INTEGRATED SAFEGUARDS DATA SHEET
APPRAISAL STAGE
Report No.: ISDSA174
Public Disclosure Copy
Date ISDS Prepared/Updated: 18-Sep-2012
I. BASIC INFORMATION
1. Basic Project Data
Country: Kyrgyz Republic Project ID: P120435
Project Name: Kyrgyz Health Results Based Financing (P120435)
Task Team Son Nam Nguyen
Leader:
Estimated 31-Oct-2011 Estimated 15-Nov-2012
Appraisal Date: Board Date:
Managing Unit: ECSH1 Lending Technical Assistance Loan
Instrument:
Sector: Health (100%)
Theme: Health system performance (95%), Gender (5%)
Financing (In USD Million)
Financing Source Amount
Borrower 0.00
Health Results-based Financing 11.00
Total 11.00
Public Disclosure Copy
Environmental C - Not Required
Category:
Is this a No
Repeater
project?
2. Project Objectives
The Project Development Objective is to (1) pilot performance-based payments and/or enhanced
supervision for quality of maternal and neonatal care in randomly selected rayon hospitals; and (2)
strengthen the Government’s and providers’ capacity in performance-based contracting and
monitoring and evaluating for results.
3. Project Description
Project description:
Component 1: Pilot Performance-Based Payments and Enhanced Supervision for Quality of Care
(US$9.591 million)
This component will include a randomized controlled trial, aims to test two alternatives for
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improving the quality of maternal and neonatal care at the rayon hospital level: (a) an enhanced
supervision scheme using a Balanced Scorecard (BSC) together with a performance-based payment,
and (b) an enhanced supervision scheme using a BSC only.
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This component will benefit from an Impact Evaluation (IE) financed by a separate Trust Fund
executed by the Bank. The IE will assess the effectiveness of performance-based payments on
quality of maternal and child health care. The results of the IE will be used to inform the government
on potential future provider payment reforms in the health sector.
Component 2: Strengthen the Government’s and Providers’ Capacity in Performance-Based Payment
Reform and Monitoring and Evaluation for Results
(US$1.409 million)
The MOH and the MHIF will receive support to become more effective and efficient in performance-
based contracting, regulation, quality control, and monitoring and evaluation (M&E). Providers in
participating facilities will receive training and other support to: (a) understand their roles and
responsibilities under performance-based contracting; (b) enhance their capacity to conduct peer
verification of results; and (c) increase their ability to conduct self M&E for results.
4. Project location and salient physical characteristics relevant to the safeguard
analysis (if known)
Kyrgyz Republic
5. Environmental and Social Safeguards Specialists
6. Safeguard Policies Triggered? Explanation (Optional)
Environmental Assessment OP/ No
BP 4.01
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Natural Habitats OP/BP 4.04 No
Forests OP/BP 4.36 No
Pest Management OP 4.09 No
Physical Cultural Resources OP/ No
BP 4.11
Indigenous Peoples OP/BP 4.10 No
Involuntary Resettlement OP/BP No
4.12
Safety of Dams OP/BP 4.37 No
Projects on International No
Waterways OP/BP 7.50
Projects in Disputed Areas OP/BP No
7.60
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II. Key Safeguard Policy Issues and Their Management
A. Summary of Key Safeguard Issues
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1. Describe any safeguard issues and impacts associated with the Restructured project.
Identify and describe any potential l arge scale, significant and/or irreversible impacts:
Project's environmental category is rated C. Hospitals are not allowed to use the incentive
payments for any major repairs. Major works shall be considered any works that requires
excavation, generate more than five truckloads of waste, or removal of asbestos. I addition,
hospital balance scorecard will include performance indicators relating to compliance with
applicable government laws and regulations in health care waste management. In this context,
there are not any potential large scale, significant and/or irreversible impacts
2. Describe any potential indirect and/or long term impacts due to anticipated future activities
in the project area:
N/A
3. Describe any project alternatives (if relevant) considered to help avoid or minimize adverse
impacts.
N/A
4. Describe measures taken by the borrower to address safeguard policy issues. Provide an
assessment of borrower capacity to plan and implement the measures described.
N/A
5. Identify the key stakeholders and describe the mechanisms for consultation and disclosure
on safeguard policies, with an emphasis on potentially affected people.
N/A
B. Disclosure Requirements Date
Technical Assistance Project
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For a TA project which will finance the preparation of a specific safeguards instrument, please
indicate type of document disclosed, if any.
N/A
If the project triggers the Pest Management and/or Physical Cultural Resources policies, the
respective issues are to be addressed and disclosed as part of the Environmental Assessment/
Audit/or EMP.
If in-country disclosure of any of the above documents is not expected, please explain why:
N/A
C. Compliance Monitoring Indicators at the Corporate Level (to be filled in when the
ISDS is finalized by the project decision meeting)
The World Bank Policy on Disclosure of Information
Have relevant safeguard policies documents been sent to the Yes [ ] No [ ] NA [ ]
World Bank's Infoshop?
Have relevant documents been disclosed in-country in a public Yes [ ] No [ ] NA [ ]
place in a form and language that are understandable and
accessible to project-affected groups and local NGOs?
All Safeguard Policies
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Have satisfactory calendar, budget and clear institutional Yes [ ] No [ ] NA [ ]
responsibilities been prepared for the implementation of
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measures related to safeguard policies?
Have costs related to safeguard policy measures been included Yes [ ] No [ ] NA [ ]
in the project cost?
Does the Monitoring and Evaluation system of the project Yes [ ] No [ ] NA [ ]
include the monitoring of safeguard impacts and measures
related to safeguard policies?
Have satisfactory implementation arrangements been agreed Yes [ ] No [ ] NA [ ]
with the borrower and the same been adequately reflected in
the project legal documents?
III. APPROVALS
Task Team Leader: Son Nam Nguyen
Approved By
Sector Manager: Name: Johanne Angers (SM) Date: 18-Sep-2012
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