SFG3838



Health System Performance Strengthening Project (HSPSP):




  DEVELOPMENT OF AN ENVIRONMENTAL AND SOCIAL
   MANAGEMENT FRAMEWORK AND HEALTH WASTE
              MANAGEMENT PLAN
LIST OF ACRONYMS AND ABBREVIATIONS


CHDA       Community Health and Development Agents (Agentes de
           Desenvolvimento Comunitário e Sanitário, ADECOS)
CHW        Community Health Workers
DHIS2      District Health Information Software 2
DNPAIA     Direcção Nacional de Prevenção e Avaliação de Impactes
           Ambientais/ National Directorate for Prevention and Evaluation of
           Environmental Impacts
DNSP       Departamento Nacional de Saúde Pública (National Department of
           Public Helath)
EIA        Environmental Impact Assessment
ENA        Estratégia Nacional do Ambiente (National Environmental Strategy)
ESMF       Environmental and Social Management Framework
GDP        Gross Domestic Product
HCWMP      Health Care Waste Management Plan
HSPSP      Health System Performance Strengthening Project
IP         Indigenous People
MHSS       Municipal Health Services Strengthening
LMIC       Lower Middle Income Country
MINAMB     Ministério do Ambiente/ Ministry of Environment
MoH        Ministry of Health
MPLA       Popular Movement for the Liberation of Angola
NHS        National Health System
MoE        Ministry of Environment
MoH        Ministry of Health
PASSII     Projecto de Apoio ao Sector da Saúde (Health Sector Support
           Project)
PCU        Project Coordination Unit
PIU        Project Implementation Unit
PNGA       Programa Nacional de Gestão Ambiental (National Environmental
           Management Programme)
PRSMS      Municipal Health Services Strengthening Project
SADC       Southern African Development Community
SNS        Sistema Nacional de Saúde (National Health System)
UNDP       United Nations Development Programme
UNITA      National Union for the Total Independence of Angola
WHO        World Health Organisation


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Table of Contents
LIST OF ACRONYMS AND ABBREVIATIONS ......................................................................................... II
SUMÃ?RIO EXECUTIVO ........................................................................................................................1
EXECUTIVE SUMMARY ..................................................................................................................... 13
  BACKGROUND TO THE ESMF ........................................................................................................................ 13
  PROJECT DESCRIPTION.................................................................................................................................. 14
  COMPONENTS OF THE PROJECT ..................................................................................................................... 14
  PROJECT BENEFICIARIES ................................................................................................................................ 15
  INSTITUTIONAL ARRANGEMENTS .................................................................................................................... 16
  PUBLIC CONSULTATIONS ............................................................................................................................... 18
  WORLD BANK SAFEGUARD POLICIES .............................................................................................................. 18
  ANGOLA ENVIRONMENTAL AND SOCIAL MANAGEMENT LEGAL FRAMEWORK ........................................................ 19
  GAPS IN THE ANGOLA LEGAL FRAMEWORK AND WORLD BANK SAFEGUARD POLICIES ............................................. 20
  POTENTIAL ENVIRONMENTAL AND SOCIAL IMPACTS AND MITIGATION MEASURES ................................................... 20
  ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK MONITORING REQUIREMENTS.................................... 21
  ENVIRONMENTAL AND SOCIAL SCREENING PROCESS ......................................................................................... 22
  TRAINING AND INSTITUTIONAL CAPACITY DEVELOPMENT NEEDS ......................................................................... 22
  CONCLUSIONS AND RECOMMENDATIONS ........................................................................................................ 23
1      INTRODUCTION .........................................................................................................................1
    1.1    PROJECT DESCRIPTION....................................................................................................................... 2
    1.2    PROJECT IMPLEMENTATION ARRANGEMENT ......................................................................................... 5
    1.3    OBJECTIVES OF THE ENVIRONMENTAL SOCIAL MANAGEMENT FRAMEWORK (ESMF) .................................. 5
2   METHODOLOGY USED TO PREPARE THE ENVIRONMENTAL AND SOCIAL MANAGEMENT
FRAMEWORK (ESMF) .........................................................................................................................8
3    OVERVIEW OF ANGOLA’S ENVIRONMENTAL POLICIES, LAWS, PROCEDURES, REGULATORY AND
ADMINISTRATIVE FRAMEWORKS .......................................................................................................9
  3.1     ENVIRONMENTAL FRAMEWORK LEGISLATION FOR THE REPUBLIC OF ANGOLA ............................................ 9
     3.1.1 The National Environmental Management Programme....................................................... 10
     3.1.2 National Directorate for the Prevention and Evaluation of Environmental Impacts ............ 10
     3.1.3 Permits and licences .............................................................................................................. 13
     3.1.4 Offences and penalties .......................................................................................................... 14
     3.1.5 EIA Guidelines ........................................................................................................................ 15
     3.1.6 EIA procedure in Angola ........................................................................................................ 15
     3.1.7 Review of EIA reports ............................................................................................................ 16
     3.1.8 Environmental monitoring and audits .................................................................................. 17
     3.1.9 Other relevant environmentally-related legislation in Angola .............................................. 17
4      OVERVIEW OF THE WORLD BANK’S SAFEGUARD POLICIES TRIGGERED ...................................... 28
    4.1    SUMMARY .................................................................................................................................... 28


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     4.2     SAFEGUARD POLICIES TRIGGERED BY THE PROJECT ............................................................................... 29
        4.2.1 OP 4.01 Environmental Assessment ...................................................................................... 29
        4.2.2 OP 4.04 Natural habitats....................................................................................................... 31
        4.2.3 OP 4.10 Indigenous People .................................................................................................... 32
        4.2.4 World Bank Policy on Disclosure of Information ................................................................... 33
5       GAPS IN ANGOLA LEGISLATION AND IN THE WORLD BANK SAFEGAURD POLICIES ...................... 36
6       POTENTIAL ENVIRONMENTAL AND SOCIAL IMPACTS DUE TO PROPOSED PROJECTS .................. 37
     6.1    SUMMARY .................................................................................................................................... 37
     6.2    NEGATIVE IMPACTS ........................................................................................................................ 38
7       CUMULATIVE IMPACTS ............................................................................................................ 42
8       MITIGATION MEASURES........................................................................................................... 43
9       ENVIRONMENTAL AND SOCIAL SCREENING PROCESS ................................................................ 49
     9.1    SUMMARY .................................................................................................................................... 49
     9.2    STEP 1: SITE SCREENING.................................................................................................................. 49
     9.3    STEP 2: ENVIRONMENTAL CATEGORIES OF THE ACTIVITIES .................................................................... 50
     9.4    STEP 3: CARRYING OUT ENVIRONMENTAL WORK ................................................................................ 50
     9.5    STEP 4: REVIEW AND APPROVAL ....................................................................................................... 51
     9.6    STEP 5: PUBLIC CONSULTATIONS AND DISCLOSURE .............................................................................. 52
     9.7    STEP 6: ENVIRONMENTAL MONITORING AND FOLLOW UP ..................................................................... 53
     9.8    RESPONSIBILITIES FOR THE IMPLEMENTATION OF THE SCREENING PROCESS .............................................. 53
10 GUIDELINES FOR ENVIRONMENTAL AND SOCIAL MANAGEMENT PLANS AND MONITORING
REQUIREMENTS ............................................................................................................................... 56
  10.1 GENERIC ENVIRONMENTAL MANAGEMENT PLAN ................................................................................ 56
  10.2 MONITORING REQUIREMENTS .......................................................................................................... 56
11      GRIVANCE REDRESS MECHANISM............................................................................................. 59
12      TRAINING AND CAPACITY BUILDING REQUIREMENTS ............................................................... 60
13      RECOMMENDATIONS ............................................................................................................... 61
14      LIST OF INDIVIDUALS/INSTITUTIONS CONTACTED UNDER PUBLIC CONSULTATIONS................... 62
15      REFERENCES ............................................................................................................................ 65
16     ANNEXES: ................................................................................................................................ 66
     16.1 ENVIRONMENTAL AND SOCIAL SCREENING CHECKLIST .......................................................................... 66
     16.2 ENVIRONMENTAL AND SOCIAL FIELD APPRAISAL FORM ........................................................................ 71
Table 1: health facilities that are part of the hspsp in angola ......................................... 16
Table 2: Health status indicators for Angola .................................................................... 1
Table 3: Population and demographic statistics for Angola vs Africa for the year 2017 .. 2
Table 4: Other relevant legislation in Angola ................................................................. 17
Table 5: Safeguard Policies triggered by the Project .................................................... 29


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Table 6: Summary Table of Potential Impacts of the Project and Mitigation Measures . 43
Table 7: Responsibilities for Implementation of the proposed screening Process ......... 53
Table 8: Stakeholder database - angola hspsp ............................................................. 63


Figure 1: Context map of Angola showing the 18 provinces into which the country has
    been divided. ............................................................................................................ 3




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SUMÃ?RIO EXECUTIVO

Antecedentes ao QGAS

O Quadro de Gestão Ambiental e Social (QGAS), apresenta um informe sobre a
implementação do Projecto para o Fortalecimento do Sistema de Saúde (PFSA), busca
delinear as disposições e as necessidades de formação na área ambiental durante a
implementação e monitoria das medidas de mitigação identificadas para projectos
desenvolvidos no âmbito do PFSA. O PFSA manterá o status de categoria B de
avaliação ambiental de seu antecessor (ou seja, o Projecto Municipal de Fortalecimento
de Serviços de Saúde), que exclarece o motivo pelo qual uma análise ambiental e
ambiental parcial é considerada adequada para abordar questões ambientais e sociais
específicas associadas a qualquer obra de engenharia e com o fornecimento de
suprimentos médicos (ou seja, que causaria preocupações com o gestão de resíduos
de saúde).

O QGAS fornecerá diretrizes ambientais e sociais, bem como um mecanismo de
selecção para contratadas, supervisores e a Unidade de Implementação do Projecto
(UIP) para garantir que os investimentos propostos e as subsequentes operações e a
manutenção sejam realizados de forma ambientalmente e socialmente sustentável.

O presente documento foi elaborado com base numa bibliografia sobre Angola e as
áreas afectadas do Projecto (ou seja, as 18 províncias); revisão das lições da síntese
das disposições relevantes do quadro jurídico angolano referente às Políticas de
Salvaguarda do QGAS e do Banco Mundial e os documentos de orientação; bem como
os comentários obtidos das reuniões de consulta pública realizadas ao preparar este
documento.

Os impactos ambientais e sociais do Projecto previstos serão provavelmente mínimos
dado que os impactos ambientais negativos normalmente ocorrem durante as fases de
construção dos Projectos e porque este é essencialmente um Projecto social com uma
grande componente do trabalho virado principalmente para a capacitação e
implementação de medidas para melhorar a prestação de serviços de saúde (ou seja,
administração de vacinas e medicamentos, formação e desenvolvimento de habilidades
para pessoal adequado e profissionais de saúde, etc.). Podem também surgir impactos
relacionados com os riscos de saúde ocupacional para trabalhadores durante a fase de
operacionalização das unidades sanitárias e riscos para a saúde ambiental para
morradores e residentes nas comunidades circunvizinhas ás unidades sanitárias. Os
trabalhadores estão também susceptíveis de estar expostos a níveis significativamente


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mais altos de contaminação, pois estão em contacto directo com as unidades
sanitárias.

Descrição do Projecto

O Projecto de Fortalecimento do Desempenho do Sistema de Saúde (PFSA) pretende
melhorar os serviços de saúde materno-infantil em Angola através da reabilitação e
melhoria da infra-estrutura de saúde e da prestação de serviços como vacinação,
formação de profissionais de saúde e a melhoria da capacidade dos sistemas de saúde
no fornecimento de serviços de saúde primária como parte do Sistema Nacional de
Saúde (SNS), de forma a garantir a sustentabilidade e a resiliência do serviço de saúde
em Angola (que foi negligenciada durante a prolongada guerra civil do país).


The objectives of this QGAS are to:

      Proporcionar um processo de selecção ambiental e social para futuros
       investimentos na melhoria ou reabilitação de infra-estrutura de saúde existente
       ou nova (isto é, estabelecimentos de saúde, capacitação e formação de pessoal,
       prestação de serviços de saúde materno-infantil e primário, etc.) e para os quais
       podem ser necessárias medidas adequadas de mitigação. O QGAS será assim
       usado como uma ferramenta prática durante a implementação do Projecto.
      O processo de triagem será conduzido de acordo com as prescrições da Política
       de Salvaguarda do Banco Mundial (OP 4.01 Avaliação Ambiental), que exige
       que todas as operações financiadas pelo Banco sejam avaliadas para possíveis
       impactos ambientais e sociais e que o trabalho ambiental requerido seja
       realizado com base nos resultados da triagem, que podem indicar o seguinte:
          o Que nenhum trabalho ambiental adicional seria necessário;
          o A aplicação de medidas de mitigação simples por pessoal qualificado
              seria suficiente;
          o Que uma avaliação separada do Impacto Ambiental (EIA) seria
              necessária de acordo com as leis e regulamentos ambientais aplicáveis
              em Angola;
          o Que deve haver um Plano de Gestão Ambiental e Social apropriado
              (PGAS);
          o Que um Plano de Gestão de Resíduos Hospitalares deve ser preparado.

Componentes do Projecto

   1) A primeira componente implica melhorar a qualidade dos serviços de saúde nas
      províncias alvo (para um orçamento estimado em 65,0 milhões US $). Esta


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      componente implicaria apoiar actividades a níveis provincial e municipal para
      melhorar a qualidade dos serviços de saúde, bem como o desenvolvimento de
      um piloto de Financiamento Baseado em Resultados (FBR) em duas províncias
      selecionadas (US $ 10,0 milhões).

          a. A primeira sub-componente deste Projecto tem como objectivo melhorar a
             qualidade dos serviços de saúde materno-infantil a níveis provincial e
             municipal.
          b. A segunda subcomponente implica a gestão da FBR (10,0 US $ milhões)
             para apoiar a prestação de serviços de saúde através de um foco de
             desempenho a nível provincial e municipal.

   2) A segunda componente do Projecto envolve o fortalecimento da administração
      do Sistema Nacional de Saúde (NHS) para apoiar na prestação de serviços de
      saúde de qualidade (US $ 25,0 milhões). Esta componente visa fortalecer as
      instituições em todo o sistema nacional de saúde para melhorar a qualidade e
      coordenação dos serviços de saúde prestados à níveis municipal, provincial e
      nacional.

   3) A terceira componente tem como objectivo apoiar a capacidade de resposta a
      prevenção de emergências de saúde pública através da provisão de fundos para
      financiar esforços de resposta destinados à prevenção de potenciais surtos e
      pandemias. Esta componente só será desenvolvida em caso de emergências de
      saúde pública e quando certas acções acordadas pelo governo e pelas equipas
      do Banco forem alcançadas/ não alcançadas. Esta componente se assemelha a
      um plano de resposta de emergência que só será desencadeado durante casos
      de emergência e detalhará as acções e medidas de resposta a serem
      implementadas durante essas emergências.

   4) A quarta componente é a Gestão de Projectos, Monitoria e Avaliação (US $ 10
      milhões). Esta componente sustenta implementação do Projecto pelo Ministério
      da Saúde (MdS), incluindo a de Projectos, tarefas fiduciárias, além de Monitoria
      e Avaliação (M & A).


Beneficiários do Projecto

O PFSA beneficiará mulheres em idade reprodutiva e crianças menores de cinco anos
em 21 municípios de sete províncias. As províncias e seus respectivos municípios são
os seguintes: (i) Bengo (Ambriz e Dande, (ii) Luanda (Icolo e Bengo), (iii) Lunda Norte
(Chitato, Cambulo, Cuango e Lucapa) (iv) Malanje (Cacuso) Calandula, Malanje e


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Caculama); (v) Moxico [Comanongue, Luau e Luena (Moxico)]; (vi) Uige (Maquela do
Zombo, Negage, Sanza Pombo e Uige); (vii) Cuando Cubango (Cuito Cuanavale,
Mavinga e Menongue).

A população destes 21 municípios representa um total de 3,8 milhões de habitantes,
que corresponde a cerca de 13,5% da população Angolana. O Projecto visa melhorar o
desempenho de 288 estabelecimentos saúde de cuidados de saúde primários (ou
seja, 117 postos de saúde, 93 centros de saúde e 22 hospitais municipais) nos
municípios-alvo. As 288 unidades de cuidados de saúde primárias identificadas
representam cerca de 70% das unidades de saúde existentes nos 21 municípios, uma
vez que não foi possível cobrir todas as instalações.


Os critérios e considerações utilizados foram os seguintes:
   • Todos os Hospitais Municipais foram considerados
   • Uma grande parte dos Centros de Saúde e Centros de Saúde Materno-Infantil
       foram considerados
   • Hospitais gerais foram excluídos (não foram consideradas unidades primárias,
       especialmente quando existem hospitais municipais);
   • Algumas estações e centros de saúde foram excluídos (em algumas províncias,
       como as estações de Moxico e Malange, servem uma pequena população e
       envolvem distâncias longas tornando-as inacessíveis)
   • Kuando-Kubango - Estes são números estimativos visto que uma pesquisa não
       foi realizada por ser uma nova província para o Projecto.


                                 70% das
              Unidades           Unidades                  Hospitais
 Província Consideradas        Consideradas Postos Centros Municipais     Total
 Luanda               24                  16    11       4          1         16
 Bengo                39                  27    19       6          2         27
 Lunda N.             45                  31    19       7          5         31
 Moxico               50                  35    19      14          2         35
 Malange              50                  35     9      22          4         35
 Uige                 80                  56    22      30          4         56
 K. Kub.             *40                  32    18      10          4         32
 Total               288                232    117      93         22       232
 * Estimated number

TABELA 1: UNIDADES SANITÃ?RIAS QUE FAZEM PARTE DO PFSA EM ANGOLA



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Disposições Institucionais

Este Projecto será implementado de forma colaborativa envolvendo várias instituições
que trabalham em conjnto. O Ministério da Saúde terá a responsabilidade geral de
implementação do Projecto. O Departamento Nacional de Saúde Pública (DNSP) terá a
responsabilidade diária na implementação do Projecto. Será estabelecida uma Unidade
de Coordenação de Projecto específica (UCP) no MDS que será incorporada
fisicamente nos escritórios da DNSP. A UCI será composto pelo pessoal do MDS que
ocupará as seguintes funções: um Director de Projecto que reporta ao Director
Nacional de Saúde Pública, um Coordenador de Projecto, um Coordenador de Projecto
FBR, Especialista em M & E, um Especialista em Gestão Financeiro (FM) e um
Especialista em Procurement, onde todos apresentam relatórios ao Director do
Projecto. Além disso, para apoiar ainda mais a capacidade fiduciária, a UCI terá dois
funcionários das finanças e um Assistente de Procurement.


Estas Disposições Innstitucionais desvia-se do estabelecido no actual Projecto
Municipal de Fortalecimento de Serviços de Saúde, na medida em que visa capacitar a
UCP no Ministério da Saúde de duas formas, sendo instalado no Ministério da Saúde e
não fora e incorporando pessoal do Ministério da Saúde nas cargos e funções chave de
UIP em vez de contar principalmente com consultores internacionais. Para apoiar o
Ministério da Saúde no estabelecimento e capacitação da UIP no Ministério da Saúde,
o Projecto irá financiar consultores internacionais nas áreas de Gestão Financeira e
Procurement por um período de seis meses a um ano que irá formar o pessoal do
Ministério da Saúde que posterioremente assumirá essas funções na UCP. O
especialista em Gestão Financeira Projecto a ser recrutado irmá capacitar as duas
equipes de Finanças do Ministério da Saúde que serão integradas na UCP, onde uma,
será selecionada para assumir o cargo de Especialista em Gestão do Projecto num
período compreendido entre 12 a 24 meses. Além disso, a equipe da UIP será apoiada
pela equipe técnica do Ministério da Saúde em cada área técnica específica do
Projecto, tais como financiamento da saúde, saúde pública, recursos humanos para
área da saúde, sistemas de informação em saúde, epidemiologia, entre outros. Além
disso, um coordenador FBR fará a gestão do aspecto FBR do Projecto.

A Figura 14 abaixo fornece uma visão geral da estrutura do MDS que irá apoiar e
implementar o Projecto.




