Cambodia: Cambodia Rapid Immunization Support and Resilient Health Infrastructure Project

OBJECTIVE

To increase access to eligible COVID-19 vaccines for target population groups in Cambodia and strengthen resilience of health systems for future pandemics by upgrading priority facilities to Ministry of Health (MoH)’s service standards.

DESCRIPTION

Original approved Project envisaged supporting the procurement of vaccines against COVID-19. The Project has been restructured to incorporate a new investment component. The new component will upgrade infrastructure and services at seven referral hospitals and one national clinic, helping these eight facilities meet the MoH’s service standards. The infrastructure upgrade will integrate energy-efficient and climate-resilient features, upgrade waste treatment facilities, and equip participating facilities with medical and nonmedical equipment in addition to project management support and capacity building.

Kep Provincial Hospital (Kep), Kampong Thom Provincial Hospital (Thom), Kampong Speu Provincial (Speu) Hospital, Ratanak Mondol Referral Hospital (Ratanak), Sambour Referral Hospital (Sambour), Srey Santhor Referral Hospital (Srey), Stoung Referral Hospital (Stoung) and National Clinic for AIDS Dermatology and STD, Phnom Penh (NCHADS).

ENVIRONMENTAL AND SOCIAL INFORMATION

Applicable Policy and Categorization. The Project is co-financed with ADB as lead co-financier, and the Project’s environmental and social (ES) risks and impacts had been assessed in accordance with the ADB’s Safeguard Policy Statement (SPS). To provide a harmonized approach to addressing the Project’s ES risks and impacts, and as permitted under AIIB’s Environmental and Social Policy (ESP), ADB’s SPS continues to apply to the Project in lieu of AIIB’s ESP. Under ADB’s SPS, the Project has been re-categorized as B for Environment and Category C for Involuntary Resettlement (IR) and Indigenous Peoples (IPs), which are equivalent to Category B if AIIB’s ESP were applicable.

Environmental and Social Instruments. An Initial Environment Examination (IEE) with an Environment Management Plan (EMP), as well as a Gender Action Plan were prepared and have been disclosed on ADB’s website. The IEE and EMP will be updated upon detailed design, as needed. An initial environmental impact assessment (IEIA) will be also prepared for each hospital. All IEIAs, Ministry of Environment (MOE) approvals, and other permits as relevant, will be secured prior to commencement of works. Consultations at 8 selected facilities have been conducted and will be carried on to stakeholders once the designs are ready.

Environmental and Social Aspects. The Project involves civil works for the construction and/or upgrade of the selected facilities. Such works could cause temporary and localized adverse environmental impacts and pose risks to occupational health and safety (OHS). All these impacts are anticipated to be limited to the construction period, site-specific, and can be readily mitigated with good construction, environmental, and safety management practices. Demolition of existing buildings including demolition waste management will require careful planning and execution. No significant impacts and/or risks beyond those typical for healthcare facilities are anticipated during operation of the hospitals. The Project will enhance waste management facilities and practices, including the provision of hazardous waste storage and treatment equipment, and wastewater collection and onsite treatment. In addition, the Project will positively impact physical access to healthcare and generate short-term jobs during construction and long-term healthcare roles post-renovation. Access to healthcare for women, children, people with disabilities, and marginalized communities will improve through upgraded hospital services, expanded maternal and child health and pediatric care, universal access principles, and culturally sensitive spaces. Healthcare staff will be trained to support Gender Based Violence (GBV) survivors and strengthen knowledge on ethical conduct, ensuring inclusive and non-discriminatory services. The Project is expected to improve health outcomes, lower out-of-pocket expenses, and support healthcare staff well-being. Marginalized groups will be engaged in design consultations to ensure facilities are accessible to all.

Stakeholder Engagement, Consultation and Information Disclosure. Consultations at 8 selected facilities have been conducted and will be carried on to stakeholders once the designs are ready. Critical stakeholders for the Project include (i) people affected by COVID-19, (ii) people eligible for COVID-19 vaccination, with a focus on women and hard-to-reach groups, and (iii) people residing in the catchment areas of the seven hospitals and one national clinic being upgraded under output 2. Other key stakeholders include, but are not limited to, the Ministry of Health (MoH) as executing agency and the implementing agencies, government officials at national and sub-national levels, interested community-based and civil society organizations, relevant private sector entities, and development partners. Additional ES documents including IEIAs will be prepared in English and Khmer languages and will be made available to the public in print at the Ministry of Health, distributed during stakeholder consultations and outreach activities as appropriate, and posted on the ADB website. AIIB will also disclose this documentation through update PSI of the Project.

Project Grievance Redress Mechanism (GRM). The PMU will set up and maintain a GRM for the Project, with GRM sub-systems to be established in each hospital. The GRM will cover all ES related complaints and concerns linked to the Project. Participating hospitals and NCHADS will designate focal points to support supervision of EMP implementation on site and act as local entry points for the GRM. The information of established GRMs will be timely disclosed to local communities in an appropriate manner. Any complaint involving a particular hospital will be referred to the GRM sub-system of the hospital for immediate action.

Monitoring and Reporting Arrangement. ES monitoring and reporting requirements are defined in the EMP. The PMU will be responsible for overseeing EMP implementation of the Project. Semi-annual environmental monitoring reports (SEMR) will be prepared by the Detailed Design and Construction Supervision (DDCS) firms based on an agreed format. DDCS firms will include international and national environment consultants to supervise construction works, including implementation of Construction ESMP (CEMP) by contractors and their compliance with health and safety requirements, labor and working conditions, etc. Each works contractor will assign qualified staff to coordinate environmental, health and safety aspects of construction works in accordance with requirements and procedures defined in the EMP.