89397 INTEGRATEDSAFEGUARDSDATASHEET Date prepared/updated: May 29,2014 I. Basic Information . 1 B asrc . tD ata . P rOJeC Country: Moldova Project ID: PJ50873 Organization: Center for Health Policies and Studies Additional Project ID (if any): nla Project Name: Implementing Pmticipatory Social Accountability for Better Health Project Task Team Leader: Massimo Mastruzzi Appraisal Date: 5112/2014 Estimated Board Date: n/a Managing Unit: WBIGA Lending Instrument: Small RETF Sectors: Health and Social Accountability Theme: Social Development/Gender/Inclusion IBRD Amount (US$m.): IDA Amount (US$m.): GEF Amount (US$m.): PCF Amount (US$m.): Other financing amounts by source: GPSA Grant US$730,000 Environmental Category: C Is this a transferred project Yes [X] No [ ] Simplified Processing Simple [ ] Repeater [ ] Is this project processed under OP 8.00 (Rapid Response to Crises Yes [ ] No [X] and Emergencies) 2. Project Objectives: The overall development objective of this proposal is to enhance the citizens' voice and establishing mechanisms for participatory monitoring, thus contributing to better informed policy design and improved health service delivery in Moldova. 3. Project Description: Component 1: Promoting citizen monitoring of hospital performance. The key objective of this component is to improve information flows about hospital performance by leveraging participatory monitoring and evaluation tools, in particular: Hospital Performance Score Card (HPSC). The proposed mechanism is a combination of techniques of Patient Report Card, based on patient satisfaction questiormaire, and social audit of hospitals that covers resources utilization, generated outputs, quality, and access indicators. The HPSC process will use www.spitale.md website for data presentation, gathering feedback, communication and media coverage. The specific steps for HPSC process will include: • Development of the HPSC tool and its refinement in consultation with stakeholders. • Piloting and testing of the tool. • Replication at country-level and institutionalization. Hospital Efficiency Evaluation Framework (HEEF). HEEF is a particular type of social audit based on statistics compilation and designed for evaluation of resources' allocation and results of hospital activity. The tool will use a set data related to hospital inputs and outputs, methodology for data collection and data econometric analysis. The HEEF process will also use www.spitale.md website for data presentation, gathering feedback, publication of reports and public presentations. The HEEF process will include: • Development of the tool and its adjustment in consultation with stakeholders. • Producing a Report. • Distribution and feedback collection. • Follow-up and institutionalization. Component 2: Strengthening performance based incentive program in family medicine through social audits of primary health care institution. The key objective of this component is to strengthen performance based incentive program by promoting Primary Healthcare Performance-based Incentives Audits (PHCPIA) that would help the National Health Insurance Fund and the Ministry of Health verify the validity of performance indicators supplied by service providers. PHCPIA is a social audit technique based on quantitative and qualitative analysis of PHC institutions activity in the context of performance- based incentive program. The PHCPIA process will include: • Development of the PHCPIA Tool. • Conducting PHCPIA. • Producing a Report. • Distribution and feedback collection. • Follow-up and institutionalization. The PHCPIA process will be applied using transparency website, publication of reports and public presentations. Component 3: Creating an enabling environment for informed public dialogue in health. Activities included in this component are geared towards creating the enabling environment for effective public pm1icipation including complementing existing evaluation processes, improving information flows and promoting opportunities for improve public dialogue. This will include: 2 • Tools aimed at improving transparency of information in health. • Annual Public Opinion Polls on health services. • Promote adoption of social accountability tools as inputs for budgetary processes and performance based financing of health institutions. • Analysis and dissemination of expenditure flows. • Organize relevant policy dialogues on health reforms impact and sustainability. Component 4: Facilitate Knowledge and Learning to enhance effectiveness of social accountability interventions in Moldova and around the world and project management. The objective of this component is to ensure that mechanisms for learning and sharing are developed both to support social accountability practitioners in Moldova as well as ensure that lessons learned from the implementation of social accountability mechanisms are taken into account to deepen knowledge base on the effectiveness of such interventions. This will include inter alia: • Build/develop sustainable information-communication