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O Ministério da Saúde informou ao BM que não possui capacidade fiduciária e
destacou isso como sendo um risco para o Projecto. O Banco irá descrever as medidas
de mitigação para desenvolver essa capacidade no Ministério da Saúde. Isto precisará
ser feito em conjunto com a capacidade ambiental através da nomeação de um recurso
que supervisionará a implementação do QGAS / ESMP e EMPs específicos para
estudos de EIA que podem ser preparados para Projectos específicos que serão
implementados para melhorar a infra-estrutura ou para casos em que é necessário
construir novas infra-estruturas (ou seja, laboratórios).

O papel desempenhado pelo MoE será o de apoiar o Ministério da Saúde (através da
UIP) na identificação de Projectos e actividades que exigem o licenciamento de acordo
com o ESMP ou o EMPS específico do Projecto. Especificamente, o MOE ou o
especialista ambiental designado prestará acessoria no quadro ambiental de acordo
com o QGAS, bem como os protocolos para a implementação do Projecto para
maximizar a conformidade ambiental e a sustentabilidade. Todos os Projectos de
desenvolvimento propostos precisarão ser submetidos a análise para determinar a
necessidade de licenciamento ou estarem sujeitos às medidas de mitigação
identificadas nos casos em que não seja necessário o licenciamento.




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Consultas Públicas

As consultas públicas serão realizadas em locais selecionados em todos os 21
municípios abrangidos pelo PFSA, com o objetivo de colher percepções públicas sobre
a melhoria das instalações de saúde, bem como sobre os serviços de saúde materno-
infantil proposto. O processo de consulta compreenderá os seguintes métodos: (i)
consultas de forma individual com os principais interessados (funcionários de
ministérios de execução, organizações nacionais, ONGs, Banco Mundial e equipe
técnica de províncias alvo), (ii) reuniões públicas a serem realizadas nos municípios,
(iii), bem como reuniões de grupos focais ou consultas com comunidades específicas
que exigem atenção centrada ou sessões de consulta inovadoras.


O objectivo do processo de consulta será de reunir as percepções e opiniões gerais de
todas as partes interessadas relevantes (pessoas afectadas pelo Projecto, bem como
pessoas interessadas) no Projecto proposto. Entre outros, os Consultores procurarão
identificar e confirmar as condições nos diferentes contextos provinciais e locais onde
as unidades sanitárias estão a funcionar ou serão estabelecidas, bem como determinar
os impactos específicos que precisarão ser abordados no âmbito do presente QGAS.

Políticas de Salvaguarda do Banco Mundial


As Políticas de Salvaguarda do Banco Mundial (OPs) são obrigatórias na obtenção de
apoio financeiro para Projectos voltados para a redução da pobreza e melhoria de
meios de subsistência e condições socioeconómicas em comunidades desfavorecidas.
Os impactos ambientais previstos no PFSA são mínimos, dado que o Projecto pretende
melhorar o acesso aos serviços de saúde já prestados pelos centros de saúde. Para a
maior parte, isso incluirá equipamentos e material que pode desencadear a
necessidade de eliminação de resíduos hospitalares (ou seja, perigosos) de acordo
com as políticas e diretrizes aplicáveis.

Embora a melhoria das instalações de saúde ou a provisão de novas instalações (ou
seja, laboratórios) possa causar efeitos ambientais e sociais mínimos, é importante que
estes sejam abordados no QGAS ou como parte de quaisquer Projectos de EIA que
possam ser conduzidos com base nos requisitos específicos desses Projectos. A lista
de verificação apresentada nos Anexos dará orientação em termos de necessidade de
EIAs ou se as actividades podem ser realizadas após a implementação de medidas de
mitigação e as directrizes fornecidas no ESMP. O OP específico desencadeado por
actividades no âmbito do PFSA é OP 4.01 (Avaliação Ambiental).



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O QGAS fornece ferramentas práticas para a preparação e / ou implementação de
Planos de Gestão Ambiental e Social (ESMPs), com a sua preparação descrita em
documentos separados, preparados em paralelo com o presente QGAS.

Quadro Jurídico Ambiental e Social de Angolano

Um resumo das políticas, leis e regulamentos ambientais e sociais em Angola,
particularmente aqueles relevantes para o Projecto, foi incluído no presente QGAS. A
legislação relevante em Angola inclui o seguinte:

   •   A Constituição da República de Angola (2010)
   •   Lei de Bases do Ambiente 5/1998.
   •   Lei da �gua 6/20002
   •   Lei de Terras 9/2004
   •   Lei do Ordenamento do Território e Urbanismo
   •   Lei de Recursos Biológicos e Aquáticos 6/2004
   •   Lei de Actividades Petrolíferas 20/2004
   •   Decreto Sobre Avaliação de Impacto Ambiental 51/2004
   •   Decreto sobre Licenciamento Ambiental 59/2007
   •   Regulamentos sobre Danos Ambientais 194/2001
   •   Decreto sobre Auditorias Ambientais 1/2010
   •   Decreto sobre Proteção Ambiental para a indústria do petróleo 39/2000
   •   Decreto sobre Proteção Ambiental para Atividades Petrolíferas 10/2000
   •   Lei das Pescas 20/1992.
   •   Lei do Trabalho
   •   Regulamento sobre Contratação de Obras Públicas Civís
   •   Regulamento de Consulta Pública


O EIA de Angola é regulada pela Lei Quadro Ambiental. O artigo 16 da Lei do Quadro
Ambiental prevê EIA obrigatórias e o Decreto sobre Avaliação de Impacto Ambiental
51/2004 e o processo o processo a ser seguido. O artigo 17 trata do licenciamento, o
artigo 18 da auditoria, ambos têm como base os passos semelhantes aos
desenvolvidos pelo Banco Mundial. Existem quatro categorias de Projectos, a saber:
Categoria A + que exigem que um EIA completo seja realizado e supervisionado por
Revisores Especialistas Independentes com experiência verificável; Categoria A que
requerem uma EIA completa; A categoria B, que exige um estudo ambiental
simplificado, como os impactos potenciais de Projectos neste grupo são considerados
menos significativos ou requerem medidas de mitigação menos complexas; e Categoria
C que não requerem EIA, mas devem respeitar os regulamentos sobre impacto
ambiental. Estes são amplamente alinhados às categorias do Banco Mundial.


                                                                                  8
O Ministério do Meio Ambiente (MMA) é responsável por questões relacionadas à
gestão ambiental a todos os níveis (nacional, provincial e distrital), com a assistência
da Direcção Nacional de Prevenção e Avaliação de Impactos Ambientais (DNPAIA),
que avalia os relatórios recebidos e encaminhados para o MoE com recomendações
sobre a necessidade ou não de uma Licença Ambiental.

Lacunas no quadro jurídico de Angola e nas políticas de salvaguarda do Banco
Mundial


A principal lacuna entre a legislação Angolana e as Políticas de Salvaguarda do Banco
Mundial é a falta de procedimentos e normas claras para lidar com a saúde e a
segurança da população local de uma área do Projecto e / ou dos trabalhadores do
Projecto. A legislação Angolana aborda a segurança no local de trabalho, mas, no
entanto, é insuficiente em termos de disposições específicas para Projectos, tais como
actividades específicas que se enquadram no PFSA. Para combater a lacuna nos
procedimentos de saúde e segurança, recomenda-se que as Diretrizes Ambientais, de
Saúde e Banco Mundial (2007) orientem o proponente do Projecto em todas as fases
de implementação do Projecto e forneçam algumas orientações sobre medidas de
mitigação adequadas a serem tomadas.

Potenciais Impactos ambientais e sociais s e medidas de mitigação


Uma vez que actividades relacionadas com a implementação do PFSA implicam
melhoria do acesso aos serviços de saúde, bem como a construção ou actualização de
laboratórios em locais já existentes, não estão previstas aquisições de terras ou
impactos negativos em habitats importantes. A maioria dos impactos antecipados pode
ser respondidas de forma adequada ou pelas medidas genéricas de mitigação
propostas neste QGAS. É possível que algumas actividades, como a construção ou a
renovação de laboratórios, possam desencadear estudos de EIA que incluam EMPs
mais detalhados abordando medidas específicas de mitigação que orientarão a
implementação do Projecto.

As actividades e os sub-Projectos no âmbito do Projecto PFSA foram considerados
Projectos de Categoria B, pois todos os potenciais impactos para as sub-componentes
ou as actividades do Projecto são considerados específicos do local, reversíveis ou
passíveis de acções de gestão e, em todos os casos, as medidas de mitigação podem
ser prontamente projectadas. Alguns dos impactos genéricos ambientais e sociais


                                                                                      9
incluem, mas não estão limitados aos seguintes: erosão do solo (resultante da
depuração da vegetação e escavações de solos onde exista reabilitação ou construção
de novos locais); poeira e poluição do ar; geração de resíduos sólidos e líquidos e seu
tratamento ou descarte; resíduos hospitalares (cuidados de saúde) e a necessidade de
tratamento ou eliminação; riscos de infecções para profissionais de saúde; riscos de
propagação de doenças como o aumento das taxas de HIV / AIDS como resultado do
afluxo de trabalhadores sazonais para os locais do Projecto; incidentes e acidentes no
local de trabalho; bem como ruído e vibrações e conflitos sociais, entre outros.

Embora alguns impactos ambientais e sociais negativos sejam esperados neste
Projecto, há também alguns impactos positivos significativos que podem contrariar os
negativos. Os impactos positivos incluem: melhor estado de saúde em Angola,
ambientes seguros e saudáveis, melhores meios de subsistência e estimulação
económica como resultado de uma população muito mais saudável, entre outros.

Requisitos de Monitoria do Quadro de Gestão Ambiental e Social

O monitoria e o relatório de progresso são fundamentais para a boa implementação do
EMSF, bem como do Projecto geral PFSA. Os relatórios têm como base um conjunto
de indicadores que devem ser reportados regularmente, com responsabilidades
específicas e indicadores aqui estabelecidos, que serão integrados ao sistema geral de
monitoria e avaliação (M & E) do Projecto. O objectivo específico do processo de
monitoria é de garantir que o ESMP seja cumprido e verificado a todos os níveis e
estágios do ciclo de implementação do Projecto. O monitoria deve ser um processo
contínuo e deve incluir o estágio de conformidade, bem como a realização dos
objectivos do Projecto.

Dado o número de instituições envolvidas na implementação do PFSA, recomenda-se
que uma equipe de coordenação interinstitucional, com o apoio do Comité Director,
coordene e actue com outras instituições governamentais relevantes no que se refere a
monitoria ambiental e social do Projecto. Os relatórios semanais, mensais, trimestrais e
anuais devem ser preparados e distribuídos para todas as entidades relevantes.

A implementação e a monitoria da QGAS devem ser realizadas por cada um dos
proponentes do Projecto, em conjunto com as autoridades provinciais e locais e após
consulta às pessoas afectadas. As revisões anuais da implementação do QGAS serão
realizadas por um consultor local independente, ONG ou outro provedor de serviços
que não esteja envolvido no PFSA, sujeito a aprovação do Comité de Direcção e do
Banco Mundial. Auditorias independentes, bi-anuais solicitadas devem ser realizadas.




                                                                                     10
Processo de triagem ambiental e social

O processo de triagem destina-se a determinar que actividades do Projecto resultarão
provavelmente em impactos ambientais e sociais negativos significativos, com vistas a
determinar medidas adequadas de mitigação de impacto para essas actividades e
garantir a sustentabilidade ambiental de sub-Projectos realizados nas áreas do
Projecto.

O processo de triagem para este Projecto consiste em quatro etapas: i) revisão da lista
de verificação de impactos ambientais e sociais para Projectos; ii) triagem dos impactos
das sub-componentes e dos locais; iii) atribuição de categorias ambientais; e iv)
preparação, revisão e aprovação de um Plano de Acção Ambiental.

O processo de triagem será realizado utilizando um formulário de triagem a ser
anexado a este QGAS. As salvaguardas já estabelecidas pela equipe especializada
nas unidades de implementação serão responsáveis pela realização do processo de
selecção ambiental e social em estreita colaboração com a DNPAIA e a Unidade de
Coordenação do Ministério da Saúde (UCP) no Ministério da Saúde.

Necessidades de Formação e Capacitação Institucional

A BM já identificou a necessidade capacitação institucional no Ministério da Saúde,
especialmente para a UCP, particularmente no que se refere à Gestão Financeira do
Projecto ou a outros aspectos do Projecto (ou seja, gestão ambiental). Propomos que
sejam realizadas sessões dedicadas com a UCP para aconselhá-las e induzi-las no
QGAS e em quaisquer EMPs ou ESMPs que acompanharão este QGAS. Além disso,
esse treinamento deve se concentrar no processo ambiental que é parte deste QGAS
para permitir que os funcionários compreendam melhor suas responsabilidades para a
implementação de Projectos. Especificamente, a formação inicial / capacitação incidirá
sobre:

      Identificar e capacitar pessoal relevante a todos os níveis, que será responsável
       pelo monitoria de PGES a nível local, distrital e provincial;
      Assegurar uma coordenação intra-institucional eficaz para satisfazer a
       implementação adequada das medidas de mitigação propostas para melhorias
       contínuas na gestão ambiental e social.


Para uma efectiva integração das medidas de mitigação propostas na planificação,
implementação e operacionalização das actividades do programa, a implementação do
EMP do Projecto é da responsabilidade dos proponentes do Projecto (MDS, através da


                                                                                     11
UCP, bem como as Províncias e os respectivos municípios) que assegurarão o
cumprimento de todas as medidas estipuladas no PGES pelas partes interessadas.
Além disso, deve ser obrigatório que todos os empreiteiros e supervisores empregem
Especialistas Ambientais experientes para garantir o cumprimento do QGAS / ESMP.

Conclusão e Recomendações


Espera-se que os impactos ambientais e sociais negativos associados ao Projecto e às
actividades que serão realizadas como parte do PFSA sejam de baixo a curto prazo,
colocados a curto prazo, principalmente insignificantes, e podem ser mitigados pelo
cumprimento deste QGAS e dos regulamentos de EIA relevantes e prescrições
(quando relevante), bem como o Plano de Gestão Ambiental e Social (ESMP). Devem
ser delineadas medidas específicas a ser implementadas pelas Contratadas, que
devem fazer parte do contrato e subsequentes EMPs.




                                                                                 12
EXECUTIVE SUMMARY

Background to the ESMF

The Environmental and Social Management Framework (ESMF), which informs the
implementation of the Health System Performance Strengthening Project (HSPSP),
seeks to outline institutional arrangements and related environmental training needs
during implementation and monitoring of the mitigation measures identified for projects
under the HSPSP. The HSPSP will retain the environmental assessment category B
status of its predecessor (i.e. the Municipal Health Services Strengthening Project),
which informs why a partial environmental and social analysis is considered adequate to
address specific environmental and social issues associated with any civil works and
with the provision of medical supplies (i.e. which would trigger concerns about
healthcare waste management).

The ESMF will provide environmental and social guidelines, as well as a screening
mechanism for contractors, supervisors, and the Project Implementation Unit (PIU) to
ensure that proposed investments and subsequent operation and maintenance are
carried out in an environmentally and socially sustainable manner.

The current document was prepared on the basis of extensive literature reviews on
Angola and the affected project areas (i.e. the 18 provinces); review of lessons from the
synthesis of relevant provisions from the Angolan legal framework related to the ESMF
and World Bank Safeguard Policies and guideline documents; as well as feedback
obtained from public consultation meetings carried out when preparing this document.

The environmental and social impacts anticipated from the project are likely to be very
minor given that negative environmental impacts normally arise during the construction
phases of projects and because this is essentially a socially-premised project with a
large component of the work focusing mainly on capacity building and implementation of
measures to improve the provision of healthcare services (i.e. administration of
vaccinations and medicines, provision of training and skills to suitable personnel and
healthcare workers, etc.). Impacts may also arise during the operational phase of the
healthcare facilities related to both occupational health risks to workers and
environmental health risks to residents and workers adjacent to the health units.
Workers are also likely to be exposed to significantly higher levels of contaminants as
they are in direct contact with the healthcare facilities and units.



                                                                                      13
Project description

The Health System Performance Strengthening Project (HSPSP) sets out to improve
maternal and child healthcare services in Angola through rehabilitating and improving
health infrastructure and provision of services such as vaccination, training of medical
health professionals, as well as strengthening the capacity of the healthcare systems to
provide primary health services as part of the National Health System (NHS), in a
manner that will ensure the sustainability and resilience of the healthcare service in
Angola (which had been neglected during the protracted civil war in the country).

The objectives of this ESMF are to:

   ï‚·   to provide an environmental and social screening process for future investments
       in the improvement or rehabilitation of existing or new healthcare infrastructure
       (i.e. healthcare facilities, capacity building and training of staff, provision of
       maternal, child and primary healthcare services, etc.) and for which appropriate
       mitigation measures might be required. The ESMF will thus be used as a
       practical tool during project implementation.
   ï‚·   The screening process will be conducted in line with the prescripts of the World
       Bank Safeguard Policy (OP 4.01 Environmental Assessment), which requires
       that all Bank-financed operations are screened for potential environmental and
       social impacts, and that the required environmental work will be carried out
       based on the screening results, which may indicate the following:
           o That no additional environmental work would be required;
           o The application of simple mitigation measures by qualified staff would be
               sufficient;
           o That a separate environmental impact assessment (EIA) would be
               required in keeping with applicable environmental laws and regulations in
               Angola;
           o That there must be an appropriate Environmental and Social Management
               Plan (ESMP);
           o That a Healthcare Waste Management Plan ought to be prepared.

Components of the Project

   5) The first component entails improving the quality of health services in target
      Provinces (for an estimated budget of US$65.0 million). This component would
      entail supporting activities at the provincial and municipal levels to improve the
      quality of healthcare services as well as the development of a results-based
      financing (RBF) pilot in two selected provinces (US$10.0 million).



                                                                                      14
          a. The first sub-component of this project is on the improvement of the
             quality of maternal and child healthcare services at the provincial and
             municipal levels.
          b. The second subcomponent entails piloting RBF (US$10.0 million) to
             support the delivery of healthcare services through a performance focus at
             the provincial and municipal level contexts.

   6) The second component of the project entails strengthening the stewardship of
      the National Health System (NHS) to support the delivery of quality health
      services (US$25.0 million). This component aims at strengthening institutions
      across the national health system to improve the quality and coordination of
      healthcare services delivered at the municipal, provincial, and national levels.

   7) The third component aims to support the capacity to respond to and prevent
      public health emergencies through the provision of surge funding to finance
      response efforts directed at preventing outbreaks from potentially becoming
      deadly pandemics. This component will only be triggered in case of public health
      emergencies and when certain actions agreed to by the Government and Bank
      teams are met/ not met. This component resembles an emergency response
      plan of sorts which will only be triggered during cases of emergencies and will
      detail response actions and measures to be implemented during such
      emergencies.

   8) The fourth component is Project Management, Monitoring and Evaluation
      (US$10M). This component supports project implementation by the Ministry of
      Health (MoH), including project management, fiduciary tasks, as well as
      Monitoring and Evaluation (M&E).

Project beneficiaries

The HSPSP will target women of reproductive age and children under the age of five in
21 municipalities in seven provinces. The provinces and their respective municipalities
are the following: (i) Bengo (Ambriz and Dande; (ii) Luanda (Icolo e Bengo); (iii) Lunda
Norte (Chitato, Cambulo, Cuango, and Lucapa; (iv) Malanje (Cacuso, Calandula,
Malanje, and Caculama); (v) Moxico [Comanongue, Luau, and Luena (Moxico)]; (vi)
Uige (Maquela do Zombo, Negage, Sanza Pombo, and Uige); (vii) Cuando Cubango
(Cuito Cuanavale, Mavinga, and Menongue).

The population of these 21 municipalities represent a total of 3.8 million people
comprise about 13.5 % of the population of Angola. The project aims to improve the
performance of 288 primary health care facilities (i.e. 117 health posts, 93 health


                                                                                     15
centres and 22 municipal hospitals) in the target municipalities. The 288 primary health
care units identified represent about 70% of existing health units in the 21 municipalities
as it was not possible to cover all facilities.

The criteria and considerations used were as follows:
   ï‚· All the Municipal Hospitals were considered
   ï‚· A large part of the Health Centres and Maternal and Child Health Centres were
       considered
   ï‚· General Hospitals were excluded (not considered as primary units, especially
       when there are Municipal hospitals);
   ï‚· Some stations and health centres were excluded (in some provinces such as
       Moxico and Malange stations are serve a small population and involve long
       distances making them inaccessible)
    Kuando-Kubango – These are estimated numbers as a survey has not been
       done because it is a new province for the project.



