The World Bank Report No: ISR11614 Implementation Status & Results Vietnam Hospital Waste Management Support Project (P119090) Public Disclosure Copy Operation Name: Hospital Waste Management Support Project (P119090) Project Stage: Implementation Seq.No: 5 Status: ARCHIVED Archive Date: 29-Sep-2013 Country: Vietnam Approval FY: 2011 Product Line: IBRD/IDA Region: EAST ASIA AND PACIFIC Lending Instrument: Specific Investment Loan Implementing Agency(ies): Key Dates Board Approval Date 29-Mar-2011 Original Closing Date 31-Aug-2017 Planned Mid Term Review Date 31-Aug-2014 Last Archived ISR Date 23-Jun-2013 Effectiveness Date 29-Aug-2011 Revised Closing Date 31-Aug-2017 Actual Mid Term Review Date Project Development Objectives Project Development Objective (from Project Appraisal Document) The project development objective is to reduce environmental degradation and potential risks for human health through the improved management of health care waste in Vietnam's hospitals. Has the Project Development Objective been changed since Board Approval of the Project? Yes No Component(s) Component Name Component Cost Component 1: Policy and Institutional Environment Strengthening 9.00 Component 2: Hospital Waste Management Improvement Facility 134.00 Component 3: Project Implementation Support and Coordination 7.00 Overall Ratings Previous Rating Current Rating Public Disclosure Copy Progress towards achievement of PDO Moderately Unsatisfactory Moderately Unsatisfactory Overall Implementation Progress (IP) Unsatisfactory Moderately Unsatisfactory Overall Risk Rating High Substantial Implementation Status Overview The project implementation is picking up speed since March 2013, and project management and coordination has improved at the central level. The sub-project grant agreement was revised to include a timetable for each steps of processing, standardized forms and documents to be used, and a clear responsibility of each party. The authority to sign the sub-grant agreements was delegated by the Minister to the Project Director, and the day-to-day implementation decisions have been made by the Project Deputy Director. The arrangement to review and approval sub-project documents by the Central Project Management Unit, the line departments in Ministry of Health, and Vietnam Health Environment Management Agency, was clarified and agreed. The new arrangement has helped to shorten the process at the central level. The remaining challenges on project management are: (i) to introduce Page 1 of 9 The World Bank Report No: ISR11614 similar simplified procedures to the Provinces and reduce the processing time at the local level; and (ii) to provide more technical assistance in preparing hospital waste management plans, procurement plans, and bidding documents at both central and provincial levels. Public Disclosure Copy Locations Country First Administrative Division Location Planned Actual Vietnam Not Entered Tinh Tien Giang Vietnam Not Entered Sa Dec Vietnam Not Entered Tinh Long An Vietnam Not Entered Tinh Kien Giang Vietnam Not Entered Ha Noi Vietnam Not Entered Tinh Dong Thap Vietnam Not Entered Tinh Dong Nai Vietnam Not Entered Cai Lay Vietnam Not Entered Bien Hoa Vietnam Not Entered Tinh Ben Tre Vietnam Not Entered Huyen Ba Tri Vietnam Not Entered Thi Xa Go Cong Vietnam Not Entered Huyen Cai Be Vietnam Not Entered Huyen Thap Muoi Vietnam Not Entered Huyen Hong Ngu Vietnam Not Entered Kien Giang Provincial General Hospital Public Disclosure Copy Vietnam Not Entered Hanoi Hospital of Traditional Medicine Vietnam Not Entered Kien Giang Hospital of Traditional Medicine Vietnam Not Entered Tien Giang General Hospital Vietnam Not Entered Cai Lay District Hospital Vietnam Not Entered Go Cong District Hospital Vietnam Not Entered General Hospital of Sa Dec Page 2 of 9 The World Bank Report No: ISR11614 Country First Administrative Division Location Planned Actual Vietnam Not Entered Dong Thap General Hospital Public Disclosure Copy Vietnam Not Entered Long An General Hospital Vietnam Not Entered Ben Tre General Hospital Vietnam Not Entered Cu Lao Minh District Hospital Vietnam Not Entered Ba Tri District Hospital Results Project Development Objective Indicators Indicator Name Core Unit of Measure Baseline Current End Target Increased share of hospitals' wastewater Percentage Value 0.00 0.00 40.00 meeting the environmental standards Date 30-Jul-2013 Comments Hospital grants are being prepared or implemented, none is completed. Increased share of properly segregated and Percentage Value 0.00 0.00 40.00 treated infectious health care waste Date 30-Jul-2013 Comments