tools based on existing and popular tools to serve as a platform for disseminating and using health systems' data and project results. • Promote and monitor that project results, achieved on social accountability tools, are effectively used by MOH, NHIC and other governmental institutions to complement formal M&E and to inform about policy process. • Conduct a series of capacity building activities with local CSOs, local public authorities, media institutions, etc. for promotion of social accountability in healthcare. • Network with other GPSA grantees. • Documentation of what works, lessons learned and suggestion for further improvements in future initiatives. • Management, monitoring and evaluation of project activities including audits. 5. Safeguard Policies Triggered (please explain why) Yes No Environmental Assessment (OPffiP 4.01) X Natural Habitats (OPffiP 4.04) X Forests (OPffiP 4.36) X Pest Management (OP 4.09) X Physical Cultural Resources (OPffiP 4.11) X Indigenous Peoples (OPffiP 4.10) X Involuntary Resettlement (OPffiP 4.12) X Safety of Dams (OPffiP 4.37) X Pro.iects on International Waterways (OPffiP 7.50) X Pro.iects in Disputed Areas (OPffiP 7.60) X 3 II. Key Safeguard Policy Issues and Their Management A. Summary of Key Safeguard Issues I. Describe any safeguard issues and impacts associated with the proposed project. Identify and describe any potential large scale, significant and/or irreversible impacts: The project will not finance any physical activities, no risks related to environmental or social safeguards policies are anticipated during implementation of project activities. 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: This project is not expected to trigger any safeguards policies as the project screening identified minimal environmental or social risks related to project activities. The project does not anticipate any civil works to be financed under this Grant. The project is assigned the Environmental Category C, requiring no further environmental and social assessment. 5. Identify the key stakeholders and describe the mechanisms for consultation and disclosure on safeguard policies, with an emphasis on potentially affected people: Project's direct beneficiaries include: empowered citizens and civil society organizations that may benefit from the information and knowledge generated by the Project, as well as from improved governance and transparency in service delivery processes. The project proposes to enforce the mechanisms of accountability, including efforts to enhance citizen knowledge and use of conventional mechanisms, through promoting transparency and civic engagement. The proposed social accountability initiatives will serve the needs of the entire population, focusing primarily on poor and vulnerable people through establishing mechanisms for their effective participation in decision-making and improving access to quality services. The project aims at enhancing the citizens' voice and establishing mechanisms for participatory monitoring, thus contributing to better informed policy design and improved service delivery. The Ministry of Health and other relevant government stakeholders. The Project interventions and obtained results will be used for strengthening governance and decision-making processes by the Ministry of Health, National Health Insurance Company (NHIC), Parliamentary Committee on Social Protection and Health, National Center for Health Management, National Council for Evaluation and Accreditation in Health, Medicines and Medical Devices Agency, Court of Accounts, Local Authorities, as well as hospitals and Primary healthcare institutions. The Project's indirect beneficiaries include: (I) organizations operating in sectors not directly targeted by the Project, but who can study its results and implement similar interventions in their sectors; (2) the Ministry of Finance which will have additional information on how effectively 4 education public funds are spent at the facility level; and (3) international donor programs supporting the health sector in Moldova. B. Disclosure Requirements Date Environmental Assessment/Audit/Manage ment Plan/Other: Was the document disclosed prior to appraisal? NIA Date of receipt by the Bank NIA Date of "in-country" disclosure NIA Date of submission to InfoShop NIA For category A projects, date of distributing the Executive Summary of the EA to the Executive Directors Resettlement Action Plan/Framework/Policy Process: Was the document disclosed prior to appraisal? NIA Date of receipt by the Bank NIA Date of "in-country" disclosure NIA Date of submission to InfoShop NIA Indigenous Peoples Piau/Planning Framework: Was the document disclosed prior to appraisal? NIA Date of receipt by the Bank NIA Date of "in-country" disclosure NIA Date of submission to InfoShop NIA Pest Management Plan: Was the document disclosed prior to appraisal? Date of receipt by the Bank NIA Date of "in-country" disclosure NIA Date of submission to InfoShop NIA * If the project triggers the Pest Management and/or Physical Cultural Resources policies, the respective issues arc 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, pleas.e explain why: C. Compliance Monitoring Indicators at the Corporate Level (to be filled in when the ISDS is finalized by the project decision meeting) OP/BP 4.01 -Environment Assessment Does the project require a stand-alone EA (including Yes [ ] No [ ] NIA [X ] EMP) report? If yes, then did the Regional Environment Unit or Sector Manager (SM) review and approve the EA report? 