                   Units     70% of Units                              Municipal
     Province Considered Considered                 Posts   Centres    Hospitals    Total
     Luanda               24          16                11         4            1       16
     Bengo                39          27                19         6            2       27
     Lunda N.             45          31                19         7            5       31
     Moxico               50          35                19        14            2       35
     Malange              50          35                  9       22            4       35
     Uige                 80          56                22        30            4       56
     K. Kub.             *40          32                18        10            4       32
     Total              288          232               117        93           22      232
     * Estimated number

TABLE 2: HEALTH FACILITIES THAT ARE PART OF THE HSPSP IN ANGOLA


Institutional arrangements

This project will be implemented in a collaborative fashion involving several institutions
working together. The MoH will have overall responsibility for project implementation.
The National Department of Public Health (DNSP) will be responsible for the day-to-day
implementation of the project. A specific Project Coordination Unit (PCU) within the
MOH will be established that will be physically housed in the DNSP offices. The PIU
will consist of MoH staff who will occupy the following roles: a Project Director who
reports to the National Director of Public Health, a Project Coordinator, an RBF Project



                                                                                             16
Coordinator, an M&E Specialist, a project Financial Management (FM) Specialist, and a
Procurement Specialist, who all report to the Project Director. In addition, to further
support the fiduciary capacity, the PIU will include two finance staff and a Procurement
Assistant. This institutional arrangement deviates from that established under the
current Municipal Health Services Strengthening Project as it aims to build the PCU
capacity within the MoH in a two-fold manner, by being housed within the MoH and not
externally, and by incorporating MOH staff to take on key PIU roles and functions
instead of relying primarily on international consultants. To support the MOH in
establishing and building the PIU capacity within the MOH, the project will finance
international consultants in the areas of Financial Management and Procurement for a
six-month to one-year period who will train the MOH staff who will take on these
positions with the PCU. The project FM Specialist to be recruited will train the two MOH
finance staff to be deployed at the PCU, where one of them will be selected to take over
the position of project FM Specialist within a period between 12 to 24 months.
Furthermore, the PIU team will be supported by technical staff of the MOH for each
specific technical area of the project, such as health financing, public health, human
resources for health, health information systems, epidemiology, among others. In
addition, an RBF coordinator will manage the RBF aspect of the project.

Figure 14 below provides a visual overview of the MOH structure that will support and
implement the project.




The MoH have indicated to the WB that they do not have fiduciary capacity and
highlighted this as a risk to the project. The Bank will outline mitigation measures to
build this capacity in the MoH. This will need to be done jointly with environmental
capacity through the appointment of a resource who will oversee the implementation of

                                                                                     17
the ESMF/ESMP and specific EMPs for EIA studies that may be prepared for specific
projects that will implemented to upgrade infrastructure or for those cases where new
infrastructure (i.e. laboratories) need to be built.

The role played by the MoE will be that of advising the MoH (through the PIU) with the
identification of projects and activities that require licensing as per the ESMP or project
specific EMPS. Specifically, the MoE or the appointed environmental specialist will
advise on the environmental framework as per the ESMF as well as the protocols for
project implementation to maximise environmental compliance and sustainability. All
proposed development projects will need to be subjected to screening to determine the
need for licensing or subjected to the mitigation measures identified in cases where no
licensing is required.

Public consultations

Public consultations will be carried out in selected sites in all 21 municipalities targeted
by the HSPSP, with the objective of gathering public perceptions of the proposed
improvement of healthcare facilities as well as maternal child healthcare services. The
consultation process will comprise the following methods: (i) consultations on a one-to-
one basis with key stakeholders (officials from line ministries, national organizations,
NGOs, the World Bank and technical staff from targeted provinces), (ii) public meetings
to be held in the municipalities, (iii) as well as focus group meetings or consultations
with specific communities who require focused attention or innovative consultation
sessions.

The objective of the consultation process will be to gather the general perceptions and
views of all relevant stakeholders (project affected persons as well as interested
persons) on the proposed project(s). Among others, the Consultants will seek to identify
and confirm conditions in the different provincial and local contexts where the
healthcare facilities are in place or will be established, as well as determine specific
impacts that will need to be addressed under the scope of the present ESMF.

World Bank Safeguard Policies

The World Bank Safeguard Policies (OPs) are mandatory to obtain financial support for
projects that are geared to poverty reduction and improvement of livelihoods and
socioeconomic conditions in underprivileged communities. Environmental impacts
envisaged under the HSPSP are minimal given that the project plans to improve access
to healthcare services already being provided by health centres. For the most part, this
will include equipment and medical supplies which may trigger the need for disposal of
medical waste (i.e. hazardous) in line with applicable policies and guidelines.


                                                                                         18
Although improvement of healthcare facilities or the provision of new facilities (i.e.
laboratories) is expected to cause minimal environmental and social effects, it is
important that these are addressed in the ESMF or as part of any EIA projects that may
need to be conducted based on the specific requirements of such projects. The
screening checklist provided in the Annexes will provide guidance in terms of the need
for EIAs or if activities can proceed following the implementation of mitigation measures
and guidelines provided in the ESMP. The specific OP triggered by activities under the
HSPSP is OP 4.01 (Environmental Assessment).

The ESMF provides practical tools for preparing and/or implementing Environmental
and Social Management Plans (ESMPs), with the preparation thereof described in
separate documents prepared in parallel to the present ESMF.

Angola Environmental and Social Management Legal Framework

A summary of environmental and social related policies, laws and regulations in Angola,
particularly those of relevance to the Project has been included in the present ESMF.
Relevant legislation in Angola include the following:

   ï‚·   The Constitution of the Republic of Angola (2010)
   ï‚·   Environment Framework Law 5/1998.
   ï‚·   Water Law 6/20002
   ï‚·   Land Law 9/2004
   ï‚·   Land Use Planning and Urban Development Act 3/2004
   ï‚·   Biological and Aquatic Resources Act 6/2004
   ï‚·   Petroleum Activities Act 20/2004
   ï‚·   Decree on Environmental Impact Assessment 51/2004
   ï‚·   Decree on Environmental Licencing 59/2007
   ï‚·   Environmental Damage Regulations 194/2001
   ï‚·   Decree on Environmental Audits 1/2010
   ï‚·   Decree on Environmental Protection for the Oil Industry 39/2000
   ï‚·   Decree on Environmental Protection for Petroleum Activities 10/2000
   ï‚·   Fisheries Act 20/1992.
   ï‚·   Labour Law
   ï‚·   Regulations on Contracting for Public Civil Works
   ï‚·   Public Consultation Regulations

Angola’s EIA is regulated by the Environmental Framework Law. Article 16 of the
Environmental Framework Law makes provision for mandatory IEAs and the Decree on


                                                                                      19
Environmental Impact Assessment 51/2004 and the process to be followed. Article 17
deals with licensing, article 18 with auditing, both of which are based on steps similar to
those developed by the World Bank. There are four categories of projects, namely:
Category A+ which require a full EIA to be undertaken and supervised by Independent
Specialist Reviewers with verifiable experience; Category A which require a full EIA;
Category B which require a simplified Environmental Study as the potential impacts of
projects in this grouping are considered less significant or require less complex
mitigation measures; and Category C which do not require an EIA but must abide by the
regulations on environmental impact. These are broadly aligned to the World Bank
categories.

The Ministry of Environment (MoE) is responsible for issues related to environmental
management at all levels (national, provincial and district), with the assistance of the
Directorate for the Prevention and Evaluation of Environmental Impacts (DNPAIA), who
evaluate reports received and forward to the MoE with recommendations on whether an
Environmental Licence is required or not.

Gaps in the Angola legal Framework and World Bank Safeguard Policies

The major gap between the Angolan legislation and the World Bank Safeguard Policies
is the lack of clear procedures and norms for handling health, safety and security of
both the local population of a project area and/ or the project workers. The Angolan
legislation does touch on safety in the workplace, but does however fall short in terms of
making specific provisions for projects such as specific activities that will fall under the
HSPSP. To bridge the gap on procedures for health, safety and security, the World
Bank Group Environmental Health and Safety Guidelines (2007)1 are recommended to
guide the project proponent throughout all phases of implementation of the project, and
to provide some guidance on suitable mitigation measures that should be taken.

Potential environmental and social impacts and mitigation measures

Because activities related to the implementation of the HSPSP entail improvement of
access to healthcare services as well as construction or upgrade of laboratories on
already-existing sites, no land acquisition or negative impacts on important habitats are
envisaged. Most of the impacts anticipated can be sufficiently catered or by the generic
mitigation measures proposed in this ESMF. It is possible that some activities such as
the construction or renovation of laboratories may trigger EIA studies that would include
more detailed EMPs addressing specific mitigation measures that will guide project
implementation.
1
    World   Bank   Group      EHS   2007:   http://www.ifc.org/wps/wcm/connect/554e8d80488658e4b76af76a6515bb18/Final%2B-
%2BGeneral%2BEHS%2BGuidelines.pdf?MOD=AJPERES



                                                                                                                     20
Activities and subprojects under the HSPSP project have been assumed to be Category
B projects as all potential impacts for the sub-components or project activities are
considered site-specific, reversible or amenable to management actions, and in all
cases mitigation measures can be readily designed. Some of the generic environmental
and social impacts include, but are not limited to the following: soil erosion (resulting
from vegetation clearance and excavations of soils where there is rehabilitation or
construction of new sites); dust and air pollution; solid and liquid waste generation and
the treatment or disposal thereof; medical (healthcare) waste and the need for treatment
or disposal thereof; risks of infections for healthcare personnel; risks of spread of
diseases such as increases in HIV/AIDS rates as a result of the influx of temporary
workers into project sites; incidents and accidents in the workplace; as well as noise
and vibrations and social conflicts, amongst others.

Although some negative environmental and social impacts are expected from this
project, there are also some significant positive impacts that may counteract the
negative ones. The positive impacts include: improved health status in Angola, safe and
healthy environments, improved livelihoods and economic stimulation as a result of a
much healthier population, amongst others.

Environmental and Social Management Framework Monitoring Requirements

Monitoring and reporting on progress are critical for the successful implementation of
the EMSF as well as of the overall HSPSP project. Reporting is based on a set of
indicators which should be reported on, on a regular basis with specific responsibilities
and indicators set out here which will be mainstreamed into the overall monitoring and
evaluation (M&E) system for the project. The specific objective of the monitoring
process is to ensure that the ESMP is complied with and verified at all levels and stages
of the project implementation cycle. Monitoring shall be a continuous process and
should include the status of compliance as well as achievement of the objectives of the
project.


Given the number of institutions involved in the implementation of the HSPSP, it is
recommended that an inter-institutional coordination team, with the support of the
Steering Committee, coordinates and liaises with other relevant government institutions
with regards to environmental and social monitoring of the project. Weekly, monthly,
quarterly and annual reports shall be prepared and distributed to all relevant entities.

The ESMF implementation and monitoring should be carried out by each of the project
proponents, in conjunction with provincial and local authorities, and following


                                                                                      21
consultation with affected persons. Annual reviews of the implementation of the ESMF
will be carried out by an independent local consultant, NGO or another service provider
that is not involved in the HSPSP, subject to agreement by the Steering Committee and
the World Bank. Independently-commissioned bi-annual environmental audits should be
carried out.

Environmental and Social Screening Process

The screening process is aimed at determining which of the project activities are likely
to result in significant negative environmental and social impacts, with a view to
determining appropriate impact mitigation measures for such activities, and to ensure
environmental sustainability of sub-projects undertaken in the Project areas.

The screening process for this project consist of four steps: i) review of environmental
and social impacts checklist for projects; ii) screening of impacts from the sub-
components and sites; iii) assignment of environmental categories; and iv) preparation,
review and approval of an Environmental Action Plan.

The screening process will be carried out using a screening form to be attached to the
Annexes of this ESMF. The safeguards that have already been established by the
specialist team in the implementation units will be responsible for carrying out the
environmental and social screening process in close collaboration with DNPAIA and the
MoH/the Project Coordination Unit (PCU) within the MoH.

Training and Institutional Capacity Development Needs

The WB has already identified the need for institutional capacity in the MoH, especially
for the PCU especially with regard to Project Financial Management or other aspects of
the project t (i.e. environmental management). We propose that dedicated sessions be
held with the PCU to advise and induct them on the ESMF and any EMPs or ESMPs
that will accompany this ESMF. In addition, such training should focus on Environmental
process that is party of this ESMF to enable officials to better understand their
responsibilities for the implementation of projects. Specifically, the induction/training will
focus on:
    ï‚· Identifying and training relevant personnel at all levels who will be responsible for
        monitoring of ESMPs at site, district and provincial levels;
    ï‚· Ensure effective intra-institutional coordination to satisfy appropriate
        implementation of the proposed mitigation measures for continued improvements
        in environmental and social management.




                                                                                           22
For an effective integration of the proposed mitigation measures into planning,
implementation and operation of the program’s activities, the implementation of the
Project’s EMP is the responsibility of the project proponents (MoH, through the PCU, as
well as the Provinces and the respective municipalities) who will ensure compliance with
all measures stipulated in the ESMP by stakeholders. Furthermore, it should be
mandatory that all contractors and supervisors employ experienced Environmental
Specialists to ensure compliance with the ESMF/ESMP.

Conclusions and Recommendations

It is expected that the negative environmental and social impacts associated with the
project and activities that will be undertaken as part of the HSPSP will be low to short-
term, localised to short-term, mostly insignificant, and can be mitigated through
compliance with this ESMF and relevant EIA Regulations and prescripts (where
relevant) as well as the Environmental and Social Management Plan (ESMP). Specific
measures that should be implemented by Contractors have been outlined, which should
form part of the Contractors’ contract and subsequent EMPs.




                                                                                      23
1    INTRODUCTION

Decades of civil war and strife following the end of colonial rule in Angola left the
country in a dire state without a properly functioning healthcare system. Evidence for
this is in the form of a reportedly poor healthcare infrastructure and very lopsided health
metrics (i.e. high child mortality rates, high maternal mortality rates, high prevalence of
underweight children, as well as high fertility rates which are higher than those of other
countries in sub-Saharan Africa – see Table 3). In addition, Angola has very poorly
developed agricultural infrastructure, as well as lack of decent roads and dilapidated
buildings owing to lack of investment during the many years of the prolonged civil war.
The state of infrastructure, as with that of other useful socioeconomic metrics, lags that
of comparable countries in sub-Saharan Africa and even among so called Lower Middle
Income Countries (LIMC), of which Angola is a member.

The focus of this study is the health sector in Angola and hence the statistics quoted will
be primarily on the healthcare sector.

TABLE 3: HEALTH STATUS INDICATORS FOR ANGOLA
Indicator          Measure                      Angola                   Sub-Saharan Africa
                                       Source              Data        Source       Data (year)
                   Life
Life                                                38 (male)                      47 (male)
                   expectancy at    WHO 2004                        WHO 2004
expectancy                                          42 (female)                    49 (female)
                   birth
                   Infant deaths    MCS 2001        115.7
Infant mortality
                   per live 1,000                                   WDI 2009       79 (2007)
rates
                   births           IBEB 2008       150
                   Child deaths     MICS 2001       250
Under 5
                   per 1,000 live   WDI 2007        158             WDI 2009       124.9 (2007)
mortality rates
                   births           IBEP 2008       195
                   Maternal
                                    UNDP 2007       1,400 – 1,700
Maternal           deaths per
                                                                    WDI 2009       832 (2005)
mortality ratio    10,000 live
                                    WDI 2009        1400
                   births
                   Number of
                   babies per       WHO 2004        6.7
                   woman
Fertility rates    through the                                      WDI 2009       4.9 (2007)
                   end of
                   childbearing     UNICEF 2007     5.8
                   period
                   Low weight by
Prevalence of                       MICS 2001       31%
                   age > 2
underweight
                   standard                                         WHO            24.9 (2001)
children >5
                   deviation from
years                               UNICEF 2007     16%
                   average



                                                                                                  1
               Prevalence of
HIV            HIV among         UNGASS
                                              2.0%            UNAIDS 2008     5.7 (2007)
prevalence     adults (15 –      2010
               49-year-old)
Source: Connor Catherine, Denise Averbug, and Maria Miralles. July 2010. Angola Health System
Assessment 20/20, Abt Associates Inc.

TABLE 4: POPULATION AND DEMOGRAPHIC STATISTICS FOR ANGOLA VS AFRICA FOR THE YEAR 2017

Year 2017                             Angola                                 Africa
% change                   3.37                          2.55
Yearly change              970,730                       31,197,515
Migrants                   0                             -462,112
Median age                 16.5                          19.4
Fertility                  5.58                          4.66
               2
Density (p/km )            24                            42
Urban population %         37.1                          40.2
Urban population           11,047,226                    505,429,407
Country share of world 0.39%                             16.6%
population (%)
Global rank                48                            2
Source: http://www.worldometers.info/world-population/angola-population/

Public spending on health and infrastructure has decreased since 2013 owing largely to
dependence of the country on earnings from the petroleum sector. The extended period
of lower oil prices over the past year or so has put pressure on the revenue of the
Angolan government (which is still dependent on oil in the absence of meaningful
economic diversification), resulting in added pressure on the delivery of services and
reconstruction efforts. It is worth noting that countries with a similar economic profile to
that of Angola (i.e. Nigeria, Venezuela – government revenues are dependent on
earnings from oil) have been similarly affected. This means there is less money for
investment in important social infrastructure and services such as education,
healthcare, etc. Unfortunately, these are the areas that need priority investment in a
country such as Angola, which desperately needs assistance in reducing poverty and
rebuilding infrastructure damaged during the long-drawn-out civil war.

1.1    Project description

The Health System Performance Strengthening Project (HSPSP) arises out of funding
received by the Angolan Government from the World Bank for the Municipal Health
Services Strengthening Project (PRSMS, P111840). The PRSMS is a USD $70.8
million project (which was approved in 2010 and due to come to an end in 2018), to


                                                                                           2
improve the population’s utilization of maternal and child healthcare services in Angola.
The project has had some successes in the way of improved health services in Angola
such as in improved immunization and antenatal care at provincial and municipal levels,
personnel who received training in obstetric and neonatal emergencies, the integrated
management of childhood illnesses, as well as monitoring and evaluation.




FIGURE 1: CONTEXT MAP OF ANGOLA SHOWING THE 18 PROVINCES INTO WHICH THE COUNTRY HAS BEEN DIVIDED.



                                                                                               3
The PRSMS targeted 18 municipalities in six of Angola’s 18 provinces (i.e. Luanda,
Bengo, Malange, Lunda Norte, Moxico and Uige), which collectively have an estimated
population of 2.1 million of the target population in the country (i.e. the population of the
country is currently estimated at 26,655,5132). In the six provinces targeted by the
project, there was notable improvement in healthcare service delivery at the primary
level as confirmed by increased births with skilled attendants, as well as an increased
number of children receiving vaccines (i.e. the pentavalent vaccine). The PRSMS
included capacity building and training of over 2,000 personnel in areas such as
emergency neonatal and obstetric care, integrated management of childhood illnesses,
as well as management, monitoring and evaluation. The lessons and experiences
garnered from the PRSMS ought to be replicated in the other provinces in the country in
the HSPSP project and subprojects.

To protect people and the biophysical environment from negative impacts and minimize
the potential damage of such impacts on the environment, the HSPSP will be guided by
an ESMF and a separate HWMP. The ESMF will outline the institutional arrangements
and related environmental training needs for the implementation and monitoring of the
mitigation measures of anticipated projects’ environmental and social impacts.

Potential environmental impacts will be addressed in the context of this ESMF,
especially to do with expected investments in the renovation of existing healthcare
infrastructure and facilities (i.e. such as laboratories), as well as the construction of new
infrastructure/facilities. Project activities are not expected to result in loss of livelihoods
or loss of access to economic assets (i.e. access to improved healthcare services is
expected to be in already existing sites), meaning that no land acquisition or any
negative impacts on important natural habitats is envisaged as a result of project
activities associated with the HSPSP. However, as the government entails scaling up
the delivery of healthcare services to 21 municipalities in 7 provinces in the country
under the current Project and to also include municipalities in the Huila and Moximo
Provinces (i.e. which reportedly contains San Populations that may be impacted upon
by the Project), a separate public consultation process will be required. The purpose of
the public consultation process will be to assess the presence of Indigenous People in
the new Municipalities targeted by the project, as well as preparing an Indigenous
People Policy Framework (IPPF) for those cases where the presence of indigenous
peoples (i.e. the San) is confirmed.

