................................................