5 Are the cost and the accountabilities for the EMP incorporated in the credit/loan? OP/BP 4.04 -Natural Habitats Would the project result in any significant conversion or Yes [ ] No [ ] N/A [X ] degradation of critical natural habitats? If the project would result in significant conversion or degradation of other (non-critical) natural habitats, does the project include mitigation measures acceptable to the Bank? OP 4.09 - Pest ManaJ?:ement Does the EA adequately address the pest management Yes [ ] No [ ] N/A [X ] issues? Is a separate PMP required? Yes [ ] No [ ] N/A [X] If yes, has the PMP been reviewed and approved by a safeguards specialist or Sector Manager? Are PMP requirements included in project design? If yes, does the project team include a Pest Management Specialist? OP/BP 4.11 -Physical Cultural Resources Does the EA include adequate measures related to Yes [ ] No [ ] N/A [X] cultural property? Does the credit/loan incorporate mechanisms to mitigate the potential adverse impacts on physical cultural resources? OP/BP 4.10- lndiJ?:enous Peoples Has a separate Indigenous Peoples Plan/Planning Yes [ ] No [ ] N/A [X] Framework (as appropriate) been prepared in consultation with affected Indigenous Peoples? If yes, then did the Regional unit responsible for safeguards or Sector Manager review the plan? If the whole project is designed to benefit IP, has the design been reviewed and approved by the Regional Social Development Unit? OP/BP 4.12 - Involuntary Resettlement Has a resettlement plan/abbreviated plan/policy Yes [ ] No [ ] N/A [X] framework/process framework (as appropriate) been prepared? If yes, then did the Regional unit responsible for safeguards or Sector Manager review and approve the plan/policy framework/process framework? OP/BP 4.36- Forests Has the sector-wide analysis of policy and institutional Yes [ ] No [ ] N/A [X] issues and constraints been carried out? Does the project design include satisfactory measures to overcome these constraints? Does the project finance commercial harvesting, and if so, does it include provisions for cetiification system? 6 OP/BP 4.37- SafetYof Dams Have dam safety plans been prepared? Yes r 1 No [ ) NIA [X) Have the TORs as well as composition for the independent Panel of Experts (POE) been reviewed and approved by the Bank? Has an Emergency Preparedness Plan (EPP) been prepared and arrangements been made for public awareness and training? OP/BP 7.50- Proiects on International Waterways Have the other riparians been notified of the project? Yes [ ) Nor 1 NIA [X) If the project falls under one of the exceptions to the notification requirement, has this been cleared with the Legal Depm1ment, and the memo to the RVP prepared and sent? What are the reasons for the exception? Please explain: Has the RVP approved such an exception? OP/BP 7.60 - Projects in Disputed Areas Has the memo conveying all pertinent information on the Yes [ ) No [ ) NIA [X] international aspects of the project, including the procedures to be followed, and the recommendations for dealing with the issue, been prepared Does the PAD/MOP include the standard disclaimer referred to in the OP? The World Bank Policy on Disclosure of Information Have relevant safeguard policies documents been sent to Yes [ ) No [ ) NIA [X ] the World Bank's Infoshop? Have relevant documents been disclosed in-country in a public place in a form and language that are understandable and accessible to project-affected groups and local NGOs? All Safeguard Policies Have satisfactory calendar, budget and clear institutional Yes [ ) No [ ) NIA [X ] responsibilities been prepared for the implementation of measures related to safeguard policies? Have costs related to safeguard policy measures been included in the proiect cost? Does the Monitoring and Evaluation system of the project include the monitoring of safeguard impacts and measures related to safeguard policies? Have satisfactory implementation arrangements been agreed with the borrower and the same been adequately reflected in the project legal documents? 7 D. Approvals Signed and submitted by: Name/, /, Date Task Team Leader: Massimo Mastruzzi /<.A~ 5/29/2014 Environmental Specialist: Social Development Specialist Additional Environmental and/or S~cial Development Specialist(s): Approved by: , A If Regional Safeguards Coordinator: Agi Kiss ~\ vr--:- 5/29/2014 Comments: (\ Sector Manager: Roby Send({row1tsch """' 5/29/20 14 Comments: 171 ::;::::::;;-· ?', ~ (Template Version November 2007) 8