The potential environmental and social impacts associated with the Project have been
highlighted, and suitable mitigation measures to offset the potential negative impacts
have been recommended to the project proponent. Recommendations have also been

2
    https://www.populationpyramid.net/population-size-per-country/2017/


                                                                                             4
made with regards to the need to improve the institutional capacity of the entities
responsible for each of the sub-components to continue integrating environmental and
social considerations in the related projects.

1.2     Project Implementation Arrangement

The Successful implementation of projects identified in the HSPSP will follow the
framework laid out in this ESMF to contain or minimise any negative environmental and
social effects that may arise.

This will require coordination between all the groups/stakeholders with interest in the
success of the projects. Among others, the key stakeholders will involve the Ministry of
Environment (i.e. who has overall responsibility for environmental sustainability and for
ensuring that subprojects are licenced and guided by conditions in the ESMP); the
Ministry of Health (who will have overall responsibility for the HSPSP), through the
National Department of Public Health (DNSP) who will be responsible for the day-to-day
implementation of activities and subprojects under the HSPSP, some of which will
require licensing or to follow appropriate environmental protocol; as well as Provincial
Administrations and Municipalities who will be the primary beneficiaries of the
healthcare projects. It is expected that National Governmental Organisations (NGOs)
and funding faith-based groups will also be important as well and will need to be
identified during project screening.

We envisage an active role for the MoE or a dedicated resource (i.e. Environmental
Control Officer) appointed to advise the PIU on environmental measures identified in the
ESMF and the HCWMP, which will be a separate document focusing purely on medical
waste generated as part of activities related to improved access to medical services.
These sets fop documents can provide a basis for determining whether licensing is
required for specific project activities or whether the generic mitigation measures
provided are sufficient to guide project implementation (in cases where no EIAs are
required).

1.3     Objectives of the Environmental Social Management Framework (ESMF)

The Project Development Objective (PDO) is to increase the utilization of and the
quality of healthcare services in target provinces and municipalities across Angola.

      1) The first component entails improving the quality of health services in target
         Provinces (for an estimated budget of US$65.0 million). This component would
         entail supporting activities at the provincial and municipal levels to improve the



                                                                                         5
      quality of healthcare services as well as the development of a results-based
      financing (RBF) pilot in two selected provinces (US$10.0 million).

          a. The first sub-component of this project is on the improvement of the
             quality of maternal and child healthcare services at the provincial and
             municipal levels.
          b. The second subcomponent entails piloting RBF (US$10.0 million) to
             support the delivery of healthcare services through a performance focus at
             the provincial and municipal level contexts.



Comment: Interventions to improve the level of healthcare service provided involves
renovations of already-existing sites and provision of vaccinations and medical
services/supplies to hospitals and clinics. This will not involve activities which are
going to have a detrimental effect on the environment and may in fact have a positive
effect on the overall status of health and economic wellbeing in Angola.



   2) The second component of the project entails strengthening the stewardship of
      the National Health System (NHS) to support the delivery of quality health
      services (US$25.0 million). This component aims at strengthening institutions
      across the national health system to improve the quality and coordination of
      healthcare services delivered at the municipal, provincial, and national levels.



Comment: Strengthening the NHS involves coordination of services provided by the
MoH, Provinces, and Municipalities in the provision of healthcare services. Among
others, this involves coordination and sharing of resources among primary healthcare
service providers such as municipal healthcare units, health posts and health centres.



   3) The third component aims to support the capacity to respond to and prevent
      public health emergencies through the provision of surge funding to finance
      response efforts directed at preventing outbreaks from potentially becoming
      deadly pandemics. This component will only be triggered in case of public health
      emergencies and when certain actions agreed to by the Government and Bank
      teams are met/ not met. This component resembles an emergency response
      plan of sorts which will only be triggered during cases of emergencies and will
      detail response actions and measures to be implemented during such
      emergencies.

                                                                                         6
   4) The fourth component is Project Management, Monitoring and Evaluation
      (US$10M). This component supports project implementation by the Ministry of
      Health (MoH), including project management, fiduciary tasks, as well as
      Monitoring and Evaluation (M&E).

The project components are focused primarily on improving the quality of healthcare
service in healthcare facilities across Angola. Over and above improving the capacity of
institutions and the personnel who deliver the service, a key issue of concern is the
extent to which healthcare workers and society in general can be exposed to medical
waste as well as the appropriate treatment or disposal thereof. Although renovations
and upgrades of equipment/facilities may be necessary in already-existing sites, this will
be undertaken in line with generic mitigation measures outlined in this ESMF and it is
considered unlikely that there will be a need for environmental licensing preceded by
detailed Environmental Impact Assessment applications.




                                                                                        7
2   METHODOLOGY USED TO PREPARE THE ENVIRONMENTAL AND SOCIAL
    MANAGEMENT FRAMEWORK (ESMF)

The ESMF was prepared on the basis of extensive literature on environmental and
social conditions in Angola as well as lessons learned from studies conducted in the
country over the years. It must be acknowledged that information sources were limited
as there was a dearth of reliable information during the years of protracted civil war in
the country. Lesson learned from projects implemented in other countries in the SADC
region (i.e. Mozambique, South Africa) were taken into account in the preparation of this
report.

The review of legislative context of Angola provided a means of comparing
requirements in the country against the benchmark of World Bank policies and
sustainability guidelines. Benchmarking country legislation and regulations against WB
Safeguards is a key requirement of all world Bank funded projects.

Although not conducted yet up to this point, we have made provision for extensive
stakeholder engagements to be followed when finalising this ESMF to garner input from
stakeholders across the country. Necessarily, this will involve key stakeholders such as
government departments and provinces/municipalities, NGOs, research institutes,
communities in the affected communities or the target project areas, with overall
guidance and direction provided by the World Bank who are the funders of the project.
In summary, the key stages in the preparation of the ESMF included the following:

    1) Extensive literature review on environmental and social conditions in Angola to
       gather lessons and the overall framework of the project;
    2) Review of the legislative framework for Angola against the World Bank and IFC
       sustainability framework/guidelines;
    3) A public participation framework designed to feed into the project and garner
       input from interested and affected parties;
    4) Preparing the ESMF and ESMP as well as screening tool to consolidate
       information and inform implementation framework for the identified project (s).




                                                                                       8
3     OVERVIEW OF ANGOLA’S ENVIRONMENTAL POLICIES, LAWS,
      PROCEDURES, REGULATORY AND ADMINISTRATIVE FRAMEWORKS

3.1    Environmental Framework Legislation for the Republic of Angola

The Constitution of the Republic of Angola (Lei Constitucional da República de Angola)
was first signed into law in 1992, replaced in 2010, and provides the basis for the
Environmental Framework Act through Article 39. Article 39 enables environmental
protection and conservation, and the right to a healthy and unpolluted environment
(SADC Environmental Legislation Handbook, 20123).

In further detail, Article 39 (Environmental rights) provides that:

      1. Everyone has the right to live in a healthy and unpolluted environment and the
         duty to defend and preserve it.
      2. The state shall take the requisite measures to protect the environment and
         species of flora and fauna throughout the national territory, maintain the
         ecological balance, ensure the correct location of economic activities and the
         rational development and use of all natural resources, within the context of
         sustainable development, respect for the rights of future generations and the
         preservation of species.
      3. Acts that endanger or damage conservation of the environment shall be
         punishable by law.

The constitutional articles above are very important for the achievement of sustainable
development goals in the country. Owing to the history of Angola (i.e. being ravaged by
civil war for the better part of its post-liberation history), the achievement of sustainable
development goals is especially more important given the dire need to improve the
quality of life of people and the environment (and hence the need for the project to
improve the capacity of the health system). Indeed, the Articles are concerned with the
conservation and protection of natural resources, biodiversity and a healthy
environment, with a view to maintaining the natural ecological balance and meeting
basic human needs.

The Ministry of Environment is responsible for the development and coordination of the
country’s environmental policy and for implementing the National Environment
Management Programme (Programa Nacional de Gestão Ambiental (PNGA). As the

3
 Walmsley, B & Patel, S, 2011. Handbook on environmental assessment legislation in the SADC
region. 3rd edition. Pretoria: Development Bank of Southern Africa (DBSA) in collaboration with
the Southern African Institute for Environmental Assessment (SAIEA).


                                                                                                  9
authority responsible for the implementation of the Environment Framework Law, No.
5/98, the Environmental Licensing Law, No. 59/07, and all associated Regulations, the
Ministry is also responsible for the review and regulation of environmental impact
assessments (EIAs), which are a primary tool for sustainable development. Depending
on the type of project to be developed, the EIA report should also be approved by the
appropriate line ministry. This ensures that the EIA not only addresses the requirements
of the Environment Framework Law and the Decree on Environmental Impact
Assessment, but also relevant sectoral legislation.


3.1.1 The National Environmental Management Programme

The National Environmental Management Programme (PGNA). Finalised in 2009, with
the assistance of the United Nations Environment Programme (UNDP), the PGNA
emphasises the need for an environmental management strategy to protect the
environment, even though most of Angola’s natural resources are still largely intact.
Importantly, the Environment Framework Law recognises that the implementation of the
PNGA should be the responsibility of all sectors of government whose activities may
have an influence on the environment, all private individuals and organisations that
make use of natural resources, as well as those individuals who may use resources
unsustainably and cause pollution.


3.1.2 National Directorate for the Prevention and Evaluation of Environmental
      Impacts

Responsibility for EIA falls under the National Directorate for the Prevention and
Evaluation of Environmental Impacts (Direcção Nacional de Prevenção e Avaliação de
Impactes Ambientais), which, among other things, is responsible for reviewing and
commenting on draft EIA reports. The granting of an Environmental Licence for a
proposed project is based on the results and recommendations of the EIA for that
project. If required, the Ministry of Environment invites different institutions and
stakeholders to give comments and make suggestions on the final report. Although
there are efforts to identify partners for this process, the Ministry currently retains full
control of the EIA process, and there is no decentralization of decision-making to lower
government levels.

Important Decrees for environmental management and other relevant policies:

   ï‚·   The National Development Plan (PND) for 2013-2017 is the first medium-term
       plan elaborated in the framework of the new Constitution of Angola following



                                                                                         10
    approval of the Basic Law of the National Planning System. This Plan also
    includes a period of great importance for the country's future. It is at the mid-point
    of the National Long-Term Development Strategy "Angola 2025". Following
    efforts to redevelop the country after decades of civil war, Angola is entering a
    phase of modernisation and sustainable development premised on stability and
    growth, as well as respect for human life. The literacy and training of Angolans in
    technical and professional fields as well as high education has been identified as
    a basis for sustainable, equitable and rejuvenated development of Angola.
   Decree 39/00 on Environmental Protection for the Oil Industry (Protecção
    Ambiental para a Indústria Petrolífera). This decree was gazetted in October
    2000 and regulates environmental practices in the oil industry in the Angolan
    marine and terrestrial environments.
   The National Environmental Strategy (Estratégia Nacional do Ambiente (ENA).
    The Strategy is a guiding framework closely related to the PNGA, which aims to
    identify the main environmental problems in Angola and address them in order to
    achieve sustainable development goals. The ENA is geared to meet Angola’s
    needs but also reflects the goals and objectives of the United Nations
    Conference on Environment and Development. The ENA is seen by some as
    Angola’s ‘Agenda 21’.
   Angola 2025: Long-Term Strategy (Estratégia de Longo Prazo). This strategy
    document and reviews the significant challenges in Angola (i.e. very low human
    development, weak economy, inadequate health and education services,
    regional inequality, etc.) and establishes strategic options up to the year 2025.
    The plan considers the possible growth of various sectors and the main activities
    to realise this growth. The plan has been revised to include stakeholder
    aspirations and input.
ï‚·   Strategy to Combat Poverty (2003). The government has developed a strategy
    to combat poverty, following an ongoing process of reconstruction and national
    development. The overall objective is to improve the conditions of Angolan
    citizens, in particular those who are vulnerable, by getting them to participate
    actively in the socioeconomic development process.
ï‚·   National Biodiversity Strategy and Action Plan (2006). The government
    approved this Strategy (Resolution No. 42/06 of 26 July 2006) to guarantee the
    conservation and sustainable use of biological components to enable the fair and
    equitable sharing of the benefits of the use of biological resources. Its objective is
    to incorporate measures for the conservation and sustainable use of biological
    resources as well as the fair and equitable sharing of the benefits arising out of
    biological resources for the benefit of all Angolans.
ï‚·   The Environment Framework Law of 1998 (Lei de Bases do Ambiente), No.
    5/98 of 19 June 1998. This Act is based on Article 39 of the Angolan


                                                                                       11
    Constitutional Law and provides the framework for all environmental legislation
    and regulations in Angola. It gives the definitions of important concepts, such as
    the protection, preservation and conservation of the environment, the promotion
    of quality of life, and the use of natural resources. The Law incorporates the main
    international sustainable development declarations and agendas (e.g. Agenda
    21), and establishes citizens’ rights and responsibilities. Article 14 allows for the
    establishment of environmental protection areas and the setting of rules for those
    areas, including the identification of activities that would be prohibited or
    permitted in protected areas and their surroundings. Article 16 of the Law makes
    provision for mandatory EIAs for all undertakings that may have an impact on the
    balance and wellbeing of the environment and society. Clause 2 of this Article
    states that the government will develop more specific legislation on EIAs. This
    was accomplished when the Decree on Environmental Impact Assessment
    was passed in July 2004. Article 17 deals with the issue of environmental
    licensing and Article 18 with auditing. These steps are based on the guidelines
    provided by the World Bank.
ï‚·   Decree on Environmental Impact Assessment. The aim of the Decree on
    Environmental Impact Assessment (Decreto sobre Avaliação de Impacte
    Ambiental), No. 51/2004 of 23 July 2004, is to ensure better environmental
    protection, particularly in terms of human activities likely to have an impact on the
    environment (such as mining, civil construction and the exploration of natural
    resources), by� a) Providing regulations to supplement the Environment
    Framework Law on EIAs, in particular on the procedures and mechanisms to be
    used in EIAs; b) Establishing norms for conducting an EIA for public and private
    projects, which, due to their nature, dimension or location, might have significant
ï‚·   environmental and social impacts; and c) Establishing which projects should be
    subject to an EIA, what elements are to be included in the EIA, the nature and
    extent of public participation, the entity responsible for compliance with these
    legal requirements, and the EIA monitoring process.
        o Article 3: Provides definitions, including what is meant by environmental
           audit, EIA, Environmental Impact Study, public consultation, etc.;
        o Article 4: Indicates which projects require an EIA and which might be
           exempted from an EIA, such as those aimed at national defence and
           security;
        o Article 6: Indicates the kind of information that needs to be included in the
           EIA;
        o Article 10: Explains the procedure for public consultation and indicates
           that the costs of such consultations should be covered by the project
           proponent;
        o Article 16: Indicates what is considered an infraction of this Decree;


                                                                                      12
           o Article 17: Sets out the penalties for various offences; and
           o Article 22: States that environmental audits shall be conducted.
           o Article 7 of the Environment Framework Law does, however, refer to the
               development of a National Environmental Management Plan and its
               implementation.
   ï‚·   Decree on Environmental Licensing. Decree No. 59/07 on Environmental
       Licensing came into force on 14 October 2007. This Decree provides additional
       legislation to supplement Decree No. 51/04 on EIAs by providing guidance on
       topics such as: which project should be subject to an EIA; what elements are to
       be included in an Environmental Impact Study; the nature and extent of public
       participation; the entity responsible for compliance with these legal requirements;
       and the EIA monitoring process. It also indicates that only Angolan-registered
       environmental companies can submit an Environmental Impact Study for
       approval.
   ï‚·   Environmental Damage Regulations. Decree 194 of 2011 is titled
       Environmental Damage Regulations. It is applicable to all sectors, including the
       petroleum and mining industries. Highlights of the Regulations include the
       following: a). The polluter pays principle; b). Strict liability (regardless of
       culpability) for environmental damage; c). Powers of the regulatory authority (the
       Ministry of Environment) to prevent or reduce the risk of environmental injury,
       including requiring businesses to develop prevention programmes and make
       disclosures in case of an imminent threat to the environment; d). Financial
       guarantees being payable for remediation or compensation of environmental
       damage in the form of insurance policies, bank guarantees, company reserves or
       other mechanisms; e). Individuals and non-governmental organisations granted
       legal standing to pursue legal action (including class action suits) to avoid,
       remedy and/or obtain compensation for environmental damage; and f). Strict
       penalties, including fines that can reach US$100 million, as well as cancellation
       of Environmental Licences.


3.1.3 Permits and licences

In terms of Chapter 2 of the Decree on Environmental Licensing, the following
licences are required:

   a) An Environmental Licence is required for all activities that, because of their
      nature, location and scale, may have a significant environmental or social impact.
      The Environmental Licence is issued on the basis of the findings of an EIA and is
      required before the issuance of any other permits or licences under other laws.



                                                                                       13
   b) An Environmental Installation Licence is issued by the Ministry of
      Environment to authorise the setting out and change of works, in accordance
      with the specifications contained in the project.

   c) An Environmental Operations Licence is a document issued by the Ministry of
      Environment, which, subject to verification of compliance with all the
      requirements of the Environmental Impact Study, permits an undertaking or
      activity to operate and allows for the integration of the activity into the area of
      interest.


3.1.4 Offences and penalties

In terms of Article 26 of the Decree on Environmental Licensing, a person who
constructs, implements or alters any installation without an Environmental Installation
Licence, or anyone who alters a system of production without the relevant licence, will
be liable of an offence and subject to a fine. The fines are based on the value of the
project, as follows:

Value of project                                               Quantum of fine
Less than Kz 90,000                                            10%
More than Kz 90.000 and less than Kz 500,000                   7%
More than Kz 500,000 but less than Kz 1,000,000                5%
More than Kz1,000,000                                          3%

In addition, the competent authority can suspend, embargo or interdict the operation or
activity, and notify the public ministry and the line ministry accordingly ( Article 27).
Article 16 of the EIA Decree specifies the following as offences that are liable to a fine
ranging between US$1,000 and US$1 million, depending on the seriousness of the
case:

   •   The installation, start-up or extension of an activity in breach of the EIA Decree
       and any related Regulations;
   •   Obstruction or non-collaboration with the environmental auditing team, as per
       Article 22(5);
   •   Breach of the conditions of the Environmental Licence; and
   •   Non-compliance with the recommendations of the Environmental Impact Study.

In addition, offenders may have their machinery or equipment seized, have their
operations closed down, and/or be prevented from tendering for government contracts
(Article 17). Decree No. 1/10 on Environmental Audits specifies that penalties


                                                                                       14
payable for offences are a minimum of US$1000 and a maximum of US$1 000 000 for
any of the following:
   • Obstruction of or failure to cooperate with registered environmental auditors;
   • Non-compliance with the recommendations of a previous audit;
   • Working without complying with environmental regulations; and
   • Acting as an environmental auditor without being registered.


3.1.5 EIA Guidelines

Most major development projects make use of the World Bank guidelines in order to
fulfil country and lender-specific requirements.

In terms of Article 29 of the Decree on Environmental Licensing, only specialists
and mid-level or senior technical staff registered in terms of the Decree may perform
EIAs in Angola. Individual environmental consultants, environmental consulting
companies and consortia may register with the Ministry of Environment. A certificate of
registration will be issued within 30 days of the date of receipt of the application. In
order to register, the individual applicant must submit the following, in terms of Article
30: a) Name, nationality, profession, office location, residential address and tax number;
b) Academic and professional registration certificates; c) Curriculum vitae listing
environmental consulting experience and knowledge of the environmental situation in
Angola; and d) A declaration that s/he is not an employee of or contractor to the
competent authority.


3.1.6 EIA procedure in Angola

The Environment Framework Law establishes a broad rationale for the kinds of projects
that are subject to an EIA, stating that an EIA is compulsory when actions “interfere with
the social and environmental equilibrium and harmony�. Activities are listed in the Annex
to the EIA Decree and are categorised according to the following sectors:

   •   Agriculture, fisheries and forestry;
   •   Extractive industries, such as petroleum, mining and dredging;
   •   Energy industry;
   •   Glass industry;
   •   Chemical industry;
   •   Infrastructure projects; and
   •   Other projects.




