second health care in the central highlands project · child care for the poor and ethnic groups in...

Second Health Care in the Central Highlands Project (RRP VIE 44265)

Project Number: 44265 September 2013

Viet Nam: Second Health Care in the Central Highlands Project

Project Administration Manual

Contents

ABBREVIATIONS

I. PROJECT DESCRIPTION 1

A. Project Rationale, Location and Beneficiaries 1

B. Impact and Outcome 1 C. Outputs 1

II. IMPLEMENTATION PLANS 3

A. Project Readiness Activities 3

B. Overall Project Implementation Plan 4

III. PROJECT MANAGEMENT ARRANGEMENTS 8

A. Project Management Organizations – Roles and Responsibilities 8

B. Key Persons Involved in Implementation 11

C. Project Organization Structure 12

IV. COSTS AND FINANCING 14

A. Detailed Cost Estimates by Expenditure Category 15

B. Allocation and Withdrawal of Loan Proceeds 16

C. Detailed Cost Estimates by Financier 17

D. Detailed Cost Estimates by Outputs/Components 18

E. Detailed Cost Estimates by Year 19

F. Contract and Disbursement S-curve 20

G. Fund Flow Diagram 21

V. FINANCIAL MANAGEMENT 22

A. Financial Management Assessment 22

B. Disbursement 22

C. Accounting 23

D. Auditing and Public Disclosure 24

VI. PROCUREMENT AND CONSULTING SERVICES 25

A. Advance Actions 25

B. Procurement of Goods, Works and Consulting Services 25

C. Procurement Plan 26

D. Consultants’ Terms of Reference 35

E. Terms of Reference of Key CPMU and PPMU Government staff 62

VII. SAFEGUARDS 63

VIII. GENDER AND SOCIAL DIMENSIONS 64

IX. PERFORMANCE MONITORING, EVALUATION, REPORTING AND COMMUNICATION 67

A. Project Design and Monitoring Framework 67

B. Monitoring 70

C. Evaluation 70

D. Reporting 71

X. ANTICORRUPTION POLICY 71

XI. ACCOUNTABILITY MECHANISM 72

XII. RECORD OF PAM CHANGES 72

XIII. APPENDIXES 72 1. Financial Management Assessment 73

2. Terms of Reference for Financial Audit Consulting Services (Auditor) 99

3. General Procurement Assessment 114

4. List of Training 127

5. List of Civil Works 128 6. List of Hospitals to be Provided with Equipment 130

Project Administration Manual Purpose and Process

The project administration manual (PAM) describes the essential administrative and management requirements to implement the project on time, within budget, and in accordance with Government and Asian Development Bank (ADB) policies and procedures. The PAM should include references to all available templates and instructions either through linkages to relevant URLs or directly incorporated in the PAM.

The Ministry of Health (MOH) is wholly responsible for the implementation of ADB financed projects, as agreed jointly between the borrower and ADB, and in accordance with Government and ADB’s policies and procedures. ADB staff is responsible to support implementation including compliance by MOH of their obligations and responsibilities for project implementation in accordance with ADB’s policies and procedures.

At Loan Negotiations the borrower and ADB shall agree to the PAM and ensure consistency with the Loan agreement. Such agreement shall be reflected in the minutes of the Loan Negotiations. In the event of any discrepancy or contradiction between the PAM and the Loan Agreement, the provisions of the Loan Agreement shall prevail.

After ADB Board approval of the project's report and recommendations of the President (RRP) changes

in implementation arrangements are subject to agreement and approval pursuant to relevant Government and ADB administrative procedures (including the Project Administration Instructions) and upon such approval they will be subsequently incorporated in the PAM.

ABBREVIATIONS

ADB - Asian Development Bank

ADF - Asian Development Fund

AFS - audited financial statements

AOP - annual operational plan

AWP - annual work plan

CEM - Committee for Ethnic Minorities

CDC - communicable diseases control

CH - central highlands

CHS - commune health station

CPMU - central project management unit

CPS - Country Program Strategy

CQS - consultant qualification selection

DHC - district health center: integrated hospital and preventive medicine center

DOH - Department of Health

DMF - design and monitoring framework

DPMC - district preventive medicine center

DRH - district referral hospital

EARF - environmental assessment and review framework

EA - executing agency

EIA - environmental impact assessment

EG - ethnic groups

EMP - environmental management plan

EMDP - ethnic minority development plan

GDP - gross domestic product

HCFP - Health Care Fund for the Poor

HMIS - health management information system

IA - imprest account

IARS - imprest account reconciliation statement

ICB - international competitive bidding

ICS - individual consultant system

IEC - information, education, and communication

IEE - initial environmental examination

IMR - infant mortality rate (per 1,000 live births)

ICP - intercommunal polyclinic

IPD - in-patient department

JAHR - Joint Annual Health Review

GOV - Government of Viet Nam

LIBOR - London Interbank Offered Rate

MMR - maternal mortality ratio (per 100,000 live births)

MCH - maternal and child health

MDG - Millennium Development Goal

MOF - Ministry of Finance

MOH - Ministry of Health

MPI - Ministry of Planning and Investment

M&E - monitoring and evaluation

NCB - national competitive bidding

NGO - Non-Governmental Organization

NIN - National Institute of Nutrition

NPSC - National Project Steering Committee

OPD - outpatient department

PAM - project administration manual

PC - people’s committee

PHC - primary health care

PIECC - provincial IEC center

PIU - project implementation unit

PM - person-month

PMU - project management unit (central or provincial)

PPMES - project performance monitoring and evaluation system

PPMU - provincial project management unit

PPSC - provincial project steering committee

PRH - provincial referral hospital

PWD - person with a disability

QBS - quality based selection

QCBS - quality and cost-based selection

RRP - Report and Recommendation of the President to the Board

SBD - standard bidding documents

SOE - statement of expenditure

SOP - standard operating procedures

SPRSS - Summary Poverty Reduction and Social Strategy

SPS - social policy statement

ST - state treasury

TA - technical assistance

TOR - terms of reference

U5MR - under five mortality rate

UNFPA - United Nations Family Planning Agency

VBA - village birth attendant

VHW - village health worker

VSB - Vietnam State Bank

VSS - Viet Nam Social Security

WB - World Bank

WHO - World Health Organization

I. PROJECT DESCRIPTION

A. Project Rationale, Location and Beneficiaries

1. The central highlands lag most other regions of Viet Nam in terms of health and health services indicators toward Millennium Development Goals (MDGs).1 The project will help the government to further reduce maternal and child mortality by addressing access to and quality gaps in commune health stations (CHSs) and hospitals and by strengthening provincial health management in five provinces, thereby targeting the poor, ethnic groups, and women and children in particular. B. Impact and Outcome

2. The impact will be improved health and nutrition in the central highlands, in particular for women, children, the poor, and ethnic groups. The outcome will be the increased use of health services, in particular maternal and child health services in district hospitals, intercommunal polyclinics (ICPs), and CHSs. C. Outputs 3. The project will have three key outputs: (i) improved access and quality of community health care, (ii) increased access and quality of hospital services, and (iii) strengthened provincial health system management. The project will provide support in the five provinces of the central highlands, in particular for activities to improve health care for the poor, ethnic groups, and women and children living in remote communities.

1. Output 1: Improved Access and Quality of Community Health Care 4. The project will support improved community health care with a focus on maternal and child care for the poor and ethnic groups in rural locations. With support from district health offices, at least 20% of the rural CHSs will be selected to work with surrounding villages to improve community health care through outreach services, including health and nutrition promotion and maternal and child care. 2 The project builds on and expands earlier programs for improving basic health care using standard packages and quality assurance mechanisms3 and will help improve the health system and address gaps in resources. 5. The project will provide (i) 6-month pre-service training for village health workers (VHWs) and village birth attendants (VBAs) to ensure that all villages in the catchment areas of targeted CHSs have adequate VHWs and VBAs; and (ii) refresher courses for VHWs and VBAs in the selected provinces, with priority given to catchment areas of selected CHSs as appropriate. It will provide toolkits for all eligible VHWs and delivery kits for all eligible VBAs. It will also support information, education, and communication (IEC) campaigns on health and nutrition. Prior to these campaigns, the project will conduct a knowledge, attitudes, and practices study in the villages and produce IEC materials appropriate to the sociocultural context of the region. Eleven vehicles will be provided to districts lacking transportation to improve CHS supervision and

1 The Asian Development Bank (ADB) provided project preparatory technical assistance. ADB. 2011. Technical Assistance to the Socialist Republic of Viet Nam for Preparing the Second Health Care in the Central Highlands Project. Manila.

2 Selection criteria will include (i) poverty incidence, (ii) distance from the district hospital, (iii) ethnic groups population, (iv) population density, and (v) achievement of commune health standards as defined by the MOH.

3 Based on models piloted with the support of partners such as Pathfinder.

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outreach services. 6. The project will build and equip 24 CHSs, replace and equip 10 ICPs, upgrade and

equip 30 CHSs, and complete the equipment of other selected CHSs and ICPs. It will support 150 scholarships for ethnic students in medical technician or nursing degree courses and support health quality improvement through in-service skills training for CHS and ICP staff in hospitals. Staff will also be trained to be aware of sociocultural barriers and in IEC skills and caring for ethnic patients.

2. Output 2: Increased Access and Quality of Hospital Services 7. The project will support district hospitals toward improving access to referral services and reducing the overloading of provincial hospitals. A comprehensive approach, focusing on delivery of standard packages of health services, will be followed to improve hospital services and strengthen quality assurance. The project will help upgrade eight district hospitals, build one new district hospital, equip about 27 district hospitals and 3 provincial hospitals (including for emergency services), and provide 28 ambulances. It will help repair and maintain water supply and sanitation in all eligible district hospitals. 8. To improve service quality, the project will support system development and training in

infection control, waste management, and quality assurance for selected staff in all district hospitals. It will support (i) short-term technical skills training for nurses, laboratory assistants, and maintenance specialists in all district hospitals; (ii) training 162 specialist doctors; (iii) upgrading 125 assistant doctors and assistant pharmacists into doctors and pharmacists; and (iv) providing short courses for 111 specialist doctors. Priority will be given to female and ethnic candidates.

3. Output 3: Strengthened Provincial Health System Management 9. The project will help improve provincial and district health management systems. Activities will include orientation for provincial governments and local leaders and training for provincial and district health managers and CHS and ICP heads on annual planning and budgeting, management and supervision tools, quality assurance, building and equipment maintenance, and a health management information system (HMIS). 10. Capacity building in public health and hospital management will include a 3-month certificate course for provincial and district health office managers, CHS and ICP heads, and hospital managers in health services management. This will include human resources management, financial management, quality assurance, and health management information system, and mainstreaming gender and ethnic concerns. Female and ethnic staff will be prioritized. To improve training outcomes, the project will support the development of an in-service training system, including a provincial training team and coordinator, a core group of teachers to improve teaching methodologies, distant learning materials, a database to identify staff training needs, and field assessment. 11. The project will have a central project management unit (CPMU) and five provincial project management units (PPMUs). Staff will be trained in planning, monitoring, procurement, disbursement, and financial management. A project monitoring and evaluation system will be established. Project activities will be included in the annual operational plans of provinces, which will contribute to the sustainability of project benefits. The project will provide one vehicle for supervision by CPMU.

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II. IMPLEMENTATION PLANS

A. Project Readiness Activities

Indicative Activities

Months 2013 2014

Jun Jul Aug Sep Nov Dec Jan Feb Mar Who responsible

Project Detailed Outline approved

√

Viet Nam Prime Minister

Feasibility Study approved

√

MOH

Loan negotiations

√ ADB, MOH, MPI, SBV,

MOF

ADB Board approval

√

ADB

Loan signing √ MOH,MPI, SBV, MOF,

Government legal opinion provided

√

MOJ

Loan effectiveness

March 2014

SBV, ADB

ADB = Asian Development Bank, MOF = Ministry of Finance, MOH = Ministry of Health, MOJ = Ministry of Justice, MPI = Ministry of Planning and Investment, SBV = State Bank of Viet Nam. Source: Asian Development Bank.

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B. Overall Project Implementation Plan

Outputs 2014 2015 2016 2017 2018 2019

Quarter II III IV I II III IV I II III IV I II III IV I II III IV I II

DMF

Output 1: Improved Access and Quality of Community Health Care

1.1 Improved services at village level

a. Conduct KAP survey at community level b. Design appropriate IEC tools

c. Conduct outreach activities in the villages

d. Conduct IEC campaign in the villages e. Conduct meetings with villages

stakeholders

f. Train VHWs and VBAs g. Retrain VHWs and VBAs H Provide equipment for VHWs and VBAs i. Provide vehicles to districts for supervision

and support to outreach services

1.2 Improved services at CHS and ICP

a. Build and upgrade CHS and ICP b. Provide medical equipment for CHS and

ICP with civil works.

c. Provide additional medical equipment for CHS and ICP with no civil works.

d. Hospital secondment for CHS/ICP midwives and doctors (safe motherhood)

e. Hospital secondment for CHS/ICP doctors and doctor assistants (clinical skills)

f. Training in health center management, hygiene and quality assurance for CHS/ICP heads

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Outputs 2014 2015 2016 2017 2018 2019


g. Training for CHS/ICP staff on population KAP, gender and IEC techniques

h. Provide scholarships for 2 year technician or nursing training degree to ethnic group students.

Output 2: Increased Access and Quality of Hospital Services

2.1 Upgraded equipment and building

a. Build and upgrade district hospitals

b. Provide water system and sanitation equipment for district hospitals.

c. Equip district and provincial hospitals d. Provide ambulances

2.2 Enhanced capacity of the staff

a. Train hospital hygiene focal points b. Training on infection control and quality

assurance for hospital staff

c. In-service training for nurses, midwives and technologist

d. Train first level specialists e. Train second level specialists f. Train specialists (1–3 months short

courses)

g. Upgrade medical assistants to doctors h. Upgrade pharmacy assistants to

pharmacists

Output 3: Strengthened Provincial Health System Management

3.1 Senior staff management capacities developed.

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Outputs 2014 2015 2016 2017 2018 2019


a. Train managers at all levels(Annual operation plan (AOP), budgeting, monitoring, quality assurance, maintenance, result-based management)

b. Support AOP design

c. Enhance supervision of districts by provinces

d. Enhance supervision of CHS/ICP by districts

3.2 Enhanced training capacity of the

medical schools and university

a. Provide teaching equipment to medical schools and university

b. Train schools and university lecturers on teaching skills

Management Activities

a. Provide equipment to CPMU and PPMUs b. Provide vehicles for CPMU c. Hire project contractual staff d. Recruit international consultants e. Recruit national consultants f. Recruit consulting company for IEC g. Recruit consulting company for training and

quality assurance.

h. Recruit audit company i. Recruitment consulting company for

detailed engineering design of health facilities and supervision civil works

j. Detailed design of CHS/ ICP k. Detailed design hospitals

l. Tender process CHS / ICP civil works

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Outputs 2014 2015 2016 2017 2018 2019


m. Tender process hospitals civil works

n. Supervision construction CHS / ICP

o. Supervision construction hospitals

Midterm review conducted

Project completion report prepared

Annual financial audit conducted

AOP = annual operational plan; CHS = commune health stations; CPMU = central project management unit; ICP = intercommunal polyclinic; IEC = information, education, and communication, KAP = knowledge, attitude, and practices; PPMU = provincial project management unit; TBA = traditional birth attendant. Source: Asian Development Bank.

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III. PROJECT MANAGEMENT ARRANGEMENTS A. Project Management Organizations – Roles and Responsibilities

1. Executing Agency 12. The Ministry of Health (MOH) is the executing agency. The project will be implemented through project management units (PMUs) in MOH and in five provincial health departments. An MOH steering committee, chaired by the minister or vice minister along with senior official from key MOH departments will provide guidance and oversight. The project director, appointed by the minister, is responsible for coordinating project implementation. The project will be implemented in close coordination with development partners (World Bank, World Health Organization).

2. Project Management and Implementation 13. The MOH mandates the CPMU which will be the main implementing agency (IA) of the project. The Minister of Health appoints the director of the CPMU. 14. The staffing of the CPMU will include a project director, two deputy directors, a finance manager, four accountants, five procurement specialists, three disbursement officers, two medical equipment specialists, 3 civil works specialists and five support staff. Six national experts (communication/IEC, quality assurance consultant, training consultant, monitoring and evaluation specialist, safeguards specialist, social and gender specialist) will provide direct technical support to the provincial health departments (PHDs). Three international experts (chief technical advisor, civil works specialist, medical equipment specialist) will bring expertise to the project. 15. The DOHs of the five central highlands with the PPMUs are implementing agencies. The PPMUs will be established by the Provincial Peoples Committee (PPC) together with the standing committee of the DOH. The chair of the PPC appoints the manager of the PPMU. PPMUs are responsible for implementing project activities at province level, coordinating with the MOH in managing and instructing the project implementation in the provinces. PPMUs have to operate in close cooperation with relevant ministries and departments to implement the Project. The PPMUs are based in Buon Ma Thuot, Gia Nghia, Da Lat, Pleiku and Kon Tum to support project implementation in central highlands. 16. The staffing of the PPMUs will include a project director, a vice director, two accountants, a planning, monitoring and evaluation officer, a financial management specialist, project officer (procurement and civil works), a training specialist, disbursement specialist, and two support staff. Support for training and pilots will be contracted out. Every CPMU and PPMU staff will have terms of reference (TOR) and accountability mechanism in terms of quality and reporting of work. 17. All project activities will be fully incorporated into the government planning cycle at national and provincial levels. Based on the project design and actual needs, each PPMU will prepare a project annual work plan (AWP) and budget as part of the provincial health department’s (PHD) AWP and budget for review and approval by appropriate authorities at provincial and central level. 18. The Chair of the PPC approves the project components for their province based on the overall project document approved by the Minister of Health. The PPC approves directly or indirectly (by authorizing the Director of the P): the activity plan, procurement plan and results, cost estimates, annual financial balances, and the balance at project completion. The PPC is responsible for allocating sufficient budget, personnel and facilities for the project implementation; is responsible for the project implementation effectiveness at the local level.

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19. Similarly, CPMU will prepare the national AWP and budget based on consultation with the provinces and incorporation of provincial AWPs, obtain relevant approvals from the executing agency (EA) and incorporate these into the national AWP . These AWPs and budgets will be submitted to MOHs, core ministries, and the Asian Development Bank (ADB) for approval and/or concurrence. The AWPs and budgets should be approved before 15 December, if not sooner. Accordingly, PMUs should complete their respective work plans and budgets in November 2013 preliminary to loan effectiveness in April 2014. 20. The provincial steering committees will be established by the PPC. The Vice-Chair of the PPC is the head of the committee. Each PPMU functions under the committee and the CPMU. Project implementation organizations Primary Management Roles and Responsibilities

Executing agency: Assures the smooth running of the Project

Ministry of Health (MOH)/ Department of Finance and Planning

Assures project integration and complementarity with the national health interventions

Monitors, evaluates and directs the Project

Ensures timely implementation of the project, attainment of output targets, achievement of the outcome and overall performance of the project.

Ensures availability of the Government of Viet Nam (GOV) counterpart funding

Chairs National Steering Committee

Facilitates of donor cooperation (including the Asian Development Bank [ADB])

Coordinates with core ministries and ADB

Project specific management body:

central project management unit (CPMU)

Overall project administration and financial management for the executing agency (EA)

Overall project coordination and commissioning implementing agencies .

Manages national and international technical assistance;

Develops, executes, monitors, reports and evaluates the consolidated annual work plan (AWP) of the 5 provinces;

Ensure implementation of indigenous peoples plan, environment mitigation plan and gender action plan.

Conducts project risks assessment and mitigation;

Provides national level project management including finance and administration, central procurement and contract management (technical assistance [TA] and Goods), technical assistance, monitoring and operation of the project information system;

Assures proper administration of imprest accounts and sub-accounts;

Plans, conducts and monitors central level procurement ([inter]national TA and medical equipment).Oversees and supervises provincial level procurement (Civil Works and non-medical equipment);

Develops and implements suitable technical and financial control systems, management tools and procedures;

Disburses and accounts for project funds;

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Project implementation organizations Primary Management Roles and Responsibilities

Monitors expenditure against planned activities, and the application of appropriate internal controls for spending and Quality Assurance;

Reports performance against agreed budgets to the national project steering committee, in accordance with ADB standards and procedures

Facilitates interaction with the central level MOH Departments and key partner institutions as well as between the different departments of health (DOH);

Submits timely consolidated financial and technical reports;

Arranges external audits as required

Provincial project management unit (PPMU)

Overall provincial project administration and financial management for the DOH

Overall project coordination

Manages national technical assistance to the PPMU;

Develops, executes, monitors, reports and evaluates the provincial AWP, together with the districts;

Ensure implementation at province level of indigenous peoples plan, environment mitigation plan and gender action plan.

Provides provincial level Project management including finance and administration, central procurement and contract management (provincial TA, Civil Works and Goods), technical assistance, monitoring and operation of the project information system;

Assures proper administration of sub-accounts;

Disburses and accounts for project funds;

Facilitates interaction with provincial key partner institutions as well as between the different district health structures

Monitors facility operations and maintenance per standards;

Monitors expenditure against planned activities, and the application of appropriate internal controls for spending and Quality Assurance;

Reports performance against agreed budgets to the provincial project steering committee, in accordance with ADB standards and procedures

Submits timely provincial financial and technical reports;

Facilitates external audits as required

Project Steering Committee

Provide Project oversight on at least once a year

National Steering Committee headed by the MOH Leader

Providing policy guidance and facilitate inter-ministerial coordination;

Guide overall project priorities;

Approve AWPs, procurement plan, cost estimates, results, reports, annual financial balances, and the balance at project completion

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Project implementation organizations Primary Management Roles and Responsibilities

Provincial Steering Committee headed by the provincial Vice-Governor

Ensures the availability of the GOV counterpart funding;

Review and evaluate project performance;

Review project audit reports;

Propose needed changes to the project to Ministry of Health & ADB

Implementing agencies

Implement activities, guaranteeing a high Quality Standard

provincial, district and commune health structures

Report on project activities as well as on health sector performance

ADB Approve Procurement Activities

Review Project implementation twice a year, including

related policy actions and project activities

Disburse loan proceeds to the consultants and the contractors

Source: Asian Development Bank.

B. Key Persons Involved in Implementation

Executing Agency Ministry of Health (Department of Planning and Finance)

Mdm. Nguyen Thi Kim Tien Minister of Health Tel: +84 4 6273 2273 (ext 1039) Fax: +84 4 6273 2239 Office Address: 138 Giang Vo St., Ha Noi, Viet Nam

Implementing Agency Dr. Ha Van Thuy

Project Director Tel: +84 4 3726 3502 Fax: +84 4 3726 2928 Office Address: 2 Nui Truc, Ha Noi, Viet Nam Email: [email protected]

ADB Human and Social Development Division (SEHS)

Leah C. Gutierrez Director, SEHS Tel: +632 632 4445 Fax: +632 636 2228 Email: [email protected]

Mission Leader Gerard Servais Health Specialist, SEHS Tel: + 632 632 4431 Fax: +632 636 2228 Email: [email protected]

12 C. Project Organization Structure

Dept. of Human

Resources, MOH

Project Secretary

Project Vice

Director

(Admin)

Project Vice

Director

(Technical)

Health Policy Unit

Dept. of Planning

and Finance, MOH

Dept. of Science

and Training, MOH

M & E ConsultantTraining

ConsultantQA Consultant

HRD

R & E Consultant

Health

Information

Disbursement Procurement

Civil work

Chief Accountant

Admin, Driver,

CleanerAccountant Asst.

Quality

Improvement

Project

Coordinator

Equipment

Specialist

Ministry Of Health

Department of Planning and Finance

CPMUProject Director

Project

Finance

Manager

National Project

Steering Committee

IEC and Social

Marketing

S & G Cons ul ta nt +

Communi cati on Consulta nt

13

Provincial Department of Health

PPMU

HRD = Human Resources Department; M&E = monitoring and evaluation; MOH = Ministry of Health; R&E = research and environment, PPMU = provincial project management unit; S&G = social & gender consultant; TA= technical assistance. Source: Asian Development Bank.

Project Director

Project Vice Director Admin.

Project Vice Director Technical

Provincial Steering Committee

Provincial People Committee

CPMU

Director Health Services

Project Manager

Project Assistant Manager

Finance Manager

Planning and M&E Coordinator

Chief Accountant

TA Disbursement

Procurement Officer

Civil Work Officer

HRD / Training Officer

Bookkeeper, Admin.

Accountant Asst.

Project Officer

Project Officer

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IV. COSTS AND FINANCING

21. The proposed project includes a Project Loan of ($70.0 million). The Government of Viet Nam (GOV) will contribute in kind and in cash counterpart funds of $ 6.6 million. The project is estimated to cost $76.6 million, including taxes and duties, and physical and price contingencies (Table 1).

22. The proposed project does not involve any cofinancing from other donors. There are also no local contributions either in kind or in cash from community beneficiaries. The financing plan for project Loan has been verified, and the ADB loan funds and counterpart funds from Government will be made available on a timely fashion.

Table 1: Project Investment Plan

($ million) Item Amount

a A. Base Cost

b

1. Improved Access and Quality of Community Health Care 20.6 2. Increased Access and Quality of Hospital Services 39.4 3. Strengthened Provincial Health System Management 8.6 Subtotal (A) 68.6 B. Contingencies

c 5.0

C. Financial Chargesd 3.0

Total (A+B+C) 76.6 a Including taxes and duties of $4.9 million to be financed by the government and Asian Development Bank. b In January 2013 prices. c Physical contingencies computed at 2.5% of base costs. Price contingencies computed at an average of 2% on

foreign exchange costs and an average of 7% on local currency costs. d Interest during implementation for ADB loan computed at 2% per annum during the grace period and thereafter to

be capitalized in the loan amount. Source: Asian Development Bank estimates.

23. The Government of the Socialist Republic of Viet Nam has requested a loan in various currencies equivalent to SDR 46.6 million from ADB's Special Funds resources to help finance the project, 4 including taxes and duties.5 The loan will have a 25-year term, including a grace period of 5 years, an interest rate of 2.0% per annum, during the grace period and thereafter and such other terms and conditions set forth in the draft loan agreement. The Government will provide counterpart funding of $6.6 million equivalent, for civil works, project management, and recurrent costs. The financing plan is in Table 2.

Table 2: Financing Plan Source Amount ($ million) Share of Total (%) Asian Development Bank (ADF loan) 70.00 91.38 Government of Viet Nam 6.60 8.62

Total 76.60 100.00

ADF = Asian Development Fund. Source: Asian Development Bank estimates.

4 ADB may cover transportation, insurance and part of recurrent costs under the project. 5 ADB will finance the amount of taxes and duties as it (i) is within the reasonable threshold identified in the country

partnership strategy, (ii) does not represent an excessive share of the project investment, (iii) applies only in respect to ADB-financed expenditures, and (iv) is administratively expedient for the success of the project.

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A. Detailed Cost Estimates by Expenditure Category

Item

($ Million) Foreign Exchange

($ Million) Local

Currency ($ Million) Total Cost

% of Total Base Cost

A. Investment Costs 1. Civil Works 5.4 16.1 21.4 31% 2. Medical equipment 22.6 - 22.6 33% 3. Vehicles 2.8 - 2.8 4% 4. Training - 6.3 6.3 9% 5. Workshops, studies - 1.4 1.4 2% 6. International consultants 0.4 - 0.4 1% 7. National consultants - 4.2 4.2 6% 8. Community Development and IEC - 2.1 2.1 3% Subtotal (A) 31.1 30.1 61.2 89% B. Recurrent costs 1. Project Management and office equipment 1.0 4.2 5.2 8%

2. Operation and maintenance 0.4 1.8 2.2 3% Subtotal (B) 1.5 5.9 7.4 11%

Total Base Costs (A+B)

32.6 36.0 68.6 100%

C. Contingencies 1. Physical Contingencies 0.8 0.9 1.7 2. Price Contingencies 0.7 2.6 3.3 Subtotal (C) 1.5 3.5 5.0 D. Financing charges during implementation 3.0 - 3.0 Total Project Cost (A+B+C+D) 37.1 39.5 76.6

IEC = information, education, and communication. Notes: Numbers may not sum precisely because of rounding; Percentages may not total 100% because of rounding.

Source: Asian Development Bank estimates.

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B. Allocation and Withdrawal of Loan Proceeds

ALLOCATION AND WITHDRAWAL OF LOAN PROCEEDS

Category ADB Financing

No. Item

Total Amount Allocated for ADB Financing

$ million equivalent

Percentage and Basis for Withdrawal from the Loan Account

1 Civil works 18.2 85 percent of total expenditure claimed 2 Medical equipment 22.6 100 percent of total expenditure claimed

3 Vehicles 2.8 100 percent of total expenditure claimed

4 Training 6.3 100 percent of total expenditure claimed

5 Workshops, studies 1.4 100 percent of total expenditure claimed

6 International consultants 0.4 100 percent of total expenditure claimed

7 National consultants 4.2 100 percent of total expenditure claimed

8 Community Development and IEC 2.1 100 percent of total expenditure claimed

9 Project Management and office

equipment 3.2 100 percent of total expenditure claimed

10 Operation and maintenance 0.8 100 percent of total expenditure claimed

11 Financing charges during

implementation 3.0 100 percent of total amount due

12 Unallocated 5.0

Total 70.0 IEC = information, education, and communication. Source: Asian Development Bank estimates.

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C. Detailed Cost Estimates by Financiera

Item

ADB Government of Viet Nam Total Cost $ million Amount

$ million % of Cost Category

Amount ($ million)

% of Cost Category

A. Investment Cost

1. Civil Works 18.2 85% 3.2 15% 21.4 2. Medical equipment 22.6 100% - 0% 22.6 3. Vehicles 2.8 100% - 0% 2.8 4. Training 6.3 100% - 0% 6.3 5. Workshops, studies 1.4 100% - 0% 1.4 6. International consultants 0.4 100% - 0% 0.4 7. National consultants 4.2 100% - 0% 4.2 8. Community Development and IEC 2.1 100% - 0% 2.1 Subtotal (A) 58.0 95% 3.2 5% 61.2

B. Recurrent cost

1. Project management and office equipment 3.2 62% 2.0b 38% 5.2 2. Operation and maintenance 0.8 38% 1.4b 62% 2.2 Subtotal (B) 4.0

c 55% 3.4 45% 7.4

C. Contingencies

1. Physical 1.7 100% - 0% 1.7 2. Price 3.3 100% - 0% 3.3 Subtotal (C) 5.0 - 0% 5.0

D. Financing Charges during Implementation 3.0 100%

- 0% 3.0

Total Project Cost (A+B+C+D) 70.0 91%

6.6 9% 76.6

IEC = information, education, and communication. Notes: Numbers may not sum precisely because of rounding; Percentages may not total 100% because of rounding. a Including taxes and duties of $4.9 million to be financed by the government and Asian Development Bank. b In kind. c ADB will finance PMUs project contracted staff, training of all project staff, project management units recurrent costs, equipment and PMU vehicles operations

and maintenance. ADB financing does not include government salaries. Source: Asian Development Bank estimates.

18

D. Detailed Cost Estimates by Outputs/Components

Item

$ million

Total Cost

Output 1 Output 2 Output 3

Amount

% of Cost Category Amount

% of Cost Category Amount

% of Cost Category

A. Investment Cost

1. Civil Works 21.4 7.2 33% 14.3 67% - 0%

2. Medical equipment 22.6 6.0 26% 16.6 74% - 0%

3. Vehicles 2.8 0.9 32% 1.6 59% 0.3 9%

4. Training 6.3 2.7 42% 3.2 51% 0.4 6%

5. Workshops, studies 1.4 - 0% 0.6 40% 0.8 60%

6. International consultants 0.4 - 0% - 0% 0.4 100%

7. National consultants 4.2 0.9 22% 1.8 42% 1.5 36%

8. Community Development and IEC 2.1 2.1 100% - 0% - 0%

Subtotal (A) 61.2 19.8 32% 38.0 62% 3.4 6% B. Recurrent cost

1. Project management and office equipment 5.2 - 0% - 0% 5.2 100%

2. Operation and maintenance 2.2 0.8 37% 1.3 60% 0.1 3%

Subtotal (B) 7.4 0.8 11% 1.3 17% 5.3 72%

C. Contingencies

1. Physical 1.7 0.5 30% 1.1 65% 0.1 5%

2. Price 3.3 1.0 30% 2.2 65% 0.2 5%

Subtotal (C) 5.0 1.5 30% 3.3 65% 0.2 3%

D. Financing Charges during Implementation 3.0 0.9 30% 1.7 58% 0.4 12%

Total Project Cost (A+B+C+D) 76.6 23.0 30% 44.4 58% 8.8 12% IEC = information, education, and communication. Notes: Numbers may not sum precisely because of rounding; Percentages may not total 100% because of rounding. Source: Asian Development Bank estimates.

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E. Detailed Cost Estimates by Year

$ million

Item Total Year 1 Year 2 Year 3 Year 4 Year 5

A. Investment Cost

1. Civil Works 21.4 - 5.4 10.8 5.4 -

2. Medical equipment 22.6 - 5.7 11.3 5.7 -

3. Vehicles 2.8 2.8 - - - -

4. Training 6.3 1.3 1.3 1.3 1.3 1.3

5. Workshops, studies 1.4 0.3 0.3 0.3 0.3 0.3

6. International consultants 0.4 0.1 0.1 0.1 0.1 -

7. National consultants 4.2 0.8 0.8 0.8 0.8 0.8

8. Community Development and IEC 2.1 0.4 0.4 0.4 0.4 0.4

Subtotal (A) 61.2 5.6 13.9 24.9 13.9 2.8

B. Recurrent cost

1. Project management and office equipment 5.2 1.1 1.0 1.0 1.0 1.0

2. Operation and maintenance 2.2 0.4 0.4 0.4 0.4 0.4

Subtotal (B) 7.4 1.5 1.5 1.5 1.5 1.5

C. Contingencies

1. Physical 1.7 0.3 0.3 0.3 0.3 0.3

2. Price 3.3 0.7 0.7 0.7 0.7 0.7

Subtotal (C) 5.0 1.0 1.0 1.0 1.0 1.0

D. Financing Charges during Implementation 3.0 0.0 0.2 0.5 1.0 1.3

Total Project Cost (A+B+C+D) 76.6 8.2 16.6 27.9 17.3 6.6 IEC = information, education, and communication. Notes: Numbers may not sum precisely because of rounding; Percentages may not total 100% because of rounding. Source: Asian Development Bank estimates.

