Social Due Diligence Report on Involuntary Resettlement Project Number: 48118-004 September 2020 Republic of the Union of Myanmar: Greater Mekong Subregion Health Security Project (Additional Financing) Prepared by Ministry of Health and Sports for the Asian Development Bank. This safeguards 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. ABBREVIATIONS ADB - Asian Development Bank CDC - communicable disease control COVID-19 - coronavirus disease DOMS - Department of Medical Services GMS - Greater Mekong Subregion GRM - grievance redress mechanism MOHS - Ministry of Health and Sports PMU - project management unit SPS - Safeguard Policy Statement WHO - World Health Organization 2 CONTENTS I. INTRODUCTION AND PROJECT BACKGROUND 4 A. Introduction 4 B. Background and Project Rationale 4 II. SCOPE OF THE DUE DILIGENCE AND SUBPROJECTS/HOSPITALS 5 III. FINDINGS OF THE DUE DILIGENCE 4 IV. INSTITUTIONAL ARRANGEMENTS 4 V. CONCLUSIONS AND RECOMMENDATIONS 5 I. INTRODUCTION AND PROJECT BACKGROUND A. Introduction 1. This is a social due diligence report on Involuntary Resettlement prepared for the proposed Greater Mekong Subregion (GMS) Health Security Project (Additional Financing). 2. As per ADB’s Safeguard Policy Statement (SPS 2009), project screening and categorization are undertaken to (i) determine the significance of potential impacts or risks that a project might present with respect to the environment, involuntary resettlement, and Indigenous Peoples; (ii) identify the level of assessment and institutional resources required to address safeguard issues; and (iii) determine the information disclosure and consultation requirements. Using environment, involuntary resettlement, and Indigenous Peoples screening checklists, the project is categorized. A proposed project is assigned to one of the following categories depending on the significance of the probable involuntary resettlement impacts: Category A. A proposed project is classified as category A if it is likely to have significant involuntary resettlement impacts. A resettlement plan, including assessment of social impacts, is required. Category B. A proposed project is classified as category B if it includes involuntary resettlement impacts that are not deemed significant. A resettlement plan, including assessment of social impacts, is required. Category C. A proposed project is classified as category C if it has no involuntary resettlement impacts. No further action is required. 3. A project’s involuntary resettlement category is determined by the category of its most sensitive component in terms of involuntary resettlement impacts. The involuntary resettlement impacts of an ADB-supported project are considered significant if 200 or more persons will experience major impacts, which are defined as (i) being physically displaced from housing, or (ii) losing 10% or more of their productive assets (income generating). The level of detail and comprehensiveness of the resettlement plan are commensurate with the significance of the potential impacts and risks. A screening has been done (Refer to Annexure-1) for the project and based on the screening, the additional financing is categorized as “C” for involuntary resettlement. Therefore, this due diligence has been prepared to conform the category “C” on involuntary resettlement. B. Background and Project Rationale 4. ADB approved the GMS Health Security project on 22 November 2016 for $125 million equivalent from its ordinary capital resources.1 Building on ADB’s prior investments in 1 The ongoing project comprises (i) loans to Cambodia (SDR15,012,000 [$21 million]), the Lao PDR (SDR2,856,000 [$4 million]), Myanmar ($12 million), and Viet Nam (SDR56,946,000 [$80 million]); and (ii) a grant to the Lao PDR ($8 million). ADB also provided project preparatory technical assistance of $1.3 million to Cambodia, the Lao PDR, Myanmar, and Viet Nam. ADB. Regional: Greater Mekong Subregion Health Security Project; and ADB. Technical Assistance: Greater Mekong Subregion Health Security Project. communicable disease control (CDC) in the GMS,2 the ongoing project aims to strengthen regional cooperation and subnational CDC systems, particularly in border areas. The impact of the ongoing project is strengthened GMS public health security. The outcome is GMS health system performance regarding health security improved. 