                                                                                       15
No scoping phase is required for projects in Angola. The EIA Decree specifies the
activities that are required during the EIA process, as well as the contents of the EIA
report. The activities required as part of the Environmental Impact Study are set out in
Articles 6 and 7 of the EIA Decree. The Environment Framework Law (Article 16) and
the EIA Decree (Article 9) specify the following contents of an EIA report:

   •   A non-technical summary of the project;
   •   A description of the planned activities, including all technological alternatives as
       well as the no-go option;
   •   A general description of the state of the environment of the chosen locations for
       the project;
   •   Summary of opinions and comments obtained from public consultations;
   •   A description of possible environmental and social changes caused by the
       project;
   •   An indication of the measures envisaged to eliminate or minimise negative social
       and environmental effects; and
   •   An indication of the systems envisaged for controlling and monitoring the activity.

All projects listed in the Annex to the EIA Decree 51/2004 are subject to a public
consultation programme organised by the Ministry of Environment, as prescribed in
Article 10 of the EIA Decree. The public consultation process, to be undertaken by the
responsible ministry, comprises the following steps:
    • Release of the non-technical summary of the EIA report to the interested and
        affected parties (as defined in Article 3 of the Decree);
    • Consideration and appraisal of all presentations and comments relating to the
        proposed project; and
    • Compilation of a brief report within eight days of the completion of the
        consultation period, specifying the steps taken, the level of public participation,
        and the conclusions that may be drawn.

The consultation process must take place over a period of five to ten days and the costs
must be borne by the developer.


3.1.7 Review of EIA reports

Once completed, the EIA reports and any supporting documents must be sent to the
relevant line ministry. Within five days of receiving these documents, the line ministry
must forward such documentation to the Ministry of Environment. The review is
conducted by the Directorate for the Prevention and Evaluation of Environmental
Impacts (DNPAIA) and the line ministry relevant to the project in question. For projects


                                                                                        16
in urban areas or that affect human settlements, the minister responsible for planning
should also be included in the review process. Within 30 days from the date of receipt of
the documents, the EIA Directorate in the Ministry of Environment must evaluate the
EIA report. If a favourable opinion is received, the Ministry of Environment shall issue an
Environmental Licence. If there is insufficient information in the EIA report, the Ministry
of Environment may request additional information before it can make a decision. If,
however, a negative opinion is received from the Directorate, the project cannot be
authorised or licenced. The final decision must be made public.


3.1.8 Environmental monitoring and audits

Per Article 22 of the EIA Decree, the Ministry of Environment is responsible for
monitoring the implementation of the EIA in specific projects and must decide on the
imposition of fines in the case of non-compliance (i.e. for those projects which do not
comply with EIA rules and recommendations or which otherwise have a negative impact
on the environment). Decree No. 1/10 on Environmental Audits, gazetted in January
2010, establishes terms under which environmental audits take place. Article 18 of the
Environment Framework Law states that any activities that take place without the
necessary environmental and social mitigation, and from which environmental damage
is observed, are subject to environmental auditing. The Decree explains types of audits
that may be conducted, and that such audits must be conducted by authorised public or
private bodies. It makes provision for the registration and accreditation of environmental
auditors. The costs of the audits are carried by the entity being audited.


3.1.9 Other relevant environmentally-related legislation in Angola

TABLE 5: OTHER RELEVANT LEGISLATION IN ANGOLA
   Legislation          Key elements                                            Responsible
                                                                                authority
   Fisheries Act            •   The Act regulates fishing in marine and Ministry of
   (Lei das                     interior waters. The Act establishes the Fisheries
   Pescas),                     principle that fisheries are for public use and
   No. 20/92 of                 stipulates quotas consistent with the
   14 August 1992               conservation of marine resources, adjusted
                                according to available fishing potential and
                                season.
                            •   It regulates the fishing industry with the aim
                                of achieving sustainable development.
   Biological and           •   This innovative Act is very comprehensive Ministry of


                                                                                        17
Aquatic               and emphasises the need for policies aimed Fisheries
Resources             at preserving and regenerating biological
Act, No. 6-A/04       and aquatic resources.
of                •   It is also a mechanism for the harmonisation
8 October 2004        of different legislation on marine resources,
                      particularly on fisheries and aquaculture
                      activities.
                  •   The Ministry of Fisheries has to be
                      consulted before the implementation of any
                      project pertaining to the exploitation of
                      natural resources within inland waters.
                  •   The Act considers it a crime to discharge
                      any objects or substances that are likely to
                      cause serious damage to biological
                      resources. It further states that any
                      individual or collective person that causes
                      damage to the environment should repair
                      the damage and indemnify the state.
                  •   The Act was developed as part of the
                      government’s policies on environmental
                      protection and the sustainable use of natural
                      resources. It draws on the Constitution and
                      the Environment Framework Law. The Act
                      also considers international instruments
                      such as the United Nations Law of the Sea,
                      the Convention on Biological Diversity, and
                      the      Southern      African   Development
                      Community (SADC) Protocol on Fisheries.
                  •   The Act considers biological and aquatic
                      resources as important food sources for
                      subsistence, economic activities and
                      renewable resources.
                  •   The most important part of the Act in
                      relation to environmental protection is Title
                      II, which deals in its five chapters with
                      measures for the protection of biological
                      aquatic resources and the marine
                      environment.
                  •   This legislation included the Hunting
                      Regulation (Regulamento de Caça), Decree



                                                                             18
                      No. 2873 of 11 December 1957, Forestry
                      Regulation (Regulamento Florestal), Decree
                      No. 44 531, and National Parks Regulation
                  •   (Regulamento de Parques Nacionais),
                      Decree No. 10 375 of 15 October 1958.
                  •   In its annexes, Decree No. 40 040 included
                      a list of mammal and bird species whose
                      hunting was considered illegal.
                  •   Decree No. 43/77 of 5 May 1977 approved
                      the structure of the Ministry of Agriculture
                      and defined five different categories for
                      protected areas, namely national parks,
                      strict nature reserves, partial reserves,
                      regional nature parks and special reserves.
                      This differentiation of categories does not
                      include issues such as rural community use
                      of wildlife or the conservation on heritage
                      sites and important monuments.
                  •   This legislation is being reviewed through a
                      Food and Agriculture Organization project
                      known as Participatory Formulation of Policy
                      and Legislation on Forest, Wildlife and
                      Protected Areas.
Decree on Soil,   •   The first legislation on nature conservation Ministry of
Flora and Fauna       and the establishment of protected areas for Agriculture
Protection,           different purposes (initially for hunting and
No. 40 040 of         later for nature conservation) was issued on
1955                  20 January 1955 through Decree No. 40
                      040 (published in the Official Bulletin on 9
                      February 1955). This Decree covered
                      aspects related to soil, fauna and flora
                      protection, conservation and use of game,
                      and the establishment of national parks,
                      nature reserves and controlled hunting
                      areas. It pioneered the establishment of the
                      Nature Conservation Council (Conselho de
                      Proteção à Natureza) to control protected
                      areas and develop enabling legislation.
                  •   This legislation included the Hunting
                      Regulation (Regulamento de Caça), Decree



                                                                             19
                      No. 2873 of 11 December 1957, Forestry
                      Regulation (Regulamento Florestal), Decree
                      No. 44 531, and National Parks Regulation
                      (Regulamento de Parques Nacionais),
                      Decree No. 10 375 of 15 October 1958.
                  •   In its annexes, Decree No. 40 040 included
                      a list of mammal and bird species whose
                      hunting was considered illegal.
                  •   Decree No. 43/77 of 5 May 1977 approved
                      the structure of the Ministry of Agriculture
                      and defined five different categories for
                      protected areas, namely national parks,
                      strict nature reserves, partial reserves,
                      regional nature parks and special reserves.
                      This differentiation of categories does not
                      include issues such as rural community use
                      of wildlife or the conservation on heritage
                      sites and important monuments.
                  •   This legislation was reviewed through a
                      Food and Agriculture Organization project
                      known as Participatory Formulation of Policy
                      and Legislation on Forest, Wildlife and
                      Protected Areas.
Mining Code       •   The Mining Code of 2011 repeals a number Ministry of
(Código               of old laws relating to mining, such as the Geology
Mineiro),             Law of Mines (Lei das Minas), No. 27 of and Mines
23    September       1979, the Geological and Mining Activities
2011                  Law, No. 1 of 1992, and the Diamond Act,
                      No. 16 of 1994. The new Mining Code
                      amalgamated these (and other laws) into a
                      single set of regulations, with the intention of
                      providing easier access to applicable laws
                      and harmonising, to the extent possible, the
                      rules and procedures that apply to particular
                      activities.
                  •   The Code applies to all mining activities
                      (such      as   prospecting,     mining     and
                      commercialisation) that take place in Angola
                      and all maritime areas that are subject to
                      the Angolan jurisdiction. It does not apply to



                                                                         20
                hydrocarbons, whether in liquid or gas form.
            •   The Code further provides that, in
                consideration for granting mining rights, the
                Angolan state shall be entitled to
                compensation, in the form of a participation
                of not less than 10% in the company that
                conducts the activities and/or allocations in
                kind of the minerals to be extracted.
            •   The Code contains specific rules for mining
                activities that involve strategic minerals.
                Gold, diamonds and radioactive minerals
                are currently designated as strategic
                minerals, although the Angolan Executive
                can designate others.
            •   All mineral resources that can be found in
                Angola and within the maritime boundary of
                Angola are deemed the property of the
                Angolan state. However, the minerals
                explored and extracted by holders of mining
                rights are the property of these parties in
                accordance with the terms of their
                concession.
            •   Mining rights can be granted for the
                following activities:
                  o Prospecting for specific minerals;
                  o Mining of specific minerals;
                  o Prospecting       and     exploitation  of
                     minerals for civil construction; and
                  o Artisanal mining.
            •   The Mining Code imposes a number of
                obligations on the holders of mining rights
                regarding the exercise of their rights. These
                include obligations in the areas of:
                  o Hygiene, health, security and training;
                  o Environmental protection;
                  o Use of soil; and
                  o Use of explosives.
Land Use    •   After independence, issues relating to land Ministry of
Planning        use planning and urban management were Environment
and Urban       not considered a priority in terms of the



                                                                    21
Development        development of new legislation. Most of the      Ministry of
Act,               legislation on this issue was inherited from     Agriculture
No. 3/04 of        the colonial period and is thus outdated and
25 June 2004       inefficient.
               •   The existing legislation on territory, town
                   and country planning and urban issues is
                   fragmented and not in line with scientific and
                   technological progress.
               •   In addition, the growth of the main cities,
                   particularly from urbanisation in the coastal
                   areas as result of the war and migration in
                   search of urban opportunities, has
                   exacerbated problems in the management
                   of urban areas, leading to overcrowded and
                   dilapidated cities.
               •   The lack of integrated and coordinated
                   plans to respond to the growing number of
                   people, which is associated with the
                   inefficient development and growth of the
                   cities, has motivated the development of this
                   law.
               •   The Act adopts a concept of integrated
                   planning, which not only includes socio-
                   economic aspects but also attempts to
                   create synergies in the relationship between
                   the city and the countryside. It calls for the
                   establishment of a decentralised system to
                   coordinate land use planning.
Land Law,      •   This Law deems land the property of the          Ministry of
No. 9/04 of        state and proposes the following multiple        Environment
9 November         uses for the land:
2004                    o A shelter and home for the
                           inhabitants of Angola, which implies
                           the existence of an appropriate urban
                           planning system;
                        o A source of natural resources that
                           can be used for mining, agriculture,
                           forestry and land planning; and
                        o A support for economic, agricultural
                           and industrial activities.



                                                                              22
                  •   The Land Law contains a number of aspects
                      related to the environment, which are
                      important to foster sustainable development
                      and the improved use of the soil and natural
                      resources. The Law refers to various other
                      pieces of environmental legislation, with
                      particular emphasis on the Environment
                      Framework Law.
                  •   The other legislation is used to support
                      mechanisms for the implementation and
                      enforcement of certain Articles and clauses
                      of the Law.
                  •   It presents two land classifications, namely
                      urban land (areas for the construction of
                      buildings) and rural land (areas for
                      agriculture, raising livestock, forestry and
                      mining). The ministry dealing with land
                      planning      and     environment     is   the
                      government institution that declares such
                      land, based on a proposal from other
                      government entities dealing with similar
                      issues. This is the case for the
                      establishment of mining and oil schemes
                      and the industrial sector. The government
                      decides on the establishment of protected
                      areas (total and partial reserves) for specific
                      purposes, such as environmental protection,
                      national      security,     preservation     of
                      monuments, and historical sites. These
                      reserves include both coastal areas (e.g.
                      territorial sea, contiguous zone, economic
                      exclusive zone, islands and estuaries) and
                      land areas (e.g. roads, inland borders,
                      airports and ports, and military bases).
Water Law (Lei    •   This Act states the priorities for the use of State
das Ã?guas), No.       surface water resources in Angola. It Secretariat
6/02 of 21 June       enables the State Secretariat to ensure for Water
2002                  environmental protection and conservation
                      of areas of partial protection. It provides a
                      list of water management principles,



                                                                        23
                      particularly the harmonisation of the water
                      management policy with land use planning.
                  •   The Act calls for the development of a
                      General Plan for the Development and Use
                      of Water Resources in Basins.
                  •   It further notes that water resources are
                      state property.
                  •   Article 6 gives the right to the organ of state
                      responsible for water affairs to ensure the
                      preservation and conservation of areas of
                      partial protection.
                  •   The Act describes a number of principles of
                      water management that the government
                      should put into practice. These include: the
                      right of individuals and entities to access
                      water; integrated management of water
                      resources; institutional coordination and
                      community participation; the harmonisation
                      of the water management policy with land
                      use planning and environmental policies;
                      water as a renewable resource for people;
                      and the relationship between pollution and
                      social and financial issues.
                  •   The      Water      Law     encourages      the
                      development of a new administrative policy
                      for the water sector, which includes a
                      decentralised system of control over the use
                      of water, as well as for the protection of
                      water resources and the environment. In the
                      implementation of such a policy, the
                      government aims to achieve a number of
                      objectives, namely to ensure access to
                      water resources; ensure a continuous
                      balance between the availability of water
                      resources and demand; promote research
                      activities and the sustainable use of existent
                      water resources; ensure proper sewage
                      systems; and regulate the discharge of
                      domestic effluents.
Law on Internal   •   This Law regulates control over internal State



                                                                        24
Waters, Ocean           waters and lakes.                          Secretariat
and Exclusive       •   It also regulates the use of natural for Water
Economic Zone           resources, the protection of the marine
(Lei sobre águas        environment, the promotion of scientific
interiores,             marine research, and the use of artificial
oceanos e zona          structures.
económica
exclusiva), No.
21/92 of 28
August 1992
Local               •   The Act establishes that local governments         Provincial
Municipalities          are responsible for the promotion of               and
Act (Lei das            development, basic sanitation,                     local
Autoridades             environmental protection and land                  authorities
Locais), No.            management.
17/99
of 1999
Oil Activities      •   The Decree states the need to regulate oil         Ministry of
Decree (Decreto         exploration activities in a way that ensures       Petroleum
Lei das                 sustainable development.
Actividades         •   It recognises the important role of oil in the
Petrolíferas),          Angolan economy and its impact on the
No. 39/00 of            environment, and calls for the compulsory
10 October 2000         implementation of EIAs for any offshore or
                        onshore project.
Petroleum           •   This Act includes principles of economic           Ministry of
Activities Law,         policies, particularly for the protection of       Petroleum
No. 10/04 of            national interests, the promotion of the
12      November        workforce, the valuation of minerals, and
2004                    environmental protection.
Including:          •   It establishes the exclusivity principle for the
Petroleum               national petroleum concessionary Sonangol,
Activities Waste        by giving Sonangol the right to use natural
Management,             resources through the establishment of
Removal and             partnerships with other foreign companies.
Disposal,           •   Article 7/2 states that all petroleum
Executive               operations must be conducted carefully, by
Decree        No.       considering the safety of people and
8/05;                   infrastructure as well as the protection of the
Petroleum               environment and the conservation of nature.


                                                                                     25
Activities Spill       Furthermore, Article 9/3 notes that rights for
Notification           petroleum operations can only be granted if
Procedures,            measures are in place to ensure the
Executive              sovereignty of the country, safety,
Decree                 environmental protection, research and the
No. 11/05;             management and preservation of natural
Management             resources, including the living and non-living
of Operational         aquatic biological resources.
Discharge          •   Article 24 on Environmental Protection
during                 indicates that all companies involved in
Petroleum              petroleum operations, including Sonangol,
Activities,            have to implement appropriate measures to
Executive              ensure environmental protection and
Decree                 preservation. This includes health, water,
No. 12/05              soil and subsoil, air, biodiversity
                       preservation, flora and fauna, ecosystems,
                       landscapes, atmosphere and cultural,
                       archaeological and aesthetic values. In
                       addition, Article 24/2 requires plans on
                       environmental preservation, EIA plans,
                       rehabilitation plans and environmental
                       audits to be submitted to the competent
                       authorities within the established
                       timeframes.
Decree on          •   This Decree, which is administered by the        Ministry of
Environmental          Ministry of Petroleum, aims at protecting the Petroleum
Protection             environment from petroleum exploration and
for Petroleum          production activities. It defines the
Activities,            environment as including, inter alia, fauna,
No. 39/00 of           flora, soil, water, landscape, cultural values,
10 October 2000        atmosphere and the like, and is applicable
                       to activities both off- and onshore (Article 3).
                   •   In regulating petroleum activities in a way
                       that ensures sustainable development, the
                       Decree recognises the impact of these
                       activities on the natural environment. It also
                       calls for compulsory implementation of EIAs
                       as an important instrument for ensuring
                       environmental protection in any project. It
                       provides details on the EIA process, with an



                                                                                  26
    emphasis on the procedure for obtaining an
    Environmental Licence from the Ministry of
    Urbanisation and Environment (Article 6).
•   The government is developing
    complementary legislation to this Decree,
    including on the management of operational
    discharges; the management, collection and
    treatment of waste; and the procedures for
    the notification of oil spills.
•   Other legislation for the petroleum industry
    include an Executive Decree on the
    procedures for waste management (No.
    8/05 of 5 January 2005), an Executive
    Decree on the procedures for oil spill
    notification (No. 11/05 of 12 January 2005),
    and an Executive Decree on procedures for
    the management of operational discharges
    (No. 12/05 of 12 January 2005)




                                                   27
4     OVERVIEW OF THE WORLD BANK’S SAFEGUARD POLICIES TRIGGERED

4.1       Summary

The World Bank's Environmental and Social Safeguard Policies are considered a
cornerstone of its support to sustainable poverty reduction projects. The policies require
governments receiving funding from the World Bank to address certain environmental
and social risks in order to receive Bank support for investment projects. As a rule, the
WB policies include requirements that projects should include such as the need for
environmental and social impact assessments, consulting with affected communities
about the impacts that such projects would have, as well as the need for the livelihoods
of affected people to be restored (i.e. either re-establish their pre-existing conditions or
improve upon them). The effectiveness and overall positive impacts of projects and
programs supported by the Bank has substantially increased as a result of the attention
focused on these policies. Safeguard policies have often provided a useful platform for
the participation of stakeholders in project design, and have been an important
instrument for building ownership among local populations.

The World Bank’s key Operational Policies and associated Bank Procedures are critical
to ensuring that potentially adverse environmental and social consequences are
identified, minimized, and mitigated, and receive attention during the Bank’s project
preparation and approval processes. These Operational Policies or Safeguards include:

      ï‚·   OP 4.01 Environmental Assessment;
      ï‚·   OP 4.04 Natural Habitats;
      ï‚·   OP 4.09 Pest Management;
      ï‚·   OP 4.11 Cultural Heritage;
      ï‚·   OP 4.12 Involuntary Resettlement;
      ï‚·   OP 4.10 Indigenous People;
      ï‚·   OP 4.36 Forests;
      ï‚·   OP 4.37 Safety of Dams;
      ï‚·   OP 7.50 Projects on International Waterways;
      ï‚·   OP 7.60 Projects in Disputed Areas.