20

F. Contract and Disbursement S-curve

21

G. Fund Flow Diagram Source: Asian Development Bank.

(b)

(b) (b) (a)

(a)

(a) (a) (a) (b)

(c)

(c)

(b) (c)

(b) (c)

Ministry of Finance (Department of Debt

Management and External Finance)

Asian Development

Bank (Loan Account)

Supplier/ Contractor

Central Project Management Unit

Respective State

Treasury

Imprest Account at designated

commercial bank

Supplier/ Contractor Provincial

Level

Provincial Project Management Unit

Respective State

Treasury

Sub-account at designated

commercial bank

(b) (a)

(a) Documentation flow (withdrawals to imprest account) (b) Documentation flow (direct payment) (c) Documentation flow (payment from imprest account)

(a) Flow of funds (withdrawals to imprest account) (b) Flow of funds (direct payment) (c) Flow of funds (payment from imprest account)

(c) (c)

(c) (c)

Activities

(b)

District Advance

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V. FINANCIAL MANAGEMENT

A. Financial Management Assessment

24. The Financial Management Assessment (FMA) has been prepared in accordance with ADB’s Guidelines for the Financial Management and Analysis of Projects6 and the publication Financial Due Diligence: A Methodology Note.7 The FMA considers the MOH in Viet Nam as the executing agency (EA) for the proposed Second Health Care in the Central Highlands Project. The FMA includes review of the accounting and reporting system, internal and external auditing arrangements, fund disbursement procedures, and information systems. The instrument used for the assessment was ADB’s financial management assessment questionnaire. Appendix 1 describes in details the results of the FMA performed for the proposed project.

25. EA will prepare an updated Financial Management Manual for the project for training of all project finance staff and relevant key persons before the Loan becomes effective.

26. The proposed CPMU core staff was in charge of the financial management of the first Health Care in the Central Highlands Project (HICH). 8 Therefore it has extensive experience in ADB project financial management, including capacity to manage foreign exchange risk. There were no issues regarding the use of imprest accounts or SOE procedures during the previous project. B. Disbursement

27. The Loan proceeds will be disbursed in accordance with ADB’s Loan Disbursement Handbook (2012, as amended from time to time)9 and detailed arrangements agreed upon between the Government and ADB.

28. Pursuant to ADB's Safeguard Policy Statement (2009),10 ADB funds may not be applied to the activities described on the ADB Prohibited Investment Activities List set forth at Appendix 5 of the Safeguard Policy Statement. All financial institutions will ensure that their investments are in compliance with applicable national laws and regulations and will apply the prohibited investment activities list to subprojects financed by ADB.

29. An imprest account, managed by CPMU, will be opened in a commercial bank acceptable to SBV to receive funds from ADB and disburse to beneficiaries.11 The currency of the imprest account will be US Dollar (USD). The ceiling of the imprest account is 10% of the loan amount. The imprest account will be established, managed, replenished and liquidated in accordance with ADB’s Loan Disbursement Handbook (2012, as amended from time to time) and the financial regulations of the Government. The imprest account is to be used exclusively for ADB’s share of eligible expenditures. The CPMU may request for initial and additional

6 ADB. 2005. Financial Management and Analysis of Projects. Manila. Refer to page 14 of Knowledge Management

Addendum for more information on the FMA. 7 ADB. 2009. Financial Due Diligence: A Methodology Note. Manila. Refer to page 3 for more information on the

FMA. 8 ADB. 2003. Report and Recommendation of the President to the Board of Directors: Proposed Loan to the Socialist Republic of Viet Nam for the Health Care in the Central Highlands Project. Manila.

9 Available at: http://www.adb.org/Documents/Handbooks/Loan_Disbursement/loan-disbursement-final.pdf. 10 Available at: http://www.adb.org/Documents/Policies/Safeguards/Safeguard-Policy-Statement-June2009.pdf 11 ADB loan may finance bank charges.

23

advances to the imprest account based on an Estimate of Expenditure Sheet12 setting out the estimated expenditures to be financed through the account for the forthcoming 6 months. Supporting documents should be submitted to ADB or retained by CPMU in accordance with ADB’s Loan Disbursement Handbook when liquidating or replenishing the imprest account. The CPMU, who established the imprest account in its name, is accountable and responsible for proper use of advances to the imprest account, including advances to the sub-accounts (held by PPMUs).

30. Before the submission of the first withdrawal application, SBV should submit to ADB sufficient evidence of the authority of the person(s) who will sign the withdrawal applications on behalf of the borrower, together with the authenticated specimen signatures of each authorized person.

31. The minimum value per withdrawal application is $100,000 equivalent, unless otherwise approved by ADB. MOH is to consolidate claims to meet this limit for reimbursement and imprest account claims. Withdrawal applications and supporting documents will demonstrate, among other things that the goods, and/or services were produced in or from ADB members, and are eligible for ADB financing.

32. For consulting services and large goods and civil works contracts, PMUs should use generally direct payment and commitment letter procedures as guided by the ADB’s Loan Disbursement Handbook 2012, amended from time to time.

33. The SOE procedure13 may be used for reimbursement of eligible expenditures or liquidation of advances to the imprest account(s). The ceiling of the SOE procedure is the equivalent of $100,000 per individual payment. SOE records should be maintained and made readily available for review by ADB's disbursement and review mission or upon ADB's request for submission of supporting documents on a sampling basis, and for independent audit. Reimbursement and liquidation of individual payments in excess of the SOE ceiling should be supported by full documentation when submitting the withdrawal application to ADB.

34. The 5 provincial health departments (PPMUs) will each open a sub-account at the same bank holding the imprest account. Funds can be transferred from the imprest account to these sub-accounts based on AWPs prepared by PPMU and acceptable to CPMU.14 The sub- accounts are to be used exclusively for ADB’s share of eligible expenditures. Supporting documents should be submitted to ADB or retained by the CPMU/PPMU in accordance with ADB’s Loan Disbursement Handbook when liquidating or replenishing the sub-accounts.

C. Accounting

35. The MOH, CPMU and PPMU will maintain, or cause to be maintained, separate financial records for the project, by funding source, for all expenditures incurred on the project and prepare consolidated project financial statements in accordance with financial reporting arrangements acceptable to ADB. 36. The financing units established in the MOH, CPMU and PPMU involved in project implementation will maintain records and accounts that identify goods and services from loan

12 Available in Appendix 10B of the Loan Disbursement Handbook. 13 SOE forms are available in Appendix 9B of the Loan Disbursement Handbook. 14 This request will be prepared based on the value of the AWP proposed by PPMU and approved by the CPMU and

to be attached as an appendix of the request.

24

proceeds and financing sources, expenditures incurred, and use of government counterpart funds. These accounts will be established and maintained in conformity to the government's accounting laws and regulations and in accordance with sound accounting principles and standards acceptable to ADB. The CPMU will be responsible for (i) preparing disbursement projections, (ii) requesting budgetary allocations for counterpart funds, (iii) collecting supporting documents, and (iv) preparing, and sending withdrawal applications to ADB. D. Auditing and Public Disclosure

37. The MOH will cause the detailed consolidated project financial statements to be audited in accordance with International Standards on Auditing and in accordance with the Government's audit regulations by an independent auditor acceptable to ADB. The audited project financial statements will be submitted in the English language to ADB within 6 months of the end of the fiscal year by the executing agency. 38. The annual audit report will include an audit management letter and auditor’s opinions which cover (i) whether the project financial statements present a true and fair view or are presented fairly, in all material respects, in accordance with the applicable financial reporting framework; (ii) whether loan and grant proceeds were used only for the purposes of the project or not; (iii) the level of compliance for each financial covenant contained in the legal agreements for the project; (iv) compliance with the imprest fund procedure; and (v) compliance with use of the SOE procedure certifying (a) to the eligibility of those expenditures claimed under SOE procedures, and (b) proper use of the procedure in accordance with ADB’s Loan Disbursement Handbook and the project documents. 39. Compliance with financial reporting and auditing requirements will be monitored by review missions and during normal program supervision, and followed up regularly with all concerned, including the external auditor. 40. The government and MOH have been made aware of ADB‘s policy on delayed submission, and the requirements for satisfactory and acceptable quality of the audited project financial statements.15 ADB reserves the right to require a change in the auditor (in a manner consistent with the constitution of the borrower/grantee), or for additional support to be provided to the auditor, if the audits required are not conducted in a manner satisfactory to ADB, or if the audits are substantially delayed. ADB reserves the right to verify the project's financial accounts to confirm that the share of ADB‘s financing is used in accordance with ADB‘s policies and procedures.

15 ADB Policy on delayed submission of audited financial statements:

(i) When audited project financial statements are not received by the due date, ADB will write to the executing agency advising that (a) the audit documents are overdue; and (b) if they are not received within the next six months, requests for new contract awards and disbursement such as new replenishment of imprest accounts, processing of new reimbursement, and issuance of new commitment letters will not be processed;

(ii) When audited project financial statements have not been received within 6 months after the due date, ADB will withhold processing of requests for new contract awards and disbursement such as new replenishment of imprest accounts, processing of new reimbursement and issuance of new commitment letters. ADB will (a) inform the executing agency of ADB’s actions; and (b) advise that the loan may be suspended if the audit documents are not received within the next six months; and

(iii) When audited project financial statements have not been received within 12 months after the due date, ADB may suspend the loan.

25

41. Public disclosure of the project financial statements, including the audit report on the project financial statements, will be guided by ADB’s Public Communications Policy (2011).16 After review, ADB will disclose the project financial statements for the project and the opinion of the auditors on the financial statements within 30 days of the date of their receipt by posting them on ADB’s website. The Audit Management Letter will not be disclosed.

VI. PROCUREMENT AND CONSULTING SERVICES

A. Advance Actions

42. All advance actions will be undertaken in conformity with ADB‘s Procurement Guidelines (March 2013, as amended from time to time)17 and ADB‘s Guidelines on the Use of Consultants by ADB and its Borrowers (March 2013, as amended from time to time).18 The issuance of invitations to bid under advance contracting will be subject to ADB approval. The Borrower and MOH have been advised that approval of advance contracting does not commit ADB to finance the Project.

43. MOH will take advance action to ensure project readiness and timely implementation. MOH will finalize the project implementation plan and the procurement plan. It will also prepare terms of reference and recruitment of (i) two international consultants (project coordinator and civil works specialist); (ii) 9 national consultants; and (iii) two consulting firms. The consultants’ recruitment process will begin after the feasibility study has been approved. Consultants’ positions will be advertised in newspapers of national circulation, and on ADB website. Consultant contracts will be signed after loan/grant effectiveness. B. Procurement of Goods, Works and Consulting Services

44. All procurement of goods and works will be undertaken in accordance with ADB Procurement Guidelines (2013, as amended from time to time). MOH will advertise all consulting opportunities through the Consultant Management System at www.adb.org. EA will obtain user login credentials from ADB. 45. Under the Project, international competitive bidding (ICB) procedures will be used for civil work contracts estimated to cost $5,000,000 or more; national competitive bidding (NCB) procedures will be used for civil work contracts below $5,000,000. For Goods, ICB procedures will be used for goods valued at $3,000,000 or above; NCB procedures will be used for goods valued below $3,000,000; Civil works contracts and goods costing $100,000 or less will be procured through shopping. 46. Civil works procurement packages and other equipment will be awarded based on local competition and will be managed by the five PPMUs with supervision by the Central level and ADB when they are below $1,000,000. Above this level the CPMU will take a leading role and the bidding methodology will be international and national but the bidding process will be launched locally in the provinces. 47. Medical equipment and supplies packages will be procured by CPMU on basis of ICB, NCB, shopping or direct purchase. 16 Available from http://www.adb.org/documents/pcp-2011?ref=site/disclosure/publications 17 Available at: http://www.adb.org/Documents/Guidelines/Procurement/Guidelines-Procurement.pdf 18 Available at: http://www.adb.org/Documents/Guidelines/Consulting/Guidelines-Consultants.pdf

26

48. Vehicles (hospital ambulances and district outreach vehicles) will be procured through ICB. 49. An 18-month procurement plan indicating threshold and review procedures, goods, consulting service contract packages and NCB guidelines is in Section C. 50. All consultants will be recruited according to Guidelines on the Use of Consultants by ADB and its Borrowers (2010, as amended from time to time).19 The terms of reference for all consulting services are detailed in Section D. 51. The project will recruit international individual consultants and national individual consultants. Details of the type of consultant and their respective length of engagement are details in Sections C and D. The Project will require seven consulting firms for (i) information, education and communication (IEC); (ii) training program and health care quality insurance; (iii) civil works detail design and supervision (four firms); and (iv) financial audit. Consulting firms will be hired under Quality- and Cost-Based Selection (QCBS), Quality-Based Selection (QBS), Least Cost Selection (LCS). C. Procurement Plan

Basic Data Project Name: Second Health Care in the Central Highlands Country: Viet Nam Executing Agency: Ministry of Health Loan Amount: $70.0 million Loan Number: TBD Date of First Procurement Plan: 16 July 2013 Date of this Procurement Plan: 16 July 2013

1. Process Thresholds, Review and 18-Month Procurement Plan

a. Project Procurement Thresholds

52. Except as the Asian Development Bank (ADB) may otherwise agree, the following process thresholds shall apply to procurement of goods and works.

Procurement of Goods and Works Method Threshold

For Works International Competitive Bidding Above $5,000,000 National Competitive Bidding Shopping

Below $5,000,000 $100,000 and below

For Goods International Competitive Bidding National Competitive Bidding Shopping

Above $3,000,000 From $100,001 to $3,000,000 $100,000 and below

b. ADB Prior or Post Review

53. Except as ADB may otherwise agree, the following prior or post review requirements apply to the various procurement and consultant recruitment methods used for the project.

19 Checklists for actions required to contract consultants by method available in e-Handbook on Project

implementation at: http://www.adb.org/documents/handbooks/project-implementation/.

27

Procurement Method Prior or Post Comments Procurement of Goods and Works

International Competitive Bidding National Competitive Bidding Shopping

Prior Prior/Post

Prior/Post

All contracts Prior review for 1st contract and subject to satisfactory execution, post review for the subsequent contracts being awarded by the same PMU Prior review for 1st contract and subject to satisfactory execution, post review for the subsequent contracts being awarded by the same PMU

Recruitment of Consulting Firms

Quality- and Cost-Based Selection (QCBS) Quality-Based Selection (QBS) Least Costs Selection (LCS)

Prior

Recruitment of Individual Consultants Individual Consultants Prior

c. Goods and Works Contracts Estimated to Cost More Than $1 Million

54. The following table lists goods and works contracts for which procurement activity is either ongoing or expected to commence within the next 18 months.

General Description

Contract Value

Procurement Method

Prequalification of Bidders (y/n)

Advertisement Date

(quarter/year) Comments Civil Works

WWTP in Dak Lak, Lam Dong, Dak Long and Gia Lai

1,800,000 NCB N IV Q 2015 Package CW3

36 CHS in Kon Tum (New + Upgrade)


9 new ICPs in Lam Dong


Procurement Vehicles

2.740,000 ICB N I Q 2015 Package E3

Medical Equipment 1,604,070 NCB N IV Q 2015 Package E6 New and upgraded CHS (including furniture) all provinces

Medical Equipment 1,714,410 NCB N IV Q 2015 Package E7 New and upgraded ICPs (including furniture) all provinces

d. Consulting Services Contracts Estimated to Cost More Than $100,000

55. The following table lists consulting services contracts for which procurement activity is either ongoing or expected to commence within the next 18 months.

28

General Description Contract Value

Recruitment Method

1

Advertisement Date

(quarter/year)

International or National

Assignment Comments

315,000 QCBS II Q 2014 National To be recruited by the PMU:80:20

Design and detailed engineering of referral hospitals and waste water treatment plants (WWTP)


Supervision of the CHS and ICPs construction


Supervision of the district hospitals and WWTP


Firm 1: IEC Campaign 300,000 QBS II Q 2014 National To be recruited by the PMU

Firm 2: Quality of Health Care and Training

500,000 QBS I Q 2014 National To be recruited by the PMU

e. Goods and Works Contracts Estimated to Cost Less than $1 Million

and Consulting Services Contracts Less than $100,000 56. The following table groups smaller-value goods, works and consulting services contracts for which procurement activity is either ongoing or expected to commence within the next 18 months.

General Description

Value of Contracts (cumulative)

Number of Contracts

Procurement / Recruitment Method

a Comments

Civil Works

ICP in Eakly - District Kron Pak (Dak Lak)

340,000 1 NCB Package CW4

10 new CHS in Dak Nong 864,000 1 NCB Package CW8 8 CHS in Gia Lai (New + Upgrade) 595,800 1 NCB Package CW6 Goods Solid waste management equipment

900,000 1 NCB Package E4, Lot 2 -specific equipment

Equipment for VHW 818,500 1 NCB Package E12 Teaching/Training Equipment 468,250 1 NCB Package E4, Lot 1

-specific equipment Equipment for PCMU 79,500 1 Shopping Package E1 Procurement Equipment 5 PPMU 250,000 5 Shopping Package E2 Additional Equipment for CHSs 1,500,000 15 packages Shopping Additional Equipment for ICPs 350,000 5 packages Shopping Water and sanitation equipment repairs in district hospitals

1,080,000 10 packages Shopping

Logistic services for packages 3 to 11 for goods: receiving goods at port, custom clearance, domestic transport of goods to end users at central and provincial levels

980,000

2 NCB

Inspection of Goods at port of destination packages 3 to 11 for goods

100,000 2 Shopping

Insurance of goods from port of destination to end – users places. Packages 3 to 11 for goods

100,000 2 Shopping

29

General Description

Value of Contracts (cumulative)

Number of Contracts

Procurement / Recruitment Method

a Comments

IEC materials for village communities

791,000 1 NCB

Consulting Services Audit services 200,000 1 LCS National Firm Individual CTA/Project/Planning coordinator (Vietnamese)

240,000 1 ICS/International 48 person-months

Medical equipment specialist 1 45,000 1 ICS/International 3 person-months Medical equipment specialist 2 36,000 1 ICS/National 12 person-months Medical equipment specialist 3 36,000 1 ICS/National 12 person-months Civil Work specialist 1 180,000 1 ICS/International 9 person-months Civil Work specialist 2 96,000 1 ICS/National 48 person-months Civil Work specialist 3 96,000 1 ICS/National 48 person-months Disbursement consultant 240,000 2 ICS/National 120 person-months Procurement consultant 216,000 2 ICS/National 108 person-months Finance manager 120,000 1 ICS/National 60 person-months Medical equipment consultant 56,000 2 ICS/National 28 person-months Midterm Review consultant 6,000 1 ICS/National 3 person-months Project completion report consultant 1

6,000 1 ICS/National 3 person-months

Project completion report consultant 2


Communication/IEC consultant 72,000 1 ICS/National 36 person-months Quality assurance consultant 96,000 1 ICS/National 48 person-months Training consultant 120,000 1 ICS/National 60 person-months Safeguards specialist 12,000 1 ICS/National 6 person-months Social and gender consultant 32,000 1 ICS/National 16 person-months Translator 50,000 1 25 person-months Monitoring and evaluation specialist


2. Indicative List of Packages Required Under the Project

57. The following table provides an indicative list of all procurement (goods, works and consulting services) over the life of the project. Contracts financed by the Borrower and others should also be indicated, with an appropriate notation in the comments section.

General Description

Estimated Value

(cumulative)

Estimated Number of Contracts

Procurement Method

Domestic Preference Applicable

a Comments

Goods Equipment 20,500,000 9 ICB N Medical equipment,

district and provincial hospitals, teaching equipment, solid waste management equipment and vehicles

Medical equipment 818,000 4 NCB N Equipment for village health workers and village midwives. ICPs and CHSs

Medical Equipment and sanitation equipment

3,250,000 35 Shopping N Office equipment, Supplementary equipment CHS and ICPs, Sanitation district hospitals

30

General Description

Estimated Value

(cumulative)

Estimated Number of Contracts

Procurement Method

Domestic Preference Applicable

a Comments

Logistic services for procurement of medical equipment

980,000 2 NCB N Medical equipment packages E4 to E11: receiving goods at port, custom clearance, domestic transport of goods to end users at central and provincial levels

Inspection at port of destination and insurance of Goods

200,000 4 Shopping N

Works Rehabilitation and construction WWTP, district and provincial hospitals

14,300,0000 5 NCB N

Rehabilitation and construction commune health centers and ICPs

7,200,000 5 NCB N

Consulting services A. Firm Design, detailed engineering and supervision civil works

1,886,000 4 QCBS 80:20 BDP

NGO for behavioral change communication, and training and quality of health services

800,000 2 QBS Full proposal (i) Behavior change campaigns conducted, health insurance social marketing

(ii) Quality of health services and Training

Financial Audit 200,000 1 LCS BDP

Individual consultants International consultants

405,000 3 ICS

National consultants 1,350,000 19 ICS a See Procurement Guidelines, Appendix 2. b Indicate recruitment method and whether it is for international or national assignment. c See PAI 2.02G: full, simplified or biodata proposal. Source: Asian Development Bank estimates.

3. National Competitive Bidding

a. General

58. The laws to be followed for national competitive bidding are set forth in (i) the Law on Procurement No. 61/2005/QH11 of 29 November 2005, (ii) the Construction Law no. 16/2003/QH11 of 26 November 2003, (iii) the Amendment Law No. 38/2009/QH12 of 19 June 2009 amending and supplementing key articles of the above-mentioned two laws, and (iv) the processes described in Decree No. 85/2009/ND-CP of 15 October 2009 on “Guiding Implementation of Procurement Law and Selection of Construction Contractors under the Construction Law”. Whenever any procedure in the national procurement laws is inconsistent with the ADB Procurement Guidelines (March 2013, and as amended from time to time), the ADB Guidelines shall prevail, amongst others on the following.

31

b. Registration

(i) Bidding shall not be restricted to pre-registered firms and such registration shall not be a condition for participation in the bidding process.

(ii) Where registration is required prior to award of contract, bidders: (a) shall be allowed a reasonable time to complete the registration process; and (b) shall not be denied registration for reasons unrelated to their capability and resources to successfully perform the contract, which shall be verified through post-qualification.

(iii) Foreign bidders shall not be required to register as a condition for submitting bids.

(iv) Bidder’s qualification shall be verified through pre- or post-qualification process.

c. Eligibility

(i) National sanction lists may only be applied with approval of ADB.20 (ii) A firm declared ineligible by ADB cannot participate in bidding for an ADB

financed contract during the period of time determined by ADB. (iii) A firm which has been engaged by the borrower to provide consulting services

for the preparation or implementation of a project, and any of its affiliates, shall be disqualified from subsequently providing goods, works, or services, resulting from or directly related to the firm's consulting services for such preparation or implementation.

d. Prequalification and Post qualification

(i) Post qualification shall be used unless prequalification is explicitly provided for in the loan agreement/procurement plan. Irrespective of whether post qualification or prequalification is used, eligible bidders (both national and foreign) shall be allowed to participate.

(ii) In the event where pre-qualification is used, interested firms shall be given no less than 42 days to prepare their pre-qualification submission.

(iii) When pre-qualification is required, the evaluation methodology shall be based on pass/ fail criteria relating to the firm’s experience, technical and financial capacities.

(iv) Qualification criteria shall be clearly specified in the bidding documents, and all criteria so specified, and only criteria so specified, shall be used to determine whether a bidder is qualified. The evaluation of the bidder’s qualifications should be conducted separately from the technical and commercial evaluation of the bid.

(v) In carrying out the post-qualification assessment, the Employer/ Purchaser shall exercise reasonable judgment in requesting, in writing, from a bidder missing factual or historical supporting information related to the bidder’s qualifications and shall provide reasonable time period (a minimum of 7 days) to the bidder to provide response.

20 Section 52 of the Integrity Principles and Guidelines allows ADB to sanction parties who fail to meet ADB's high

ethical standards based on the decisions of third parties, such a decision can only be made by the Integrity Oversight Committee on the basis of ADB's own independent examination of the evidence. As such, the process should follow the normal assessment and investigative processes prescribed by the Integrity Principles and Guidelines. http://www.adb.org/Documents/Guidelines/Integrity-Guidelines-Procedures/integrity-guidelines-procedures-2006.pdf.

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e. Preferences

(i) No preference of any kind shall be given to domestic bidders or for domestically manufactured goods.

(ii) Regulations issued by a sectoral ministry, provincial regulations and local regulations which restrict national competitive bidding procedures to a class of contractors or a class of suppliers shall not be applicable.

(iii) Foreign bidders shall be eligible to participate in bidding under the same conditions as local bidders, and local bidders shall be given no preference (either in bidding process or in bid evaluation) over foreign bidders, nor shall bidders located in the same province or city as the procuring entity be given any such preference over bidders located outside that city or province

f. Advertising

(i) Invitations to bid (or prequalify, where prequalification is used) shall be advertised in Government Public Procurement Bulletin. In addition, the procuring agency should publish the advertisement in at least one widely circulated national daily newspaper or freely accessible, nationally-known website allowing a minimum of 28 days for the preparation and submission of bids and allowing potential bidders to purchase bidding documents up to at least 24 hours prior the deadline for the submission of bids. Bidding of NCB contracts estimated at $500,000 or more for goods and related services or $1,000,000 or more for civil works shall be advertised on ADB’s website via the posting of the Procurement Plan.

(ii) Bidding documents shall be made available by mail, or in person, to all who are

willing to pay the required fee, if any. (iii) The fee for the bidding documents should be reasonable and consist only of the

cost of printing (or photocopying) the documents and their delivery to the bidder. (Currently set at 1 Mln VND, increase subject to approval of ADB)

g. Standard bidding documents

(i) The Borrower’s standard bidding documents, acceptable to ADB, shall be used. The bidding documents shall provide clear instructions on how bids should be submitted, how prices should be offered, and the place and time for submission and opening of bids.

(ii) Bidders shall be allowed to submit bids by hand or by mail/ courier.

h. Bid Opening

(i) All bids received after the deadline for submission indicated in the bidding documents will be rejected.

(ii) All bids received before the bid submission deadline shall be opened except those with proper notice of withdrawal.

(iii) A copy of the bid opening record shall be promptly provided to all bidders who submitted bids.

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i. Bid Evaluation

(i) Merit points shall not be used in bid evaluation. (ii) Bidders shall not be eliminated from detailed evaluation on the basis of minor,

non-substantial deviations.21 (iii) Except with the prior approval of ADB, no negotiations shall take place with any

bidder prior to the award, even when all bids exceed the cost estimates. (iv) A bidder shall not be required, as a condition for award of contract, to undertake

obligations not specified in the bidding documents or otherwise to modify the bid as originally submitted.

(v) Bids shall not be rejected on account of arithmetic corrections of any amount. However, if the Bidder that submitted the lowest evaluated bid does not accept the arithmetical corrections made by the evaluating committee during the evaluation stage, its bid shall be disqualified and its bid security shall be forfeited.

j. Rejection of All Bids and Rebidding

(i) No bid shall be rejected on the basis of a comparison with the owner's estimate or budget ceiling without the ADB’s prior concurrence.

(ii) Bids shall not be rejected and new bids solicited without the ADB’s prior concurrence.

k. Participation by Government-owned enterprises

59. Government-owned enterprises shall be eligible to participate as bidders only if they can establish that they are legally and financially autonomous, operate under Enterprise law and are not a dependent agency the contracting entity. Furthermore, they will be subject to the same bid and performance security requirements as other bidders.

l. Non-eligibility of military or security units

60. Military or security units, or enterprises which belong to the Ministry of Defense or the Ministry of Public Security shall not be permitted to bid.

m. Participation by Foreign contractors and suppliers. Joint Ventures and Associations

(i) Foreign suppliers and contractors from eligible countries shall, if they are interested, be allowed to participate without being required to associate or form joint ventures with local suppliers or contractors, or to subcontract part of their contract to a local bidder.

(ii) A bidder declared the lowest evaluated responsive bidder shall not be required to form a joint venture or to sub-contract part of the supply of goods as a condition of award of the contract.

(iii) License for foreign contractors operation in Viet Nam would be provided in a timely manner and will not be arbitrarily withheld.

21 Minor, non-substantial deviation is one that, if accepted, would not affect in any substantial way the scope, quality,

or performance specified in the contract; or limit in any substantial way, the Contracting entity rights or the Bidder’s obligations under the proposed contract or if rectified, would not unfairly affect the competitive position of other bidders presenting substantially responsive bids.

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n. Publication of the Award of Contract. Debriefing.

(i) For contracts subject to prior review, within 2 weeks of receiving ADB’s “No-objection” to the recommendation of contract award, the borrower shall publish in the Government Public Procurement Bulletin, or well-known and freely-accessible website the results of the bid evaluation, identifying the bid and lot numbers, and providing information on: i) name of each bidder who submitted a bid; ii) bid prices as read out at bid opening; iii) name and evaluated prices of each bid that was evaluated; iv) name of bidders whose bids were rejected and the reasons for their rejection; and v) name of the winning bidder, and the price it offered, as well as the duration and summary scope of the contract awarded.

(ii) For contracts subject to post review, the procuring entity shall publish the bid evaluation results no later than the date of contract award.

(iii) In the publication of the bid evaluation results, the borrower shall specify that any bidder who wishes to ascertain the grounds on which its bid was not selected, should request an explanation from the procuring entity. The procuring entity shall promptly provide an explanation of why such bid was not selected, either in writing and / or in a debriefing meeting, at the option of the borrower. The requesting bidder shall bear all the costs of attending such as debriefing. In this discussion, only the bidder’s bid can be discussed and not the bids of competitors. o. Handling of Complaints

61. The national competitive bidding documents shall contain provisions acceptable to ADB describing the handling of complaints in accordance with Chapter X of Decree No. 85/2009/ND-CP, read with Articles 72 and 73 of the Law on Procurement No. 61/2005/QH11.

p. ADB Member Country Restrictions

62. Bidders must be nationals of member countries of ADB, and offered goods, works, and services must be produced in and supplied from member countries of ADB.

q. Fraud and Corruption

63. ADB will sanction a party or its successor, including declaring ineligible, either indefinitely or for a stated period of time, to participate in ADB-financed activities if it at any time determines that the firm has, directly or through an agent, engaged in corrupt, fraudulent, collusive, or coercive practices in competing for, or in executing, an ADB-financed contract.

r. Right to Inspect/ Audit

64. Each bidding document and contract financed from by ADB shall include a provision requiring bidders, suppliers, contractors to permit ADB or its representative to inspect their accounts and records relating to the bid submission and contract performance of the contract and to have them audited by auditors appointed by ADB.

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D. Consultants’ Terms of Reference

1. International Project Coordinator (PC) (48 person-months)

65. Qualifications, experience and specific skills:

(i) Master’s Degree in Public Health, Economics or Management (10 years’ experience)

(ii) Proven experience in project management, planning and budgeting in Viet Nam (5 years’ experience)

(iii) Strong in M&E, Results Oriented Management (ROM) performance set up, planning, management and assessment (3 years’ experience)

(iv) Preferable with experience in the implementation of ADB / WB funded projects (v) Ability to work independently at national, provincial and district levels (vi) Willingness to do field work assignments for at least 50% of the contracted time (vii) Strong interpersonal skills and experience in capacity building of counterpart

staff at different levels (viii) Ability to lead a team effectively (ix) Vietnamese language native language and strong English language skills (both

written and spoken) (x) Microsoft package (Word, Excel, PowerPoint and Microsoft Project)

66. The PC will have the overall responsibility for management of the CPMU, for supporting and coordinating the CPMU technical and administrative team, national consultants, consulting companies, PPMU managers. In particular, the consultant will undertake the following tasks:

(i) Develop standard operating procedures for the Project (ii) Prepare a detailed consolidated plan, timetable, and annual budget for

implementation and seek agreement from MOH and ADB (iii) Select, supervise, and monitor activities of national consultants (iv) Organize team meetings and supervise all technical project staff (v) Prepare regional communication materials and facilitate the dialogue to promote

regional technical seminars (vi) Facilitate and arrange annual review as well as midterm and project completion

evaluations, workshops, meetings, and seminars (vii) Ensure that the project is implemented in accordance with the cooperative

agreement, donor regulations, and internationally recognized quality standards (viii) Participate in the development of strategic work plans with clear objectives and

achievement benchmarks, long-term and short-term priorities, implementation plans, financial projections and tools for evaluation

(ix) Plan, monitor, improve quality and accompany activities in accordance with the cooperative agreement, including financial auditing, surveys, evaluations and ADB monitoring missions

(x) Review provincial AWPs and provide comments. (xi) Facilitate the organizational development and capacity building of the local

partner organization involved in the provision of health service promotional interventions

(xii) Ensure appropriate quality control systems are in place and implemented across programs (includes the development of indicators and monitoring and evaluation [M&E] systems)

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(xiii) Support project staff by creating and maintaining a work environment that promotes teamwork, trust, mutual respect, and empowers staff to take responsibility and show initiative

(xiv) Undertake consultation meetings with partners (multilateral and bilateral organizations, International and national non-government organizations [NGOs]) and other stakeholders as part of the policy development process and ensure that adequate technical inputs are provided

67. Candidates with the following characteristics will be preferentially selected with suitable evaluation rating: women, ethnic groups and person with disability (PWD).

2. International Civil Works Specialist (9 person-months)


(i) Degree in Civil Engineering and/ or Architecture (≥ Bachelor degree) (ii) Management of design and construction supervision aspects for health facilities

(CHS, ICP, district referral hospital [DRH]) in similar circumstances (≥ 15 years’ experience)

(iii) Experience with Waste Water Treatment Plants (WWTP) (≥ 3 years’ experience) (iv) Ability to work as part of a team effectively, to take own initiative and to guide

the national civil work experts from a distance (v) Willingness to accompany the project during 3 years and to do field work

assignments if needed (vi) Proficiency in English language skills (both written and spoken) (vii) Microsoft package (Word, Excel, PowerPoint and Microsoft Project) and

engineering design software

69. Tasks:

(i) Assist during procurement in organizing and evaluating the bidding process, especially for those civil works organized or directly accompanied by the CPMU (> 1,000,000 $) and the selection of the civil works consulting firm

(ii) Liaise with the 2 national civil works coordinators (iii) Oversee and approve the work of the 2 Consulting firms for civil works

(CHS/ICP and DRH/WWTP), especially on the quality of the plans, the technical description (phase 1) and on the quality assurance activities (phase 2)

(iv) Advice the national civil works specialists on tools development, training curriculums, including for on-the-job training during construction sites visits and on supervision

(v) Orient the national civil works specialist to work closely and in a participatory way with the Consulting firm for CHS/ICP and for DRH/WWTP during the design period (phase 1) by providing them MOH standard plans and guidelines and facilitating their contact with the provincial civil works specialists

(vi) Orient the national civil works specialist to accompany closely and in a participatory way the Consulting firm for CHS/ICP and for DRH / WWTP during the construction phase and the handover certificates

(vii) Monitor the civil works progress in the 5 provinces to the CPMU and/or ADB if required

(viii) Assist CPMU, PPMU and ADB in any other task related to civil works and its procurement as requested

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70. Candidates with the following characteristics will be preferentially selected with suitable evaluation rating: women, ethnic groups and PWD.