Hospital grants are being prepared or implemented, none is completed. Increased number of health care staff following Percentage Value 0.00 0.00 90.00 correct occupational safety practices, including Date 30-Jul-2013 usage of personal protective equipment Comments Hospital grants are being prepared or implemented, none is completed. Public Disclosure Copy Improved perception among communities Percentage Value 0.00 0.00 90.00 adjacent to project hospitals about health Date 30-Jul-2013 waste being properly managed Comments Hospital grants are being prepared or implemented, none is completed. Intermediate Results Indicators Page 3 of 9 The World Bank Report No: ISR11614 Indicator Name Core Unit of Measure Baseline Current End Target Effective CPMU and TAG support to Percentage Value 0.00 0.00 80.00 Component 2 beneficiaries Date 30-Jul-2013 Public Disclosure Copy Comments Data is not available because questionnaires are not designed. The mission requested CPMU to finalize questionnaire in August and conduct survey in November 2013. Effective monitoring Percentage Value 100.00 100.00 Date 30-Jul-2013 Comments CPMU has conducted regular monitoring to speed up implementation. Number of hospital grants approved Number Value 0.00 19.00 150.00 Date 30-Jul-2013 Comments No change. Number of Health Care Waste Management Number Value 0.00 11.00 60.00 Plans approved Date 30-Jul-2013 Comments 10 central hospitals and 18 provincial hospitals up to date Central and provincial hospital receiving Percentage Value 0.00 scheduled environmental monitoring visits Date 30-Jul-2013 Comments Under VIHEMA's environmental monitoring program, all hospitals are receiving environmental monitoring visits. Public Disclosure Copy Provincial Hospitals receiving scheduled Percentage Value 0.00 70.00 environmnetal monitoring visits Sub Type Date 30-Jul-2013 Breakdown Comments Data is not available and it will be available when the grants implementation are completed. Central Hospitals receiving scheduled Percentage Value 0.00 100.00 50.00 environmnetal monitoring visits Sub Type Date 30-Jul-2013 Page 4 of 9 The World Bank Report No: ISR11614 Breakdown Comments Under VIHEMA's environmental monitoring program, all central hospitals are receiving environmental Public Disclosure Copy monitoring visits Improved knowledge and skills of key health Number Value 0.00 5463.00 personnel in health care waste management Date 30-Jul-2013 standards and practices Comments Training modules are not developed and training for hospitals are expecting to be delivered in the first quarter of 2014, after national TOT training will be provided in the last quarter of 2013. Number of technical staff in environment Number Value 0.00 0.00 310.00 monitoring agency trained with 80% passing Sub Type Date 30-Jul-2013 test score Breakdown Comments Training module is under developed. Training course for technical staff in environmental monitoring agency will be delivered in thefirst quarter of 2014. Number of HCWM administrators in DOH, Number Value 0.00 0.00 2332.00 health care facilities, preventive health centers Sub Type Date 30-Jul-2013 trained with 80% passing test score Breakdown Comments Training module is under developed and training course for HCWM administrators is expected to be delivered in the first quarter of 2014. Number of leaders of health, DONRE, Number Value 0.00 0.00 2545.00 Environment Police, other agencies trained Sub Type Date 30-Jul-2013 Public Disclosure Copy with 80% passing test score Breakdown Comments Training module is under developed and training course for leaders is expected to be delivered in the last quarter of 2013. Number of trainers trained with 80% passing Number Value 0.00 0.00 276.00 test score Sub Type Date 30-Jul-2013 Breakdown Comments Training module is not developed and training course Page 5 of 9 The World Bank Report No: ISR11614 for trainer is expecting to be delivered in the last quarter of 2013. Health personnel receiving training (number) Number Value 0.00 0.00 5463.00 Public Disclosure Copy Date 30-Jul-2013 Comments Training module is under consultation process. TOT training is expecting to be delivered in the first quarter of 2014. Number of hospital grants completed Number Value 0.00 0.00 150.00 Date 30-Jul-2013 Comments None of hospital grants has completed. Expectedly, two health facilities will complete construction and installation in December 2013. Number of hospitals meeting: (a) wastewater Number Value 0.00 0.00 140.00 standards; (b) solid waste standards; (c) Date 30-Jul-2013 HCWM practice standard Comments Hospital grants are being prepared or