The World Bank, through its Disclosure Policy BP 17.50, requires that all Safeguard
documents are disclosed in the respective countries as well as at the WB’s Infoshop
prior to the appraisal of a project or for fast-tracking Initiatives prior to the signing of a
Grant Agreement.



                                                                                           28
4.2    Safeguard Policies triggered by the Project

As detailed in the project description section, the Health System Performance
Strengthening Project (HSPSP) will focus primarily on improvement of health services
and is not expected to include extensive civil works such as the construction and
rehabilitation of facilities (i.e. expect where deemed absolutely necessary to facilitate
the provision of health services – such as building of clinics, health facilities, etc.).

Where civil works are involved, these will trigger the need for the relevant safeguards to
avoid or minimize negative environmental and social effects. Consequently, the HSPSP
is expected to trigger the following World Bank Operational Policies: Environmental
Assessment (OP/BP 4.01); Natural Habitat (OP/BP 4.04); and Indigenous Peoples
(OP/BP 4.10), as described below.

Table 6: Safeguard Policies triggered by the Project
 Safeguard Policies Triggered by the Project                 Yes        No
   ï‚·    Environmental Assessment (OP/BP 4.01)                 X
   ï‚·    Natural Habitats (OP/BP 4.04)                         X
   ï‚·    Pest Management (OP 4.09)                                        X
   ï‚·    Physical Cultural Resources (OP/BP 4.11)                         X
   ï‚·    Forests (OP/BP 4.36)                                             X
   ï‚·    Safety of dams (OP 4.37)                                         X
   ï‚·    Indigenous Peoples (OP/BP 4.10)                       X
   ï‚·    Involuntary Resettlement (OP/BP 4.12)                            X
   ï‚·    Project on International Waterways (OP/BP 4.50)                  X


4.2.1 OP 4.01 Environmental Assessment

The aim of OP 4.01 is to ensure that World Bank-financed projects are environmentally
and socially sustainable, and ensure better decision making through the integration of
environmental and social impact considerations throughout the different phases of
development project and actions (i.e. design, planning, and implementation). The main
objectives of Environmental Assessment (EA) is to ensure the consideration of
environmental aspects (air, water, and land), human health and safety, social aspects
(involuntary resettlement, local communities and cultural heritage), as well as
consideration of trans-boundary and global environmental effects such as climate
change. OP 4.01 is applicable whenever a proposed project or actions have the
potential to cause negative environmental effects to the surroundings.




                                                                                       29
The projects are classified into one of the following four categories depending on the
type, location, sensitivity and scale of the project and the nature and magnitude of
potential environmental impacts.

   ï‚·   Category A: A proposed project is classified as Category A if it is likely to result
       in significant adverse environmental impacts that are sensitive, diverse, or
       unprecedented. These impacts may affect a more extensive area than the sites
       or facilities where physical activities take place. The Environmental Assessment
       for a Category A project examines the potential negative and positive
       environmental impacts, compares them with those of other feasible alternatives
       (including the situation without the project.) and recommends necessary
       measures to avoid, minimize, mitigate or compensate for adverse impacts and
       improve the environmental performance impacts. For a Category A project, the
       proponent is responsible for preparing a report, usually an Environmental and
       Social Impact Assessment (ESIA) with its respective Environmental and Social
       Management Plan (ESMP) or environmental auditing as required.

   ï‚·   Category B: A proposed project is classified as Category B if its potential
       adverse environmental impacts on human populations or environmentally
       important areas, including aquatic ecosystems, forests, grasslands and other
       natural habitats, are less adverse than those provided for Category A projects.
       These impacts are specific to the project site; few if any of them are irreversible,
       and in most cases the identification of mitigation measures is faster for projects
       of this Category than for Category A. Just as is the case for Category A projects,
       the potential negative environmental impacts are examined and
       recommendations made on measures needed to prevent, minimize, mitigate or
       compensate for adverse impacts and improve environmental performance. For
       simple projects with minimal social and environmental impacts, the preparation of
       the Environmental and Social Management Plan based on the ESMF is
       sufficient. Likewise, the drafting of a Resettlement Plan based on QPR may also
       be sufficient.

   ï‚·   Category C: A proposed project is classified as Category C if the possibility of
       adverse environmental impacts is minimal or non-existent. In addition to the
       preliminary environmental analysis, it does not require any additional action for a
       project of Category C status.

   ï‚·   Category FI: A proposed project classified in Category FI engages investment
       funds from the World Bank through a financial intermediary, in subprojects that
       may result in adverse environmental impacts.



                                                                                        30
The Municipal Health Services Strengthening Project out of which the current ESMF for
the HSPSP was born had been allocated a Category B status and it is expected that
some of the projects that will be implemented under the current project will retain the
Category B classification. Category B classification means that such projects are likely
to have significant environmental and social impacts which will be site site-specific and
can be mitigated or avoided with an Environmental and Social Management Plan or
through improved design and layout of the project. Potential negative environmental and
social impacts are likely to result from rehabilitation and construction-related activities,
which may include soil, surface and groundwater pollution, air pollution, loss of
vegetation, health and safety issues, as well as noise, dust, and disruption of social and
cultural practices. Some of the impacts, if not properly mitigated, have the potential of
affecting far more extensive areas, beyond the Project sites or the areas where physical
activities will occur.

Once specific subprojects have been defined, an evaluation through a simple
environmental and social impact assessment (ESIA) and an Independent Social and
Environmental Management Plan based on the results of the analysis/ social and
environmental screening will be prepared by experts in social areas, health and safety
for specific areas of implementation of the Project. The costs for carrying out such
evaluation will be included in the Project budget. The results of the selection and the
determination of categories of sub-projects will be confirmed and approved by the
Ministry of Health to verify compliance with the Angolan EIA legislative framework. The
current ESMF is elaborated to focus on those potential environmental and social effects
likely to occur during the planning/ improvement and or operational activities associated
with the HSPSP project areas.

4.2.2 OP 4.04 Natural habitats

Although considered in this project, it must be stated upfront that the impacts of the
project on important natural habitats are considered highlight unlikely as development
activities envisaged as part of the HSPSP will be on already existing sites that will likely
already have been transformed/impacted upon, thus not experience any significant
transformation.

For most parts of Angola, the biophysical environment is considered to be in a relatively
undisturbed state and least affected during the prolonged civil war in the country. As a
result, natural habitats remain intact in many areas. For this reason, it is important that
any development activities that take place do so with due regard to the state of the
natural habitats.




                                                                                         31
The key objective of this policy is to promote environmentally-sustainable development
by supporting the protection, conservation, maintenance, and rehabilitation of natural
habitats and their functions. The key operational principle guiding this policy are the
following:

   ï‚·   Use a precautionary approach to natural resources management to ensure
       opportunities for environmentally sustainable development. Determine if project
       benefits substantially outweigh potential environmental costs;
   ï‚·   Avoid significant conversion or degradation of critical natural habitats, including
       those habitats that are (a) legally protected, (b) officially proposed for protection,
       (c) identified by authoritative sources for their high conservation value, or (d)
       recognized as protected by traditional local communities;
   ï‚·   Where projects adversely affect non-critical natural habitats, proceed only if
       viable alternatives are not available, and if appropriate conservation and
       mitigation measures, including those required to maintain ecological services
       they provide, are in place. Include also mitigation measures that minimize habitat
       loss and establish and maintain an ecologically similar protected area;
   ï‚·   Whenever feasible, give preference to siting projects on lands already converted;
   ï‚·   Consult key stakeholders, including local nongovernmental organizations and
       local communities, and involve such people in design, implementation,
       monitoring, and evaluation of projects, including mitigation planning;
   ï‚·   Provide for the use of appropriate expertise for the design and implementation of
       mitigation and monitoring plans; and
   ï‚·   Disclose draft mitigation plan in a timely manner, before appraisal formally
       begins, in an accessible place and in a form and language understandable to key
       stakeholders.

4.2.3 OP 4.10 Indigenous People

It is expected that the project may impact on Indigenous People in parts of provinces in
the southern part of Angola (i.e. such as Huila, Moximo, Cunene, and Kuando Kubanga)
where indigenous San people are known to reside. The interests and aspirations of
these communities ought to be taken into account in project design so that they derive
maximal benefits from the project.

The objective of this operational policy is to design and implement projects in a way that
fosters full respect for Indigenous Peoples’ dignity, human rights, and cultural
uniqueness and so that they: (a) receive culturally compatible social and economic
benefits; and (b) do not suffer adverse effects during the development process. The
applicable operational principles include the following:



                                                                                          32
   ï‚·   Screen early to determine whether Indigenous Peoples are present in, or have
       collective attachment to, the project area. [Indigenous Peoples are identified as
       possessing the following characteristics in varying degrees: self-identification and
       recognition of this identity by others; collective attachment to geographically
       distinct habitats or ancestral territories and to the natural resources in these
       habitats and territories; presence of distinct customary cultural, economic, social
       or political institutions; and indigenous language.];
   ï‚·   Undertake free, prior and informed consultation with affected Indigenous Peoples
       to ascertain their broad community support for projects affecting them and to
       solicit their participation: (a) in designing, implementing, and monitoring
       measures to avoid adverse impacts, or, when avoidance is not feasible, to
       minimize, mitigate, or compensate for such effects; and (b) in tailoring benefits in
       a culturally appropriate manner;
   ï‚·   Undertake social assessment or use similar methods to assess potential project
       impacts, both positive and adverse, on Indigenous Peoples. Consider options
       preferred by the affected Indigenous Peoples in the provision of benefits and
       design of mitigation measures. Identify social and economic benefits for
       Indigenous Peoples that are culturally appropriate, and gender and inter-
       generationally inclusive and develop measures to avoid, minimize and/or mitigate
       adverse impacts on Indigenous Peoples;
   ï‚·   Prepare an Indigenous Peoples Plan that is based on the social assessment and
       draws on indigenous knowledge, in consultation with the affected Indigenous
       Peoples’ communities and using qualified professionals. Normally, this plan
       would include a framework for continued consultation with the affected
       communities during project implementation; specify measures to ensure that
       Indigenous Peoples receive culturally appropriate benefits, and identify measures
       to avoid, minimize, mitigate or compensate for any adverse effects; and include
       grievance procedures, monitoring and evaluation arrangements, and the budget
       for implementing the planned measures;
   ï‚·   Disclose the draft Indigenous Peoples Plan, including documentation of the
       consultation process, in a timely manner before appraisal formally begins, in an
       accessible place and in a form and language that are understandable to key
       stakeholders;
   ï‚·   Monitor implementation of the Indigenous Peoples Plan, using experienced
       social scientists.


4.2.4 World Bank Policy on Disclosure of Information

As part of the World Bank’s recognition of the right to information, the institution has
developed information disclosure policies which generally contain the following


                                                                                        33
elements: principles of disclosure; exceptions to disclosure; routine disclosure; and
request-driven disclosure. Disclosure of documents (including a summary of the project,
and a summary of Environmental Assessment) should be in the local language, at a
public place accessible to project-affected groups and local non-governmental
organizations. In-country disclosure of information is the responsibility of the borrower,
in this case the Ministry of Health. Disclosure in the InfoShop is the responsibility of the
World Bank.

Documents that need to be disclosed include:
  ï‚· Integrated Safeguards Data Sheet
  ï‚· All Safeguard mitigation plans:
        o Environmental Assessment/ Environmental Management Plan
        o Indigenous Peoples Plan
        o Natural Habitats

Timing of Disclosure and Consultation
   o Draft documents should be made available to stakeholders well in advance of
      consultations;
   o All required public consultations should be completed, and draft or final
      documents disclosed prior to the project Appraisal;
   o Final documents (incorporating results of consultations) should be disclosed for
      the record.

For the present ESMF document, information disclosure will be initiated by
advertisement of public participation meetings to be held in the affected project areas
which will still be determined. The meetings will provide an opportunity for stakeholders
to provide comments and useful inputs to be taken into consideration when planning
and implementing the proposed HSPSP subprojects. As the EMSF has now been
drafted, it is proposed that the disclosure process be through continued interaction with
stakeholders using contact details that will be gathered during public meetings. Email
communication shall be used to notify stakeholders that the ESMF document has now
been drafted and it is available for comment. A hyperlink will also be provided to a site
where the document will be stored and can be downloaded. The E-mail to be sent to
stakeholders will also include the executive summary of the ESMF (Portuguese
version), wherein stakeholders shall be invited to provide further comments as required.
Newspaper advertisements will also be distributed targeting the most widely distributed
and read newspapers in each region to inform stakeholders of the availability of the
ESMF document for review. The Ministry of Health will assist with nominating relevant
officials to whom comments can be sent by stakeholders. Additionally, the MoH shall
ensure the availability of the full ESMF in Portuguese in its offices in all cities.


                                                                                         34
35
5   GAPS IN ANGOLA LEGISLATION AND IN THE WORLD BANK SAFEGAURD
    POLICIES

The major gap identified is in relation to the lack of clear procedures and norms for
handling health, safety and security for both the local population of a particular project
area and/ or the project workers. Although the Angolan legislation does include
measures for safety in the workplace which will be used for workers in the healthcare
facilities associated with the HSPSP, it is proposed that the International Finance
Cooperation (IFC) Performance Standards4 are recommended in order to bridge the
gaps that exist in procedures for health, safety and security. This section provides a
description of the specific standard on health and safety to guide the project proponent
throughout all phases of implementation of the project, and provides some guidance on
what mitigation measures should be taken.

Performance Standard 4 (PS 4) recognizes that project activities, equipment, and
infrastructure often bring benefits such as employment and access to services.
However, projects also have the potential of increasing exposure to risks and impacts
arising from equipment accidents, structural failures, and releases of emissions and
hazardous materials. Local inhabitants of the project areas may also be affected by
impacts on their surroundings, exposure to diseases, and the use of security personnel.

The objectives of the PS 4 are to:

    ï‚·   avoid or minimize risks to and impacts on the health and safety of the local
        community during the project life cycle from both routine and non-routine
        circumstances; and to
    ï‚·   ensure that the safeguarding of personnel and property is carried out in a
        legitimate manner that avoids or minimizes risks to the community’s safety and
        security.

The PS 4 requires that risks and impacts to the health and safety of the affected
community during the design, construction, operation, and decommissioning phases of
projects are identified and that preventive measures to address such impacts are put in
place. Where the project poses risks to or adverse impacts on the health and safety of
affected communities, an Action Plan ought to be prepared and disclosed by the project
proponent.


4
 IFC Performance Standard on Environmental and Social Sustainability:
https://www.ifc.org/wps/wcm/connect/c8f524004a73daeca09afdf998895a12/IFC_Performance_Standards.pdf?M
OD=AJPERES


                                                                                                 36
The following should be considered when assessing the potential risks related to health,
safety and security:
   ï‚· Infrastructure and Equipment Safety;
   ï‚· Hazardous Materials Safety;
   ï‚· Environmental and Natural Resource Issues (such as floods/ landslides etc.);
   ï‚· Community Exposure to Disease (such as water-borne illnesses etc.);
   ï‚· Emergency Preparedness and Response.

The project proponent should assess the potential risks and impacts from project
activities and inform affected local populations of significant potential hazards in a timely
manner. It is also the responsibility of the project proponent to support and work with the
project affected population and the local government structures to respond to any
emergencies that may arise. For the purposes of implementation of this ESMF, potential
health, safety and security impacts associated with the project have been identified, and
mitigation measures have been recommended in the section that follows.


6     POTENTIAL ENVIRONMENTAL AND SOCIAL IMPACTS DUE TO PROPOSED
      PROJECTS

6.1   Summary

Potential impacts associated with the HSPSP projects include construction and upgrade
of laboratories which would lead to adverse impacts such as direct impacts on sites, the
generation of solid and liquid waste, the generation of medical waste and the disposal
thereof, as well as occupational risks faced by workers in the healthcare facilities or
during construction/renovations of laboratories and infrastructure.

It is expected that any potential negative environmental and social impacts associated
with the proposed HSPSP activities and subprojects will be localized and of short-term
duration, and can be significantly offset or minimized through adequate planning and a
through implementation of ESMP by contractors and workers in the healthcare facilities
(i.e. those responsible for the improvement works or any construction-related projects).

Any construction activities related to the improvement or rehabilitation of healthcare
facilities may result in negative environmental and social effects (e.g. on habitats, soils,
workers, Indigenous Peoples and inhabitants, etc.). Most direct impacts will be related
to site clearance and disturbance of habitats associated with the rehabilitation or
upgrade of laboratories/facilities, especially in cases where new infrastructure is
considered necessary.



                                                                                          37
With regards to the rehabilitation of existing infrastructures, potential negative impacts
are likely to be related to contamination of air and water sources which may pose
impacts on the natural environment as well as human health. Considering that the main
activities of the proposed program will be conducted in urban/ built up areas where
healthcare facilities are located, some of the indirect impacts will be related to public
nuisance, including disruptions of public access, disruptions of traffic, noise and dust
emissions, as well as health and safety issues that may be experienced by workers in
the healthcare facilities. Occupational hazards that healthcare workers may be exposed
to include unsafe working conditions, stress as a result of taking care of sick people who
themselves are vulnerable, risks of infections if not wearing suitable protective
clothing/attire or not having proper immunisations against diseases, as well as general
hazards as a result of lack of suitable training on healthcare procedures and hygiene.

6.2       Negative Impacts

In general, it is expected that negative environmental and health and safety impacts will
involve temporary disturbances in smaller areas and with limited permanent effects that
can effectively be mitigated through the implementation of an ESMP at project level.

Negative impacts on the biophysical environment identified during the construction
phase vary between low to moderate. All potential impacts on biology are low, except
for the loss of vegetation cover and plant diversity, which is considered to be of high
importance, dropping to moderate following implementation of mitigation measures.
Most of the impacts applicable during the construction period can be mitigated to the
greatest extent possible.

The negative socioeconomic impacts identified are mostly of low intensity or
insignificant, and can be reduced significantly after implementation of the proposed
mitigation measures. The impacts will come up during both the construction and
operational phases of the project.

The main impacts related to health and safety during the pre-construction phase is
mostly related to the design of buildings such as clinics and healthcare posts, amongst
others. It is therefore necessary that the following safety measures are taken into
consideration:

      ï‚·    availability of fire extinguishers and/or fire alarm systems and appropriate storage
           areas for chemicals;
      ï‚·    hazardous and flammable materials to reduce risks;
      ï‚·    Local inhabitants and workers should be informed of all safety measures;



                                                                                            38
    ï‚· Signals and the necessary signage should be placed close to potential areas of
      danger.
The key impacts likely to result from the proposed activities are summarized as follows:

a) Direct impacts of the construction/rehabilitation phase:
     Contamination of soils, ground and surface water as a result of chemicals (oils,
      fuels and lubricants from machinery and vehicles working on site, remains of
      paints, etc.) particularly on sites located near waterways – can be minimized
      through adoption of an EMP that details suitable mitigation and management
      measures to be taken, as well as use of suitable clothing and protective
      equipment.
     Air and noise quality may be affected as a result of construction activities – these
      can be mitigated by following existing Regulations and the EMP.
     Public nuisance and health impacts resulting from inadequate disposal of solid
      wastes.
     Increased risk of work-related accidents as a result of lack of use of personal
      protective equipment by workers during the construction phase.
     Regarding Health and Safety aspects, projects can be implemented without any
      significant risks and impacts, provided that the Health and Safety requirements
      stated are implemented.
     For any construction works, it is highly recommended to hire local workers
      wherever possible. This will improve acceptance of the project by local residents
      in project areas even if they do not benefit directly from the improved healthcare
      facilities.
     Spread of HIV/AIDS during the construction phase of healthcare infrastructure
      may perpetuate poverty in the municipalities by impacting on the most
      economically-productive members of society– this can be mitigated through
      awareness raising and conscientize workers about the socioeconomic risks at
      play.

b) Indirect impacts during and after construction/ rehabilitation works:

       The contractor should establish all the necessary means for waste water and
        solid waste collection, which should be available during and after the construction
        phase. This is to ensure that the water used during the project is not
        contaminated and does not expose workers and inhabitants to health risks;
       It is anticipated that indirect impacts will be related to nuisance and these will
        include disruption of public access, disruption of traffic (including pedestrians),
        noise and dust emission, public safety issues, disruption of access to public and
        private property including residential and commercial areas located in proximity
        of the sites;

                                                                                        39
       Differences in the visual appearance of the area (as a result of the construction
        of new infrastructures such clinics, healthcare posts or any other healthcare
        facilities, among others).
       Noise and dust emissions which may lead to impacts on human health
        particularly in the communities living in proximity to project areas;
       Disruption of public access affecting pedestrian and traffic during the construction
        activities particularly in the towns, and in sensitive locations such as schools,
        markets and health facilities;
       Poor sanitation in construction areas which can be mitigated/ avoided with the
        provision of adequate washing and toilet facilities close to the works.
       Involuntary resettlements resulting from the construction of new infrastructure
        which may affect particularly single women and households headed by children
        especially in peri-urban areas;

c) Direct and indirect impacts during the operational phase of the healthcare facilities:

A large part of the work will involve capacity building and capacitating workers who will
deliver healthcare services in the healthcare facilities. This will entail making contact
with patients and children and administering vaccines and medication as appropriate.
The major risk to healthcare workers will be in the form of:

       Increased occupational health risks and infections experienced by workers or
        nurses who administer vaccines and medication;
       Risk of spread of diseases for workers dealing with primary healthcare and
        maternal/child healthcare cases;
       Exposure to water- borne, water based, water-related, and vector- borne
        diseases, and communicable diseases;
       Exposure to medical waste (hazardous) generated during the operational phase
        of the project as well as adequate disposal in licenced facilities or lack thereof.