3. International Equipment Specialist (3 person-months)


(i) Background in electronic/biomedical/hospital engineering (≥ Bachelor degree) (ii) Demonstrated understanding of medical equipment with/without hospital

engineering (iii) Relevant experience for government and/or international funded projects (≥ 10

years’ experience) (iv) Demand analysis for medical equipment at each identified level of health facility

(≥ 5 years’ experience) (v) Familiar with developing generic (non)medical equipment specifications (≥ 5

years’ experience) (vi) Knowledgeable on South East Asian markets for (non)medical equipment (≥ 5

years’ experience) (vii) Proficiency in English language skills (both written and spoken) (viii) Advanced Microsoft package (Excel, database and Microsoft project)

72. Tasks:

(i) Review and update equipment plan as requested (ii) Providing support to CPMU and PPMUs in reviewing technical specifications for

(non)medical equipment, prepared by the national equipment specialist, for each bidding model, (ICB, NCB or Shopping method)

(iii) Review the composition of the different bidding packages / lots to ensure a competitive bidding process in the most cost-efficient way

(iv) Contribute to improving content and training methodology for workshops to strengthen the maintenance capacity of hospitals

(v) Assist CPMU, PPMU and ADB in any other task related to equipment as requested


4. National Equipment Specialist (28 person-months, 2 positions)


(i) Background in electronic/biomedical/hospital engineering (≥ Bachelor degree) (ii) Demonstrated understanding of medical equipment with/without hospital

engineering (iii) Relevant experience for government and/or international funded projects (≥ 5

years’ experience) (iv) Demand analysis for medical equipment at each identified level of health facility

(≥ 3 years’ experience) (v) Familiar with developing generic (non)medical equipment specifications (≥ 3

years’ experience) (vi) Proficiency in English language skills (both written and spoken)

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(vii) Advanced Microsoft package (Excel, database and Microsoft project) 75. Tasks:

(i) Review and update equipment plan as requested (ii) Prepare technical specifications for (non)medical equipment, for each bidding

package, (ICB, NCB or Shopping method) (iii) Review the composition of the different bidding packages / lots to ensure a

competitive bidding process in the most cost-efficient way (iv) Contribute to improving content and training methodology for workshops to

strengthen the maintenance capacity of hospitals (v) Perform any other task related to equipment as requested

5. National Architecture and Civil Works Specialist (96 person-months, 2 positions)


(i) Degree in Civil Engineering and/ or Architecture (≥ Bachelor degree) (ii) Management of design and construction supervision aspects for health facilities

(CHS, ICP, DRH) (≥ 5 years’ experience) (iii) Experience with WWTP is an advantage (iv) Ability to work either as part of a team effectively, to take own initiative and to

work independently with minimal supervision (v) Willingness to be based in the central highlands and to do field work

assignments for at least 50% of the time (vi) Ability to work either as part of a team effectively, to take own initiative and to

work independently with minimal supervision (vii) Proficiency in Vietnamese language and preferably good English language skills

(both written and spoken). Willingness to do technical translation and interpretation tasks

(viii) Microsoft package (Word, Excel, PowerPoint and Microsoft Project) and engineering design software

77. Tasks:

(i) Assist procurement in organizing and evaluating the bidding process, especially for those civil works organized or directly accompanied by the CPMU (> 1,000,000 $) and the selection of the civil works consulting firm

(ii) Liaise with the provincial civil works coordinator for the provinces under his/her responsibility

(iii) Train, including on-the-job training during construction sites visits and supervise provincial civil works specialist at the commune (CHS / ICPs) / district level (DRH)

(iv) Assist the provincial civil works specialist to work closely and in a participatory way with the Consulting firm for CHS/ICP and for DRH / WWTP during the design period (phase 1) by providing them MoH standard plans and guidelines and facilitating their contact with the provincial civil works specialists

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(v) Assist the provincial civil works specialist to accompany closely and in a participatory way the Consulting firm for CHS/ICP and for DRH / WWTP during the construction phase (phase 2) and the handover certificates

(vi) Supervise and assist in the provincial procurement process for civil works (vii) Document, monitor and report on the civil works progress in the 5 provinces to

the CPMU and/or ADB if required (viii) Assist CPMU, PPMU and ADB in any other task related to civil works and its

procurement as requested


6. National Equipment Specialist (24 person-months, 2 positions)


(i) Background in electronic/biomedical/hospital engineering (Bachelor degree) (ii) Relevant experience for government and/or international funded projects (≥ 5

years’ experience) (iii) Relevant experience also with developing the technical descriptions for non-

medical equipment (≥ 5 years’ experience) (iv) Willingness to do field work at least 30% of the contracted time (v) Good English and Vietnamese language skills (both written and spoken) (vi) Advanced Microsoft package (Excel, database and Microsoft project)

80. Tasks:

(i) Work together with (inter)national equipment and procurement specialist to

ensure a smooth procurement process in all its aspects (ii) Ascertain to CPMU and PPMUs procurement specialists that technical

descriptions in the bidding documents are conform to the needed technical requirements specified in the bidding document

(iii) On request from CPMU or PPMU, assist to check the equipment at site to ensure that they are consistent to the signed contract

(iv) Assist to review equipment plan proposed by CPMU and/or PPMUs (v) Organize workshops to strengthen the maintenance capacity of hospitals (vi) Assist CPMU, PPMU and ADB in any other task related to equipment as

requested


7. National Monitoring and Evaluation Specialist (60 person-months)


(i) Medical doctor (≥ 15 years’ experience) (ii) Master degree is preferable (iii) M&E experience (≥ 5 years’ experience) (iv) Data base development and maintenance experience (≥ 5 years’ experience) (v) In-depth knowledge of the Vietnamese Health System

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(vi) Willingness to be based in central highlands and to do field work assignments for at least 70% of the contracted time

(vii) Ability to work either as part of a team effectively, to take own initiative and to work independently with minimal supervision

(viii) Proficiency in Vietnamese language and good English language skills (both written and spoken). Willingness to do technical translation and interpretation tasks

(ix) Microsoft package (Word, Excel, PowerPoint and Microsoft Project) and database languages

83. Tasks:

(i) Be in contact with MOH for M&E policies and future developments: official data

collection forms, M&E reporting formats, data collection guidelines, introduction of web-based HMIS reporting (hospital and ICP/CHS level), M&E indicators and their definitions, health sector performance reports,

(ii) Develop a software and hardware HMIS inventory system for all hospitals, train provincial staff and guarantee data completeness

(iii) Collect copies and analyze different existing database software for hospital health service provision, billing and Social Security refunds

(iv) Collect and analyze all existing reports on M&E (national programs as well as DMF related) at provincial level and at district level for the 11 poverty intervention district, starting from 2010 and triangulate them with data available from MOH Central level as well as from individual surveys

(v) Develop a detailed standardized project M&E reporting system, train provincial M&E staff on its use and follow up on proper reporting

(vi) Assure proper DMF M&E documentation and analysis, including quarterly report writing for CPMU with consolidated data analysis from the 5 provinces and the 11 poverty intervention districts

(vii) Monitor health sector performance, with special attention to the 11 poverty intervention districts

(viii) Prepare, together with other CPMU members, central level annual, mid-term and project completion workshops and evaluations

(ix) Assist MOH and ADB in any data requirement and analysis (x) Help to design and accompany closely all project surveys (xi) Make a training needs assessment for M&E, quality improvement and planning

as part of the CPMU technical team (xii) Develop an M&E development plan and spearhead its implementation (xiii) Organize and facilitate training on M&E, quality improvement and planning to

the provinces and districts (xiv) Assist CPMU, PPMU and ADB in any other task related to M&E and health

management information system (HMIS) as requested


8. National Quality Assurance Specialist (48 person-months)


(i) Medical doctor, Postgraduate degree is preferable (≥ 15 years’ experience)

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(ii) Clinical medicine experience (≥ 5 years’ experience) (iii) Health management experience (≥ 5 years’ experience) (iv) MOH experience, especially in clinical standard development and training

experience is preferable (v) Willingness to be based in central highlands and to do field work assignments

for ≥ 70% of contracted time (vi) Ability to work either as part of a team effectively, to take own initiative and to



(viii) Microsoft package (Word, Excel, PowerPoint and Microsoft Project) 86. Tasks:

(i) Be in contact with MOH and its partners on Quality Improvement (QI) policies, guidelines, management tools, initiatives and good practices and follow up their future developments

(ii) Develop, in collaboration with the 5 provinces and with the assistance of the international QI specialist, a detailed standardized Quality Improvement mechanism, set up, monitoring system and QI plan at district hospital, DPMC and CHS levels, train provincial and district staff on its installation and development and follow up the implementation, initially in few pilot districts amongst the 11 poverty intervention districts

(iii) Accompany and mentor closely the NGO contracted for IEC MCH development, and health service promotion, focusing on increasing utilization by making QI measures, commitments and achievements publically known

(iv) Assist the other CPMU members, in the development of master inventory lists on HRD, infrastructure, equipment, and soft/hardware HMIS inventory systems for all hospitals, in the training of provincial/district staff and in assuring data completeness

(v) Assist in the development of interlinked and interactive electronic data base networks with inventory lists, M&E data, HMIS health facility and referral service data) to facilitate Quality Improvement management and monitoring

(vi) Assist M&E in the collection and analysis of all M&E and HMIS reports at provincial and district level (11 poverty interventions)

(vii) Develop, in collaboration with the 5 provinces, a detailed standardized Quality benchmark assessment system for annual operational plan (AOP), DoH senior management, hospital and CHS, a benchmark assessment plan, training and organize it on a yearly basis

(viii) Assure proper DMF M&E documentation and analysis (ix) Contribute to the quarterly and annual report writing for CPMU with consolidated

data analysis on Quality Improvement Interventions (x) Monitor health sector performance, with special attention to the 11 poverty

intervention districts (xi) Assist in the design and implementation of all project surveys (xii) Assist in the training needs assessment for quality improvement, M&E and

planning as part of the CPMU technical team (xiii) Organize and facilitate training on quality improvement, M&E, planning and

budgeting to the provinces and districts (xiv) Assist MoH and ADB in any data on service quality standards and analysis

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(xv) Prepare, together with other CPMU members, central level annual, mid-term and project completion workshops and evaluations

(xvi) Assist CPMU, PPMU and ADB in any other task related to Quality Improvement as requested


9. National Training Consultant (60 person-months) 88. Qualifications, experience and specific skills:

(i) University degree in Public Health, Health Education or other relevant field (ii) Education, preferably in the health sector (iii) Excellent skills in project management demonstrated in previous jobs (≥ 10

years’ experience ≥ 5 years’ experience) (iv) Willingness to be based in central highlands and to do field work assignments

for at least 70% of the contracted time (v) Ability to work either as part of a team effectively, to take own initiative and to

work independently with minimal supervision (vi) Proficiency in Vietnamese language and preferably good English language skills


(vii) Microsoft package (Word, Excel, PowerPoint and Microsoft Project)

89. Tasks:

(i) Review MOH current National HRD Plan, policies and guidelines in the context of the Project adopting a Training Systems development

(ii) Assist the key institutes, PMUs and MOH to establish the Training Systems Framework and strategy to guide all training to be undertaken in the Project

(iii) In consultation with Provincial Training Working Groups and relevant national institute training experts, develop a common approach to the training of Provincial and District Trainers, and design and produce the training procedures manual, applying due attention to safeguard policies on gender and ethnic groups

(iv) Make sure HRD interventions by the project as well as by other channels are disseminated to the districts, including potential support and priorities

(v) Assist DOHs to develop and implement their own comprehensive HRD polices, on continuous education, as well as on long term continued education, which benefit the provincial health system as well as the individuals

(vi) Develop a HRD data base, for provincial use with assistance of other ADB HRD interventions and make sure the 5 DoHs are trained in its use and put into implementation

(vii) Ascertain that adequate HRD long and short term selection structures and procedures are in place to guarantee an optimal use of existing HRD opportunities

(viii) Follow up scholarship students and monitor the quality of education and their progress

(ix) Based on the review work with the training institutes to undertake a Training Needs Assessment (TNA) of staff engaged in the Project

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(x) Assist CPMU, PPMU and Provincial Medical Schools to develop regular needs-based training assessments and tailored training courses

(xi) Together with the MOH (or nominated institute) review training needs as identified by national, provincial and district staff and local institutions and approve HRD in provincial AWPs

(xii) Provide advice of the required linkages and partnership for HRD in the country (xiii) Identify successful training modalities, that use science-based, participatory

learning methods for doctors, nurses, and other health workers, including community volunteers

(xiv) Develop training modules to assist district and provincial long term and short term training activities of the project

(xv) Assist in the development of training packages for skills based training and TOT for Master Trainers from provincial health departments

(xvi) Accompany and supervise TA for training organized by CPMU on health system and project management

(xvii) Identify key materials and experts to assist with the project training activities (xviii) Provide technical assistance and guidance to program staff and partners during

the development of new programs, and with best practice methodologies instituted

(xix) Oversee the implementation of gender and ethnicity safeguards (xx) Monitor progress with implementation of HRD strategies in line with existing key

policies and provincial HRD policies and plans (xxi) Produce regular reports, briefing papers and disseminate good practices

documents on HRD from other stakeholders (xxii) Assist CPMU, PPMU and ADB in any other task related to HRD as requested


10. National Social and Gender Specialist (16 person-months) 91. Qualifications, experience and specific skills:

(i) Relevant experience in accompanying social, gender, ethnic groups and resettlement interventions (≥10 years’ experience)

(ii) Experience in the health sector, especially with community MCH interventions as well as with HRD (≥5 years’ experience)

(iii) Strong interpersonal skills and experience in capacity building of counterpart staff at different levels

(iv) Willingness to be based in central highlands and to do field work assignments for at least 70% of the contracted time

(v) Ability to work either as part of a team effectively, to take own initiative and to work independently with minimal supervision

(vi) Proficiency in Vietnamese language and preferably good English language skills (both written and spoken). Willingness to do technical translation and interpretation tasks

(vii) Microsoft package (Word, Excel, PowerPoint and Microsoft Project) 92. Tasks:

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(i) Advise and assist PPMU staff to identify and collect relevant national evidence-based data on gender, ethnic groups and MCH services and relevant health data in their provinces

(ii) Provide training on mainstreaming gender and ethnic groups related material into Project training activities

(iii) Provide technical guidance and monitor the implementation of the gender, ethnic groups and resettlement strategies and plans

(iv) Ascertain that safeguard procedures are in place and implemented during the project implementation, especially on guaranteeing adequate recruitment procedures and Human Resource Development in favor of gender, ethnic groups and disability

(v) Advise on the incorporation of gender considerations in the design, implementation and analysis of the Baseline and Project Completion survey and subsequent monitoring and evaluation

(vi) Propose a strategy to ensure baseline analysis and M&E results on social and gender issues are utilized in the development of policies and programs at the provincial level

(vii) Formulate detailed safeguard procedures and monitoring tools on poverty reduction and social strategy, gender and indigenous peoples plan and resettlement framework

(viii) Assist CPMU, PPMU and ADB in any other task related to gender, ethnicity and resettlement as requested


11. National Safeguards Specialist (6 person-months) 94. Qualifications, experience and specific skills:

(i) University degree in Environmental Science or Public Health (≥ bachelor degree)

(ii) Training and experience in environmental assessments or studies (≥ 5 years’ experience)

(iii) Pollution measurement, monitoring and documentation (≥ 5 years’ experience) (iv) Engineering experience or background in health care settings or hospitals,

focusing on civil works and equipment in health care facility (≥ 5 years’ experience)

(v) High analytical skills and attentive to detail (vi) Good management ability and communication skills (vii) Willingness to do field work assignments for at least 70% of the contracted time (viii) Ability to work either as part of a team effectively, to take own initiative and to

work independently with minimal supervision (ix) Proficiency in Vietnamese language and preferably good English language skills


(x) Microsoft package (Word, Excel, PowerPoint and Microsoft Project)

95. Tasks:

(i) Perform inspection of solid medical waste management system during

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construction and operation stage (ii) Perform inspection of wastewater treatment system during construction and

operation stage (iii) Perform inspection of environmental impact mitigation measures during

construction and operation stage (iv) Confer with hospital Health Care Waste Management committees on the

implementation of the environmental plan (v) Coordinate with construction health and safety team, housekeeping and facilities

maintenance team (vi) Provide technical advice and prepare recommendations to solve environmental

monitoring problems


12. National Communication and IEC Specialist (36 person-months) 97. Qualifications, experience and specific skills:

(i) Degree in social science and/or communication, postgraduate degree preferred (≥10 years’ experience)

(ii) Relevant experience with IEC and health service promotional campaigns (≥5 years’ experience)

(iii) Experience in the commercial sector is a special advantage (iv) Strong interpersonal skills and experience in capacity building of counterpart

staff at different levels (v) Willingness to be based in central highlands and to do field work assignments

for at least 70% of the contracted time (vi) Ability to work either as part of a team effectively, to take own initiative and to



(viii) Microsoft package (Word, Excel, PowerPoint and Microsoft Project)

98. Tasks:

(i) Assist in the development of the bidding process for the consulting company contracting for MCH IE, and health service promotion

(ii) Assist in the evaluation of the QCBS bidding process of the consulting company Assist in the development of a detailed intervention plan together with the consulting company

(iii) Assist and accompany the detailed monitoring tools on Consulting company performance assessment

(iv) Approve AOPs for the Consulting company and accompany its interventions (v) Assist CPMU, PPMU and ADB in any other task related to IEC, and health

service promotion as requested


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13. National Procurement Consultant (108 person-months, 2 positions)


(i) At least a Bachelor Degree in Economics, Logistics or another related field. (ii) At least 5 years experiences in ADB/WB procurement practices of goods and

consulting services. (iii) Good oral and written skills in English. (iv) Ability to build capacity in staff at provincial level in procurement.

101. Tasks:

(i) Prepare procurement plans for goods and consulting services. Obtain approval from the PD; submit to relevant agencies for review and approval (MOH and ADB).

(ii) Finalize TORs for national consultant positions and follow ADB procedures to recruit them.

(iii) Procure goods at central level following ADB procedures. (iv) Train PIUs’ staff the in procedures required for purchasing of minor goods and

services at provincial level and provide technical assistance to them when needed.

(v) Assist the Deputy Project Director (DPD) and the Project Implementation (vi) Consultant in the preparation of the PMU’s AOP and Project AOP. (vii) Assist the DPD and the Project Chief Technical Advisor in review and approval

of AOPs submitted by PIUs.

14. National Disbursement Consultants (120 person-months, 2 positions)


(i) At least bachelor’s degree in financing or accounting. (ii) Working experience in financing or accounting for 10 years. (iii) Working experience in ADB funded project and having sound knowledge of

disbursement procedures of the Viet Nam Government and ADB for 5 years. (iv) Preferably working experience in financing or accounting in the health sector. (v) Ability to work either as part of a team effectively or independently with minimal

supervision. (vi) Language: fluency in English, proven written excellence. (vii) Microsoft package: proficiency in office and financial management software

applications.

103. Task description

(i) Carry out disbursement procedures and withdrawal applications for the project activities, in accordance with regulations and guidelines of the Government of Viet Nam and ADB for disbursement, including:

(ii) replenishment of CPMU and PPMU's imprest account, (a) direct payment with ADB or PPMU, and (b) reimbursement, (c) special commitments (if any) to submit to MOF and the donor.

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(iii) Review PPMU's quarterly and annual disbursement plan, and develop the project quarterly and annual disbursement plan to submit to CPMU’s review

(iv) Prepare regularly or irregularly quarterly and annual reports on project financial activities in compliance with CPMU's files

(v) Support project activities with regard to financial and accounting aspects: (a) Monitor and summarize the project’s fixed assets. (b) Provide guidance and advices to the PPMUs in carrying out liquidation

procedures regarding the project components. (c) Monitor and aggregate the project’s liquidation and withdrawal progress

on equipment and civil work contracts at PPMUs. (d) Conduct expenditure control procedures at the State Treasury. (e) Participate in supervision missions on disbursement activities and

approval of periodical liquidation at PPMUs. (f) Develop budget fund plan and investment fund plan on the basic of the

project overall Action Plan. (g) Participate in working with auditor and ADB mission team members. (h) Prepare report on summarizing investment fund of PMU and PPMU

under project components from the beginning to the end of the project. (vi) Provide guidance and training to other accountants in the disbursement group at

both central level and provincial level to carry out disbursement assignments in accordance with guidelines and regulations of Viet Namese Government and ADB.

(vii) Fulfill other duties reasonably assigned by the Director of CPMU.

15. National Project Finance Manager (60 person-months)


(i) The Project Finance Manager will have a senior position requiring a bachelor’s degree in financing or accounting.

(ii) Working experience in financing or accounting should be 10 years. (iii) Working experience in ADB funded project financial management: 5 years. (iv) Working experience in financing or accounting in the health sector for at least 3

years. (v) Ability to work either as part of a team effectively or independently with minimal

supervision. (vi) Language: fluency in English with proven record of well written English. (vii) Microsoft package: proficiency in office and financial management software

applications. 105. Task description

(i) Ensure early production of a Financial Management Operations Manual for the project

(ii) Manage project funds according to the requirements of ADB and Government (iii) In collaboration with other concerned people, prepare results oriented annual

budget plan for the project and monitor the expenditure using the required formats

(iv) Ensure withdrawal applications are prepared and submitted to relevant agencies, follow up on payments, as well as follow up the subsequent replenishment from ADB and MOH

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(v) Ensure proper authorization and accounting of operating costs which will be classified by nature of expenses and sources of funding and by categories

(vi) Ensure sound financial control, documentation and flow of information of project (vii) Review and provide recommendations to the Project Director on the day-to-day

operating expenses and other financial transactions (viii) Ensure timely submission and consolidation of financial reports and disseminate

to all concern parties on a timely fashion (ix) Manage all accounting staff and assist to develop a clear responsibility for each

staff to avoid overlapping task and to ensure achievement of best performance (x) Provide training to all the project accounting staff and provide regular

supervision (xi) Assist the internal and external auditors to conduct concurrent, monthly and

external, annual audit by furnishing them with appropriate documents (xii) Assist in identifying the location of assets, their proper inventory and facilitate

communication with the concerned units/departments for the audit purpose

(xiii) Supervise the competitive procurement tender processes in cooperation with the procurement expert and ensure appropriate procedures

(xiv) Ensure overall good financial governance and abidance by the regulations, to keep the financial management of the project transparent and accountable

(xv) Contribute to improvements in financial management by means of recommendations to the Project Steering Committee, CPMU and PMUs for policy development

(xvi) Other tasks as regulated by government for this CA/CFO position in donor funded projects not yet mentioned here

(xvii) Coordinate all accounting positions and with the relevant experts

106. Candidates with the following characteristics will be preferentially selected with equal evaluation rating: women, ethnic minority and PWD.

16. Consulting Civil Works (QCBS 80:20)

107. There will be two assignments:

(i) CHSs and ICPs (2.5 years) (ii) District Referral Hospitals and Waste Water Treatment Plants (3 years)

108. Assignment Objectives. The principal objective of this assignment is to ensure the Technical Quality and Timeliness of the civil works program proposed to be undertaken under the project. The overall civil works program would be procured and managed under the ADB Procurement and Contracts Management procedures; and, therefore, the entire assignment will be executed under this framework. 109. Scope of Services and Technical Requirements. The consultancy is divided into 2 lots which can be won by a different company.

(i) The MOH already developed standardized CHS and ICP designs. The design of CHSs and ICP will be based on each specific geographic conditions, the size of the population and the availability of water sources. In total of about 54 CHS will have civil works, of which 24 will be completely new buildings and 30 will be either repaired and/or expanded. About 10 new ICPs will be built.

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(ii) The Ministry of Health has already developed building briefs for DRH. The referral hospital designs will follow the building brief concepts. In total 1 new hospital and approximately 9 renovations will be organized. About 8 WWTP at DRHs need to be designed and constructed.

110. Note should be taken that the assessment of the 100 bed new DRH in Krong Buk (Dak Lak) would be focused on the design/ design review and detail engineering and supervision of the following facilities:

(i) Operating Theater / Surgical Ward; (ii) Blood Depot; (iii) Internal Medicine, Pediatric, Gynecology and Obstetrician Ward; (iv) Sterilization Unit; (v) Emergency Ward; (vi) Outpatient Department (vii) Administration and support services (kitchen, laundry, mortuary, solid waste

plant) (viii) Inter-building Circulation and Connection Infrastructure; (ix) Drainage and Sewerage System Connection; (x) Waste Water Treatment Plant.

111. The Consultant will have overall responsibility for ensuring the technical quality, cost effectiveness and timeliness of civil works planning and designs undertaken under the project funds. The Consultant will report to the CPMU Project Director through Project Coordinator and work in close collaboration with the CPMU and PPMU management teams. 112. The assignment consists of two phases:

(i) Phase-I: Design and Detail Engineering: Lump sum (ii) Phase-II: Construction Supervision: time based

113. Specific responsibilities will include the following:

a. Phase-I: Design and Detail Engineering

i. Assessment

114. An evaluation of the sites and existing buildings will be undertaken to decide whether renovation or new building construction is more cost effective and more functionally responsive. It will therefore be necessary to develop individual plans for each Health Facility site incorporating existing and new building approved by the MOH. Particular attention will be paid to the development of a site plan integrating the rehabilitated (if any) and the new buildings (if any) as an integral part of the design. 115. The assessment of CHS and ICPs’ sites regarding the water supply, sanitation and electrical supplies, as required by the TOR, should be focused on the development of individual CHS and ICP plans incorporating the actual site features and requirements with the designs approved by the Ministry of Health.

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ii. Pre-Design stage

(i) All the health facilities would be surveyed by the consultant. (ii) Consult with the project and key staff involved in designing plan on all aspects of

civil works, including planning, site visits, facilities locations, design and cost estimates.

(iii) The benefitting communities, in particular women, poor and ethnic groups will be consulted during the pre-design phase to ensure that their concerns are integrated into health facilities design.

(iv) Conduct topo-graphical site surveys showing existing buildings and other important features (e.g. valid land titles).

(v) The consultant will be required to collect and process data on the existing condition of water supply, waste disposal and electricity supply to each health facility.

(vi) Obtain approval from the MOH.

iii. Design Stage (Preliminary Design) 116. For CHS and ICP:

(i) Prepare architectural, structural, civil, water and sanitation and electrical preliminary designs including for the provision of sharps pit and water supply system (public/private water supply system, well water, rain water harvesting), storage, plumbing, water treatment (if require), two-chamber septic tank, other water utilities. The electrical supply system will include source of electricity (generator, public/private electrical supplies, and or solar energy), electrical wiring and lighting. While preparing these designs, it must be ensured that the existing buildings are adapted and integrated properly with the new system(s). Attention will be paid to improving the “user-friendliness” of the designs and access for the people with a functional limitation.

(ii) Prepare list of the existing system with suggested rehabilitation strategy. (iii) Prepare brief technical and materials specifications for the proposed preliminary

design. (iv) Preliminary reports for all the services. (v) External arrangements for fence, gates, paved access and landscaping. (vi) Obtain approval from MOH on the preliminary designs and specifications. MOH

may involve experts as it deems fit at this stage to review and approve the designs. MOH may also submit these preliminary designs to the ADB for their comment and/or approval. An independent international consultant will be hired to approve the quality of the designs. The Consultants will be required to assist the MOH in any manner required, during these reviews and make amendments till the final approval is granted.

(vii) Provide initial Cost Estimates (Preliminary Estimates) for the facilities for review/ consideration/ approval from MOH.

117. For Referral Hospital:

(i) Prepare preliminary architectural designs of each selected building. While preparing these designs, it must be ensured that the existing buildings are adapted and integrated properly with the new buildings. Attention will be paid to improving the “user-friendliness” and disabled access (i.e. patients, their families

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and health staff) and an easy patient flow of the facilities. (ii) Prepare a list of the defects in the existing buildings with suggested

rehabilitation strategy. (iii) Prepare a table of functions and facilities based on the Building Brief

requirements and in consultation with the end-users, the Facility Director and staff.

(iv) Prepare brief technical and materials specifications for various areas in the building(s).

(v) Preliminary reports for all the services like electrical, A/C, water supply and disposal etc.

(vi) Obtain approval from MOH on the preliminary designs and specifications. MOH may involve experts as it deems fit at this stage to review and approve the designs. MOH must also submit these designs to ADB for their comment and/or approval. An independent international consultant will be hired to approve the quality of the designs. The Consultants will be required to assist the MOH/DOH in any manner required, during these reviews and make amendments till the final approval is granted.

(vii) Provide initial Cost Estimates (Preliminary Estimates) for the facilities for review/ consideration/approval from MOH & DOH.

iv. Design Stage (Detailed Designs)

118. Detailed drawings CHS and ICP will include:

(i) Architectural, structural and civil floor plans and sections will be prepared for all buildings including full details for new water supply and sewage disposal details and / or electrical fitting layouts. Access for People with a disability needs to be shown explicitly.

(ii) Schematic drawings for water supply and / or electrical supply systems will be prepared showing the internal layouts of supply and distribution networks.

(iii) Site plan will be prepared showing all the buildings, locations of water point, water reservoirs, sanitation area (toilet/bathroom), client kitchen area, electric connection and external routing of water supply and disposal pipes and electric cable up to the building.

(iv) Detailed drawings of septic tanks where water supply and disposal systems are to be incorporated.

(v) Detailed drawings for fence, gates, paved areas and landscaping. (vi) All the above drawings will show methods of connections of various services. (vii) Details of materials, specifications and bill of quantities will be prepared for the

bids. 119. Detailed drawings for DRH. In general it should follow the building brief of the MOH for the different services and try to adapt them with the existing referral hospital design as much as possible in order to prepare designs/drawings and details for foundations, architectural, structural, electrical, mechanical and, fire safety, communication and public health works like water supply, sewerage, storm water drainage, roads, paths and landscaping etc. to make the building and the campus functional. All these drawings shall be good for execution so that the bills of quantities can be prepared from them. 120. Architectural drawings: these will include at least the following details:

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(i) All floor plans, elevations and sections; (ii) Toilets, staircases, lifts / disability access, railings, flooring pattern; (iii) False-ceiling; (iv) Integrated service drawing; (v) Built-in furniture; (vi) Any other detail required for proper completion of the works.

121. Structural drawing: these will include at least the following:

(i) Design basis report; (ii) Detailed design with calculations; (iii) All detailed drawings as required; (iv) A structural safety certificate for all works.

122. Water supply, waste and sewerage disposal, sanitary installations and storm water drainage layout:

(i) Design basis report; (ii) Detailed design with calculations, assuring accessibility for people with a

disability; (iii) Bore-well details if required; (iv) Layouts and schematic drawings showing the pipelines as well as detailed

drawings showing internal and external water supply; (v) Sanitary and water supply installations; (vi) Sewerage disposal including sewage treatment and plant; (vii) Recycling of treated water from the sewage treatment plan; (viii) Overhead tank and underground reservoir; (ix) Storm water drainage including rain water harvesting; (x) Other elements for re-cycling the resources which are necessary for a “Green

Building”, etc. 123. Electrical: these will include at least the following details:

(i) Design basis report; (ii) Detailed design with calculations; (iii) Internal and external electrical layout showing the entire distribution system,

emergency circuit including the electrical back-up; (iv) Design of electric substation; (v) Electrical back-up and public connection (vi) Schematic drawings/design; (vii) Provision of telephone, broad band conduits, T.V. conduits, and other electronic

equipment; (viii) Any other element that is necessary for energy conservation and are necessary

for “Green Building”.

124. Air conditioning: these will include at least the following details:

(i) Design basis report; (ii) Detailed design with calculations; (iii) Internal and external layouts showing the entire air circulation system; (iv) Building management system to optimally utilize all the installation in the

building and monitor their functioning;

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(v) Any other element that is necessary for energy conservation and are necessary for a “Green Building.”

125. Fire safety services:

(i) Design basis report; (ii) Provision for the fire safety as per relevant codes.

126. Campus development and landscaping:

(i) All drawings showing areas to be landscaped, detail of horticulture, plantation, water bodies, roads, parking footpath, boundary wall, signage, street lights and gates etc.

127. Note: In undertaking the assignment activities the Consultant should take into consideration the following:

(i) Any other relevant drawing details or designs that might be required for proper and satisfactory completion of the project;

(ii) Requirement that all designs must be prepared as per relevant national and international building and engineering codes;

(iii) Requirement to improve ecological and climatic aspect, the user friendliness, and the spatial organization of the whole site;

(iv) Requirement to identify and recommend the use of the ecological water treatment and solar energy systems, where viable;

(v) Requirements for the infection control and the optimal connection and functional concept for each building within the health facility compound and infrastructure.

128. Bill of Quantities (BoQs) and Detailed Cost Estimates: The Consultant shall finalize the BoQ from the approved drawings. The detailed cost estimates shall be prepared based on prevailing market rates supported with detailed rate analysis for each item. The detailed estimate shall be complied along with necessary reports and drawings as required by the MOH. 129. Specification: The Consultant is required to finalize the specifications for items with relevant material test reports and their acceptance standards for results. The Consultant should recommend use of local materials where possible. 130. Basic Documents: The Consultant shall regularly submit finalized basic documents to the CPMU and relevant PPMU for each package in hard copies accompanied by the soft copies, as follows:

(i) Drawings- in PDF file format; (ii) BoQs and Detailed Cost Estimates - in MS Excel file format; (iii) Specifications - in MS Word file format.