5. The additional financing for Myanmar will support implementation of the government’s Health Sector Contingency Plan for coronavirus disease (COVID-19).3 It will expand the overall project scope to encompass 31 district and township hospitals requiring immediate investment for upgrading clinical care, infection prevention and control, and human resource capacity for responding to COVID-19 and other future public health threats. These 31 hospitals are located across the country’s 14 states and regions and 1 union territory. Target hospitals are in areas that are highly vulnerable because of poverty, ethnicity, and inadequate access to essential services, including health care.4 The target hospitals have also been selected with reference to the investments of other development partners, ensuring complementarities across projects.5 6. The project impact and outcome will remain the same. Activities under the additional financing will be consolidated and delivered through output 4 that is aligned with, and contributes to, the original project outcome. Output 4 will be rephrased as “emergency preparedness and response capacity for COVID-19 strengthened”. The main activities under output 4 will strengthen capacity across three core areas of district and township hospital service delivery, namely (i) clinical management and medical care services, (ii) hospital infection prevention and control, and (iii) human resources. II. SCOPE OF THE DUE DILIGENCE AND SUBPROJECTS/HOSPITALS 7. The project has various components having physical and non-physical intervention. The physical intervention is very minimal and is confined to minor renovation work. The scope covered under the due diligence is 31 existing district and township hospitals. The due diligence report has been prepared in due consultation with the executing agency which is Ministry of Health and Sports (MOHS) and in consultation with the respective hospitals. The subprojects/hospitals covered under the due diligence report are described below in Table 1 and the location map is provided in Figure-1: 2 ADB. GMS Regional Communicable Diseases Control Project; and ADB. Second GMS Regional Communicable Diseases Control Project. 3 Ministry of Health and Sports (MOHS). 2020. Health Sector Contingency Plan. Outbreak Response on COVID-19 and Other Emerging Respiratory Diseases in Myanmar. The plan is aligned with WHO’s Strategic Preparedness and Response Plan for COVID-19. WHO. 3 February 2020 (Draft). 2019 Novel Coronavirus (2019 nCoV): Strategic Preparedness and Response Plan. Geneva. 4 The MOHS has identified more than 100 hospitals requiring upgrading to respond to COVID-19. Hospitals that are accessible to ethnic populations and to populations in hard-to-reach and border areas were prioritized for ADB support. Hospital selection was coordinated with other development partners involved in MOHS’s COVID-19 response. 5 ADB and other development partners ensures alignment of COVID-19 support through the health cluster coordination mechanism, established by MOHS. The World Bank will provide investment for 61 provincial, state, and district hospitals in locations not supported under the ADB additional financing. Table 1: List of Hospitals under the Due Diligence for Additional Financing No. Name of Subproject/Hospital Name of Township Name of District 1 Pharkant Township Hospital Pharkant Mohnyin 2 Puta-O Township Hospital Puta-O Puta-O 3 Bawlakhae District Hospital Bawlakhae Bawlakhae 4 Kamamaung Township Hospital Kamamaung Hpa pun 5 Myawaddy District Hospital Myawaddy Myawaddy 6 Htantalan Township Hospital Htantalan Phalan 7 Toungup Township Hospital Toungup Thandwe 8 Namhkham Township Hospital Namhkham Muse 9 Mong Set District Hospital Mong Set Mong Set 10 Kalaw District Hospital Kalaw Kalaw 11 Mine Shu township Hospital Mine Shu Loilin 12 Ye Township Hospital Ye Mawlawmyaing 13 Tanintharyi Township Hospital Tanintharyi Kawthaung 14 Boatbyin Township Hospital Boatbyin Dawei 15 Homalin District Hospital Homalin Homalin 16 Tamu District Hospital Tamu Tamu 17 Kathar District Hospital Kathar Kathar 18 Kawlin Township Hospital Kawlin Kathar 19 Satote Tayar Township Hospital Satote Tayar Minbu 20 Mindone Township Hospital Mindone Thayet 21 Gangaw District Hospital Gangaw Gangaw 22 Thayarwady District Hospital Thayarwady Thayarwady 23 Shwe Kyin Township Hospital Shwe Kyin Bago 24 Tontay Hospital Tontay Yangon South 25 Taikkyi Hospital Taikkyi Yangon North 26 Mawlamyaing Kyun Township Hospital Mawlamyaing Kyun Labutta 27 Bogalay Township Hospital Bogalay Phyapon 28 Tat Kone Hospital Tat Kone Nay Pyi Taw 29 Myingyan District Hospital Myingyan Myingyan 30 Yamethin Hospital Yamethin Yamethin 31 Mogok Hospital Mogok Mandalay Figure 1: Location of of Hospitals