A mitigation measure to offset the risk of impacts during the operational phase of the
project may be in the form of taking suitable preventative measures to minimise the risk
of infections or contracting diseases. In addition, increased collaboration between the
different parties involved in the project (i.e. Affected Communities, local government
agencies, Provinces and the MoH, other relevant parties) in their preparations of
response plans to respond effectively to emergency situations (i.e. such as health
emergencies and spikes in infections or spread of diseases such as malaria, typhoid,
etc.), especially when their participation and collaboration are necessary to respond to
such emergency situations.




                                                                                         40
41
7   CUMULATIVE IMPACTS

Cumulative impacts are limited to those impacts generally recognized as important on
the basis of scientific concerns and/or concerns from Affected Communities. Examples
of cumulative impacts include: incremental contribution of gaseous emissions to an
airshed; reduction of water flows in a watershed due to multiple withdrawals; increases
in sediment loads to a watershed; interference with migratory routes or wildlife
movement; or more traffic congestions and accidents due to increases in vehicular
traffic on community roadways.

In the context of the HSPSP, situations such as overall decrease in health status across
the country as measured by different metrics (i.e. high rates of cholera, malaria, typhoid,
HIV AIDS infections, malnutrition, etc.) may be regarded as cumulative impacts of the
lack of or a deteriorating health system in the country. It can be argued that the lack of
cumulative effects may be an indication of improved health status in the country and
thus the success of this project. There will thus be no cumulative impacts experienced if
all the management measures identified in the ESMF and ESMP as well as guidelines
in the OPs are implemented successfully to contain or offset the identified impacts. In
addition, project-specific EMPs that go hand in hand with Environmental Licences will
detail any cumulative measures considered relevant to specific projects and how such
can be prevented.




                                                                                        42
8   MITIGATION MEASURES

The table below presents some generic mitigation measures considered important to
the success of the HSPSP overall. Much more specific mitigation measures will be
project-specific and will be identified during EIA studies or much more specific ESMP
that will be prepared to address specific circumstances and context of projects. When
the project scope has been fully defined, it will be much easier to prepare ESMP’s
responding to particular projects based on specific impacts envisaged for particular
projects.

TABLE 7: SUMMARY TABLE OF POTENTIAL IMPACTS OF THE PROJECT AND MITIGATION MEASURES
 Potential Negative Impacts                       Mitigation Measures
 Vegetation and Soils Vegetation                  Reinstatement of vegetation cleared
                        clearance and soil        following completion of works; rehabilitation
                        disturbances              of sites disturbed soils immediately after
                                                  completion of works.
 Quality of water         During all types of     During construction works:
                          construction or
                          rehabilitation works,   Measures include: proper storage of
                          residual waters,        hazardous chemical products at the Project
                          chemicals and oils      sites. Other measures include adequate
                          are discharged.         drainage of water and/or other liquid wastes
                          These have the          used during construction and operation
                          potential of            phases of the Project.
                          adversely affecting
                          underground water       All products used during the Project should
                          and soils in the        be nontoxic and biodegradable.
                          areas where the
                          project is              The use of chemical products such as oils,
                          implemented.            lubricants and fuels should be limited and
                                                  controlled/ supervised.
                            Pollution of
                             underground          Drainage systems in the Project sites
                             water                should be equipped with a water/ oil
                            Variations in        separator.
                             water levels
                            Pollution
                             resultant from
                             the lack of
                             effective
                             management in
                             the water
                             catchment areas
                            Salt Intrusion

 Air pollution            Dust/ toxic             Mitigation measures include watering


                                                                                                  43
                       chemicals in the air    surfaces to reduce dust and reduce usage
                       during construction     of chemicals (toxic).
                       or rehabilitation
                       works                   Reduction of wind speed with the use of
                                               wind breaks and covering dirt roads with tar.

                                               Some low-cost mitigation measures include:
                                                  Wetting exposed surfaces with water
                                                     to minimise the spread of dust;
                                                  Adequate preparation of
                                                     construction material such as
                                                     cement;
                                                  Reduction of speed limits and/ or
                                                     access to roads that lead to the
                                                     project areas;
                                                  Ensure regular maintenance of
                                                     vehicles and equipment used on
                                                     sites;
                                                  Avoid starting fires in open areas.

Risk of work-related   Risks of accidents          It is important that workers are
accidents during       likely to increase in        inducted and receive the necessary
construction/upgrade   construction or              training prior to resumption of work
of equipment           upgrade sites                activities to minimise the risks of
                                                    accidents related injuries.
                                                   The EMP for each construction site
                                                    ought to include suitable training for
                                                    staff on health and safety measures
                                                    and work conduct as well as activities
                                                    that are allowed/not allowed.

Social conflicts       Potential for social    Mitigation measures include:
                       conflicts between
                       workers (from other         Ensure       that      the     proposed
                       areas) at site and           construction/rehabilitation works are
                       members of local             carried out by members of the
                       community                    community residing in the specific
                                                    municipality where the project is
                                                    undertaken, and priority be given to
                                                    local    construction      firms    with
                                                    knowledge of the local social norms;
                                                   As a rule, prioritise the recruitment of
                                                    workers from communities where
                                                    projects are implemented.

Noise and vibrations   Noise and vibrations    Mitigation measures include:
                       are common during
                       construction and            Choosing less noisy equipment and
                       rehabilitation works,        making use of equipment that is in
                       and these can be             good conditions


                                                                                           44
                       exceeded                    Usage of silencers to reduce
                                                    vibrations     of   equipment      during
                                                    construction phases
                                                   Where necessary, reduce construction
                                                    time and the running speed of noisy
                                                    equipment
                                                   Planning and logistics should be
                                                    appropriate – plan noisy activities for
                                                    early hours of the day and inform local
                                                    inhabitants of activities that will result
                                                    in noise and vibrations.
                                                   Monitor noise and vibrations and to
                                                    ensure the sound ratings levels are
                                                    kept at IFC/WB recommended levels
                                                    for rural or urban areas as befitting of
                                                    the context or conditions of the areas
                                                    where        projects     are       being
                                                    implemented.

Water treatment        Liquid and solid        Solid and liquid waste should be managed
                       waste       will   be   adequately to reduce adverse impacts on
                       produced during the     water and soils and to ensure safety in the
                       construction     and    Project area
                       rehabilitation
                       phases       of   the   Hazardous/ toxic waste should be disposed-
                       project.                of correctly

                                               The contractor should categorise all waste,
                                               and should adopt the practice of recycling
                                               whenever possible.
Health of population   Water-borne             Where water/ oil leaks occur, separators
in Project areas       illnesses resultant     should be installed and cleaned regularly
                       from still waters/
                       waste water             Solid waste should be covered to avoid
                       treatment.              contamination of water

                                               Guidelines and procedures on cleaning oil/
                                               fuel/ chemical leaks should be made
                                               available

                                               Water leaks if unattended in the distribution
                                               systems can create permanent wet
                                               conditions, leading to the proliferation of
                                               mosquitoes in the beneficiary communities.
                                               MoH shall ensure that community
                                               sensitization is carried out on management
                                               of tap water in households. Regular
                                               monitoring and maintenance of water
                                               distribution network is also required for early
                                               identification of leaks and repairs.


                                                                                             45
Waste water            Poor sanitation in   Mitigation measures to offset this impact
treatment              construction or      may include:
                       upgrade sites
                                                   Provision of adequate washing and
                                                    mobile toilet facilities on project sites
                                                    during construction or upgrade
                                                    activities;
                                                 All healthcare facilities to have
                                                    suitable          water-born           or
                                                    environmentally suitable sanitation
                                                    facilities that meet applicable WHO
                                                    standards.
Soil erosion           Increase in soil          Implement appropriate soil erosion
                       erosion and                  control measures such as minimising
                       potential for                run-off, building terraces and
                       landslides may               diversions, etc.
                       occur.                    Combine civil construction, tree-
                                                    planting and small earth movements
                                                    to help stabilize soils,
                                                 Establish protection zones in
                                                    unoccupied areas or areas that
                                                    become          unoccupied         when
                                                    households are moved/ resettled;
                                                 Mining of construction materials in
                                                    borrow pits to be preceded by
                                                    appropriate mining plan which
                                                    identifies     measures       for    site
                                                    decommissioning and restoration
                                                    plan
Climate        change Effects of climate    The MoH ought to take into account
effects               change on overall     anticipated impacts of climate change in
                      health status and     Angola (i.e. .as per latest UNFCCC findings)
                      risks of spikes in    and factor such impacts in the likelihood of
                      diseases              spread of diseases as a result of shifts in
                                            habitats and incorporate this into the
                                            emergency response plans that will be part
                                            of this ESMF.
Health, safety    and Incidents and         Safety and security measures in the
security              accidents are bound   workplace should include:
                      to occur in the
                      workplace                  Restrict access to construction sites
                                                  and protect surroundings of the
                                                  project area;
                                                 Make provisions for security guards at
                                                  entrances and exits of construction
                                                  sites
                                                 Ensure that workers know how to
                                                  swim – where construction sites are
                                                  close to water
                                                 Make provisions for proper training on



                                                                                            46
       the use of equipment as well as
       training on health and safety
       procedures in the workplace to
       workers and provide safety
       equipment to workers (such as
       helmets, gloves, goggles, boots) etc.
      Prepare an emergency response plan
      Make provisions for a health unit and
       first aid for small works; for larger
       works arrangements for the use of
       ambulances and local medical
       facilities should be made, as required
       by the World Bank standard
       contracts: In collaboration with local
       health authorities, the Contractor shall
       ensure that medical staff, first aid
       facilities, sick bay and ambulance
       service are available at all times at
       the Site and at any accommodation
       for Contractor’s and Employer’s
       Personnel. The Contractor shall
       appoint an accident prevention officer
       at      the   Site,   responsible      for
       maintaining safety and protection
       against accidents. This person shall
       be qualified for this responsibility, and
       shall have the authority to issue
       instruction�.
      Ensure that sufficient lighting is
       available for night works
      Establish speed limits at site areas to
       avoid accidents
      Distribute mosquito nets to project
       workers who remain on-site
      Liquid and solid waste should be
       disposed off-site
      Outbreaks of malaria, urinary
       infections and water-borne illnesses
       should be monitored
      Make provisions for access to potable
       water and washrooms during works
       and of water, sanitation and hygiene
       (WASH) programmes directed
       towards the local population of the
       areas covered by the project

The WHO as well as the IFC Performance
Standard 4 recommendations for health (in
the case of the former), safety and security
(in the case of the latter) in the workplace
should be followed.


                                                47
Socio-economic       Potential loss of         Specific project areas or areas of
                     land, interruptions in     work should be identified and chosen
                     income generating          in a consultative and participative
                     activities                 manner to avoid disturbances and
                                                negative social implications;
                                               Where possible, labour from local
                                                inhabitants of the project areas
                                                should be used to avoid/ reduce
                                                social conflict;
                                               Education and sensitization of
                                                workers and inhabitants on the
                                                prevention of HIV/AIDS should be
                                                organized. Condoms should be
                                                distributed      to  inhabitants  and
                                                healthcare workers.
                                               Respect for local cultural habits and
                                                for religious and cultural areas.

Increased health     During the                Basic hygiene and preventative
risks and exposure   operational phase,         measures to be exercised by all
to diseases          healthcare workers         healthcare workers;
                     likely to be exposed      Suitable protective equipment to be
                     to infections and          worn at all times;
                     increased risks of        All healthcare workers to receive
                     contracting disease.       comprehensive induction and training
                                                prior to starting with work;
                                               Each facility to have a health and
                                                safety plan to be used by all
                                                personnel.




                                                                                    48
9     ENVIRONMENTAL AND SOCIAL SCREENING PROCESS

9.1   Summary

The screening process described in this section is aimed at determining which activities
(construction/rehabilitation/operational works) are likely to result in significant negative
environmental and social effects with a view to determine appropriate impact mitigation
measures for those activities, and ensuring the environmental sustainability of sub-
projects undertaken in the Project areas, through effective monitoring of impacts during
the construction/rehabilitation or operational phases. The outcome of the screening
process will determine the extent of environmental considerations required preceding
the carrying out of activities of the Project.

For the purpose of the construction/rehabilitation of civil works, an Environmental
Screening Form (Appendix 2) has been considered. However, the form does not fully
address some of the key environmental and social effects likely to result from the
proposed activities. Thus, an Environmental and Social Screening Form (Appendix 3)
has been devised to support environmental and social decision-making of the proposed
works.

The form is also designed to be used by the persons involved in the implementation of
the HSPSP overall and relevant decision makers, in order to identify mitigation
measures for the activities likely to have adverse environmental and social effects, and
identify the need for advanced environmental assessment.

The Form covers information which will help reviewers describe the bio-physical
aspects and social conditions of the proposed sites for installation of the infrastructure,
in order to identify the potential impacts of the activity on the environment and on the
social settings, and to identify the need for mitigation or compensation measures, as
may be appropriate.

9.2   Step 1: Site Screening

The Directorate for the Prevention and Evaluation of Environmental Impacts will
appraise the project’s plans and activities to identify the basic environmental and social
issues associated with the development projects. The Directorate shall work in
coordination with the project proponent or representatives thereof to determine the
likelihood of the project to cause negative environmental and social impacts. Where
relevant, the Directorate, together with other members of the team shall conduct a site
visit with a view to verify the site conditions and hence determine what the potential
environmental and social impacts associated with the projects are.



                                                                                         49
After the site visit, the Directorate representatives will complete the Environmental and
Social Screening Form presented in Appendix 4, in order to identify the potential
environmental and social effects, determine their significance, categorize the activity
and propose appropriate environmental impact assessment (EIA) by assigning the
appropriate Category (A, B or C).

9.3   Step 2: Environmental Categories of the Activities

The criteria for categorization of the proposed activities for this ESMF is based on the
World Bank’s OP 4.01 for Environmental Assessment which is in many ways similar to
the Angolan EIA regulations. Categorization will be preceded by filling the
Environmental and Social Screening Form (Appendix 4) and the information gathered in
this form will be used to assign the appropriate environmental category: A, B or C as
described below. Environmental categorization of activities will be carried by the
Directorate in consideration of the criteria below.

Box 1: Criteria for Environmental Categorization of the proposed activities
 Category A: activities requiring an Environmental Impact Assessment;
 Category B: activities requiring an Environmental Impact Assessment (EIA) or/and
 an Environmental Management Plan (EMP);
 Category C: activities that are exempt from detailed environmental impact
 assessment, but which shall be implemented in observance of environmental
 management best practices.

Given the nature of the foreseen works, it is anticipated that most activities will fall under
Categories B and C, given that the potential environmental and social impacts are site-
specific, minimal, and which can be easily mitigated through a simple environmental
management plan (for category B activities) and environmental management best
practices for category C projects.

The project proponents will be required to fill the environmental and social screening
forms of the proposed construction/rehabilitation works, propose adequate
environmental classification of the activities, and communicate the results of the
screening to the Directorate for the Prevention and Evaluation of Environmental Impacts
and to the Environmental Ministry for decision-making.

9.4   Step 3: Carrying out Environmental Work

Following the analysis of the screening form and the categorization of the activity, and
the determination of the level of environmental work required, the Directorate will make
a recommendation on whether:



                                                                                           50
      a) The Environmental Impact Assessment (EIA) is necessary;
      b) A simple Environmental Management Plan is required; or
      c) The project is exempted from environmental impact assessment but its
         implementation must be based on environmental management best-practices.

As per the proposed screening process, the following environmental work can be
conducted:

      a) Use of the environmental and social checklist (Appendix 3): The environmental
         and social checklist will be filled by the Directorate for the Prevention and
         Evaluation of Environmental Impacts/project proponent. This activity will take
         place in parallel to the preparation of plans and drawings of the proposed
         construction/rehabilitation works under the HSPSP

Category B activities may require only the application of mitigation measures indicated
in the checklist.

      b) Requirements for Environmental Impact Assessment: In case the results of the
         environmental and social screening process indicates the need for environmental
         impact assessment as a result of the complexity of the proposed activities under
         the HSPSP, EIAs will be carried out by an authorized consultancy firm, in line
         with the Regulations for Environmental Impact Assessment Processes
         administered by the Ministry of Environment, and in consideration of the Bank’s
         OP 4.O1 for Environmental Impact Assessments.

9.5       Step 4: Review and Approval

The environmental and social screening forms as well as the EIA reports will be
submitted to the Ministry of Environment for review and decision-making. In summary,
the Ministry of Environment will be responsible for the following:

          Review of the results and recommendations submitted by the Directorate for the
           Prevention and Evaluation of Environmental Impacts based on the environmental
           and social screening form (Appendix 3);
          Review of the proposed mitigation measures presented in the Environmental
           Checklist (Appendix 3);
          Review the results of the conducted EIAs and EMPs to determine whether the
           relevant environmental and social issues have been properly addressed, and
           relevant mitigation measures have been put in place for the proposed civil works.




                                                                                         51
The Directorate will make recommendations for approval to the Ministry of Environment
in consideration of the results of the review process.

In the case of approval of an EIA Report, an Environmental License will be issued in
conformity with the requirements of the Decree and Regulations for Environmental
Impact Assessment and Licensing to explicitly state how the findings of the EIA Report
were used to make the final decision.

Once the environmental and social screening form has been approved by the
Directorate, the project proponent and the Directorate will be notified and the
development works can begin.

9.6       Step 5: Public Consultations and Disclosure

As per the EIA Regulations for Environmental Impact Assessment Process, public
consultation is an integral part of the EIA activities and should be considered during and
throughout the preparation of the EIA, in collaboration with relevant bodies and the
Project Affected Persons (PAPs) and may include:

          Conducting one or more public (members of the community, government and
           non-government entities and other stakeholders) meetings with a view to present
           the proposed activities, and gather public views, concerns and expectations
           regarding the proposed project;
          Register all the issues raised and ensure that communication channels between
           the public and the project team are established with a view to gather public
           perception regarding the proposed project.

Public meetings must be preceded by a public announcement which clearly states
where the meetings will be held, the date, and such notice must be publicized though
the newspaper with the highest circulation figures form the area, or the most utilised
communication medium (e.g. radio, TV, newspaper) 5 – 10 days before the meeting
date. In certain cases, members of the public may require baseline information to gain
an understanding of the project prior to the meeting date, to allow them to participate
actively during the public meetings.

Public consultation should contribute to the elaboration of the reports by identifying the
key issues which should be addressed in detail during the environmental assessment of
the project’s activities. The results of consultations should be included into the EIA
Report and it should be explicitly stated how these results have been used in the EIA
report and in making the final decision of the EIA Report.




                                                                                       52
All relevant information necessary for the consultation should be provided to the public
timely, prior to the consultation, and must be in a form and language understandable
and accessible to the groups to be consulted. In terms of disclosure of information, all
reports related to the consultation process, the environmental assessment and/or the
ESMF and ESMP reports should be made available in a public place accessible to the
affected and interested groups including non-governmental organizations. These
reports should also be formally submitted to the World Bank in-country and
subsequently the Bank makes them available in the InfoShop. Disclosure process for
the ESMP should follow the same approach as proposed in the present ESMF.