131. Clarification for Procurement: If required, provide clarification to the PPMU for finalization of bid documents and the issues raised by ADB and the independent TA for civil works. 132. Design Calculations and Material Take-off sheets: The Consultant is required to

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submit all the design calculations for structural, electrical, and other designs. All the take-off sheets shall be submitted in support of the bill of quantities. The MOH reserves the right to the designs proof checked by an independent consultant for which the consultant shall provide all required technical support. The cost for the proof check consultant will be borne by the Project. 133. Monthly Progress Report: These shall include progress made on the plan of operations, sites survey, design, deliverable document for tendering, obstacles encountered and implications for future assignment. 134. An assignment Completion Report at the end of the contract will be submitted to the MOH. 135. Inputs Provided by the Client. Use of MOH standard designs for health facilities (as available): The Ministry of Health has already designed module building for the different departments. The design will be made available to the consultant for consideration. However, for water supply and sanitation at CHSs and ICPs, the Consultant shall prepare specific design in adaption with the local geographic conditions. 136. Data Collection and Research and Design Inputs. It is expected that the tasks outlined in this TOR will be carried out by suitably qualified and experienced professional staff that will be principally based in the region and will be well integrated into the project program management team of the MOH. The Consultant may choose to collaborate with local architectural/engineering firms/individuals for this assignment. The professional staff will be required, as and when necessary to visit the sites of the health facilities for data collection, surveys, and consultation with end-users. 137. Reporting and Outputs

(i) Inception Report (upon completion of the Pre-design Stage)-10 copies (ii) Preliminary Design Report including Drawings (upon completion of the

Preliminary Design Stage)-10 copies (iii) Detailed Estimates including Drawings (upon completion of the Detailed Design

Stage) -10 copies (iv) Approved for Execution Drawings (upon completion of all assignment activities)-

10 copies (v) Basic Documents: regular submission to the CPMU and relevant PPMU for each

package - 1 hard copy and 1 soft copy of Drawings; BoQs; Detailed Cost Estimates; and Specifications.

(vi) Monthly Progress Reports -10 copies (vii) Final Report (upon completion of all assignment activities)- 10 copies

138. Over and above the specified basic outputs, the consultant will submit other reports and document that are progressively required as part of the assignment. Documents, as mutually agreed between Client and Consultant, will also be supplied in Vietnamese. 139. Key Personnel and Technical Support Staff. The Consultant shall provide qualified experts to carry out the services. Their choice should take into account the need to recognize and build up local capacities in health facilities civil works design and engineering. 140. For CHSs and ICPs. The estimated number of professional staff-months required for the assignment is: 102 staff-months. It is envisaged that the following key professional staff will

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be required to provide varying degrees of inputs for the assignment:

(i) Team Leader (National) – 6 staff months: with at least 15 years of experience, holder of a degree in Civil Engineering and/ or Architecture with experience in management of design and construction supervision aspects relevant to the project. To provide the continuity in the project, this person / post should be the same till the completion of this assignment i.e. design and construction supervision;

(ii) Four Health Facilities Planners/Coordinators (Architects/Civil Engineers) (National) – 24 staff months: with at least 10 years of experience, holders of a degree in Architecture or Civil Engineering; with 3 years of professional experience in health facilities planning / design. Like above, (s)he should also continue till completion of the assignment;

(iii) One Mechanical & Electrical/Utilities Engineer/Coordinator (National) – 6 staff months: with at least 7 years of experience, holder of degree Mechanical & Electrical Engineering; with 3 years of professional experience of work in health facilities M&E engineering;

(iv) Four Quantity Surveyors & Cost Estimators (National) – total 12 staff months: with at least 7 years of experience, holder of a degree in Civil Engineering; with at least 3 years of professional experience of work in health facilities Quantity Surveys and Cost Estimates. Like above, they should also continue till completion of the assignment;

(v) One Water Supply Engineer/Coordinator (National) – 6 staff months: with at least 7 years of experience, holder of degree in Civil and /or Mechanical Engineering; with at least 3 years of professional experience of work in health facilities water supply engineering and sanitation;

(vi) Four Mechanical & Electrical Assessment Engineers (National) – 12 staff months: with at least 5 years of relevant professional experience, holder of a degree in Civil and /or Mechanical Engineering;

(vii) Four Water Supply Assessment Engineers (National) – 12 staff months: with at least 5 years of relevant professional experience, holder of a degree in Civil and /or Mechanical Engineering;

(viii) Four AutoCAD Experts (National) – 24 staff months: with at least 3 years of experience, holder of a diploma in AutoCAD System.

(ix) One infection control expert –1 staff month, with at least 3 years experience in related fields

(x) One expert in sustainable construction design –1 staff month, with at least 3 years experience in related fields

141. The Consultant may also mobilize a team of Support staff/ draft persons (National). The technical staff shall have diplomas in each expert mentioned in points above. For costing purposes five support staff should be considered for six (6) months each. However, the bidder will have to appoint and use the services of support staff as required for successful completion of assignment. 142. The Team Leader would be assigned to undertake tasks and responsibilities to manage the assignment activities and outputs required by TOR for the CHSs/ICPs. 143. It is expected that the Consultant’s staff inputs shall be organized in four (4) teams working on 56 CHS and 9 ICPs (1 team Dak Nong / Gia Lai, 2 teams Kon Tum and 1 team for the 9 ICPs), as follows:

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(i) Coordinating Unit:

(a) One Lead CHS/ICP Health Facilities Planner/Coordinator (National) (b) Four Health Facilities Planners/Coordinators (c) Mechanical & Electrical Engineer/Coordinator (National) (d) Water Supply Engineer/ Coordinator (National)

(i) Four (4) Appraisal Teams, each including:

(a) Quantity Surveyor and Cost Estimator (National) (b) AutoCAD Expert (National) (c) Water Supply Assessment Engineer (National) (d) Mechanical & Electrical Assessment Engineer (National)

144. For Referral Hospital. The estimated number of professional staff-months required for the assignment is: 84 staff-months. It is envisaged that the following key professional staff will be required to provide varying degrees of inputs for the assignment:

(i) Team Leader (International) – 12 staff months: with at least 15 years of experience, holder of a degree in Civil Engineering and/ or Architecture with experience in management of design and construction supervision aspects relevant to the project. To provide the continuity in the project, this person / post should be the same till the completion of this assignment i.e. design and construction supervision;

(ii) Two Health Facilities Planners/Coordinators (Architects/Civil Engineers) (National) – 24 staff months: with at least 10 years of experience, holders of a degree in Architecture or Civil Engineering; with 3 years of professional experience in health facilities planning / design. Like above, they should also continue till completion of the assignment;

(iii) One Mechanical & Electrical/Utilities Engineer/Coordinator (National) – 12 staff months: with at least 7 years of experience, holder of degree Mechanical & Electrical Engineering; with at least 3 years of professional experience of work in health facilities M&E engineering. Like above, one of these should also continue till completion of the assignment;

(iv) One Structural Design Engineer/Coordinator (National) – 12 staff months: with at least 7 years of experience, holder of degree in Structural and/ or Civil Engineering; with 3 years of professional experience of work in health facilities structural design engineering;

(v) Two Quantity Surveyors & Cost Estimators (National) – total 8 staff months: with at least 7 years of experience, holder of a degree in Civil Engineering; with at least 3 years of professional experience of work in health facilities Quantity Surveys and Cost Estimates. Like above, they should also continue till completion of the assignment;

(vi) Two Architectural Assessment Experts (National) – total 4 staff months: with at least 5 years of relevant professional experience, holder of a degree in Architecture;

(vii) Two Structural Design Assessment Engineer / Civil Engineer (National) – total 4 staff months: with at least 5 years of relevant professional experience, holder of a degree in Structural and / or Civil Engineering;

(viii) Two AutoCAD Experts (National) – total 12 staff months: with at least 3 years of experience, holder of a diploma in AutoCAD System.

(ix) One infection control expert: 1 staff month, with at least 3 years experience in

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related fields (x) One expert in sustainable construction: 1 staff month, with at least 3 years

experience in related fields

145. The Consultant may also mobilize a team of Support staff/ draft persons (National). The technical staff shall have diplomas in each expert mentioned in points above. For costing purposes five support staff should be considered for twelve (12) months each. However, the bidder will have to appoint and use the services of support staff as required for successful completion of assignment. 146. The Team Leader would be assigned to undertake tasks and responsibilities to manage the assignment activities and outputs required by TOR for the DRHs. 147. It is expected that the Consultant’s staff inputs shall be organized in two (2) teams working on 7 Referral Hospitals and 8 WWTPs (Lam Dong – Dak Nong: 1 team, Dak Lak and Gia Lai 1 team), as follows:

(i) Coordinating Unit, including: (a) One Lead DRHs Health Facilities Planner / Coordinator (International/

National) (b) Two Health Facilities Planner/ Coordinator (c) One Mechanical & Electrical Engineer/ Coordinator (National) (d) One Structural Design Engineer/ Coordinator (National)

(ii) Two (2) Appraisal Teams, each including: (a) One Quantity Surveyor and Cost Estimator (National) (b) One AutoCAD Expert (National) (c) One Architectural Assessment Expert (National) (d) One Structural Design Assessment/Civil Engineer (National)

148. Qualification of the Consultant Firm(s). The Consultant firm should have at least 10 years experiences in conducting similar civil works design in developing countries or in the region. They must have very good past performance records. 149. Timeline. The time period for Phase - I of the assignment is expected be 6 months for CHS/ICP and 12 months for the DRH/WWTP.

b. PHASE - II: Construction Supervision 150. Overall Scope of service

(i) Monitor and supervise construction works undertaken by contractors, ensuring (a) quality of construction works; (b) adherence to specification; and (c) timely completion works

(ii) Interface and manage with all aspect of construction works (iii) Administer the contract for the construction service and be responsible for

efficient implementation of construction through careful monitoring of contractor performance.

(iv) Check and certify contractor’s bills (both running bills and final bills) including rates for extra items and assisting PMU if there are any disputes with the contractor(s).

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151. The Construction Supervision will be carried out through the appointment of site engineers (construction supervisors), Water and Sanitation Engineer and Electrical Engineer and a Team Leader under the responsibility of the Construction Supervision Firm. The local site engineers will help plan, implement, supervise and monitor the construction work to which they are specifically allocated. The Firm should propose to employ team members from the design team for supervision activities. In this case the firm needs to clearly interlink their proposed task as continuation from the design phase. The work plan for construction supervision should also include the site visits of the design team members to resolve the onsite issues. Also see ‘7’ above for the posts / staff that should continue from design into supervision component. 152. Specific responsibilities of the supervisor/s for civil component of the building/s, inter alia, will include the following:

(i) Familiarization. Familiarization with the MOH/the project’s health facility construction policy and procedures construction management requirements, involvement of DOH management, contractor contracts and the agreed construction schedule.

(ii) Checking of Site/s (as required before the start of new construction work) (a) Check the site and ensure that it is suitable to commence construction. (b) Prepare and submit a site checking report, including photographic evidence.

(iii) Inspection & Supervision (a) Carry out site supervision at the construction sites on a regular basis

including if required during the weekends. (b) Ensure that the contractor(s) meets all project requirements for protection of

the environment, site and waste management, provision of clean water and sanitation facilities.

(c) Certify all structural works before casting and be physically present during the casting of the important critical construction elements.

(d) Ensure that the contractors are aware of the Complaints Procedures available to them under the contract (this is clearly recorded in the contract document).

(e) Participate in the final inspection of completed works and in the certification of completion.

(f) Participate in the inspection at the end of the defects and liabilities period, if the contract is still in force.

(iv) Construction Quality (a) Certify that formwork dimensions, alignment and quality, and reinforcement

size and arrangements are correct before the casting of any structural member including foundation, columns, beams and lintels.

(b) Inspect all materials to ensure they meet contract specifications. (c) Approve all the samples of materials where required. (d) Ensure that all the materials are tested at the required frequency as per

acceptable codes. Special care shall be paid to the testing of concrete, bricks, cement, sand, aggregate samples.

(e) Check concrete mix to ensure it meets contract specifications. (f) Instruct the contractors in brick laying techniques to improve the standard of

brickwork. (g) Ensure that beams, floors and columns are properly compacted during

casting.

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(h) Check door and window frames before they are erected to insure they are of the required material type and that they are free from defects.

(i) Check quality, type and sizes of all material before acceptance of work. (j) Continuously monitor the quality and progress on site during major concrete

casting works to ensure proper mix of materials and to ensure compliance with specified standards.

(v) Completion of Works and Certification of Contractor(s) Invoices (a) Check and certify the works as complete for necessary Works Completion

Certificate to be issued. (b) Check and certify contractor(s) claimed invoices for compliance with the

execute works and technical specifications (c) Certify all ‘As built’ drawings from all the contractors before clearing the final

bills of the contractors.

153. Professionalism. The Site Engineers (Construction Supervisors) deputed by the construction supervision firm are expected to strictly adhere to professional and ethical standards in the conducting their work and will be held accountable for defects in constructions not properly reported to the CPMU and PPMUs. The Construction Supervision Firm will also be held accountable for construction defects not handled in accordance with prescribed contractual procedures. 154. Work Reports

(i) The Construction Supervision Firm (through its local site supervisors) will report to the CPMU and PPMU through the HICH Infrastructure Coordinator for day to day construction and contract related matters.

(ii) Report all problems on site to the HICH Infrastructure Coordinator (through telephone) and keep the PPMU management informed as well.

(iii) Prepare detailed monthly progress reports giving the scheduled and actual progress of each of the health facility construction, delays if any, reasons for delays and suggestions to mitigate these.

(iv) Check and submit additional reports as necessary to support contractor’s invoices requesting payment.

(v) Submit photographic evidence of construction quality and construction achievements to support invoice certification.

(vi) As and when requested by CPMU / PPMU, attend the periodic meetings to be held in Hanoi or in the Central Highlands (or at respective sites) to assess the progress and quality of the work and to discuss problems, if any, and how to address them.

155. Deliverables. The Supervision Firm shall submit the follows deliverables:

(i) Inception Report within 3 week after commencement of services. (ii) Monthly progress reports. (iii) Completion report together with as built drawings (hard and soft copies).

156. Staff Inputs

(i) For CHS and ICP. The construction supervision inputs required for this assignment shall be organized taking into consideration of design schedule and time required for procurement process (estimated from 3 to 6 months). The

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supervision shall compose of: (a) Team Leader (International / National) – 12 months (the same team leader

will be used for Phase-I and Phase-II of the assignment): qualifications should be the same as in 7 (a) above. The intention is that this person should lead the project from the beginning to the end.

(b) Five Construction Supervisors (CHSs (1 Dak Nong, 1 Gia Lai, 2 Kon Tum) and ICPs (1)) (National): – 60 staff months: with qualifications as BSc in Civil Engineering with at least 5 years of relevant field experience in construction supervision. The intention is that these persons should follow the project from the beginning to the end.

(c) Three Quantity Surveyors & Cost Estimators (National): ≥ 7 years of experience, holder of a degree in Civil Engineering; with 3 years of professional experience of work in health facilities Quantity Surveys and Cost Estimates. Like above, they should also continue till completion of the assignment.

(d) The estimated number of professional staff-months required for the assignment is: 102.

(ii) For Referral Hospital. The construction supervision inputs required for this assignment shall be organized taking into consideration of design schedule and time required for procurement process (estimated from 3 to 6 months). The supervision shall compose of: (a) Team Leader (International) – 18 months (the same team leader will be

used for Phase-I and Phase-II of the assignment): qualifications should be the same as in 7 (a) above. The intention is that this person should lead the project from the beginning to the end.

(b) Construction Supervisors [DRHs (Dak Nong-Lam Dong (1), Gia Lai (1), Dak Lak (1)] (National): – 54 staff months: with qualifications as BSc in Civil Engineering with at least 7 years of relevant field experience in construction supervision. The intention is that this person should follow the project from the beginning to the end.

(c) Construction Supervisor (Electro-Mechanical Works) – 18 staff months for construction of DRHs with qualifications as BSc in Electrical/ Mechanical Engineering with at least 7 years of relevant field experience in construction supervision. The intention is that this person should follow the project from the beginning to the end.

(d) Quantity Surveyor & Cost Estimator (National) – 18 months for construction of DRHs and WWTP with ≥ 7 years of experience, holder of a degree in Civil Engineering; ≥ 3 years of professional experience of work in health facilities Quantity Surveys and Cost Estimates. Like above, they should also continue till completion of the assignment

(e) The estimated number of professional staff-months required for the assignment is: 108.

157. Logistic arrangement. The Consultant firm will be responsible for making their own arrangement for office space, utilities, equipment, supplies, transport and all other logistical arrangement necessary to carry out its tasks. 158. Qualification of the Consultant Firm. The Consultant firm should have at least 10 years experiences in conducting similar civil works design and supervision in developing countries or in the region. They must have very good past performance records.

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159. Timeline

(i) For CHS and ICP. The time period for Phase - II of the assignment is expected be 12 months construction. The total period for the assignment is expected to be 18 months for preparation and construction and 12 months later for the handover certificates: 30 months in total. During this overall period all construction works will be executed simultaneously depending on individual construction contract schedules planned.

(ii) For Referral Hospital. The time period for Phase - II of the assignment is expected be 18 months. There would be an overlapping of Phase - I and Phase - II. The total period for the assignment is expected to be 24 months for preparation and construction and 12 months later for the handover certificates: 36 months in total.

(iii) During this overall period all construction works will be executed simultaneously depending on individual construction contract schedules planned.

160. TOR Audit Company, LCS (See detailed TORs in Appendix 2) National Audit Firm (lump sum contract) Experience in Viet Nam with donor funded projects. Sound Knowledge of financial management software and international accounting management practices

(i) Conduct project inspections at CPMU, provincial, and district levels (ii) Review financial management documentation (iii) Assess adequacy of the financial reporting (iv) Evaluate whether disbursements made are in accordance with purpose (v) Note financial related issues and indicate causes and remedies (vi) Prepare audit report

161. TOR Training and Quality Assurance Consulting Company, QBS National Consulting Company or NGO Experience in Viet Nam with donor funded projects. Sound working experience with provincial and district health offices and medical schools. Experience in implementation of quality assurance measures in public health facilities.

(i) Improve pedagogical skills of the teaching staff of the 4 medical schools and medical university in the project area

(ii) Review and improve main training curricula at province and district level, and introduce gender aspects in the curricula.

(iii) Support maintenance of human resources database at provincial level, including data on service training.

(iv) Review and provide comments on provincial AWP, in particular: training programs for the staff

(v) Based upon national benchmark for quality in CHS and hospitals, support DHO (District Health Office) and PHO in the implementation of a monitoring of quality in the health facilities.

(vi) Training in hygiene for health facilities: (a) review the existing training modules, and (b) organize and support the training of the staff at all levels.

(vii) Ensure that training provided by the projects include appropriate input on hand washing, hygiene and infection control.

(viii) Contribute to the identification of hygiene measures for district hospitals. (ix) Training in management of health system: (a) review the existing training

modules, and (b) organize and support the training of the staff at all levels (x) Conduct, in collaboration with PPMU, orientation sessions for provincial

governments and local leaders on health system management.

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162. TOR for IEC Company, QBS National Consulting Company or NGO Experience in Viet Nam with donor funded projects. Sound working experience with provincial and district health offices. Experience in designing and implementing, IEC campaign in poor, remote and ethnic groups area

(i) Support respective PHO and DHO to design appropriate (ii) Design communication materials for IEC. The materials must be adapted

to the different ethnic groups in central highlands. (iii) Include elements of appropriate messages on hygiene (in particular hand

washing) in IEC. (iv) Review the surveys on KAP on health issues in central highland. Identify

the knowledge gaps. (v) Based on the gaps, design and implement a KAP survey. (vi) Conduct baseline and endline surveys to measure the changes in KAP

overtime. (vii) Revise the existing training modules on IEC and organize and support the

training of the staff at all levels (viii) Conduct healthy behavior awareness campaign among district decision

makers.

E. Terms of Reference of Key CPMU and PPMU Government staff Position and Minimum Required Qualification Outline of Terms of Reference

Project Director (PD) (60 person/months)

A Master Degree in a health related field. At least five years’ experience in managing projects in health sector. Good knowledge of project management in health sector. Good written and spoken English.

(i) Lead PMU to implement the Project. Ensure a sound management of imprest account. Ensure AWPs completed in a timely manner and approved by MOH and ADB.

(ii) Ensure that equipment and consulting services are delivered timely manner.. (iii) Guide the Deputy Director to conduct a monitoring training program for

provincial and district staff on both management and relevant technical aspects.

(iv) Guide the Deputy Director to develop and test supervisory checklist. (v) Prepare quarterly report and annual reports as required by the donor and

Government. (vi) Coordinate activities with other projects and programs to avoid overlapping of

funds. (vii) Act as the secretary for the Steering Committee, when needed. (viii) Other tasks as required by the Government’s regulation not mentioned here.

Deputy Project Director (DPD) (60 person/months)

A Masters degree in a health related field. At least five years experiences in managing similar CDC projects. Good knowledge of statistical analysis in health. Conversant in English. Ability to build capacity of counterpart staff at different levels.

(i) Assist the Project Director (PD) to lead the PMU when the PD is absent and assist the PD to lead the PMU to prepare AWPs and obtain approvals.

(ii) Assist the PD to ensure that equipment and consulting services are delivered timely manner.

(iii) Conduct a monitoring training program for provincial and district staff on both management and relevant technical aspects.

(iv) Develop and test supervisory checklist. (v) Prepare quarterly reports and annual reports as required by the donor and

Government. (vi) Assist the PD to coordinate activities with other projects and programs to avoid

overlapping of funds. (vii) Perform other tasks assigned by the Project Director.

(National) Chief Accountant (60 person/months)

At least 7 years Under the direction of the PD or DPD undertake the following tasks:

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Position and Minimum Required Qualification Outline of Terms of Reference

experience in donor funded project financial management and a recognized post graduate level qualifications (Bachelor or Master Degree in Accounting). Good English language skills (both written and spoken). Practical experience with the relevant computer software application for the financial management.

(i) Ensure that the imprest account is opened in a commercial bank acceptable to ADB and Government. Manage project funds according to the requirements of ADB and Government.

(ii) Review and provide recommendations to the Project Director on the day-to-day operating expenses and other financial transactions.

(iii) In collaboration with other concerned people, prepare annual budget plan for the Project and monitor the expenditure using the required format.

(iv) Ensure sound financial control, documentation and flow of information of Project. Ensure proper authorization and accounting of operating costs which will be classified by nature of expenses and sources of funding and by categories.

(v) Ensure withdrawal applications are prepared and submitted to relevant agencies and follow up on payments.

(vi) Timely consolidation of financial report and disseminate to all concern parties on a timely fashion. Follow up the subsequent replenishment from ADB and MOH.

(vii) Manage all accounting staff and assist to develop a clear responsibility for each staff to avoid overlapping task and to ensure achievement of best performance.

(viii) Provide training to the Project accounting staff of all levels and provide regular supervision.

(viii) Assist the internal and external auditors to conduct audit by furnishing them with appropriate documents. Assist in identifying the location of assets and facilitate communication with the concerned units/departments for the audit purpose.

(ix) Other tasks as regulated by government for this CA/CFO position in donor funded projects not yet mentioned here.

VII. SAFEGUARDS

163. Due diligence was core part of project preparatory TA (PPTA) and focused on poverty, social and gender analysis, attention to ethnic group issues, potential resettlement and environmental impacts. 164. Land Acquisition and Resettlement: During the PPTA no resettlement issues have been identified or are expected. Most of the civil work sites have been visited, either by the civil engineer or by the resettlement specialist or by both. Provincial Health Departments have confirmed there were no resettlement issues prior the construction of the hospitals to be completed under the project. Nevertheless it is assured that in the event that any resettlement impacts are detected during project implementation, MOH will ensure that a resettlement plan is prepared on the basis of ADB policy on involuntary resettlement (SPS 2009). A resettlement plan with a detailed technical design, disclosing all affected persons will be submitted to ADB for prior review and approval. All compensation and rehabilitation assistance will be paid before dispossession of assets. If resettlement measures need to be taken, the project will hire a national consultant to provide support in the matter.

165. Environment: The project is classified category B for environment. Mainly beneficial impacts are expected from the project, as it will support the construction, rehabilitation, and operation of health facilities, including improvement in water, sanitation, and waste management systems. However, the construction of hospitals will cause disturbances. Such impacts, which will include generation of noise and dust, deterioration of water quality through

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sediment laden runoff or improper waste disposal, exacerbation of local flooding conditions, and disruption to property access or commercial activities, will be readily managed to acceptable levels through implementation of standard construction environmental management practices. Eight hospitals will receive a waste water management plant. All hospitals supported by equipment will receive an appropriate solid waste management system with shredder and autoclave to eliminate any potential contamination. This means that contaminated waste needs to be collected separately in order to reduce its volume. All the waste water systems of the 11 ICP and 54 commune health stations with civil works will be constructed with an appropriate septic tank. In those targeted facilities for civil works as well as for the district and provincial hospitals where appropriate waste management will be introduced, there will be a technical support and training provided with ADB support. The project will hire an environment specialist to support the installation of waste management systems and the training of the staff. A budget equivalent of 1% of the equipment costs is planned for training of waste management system users. MOHs will ensure that health facility waste management in targeted health facilities is carried according to WHO health care waste management guidelines. In accordance with the ADB’s environment policy (2009), for the project of category B, a further initial environmental evaluation (IEE) is required to be prepared. The IEE includes an environmental management plan (EMP) which define the types of environmental mitigation and monitoring measures required to offset potential negative environmental impacts. 166. Indigenous People: The project includes a significant proportion of ethnic groups amongst its beneficiaries in the targeted provinces, who are among some of the poorest and most marginalized households in Viet Nam. The ethnic group settlements are often situated in remote areas and have comparatively less access to basic services. Ethnic groups have higher infant mortality rates and maternal mortality ratio. Based on that fact, the project will prioritize interventions in areas with high ethnic group populations and hence have positive impact on ethnic group peoples (category B). An indigenous peoples plan (IPP) has been developed for the project and includes: (i) specific output and outcome targets for ethnic groups, with a particular focus on ethnic groups women; (iii) AWPs and budgets integrating specific ethnic groups-related activities; (iv) IEC materials specifically designed and translated for ethnic groups; (iv) recruitment of a social development specialist will support the integration of ethnic groups development issues into project activities; (v) inclusion of provisions for addressing ethnic groups issues in all guidelines, terms of reference, strategies and plans developed under the project; (vi) scholarships offered to candidate nurses originating from ethnic groups; and (vii) disaggregation of relevant monitoring and evaluation data by ethnicity. MOH PMUs will ensure full implementation of the IPP. The IPP will be tailored according to national/provincial contexts and PMU's capacity for implementation, monitoring and evaluation.

VIII. GENDER AND SOCIAL DIMENSIONS 167. Viet Nam has a strong policy and institutional environment supporting gender equality, women empowerment and gender gap reduction. Viet Nam has ratified the convention on elimination of all forms of discrimination against women (CEDAW) and reflects this commitment in the Constitution and of the Law of Gender Equality (2006), National Strategy on Gender Equality for 2011–202022 and National Target Program for Gender equality 2011- 2015. Ministry of Health has an action plan on gender equality to foster women’s participation in the health sector for period 2011- 2015. In every ministry and local government, the committees for advancement of women (CFAW) promote government’s gender equality agenda. However,

22 GOV. 2010. Decision No: 2351/2010/QD-TTg from the Prime Minister, 24 December. Ha Noi.

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the Provincial Department of Health (DOH) CFAW’s capacity to promoting gender equality agenda is limited. 168. The project's gender classification is "gender equity as a theme" (GEN). Gender Action Plan (GAP) has been prepared, based on the gender analysis in participating provinces to promote gender inclusive design of the Project and to ensure women participation and benefit equally as men. The GAP will ensure that women have full and equitable access to Project resources, information and benefit. The GAP is in line with Government of Viet Nam gender equality law and ADB Policy on Gender and Development (1998). 169. The GAP includes the following strategies and design features:

(i) Support women’s practical gender needs through women friendly health facilities and services at commune and district level, and training opportunities for women health workers (targeting from 30% to 70% female participation in various training program and levels), and provision of equipment on need basis given priority to MCH.

(ii) Support women’s strategic gender needs through long term professional training and training of managerial skills and leadership.

(iii) Other specific design features include : (a) Gender/ethnic groups friendly design for health facilities (b) Gender and ethnicity and health relevant concerns are integrated in training

programs provided by the project. (c) Gender targets, affirmative actions integrated in annual planning process

with sufficient budget allocation. (d) Gender responsive M&E system with baseline data sex and ethnicity

disaggregated and monitored.

170. Gender Action Plan overview

Project Outputs Actions

Output 1: Improved Access and Quality of Community Health Care

• As part of upgrading of CHSs and ICPs, include appropriate facilities for antenatal and postnatal check-up, obstetric delivery, private examination and treatment room for women, and separate male and female water closets and showers, in particular attention should be given to women and men with disabilities.

• In construction contracts, include a clause that recommends an overall target of 30% employment of women in unskilled labor during construction.

• Provide IEC on HIV/AIDS, prevention of STDs, etc. for both men and women construction workers, ethnic groups who live in work areas.

• Prioritize procurement of equipment for CHSs and ICPs which address and benefit women and children’s health needs.

• Prioritize topics of pediatrics and obstetrics and gynecology in training and clinical attachments of CHS and ICPs doctors, and target a minimum 60% female participation in these activities.

• Ensure an increase in the proportion of female doctors in CHSs by 15% by reallocating the existing pool of doctors in the district.

• In the 6 months training and in-service training of VHWs and VBAs, target a minimum of 70% female participation.

• Scholarships for the 2-year nursing degree training target at least 70% female recipients and 50% for 2-year medical technician degree training.

• Integrate training module on gender equality and medical ethics in project training programs in order to equip doctors/ VHWs/ VBAs with knowledge of gender

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Project Outputs Actions equality and proper behavior of health staff.

• Carry out gender sensitive and ethnic appropriate IEC campaigns for vulnerable people including the poor, near-poor and ethnicities to: (i) increase knowledge on health topics that directly affect women (e.g., nutrition, hygiene, family planning, MCH care, domestic violence, etc.); (ii) to address socio-cultural barriers to accessing health care; and (iii) to improve their health seeking behavior and access to treatment.

• Ensure 70% of trained VHWs delivering the IEC campaign are female.

Output 2: Increased Access and Quality of Hospital Services

• As part of civil works of hospitals, ensure women friendly design features (separate male/ female toilets and showers; private rooms for women in health checks and treatment, in particular attention should be given to women and men with disabilities).

• In construction contracts, include a clause that recommends an overall target of 30% employment of women in unskilled labor during construction.

• Prioritize procurement of equipment for CHSs and ICPs which address and benefit women and children’s health needs.

• Ensure at least 50% of female participation (or proportion equivalent to the number of female staff currently employed at these levels/ areas) in the short term training courses as well as the 2-year training courses for doctor specialists.

• Ensure that the above trained female level 1 specialists are deployed in district hospitals and that females make up 20% of those deployed.

• Integrate module on gender equality and medical ethics in project training programs at district level to equip trainees with knowledge of gender equality and proper behavior of health staff.a

Output 3: Strengthened Provincial Health System Management

• Target 30% female participation among health management training’s participants. • Organize leadership skills orientation for female health managers from commune,

district and provincial levels. • Ensure that CPMU and PPMUs are staffed with at least 33% female members

including women in leadership positions and a gender focal point with gender responsibility in TORs.

• Ensure that gender and ethnic issues are integrated in all training program related to health system management strengthening.

• HMIS collects and reports on sex disaggregated data, including the baseline of sex and ethnic disaggregated data.

• Ensure gender targets are included during annual planning, review and reporting on project implementation.

• Ensure that the project monitoring and evaluation system is developed with sex and ethnic disaggregated data for reporting on GAP and DMF progress. Ensure progress reports include a section on gender, highlighting access and utilization of health care by women and men, quality of training and appropriateness of equipment to women and men, especially ethnic groups. Issues pertaining to affordability and appropriateness of health services, as well as care rendered, will be recorded and included where appropriate.

• Ensure that midterm review will consider the gender-specific challenges and concerns in accessing appropriate health services.

CHS = commune health station; CPMU = central project management unit; DMF = design and monitoring framework; GAP = gender action plan; HMIS = health management information system; ICP = intercommunal polyclinic; IEC = information, education, and communication; MCH = maternal and child health; PPMU = provincial project management unit; STD = sexually-transmitted disease; TOR = terms of reference, VBA = village birth attendant; VHW = village health workers. a Gender and domestic violence are included on the content of needs assessment (see Component B, item B1.1

in Project Detailed Outline). The findings from the assessment can be used for IEC campaign/activities or other training activities.

Source: Asian Development Bank staff.

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171. Implementation Arrangement. The CPMU and PPMUs will be responsible for implementation of the GAP and will appoint Safeguard Officers as gender focal point(s) ensuring annual planning, implementation and M&E of GAP as part of project activities. The CPMU will recruit a national gender consultant who will undertake frequent travels to project provinces and provide technical assistance to CPMU and PPMUs in GAP’s implementation, M&E and reporting. Safeguards officers and gender consultant will support CPMU and PPMUs in: (i) preparing PPMUs updated GAPs, (ii) facilitating project annual planning including gender targets, (iii) integrating gender and health module in various training program, and (iv) introducing the gender and ethnic disaggregated M&E system to CPMU and PPMUs. The CPMU will compile PPMUs reports and inform quarterly the Viet Nam Government and the ADB and on GAP progress. The GAP will be overseen by Ministry of Health/Department of Health Committee for the Advancement of Women’s member who will be part of the project steering committee at province or national levels. Budget for GAP implementation will be integrated into overall project budget.

