Due Diligence Report Project number: 44265-013 Stage: Final August 2016 VIE: Second Health Care in the Central Highlands Project in Kon Tum Province 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