For the purpose of the civil related works in the proposed HSPSP subprojects, it is
proposed that the consultation with the public be carried out in the following two phases:
    During the completion of the environmental and social screening forms and the
      respective categorization of the activity
    During the detailed evaluation of environmental and social impacts.

The Environmental Ministry (through the DNPAIA) may also provide copies of the
completed EIA Reports to the public for review and comments prior to issuing of the
final decision. The Environmental Ministry (through the DNPAIA) will also involve other
relevant bodies (provincial directorates of different line ministries, the district and the
municipal governments, education and research institutions, NGOs, local associations
etc.).

9.7   Step 6: Environmental monitoring and follow up

Environmental Monitoring intends to verify how effective and relevant the proposed
mitigation measures are, and ensure their updating where relevant for continual
improvement. For the purpose of the HSPSP subprojects, monitoring will be carried out
by the DNPAIA, or the Ministry of Environment appointed persons.

9.8   Responsibilities for the implementation of the screening process

Table below summarizes the key stages as well as the relevant institutional
arrangements to carry out the screening process, preparation and evaluation of the
proposed activities and the final decision making, to allow the initiation of works.

TABLE 8: RESPONSIBILITIES FOR IMPLEMENTATION OF THE PROPOSED SCREENING PROCESS
 Screening phase                        Responsibility
 Subprojects to be undertaken under the Project Proponent
 Health Services Performance
 Strengthening Project
 Environmental Categorization of the Project Proponent/DNPAIA

                                                                                        53
activities (categories A, B, or C)
Carrying out Environmental Work: i.e.
implementing simple mitigation measures
(Table on section 7.5), or, carrying out a
separate EIA
Review and Approval                         The DNPAIA will review the reports
                                            submitted by the project proponent/ MoH
                                            and make recommendations to MoE for
                                            final decision making and issuance of
                                            licence.
Approval of (i) the screening results; (ii) MoE (DNPAIA)
the assigned environmental category;
and (iii) recommendations to project
proponent/MoH
Selection of the consultant in case of the The MoH or its representatives will draft
need for a separate EIA                     the EIA ToRs, and prepare criteria for
                                            hiring an authorized EIA Consultant,
                                            evaluate proposed candidatures, and
                                            select the most qualified consultant and
                                            submit the selected Consultant to the
                                            specific sector. Should the procurement
                                            be carried out through World Bank funds,
                                            appointments will be based on both
                                            quality (70%) and Cost (30%).

                                          The Proponent will make decision on the
                                          selection of the EIA Consultant, draft and
                                          award a Contract for the EIA Consultant.
Carrying out the Environmental Impact     Authorized EIA Consultant
Assessment (EIA)
Approval of environmental assessment      MoE (DNPAIA)
Public Consultation and Disclosure        MoH or its appointed representatives will
                                          ensure that the results of the screening
                                          process and the EIA Reports are
                                          communicated to the public and made
                                          available to stakeholders including PAPs.
Monitoring                                Category C activities: MoH or its
                                          appointed representatives will oversee
                                          the implementation of environmental
                                          management best practices under
                                          Category C.

                                          Category B activities: DNPAIA
                                          The Generic EMP foresees the position
                                          of Environmental Control Officer (ECO)
                                          who shall be appointed by the Project


                                                                                   54
Supervisor to monitor, review and verify
the implementation of the EMP (by the
Contractor). However, in the case of this
Project, this position is not warranted in
terms     of    the    potential  negative
environmental impacts of the Project.
However, it is recommended that the
responsibility for environmental
compliance monitoring is vested in the
Resident Engineer who shall be audited
by the Environmental Engineer of MoH.
The Resident Engineer may seek advice
on environmental matters or delegate
part of his environmental responsibilities
to the Consultant.




                                         55
10 GUIDELINES FOR ENVIRONMENTAL AND SOCIAL MANAGEMENT PLANS
   AND MONITORING REQUIREMENTS

10.1 Generic Environmental Management Plan

The generic environmental and social management plan has been prepared to guide
the implementation HSPSP activities. This ESMP is generic in nature and addresses
basic environmental and social issues associated with healthcare projects. The ESMP
places emphasis on management of environmental and social issues associated with
construction-related activities, with consideration for the operational phases of projects.
The EMP does address occupational health and safety issues as well as the need to
protect healthcare workers and communities living in the vicinities of the healthcare
projects.

In order to properly address the range of environmental and social impact issues
associated with healthcare projects, it is recommended that the generic ESMP be
updated and shared with all interested stakeholders to reflect the need to address the
environmental and social impacts during planning, construction, and the operational
phases of the project.

10.2 Monitoring requirements

By nature, activities in the ESMP are subject to ongoing monitoring and adaptation to
keep the ESMP relevant to the project and the conditions in the Environmental Licence.
The Generic ESMP will suffice for most activities though for those activities for which
there is an Environmental Licence in place, there will be a need to abide by the
conditions and stipulations in the Licence to make sure that the project fulfils all the
conditions of authorisation and operation.

More specifically, the monitoring and auditing programme must be customised to satisfy
the stipulations in the Environmental Operations Licence.

Example of Generic Environmental and Social Management Plan: DISPOSAL
AND TREATMENT OF MEDICAL WASTES

Hospital waste is one of the most problematic types of waste for waste disposal and treatment
especially in developing countries.

Waste generated within hospital premises has three main components:
  ï‚· common wastes, for example, administrative office waste and kitchen waste;
  ï‚· pathogenic or infectious wastes (including sharps);



                                                                                          56
   ï‚·   hazardous wastes (mainly those originating in the laboratories containing toxic
       substances).

The quantity of the first type of waste tends to be much larger than the second and third types.


Ideally, these three types of waste should be separated. However, separation is possible only
when there is significant management commitment, in-depth and continuous training of
personnel and permanent supervision to ensure that the prescribed practices are being
followed. Otherwise, there is always a risk that infectious and hazardous materials will enter the
common waste stream.

Sound practices for managing medical wastes include the following:

Source separation within the hospital

Source separation involves isolation of infectious and hazardous wastes from common wastes
through colour coding of bags or containers. This requires a high level of commitment and
thorough management monitoring.

Treatment of infectious waste through incineration

An incinerator is difficult and expensive to maintain. However a centralized incinerator could be
maintained at a main hospital that provides services to clinics in one region. In addition, simple
low cost incinerators have recently been developed for the safe disposal of hazardous medical
wastes in developing countries and remote rural areas. These do not require a power source
and are fuelled by wood.
In Angola the main hospitals are provided with incinerators.

Disposal in a dedicated hazardous waste land-fill site

Currently this is not an option in Angola as no hazardous waste sites are in operation. However,
Angola intends to prepare a national medical waste management plan and this option may
become available in the future but probably not during LDP.

Proper disposal of hospital wastes in the absence of incineration and landfill sites

In most urban and rural areas of Angola none of the above treatment systems are widely
available, so final disposal of infectious and hazardous components of the wastes is necessary.
In the absence of landfills specifically designed to receive special wastes, hospital wastes need
to go to the local landfill or dump. In this case, close supervision of the disposal process is
critical in order to avoid contact with waste pickers. Final disposal should preferably be done in
a specially designated cell, which should be covered with a layer of lime and at least 50 cm of
soil. When no other alternative is available for final disposal, hospital wastes may be disposed
of jointly with regular wastes. In this case, however, hospital wastes should be covered


                                                                                               57
immediately by a meter thickness of appropriated cover material and always be placed more
than two meters from the edge of the deposited waste.

Transport of waste

Waste must be transported away from the areas of generation at regular intervals or daily.
Transport of waste from areas of generation must be done only by designated staff that should
be fully aware of the hazards posed by the material they handle and of protective measures to
be taken. They should be provided with adequate personal protective equipment and should be
instructed to report any injury to the medical authorities.

Additional measures that may reduce the amounts of hazardous wastes generated in clinics and
health posts include:

   ï‚·   Take-back systems, where vendors or manufacturers take back unused or out-of-date
       medications for controlled disposal.

   ï‚·   Tight inventory control over medications, to avoid wastage due to expiration dates (really
       a form of waste reduction).

The facility should be secure from trespassers and stray animal to prevent scavenging of
hazardous wastes.




                                                                                              58
11 GRIVANCE REDRESS MECHANISM

Grievance redress mechanism for Indigenous San People as part of Indigenous
People’s Management Framework.

The Indigenous San populations in southern Angola were negatively impacted upon by
the prolonged civil war especially in those areas that are littered with landmines, which
became especially inhospitable for them to settle in. Different types of San groups are
known to exist in Angola (estimates of around 3,400 were made in the book - The
Indigenous World, 20065). The San communities are known to occur in parts of the
provinces of Huila, Cunene, Kuba Kubango, and Moximo.

Not enough time was devoted to conducting public participation process for the affected
communities as part of this ESMF. Based on information gleaned from the literature, the
San communities in southern Angola tend to experience social exclusion, discrimination
and social exploitation. The majority were found to be highly vulnerable, impoverished
and food insecure and reliant on food received in exchange for work that they undertake
for their adjacent Bantu neighbours. Some of the communities relied on subsistence
through foraging for resources. The San population face pressure from the Bantu
neighbours with whom there is an uneasy relationship of servitude as a result of
competition for resources (water for instance).

From the little contact that has been established with the San of Angola, they have
proved very positive and open in welcoming support from outside. Experiences from
San communities in adjacent countries reveal that generous funding from donors could
help alleviate problems faced by the San and open ways for integration of aspects of
their culture to the mainstream to allow San children to acquire education and skills.
This would then enable the San to build their capacity, acquire relevant skills, gain
confidence in order to fight for their rights and improve their lives.

These are some of the points that will be taken into account during formal surveys or
liaisons with the San Community to prepare a formal Grievance Redress Mechanism
that will be incorporated in the ESMP.




5
    The Indigenous World, 2006. International Work Group for Indigenous affairs, Copenhagen, Denmark.


                                                                                                        59
12 TRAINING AND CAPACITY BUILDING REQUIREMENTS

To scale up the HSPSP to all provinces and municipalities in Angola will require that
lessons learned from the Municipal Health Services Strengthening Project (PRSMS) are
transmitted to new recruits or workers in the healthcare services sector/projects. A
formal process to review implementation of projects and drawing up lessons learned
during the capacity building and training of the over 2,000 healthcare workers will need
to be drawn up. A training programme can then be customised for all new recruits so
they receive the same level of training to equip them to work in the healthcare
facilities/sector.

The training ought to be extended to institutions in the healthcare sector as well. The
ESMP will be simplified and used for training of institutions and healthcare workers who
are involved in the project. In summary, the capacity building process will proceed as
follows:

   1) Review of lessons learned from the Municipal Health Services Strengthening
      project target areas and workers who were inducted into the programme;
   2) Draw a training manual covering environmental and social issues in the ESMF,
      ESMP, and screening tools;
   3) Draw up an induction manual for staff in the healthcare facilities incorporating all
      the social and environmentally-important issues highlighted;
   4) Drawn up an overall training programme for staff on mitigation and management
      measures for all healthcare facilities in Angola focusing on the construction,
      upgrade and the operational phases of all projects in the healthcare facilities.
   5) Draw up an accompanying monitoring and audit programme to test the
      successful implementation of the healthcare programme in the National Health
      System.




                                                                                       60
13 RECOMMENDATIONS

The ESMF details measures for the successful implementation of social and
environmental sustainability considerations in the HSPSP in Angola. Specific
recommendations to ensure success in implementation of the project include the
following:

  ï‚·   For the overall project to meet its set objectives and sustainability considerations,
      it is very important that this EMF and the World Bank Safeguard Policies are
      applied diligently and successfully;
  ï‚·   The recommended training programmes must be prepared and implemented;
  ï‚·   Where EIAs are required based on the outcome of the checklist, this must be
      implemented in keeping with country legislation and environmental prescripts as
      outlined in this ESMF, and World Bank Safeguard Policies;
  ï‚·   It is recommended that the Ministry of Health takes the lead in customising
      training programmes and standardisation of these into the National Health
      `system to ensure consistency and improvement of the health system in the
      country;
  ï‚·   Ongoing monitoring of all health metrics to be carried out to determine if the
      interventions (i.e. HSPSP) are yielding positive results or if there is a ned for
      adaptation and improvements in order to ensure that resources are utilised
      optimally.




                                                                                        61
14 LIST OF INDIVIDUALS/INSTITUTIONS CONTACTED UNDER PUBLIC
   CONSULTATIONS

A list of individuals and institutions who will be contacted as part of the public
participation process will be included in this section. The names and relevant contact
details will be included in the table below:




                                                                                   62
TABLE 9: STAKEHOLDER DATABASE - ANGOLA HSPSP
Date          Name            Organisation     Contacts   Location   Comments

                                               Number
                                               Email
                                               Address
                                               Number
                                               Email
                                               Address
                                               Number
                                               Email
                                               Address
                                               Number
                                               Email
                                               Address
                                               Number
                                               Email
                                               Address
                                               Number
                                               Email
                                               Address
                                               Number
                                               Email
                                               Address




                                                                                63
64
15 REFERENCES

  1. Connor Catherine, Denise Averbug, and Maria Miralles. July 2010. Angola Health
     System Assessment 20/20, Abt Associates Inc.
  2. IFC Performance Standard on Environmental and Social Sustainability:
     https://www.ifc.org/wps/wcm/connect/c8f524004a73daeca09afdf998895a12/IFC_
     Performance_Standards.pdf?MOD=AJPERES
  3. The Indigenous World, 2006. International Work Group for Indigenous affairs,
     Copenhagen, Denmark.
  4. Walmsley, B & Patel, S, 2011. Handbook on environmental assessment
     legislation in the SADC region. 3rd edition. Pretoria: Development Bank of
     Southern Africa (DBSA) in collaboration with the Southern African Institute for
     Environmental Assessment (SAIEA).




                                                                                 65
16 ANNEXES:

16.1 Environmental and Social Screening Checklist



Project title……………………………………………………………………………………..
Project number………………………………………………………………………………….
Project type……………………………………………………………………………………..
Name of district for infrastructure rehabilitation/construction…………………………………
Name of Executing Agent………………………………………………………………………
Date: ………………………………………………………………………
Name of the Approving Authority …………………………………………

PART A: BRIEF DESCRIPTION OF THE PROPOSED ACTIVITIES
Please provide brief information on the type and scale of the construction/rehabilitation activity
(total area, required land, approximate size of floor area).
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
_________________________________

Please provide information regarding actions needed during the construction of facilities
including support/ancillary structures and activities required to build them, e.g. need for borrow
pits, energy and water pipes/lines installations, access road etc.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
_____________________________
Please describe how the construction/rehabilitation activities will be carried out, including
complementary activities and infrastructures and resources required e.g. roads, disposal site,
water supply, energy requirement, human resource etc.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
__________________________________________

PART B: BRIEF DESCRIPTION OF THE ENVIRONMENTAL SITUATION AND
IDENTIFICATION OF ENVIRONMENTAL AND SOCIAL IMPACTS



                                                                                               66
#   Environmental and social aspect                          Yes   No   Don’t
                                                                                Plea
                                                                        Kno
                                                                                    se
                                                                        w
                                                                                desc
                                                                                 ribe
                                                                                   the
                                                                                prop
                                                                                osed
                                                                                  infr
                                                                                  astr
                                                                                uctu
                                                                                   res
                                                                                 loca
                                                                                tion,
                                                                                  sitti
                                                                                   ng;
                                                                                 surr
                                                                                  oun
                                                                                ding
                                                                                      s
                                                                                (incl
                                                                                  ude
                                                                                     a
map)
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
__________________________________________

Describe the land formation, topography, vegetation in/adjacent to the activity area
______________________________________________________________________________
______________________________________________________________________________
___________________________________________________

Estimate and indicate where vegetation might need to be cleared.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
________________________________________

PART C: OTHER ENVIRONMENTAL ASPECTS



                                                                                  67
Is the site zoned for the proposed land-use?
Are there any environmentally sensitive areas or threatened
species (specify below) that could be adversely affected by the
project?
Is there any intact natural forests?
Is there any surface water courses, natural springs?
Is the water table close to the surface? i.e. 0,5 m or less?
Are there any wetlands (lakes, rivers, swamp, seasonally
inundated areas) in the proximity of the site?
Is there any area of high biodiversity?
Are there habitats of endangered/threatened or rare species for
which protection is required under the Mozambican national
law/local law and/or international agreements
Is there a possibility that, due to construction/rehabilitation
works and subsequent operation of the infrastructure, the river
and lake ecology will be negatively affected with regards to its
water quality and quantity?
Is the site (or its complementary facilities) located
within/adjacent to any protected areas designated by the
government (national park, national reserve, world heritage site
etc.)?
Is the infrastructure likely to alter any historical, archaeological,
cultural heritage traditional (sacred, ritual area) site or require
excavation near same?
Will the project involve any involuntary land acquisition?
Will there be any voluntary land acquisition?
Will the activities be located in any vacant public land?
Is the site located in any or near polluted area (near a waste
dump)?
Is the site located in an area of steep slope and or susceptible to
landslides or erosion of soils?
Is the site located to agricultural land?
Is the site located in the proximities of tourism activities?
Is the project site susceptible to natural disasters (flooding, fire,
cyclones and earth quake)?
Is the site located in area of population concentration points
(schools, markets, health facilities, water sources and
commercial areas)?
Will the construction/rehabilitation activities result in the
permanent or temporary loss of crops, fruit trees and household


                                                                        68
    infra-structure (such as granaries, outside toilets and kitchens,
    livestock?
    Will the construction/rehabilitation works interfere with or block
    access, routes etc. (for people, livestock and wildlife) or traffic                        Na
    routing and flows?                                                                        me,
    Will the operating noise level exceed the allowable noise limits?                         job
    Will the construction/rehabilitation works require large number                         title,
    of staff and labourers; large/long-term construction camp?                                and
    Will the activities result in emission of large amounts of dust,                        cont
    hazardous fumes?                                                                           act
    Will the construction/rehabilitation works generate solid or                             deta
    liquid wastes? (including human excreta/sewage, asbestos)                                   ils
    If “Yes�, does the architectural plan include provisions for their                          of
    adequate collection and disposal, particularly asbestos?                                   the
    Are the construction/rehabilitation activities prone to hazards,                         pers
    risks and could they result in accidents and injuries to workers                            on
    during construction or operation?                                                        resp
    Will the operation involve use of considerable amounts of                                onsi
    natural resources (construction materials, water spillage, land,                           ble
    energy from biomass etc.) or may lead to their depletion or                                for
    degradation at points of source?                                                          filli
    Has public consultation and participation been sought?                                      ng
                                                                                               the
Form:
Name: ------------------------------------
Job title: ------------------------------------
Telephone numbers: ------------------------------------
Fax Number: ------------------------------------
E-mail address: ------------------------------------
Date: ------------------------------------
Signature: ------------------------------------


PART D: MITIGATION MEASURES

For all “Yes� responses, please briefly describe the measures taken to this effect. Subsequent to
completion of the present Environmental and Social Screening Form, the analysis by the
Directorate for the Prevention and Evaluation of Environmental Impacts will follow in order to
classify the activity into one of the categories A, B or C.




                                                                                              69
70
16.2 Environmental and Social Field Appraisal Form



 Civil work activity                Issue to be addressed                           Yes   No
 Construction/upgrade/operational   Are there agricultural lands in the proximity
 activities                         of the site (cultivated or non-cultivated
                                    lands) or any other natural resources likely to
                                    be affected by construction/rehabilitation
                                    works?

                                    Are there appropriate facilities to handle
                                    wastes resulting from the proposed
                                    construction/rehabilitation works?

                                    Will the construction/rehabilitation works
                                    require clearing of vegetation and excavation
                                    of soils?

                                    Will the use of local construction materials
                                    (borrow     pit    materials     for   brick
                                    manufacturing, need for firewood and timber
                                    harvesting) be required during the
                                    construction/ rehabilitation works?

                                    Are there pollution risks of surface and
                                    groundwater as a result of the proposed
                                    construction/ rehabilitation works?

                                    Are there suitable preventative measures to
                                    offset health and safety impacts (i.e. hand
                                    washing with soap/detergents/disinfectants?




Where the option is ‘YES’ on any of the issues above, the mitigation measures in this
ESMF should be investigated for appropriate response measures to be implemented.




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