IX. PERFORMANCE MONITORING, EVALUATION, REPORTING AND COMMUNICATION

A. Project Design and Monitoring Framework

DESIGN AND MONITORING FRAMEWORK

Design Summary Performance Targets and Indicators with Baselines

Data Sources and Reporting Mechanisms

Assumptions and Risks

Impact

Improved health and nutrition in the central highlands, in particular for women, children, the poor, and ethnic groups

By 2022, in the central highlands:

IMR: 18 infant deaths per 1,000 live births (2011 baseline: 24)

U5MR: 30 child deaths per 1,000 live births (2011 baseline: 37)

MMR: 82 maternal deaths per 100,000 live births (2009 baseline: 108)

Under-5 child malnutrition (underweight): 18% (2011 baseline: 24%)

MMR: Research Center for Rural Population and Health 2009 report

IMR, malnutrition, and U5MR: MOH Joint Annual Health Review 2012 report

Assumptions

Government continuing to give high priority to health care improvement in the central highlands

Quality of care sufficient for increased use to result in increased impact

Risk

Economic slowdown

Outcome

Increased use of health services, in particular maternal and child health services in district hospitals, ICPs, and CHSs

By 2019, in the central highlands:

Outpatient visits per person per year to district hospitals: 0.3 (2010 baseline: 0.2); and to CHSs:0.2 (2010 baseline: 0.1), in the poorest districts, with data disaggregated by age, gender, and ethnic group

Inpatient visits per person per year to district hospitals and ICPs: 0.15 (2010 baseline: 0.11), with data disaggregated by age, gender, and ethnic group

District health office reports from the health information system

General Statistics Office

Viet Nam living standards households surveys

Assumption

Better financial accessibility to services through increased social health insurance coverage

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Proportion of ethnic women deliveries assisted by skilled staff increases to 80% (2010 baseline: 50%)

Outputs

1. Improved access and quality of community health care

By 2019:

Proportion of CHSs meeting 80% of the national quality benchmarks to increase to 50% (2010 baseline: 10%)

Proportion of CHSs with at least one medical doctor to increase to 75% (or 540 doctors posted in CHSs) (2010 baseline: 58% [or 420 doctors])

Proportion of female doctors in CHSs to increase by 15% to 92 female doctors posted in CHSs (2010 baseline: 80 female doctors)

54 CHSs and 10 ICPs built or renovated and equipped

MOH Joint Annual Health Review 2012 report

District health office annual reports

Project reports

Assumptions

Sufficient candidates passing their entry exams to participate in training programs

Sufficient attention from the health managers to quality and gender balance

2. Increased access and quality of hospital services

By 2019:

Proportion of district hospitals meeting 80% of the national quality benchmark (national inventory checklist) to increase to 60% (2012 baseline: 40%)

120 level 1 specialists posted in district hospitals (20% of whom are female); two specialists per hospital (2012 baseline: 40 level 1 specialists posted in district hospitals; 0.7 specialist per hospital)

Number of district hospital beds in the region increased by 570, at least one-third of them for obstetrics and pediatrics

Hospital infection control systems put in place in 50% of hospitals

One district hospital built and equipped, 8 district hospitals upgraded, 30 provincial and district hospitals equipped

District statistics

Project reports

Assumption

Sufficient capacity for procurement process at central and provincial levels

3. Strengthened provincial health system management

By 2019:

50% of district senior managers achieving 80% of quality benchmark

Proportion of women among

Health services survey

Provincial annual reports

Project reports

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district senior managers increased by 20% to 72 senior health managers (2012 baseline: 60)

80% of provincial annual operation plans meeting 80% of minimum benchmarks, including funding for maintenance of buildings and equipment, and in-service training

Provincial training systems put in place in each province

Activities with Milestones Inputs

1. Improved access and quality of community health care 1.1 Conduct knowledge, attitudes, and practices survey in communities (Q4 2014). 1.2 Conduct outreach activities in villages (Q4 2014–Q3 2018). 1.3 Conduct information, education, and communication campaigns in the villages (Q4

2015–Q4 2017). 1.4 Train VHWs and VBAs (Q3 2014–Q4 2018). 1.5 Retrain VHWs and VBAs (Q3 2014–Q4 2018). 1.6 Provide vehicles to districts for supervision and support to outreach services

(Q4 2014). 1.7 Build and upgrade CHSs and ICPs (Q1 2015–Q4 2015). 1.8 Provide medical equipment to built and renovated CHSs and ICPs (Q4 2015). 1.9 Provide additional medical equipment to CHSs and ICPs with no civil works (Q4

2014, Q4 2015, Q4 2016, Q4 2017). 1.10 Hospital secondment of CHS/ICP staff to hospitals (Q3 2014–Q4 2018). 1.11 Train CHS and ICP heads in health center management, hygiene, and quality

assurance (Q3 2013 and Q1 2016). 1.12 Provide scholarships for 2-year medical technician or nursing training certificate

courses to ethnic students (Q2 2015–Q4 2018). 2. Improved access and quality of hospital services 2.1 Build and upgrade district hospitals (Q3 2015–Q4 2016). 2.2 Provide water system and sanitation equipment to district hospitals (Q4 2014,

Q4 2015, Q4 2016, Q4 2017). 2.3 Equip district and provincial hospitals (Q4 2016). 2.4 Provide ambulances (Q4 2014). 2.5 Train hospital hygiene focal points, and hospital staff on infection control and quality

assurance (Q1 2015, Q3 2016) 2.6 Provide in-service training to nurses, midwives, and technologists (Q3 2014–Q3

2018). 2.7 Train doctors to specialization level one and two (Q3 2014–Q3 2018). 2.8 Train specialists in short courses lasting 1–3 months (Q3 2014–Q3 2018). 2.9 Upgrade assistant doctors and assistant pharmacists into doctors and pharmacists

(Q3 2014–Q3 2018). 3. Strengthened provincial health system management 3.1 Support annual operation plan design (Q2 2014, Q2 2015, Q2 2016, Q2 2017). 3.2 Provide teaching equipment to medical schools and universities (Q4 2014). 3.3 Provide equipment and vehicles to CPMU and PPMUs (Q3 2014). 3.4 Hire project contractual staff and consultants (Q3 2014). 3.5 Recruit consulting firms for information, education, and communication; audit; and

health services quality assurance (Q3 2014). 3.6 Recruit consulting firm for detailed engineering design of health facilities and

supervision of civil works (Q2 2014–Q1 2015).

ADB: $70 million

Government of Viet Nam: $6.6 million

Output 1 $20.6 million

Output 2: $39.4 million

Output 3: $8.6 million

Contingencies: $5.0 million

Finance charges during implementation: $3.0 million

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Activities with Milestones Inputs

3.7 Undertake detailed design of CHSs, ICPs, and hospitals (Q1 2015–Q4 2015). 3.8 Supervise the construction CHSs and ICPs (Q1 2016–Q4 2016). 3.9 Supervise the construction of hospitals (Q3 2016–Q3 2017). 3.10 Conduct the midterm review (Q4 2016). 3.11 Prepare the project completion report (Q3 2019–Q4 2019). 3.12 Conduct the annual financial audit (Q1 2015, Q1 2016, Q1 2017, Q1 2018, Q4

2019). ADB = Asian Development Bank, CHS = commune health station, CPMU = central project management unit, ICP = intercommunal polyclinic, IMR = infant mortality rate, MOH = Ministry of Health, MMR = maternal mortality ratio, PPMU = provincial project management unit, Q = quarter, U5MR = under-5 mortality ratio, VBA = village birth attendant, VHW = village health worker. Source: Asian Development Bank.

B. Monitoring 172. Project Performance Monitoring Within 3 months of grant effectiveness, the EA will complete the establishment of a monitoring and evaluation mechanism to monitor project inputs, activities, outputs, outcome, and impact. The monitoring mechanism will capture the indicators provided in the design and monitoring framework and PAM on project performance monitoring and evaluation, and will be based on routine data collection instrument arrangements, completed with project specific before-and-after surveys to assess changes in access, quality and management of services, and use of services by beneficiaries of project. 173. Reporting and compliance monitoring. Before grant effectiveness, the EA will submit an inception report including a workplan for the first year and an update of the PAM. MOH will prepare a project mid-term review after 2.5 years, assessing project performance against agreed indicators and scope of work, and propose any adjustments in scope, implementation arrangements, and allocations. The EA will prepare quarterly and annual reports in English for submission to ADB within 20 days (or earlier if agreed between ADB and the EA) after end of each quarter and fiscal year, respectively. MOH will also prepare a project completion report before project closing within 6 months of physical completion of the Project. All program covenants will be monitored monthly by the PMU, and discussed during ADB review missions. Specifically, PMU will include information of Gender Action Plan and social dimensions in all project reports and project data will be disaggregated by gender and ethnic groups to the extent possible. The PMU will build up provincial staff capacity to enhance and monitor social and gender impact. 174. Safeguards monitoring: Monitoring of the safeguards will be integrated in general data collection and survey instruments and internally conducted by the PPMUs. External monitoring is not required for this project. C. Evaluation

175. ADB will conduct review missions at least twice a year, including inspection of financial management. ADB will conduct an inception mission within 1 month of grant effectiveness, a midterm review mission after 2.5 years of project implementation, and a project completion mission after 6 months after the project physical completion. The mid-term review mission will indicatively be scheduled in mid-2015. Within 6 months after the physical completion of the project, the Project Director will submit to ADB a project completion report, analyzing implementation, project performance and achievements against the targets, and expected project impact.

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D. Reporting

176. The MOH will provide ADB with (i) quarterly progress reports in a format consistent with ADB's project performance reporting system; (ii) consolidated annual reports including (a) progress achieved by output as measured through the indicator's performance targets, (b) key implementation issues and solutions; (c) updated procurement plan and (d) updated implementation plan for next 12 months; and (iii) a project completion report within 6 months of physical completion of the Project. To ensure projects continue to be both viable and sustainable, project accounts and the executing agency AFSs, together with the associated auditor's report, should be adequately reviewed.

X. ANTICORRUPTION POLICY

177. ADB reserves the right to investigate, directly or through its agents, any violations of the Anticorruption Policy relating to the Project.23 All contracts financed by ADB shall include provisions specifying the right of ADB to audit and examine the records and accounts of the EA and all project contractors, suppliers, consultants and other service providers. Individuals/entities on ADB’s anticorruption debarment list are ineligible to participate in ADB-financed activity and may not be awarded any contracts under the Project.24 178. ADB’s Anticorruption and Integrity Policy (1998, as amended to date) and the Policy relating to Enhancing ADB’s Role in Combating Money Laundering and the Financing of Terrorism (2003) were explained to and discussed with the Government, the EA and the IA. Consistent with its commitment to good governance, accountability and transparency, ADB reserves the right to investigate, directly or through its agents, any alleged corrupt, fraudulent, collusive, or coercive practices relating to the Project. To support these efforts, relevant provisions of ADB’s Anticorruption and Integrity Policy records and accounts of are included in the loan regulations and the bidding documents for the Project. In particular, all contracts financed by ADB in connection with the Project shall include provisions specifying the right of ADB to audit and examine the records and accounts of the EA and the IA and all contractors, suppliers, consultants, and other service providers as they relate to the Project. Individuals and/or entities on ADB’s anticorruption debarment list are ineligible to participate in ADB-financed activity and may not be awarded any contracts under the Project. 179. The Project will further enhance the MOHs’ capacity to comply with ADB and government procedures as outlined in the Project Administration Manual. Risks associated with project management will be mitigated by (i) training of the IA’s staff in the procurement of goods and services under the Project; (ii) periodic inspection of contractors’ activities related to fund withdrawals and settlements by the staff of the EA and IA.

180. The EA will take all actions necessary to protect the investment in goods made under this project by ensuring: (i) that all deliveries of goods procured are verified upon receipt by independent qualified inspectors including verifying that the equipment ordered is of the quality or standard as ordered, is in good and proper working order and condition; (ii) that an accurate asset register is established and maintained for each project province recording all goods procured under the project and allowing regular, unannounced inspections to take place to verify the presence of all goods and its use for the purposes for which they are purchased for this project; and (iii) all goods leaving the central procurement site are: safely delivered to their

23 Available at: http://www.adb.org/Documents/Policies/Anti-corruption-Integrity/Policies-Strategies.pdf 24 ADB’s Integrity Office website is available at: http://www.adb.org/integrity/unit.asp

72

end use site in accordance with their purchase order and are maintained in good and proper working condition at the location of delivery and used for the purpose for which it was purchased; and (iv) that all inspections of goods procured under this project are carried out by personnel who are: qualified to verify their appropriate use and are independent third parties with no conflict of interest. In this context, a conflict of interest is a situation in which such personnel has interests that could improperly influence the performance of their duties and responsibilities to carry out inspections of goods at the highest standard of ethics (such as vested interests or connections with MOH, contractors, suppliers, consultants, and other service providers as they relate to the project) and that such conflict of interest may contribute to a prohibited practice under ADB’s Anticorruption and Integrity Policy (2010).

181. In addition to the above requirements, the EA shall set up a Project website that publicly discloses on the website information on how Loan proceeds are being used, presenting (i) procurement contract awards, including for each such contract (a) the list of participating bidders, (b) name of the winning bidder, (c) basic details on bidding procedures adopted, (d) amount of the contract awarded, (e) list of goods and/or services purchased, and (f) intended and actual utilization of Loan proceeds under each contract. Any bidder may request an explanation from the IA as to why a bid was unsuccessful and the IA should respond within 20 working days. The website will be updated within 2 weeks after: (i) each award of contract, (ii) each submission of the EA’s semi-annual Safeguards Monitoring Report to ADB.

182. It is noted that the Government is taking an active approach against corruption, and recently adopted several legal changes, including the Anti-Corruption Law.

XI. ACCOUNTABILITY MECHANISM

183. People who are, or may in the future be, adversely affected by the project may submit complaints to ADB’s Accountability Mechanism. The Accountability Mechanism provides an independent forum and process whereby people adversely affected by ADB-assisted projects can voice, and seek a resolution of their problems, as well as report alleged violations of ADB’s operational policies and procedures. Before submitting a complaint to the Accountability Mechanism, affected people should make a good faith effort to solve their problems by working with the concerned ADB operations department. Only after doing that, and if they are still dissatisfied, should they approach the Accountability Mechanism.25

XII. RECORD OF PAM CHANGES

XIII. APPENDIXES

1. Financial Management Assessment 2. Terms of Reference for Financial Audit Consulting Services 3. General Procurement Assessment 4. List of Training 5. List of Civil Works 6. List of Hospitals to be Provided with Equipment

25 For further information see: http://www.adb.org/Accountability-Mechanism/default.asp.

Appendix 1 73

FINANCIAL MANAGEMENT ASSESSMENT

I. EXECUTIVE SUMMARY 1. This executive summary recapitulates the financial management (FM) assessment findings and provides input for the project documentation, including an overall assessment on the adequacy of the FM system. It describes:

(i) the adequacy of the (proposed) FM system and the financial performance of any revenue-earning entities, and present a timetable of any proposed corrective actions;

(ii) compliance with audit covenants in existing projects, and explains any actions being taken to address noncompliance;

(iii) any agreements with the borrower on standards and formats for audited financial statements and the timetable for their submission;

(iv) country-level issues and their potential impact on project arrangements, and where significant: (a) compliance with financial covenants in existing projects; (b) existing and proposed fund flow arrangements between donors, the

project, and its beneficiaries; (c) proposed supervision arrangements to mitigate weak FM arrangements;

and (d) adequacy of existing or proposed banking arrangements.

II. PROJECT DESCRIPTION

2. The proposed project aims at improving the health status of the people in the central highlands region of Viet Nam and is to become the second phase of the Health Care in the Central Highlands (HICH) project. It aims at expanding the health services network, providing increased access to services, and strengthening the health human resources in 5 provinces: Đắk Lắk, Đăk Nông, Gia Lai, Kon Tum, and Lâm Đồng with a total of 58 districts and municipalities and a population of over 5 million people. All provinces have at least 24% of ethnic minorities. The project builds on the efforts of the first project, HICH, to make health services more accessible and affordable, and more needs oriented. Amongst other outputs envisaged to further these changes, the financing of health services (output 3) and the management of health services (output 4) are to be improved. 3. The improvements of the last 2 decades in the health sector already lead to an achievement of Millennium Development Goal (MDG) 5, improved maternal health, in the national perspective. The central highland provinces, however, have higher maternal and infant mortality rates. The infant mortality rate ranges between 15 and 38 per thousand live births. Leading causes of higher than average morbidity are common health problems like respiratory, maternal and infectious conditions. The rates relate to the region’s high poverty ratio and high proportion of ethnic minorities. Of the average of 36% ethnic minorities, their spread in the provinces of Gia Lai is 45% and Kon Tum 54%. These communities generally live in low density settlements with decreased coverage by health services. The burden of disease in the central highland provinces is higher (280 DALYs1) than the national average (180 DALYs). Therefore, this region’s near poor are likely to suffer most from exclusion from the health insurance.

1 DALY or disability-adjusted life years is calculated of the time lived with a disability and the time lost due to

premature mortality (Viet Nam National Health Survey 2001—2002).

74 Appendix 1

Monthly income in the central highlands is below the national average. There is a considerable influx of migrants who search for available land or participate in illegal mining and logging activities, thus competing with and/or depriving ethnic minorities of their economic bases, as well as posing an additional burden on the health system. 4. Already, the HICH from 2006—2010 had started implementing the Government of Viet Nam (GOV) Decision 139, year 2002 to subsidize health care utilization and related costs like transport for the disadvantaged groups and, thus, increase their access to health services. 5. Health service management requires significant skills for developing properly financed annual operational plans, plan oriented implementation, and monitoring of activities. The project shall incorporate a central subsidy to disadvantaged and poor groups through a part of the loan. The implementation depends on addressed health financing requirements to provide the subsidy to the disadvantaged groups. Areas of activity will be the strengthening of a registration system, cost orientation, monitoring of spending and utilization, capacity building in planning, and management of district and provincial health offices, as well as of health services managers. 6. In HICH, the area of monitoring of health information at district level was intended to be strengthened, but resources were diverted to strengthening financial management, planning capacity, and to commune level health and medical waste management, which were perceived as greater needs. 7. The project shall now facilitate the implementation of recommendations resulting from HICH evaluation to develop evidence bases in order to facilitate needs based activity planning and resource allocation with special focus on poverty, barriers due to ethnicity, high mortality, and other factors such as migration, geography, and availability of facilities and beds. 8. Better services management shall strengthen human resource development (HRD) through training plans, recruitment and retention policies, as well as building better training capacities. A consideration of allocations to strengthen primary health care (PHC) is desired for rural and remote areas at the level of commune health stations (CHSs) and village health workers (VHWs), as much as addressing the need for expansion of infrastructure. 9. The Health Care Fund for the Poor (HCFP), paid through a Swedish International Development Cooperation Agency (SIDA) grant of USD5.6 million and GOV contribution of USD5 million, provided insurance for 1.7 million people, based on the eligibility criteria of the government for subsidized services for those poor who had registered and attained a health card. The subsidies covered:

(i) in-patient food allowance, (ii) reimbursement of actual transport costs for referral and the deceased, (iii) reimbursement of actual higher direct medical costs outside of the insurance, and (iv) provision of mobile primary health care outreach services.

10. Greatest benefit was observed for coverage of food in hospitals (42%), transport costs (23%), as well as for medical bills. While this insurance scheme came to a halt after project completion in 2010, food and transport received continued support by 3 of 5 provinces by other donors; yet in 2012, the scheme was practically closed.

Appendix 1 75

11. GOV has expanded the support for the poor and near poor through expansion of membership in the social health insurance scheme, and advised the provincial governments to roll it out to and achieve universal coverage by providing 30% financial support to premium purchases in addition to the central government’s 70% support to premium purchase for the near poor. Poor provinces shall receive central subsidies, richer provinces shall generate own resources for health insurance.2 In 2012, the government has started to revise its health financing law to enable implementation and will be adjusting the social health insurance scheme until 2014. 12. Decree 172, introduced in 2007, led to separation of district hospitals from district preventive health centers which subsequently have less infrastructure and resources and need to be separately supported by funding. On the other hand, despite the lack of medical equipment and doctors, it is the district level hospitals which attract a majority of poor and near poor people (47%), many of whom are bypassing the primary care level. Available medical equipment is rather basic, particularly at CHS level, complicated by lack of human resources and skills, mainly from specialties (surgeons, gynecologists, pediatricians, anesthesiologists, etc.), leaving gaps in ability to treat basic conditions including obstetric problems. Government is planning to penalize by passers more strongly than in the past to cut the rates which are quoted as high as 90% (Health Minister, 6 Nov 2012). 13. Spending under HICH was 91% or $27.98 million of budgeted project costs ($30.6 million). 65% were borne by an ADB loan from its Special Fund reserves. Under-spending occurred in the areas of (i) construction, (ii) training due to lowered cost norms and lower than planned domestic transport costs, and government contribution for operations and maintenance (2% only), and (iii) research and monitoring and evaluation (7%). 14. The proposed project budget is foreseen for a 5 year period at $78 million, of which $70 million is requested as ADB soft loan, and $8 million to be marked as government contribution.

III. COUNTRY ISSUES

15. For more than a decade, Viet Nam is in the process of transition to a market economy. The country has gradually improved its laws and regulations, strengthened its institutions, and built capacity to improve financial accountability. Over the last decade, the Government has implemented significant reform measures across a number of areas. Specific actions taken to increase transparency of the budget included the publication of budget outturns (since 1999) and communes’ budgets, provision of fiscal information to international organizations and donors and all relevant government agencies, and development of prudential regulations on capital adequacy, foreign exchange operations, and bank inspection. Over the years, the Ministry of Finance (MOF) have adopted collaterals and deposit insurance, prepared accounting and audit standards, and revised the budget law. 16. Viet Nam has also taken significant steps in improving laws and regulations to ensure more effective public expenditure management, thus, also facilitating private sector operations. The new Enterprise Law has provided direction for improved corporate governance. Laws on financial accountability are getting enforced in the public and private sectors, yet in 2012, many loopholes still exist, particularly in procurement and internal audit functions. In 2012, different analyses of public financial management still refer to the need for improvements on the

2 As announced by Ministry of Health (MOH) in the health insurance conference on November 6, 2012, Ha Noi,

Conference Proceedings (in Viet Namese language).

76 Appendix 1

efficiency of public investment and procurement. In the health sector, lack of efficiency of public investment is most visible in civil works and facility maintenance; operational management is little developed as well. In terms of fiscal space, costs for maintenance are not even defined; hence, in a negative sense, allowing deterioration of facilities. 17. It took until 2006 to develop a framework with laws and regulations for corporate governance in Viet Nam.3 The framework addresses a high degree of informality in the corporate sector, yet a large presence of state ownership in enterprises remained. They are economically lagging behind the open market. Institutions responsible for regulation, enforcement, and development of the capital market have limited capacity and resources. Among other key issues observed in 2006, inadequate investor protection has not been sufficiently resolved by 2012, and disclosure of quality information is still limited. As the International Monetary Fund (IMF) has observed in 2012, progress is slow in this area and risk for the public finances could be better reduced by reform of the private enterprises. In October 2012, government had to announce that it will tighten capital allocations to state projects. Health projects, however, remain paid for when starting in 2013 and listed in an investment plan. Despite this being a positive example of exempting health from public funding tightening, the fungibility (absorption) risk for projects remain as control over government spending is difficult to access. This leaves the question open whether the government will continue to provide corresponding capital to this proposed Official Development Assistance (ODA) project. 18. In 2012, further improvements on the key issues could be observed, yet the global financial crisis also had its impact on Viet Nam and macroeconomic policies were tightened. Small banks experienced a liquidity squeeze, and credit growth has slowed down.4 By October 2012, access to credit is still very difficult for domestic enterprises and their tax burden high at 25%.5 While various analyses of public financial management recommend modernization of the tax administration system, the Viet Nam Chamber of Commerce and Industry (VCCI) calls for a reduction of corporate income tax from 25% to 20% to make Viet Nam’s economy more competitive within the South East Asia (SEA) context where neighboring countries charge from 15 to 23%. 19. Viet Nam needs smarter regulations if it wants to progress faster and stabilize its economy. This would include a reduction of the complexity and costs of regulatory processes, and stronger legal institutions in order to improve the business climate. There are even calls for a regulatory reform to strengthen Viet Nam’s competitiveness within the SEA region.6 The complexity of regulations is also reflected in the ODA regulations for project management, leading to complex procedures for fund disbursements at provincial and district level (see below) and triple recording of expenditures in the health sector. Such approach opposes proposals for improving accountability and transparency in project financial management. A recent ranking by the International Finance Corporation (IFC) positions Viet Nam as unchanged over the last year and below the international average.7 In contrast, however, monitoring and inspection functions remained weak or understaffed. The same applies to the Social Health Insurance (SHI) as confirmed by the World Bank (WB) experts who demand that information is made more accessible.

3 World Bank. 2006. Corporate Governance Country Assessment: Vietnam. Series: Reports on the Observance of Standards and Codes.

4 International Monetary Fund, April 2012. 5 Pham Chi Lan, November 2012, Senior Economist, World Bank, Ha Noi. 6 Ms. Kwakwa. November 2012, Director, World Bank, Ha Noi. 7 International Finance Corporation and World Bank: “Doing Business 2013”, October 2012.

Appendix 1 77

20. Stabilization of the macroeconomic situation of Viet Nam will further take off some of the burden perceived disproportionately high by the poor if inflation would continue to decline, as through 2011 to September 2012, yet in October, stagnation is observed. The recommendation of the IMF8, to offset planned public sector wage increases by cuts in other current spending in order to reduce risks in public finances, should rather not find an attempt in cutting the subsidies for the near poor as this would contradict the government’s pro-poor policies. While the proposed project is being formulated, GOV has adopted such recommendations for the health sector and announced to offset expected salary increases, but maintained, even improved, subsidies to the (near) poor within the framework of the social health insurance. 21. Viet Nam’s growth prospects are expected to improve in the medium term perspective. While State owned enterprises’ reform shall look at reducing risk in the financial sector and public finances, health facilities require to become more cost-effective in using scarce resources. However, without government policy to adopt an accommodating fiscal stance for economic development, as recommended by IMF (2012) when external factors provoke further downside risks (such as inflation stagnation rather than decline), the effect on the health sector will be a widening gap in the affordability of health services and a decreased ability in consumption of health services. 22. The utilization of first referral and public health service is low due to lack in modern facilities and human resource, as well as low insurance coverage of the near poor (less than 1%, whereas the national average enrollment achieved by 2011 was 63%). Based on the Health Insurance Law of 2008, it is envisaged that by 2016, this law would lead to universal coverage. In June 2012, a prime ministerial decision lifted the premium payment support for the (near) poor from 50% to 70%, but of the 5 provinces, only one (Lam dong) is willing to start implementation of this decision with the coming financial year. 23. The near poor are 6-7% of the population. So far, they contribute 20% to their treatment costs, while government paid the remaining 80%. The insurance coverage through government amongst the poor is 100%; they contribute 5% to their treatment costs.

IV. RISK ANALYSIS

24. This analysis describes the findings of the Financial Management Internal Control and Risk Assessment (FMICRA) and summarizes the results in the following table: Risk Risk Assessment* Risk-Mitigation Measures Inherent Risk

1. Country-Specific Risks

Moderate 1.1 No further state health project funds (GOV 13.11.12) 1.2 Procurement tendering direct 1.3 cost norm revision due 1.4 reporting and auditing regulation 1.5 Maintenance and operations costs not defined to ensure fiscal space

1.1 Fungibility risk, no fiscal space for reform

2. Entity-Specific Risks

Moderate 2.1 Insufficient internal controls at district and provincial levels

2.1 Ensure frequent and regular financial management (FM)

8 International Monetary Fund, Viet Nam: Article IV Staff Consultation Report, April 2012.

78 Appendix 1

Risk Risk Assessment* Risk-Mitigation Measures

2.2. No inspection function in Viet Nam Social Security (VSS)

reporting, concurrent and annual audit by project 2.2.1 Ensure VSS exercises monitoring function or expands inspection at provincial and district levels 2.2.2 Introduce monthly internal auditing by central project management unit (CPMU) 2.2.3 Ensure integration of claim reimbursement into the Treasury and Budget Management Information System (TABMIS)

3. Project-Specific Risks

Negligible 3.1 Insufficient accounting staff 3.2 Internal audit

3.1 Harmonize ODA with regular government procedures and integrate recording 3.2 Introduce monthly account reconciliation, statement of expenditure (SOE) limits and concurrent audit

Overall Inherent Risk

Moderate

Control Risk

1. Implementing Entity

Negligible

2. Funds Flow

Negligible 2. High reporting requirement for loans/grants

2. Harmonization of ODA funds

3. Staffing

Moderate 3. Insufficient inspectors

3. Training, hiring technical assistance (TA), CPMU expansion

4. Accounting Policies and Procedures

Moderate 4. Internal audit missing

4. Introduce international standards and internal audit

5. Internal Audit

Moderate 5. Reconciliation of accounts infrequent

5. Introduce concurrent auditing by local tender procedure, have SOE limits, allow reimbursements only with authorization (treasury or MOH), allow activity deviance only with authorization by CPMU

6. External Audit

Substantial 6.1. Insufficient inspection system 6.2. Paper based 6.3 Triple accounting in ODA

6.1. Tender for external auditor 6.2. Ensure TABMIS analysis by auditor 6.3. Integrate ODA recording into TABMIS

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Risk Risk Assessment* Risk-Mitigation Measures

7. Reporting and Monitoring

Moderate 7. Inefficiencies & errors

7. Monthly reconciliation, harmonization: merge three reporting systems – enable VSS to supervise spending

8. Information Systems

Substantial 8. Cost norms old, cost explosion anticipated

8. Updating cost norms

Overall Control Risk Moderate

* H = High, S = Substantial, M = Moderate, N = Negligible or Low.

V. PROJECT FM SYSTEM: STRENGTHS AND WEAKNESSES

25. This section identifies significant strengths that provide a basis for relying on the (proposed) project FM system. It is partly built up on the ADB Financial Management Assessment Questionnaire, comparison with other projects’ FMA and interviews with financial managers in various donor organizations and in the executing and implementing agencies. 26. The fiduciary risk of the Viet Nam’s public financial management system, according to above risk management table, is deemed moderate, with some vulnerable areas where lenient controls are applied in reimbursements and payments to unplanned activities. Otherwise, the public accounting system and financial arrangements are fairly well documented and regulated. Challenges are (i) expanding budget coverage in line with internationally accepted norms, (ii) implementing the new Government Chart of Accounts and the Treasury and Budget Management Information System with strengthened internal control, and (iii) higher requirement of reporting for ODA projects leading to non-harmonized workload. However, erroneous recording and reporting may also cause problems, particularly with regards to the lack of internal audit, which usually helps detect such mistakes. In general, it may, however, be said that if GOV regulations for ODA projects and ADB requirements are strictly applied this will reduce fiduciary risks significantly. 27. In the very last health project supported by the WB to the Central Northern Region, the fiduciary risk assessment in 2010 resulted in identifying a medium risk in the overall fiscal environment. Capacity in Medium Term Expenditure Framework implementation and stronger commitment in budgeting (like for maintenance of facilities), implementation, monitoring, control, and advances management could mitigate the risk. It was observed that central and provincial project management units (PMU) lack experience in ADB financial management and disbursement procedures, however further training provided to PMUs will help prevent such risk. The 2007 Country Financial Accountability Assessment (CFAA) of WB determined that the financial management risks were identified in improper use and control and reporting of funds that are managed. These findings are again confirmed in the completion report of the HICH. 28. The impact of differences in cost norms between government, donors and market prices are already mentioned in the risk management table above. If adjusted during the project duration, budget reliability will dilute. Some donors use price contingencies to balance off such indifferences and provide for fiduciary space; for the ADB project, 5% price contingencies are proposed.

80 Appendix 1

29. In the following table, the significant weakness of the proposed project FM system is presented and how each weakness will be resolved. Resolutions will either be (i) risk-mitigation measures as per the risk table, or (ii) agreed actions as per the action plan. The Financial Management risks of the project arising from the identified weaknesses, together with their mitigating measures are highlighted in the table below: 30. Identified Weaknesses in Financial Management

Significant Weakness Resolution Non-comprehensive Planning and Budgeting 1. The absence of sound medium-term planning and inadequate budget for recurrent expenditure (e.g. for the maintenance of capital investment) poses the risk that plans and budgets will not be adequate.

• Annual strategic plans • Results oriented budgeting • Activity based budget lines • Monthly financial reporting and internal

auditing

2. Maintenance and operations costs not defined to allow fiscal space.

Agree to clearly state maintenance and operation costs and allocations.

Fund Inadequacy and Lack of Donor Fund Additionality There is a medium risk that GOV funding will be inadequate as project funding is substituted for mainstream funding. There is also the risk that donor funding may not turn out to be additional.

Monthly/quarterly reconciliation with counterpart funding. Agree on monthly/quarterly report with GOV for Project Steering Committee.

Out-of-date Cost Norms There is a high risk that cost norms set after approval of MOF will become outdated due to the existence of price inflation, and that norms are not revised sufficiently quick to ensure their continuing relevance.

Regularly providing realistic and up-to-date cost norms (e.g. for management, national TA and capacity building activities, civil works and medical equipment).

Lack of Transparency in the Procurement Process As GOV program, the variability and lack of fully transparent procurement processes, decentralized decision-making and community quality control, bear risks in the procurement area. Separate procurement audits are often not carried out, though previous risk assessments identified potential risk of fund leakage.

Ensure competitive tendering. Closely monitor the procurement process and provide annual audit information.

Weak Inspection Function in Health Insurance In Viet Nam Social Security agency the number of inspections is insufficient.

• Strengthen VSS monitoring capacity by expanding inspection function at provincial and district levels (to check reimbursements against medical diagnosis).

• Link data use VSS and HMIS/patient records.

Reporting and recording High workload

• Harmonize ODA with regular government

procedures and integrate recording. • Ensure integration of claim reimbursement

into TABMIS.

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Significant Weakness Resolution Weak inspection on quality • Improve inspection functions, train staff on

additional inspection function. • Facilitate TABMIS analysis.

Advances authorization Make authorization mandatory before

disbursement. Change of payment purpose Make authorization mandatory before change,

request for addendum to agreement. Weaknesses in Auditing Internal audit Not yet institutionalized in Viet Nam

Insist on monthly reconciliation of expenses, Internal audit to be done by project, e.g. a concurrent audit, mandatory audit or risk-based audit. Agree to recover ineligible expenditure identified by the auditors.

External audit Agree on external auditor selection via public tendering. A plan to be drawn up with external auditor for auditing either a) financial & system audits or b) expenditure verifications of cost estimates

Source: Asian Development Bank A. Risks in the Fund Flow

31. The major problems in the past for receipt of funds by the entity have been the changing exchange rates between SDR-USD-VND. As staff is retained from HICH to this project, the experience of handling the changing exchange rate is likely to allow confident handling of transfers. 32. In HICH, greater deviations from planned activities took place.9 Therefore, it will be important in the future to have such deviations justified and authorized by the CPMU and ADB before expenditures are made by means of a formal addendum to their financing agreement. 33. It may be seen as a risk that staff capacity in the PMU might be weakened if the PMU is assigning too many projects to too few numbers of staff. If required, procedures may be harmonized in between projects and with ODA (see Chapter IX). 34. Fungibility of donor (and government) funds needs to be prevented. This risk is owed to the above mentioned risk of administrative and financial management weaknesses in the PMUs, as well as to the recent government announcement in November that government projects shall not receive any further funding from government due to austerity measures necessary during the current impact of the financial crisis in Viet Nam.