implemented. None is completed yet. Four scientific institutes/Regional reference Number Value 0.00 0.00 4.00 labs and provincial preventive health centers Date 30-Jul-2013 have strengthened capacity for testing of solid Comments Technical specification of lab and liquid health care waste equipment is facing with a big delay. After appraisal, the project need to separate the package intotwo. Mobile lab should be appraised later by December 2013. The rest Public Disclosure Copy should go ahead in September. Functional web based software application to Number Value 0.00 0.00 250.00 provide up-to-date and transparent information Date 30-Jul-2013 about the status of HCWM in hospitals Comments The TOR for recruitment of IT company is being discussed. The TOR will be finalized and approved in the first quarter of 2014. Page 6 of 9 The World Bank Report No: ISR11614 Health facilities constructed, renovated, and/or Number Value 0.00 0.00 150.00 equipped (number) Date 30-Jul-2013 Comments None of health facilities in Public Disclosure Copy round 1 completed construction/renovation yet. Smooth implementation and monitoring of Percentage Value 0.00 100.00 100.00 grant implementation Date 05-Jun-2013 Comments All grants under round 1 have been closely monitoring on its implementation. There is no big issues raised so far, except a slow approval. Credit resources disbursed (cumulative) Percentage Value 0.00 9.00 100.00 Sub Type Date 30-Jul-2013 Breakdown Comments Actual disbursement up to date. Credit resources committed (cumulative) Percentage Value 0.00 9.00 100.00 Sub Type Date 05-Jun-2013 Breakdown Comments no further comments. Health facilities constructed, renovated, and/or Number Value 0.00 0.00 100.00 equipped (number) Date 30-Jul-2013 Comments Hospital grants are being prepared or implemented. None is completed yet. Credit resources committed (cumulative) Number Value 0.00 9.00 100.00 Sub Type Date 05-Jun-2013 Breakdown Comments Actual disbursement is very slow. Fully functional Executive Committee for Number Value 0.00 0.00 10.00 Public Disclosure Copy Environmental Protection in the Health Sector Date 30-Jul-2013 having regular inter-sectoral meetings Comments Roles and responsibilities of committee are being finalized. Official approval will be issued in September. the number of new or revised policies, Text Value 0 13 regulatory documents adopted and applied Date 05-Jun-2013 HCWM studies published and disseminated Comments Consultants were recruited. Consultation workshops were Page 7 of 9 The World Bank Report No: ISR11614 conducted. 5 documents will be issued by December 2013. Number of workshops with stakeholders Text Value 0 13 Public Disclosure Copy Sub Type Date 05-Jun-2013 Breakdown Comments Two workshops were conducted i) non burn technology and ii) training modules. Number of Technical guidance manuals Text Value 0 5 Sub Type Date 05-Jun-2013 Breakdown Comments Technical guidance manuals are under finalized. Completion is expected in December 2013. Number of Technical regulations Text Value 0 4 Sub Type Date 05-Jun-2013 Breakdown Comments Technical regulations are under developed. Consultation workshop was conducted. Non burn technology guideline is expected to be issues in the first quarter of 2014. Number of Policy and administrative Text Value 0 4 documents Sub Type Date 30-Jul-2013 Breakdown Comments The documents are under developed or consulted with Government agencies.. 06 documents are finalized, in which 4 documents will be Consultants were recruited. Public Disclosure Copy Consultation workshops officially issued by December 2013. Data on Financial Performance (as of 29-May-2013) Financial Agreement(s) Key Dates Project Ln/Cr/Tf Status Approval Date Signing Date Effectiveness Date Original Closing Date Revised Closing Date P119090 IDA-48990 Effective 29-Mar-2011 31-May-2011 29-Aug-2011 31-Aug-2017 31-Aug-2017 Page 8 of 9 The World Bank Report No: ISR11614 Disbursements (in Millions) Project Ln/Cr/Tf Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P119090 IDA-48990 Effective XDR 96.10 96.10 0.00 4.84 91.26 5.00 Public Disclosure Copy Disbursement Graph Key Decisions Regarding Implementation 1.Enlarge the pool of beneficiaries to include hospitals with 150 beds. 2. Improve efficiency of application reviews for Round 3 sub-grants using “first come, first service� approach to avoid bunching and overload. 3. Prepare for project Mid-Term Review which is tentatively scheduled for April/May 2014. Restructuring History Public Disclosure Copy There has been no restructuring to date. 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