VI. PERSONNEL 35. This chapter identifies (proposed) key staff positions and the (likely) capability of personnel to fulfill project accounting and reporting responsibilities. The attached Annex 1 is

9 Project Completion Report.

82 Appendix 1

providing an overview over the envisaged staff strength in the PMUs at central and provincial levels, consisting of government and externally contracted staff, national and international TA. 36. The entity has implemented an ADB-financed project in the past and the staff is well versed with the procedures. As proposed by CPMU, mostly the same staff, who will work in the upcoming CPMU and PPMUs of the project, have already worked in the HICH. The ODA setup for the PMU system of the project will be similar to HICH, and according to ODA regulations. Chief accountants of both CPMU and PPMU are seconded from the MOH and PHO, respectively. CPMU director is appointed by the Minister of Health. PPMU director is directed by PPC and, usually, the DOH director. Further, PMU staff could be from regular system or employed by the PMU director on contract. A. Staffing 37. PMUs at both central and provincial level will have adequate staff in number and qualification to meet the project’s workload and complexity. In case they are also attributed to the management of other donor funded projects in their province, it will be ensured that the staff capacity is increased. 38. Director of CPMU is appointed for full-time work by the Minister of Health. The CPMU is established by the Minister of Health. There is a practice in the provinces that the director of DOH is appointed for part-time work as director of the PPMU. 39. The CPMU and each PPMU would have one chief accountant. At the central level the chief accountant of CPMU is staff of the Department of Planning and Finance in the MOH. The chief accountants of PPMUs are also the chief accountants and heads of the Department of Planning and Finance in the DOH. 40. As lesson learnt from HICH, it is envisaged to strengthen the PMUs with the position of Project Finance Manager (PFM) in the CPMU. This is an advisory position to the accounting section, staffed by contracted consultants, the PFM will support the accounting section to maintain a high level of accountability and transparence in accounting and procurement. If need be, s/he will provide trainings on results and performance oriented planning, budgeting, accounting, reporting &monitoring, controlling and auditing. 41. The finance and accounts staff are adequately qualified and experienced, as all chief accountants should have university degree in accounting. Each project accounting unit consists of one chief accountant and disbursement accountants. The chief accountant of CPMU is a civil servant of MOH with qualified requirements. The chief accountant of PPMU is civil servant of DOH with qualified requirements. It is proposed that there should be two disbursement accountants at the CPMU and one at each PPMU. A procurement consultant will strengthen the procurement staff functions at all PMUs. 42. Furthermore there will be disbursement accountants who could be staff of DOH for part-time work or hired externally for fulltime work on contract at the PMUs. Disbursement accountants should have university or college degree in accounting. 43. The project accountants are versatile of GOV procedures from their university/ college training. Nevertheless, the Department of Planning and Investment has established training packages in ODA procedures and can mobilize for training if needed. Proposed project accountants for the project were trained in ADB procedures during the HICH, new entrees will

Appendix 1 83

receive such training. In general, the regular finance and accounting system has plans for periodical training, organized by DOF. 44. The duration of the contract with the finance and accounts staff needs to follow government regulations, as the majority of finance and accountant personnel are civil servants. Some disbursement accountants will be contracted for project duration and pass through a probation time, before being accepted for the whole duration of the project. Other positions of accountants, IT expert, project assistants, drivers, cashiers, etc. come from MOH, DOHs for part-time work or are directly employed by the directors. 45. The project will have written position descriptions for ADB paid positions that clearly define duties, responsibilities, lines of supervision, and limits of authority for all of the officers, managers, and staff. The CPMU will give guidance on-the-job and task descriptions in the PMU system at the various levels, which are also documented in the project administration manual (PAM). Generally, the personnel are transferred at low frequency and training will be easy to plan for. 46. The legal system is considered strong enough to enforce law in case of breaches. This has lastly been proven in the case of one province, Gia Lai, where nine staff of the DOH were accused of fraud in relation to procurement. All of them have been convicted and sentenced due to corruption with imprisonment.

VII. ACCOUNTING POLICIES AND PROCEDURES

47. This chapter describes key policies and procedures that demonstrate the adequacy of the project FM system. 48. The project will comply, as did the preceding HICH, with the current Law of Accounting, Accounting Standards and Accounting Regulations of Viet Nam, and ADB regulations as agreed in the loan agreement for the project. 49. The project has mixed funding inputs, capital or investment funds and recurrent funds. Therefore, each funding source will be separately accounted for by the project. Accounting policies comply with best practices of health and health care nature of project expenses and MOH/DOH. Any amendment, modification and selection of accounting content and method wanted by PMU needs to be approved by MOF. 50. Planning and spending of the project shall follow the Circular No. 108/2007/TT-BTC issued by MOF for ODA projects. This circular sets out regulations and practices for planning, spending, and accounting. The Circular for the accounting policy and procedure manual is updated for the project activities and effective until the project end. The accounting policies and procedures are clear and set out in the operations manual. The basis of accounting is accrual accounting. In general, Viet Namese Accounting Standards (VAS) are followed.10

10 1.VAS 1: Framework, 2.VAS 2: Inventories, 3. VAS 3: Tangible Assets, 4.VAS 4: Intangible Assets, 5.VAS 5:

Investment Property, 6. VAS 6: Leases, 7.VAS 7: Accounting for Investments in Associates, 8. VAS 8: Financial Reporting of Interests in Joint Ventures, 9. VAS 10: The Effects of Changes in Foreign Exchange Rates, 10.VAS 11: Business Combination, 11. VAS 14: Revenues and other Incomes, 12. VAS 15: Construction Contracts, 13.VAS 16: Borrowing Costs, 14. VAS 17: Income Taxes, 15. VAS 18: Provision, Contingent assets, Contingent Liabilities, 16. VAS 19: Insurance Contract, 17.VAS 21: Presentation of Financial Statements, 18. VAS 22: Disclosures in the Financial Statements of Banks and Similar Financial Institutions, 19. VAS 23: Events after the Balance Sheet Date, 20. VAS 24: Cash Flow Statements, 21. VAS 25: Consolidated financial statements and

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51. The project has adequate policies and procedures manual to guide activities and ensure staff accountability. The Ministry of Health and Ministry of Finance issued the Circular 78/2004/TT-BTC on 10/8/2004 to regulate the financial management of the HICH. Circular No. 108/2007/TT-BTC will regulate financial management of HICH2. CPMU will produce a management and operations manual, including a financial manual, which regulate project operations and submit this to MOH for approval. 52. Procedures exist to ensure that only authorized persons can alter or establish a new accounting principle, policy or procedure to be used by the entity. In Viet Nam, only the Ministry of Health and the Ministry of Finance could do so, and do it only together. 53. There are written policies and procedures covering all routine financial management and related administrative activities. The policies and procedures clearly define conflict of interest and related party transactions (real and apparent) and provide safeguards to protect the organization from them. 54. When PMUs prepare annual reports, reconciled financial reports are used to generate reports to all involving stakeholders. The three systems: the regular GOV system, the ODA regulations, and the ADB systems run parallel. It produces unnecessary workload for PPMU to report same financial contents in three different formats. This calls for harmonization. 55. The triple accounting of the project is according to existing regulations of the regular GOV system, the ODA system and the ADB requirements. The accounting software from the Health Care for Central Highlands I is expected to be used in the second phase after updates. The practice of accounting in the first phase is according to the Circular 78/2004/TTLT-BTC-BYT. The weakness of the overall system is triple entry and triple accounting for reports provided to the regular GOV system, the ODA system and to ADB. A feasible recommendation is to increase the harmonization of the ADB system with GOV system. As budget support is not in discussion, and ADB can’t change their requirements, improvements seem to be difficult. However, an option exists by integrating ODA funding into TABMIS (see Chapter XIII and IV in this report). 56. The entity will have an accounting system that allows for the proper recording of project financial transactions, including the allocation of expenditures in accordance with the respective components, disbursement categories, and sources of funds. The project will use the entity accounting system, which is supported by the accounting computer software “MISA” that kept recording project of HICH properly. It is expected that the project will use the same software (with some minor updates) from the HICH. 57. Controls are in place concerning the preparation and approval of transactions (see Chapter VII on fund flow and Chapter XV on disbursement mechanisms), ensuring that all transactions are correctly made and adequately explained. Any transaction of the project will be prepared by the chief accountant and approved by the director of the PMU. They are responsible and accountable by law for this task. All transactions in HICH were made correctly and explained.

accounting for investments in subsidiaries, 22. VAS 26: Related Parties Disclosures, 23.VAS 27: Interim Financial Reporting, 24. VAS 28: Segment Reporting, 25. VAS 29: Changes in Accounting Policies, Accounting Estimates and Errors, 26. VAS 30: Earning per share.

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58. The chart of accounts of the project will be adequate for report of project activities and disbursement categories. Viet Nam has a consistent chart of accounts according to Decision 15/2006/QD-BTC and Decision 19/2006/QD-BTC. 59. The accounting software will ensure that cost allocations to the various funding sources are made accurately and in accordance with established agreements. All invoices are entered several times into computer. The general ledger of HICH I and subsidiary ledgers reconciled are in balance. All accounting and supporting documents are retained on a permanent basis in a defined system that allows authorized users easy access. All documents are kept for at least 5 to 10 years or forever, depending on the kind. Authorized users could have access to them. A. Recording of Assets 60. Furthermore, Viet Nam has a law on the management of public assets in order to protect them from fraud, waste and abuse. Subsidiary records of fixed assets and stocks are kept up to date and reconciled with control accounts and depreciation of assets is accounted for. There are periodic physical inventories of fixed assets and stocks, which are carried out annually at the end of the year. However, assets are not sufficiently covered by insurance policies as this is not usual practice in Viet Nam. B. Segregation of Duties 61. The functional responsibilities performed by different units or persons are (i) authorization to execute a transaction, yet NOT (ii) recording of the transaction, NOR (iii) custody of assets involved in the transaction. Therefore, the functions of ordering, receiving, accounting for, and paying for goods and services are partly segregated. Bank reconciliations are prepared by someone other than those who make or approve payments. C. Budgeting System 62. The budgeting system in Viet Nam includes both physical and financial targets. Budgets are prepared for all significant activities in sufficient detail to provide a meaningful tool with which to monitor subsequent performance. 63. Procedures are in place to plan project activities, collect information from the units in charge of the different components, and prepare the budgets. Usually, the project plans and budgets of project activities are realistic, based on valid assumptions, developed by experts. All spending units have to plan, collect information and prepare the budgets. 64. Every three months, actual expenditures are compared to the budget, hence, with low frequency. Explanations are then sought to explain variances in spending from the budget. Approvals for deviation of activities from the budgeted plan are usually only sought after the fact. The head of the spending unit is responsible for the explanation of variations which the superior has to approve. The low frequency of planned expenditure verification and the absence of internal audits leave considerable space for unplanned spending and pilferage, requiring improved safeguards. D. Payments

65. Invoice-processing procedures encompass (i) copies of purchase orders and receiving reports to be obtained directly from issuing departments; (ii) comparison of invoice quantities,

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prices and terms, with those indicated on the purchase order and with records of goods actually received; (iii) comparison of invoice quantities with those indicated on the receiving reports; and (iv) checking the accuracy of calculations. 66. All invoices are stamped PAID, dated, reviewed and approved, and clearly marked for account code assignment. Controls exist for the preparation of the payroll and changes to the payroll are properly authorized. An inter-ministerial circular ensures that manuals are distributed to appropriate personnel. E. Cash and Bank

67. The Directors of PMUs are authorized signatories to the bank accounts. In HICH, the PMUs maintained adequate, up-to-date cashbooks, recording receipts and payments and will continue doing so in this project. Controls do exist for the collection, timely deposit and recording of receipts at each collection location. Bank and cash are reconciled on a monthly basis. All unusual items on the bank reconciliation are reviewed and approved by a responsible official, and all receipts are deposited on a timely basis. F. Strengthening of Accounting Policies, Procedures and Financial Reporting of

PMU 68. It is necessary to develop and introduce a Financial Management Operation Manual (FMOM) for effective operations of the accounting department. Guidelines and handouts on financial management, procurement and loan management need to be introduced for effective accounting. The FMOM should be based on the findings of this assessment. FMOM will be more detailed and adopted to Viet Nam’s environment, will include clear definition and description of the accounting policy for the project, accounting methods, type of accounting (cash or accrual), chart of accounts, accounting and reporting requirements per ADB funds (based on the International Financial Reporting Standards) and per GOV funds (chart of accounts, transactions, types of reports). 69. Procedures of procurement for the project, responsibility of the staff in accounting and procurement must also be clearly described in the FMOM. The Project Finance Coordinator (see Chapter VIII) will ensure that any additions required in the FMOM be timely effected to reflect the project specific requirements and the proposed FM structure.

VIII. INTERNAL AUDIT

70. This chapter describes (proposed) internal audit arrangements. The current legislative and regulatory frameworks in Viet Nam do not envisage organization of internal audit in the budget institutions. That is why there is no internal audit unit within the structure of the MOH or DOHs. However, periodical reconciliation could be considered as internal audit to some extent. The suggested period is to be monthly internal audit in addition to the annual external audit. 71. Therefore, a staffing structure has never been developed, nor for that reason reporting relations for internal auditors. Since monthly reconciliation of accounts are required as per regulations of MOF, some transparency is built into the system. Also, statements of expenditure in support of reimbursement claims are a reasonable safeguard against pilferage. A further strong safeguard is the role of the treasury at provincial and state level. Every payment request, supported duly by the documents as required per the ADB loan disbursement handbook, and

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any reimbursement request from contractors and consultants, is to be sent to the treasury via the PMUs for verification by the treasury. 72. Given that the role of the treasury persists, it does not seem feasible to insist on internal audit, though this would be the preferred option. However, to some extent, the treasury in a way is substituting for the function of the internal audit, though not adequately. 73. It seems to be possible to address the situation for achieving monthly controls via internal audits only within the national context, which brings back into focus the regularly made demand of the external community to Viet Nam, to adopt international auditing standards. 74. However in the current situation, a solution to the missing internal audits could be the proposed position of the Project Finance Manager. While this function will ensure proper financial management and ensuring competitive procurement selections, one of the envisaged roles will also be monthly internal auditing.

IX. EXTERNAL AUDIT

75. This chapter describes audit-related issues from previous ADB-financed projects implemented by the project and/or entity, including the status of overdue audit reports and other outstanding issues. Significant issues are included in the action plan and loan conditions. It further describes (proposed) audit arrangements for the project, including auditor appointment and auditor terms of reference (see Appendix 2 of the Project Administration Manual (PAM) for the draft auditor TOR). 76. Auditing, disbursement and accounting arrangements of the project are to be in accordance with the Circular 108/2007/TT-BTC issued by the Ministry of Finance on 7th of September 2007, and the Circular 40/2011/TT-BTC issued by the Ministry of Finance on 22nd of March 2011. 77. Project expenditures could be audited by the State Audit Agency of Viet Nam (SAV) as an item of public expenditure of MOH/DOHs according to annual schedule. However, SAV lacks the resources to provide regular and sufficient coverage of GOV accounts in general and of projects in particular. Therefore, the project is to be audited annually by independent, external auditors. This will be in line with the usual practice in Viet Nam, that donor projects are annually audited by external auditors. These are usually contracted from international auditing companies (mostly American firms) by CPMU and SAV. 78. MOH will ensure the detailed consolidated project accounts to be audited in accordance with International Standards on Auditing and in accordance with the government's audit regulations by an auditor acceptable to ADB. The audited accounts will be submitted in the English language to ADB within 6 months of the end of the fiscal year by the executing agency, the MOH. This extended reporting period is justified by the fact that the project is decentralized in five provinces and the audit procedures will have to take place in different locations. The annual audit report will include a separate audit opinion on the use of the imprest accounts and the SOE procedures. 79. Both, government and MOH have been made aware of ADB’s policy on delayed submission, and the requirements for satisfactory and acceptable quality of the audited accounts. Once the external auditor has been contracted on time, delays in the procedure are not to be expected. Even though Viet Nam has not yet adopted the international auditing

88 Appendix 1

standards, these donor-related audits are carried out in accordance with international auditing standards. 80. ADB reserves the right to verify the project's financial accounts to confirm that the share of ADB’s financing is used in accordance with ADB’s policies and procedures. The draft terms of reference for the annual project audit are in Appendix 2 of the PAM. 81. In the light of the above and the regulations of Viet Nam, the PPTA suggests the following audit arrangements for the project:

(i) After every fiscal year, CPMU selects an external auditor in accordance with the Procurement Law and signs the contract for auditing project accounts in accordance with the Ordinance on Contract to externally audit the project’s accounts.

(ii) The contractor is to be an audit company, which legally operates in Viet Nam and on the list of companies of sufficient conditions for audit, which is annually issued by the MOF/ Viet Nam Association of Certified Public Accountants.

(iii) The external auditor has to check annual financial reports of the project and to certify appropriateness and correctness of project financial statements in relations to project financial management, asset management arrangements and additional agreements between ADB and GOV.

(iv) The external auditor's opinion is also required on whether the proceeds of the ADB's loan have been utilized only for the project as stated in the Loan Agreement, the financial information contains data specifically agreed upon between GOV and ADB to be included in the financial statements, the financial information complies with relevant regulations and statutory requirements, compliance has been met with all the financial covenants contained in the Loan or Project Agreements, Imprest Account/Second Generation Imprest Account(s) funds have been correctly accounted for, and documents and controls on the use of the SOE procedure are adequate.

(v) The auditing contractor audits Project’s accounts and has to prepare auditing report in compliance with International Standards on Auditing and in accordance with the GOV audit regulations by an auditor acceptable to ADB. The auditor's report is to clearly state the reasons for any opinions that are qualified, adverse, or disclaimers. Actions on deficiencies disclosed by the external auditor in its report are to be resolved by the GOV within a reasonable time. The external auditor is to comment in the subsequent auditor’s report on the adequacy of the corrective measures taken by GOV. The report will be submitted in both Viet Namese and English to GOV and ADB within 6 months of the fiscal year’s end. This extended reporting period is justified by the fact that the project is decentralized in five provinces of Central Highlands and the audit procedures will have to take place in different locations.

(vi) The GOV has been made aware of ADB’s policy on delayed submission, and the requirements for satisfactory and acceptable quality of the audited accounts. Compliance with these ADB requirements will be monitored by review missions and during normal project supervision, and followed up regularly with all concerned, including the external auditor. ADB reserves the right to verify the project's accounts to confirm that the share of ADB’s financing is used in accordance with ADB’s policies and procedures.

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82. In the following table required audit reports and submission dates are identified:

Audit Report Due Date Annual financial statement/management report 31 January of each year External annual audit 30 June of each year Quarterly financial statement / management report Within 30 days of the quarter

Source: Asian Development Bank

X. FINANCIAL REPORTING AND MONITORING

83. This chapter describes the (proposed) financial reporting systems and the ability to report on project expenditures.. 84. Being externally funded, the project has to ensure statutory reporting on project implementation according to the requirements of all, the regular GOV system, ODA regulations and ADB. 85. All financial statements are prepared for the entity, in accordance with VAS accounting standards. Financial statements are prepared by the accounts section for the implementing unit, PPMUs and CPMU. 86. The frequency of preparation of financial statements is quarterly and annual reporting and the reports are prepared in a fairly timely scale so as to be useful to management for decision making. The report submission periods are identified in above table. 87. The reporting system needs to be adapted to report on the project components, however, the system is not designed to link physical activities with financial data. However, the financial reports do compare actual expenditures with budgeted and programmed allocations, and so are payment and reimbursement requests at various levels of the verification procedure for expenditures. In this way, the financial management reports are used by the management, e.g. to have implementation of activities verified. 88. Previous projects have established financial management reporting responsibilities that specify what reports are to be prepared, what they are to contain, and how they are to be used. The software “MISA” monitors these features of financial reporting. Financial reports are prepared directly by the automated accounting system.

XI. INFORMATION SYSTEMS

89. This chapter describes (proposed) project FM information systems. The project accounting is fully computerized by support of accounting software, called MISA cho Du an Ho tro Tay Nguyen (MISA FOR HICH II). Based on this system, the necessary project financial reports can be produced. The staff is adequately trained to maintain the system, but new staff to the PMUs will have to be trained and also, refresher courses are envisaged. The management organization and processing system safeguard confidentiality, integrity and availability of the data. 90. The TABMIS has been introduced and almost all provinces have been linked to it, all five highland provinces have already been attached to the system in April 2012.

90 Appendix 1

91. Financial procedures are significantly improved through TABMIS. Agency reporting and accountability, budget preparation, and public debt management are strengthened. TABMIS links the MOF with ministries and provinces as well as all spending units. It is a national computerized, real-time accounting system linked to treasury and budgeting activities, expenditure, cash-flow and accounting. It is proposed that the project develops a linkage between TABMIS, MISA and HMIS to allow transfer of essential financial information from TABMIS into MISA and HMIS.

XII. PROCUREMENT ARRANGEMENTS

92. This chapter describes the impact of (proposed) procurement arrangements in the FM assessment. Procurement is carried out in line with principles of value for money (VFM) and transparency. 93. A procurement Law 61/2005/QH11 became effective 2006. By supplementing the guiding degree 85/2009/NĐ-CP, which replaced the previous Degree 58/2008/NĐ-CP and the amendment 38/2009/QH12, the procurement legal framework in Viet Nam is significantly improved. As part of the effort aimed at strengthening public procurement, MPI issued standard bidding documents for procurement of goods and works. A Public Procurement Bulletin has been in official use since April 2005 for publication of bidding opportunities and information on award of large contracts and an electronic version of the bulletin is already released. The Procurement Law is expected to be revised in 2013 for more provisions of transparency and competition in public procurement. 94. A procurement committee is to be established for procurement, constituting of 8-10 persons. The committee has to decide on the bid as well as to make sure the procurement law and all its guiding decrees are followed. All procurement committee members have legal responsibility for their respective work. 95. According to the legal procurement framework, activities under VND1 billion ($50,000) are directly tendered, while public tendering with strict rules is implemented for projects over 1 billion VND. In practice, for most civil works and equipment purchases in health projects, nearly all procurements are over the VND1 billion threshold. For relatively small scale training activities (well under VND1 billion, which is the threshold for competitive tendering), direct contracting is a reasonable process for training activities and consultancies since a competitive bidding process may not generate enough interest among academic institutions and individuals. 96. However, although the reconciling spending is conducted on an annual basis and PMUs are responsible for payment to contractors, there are a number of significant potential fiduciary risks in the procurement process, due to a culture of award sharing, or the formation of contractor cartels to get around bidding rules and strict criteria of tender board assessments, or provincial preferences to choose local contractors. Also, the potential for collusion between supervisors, contractors and implementing agency staff poses risk. 97. There are risks that fund managers and tenderers could collude over contract pricing or that quality could be allowed to be lower than expected in order to generate a profit that could be used to pay kickbacks. 98. Informative transparency for monitoring is a good safeguard against such collusion and quality deterioration in civil work and medical equipment. In theory, the project procurement information is posted for public and the public is able to observe procurement processes.

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However, in practice, due to local bidders being fully engaged in their own tasks, such monitoring is rare. Informative transparency offers the monitoring officially and unofficially. 99. Safeguards are built into the system in the shape of approval of procurement plans, the use of tender committees at MOH and at provincial level to evaluate bids. Bids have to comply with pre-set costs norms and the use of Pricing Committees. Inspectorates at central and provincial levels can investigate complaints. Certified supervision consultants are not procured to verify the quality of works. 100. However, sufficient controls do not always seem to be in place to prevent conflict of interest in the awarding of contracts. There is some evidence that MOH/PPC scrutiny is formal and based largely on evidence submitted by fund managers. The newly proposed function of a Project Finance Manager in CPMU and PPMU shall ensure the required transparency and competitiveness in procurement tendering and procedures. The inspectorate function seems to respond more to noticed malpractice and inspection request, rather than undertaking random spot checks that might be a more effective deterrent to corruption and collusion. 101. Existing checks are largely based on scrutiny of paper records which may not shed light of VFM issues, such as the quality of materials used. Hence, where there is leakage, it is likely to be through civil works and equipment, since local supervision of the process is often inadequate. 102. As per the procurement law 2006, bidding is expected to be competitive, fair, transparent, efficient and economical, and to include the consideration of related-party activities. It lays out procedures related to procurement, from tendering through bidding and the definition of procurement package to procurement capacities:

(i) the Board of Directors or the authorized representatives of the stakeholders for projects financed by State funds of State-owned enterprises of 30% or more, and for 100% State-funded projects,

(ii) the Investment Owner, a borrower who directly manages and administers the projects,

(iii) the bidder or Principal bidder participating in the procurement, (iv) the independent bidder, the joint venture, the Consultant bidder, Supplier bidder,

Contractor bidder, EPC bidder, Subcontractor, Domestic or foreign bidder (v) the Procuring Entity is defined as the Investment Owner or a professional

organization with sufficient capacity and experience to be used by the Investment Owner to organize procurement in accordance with the legislations.

103. the PMUs there will be a national procurement consultant. In addition, there will be a Project Finance Manager, whose role is to ensure transparent and competitive tendering, procurement selection and services (see Chapter VIII Personnel).

XIII. DISBURSEMENT ARRANGEMENTS

104. This chapter describes (proposed) disbursement arrangements, including (i) method, (ii) SOE limits and review arrangements (where applicable), (iii) Imprest Account allocation and procedures, (iv) disbursement mechanisms, and (v) unique circumstances or requirements.

92 Appendix 1

105. The loan proceeds will be disbursed in accordance with ADB’s “Loan Disbursement Handbook” in its updated version11 and detailed arrangements agreed upon by the GOV and ADB. Pursuant to ADB's Safeguard Policy Statement (SPS),12 ADB funds may not be applied to the activities described on the ADB Prohibited Investment Activities List, set forth in the SPS. All financial institutions will ensure that their investments are in compliance with applicable national laws and regulations and will apply the prohibited investment activities list to subprojects financed by ADB. 106. MOH, the project owner and executing agency, will maintain separate project accounts and records by funding source (investment/recurrent) for all expenditures incurred by the project. Project accounts will follow accounting principles and practices prescribed by the Government's accounting laws and regulations. 107. For any expenditure of the CPMU, the implementing agency will open a central imprest account. At the provincial level, the PPMU opens a sub-account in a branch of that bank for deposits of project funds. The proposed arrangements for transferring the proceeds of the loan from the government/ Ministry of Finance to the entity have been approved as good during implementation in previous projects. The CPMU capacity of HICH (2003—2010) and of the Northern Central Health Project (2009-2014) will not be changed. The staff, at least partially, and its structure of the HICH, will be made available for managing the project; the project implementing units (PMU) have experience in the management of disbursements from ADB. They also have the exchange risk management capacity in the past to carry out diligently the management of foreign exchange risks. A. Methods of Disbursement 108. Initial withdrawal to the imprest account is carried out based on the credit line of the imprest account regulated in the loan agreement. The MOF has to decide on the withdrawal level of the credit line upon consideration of real expenditures for project implementation within the first 3 months, interest payment to the foreign donor and interest accrued in the imprest account paid by the servicing bank. 109. Three disbursement modes in project financing have been practiced in the preceding project: advance payments, direct payments/money transfer and reimbursements. All of them are following the ODA regulations and agreement with ADB as described below and with reference to the above funds flow diagram. The option for retroactive payment has been requested for by the CPMU.

1. Advance payments 110. Based on the project budget plan as approved by the MOH, the CPMU will annually place a withdrawal application to MOF for checking the advance request and having it co-signed by MOF and submitted to ADB. Usually the CPMU requests such advances twice a year (replenishments from 2nd payment onwards), but increases of this frequency are possible if required. The possible transfer amount for the advance payment/deposit is the maximum amount for the next 6 months’ budget or 10% of project funds allocated by ADB as per implementation and budget plans, whichever is lower.

11 http://www.adb.org/documents/handbooks/loan_disbursement/loan -disbursement-final.pdf. 12 http://www.adb.org/site/safeguards/policy-statement.

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111. The advance payment request is being reviewed by ADB and, if deemed appropriate, transfer of funds to the imprest account follows. The request would contain an Estimate of Expenditure Sheet for the first six months, and evidence that the imprest account has been opened. The CPMU in turn transfers the money to the imprest account of the PPMU, which will use it to pay for the planned and approved activities as per yearly plan. 112. Replenishments that follow from the second half year onwards for the first level imprest account are requested by the CPMU which submits documents listed in Chapter 3, Paragraph 2 and 7 of the Circular 108/2007/TT-BTC for disbursement to the MOF. Within 5 working days after receiving eligible documents, MOF (DMEF) will review and sign/co-sign the Withdrawal Application and send it to the ADB. The donor reviews the Withdrawal Application and transfers money to replenish the imprest account. The application will contain a Statement of Account or bank statement, and the imprest account reconciliation statement (as per Loan Disbursement Handbook). 113. The replenishment of secondary level imprest account will be requested by the PPMUs. The PPMU send the request for replenishment to the CPMU together with documents as regulated for replenishment for first level imprest account. If the documents are eligible, the CPMU will transfer money from the first level imprest account to the secondary level imprest account. Documents which are used by PPMU to replenish for secondary level imprest account will be sent to MOF and ADBfor replenishment to the first level imprest account by the CPMU. 114. Withdrawals of funds are initiated by CPMU which submits the official request for withdrawal including the filled withdrawal application form and statements attached to the donor’s form to MOF. Within 5 working days after receiving adequate eligible documents, according to the signed financing agreement, MOF reviews and signs or cosigns the withdrawal application form and sends it to the donor. 115. When PPMU directors request money transfer from the first generation imprest account, the CPMU will transfer money from that account to the second generation imprest account at provincial level within 3 working days after receiving the duly documented withdrawal request.

2. Direct payments 116. Direct payments are rare. They can be done by ADB directly to the supplier, contractor, or consultants, etc., to receive transfers from the project funds. Usually, this mechanism applies when international tenders and huge sums (to be defined by GOV and ADB),13 as for civil works or equipment, are required by local contractors (only for civil works). These parties will initially submit their invoices to PPMU or CPMU along with the corresponding supporting documents. The respective PMU will send the payment request, the required documents (as per ADB loan handbook) to the state treasury for verification, which is then providing the PMU a certificate of verified expenditure. In turn information is sent back by the treasury to the respective PMU who submits it to the MOF. After approval, MOF will submit the request to ADB for review and transfer of funds directly to the contractor account. 117. It is proposed to have medical equipment tendered and procured only through the

13 Current definitions define levels of contracting, for direct contracting: USD < 100.000, National Competitive Bidding:

USD > 100-200.000, International competitive bidding: USD > 500.000. These ceilings can be negotiated.

94 Appendix 1

CPMU. If this is acceptable to ADB, it is important to separate functions during tendering and procurement.

3. Reimbursements and Retroactive Payment

118. The reimbursement mechanism applies when PMU pay out upon certain requests. The concerned parties, e.g. a contractor, supplier or consultant, submit their invoice accompanying the reimbursement request to the respective PMU. A reimbursement takes place outside of the regular advance transfer request. 119. Expenditure in imprest accounts takes the post expenditure control procedure. When receiving the claim for payment from the contractors/suppliers/consultants, etc. the PMU shall review the payment document and accept the payment in accordance with the current regulations, calculate the amount of money which is paid by ODA source in accordance with the ratio regulated in the official project document and then request the service bank to pay from imprest accounts to the beneficiaries. The respective PMU has the right to pay funds from the project account to supplier and contractor in advance, without having to have the prior approval for payment from the higher level. 120. Within 5 working days after withdrawing money from the imprest account for payment, the PMU submits the payment document to the State Treasury for post reviewing as per the current regulation. Within 5 working days, according to the result of document reviewing, the State Treasury certifies the amount eligible for payment in the Claim for Payment form (and makes a payment from counterpart fund, if any). Claim for payment certified by the State Treasury is one of basic documents for the CPMU to replenish imprest accounts. 121. Retroactive payment is a special case of reimbursement by which the donor finances the loan eligible expenses, which occurred prior to the effectiveness of the project and paid by the borrower from their own account. Retroactive payment is applied only with the prior agreement of the donor and indicated in the financing agreement in which also specified the period and amount limit for retroactive payment. 122. Once agreed, the retroactive payment request will be reviewed by MOF within 5 working days from the date of receiving adequate eligible documents then the signed/co-signed disbursement application form is send to the donor. For reimbursement/retroactive disbursement for payments made from State budget (or originated from the budget), the disbursed amount must be deposited in the budget, where the payment was made.14 B. SOE limits and review arrangements

123. The SOE procedure is used to liquidate eligible individual advances and reimbursements out of the imprest account. Each payment under SOE shall not exceed the equivalent of $50,000 per payment. Generally, review arrangements are not applicable outside of the general reporting and auditing procedures, however, the SOE records shall be made readily available for review by ADB upon request or during disbursement or review missions, and for independent audit.15

14 Ministry of Finance, 2007: Circular 108, Guidance on Financial Management applicable to ODA projects and

programs 15 See checklists for SOE procedures and formats at: http://www.adb.org.documents/handbooks/loan_disbursement

Appendix 1 95

C. Imprest Account Allocation and Procedures

124. The project applies the imprest account/special account procedure, as described in the advance payment method. The CPMU holds the 1st generation imprest account. PPMUs hold 2nd generation imprest accounts. ADB makes an advance to the imprest account of CMPU in a servicing bank to pay for current and eligible expenditures of CPMU and for advances to imprest accounts of PPMU. The advance limit of the 1st generation imprest account is requested by the CPMU director and will be approved by ADB. The advance limit of 2nd generation imprest account is requested by PPMU directors and will be approved by CPMU director. Before the first withdrawal, the authority of person(s) who will sign the withdrawal will be proven and authenticated specimen signatures of each authorized person will be submitted to ADB. D. Unique Circumstances or Requirements 125. The economic crisis in Viet Nam could pose problems to the cash-counterpart funding. Non-cash-counterpart funding, including taxes, and integrated GOV policy commitments into project are feasible. The payment method from counterpart funds envisages that non-cash-counterpart funds are accounted like projects are accounted for. Involvement of and subsequent reporting and monitoring of integrated activities of communities and NGOs are unusual and difficult to be accounted, hence not envisaged. 126. Beneficiaries are not required to contribute to project costs, as they are the common people of Central Highlands, with a focus on the near poor and poor people. Nevertheless, integrated funding is designed for the project in view of pooling subsidized support to insurance premiums for the near poor households of the region in case other donors chip in additionally. For premium subsidy of the near poor, the GOV currently pays 70%; the project may support an additional 10%. The remaining 20% are to be paid by the near poor themselves.

XIV. AGREED ACTION PLAN 127. Where actionable weaknesses have been identified, the actions are documented in the plan below. Actions that are conditions should be noted as such. All action plans must be agreed with the borrower.

Agreed Action Responsible Person Agreed Completion Date Facilitate advance payment for first 18 months

Director CPMU Upon project commencement and within first quarter

Develop FMOM (condition)

Project Finance Coordinator Within first 2 months

Agree on retroactive payment MOH/ Director CPMU and ADB

Before project commencement

Source: Asian Development Bank

XV. CONDITIONS

128. In this chapter, all FM-related conditions are listed, fully describing actions that must be taken to meet the condition. In case they are also attributed to the management of other donor funded projects in their province, the capacity is to be increased. 129. Due to considerable additional funding from other donors overlapping with the envisaged implementation period, a few issues require attention: (i) harmonization of procedures, (ii)

96 Appendix 1

vigilance towards fungibility of funds, and (iii) supervision of counterpart funding. 130. The accounting procedures required to be accompanied by:

(i) monthly internal audits by the Project Finance Manager or a contracted in auditor (ii) quarterly financial reporting to MOH and ADB

131. The above conditions will help inform financial management transparently. It is envisaged to prepare, at project commencement, an FMOM in order to ensure that all agreed accounting and reporting procedures are duly taken into consideration. 132. MOH shall submit a management letter within 12 months of the audit report/close of the fiscal year to inform ADB of any measures taken to improve the financial management system as recommended and reported by the auditors.

XVI. FINANCIAL COVENANTS

133. This chapter lists all proposed financial covenants that will be in the (proposed) project loan agreement. 134. Payment shall only be made if activities are made as per plan. If activities, for which payments are sought, are not part of the plan, such deviations shall be justified and authorized by the CPMU before expenditures are made. Depending on the extent of deviation, the Project Steering Committee may require to be involved before activity deviance is authorized and paid for. It is also recommendable to have payment above a certain amount (e.g. $500) to be done via bank to ensure that deviations from the plan remain transparent. 135. If deviations concern a larger set of activities, civil works or equipment purchases, the directors of the PMUs, including the CPMU, will seek an addendum from ADB to the agreements for the project plan or respective annual plans. 136. If activities are deviating from plan and have been financed by mistake, and are only identified by the auditors, ineligible expenditure identified by the auditors shall be recovered. 137. As GOV usually carries out annual audits only on the GOV contributions, which is mainly non-cash, or the salaries of some of the project assigned staff appointed by the GOV, it will be necessary to tender for external auditors. If the monthly internal audits are contracted out to local auditors, these contracts shall be tendered for. 138. Concerning financial project management, reimbursement of expenditures for project activities shall be made by the PMU only with authorization of treasury or MOH and in the presence of duly submitted statements of expenditure and mandatory evidence. 139. If retroactive payment is requested by the CPMU, agreement needs to be sought between ADB and MOH about the specific period and amount of payment. 140. There is need for agreement between MOH and ADB that maintenance and operations costs, borne by government for its health facilities, will be clearly earmarked allocations in the provincial annual budgets to ensure that facilities are regularly and well maintained. MOH will inform the DOH/PMU in provinces and also involve the PPC to this end to ensure that these allocations occur in the annual budgets.

Annex 1 (of Appendix 1) 97

PROJECT MANAGEMENT UNITS

Table A: Tentative Plan for CPMU Personnel

No. Position Government

staff Contracted staff by GoV

National TA ADB

International consultant

Total

1 Project Director 1 1 2 Project Vice-Director 2 2 3 Project Secretary 1 1 4 Chief Accountant 1 1 5 TA procurement 1 1 6 TA IEC communication 1 1 2 7 TA Health Information 1 1 2 8 TA equipment 1 1 2 9 TA civil work 1 2 1 4 10 Project Coordinator 1 1 1

11 Project Finance Coordinator

1 1 1

12 Procurement 1 2 3 13 Training 1 1 2 14 Social and Gender expert 2 2 15 Environment expert 1 1

16 Disbursement expert, accountant

2 2 7

17 Bookkeeping 1 1 18 Admin, Driver, cleaner 3 3 Total 7 12 12 5 36

Table B: Tentative Plan for PPMU personnel

No. Position Government

staff

Contracted staff paid by

MOH

National Consultant paid by ADB

Total

1 Project Director 1 1 2 Project Vice-Director 1 1 3 Chief accountant 1 1 4 Planning and M&E Coordinator 1 1 5 Civil works 1 1 6 Procurement 1 1 7 Human Resource Development 1 1 1 8 Financial disbursement 1 1 9 Accountant 1 1 10 Bookkeeper, admin 1 1 11 Driver 1 1 Total 4 3 5 12

98 Annex 1 (of Appendix 1)

Table C: Proposed (identified) CPMU Personnel STT Position Concurrent/full-time staff Name

1 PMU director Concurrent Mr. Ha Van Thuy

2 PMU vice director Concurrent (2 vice directors) 1. Ms. Nguyen Thi Mai An 2. Mr. Vu Van Hung

3 Secretary Concurrent Mr. Do Van Thai 4 PMU Chief accountant Concurrent Ms. Vo Thi Hai

5 Training Coordination Group (TCG)

1 concurrent officer from Department of Science and Training (MOH)

Will be identified

6 Planning officer full-time Will be identified 7 Civil engineer full-time Will be identified 8 Procurement officer full-time Will be identified 9 Disbursement officer full-time Will be identified 10 Accountant (02) full-time Will be identified 11 Clerk full-time Will be identified 12 Driver full-time Will be identified 13 Cashier full-time Will be identified 14 Auxilary full-time Will be identified

Table D: PPMU Personnel (proposed)

STT Position Concurrent/full-time staff

1 PPMU director Concurrent (normally PHD director)

2 PPMU vice director Concurrent (normally reprentatives from Planning Unit)

3 PPMU Chief accountant Concurrent (normally PHD Chief Accountant)

4 Training officer Concurrent (normally reprentatives from Human Resource Unit)

5 Planning and M&E officer Concurrent 6 Accountant full-time 7 Driver full-time 8 Cashier/Clerk full-time

Appendix 2 99

TERMS OF REFERENCE FOR FINANCIAL AUDIT CONSULTING SERVICES (AUDITOR)

AUDIT OF ANNUAL PROJECT FINANCIAL STATEMENTS (APFS)

A. Background of the Project

1. Annex 1 presents the guidance including terms and definitions used in these terms of reference (TOR); Annex 2 presents the background, the Project’s executing agency (EA) and implementing agencies (IAs); and presents the Project’s cost structure. B. Objective

2. The objective of the audit of the annual project financial statements (APFS) is to enable the auditor to express an independent and objective opinion on:

(i) the APFS for the year(s)/period(s) then ended, and assess the progress with the overall budget, in accordance with the acceptable accounting standards and conform with ADB procedures and guidelines1;

(ii) the compliance with laws, regulations and funding agreements that have a direct and material financial effect on the entity’s financial report; and

(iii) the eligibility of claims made in Statements of Expenditure (SOEs) and the Imprest Account Statement;

3. Record keeping: The Project’s accounting system (books and records) provides the basis for the preparation of the audited APFS. The system was established to record the financial transactions of the Project, and is maintained by related Project’s EA/IAs. C. Scope of Work

4. Auditing shall be carried out in the central project management unit (CPMU) office, the EA, and five provincial project implementation Units (PPIUs), the IAs in the following five project provinces:

(i) Hanoi (CPMU) (ii) Dak Lak (iii) Kon Tum (iv) Gia Lai (v) Lam Dong (vi) Dak Nong

5. Audit Phasing:2 Month of fiscal year (FY) and report submission

Period FY start FY End Report Submission Remarks 1 01/01/2014 31/12/2014 30/06/2015 2 01/01/2015 31/12/2015 30/06/2016 3 01/01/2016 31/12/2016 30/06/2017

1 Including ADB’s Project Administration Instruction (PAI 5. 07 no. 25) and the loan agreement which require 4

opinions: use of loan proceeds, compliance with financial covenants, use of imprest fund procedure which includes imprest accounts and sub-accounts and use of statement of expenditures where applicable.

2 Note that audit periods for one auditor are allowed for all fiscal years of the Project:

100 Appendix 2

6. Contract and Procurement Mode: Although the auditor will be contracted for the audits phases mentioned above (maximum three years per contract), the auditor should submit the financial proposal in US$ in a format indicating the amount for each financial year independently. If performance is not satisfactory in one year then the client will not be bound for subsequent year’s audits. If the performance is satisfactory, the auditor may participate in the bidding process for the next fiscal years, but the total assignment should be up to 6 years for one project. The least cost selection is the procurement method agreed for auditor recruitment. The contract will be on lump sum in accordance with annual based performance (will be reviewed on annual basis).3.

7. Accounting Policies and Changes. The auditor should comment on the project’s accounting policies, and confirm the extent to which the agreed project accounting policies (see Guidance in Annex 1) have been applied. In particular, the auditor should note the impact on the APFS arising from any material deviations from the agreed accounting standards. The auditor should also comment on any accounting policy changes, either during a financial year, or from one year to another.

8. Compliance with laws, regulations and funding agreements: The auditor should be aware of the unique characteristics of the compliance auditing environment. Governments and not-for-profit organizations differ from commercial enterprises in that they may be subject to diverse compliance requirements including its compliance with financial covenants and financial assurances. Management is responsible for ensuring compliance with relevant laws, regulation and funding agreements. That responsibility encompasses the identification of applicable laws, regulations and funding agreements and the establishment of internal control designed to provide reasonable assurance that the auditee complies with those laws, regulations and funding agreements. 9. In addition to the opinion on the FSs, the auditor should provide an opinion on whether the auditee complied with laws, regulations and provision of contracts and funding agreements that have a direct and material financial effect on the entity’s FS (EFS). Where applicable, the auditor should prepare a report with separate schedule of findings and questioned costs. The scope of the audit should also refer to compliance with the Procurement procedures as set out in the funding agreements. 10. Responsibility to Consider Fraud in an Audit: The primary responsibility for the prevention and detection of fraud rests with both those charged with governance of the entity and with management. It is important that management, with the oversight of those charged with governance, place a strong emphasis on fraud prevention, which may reduce opportunities for fraud to take place, and fraud deterrence, which could persuade individuals not to commit fraud because of the likelihood of detection and punishment. It is the responsibility of those charged with governance of the entity to ensure, through oversight of management, that the entity establishes and maintains internal control to provide reasonable assurance with regard to reliability of financial reporting, effectiveness and efficiency of operations and compliance with applicable laws, regulations and funding agreements.

11. Independence of the Auditor. The auditor must be completely impartial and independent from all aspects of management or financial interests in the EA/IA being audited. The auditor should not, during the period covered by the audit nor during the undertaking of the audit, be employed by, serve as director for, or have any financial or close business

3 Full payment after the audit report is acceptable to ADB and the Government.

Appendix 2 101

relationships with any senior participant in the management of the EA/IA. It may be appropriate to remind an auditor of any existing statutory requirements relating to independence and to require an auditor to disclose any relationship that might possibly compromise his/her independence. 12. In addition management is responsible for establishing a control environment and maintaining policies and procedures to assist in achieving the objectives of ensuring the orderly and efficient conduct of the entity’s business. Therefore, in order to ensure that those assertions are addressed in the audit of the entity, it is important that International Standard on Auditing (ISA 240) “The Auditor’s Responsibility to consider Fraud in an Audit of Financial Statements” be followed. All auditors are required to follow the ISA 240.

13. ADB funded projects in Viet Nam include both central level, provincial and lower levels. The auditors may have to travel to those provinces including lower levels to do the financial audit. If it is the case, the TOR has specified the provinces (from the list in para 4) where Auditors must go to do audit.. 14. Applicable auditing standards: Vietnamese Standard of Auditing (VSA) is the “Agreed project auditing standards” with regard to the APFS preparation. The audit will be carried out in accordance with the following aspects:

(i) the auditor will plan and conduct the audit in accordance with a risk based framework with a detailed audit work program which is sufficiently extensive in its coverage of the project’s FSs to support the opinion given.

(ii) the auditor will gather evidence and prepare working papers to properly document the evidence seen in support of the opinion given, sufficient audit evidence will be gathered to substantiate in all material respects the accuracy of the information contained in supporting schedules attached to the FSs.

(iii) the auditor will review and evaluate the system of internal controls in effect, including internal audit procedures, to determine the degree of reliance that may be placed upon them and to determine the extent of testing of actual transactions needed to assure the auditor of the accuracy of the accounting records,

(iv) the audit coverage will consider the risk of material misstatement(s) as a result of fraud or error. The audit program should include procedures that are designed to provide reasonable assurance that material misstatements (if any) are detected.

D. Audit Report4

15. Audit Report: The auditor will issue the auditor report on the APFS5. The audit report on the APFS should include (i) audited project financial statement; (ii) Audit Opinion; and (iii) management letter. The documents should be reliable, comprehensive and timely information. The EA will request the auditor to correct the deficiencies, if any, till the report is acceptable to ADB. 16. Proper Project Financial Statements. The CPMU office supporting by its five PPIUs in the five project provinces, is responsible for preparing the financial statements, not the auditor. However, the auditor’s prior review of the draft financial statements can serve to improve both the form and content and streamline the audit process to ensure that the project financial

4 Template and samples of audit reports will be provided 5 This is only for APFS. The audit report on the entity Financial statements is prepared separately

102 Appendix 2

statements are prepared in accordance with the cost structure set in the Project Administration Manual (PAM). The APFS should include:

(i) the financial statements cover the current period and compare the achievement with the overall periods

(ii) A Summary of Sources and Uses of Funds received showing the Asian Development Bank (ADB) funds, funds received from other financiers6 and counterpart funds separately;

(iii) A summary of expenditures shown under the category of the main project components, the expenditures, the allocation of loan proceeds, and the procurement plan7 for both current fiscal year and cumulative to date;

(iv) Supporting schedules to the FSs which at least include: (i) A reconciliation of the amounts shown as “received by the project from ADB” with those shown as being disbursed by ADB (for direct payment); (ii) SOE: listing individual SOE withdrawal applications by specific reference number and amount in each financing agreements; and (iii) designated Account(s) statement showing movement and reconciliation with the bank statements;

(v) A Summary of the principal accounting policies that have been adopted, and other explanatory notes;

(vi) A Management Assertion that the fund of ADB has been expended in accordance with the intended purposes is included as an attachment of the FSs.

(vii) Clarify that the audit report has covered all the project’s participating provinces. 17. Proper and Specified Audit Opinions. The auditor’s opinions shall cover:

(i) Whether the financial statements present fairly in accordance with the adopted accounting policies for the specified program /project and that the funds were utilized for the purposes defined by the funding agreement; and comment on whether ADB financing (and all external financing since ADB is not the only financier) has been used in accordance with the conditions of the relevant financing agreement, with due attention to economy and efficiency, and only for the purposes for which the financing was provided, as detailed in the supporting documents;

(ii) Whether counterpart funds have been provided and used in accordance with the relevant financing agreements, with due attention to economy and efficiency, and only for the purposes for which they were provided;

(iii) Whether goods, works and services financed have been procured in accordance with the relevant financing agreements including specific provisions of the ADB Procurement Policies and Procedures. Fixed assets procured by all financiers shall also be reviewed;

(iv) Whether the expenditures submitted to ADB are eligible for financing and all necessary supporting documents, records, and accounts in support of credit withdrawals have been adequately maintained with clear linkages between the books of account and reports presented to ADB;

(v) Whether the funds disbursed through Statement of Expenditure (SOEs) are in compliance with ADB procedures; and have been utilized for the purposed

6 For projects that receive funding from other sources, the annual project financial statements should include all

sources of funds not only counterpart funds. (PAI No. 5.07 no. 18) 7 PAI No. 5.07 no. 18 requires that the annual project financial statements should include comparative figures for the

preceding reporting year and cumulative figures from the loan effectiveness date to the end of the current reporting year.

Appendix 2 103

defined in the funding agreements. Where ineligible expenditures are identified as having been included in withdrawal applications and reimbursed against, these should be separately noted by the auditor. Auditor shall confirm or otherwise, whether adequate supporting documentation has been maintained to support claims to ADB for reimbursement of expenditures incurred and that the expenditures are eligible for financing under the loan agreement.

(vi) Whether designated Accounts (imprest account and sub-accounts) gives a true and fair view of the receipts collected and payments made and supports imprest and sub-accounts liquidations and replenishments during the year; and whether the accounts have been maintained in accordance with the provisions of the relevant financing agreements and funds disbursed out of the account were used only for the purpose intended in the financing agreement and other supporting documents;

(vii) the compliance with financial covenants. The auditor is required to confirm the level of compliance for each financial covenant contained in the Project legal agreement, and indicate, where applicable, the extent of any noncompliance, by reference to the specified (required) and actual performance measurements for each financial covenant for the fiscal year concerned. The auditor shall also assess the compliance of the financial statements with the Government laws and regulations;

18. Proper Management Letter.8 The auditor shall issue a management letter focused on matters that may adversely affect project implementation and/or the EA operation, and the level of fiduciary risk to which ADB is exposed. At the minimum, this should include:

(i) A general overview of the internal control systems of the project and the EA and IAs including an opinion on their internal controls system(s) in providing project management with useful and timely information for corrective action; Give comments and observations on the accounting records, systems and controls that were examined during the course of the audit;

(ii) identification of material deficiencies or weaknesses in the project or EA/IA’s internal controls over financial reporting or overall system of internal control; Give comments on significant matters that the auditor considers should be brought to the attention of the project’s management and ADB and any other matters that the auditor considers pertinent, including ineligible expenditures;

(iii) auditor’s recommendations for improvements or to rectify the identified weaknesses in point b); communicate matters that have come to the auditor’s attention during the audit which might have a significant impact on the implementation of the project;

(iv) clients comments on the findings and recommendations; and also include responses from the EA and IAs to the issues highlighted by the auditor report on the degree of compliance with each of the financial covenants in the financing agreement and give comments, if any, on internal and external matters affecting such compliance; and provide recommendations for improvement; Include responses from the EA and IAs to the issues highlighted by the auditor;

(v) follow-up action and give comments on the status of significant matters raised in previous management letters; and on previous audits’ recommendations that have not been satisfactorily implemented;

8 Template and samples of management letters will be provided.

104 Appendix 2

(vi) Provide practical recommendations on the steps that could be taken to become materially compliant with the agreed project accounting policies (see Terms and Definitions), together with a time frame for making these changes;

E. Available Information

19. The auditor should have access to all legal documents, correspondences, and any other information associated with the project and deemed necessary by the auditor. The auditor will also obtain confirmation of amounts disbursed and outstanding at ADB. Available information should include copies of the relevant project appraisal document; financing agreement; financial management assessment reports; supervision mission reports and implementation status reports. 20. The auditor shall have the right of access to banks and depositories, consultants, contractors and other persons or firms engaged by the project. In case access has been restricted, the auditor must note this in the management letter.

21. ADB can request access to the auditors unedited audit working papers. If necessary, the audit firm can be requested to participate in a wrap-up session for the Ministry of Finance (MOF), the EA/IAs and ADB to share common findings across projects being audited and provide recommendations for addressing bottlenecks in preparation for the next audit.

F. Auditor Qualification

22. Requirements on the Qualification of the Auditing Company and Auditors are as follows:

1. For Auditing Company

23. The auditor must be authorized to practice in Viet Nam and be capable of applying the agreed auditing standards. 24. The detailed requirements on the qualification of the auditing company are:

(i) Be a legal entity with business license granted by the competent authority; (ii) Be included in the 2012 Certified Public Auditor List acceptable to Vietnam

Association of Certified Public Accountants; (iii) The auditor should have adequate staff, with appropriate professional

qualifications and suitable experience in finance/financial management in Official Development Assistance (ODA) funded projects or Government projects/ programs, including experience in auditing the EFS comparable in nature, size and complexity to the entity whose audit they are to undertake;

(iv) The audit firm must notify and get written endorsement of the EA every time the auditor substitutes a staff member assigned for the project audit.

2. For Individuals:

25. The general requirements on the Qualification of Individuals are as follows: (i) Please be noted that only national experts will be considered and selected for this

assignment. (ii) Auditors shall hold relevant professional qualifications with in-depth experience in

conducting audits of project FSs. They should be properly granted with certified

Appendix 2 105

auditor certificate by the Ministry of Finance (MOF) or legal international auditor certificate. For particular proposed consultants as auditors as mentioned below, at least 50% personnel must have certificates of auditor granted by MOF or relevant international audit certificates.

(iii) Auditors should hold a fair opinion on, and be independent of, control of the submitting entity and the employer by whom they were appointed.

(iv) The auditor should follow procedures and methodology that conform to Vietnamese Standards on Auditing (VSA).

26. The required qualifications and competence of the key national experts are summarized below:

(i) Audit Director: A university graduate (preferably with a post–graduate degree) in accounting/finance, certified auditor certificate by the MOF and international certificate (ACCA or other recognized international accounting/ auditing certificate), at least 15 years or above experience working in auditing services with 4-year experience in management of auditing teams. The actual working years in auditing must be 8 years or above since being granted with Vietnamese or international auditor certificate. Should have worked as Audit Director for at least 3 audit contracts on ADB, the World Bank or other international donors funded projects. Fluent English is compulsory;

(ii) Audit senior/ Team leader: A university graduate, preferably with a post–graduate degree in Accounting/finance, certified auditor certificate by the MOF, preferably to whom holding international certificate (ACCA or other recognized international accounting/auditing certificate), at least 8 years or above experience working in auditing services. The actual working years in auditing must be 5 years or above since being granted with Vietnam or international auditor certificate; should have worked as Audit Senior/Team Leader for at least 3 audit contracts on ADB, the World Bank or other international donors funded projects (experience in health services related ODA projects would be preferable). Fluent English is compulsory.

(iii) Audit assistant/ Auditor: A university graduate (preferably with a post –

graduate degree) in Accounting/finance, preferably holding Vietnamese auditor certificate certified by the MOF, 5 years experience or above working in auditing services. Should have worked as Auditor for 3 audit contracts on ADB’s, the World Bank’s or other international donors’ funded projects, experience in health services related ODA projects would be preferable). English proficiency would be preferable.

27. Outline Responsibilities of proposed position:

(i) Audit Director: (a) Direct all auditing activities from planning; personnel arrangement; work

assignment, audit procedures performance, resolving problems arising during the audit process; synthesizing audit data, preparing audited APFS;

(b) Be responsible for professional guidance for the entire contract audit and management comments during the audit period;

(c) Manage, control and review quality of each group at each stage of the audit process; unify the common issues related to audit work in groups;

106 Appendix 2

(d) Be the point of contact with the PMU and resolve the rising issues related to the audit contract.

(ii) Audit Senior/Team leader:

(a) Be in charge of audit team to perform auditing activities in a number of audited agencies as planned;

(b) Prepare the working plan for the audit team and arrange the audit groups to implement each task;

(c) Synthesize data and summarize management issues in the audited agencies;

(d) Inspect and review the minutes of audit of each group to provide recommendations on the financial management, project activities management in the audited agencies, and prepare the draft of the audit report.

(iii) Auditor:

(a) Implement the audit program, audit assigned sections in the agencies, be responsible for the data and issues related to the auditing activities.

(b) Support the preparation of the audit report; draft the minutes of audit; report to the Team leader regarding the issues related to the audit in the agencies.

28. In order to meet with the working plan and the scheduled report delivery as requested, the auditing company shall include one Team Leader and about 4 auditors and other positions having suitable qualification and experience. For each audit period, the following are the indicative person-months for each position in the audit team: Audit Director: 3 person-months; Team Leader: 2.8 person-months; and Auditor: 10.8 person-months each. The person-months are only estimates since the audit firm will be paid not on person-months spent, but will be remunerated on lump sum based performance for each annual package. 29. The auditing company should provide to the Government project management unit the following: working schedule, management and execution method together with allocated man power to implement the auditing activities to ensure good contract performance. 30. Reporting Requirements: The audited financial statements including the report should be received by ADB not later than six months after the end of the fiscal year/period to which the audit refers and should be prepared in English in 08 hard copies.

31. Reporting Relationships:

(i) The audit services will be contracted by the following executing agency: Central Management Unit The Auditor shall report to: the Project Director and Chief Accountant

(ii) The Auditor should maintain and file the work papers and provide them to the Government and/or ADB when requested.


THE GUIDANCE INCLUDING TERMS AND DEFINITIONS USED IN THIS TERMS OF REFERENCE

1. Terms of Reference (TOR) template: This template of TOR is appropriate for an APFS audit. It should be completed—by the borrower, Executing Agency (EA) or Project Preparatory Technical Assistance (PPTA) consultants—and provided to ADB for comments before fact finding. This template can be applied to the audit of either a revenue-earning or nonrevenue-earning project. 2. The auditor shall review ADB Procurement Guidelines, Guidelines on the Use of Consultants by ADB and its Borrower, ADB Project Administration Instructions and other ADB template and manual for procurement and selection of consultants and comments on the compliance of the procurement practice of the project. 3. Record Keeping. The auditor shall pay particular attention to whether all necessary supporting documents, records, and accounts have been kept in respect of all project activities, with clear linkages between the accounting records and the APFS. This shall include:

a) computation and recalculation, including checking the mathematical accuracy of estimates, accounts or records;

b) reconciliation, including reconciling related accounts to each other, subsidiary records to primary records and internal records to external documents;

c) physical observation, including inspecting or counting tangible assets, such as materials, inventory, land ,buildings, property or equipment;

d) confirmation, including directly confirming balances or transactions with external third parties, such as cash balances, accounts receivable or accounts payable;

e) sampling, including vouching or examining supporting documentation to determine if balances are properly stated; and

f) tracing, including tracing journal postings, subsidiary ledger balances, and other details to corresponding general ledger accounts or trial balances.

4. The Scope: The auditor should be sufficiently clear with the scope of the audit to properly define what is expected of him, but should not restrict the audit procedures or the techniques the auditor may wish to use to form an opinion. The TOR will generally have to be customized to a particular audit situation. The list of issues outlined in the TOR is not exhaustive, nor should all matters be addressed in every project. The scope and detail of an audit are likely to be unique for each project. 5. The form of the APFS and supporting documentation that will be supplied to the auditor, and on which they are to give an opinion and a report, should be specified. In practice, the form and content of APFS will vary among countries and projects. For instance, the APFS may comprise a Statement of Receipts and Payments only on project transactions. Other schedules may include cumulative work-in-progress, assets and inventories, and summarized bank reconciliation. The estimated time for providing these documents to the auditor should be stated (e.g., one month after financial year-end). This schedule helps the auditee and the auditor plan for the accounts-preparation and the audit process 6. Internal Control Systems. The auditor shall assess the adequacy of the project financial management systems, including internal controls. The assessment includes whether:


(i) proper authorizations are obtained and documented before transactions are entered into;

(ii) accuracy and consistency are achieved in recording, classifying, summarizing and reporting transactions;

(iii) reconciliations with internal and external evidence are performed on a timely basis by the appropriate level of management;

(iv) balances can be confirmed with external parties; (v) adequate documentation and an audit trail is retained to support transactions; (vi) transactions are allowable under the agreements governing the project; (vii) errors and omissions are detected and corrected by project personnel in the

normal course of their duties, and management is informed of recurring problems or weaknesses;

(viii) management does not override the normal procedures and the internal control structure; and

(ix) assets are property accounted for, safeguarded and can be physically inspected.

7. Statements of Expenditures (SOEs). The auditor shall audit all SOEs used as the basis for the submission of credit withdrawal applications to ADB. These expenditures should be compared for project eligibility with the relevant financing agreements (and with reference to the Report and Recommendation to the President (RRP) and other project documents for guidance when considered necessary). Where ineligible expenditures are identified as having been included in withdrawal applications and reimbursed against, these should be separately noted by the auditor. The annual audit report should include a separate paragraph commenting on the accuracy and propriety of expenditures withdrawn under SOE procedures, and the extent to which ADB can rely on those SOEs as a basis for credit disbursement. Annexed to the APFS should be a schedule listing individual SOE withdrawal applications by specific reference number and amount. 8. Designated Accounts: The Imprest Account reflects: (i) deposits and replenishment received from financiers; (ii) payments substantiated by withdrawal applications; and (iii) the remaining balance at financial year-end. The auditor must form an opinion on whether the Imprest Account(s) and the sub-accounts were used in compliance with required procedures (e.g., those of ADB and other cofinanciers), and the fairness of the presentation of each account activity and the year-end balance. The auditor should examine the eligibility and correctness of financial transactions during the period under review, account balances at the end of the period, the operation and use of each account in accordance with the financing agreement, and the adequacy of internal controls for this particular disbursement mechanism. The auditor will examine whether each Account has been maintained in accordance with the provisions of the relevant financing agreements.

9. Financial Covenants: The financial covenants that are applicable to projects are included in loan agreements. The Auditor should list, describe and fully reference all applicable financial covenants, review and comment on the compliance. 10. Compliance with Financial Covenants. The auditor will confirm compliance with each financial covenant contained in the project legal documents. Where present, the auditor should indicate the extent of any noncompliance by comparing required and actual performance measurements for each financial covenant for the financial year concerned. 11. Financial Assurances Applicable to Projects: The financial assurances that are applicable to the EA—such as a commitment to employ suitably-qualified accounting


personnel—will be included in project legal documents. The auditor should list, describe and fully reference all applicable financial assurances, review and comment on the compliance.

12. Compliance with Financial Assurances. The auditor will confirm compliance with all financial assurances contained in the project legal documents Where present, the auditor should indicate the extent of any noncompliance by comparing required and actual performance of the borrower in respect of these ADB requirements for the financial year concerned.

13. Procurement Policies and Procedures: Review ADB Procurement Guidelines and comment on the compliance of the procurement practices of the project.

14. Technical Experts: Depending on the complexity of procurement activities, the auditor may consider involving technical experts during the audit engagement. In cases where such experts are involved, the auditor is expected to comply with provisions of International Standard on Auditing 620: Using the Work of an Expert. Consideration to use of the work of experts should be brought to the early attention of the borrower and the ADB for mutual agreement and appropriate guidance

15. Auditor requirements: The details of the proposed contractor of the auditor’s services should be provided. If the contractor is acting on behalf of, or is part of, a larger authority or entity, this should be disclosed, to assist prospective auditors to determine their independence.

16. Annual Project Financial Statements (APFS): APFS may comprise a Statement of Receipts and Disbursements (Cash flow statement). This template is specifically intended for audits of these types of APFS. Other schedules of value or cumulative work-in-progress, assets and inventories and a summarized reconciled bank statement are to be attached. Project reporting requirements will usually be specified in the RRP or project documents such as the loan agreement. The component parts of the APFS should be specified in this TOR. The APFS comprises:

- Statement of the National Project Implementation Unit - Statement of Receipts and Disbursements - Statement of Project Implementing Expenditures - Statement of Imprest Account - Statement of Loan Withdrawals - Notes to the Financial Statements and Other Information.

17. APFS should include: (a) a summary of funds received showing ADB funds, any

cofinancing and counterpart funds separately; (b) a summary of expenditures shown under the main project components, allocation of loan or grant proceeds, procurement plan, and by main categories of expenditures (as referenced in loan and appraisal documentation) for the year ending 31 December 20xx and cumulative expenditures on the project to date; and (c) statement of fund balance as of 31 December, the fiscal year in Viet Nam. .

18. Applicable agreed auditing standards: The agreed auditing standards will normally be documented in the RRP, loan and grant agreement, and/or other project documents. The “Agreed auditing standards” is the Vietnamese Standards on Auditing.

19. Agreed Project Accounting Policies: The project accounting policies that govern APFS

preparation will normally be agreed and documented in the RRP and/or loan agreement.


Choose the appropriate option. “Agreed project accounting policies” with regard to preparation of Annual Project Accounts, means: Vietnamese Accounting Standards.

20. Although the auditor will use the Vietnamese Standards on Auditing, before conducting the audit, the auditor shall review the following International Standards on Auditing (ISA) promulgated by the International Auditing and Assurance Standards Board (IAASB):

(i) ISA 240: Auditor’s Responsibility to Consider Fraud in an Audit of Financial

statements; ISA 200: Overall Objectives of Independent Auditors, and the Conduct of an Audit the Entity in Accordance with ISA:

(ii) ISA 210: Agreeing the terms of audit engagements (iii) ISA 220: Quality control for an Audit of FSs. (iv) ISA 315: Indentifying and Assessing the Risks of Material Misstatements through

Understanding the Entity and its Environment (v) ISA 250: Consideration of Laws and Regulations in an Audit of Financial

Statements: (vi) ISA 260: Communication of Audit Matters with Those Charged with Governance -

ISA 330: The Auditor’s Procedures in Response to Assessed Risks (vii) ISA 402: Audit Considerations Relating to an Entity Using a Service Organization

ISA 580: Written Representations (viii) ISA 620: Using the Work of an Expert.

21. Different standards: If the auditing standards which auditors shall comply with to

conduct audit procedures and express their opinions on the FS, the statement on compliance and the statement on effectiveness of the internal control system are different, the auditor shall disclose the differences including the implications in its reports.


PROJECT BACKGROUND, EXECUTING AND IMPLEMENTING AGENCIES

A. The Project to be Audited

1. Project No: __________________________________ 2. Project Name: Second Health Care in the Central Highlands Project 3. Executing Agency: Ministry of Health (MOH) 4. Implementing Agencies: The project will be implemented through the central project

management unit (CPMU) in MOH (Department of Planning and Finance) and five provincial project management units (PPMUs) in the provincial departments of health.

5. Total Project Costs $76.6 million (from all financiers)

B. Project Description

1. Project Rationale, Location and Beneficiaries

1. The central highlands lag most other regions of Viet Nam in terms of health and health services indicators toward Millennium Development Goals (MDGs).1 The project will help the government to further reduce maternal and child mortality by addressing access to and quality gaps in commune health stations (CHSs) and hospitals and by strengthening provincial health management in five provinces, thereby targeting the poor, ethnic groups, and women and children in particular.

2. Impact and Outcome

2. The impact will be improved health and nutrition in the central highlands, in particular for women, children, the poor, and ethnic groups. The outcome will be the increased use of health services, in particular maternal and child health services in district hospitals, intercommunal polyclinics (ICPs), and CHSs.

3. Outputs

3. The project will have three key outputs: (i) improved access and quality of community health care, (ii) increased access and quality of hospital services, and (iii) strengthened provincial health system management. The project will provide support in the five provinces of the central highlands, in particular for activities to improve health care for the poor, ethnic groups, and women and children living in remote communities.

a. Output 1: Improved Access and Quality of Community Health Care

4. The project will support improved community health care with a focus on maternal and child care for the poor and ethnic groups in rural locations. With support from district health offices, at least 20% of the rural CHSs will be selected to work with surrounding villages to improve community health care through outreach services, including health and nutrition promotion and maternal and child care. 2 The project builds on and expands earlier programs

1 The Asian Development Bank (ADB) provided project preparatory technical assistance. ADB. 2011. Technical Assistance to the Socialist Republic of Viet Nam for Preparing the Second Health Care in the Central Highlands Project. Manila.

2 Selection criteria will include (i) poverty incidence, (ii) distance from the district hospital, (iii) ethnic groups population, (iv) population density, and (v) achievement of commune health standards as defined by the MOH.


for improving basic health care using standard packages and quality assurance mechanisms3 and will help improve the health system and address gaps in resources. 5. The project will provide (i) 6-month pre-service training for village health workers (VHWs) and village birth attendants (VBAs) to ensure that all villages in the catchment areas of targeted CHSs have adequate VHWs and VBAs; and (ii) refresher courses for VHWs and VBAs in the selected provinces, with priority given to catchment areas of selected CHSs as appropriate. It will provide toolkits for all eligible VHWs and delivery kits for all eligible VBAs. It will also support information, education, and communication (IEC) campaigns on health and nutrition. Prior to these campaigns, the project will conduct a knowledge, attitudes, and practices study in the villages and produce IEC materials appropriate to the sociocultural context of the region. Eleven vehicles will be provided to districts lacking transportation to improve CHS supervision and outreach services. 6. The project will build and equip 24 CHSs, replace and equip 10 ICPs, upgrade and equip 30 CHSs, and complete the equipment of other selected CHSs and ICPs. It will support 150 scholarships for ethnic students in medical technician or nursing degree courses and support health quality improvement through in-service skills training for CHS and ICP staff in hospitals. Staff will also be trained to be aware of sociocultural barriers and in IEC skills and caring for ethnic patients.

b. Output 2: Increased Access and Quality of Hospital Services

7. The project will support district hospitals toward improving access to referral services and reducing the overloading of provincial hospitals. A comprehensive approach, focusing on delivery of standard packages of health services, will be followed to improve hospital services and strengthen quality assurance. The project will help upgrade eight district hospitals, build one new district hospital, equip about 27 district hospitals and 3 provincial hospitals (including for emergency services), and provide 28 ambulances. It will help repair and maintain water supply and sanitation in all eligible district hospitals. 8. To improve service quality, the project will support system development and training in infection control, waste management, and quality assurance for selected staff in all district hospitals. It will support (i) short-term technical skills training for nurses, laboratory assistants, and maintenance specialists in all district hospitals; (ii) training 162 specialist doctors; (iii) upgrading 125 assistant doctors and assistant pharmacists into doctors and pharmacists; and (iv) providing short courses for 111 specialist doctors. Priority will be given to female and ethnic candidates.

c. Output 3: Strengthened Provincial Health System Management

9. The project will help improve provincial and district health management systems. Activities will include orientation for provincial governments and local leaders and training for provincial and district health managers and CHS and ICP heads on annual planning and budgeting, management and supervision tools, quality assurance, building and equipment maintenance, and a health management information system. 10. Capacity building in public health and hospital management will include a 3-month certificate course for provincial and district health office managers, CHS and ICP heads, and

3 Based on models piloted with the support of partners such as Pathfinder.


hospital managers in health services management. This will include human resources management, financial management, quality assurance, and health management information system, and mainstreaming gender and ethnic concerns. Female and ethnic staff will be prioritized. To improve training outcomes, the project will support the development of an in-service training system, including a provincial training team and coordinator, a core group of teachers to improve teaching methodologies, distant learning materials, a database to identify staff training needs, and field assessment. 10. The project will have a central project management unit (CPMU) and five provincial project management units (PPMUs). Staff will be trained in planning, monitoring, procurement, disbursement, and financial management. A project monitoring and evaluation system will be established. Project activities will be included in the annual operational plans of provinces, which will contribute to the sustainability of project benefits. The project will provide one vehicle for supervision by CPMU.

114 Appendix 3

GENERAL PROCUREMENT ASSESSMENT Proposed Project Name: Second Health Care in the Central Highlands Project

Proposed Amount ($): 78 Million

Executing/Implementing Agency: Ministry of Health

Source of Funding: ADB and Vietnamese Government

Assessor: Vu Quang Ngoc and Ngo Thai Son Date: Dec 2012

Expected Procurement The procurement mainly consists of NCB for upgrading/ building health facilities and ICB/NCB for procurement for medical equipment as well as furniture for CPMU and PPMU. In terms of consulting service, a team of international and national individuals and consulting firms will be selected by CPMU with ADB approval. The recruitment methods used will be QCBS, QBS, CQS, ICS and LFS methods. General Procurement Environment Assessment Risk Assessment:

Criterion Risk A. Legal and Regulatory Framework Low B. Institutional Framework Low C. Procurement Market and Operations Low D. Integrity of the Procurement System Low OVERALL RISK RATING Low

Summary of Findings: Vietnam has established law on procurement since 1999 and is regularly updated it to ensure compatibility with international laws and current situation in the country. Law, decree and circular on implementing the procurement law are detailed and are appropriate to the most common procurement situations. Procurement procedures are quite tight with several approval levels which cause some delay in implementation period. Differences between ADB and government on approval procedures timeline may be an obstacle to implement the project on schedule. Draft Laws and degrees are public for comment before getting approval from Government. Detailed implementation instructions are issued after issuance of a new regulation. A draft modification of Procurement law is currently being discussed before being submitted for the Government for consideration. The proposed modifications will make the national legal framework more compatible with international procurement system. It is important that the staff of the proposed project will be systematically informed about the new regulation. The invitations for bids have to be publicized in the public procurement journal and in other national newspapers. No regulation requires the collection of national statistic on procurement at the moment. Agency Procurement Capacity Assessment Risk Assessment:

Criterion Risk A. Organizational and Staff Capacity Average B. Information Management Low C. Procurement Practices Average D. Effectiveness Low E. Accountability Measures Low OVERALL RISK RATING Average

Appendix 3 115

Summary of Findings: International consultant on medical equipment and civil work detailed design may be necessary to reinforce the technical project management unit capacity. National staff currently working in the CPMU knows ADB and national procedures. English language is a challenge for national staff and national consultants. The provincial health offices (PHO) of the five project provinces have managed ADB funds during the Health Care in Central Highlands Project (HICH)1 from 2005 to 2010. Most contracted staffs from the previous project are currently still employed by PHOs. They are familiar with civil work procurement. CPMU staffs have experience with donor fund as ADB, WB and other international donors. CPMU is currently administering a WB project. Organizational and Staff Capacity The most concern of the staff capacity is English language barrier where two or three person can work in English. The CPMU and Provincial PMUs (PPMUs) are familiar with good and civil procurements procedures. There are some minor misunderstandings of procedures on recruiting consulting services. The head of procurement committees are director/ vice director of the CPMU and PPMUs. The director of PPMU is also director/ vice director of the PHO and has long experience in public procurement. National procurement has been done by PPMU is various as civil works, goods and consulting services in method of NCB, shopping and QCBS. CPMU has long experience with procurement of goods and consulting services in method of NCB, ICB, shopping and QCBS. Information Management CPMU has managed the previous project HICH during 5 years. The hard copy of procurement records normally are kept in aluminum box with locks. It’s not easy to find detailed information after the end of the project as staff is not available. While procurement information is fragmented, the information management is rated low risk. Procurement Practices Procurement of Goods and Works Risk Assessment: Risk rating for this criterion is LOW. Summary of Findings: The procurement activities has undertaken by either CPMU for equipment or PPMU for civil work. PMUs are experience with methods of procurements. Consulting Services Risk Assessment: Risk rating for this criterion is AVERAGE Summary of Findings: Hiring the international procurement specialist may not be needed as the capacity of the CPMU is strong enough. However, international technical expertise on medical equipment and civil works detailed design is needed. CPMU and PPMUs staff have some minor misconception on consulting firms recruitment and should be retrained.

1 ADB. 2003. Report and Recommendation of the President to the Board of Directors: Proposed Loan to the Socialist Republic of Viet Nam for the Health Care in the Central Highlands Project. Manila.

116 Appendix 3

Effectiveness Risk Assessment: Risk rating for this criterion is LOW. Accountability Measures Risk Assessment: Risk rating for this criterion is LOW. Summary Assessment CPMU and PPMUs have experience with procurement law and regulations of both ADB and Government. Staff’s capacity can be improved, particularly English language and regular update on new laws and regulations. Some minor wrong understanding about procurement consulting services needs to be corrected to ensure compliance with ADB and government regulations.

Specific Recommendations, Project Implementation Risks Recommended Action Responsibility and comment The over load of government CPMU and PPMU staffs working only part time for the project.

Recruit additional national staff with detail TORs

PPMU and CPMU

Weak implementation capacity Train PMU and PPMUs in planning, procurement, and financial management. Ensure timely availability of consultants and additional contracted staff. Ensure regular supervision and reporting

ADB, CPMU, PPMU

Capacity Constraint Recommended Action Responsibility and comment Updated law and regulation of ADB and government

Annual training sessions with ADB and Government specialists to update CPMU and PPMU knowledge.

CPMU and PPMU should organize annually meeting regarding procurement topic where the experience can be shared and new laws and decrees explained

English language capacity Extra English course for government staffs

PPMU government staff

General Recommendations, EA/IA Risks/Capacity Constraint Recommended Action Responsibility and comment Insufficient of communication during implementation phase in all levels

Heads of PPMUs and CPMU and ADB must be regularly updated on problems encountered during procurement. Appropriate solutions have to be implemented timely. Ensure the reports have been submitted precisely and on time.

PPMUs and CPMU

Lengthy administrative procedures

Provide staff training; support also provided through experts and ADB. Ensure support of core ministries and provinces for timely processing

ADB, CPMU and PPMU

Appendix 3 117

General Recommendations, Procurement Environment Risk/Capacity Constraint Recommended Action Responsibility and comment Poor governance and corruption

CPMU and implementing agencies receive training in anticorruption policies. ADB and CPMU conduct spot-checks

CPMU and ADB

I. GENERAL PROCUREMENT ENVIRONMENT ASSESSMENT

A. Specific Assessment and Ratings

Question Yes/No Narrative Explanation Risk

A. LEGAL AND REGULATORY FRAMEWORK 1. Is there a procurement law?

Is there a single law governing procurement that is consistent with internationally accepted principles and practices; or is procurement governed through various laws, decrees etc.?

Yes the Law on Procurement No. 61/2005/QH11 of 29 November 2005, (ii) the Construction Law no. 16/2003/QH11 of 26 November 2003, (iii) the Amendment Law No. 38/2009/QH12 of 19 June 2009 amending and supplementing key articles of the above-mentioned two laws. However, the MPI is submitting a proposal to Government for update the procurement law.

Average

2. Does the procurement law have implementing regulations? Does the procurement law have implementing rules and regulations that support it by providing the details that are not normally found in a law? Are these clear, comprehensive and consolidated as a set of regulations that are available in a single and accessible place? Are these regularly updated?

Yes Decree No. 85/2009/ND-CP of 15 October 2009 on “Guiding Implementation of Procurement Law and Selection of Construction Contractors under the Construction Law”. Decree No. 68/2012/ND-CP of 12 September 2012 on changing and adding some article of Decree No. 85/2009/ND-CP of 15 October 2009 on “Guiding Implementation of Procurement Law and Selection of Construction Contractors under the Construction Law”.

Average

3. Are the procurement law and regulations clear and concise? If there is a single law that is easy to follow, then the risk is “low”. If the law is complex and difficult to follow, then the risk is “average”. If there is no single law, then the risk is “extremely high” or “high”.

Yes Single law exists but keeps being modified so it will cause some difficulties for applying and implementing.

Low

4. What does the procurement law/regulation cover? If there is a single law, the risk will be “low” if it covers drafting and use of standard bidding documents, evaluation, contracting through to the

Yes Single law is existing and MPI issued standard bidding documents, evaluation and contracts including payment, warranty d for each procurement type e.g. equipment, civil and works as well as procurement

Low

118 Appendix 3

Question Yes/No Narrative Explanation Risk management of contracts, including payment, warranty and defects liability periods. The less the procurement process is covered the higher the risk. If there is no single law, then the risk is “extremely high” or “high”.

method

5. Does the procurement law/regulation cover the procurement of consulting services? If there is a single procurement law that also covers consulting services, then the risk is “low”. If consulting services are not covered, or there is no law, then the risk is “extremely high” or “high”.

Yes There are some others regulations appropriates for each type of procurement of consulting services Regulation No 06/2010/TT- BKH of 09 March 2010 for hiring consulting firm Circular No 09/2011/TT-BKHDT of 7 September 2011 on detailing the required contents of requirement dossiers for consultancy bids appointment. Circular No 07/2012/TT-BXD on 26 October 2012 on guiding the determination and the management of the expenditure on foreign consultants on construction in Vietnam.

Low

6. Does the procurement law/regulation differentiate between processes for goods, works and consulting services? If there is a single law that deals separately with consulting services, then the risk is “low”. If there is a single law that provides some differentiation, but the processes are similar, then the risk is “average”. If there is no single law, or it applies the same processes to consulting services as for goods and works, then the risk is “extremely high” or “high”.

Yes Low

7. Does the law/regulation require the advertisement of all procurement opportunities? A “low” risk may be indicated if advertisement is required for all procurements above $25,000. An “average” risk may be indicated if advertisement is required only for procurements above $100,000. A “high” risk may be indicated if advertisement is required for all procurements above a threshold that is higher than $100,000. An “extremely high” risk should be indicated if no advertisement is required.

Yes Regulation No 20/2010/TTLT-BKH-BTC of 21 September 2010 on providing information to Vietnam public procurement review

Low

Appendix 3 119

Question Yes/No Narrative Explanation Risk 8. Are contract awards advertised?

The same thresholds as stated at A7 should be applied.

Yes only for procurements above $100,000 Low

9. Are there restrictions on goods, works and services on the basis of origin? If there is no limitation, restriction and/or preference scheme, then the risk is “low”. If there are restrictions or a national preference scheme, then the risk is “average”. If procurement is solely limited to those of national origin, then the risk is “extremely high” or “high”.

No Low

10. Does the procurement law or relevant legislation and regulation provide acceptable provisions for the participation of state-owned enterprises (SOEs)? If an exception is given to SOEs that are legally and financially autonomous and are not dependent agencies of the purchaser/employer, then the risk is “low”. Otherwise, the risk is “extremely high” or “high”.

Yes Low

11. Are there restrictions on the nationality of bidders and consulting firms to be invited? If there is no limitation, restriction and/or preference scheme, then the risk is “low”. If there are nationality restrictions or a national preference scheme, then the risk is “average”. If procurement is solely limited to national firms and individuals, then the risk is “extremely high” or ”high”.

No Low

12. Are foreign bidders and consultants forced to submit offers through or with local partners? If this is never required, then the risk is “low”. If this is required under certain circumstances, then the risk is “average”. If this is always required, then the risk is “extremely high” or “high”.

No Low

13. Is there a domestic preference scheme? If there is no scheme, then the risk is “low”. If it is applied in limited circumstances, then the risk is “average”. If a domestic preference scheme is applied across the board, then the risk is “extremely high” or “high”.

No Low

120 Appendix 3

Question Yes/No Narrative Explanation Risk 14. Is there a national standard

mandated for the use for quality control purposes? If there are no mandated national standards or if these have direct and accessible international equivalents, then the risk is “low”. If there are mandated national standards that have no international equivalents, then the risk is “high”.

No Low

15. Are any agencies or parts of public expenditure exempt from the procurement law/regulation? If yes, such as defense equipment, then the risk may range from “average” to “extremely high, depending on the extent of the exemption. For example, if an exemption is out rightly granted to medicines, text books or other similar commodities, then the risk is “extremely high”.

No Low

16. Is the default method for procurement open competition? If yes, then the risk is “low”. If no, or if it is not clearly established, then the risk may be “extremely high” or “high”.

Yes Low

17. Is open competition easily avoided? If avoidance requires the approval of an oversight agency, then the risk is “low”. If open competition can be avoided by senior management decision, then the risk is “average”. If the procurement law/regulation allows the avoidance of open competition above a certain national threshold on the basis of circumstances that are not in response to natural disasters, i.e. simple urgency, then the risk is “extremely high” or “high”.

No Low

18. Does the procurement law/regulation require pre-qualification? If it is only for complex or high value contracts, then the risk is “low”. If no pre-qualification is allowed, then the risk is “average”. If it applies to all contracts, then the risk is “high”.

No For complex or high value contract only

Low

19. Does the procurement law/regulation require the pre-registration of bidders? If no pre-registration is required, then the risk is “low”. If it is only

No Low

Appendix 3 121

Question Yes/No Narrative Explanation Risk required for special types of goods, such as medicines, then the risk is “average”. If yes, then the risk is “extremely high” or “high”.

20. Does the procurement law/regulation mandate the use of standard documents? If it does and there are documents for goods, works and consultants services, then the risk is “low”. If it is required just for only two of the three procurement types, then the risk is “average”. If it is required for only one of the procurement types, or it is required but no documents have yet been issued, then the risk is “high”. If standard documents are not required, then the risk is “extremely high”.

Yes Low

21. Have these standard documents been approved for use on ADB projects? If yes, then the risk is “low”. If some, but not all, then the risk is “average”. If no, then the risk is “extremely high” or “high”.

Yes Following ADB standard document updated on March 2013 and later releases

Low

22. Is there a national procurement manual or guide? If an omnibus procurement manual or guide exists, then the risk is “low”. If a manual exists, but it is out of date or is not widely used/distributed, then the risk is “average”. If there is no manual, then the risk is “extremely high” or “high”.

Yes Low

B. INSTITUTIONAL FRAMEWORK 23. Which body oversees public

procurement? If there is a regulatory body at an adequate level in government, and financing is secured by the legal/regulatory framework, then the risk is “low”. If the body is at an adequate level, but financing is subject to administrative decisions and can be changed easily, then the risk is “average”. If the level of the body is too low or financing is inadequate for proper discharge of its responsibilities, then the risk is “high”. If there is no body, or the body is too low with no independence to perform its

Depending on the nature of the procurement, it can be a department of PPCs or Ministries.

Low

122 Appendix 3

Question Yes/No Narrative Explanation Risk obligations, then the risk is “extremely high”.

24. What powers does the oversight body have? The rating may range from “low” to extremely high”, depending on whether the body exercises all, some, a few or none of the following responsibilities: providing advice to contracting entities, drafting amendments to the legal/regulatory framework, monitoring public procurement, providing procurement information, managing statistical databases, reporting on procurement to other parts of government, developing/supporting the implementation of initiatives for improvements to the public procurement system, and providing implementation tools and documents to support capacity development.

They exercises all responsibilities mentioned.

Low

25. Is there a nationwide procurement training plan? If procurement trainings are regularly implemented nationwide and needs are regularly assessed, then the risk is “low”. If there is an existing program, but it is insufficient to meet national needs, then the risk is “high”. If there is no formal training program, then the risk is “extremely high”. Consider also the existence of a helpdesk.

No Only person who has procurement certificate can be as a part of the team who prepare the bidding document or evaluate the bid documents.

High

26. Is there a procurement accreditation or professionalization program? If there is an externally recognized program, then the risk is “low”. If it is a government sponsored program, then the risk is “average”. If there is no accreditation or professionalization program, then the risk is “high”.

Yes The detail training course has been developed. Only qualified person can be as a tutor.

Low

27. Are major projects identified within agencies’ appropriations or budgets? If yes, then the risk is “low”. If no, but a system is in place for the ring-fencing of project funds, then the risk is average. If neither condition exists, then the risk is “high”.

Yes Low

28. Is the procurement cycle tied to an annual budgeting cycle, i.e. can procurement activity only commence once a budget is approved? If yes, and a medium-term

Yes Low

Appendix 3 123

Question Yes/No Narrative Explanation Risk expenditure framework is in place, then the risk is “low”. If an activity may start up to, but excluding contract award, then the risk is “average”. If the procurement cycle is not tied to an annual budget, then the risk is “extremely high” or “high”.

29. Once an appropriation or budget is approved, will funds be placed with the agency or can the agency draw them down at will? If yes, then the risk is “low”. If now, such when additional bureaucratic controls are imposed (such as a cash release system), then the risk is “extremely high” or “high”.

Yes Based on the new regulation If the procurement plan is approved the finance is allocated.

Low

30. Is there a nationwide system for collecting and disseminating procurement information, including tender invitations, requests for proposals, and contract award information? If there is an integrated information system that provides up-to-date information and is easily accessible at no or minimum cost, then the risk is “low”. If there is such an integrated information system that covers majority of contracts, but access is limited, then the risk is “average”. If there is a system, but it only provides information on some of the contracts and is not easily accessible, then the risk is “high”. If there is no procurement information system, except for some individual agency systems, then the risk is “extremely high”.

Yes The information is limited. Information can be access either through the paper version release every day or through its website

Average

31. When an agency is implementing a project using funds from the national budget, are there general experiences/reports of funding delays that significantly hamper procurement? If no, then the risk is low. If yes, then the risk is “extremely high” or “high”.

No Low

32. Is consolidated historical procurement data available to the public? If yes, then the risk is “low”. If the data is too much or too little, then the risk is “average”. If none, then the risk is “extremely high” or “high”.

No Information is available in the national website on procurement but not all the packages are there

Average

124 Appendix 3

Question Yes/No Narrative Explanation Risk 33. Does the law/regulation require the

collection of nationwide statistics on procurement? If yes and statistics are actually collected, then the risk is “low”. If yes, but data is not collected or used, then the risk is “average”. If there is no requirement, then the risk is “extremely high” or “high”.

No No requirement of collecting nationwide statistics on procurement

High

C. PROCUREMENT MARKET AND OPERATIONS 34. Do formal mechanisms exist to

encourage dialogue and partnerships between the government and the private sector, and are these well established in the procurement law/regulation? If such mechanisms exist, such as programs to build the capacity of private companies and small businesses to participate in public procurement, and these are effective, then the risk is “low”. If such mechanisms exist, but there is no proof of its effectiveness, then the risk is “average”. If no such mechanisms exist, then the risk is “extremely high” or “high”.

Yes Draft version of procurement law is public for comment before approval

Low

35. Are private sector institutions well organized and able to facilitate access to the market? If the private sector is competitive, well organized and able to participate in open competition, then the risk is “low”. If there is a reasonably well functioning private sector, but competition for large contracts is concentrated in a relatively small number of firms, then the risk is “average”. If the private sector is relatively weak and/or competition is limited owing to monopolistic or oligopolistic features in important segments of the market, then the risk is “high”. If the private sector is not well organized and lacks capacity and access to information for participation in the public procurement market, then the risk is “extremely high”.

Yes Low

36. Is there an alternative disputes resolution process independent of the government and courts? If there is an arbitration law with an independent process, then the risk is “low”. If there is no arbitration law,

Yes Low

Appendix 3 125

Question Yes/No Narrative Explanation Risk but the standard contracts use ICC or similar dispute resolution provisions, then the risk is “average”. If alternative dispute resolution is not practiced, or if arbitration is through the courts or can be overturned by the courts, then the risk is “extremely high” or “high”.

D. INTEGRITY OF THE PROCUREMENT SYSTEM 37. Are there systematic procurement

process audits? If yes, then the risk is “low”. If only financial audits are conducted, then the risk is “average”. If no systematic audits are conducted, then the risk is “extremely high” or “high”.

Yes Financial audit only Average

38. Does the procurement law/regulation contain provisions for dealing with misconduct, such as fraud and corruption? A cross reference to an anti-corruption law will suffice. If yes, then the risk is “low”. If no, then the risk is “extremely high” or “high”.

Yes Low

39. Is fraud and corruption in procurement regarded as a criminal act, whereby the penalty includes imprisonment? If yes, then the risk is “low”. If no, then the risk is “extremely high” or “high”.

Yes Low

40. Have there been prosecutions for fraud and corruption? If there have been successful prosecutions for fraud and corruption, then the risk is “low”. If prosecutions seem to focus solely on low grade/junior staff, then the risk is “average”. If there is no evidence of any prosecution, then the risk is “extremely high” or “high”.

Yes Low

41. Does the legal/regulatory framework allow for sovereign immunity to agencies for claims against them? If plaintiffs can sue the government for contractual non-performance, then the risk is “low”. If they cannot, then the risk is “extremely high” or “high”.

Yes Low

42. Do the regulations allow for the debarment of firms and individuals? If there is a debarment process that

Yes Low

126 Appendix 3

Question Yes/No Narrative Explanation Risk is transparent and equitable, and undertaken by an independent oversight agency, then the risk is “low”. If there is a process and it is administered by a single agency, such as the Ministry of Finance, then the risk is “average”. If it is administered by the procuring agency, then the risk is “high”. If there is no debarment mechanism, then the risk is “extremely high”.

B. General Ratings Criterion Risk A. Legal and Regulatory Framework Low B. Institutional Framework Low C. Procurement Market and Operations Low D. Integrity of the Procurement System Low OVERALL RISK RATING Low

Appendix 4 127

LIST OF TRAININGS

Type of Training Trainees COMPONENT 1

1 Training in health center management, hygiene and quality assurance for CHS/ICP heads (2 weeks, intermittent) 1000

2 Safe motherhood for midwives in CHS and ICP (2 weeks) 800 3 Safe motherhood for doctors in CHS and ICP (1 week) 1200 4 Pre-service training for VHW (3 month course) 525 5 Pre-service training for VBA (6 month course) 525 6 In-service training for VHW (one week course) 1400 7 In-service training for VBA (one week course) 400 8 Train the CHS, ICP staff and districh health office: knowledge of KAP of the

population, utilization of IEC material, IEC techniques (1 week) 1664 9 Scholarship for 150 ethnic group assistant doctors students (certificate 2 years) 150 COMPONENT 2 10 Training for teachers/lecturers (TOT) of the medical schools (6 month) 40 11 Training for district hospitals nurses, technicians, midwives (2 weeks) 1800 12 Specialty Education for Physicians with 2 year experience 111 13 Hygiene and infection control for focal point in hospital 288 14 Hygiene and infection control for staff in hospital 720 15 Training level 1 specialists 132 16 Training level 2 specialists 30 17 Upgrade assistant doctors / assistant pharmacists to doctors / pharmacists (4

years) 125 COMPONENT 3 18 Training strategic planning for senior health managers 325 19 Training in Results-based Planning and Coordination for PMU and PPMU staff 30 21 Training in ADB Procurement, Financial management, Governance, Gender for

PMU and PPMU staff 60 22 Training in annual planning for PMU and PPMU staff 30 23 Training in HMIS and M&E or PMU and PPMU staff 125

Source: Asian Development Bank. 1. Training for medical equipment use. Training will be provided on site by the supplier of medical equipment. EA will ensure that the training is included in the supplier’s contract. 2. Upgrading safe motherhood capacity: Training for CHS and ICP staff (midwives and physicians), about 600, that have not received in-service training in the past 2 years will be offered practical training courses in safe motherhood to update safe motherhood knowledge and skills. Courses will be one month long and will be provided in the provincial hospitals by hospital staff supported by medical schools teachers. The provincial hospital staff will be provided a curriculum and trained to organize these programs each quarter. 3. Clinical training for CHS and ICP staff. About 1,200 CHS and ICP staff will take turns to learn clinical practice in district hospitals. The plan is for each CHS and ICP staff member to attend an in-service knowledge and skills training program in the district hospital once a year for one week. The district hospital staff will be provided a curriculum and trained to organize these programs each quarter.

128 Appendix 5

LIST OF CIVIL WORKS

Procurement Package Province District Commune Type

Repair & Upgrade New WWTP

2 Dak Lak KrongBuk KrongBuk DH 1 3 Dak Lak KrongBuk KrongBuk WWTP 1 3 Dak Lak Buon Ma Thuot Buon Ma

Thuot WWTP 1

4 Dak Lak Krong Pak Eakly RPC 1 5 Dak Nong Đăk R'lấp Đăk R'lấp DH 1 6 Dak Nong CưJút CưJút DH 1 3 Dak Nong CưJút CưJút WWTP 1 7 Dak Nong KrôngNô KrôngNô DH 1 3 Dak Nong KrôngNô KrôngNô WWTP 1 3 Dak Nong Tuy Duc Tuy Duc WWTP 1 8 Dak Nong KrôngNô Duc Xuyen CHS 1 8 Dak Nong Tuy Đức Quang Tân CHS 1 8 Dak Nong KrôngNô DăkBuk So CHS 1 8 Dak Nong Đăk Glong Quang Son CHS 1 8 Dak Nong Đăk Glong Quang Hòa CHS 1 8 Dak Nong Đăk Song Dúc An CHS 1 8 Dak Nong CưJút EaTling CHS 1 8 Dak Nong CưJút Nam Dong CHS 1 8 Dak Nong Dak Rlap Nghia

Thang CHS 1

8 Dak Nong DaK Song Thuan Hà CHS 1 10 Gia Lai Chu Pah Chu Pah DH 1 11 Gia Lai Chu Prong Chu Prong DH 1 3 Gia Lai Chu Prong Chu Prong WWTP 1 12 Gia Lai Chu Se Chu Se DH 1 3 Gia Lai Chu Se WWTP 1 13 Gia Lai Chu Se Dun CHS 1 13 Gia Lai Chu Se IaBlang CHS 1 13 Gia Lai Ia Pa IaBroai CHS 1 13 Gia Lai Chu Prong Bau Can CHS 1 13 Gia Lai Chu Pah Ia Le CHS 1 13 Gia Lai Duc Co IaKla CHS 1 13 Gia Lai IaGrai IaPech CHS 1 13 Gia Lai Chu Prong I aPhin CHS 1 14 Kon Tum Dak Glei Ngoc Linh CHS 1 14 Kon Tum Dak Glei Dak Man CHS 1 14 Kon Tum Ngoc Hoi Đăk Nông CHS 1 14 Kon Tum Ngoc Hoi Dak Xu CHS 1 14 Kon Tum Ngoc Hoi Sa Loong CHS 1 14 Kon Tum Ngoc Hoi DacKan CHS 1 14 Kon Tum Kon Tum Ngo May CHS 1 14 Kon Tum Dak To Kon Dao CHS 1 14 Kon Tum Sa Thay Sa Thay CHS 1 14 Kon Tum Sa Thay Sa Son CHS 1 14 Kon Tum Dak Glei Dak Glei CHS 1 14 Kon Tum Kon tum Dac Ro Wa CHS 1 14 Kon Tum Kon Tum Kroong CHS 1 14 Kon Tum Tu Mo Rong Tu Mo Rong CHS 1

Appendix 5 129

Procurement Package Province District Commune Type

Repair & Upgrade New WWTP

14 Kon Tum Dak Ha Ngoc Wang CHS 1 14 Kon Tum Dak Ha Dak Ha CHS 1 14 Kon Tum Dak Ha Dak Ui CHS 1 14 Kon Tum Sa Thay Mo Ray CHS 1 14 Kon Tum Kon Ray Dak Koi CHS 1 14 Kon Tum Tu Mo Rong Dak Sao CHS 1 14 Kon Tum Tu Mo Rong TeXang CHS 1 14 Kon Tum Tu Mo Rong Dak To Kan CHS 1 14 Kon Tum Kon Tum Truong

Chinh CHS 1

14 Kon Tum Kon Tum Doan Ket CHS 1 14 Kon Tum Kon Tum Hoa Binh CHS 1 14 Kon Tum Dak To Dac To (Thi

Tran Dac?) CHS 1

14 Kon Tum Dak To Van Lem CHS 1 14 Kon Tum Sa Thay Gia Ly CHS 1 14 Kon Tum Kon Ray Dak To

Lung CHS 1

14 Kon Tum Kon Ray Dak Tre CHS 1 14 Kon Tum Kon Ray Tan Lap CHS 1 14 Kon Tum Kon Plong Dak Long CHS 1 14 Kon Tum Kon Plong Ngoc Tem CHS 1 14 Kon Tum Kon Plong Dak Nen CHS 1 14 Kon Tum Kon Plong Po E CHS 1 14 Kon Tum Dak To dak ro Nga CHS 1 15 Lam Dong Da Huoai Madaguoi DH 1 3 Lam Dong Da Huoai Madaguoi WWTP 1 15 Lam Dong Lam Ha Dinh Van DH 1 16 Lam Dong Ka Don Ka Don IPC 1 16 Lam Dong DucTrong Da Loan IPC 1 16 Lam Dong DucTrong Ninh Gia IPC 1 16 Lam Dong Lac Duong Da Nhim IPC 1 16 Lam Dong Dam Rong Phi Lieng IPC 1 16 Lam Dong Da Lat Xuan

Truong IPC 1

16 Lam Dong Cat Tien Phuoc Cat 1 IPC 1 16 Lam Dong BaoLoc LocThanh IPC 1 16 Lam Dong Bảo Lâm Loc An IPC 1

CHS = commune health station; DH = district hospital; ICP = intercommunal polyclinic; WWTP = waste water treatment plant. Source: Asian Development Bank.

130 Appendix 6

LIST OF HOSPITALS TO BE PROVIDED WITH EQUIPMENT

Type Province Name

DH Lam Dong Bảo Lâm DH - 50 Beds

DH Lam Dong Đam Rông - 40 Beds

DH Lam Dong Cát Tiên DH - 50 Beds

DH Lam Dong Đạ Tẻh DH - 60 Beds

DH Lam Dong Di Linh DH - 70 Beds

DH Lam Dong Đơn Dương DH - 100 Beds

DH Lam Dong Đức Trọng DH - 120 Beds

DH Lam Dong Loc Thanh DH

DH Lam Dong Lạc Dương DH - 30 beds

DH Lam Dong Lam Ha

DH Lam Dong Đạ Huoai DH - 120 Beds

PH Kon Tum Kontum PH

DH Kon Tum Kon Plong DH

DH Kon Tum Tu Mơ Rông DH

DH Gia Lai Ayun Pa DH

DH Gia Lai Kbang DH

DH Gia Lai Krông Pa DH

DH Gia Lai Chu Pah DH

DH Gia Lai Chu Prong DH

DH Gia Lai Chu Se DH

PH Dak Nong Đắk Nông PH

DH Dak Nong Đăk Glong

DH Dak Nong Tuy Đức

DH Dak Nong Krong No

DH Dak Nong Cu Jut

PH Dak Lak

DH Dak Lak Ea Súp DH

DH Dak Lak Buôn Đôn DH

DH Dak Lak Lak DH

DH Dak Lak Krong Buk DH = district hospital; PH = provincial hospital. Source: Asian Development Bank.