DHAKA, Sept 19, 2018 (BSS) – The Asian Development Bank (ADB) has
approved an additional loan financing of US$ 110 million for a project that
is improving access to urban primary healthcare services in Bangladesh
through Public-Private Partnerships (PPPs).
“ADB’s support to the government-led Urban Primary Health Care Services
Delivery Project approved in 2012 has been filling a vacuum created by the
lack of urban public primary healthcare by increasing access to quality
services, especially for poor households,” said ADB Social Sector Specialist
Brian Chin.
He said the new financing will focus on strengthening the service
delivery system, building on the results of the 2012 project and two previous
projects to meet unmet demands and develop self-reliance in the running of
the system.
The project is recognised as an innovative model of partnership between
the government, which contracts out health service delivery, and service
providers (mainly nongovernment organisations), an ADB press release said.
As originally financed in 2012 with a US$ 50 million ADB loan and US$ 20
million co-financing, it is one of the largest PPP projects for primary
healthcare delivery in the South Asia.
Previously, the ADB provided a US$ 40 million loan and US$ 4.5 million
co-financing for a first project to support health services in four cities
during 1998-2005. A second project followed in 2005-2012 backed by a US$ 30
million loan, US$ 10 million grant, and US$ 30 million co-financing widening
the support to six cities and five municipalities.
As originally envisaged, the 2012 project covers 10 cities and four
municipalities representing about 17 percent of the total 57 million urban
population.
According to a review in 2015, the project has been providing services to
more than 23 million clients, of whom 74 percent were female, and has
constructed a network of 180 health facilities and 224 satellite clinics. The
project is also building experience in the management and contracting of
healthcare service delivery, as well as monitoring and evaluation systems.
The review concluded that the project merits continuation and expansion
to ensure that the growing demand for healthcare in urban areas is met.
The additional financing will cover the cost of a five-year extension to
assist the government to strengthen local healthcare systems and continue to
expand the PPP system of contracting to service providers. It expands
coverage to an additional city and 10 municipalities, and will build eight
additional reproductive healthcare centres and 24 primary healthcare centres.
The sustainability of health services will be ensured through a series of
management, institutional, and staffing reforms. The new financing will build
on previous efforts toward climate change mitigation by adopting solar
panels, rainwater harvesting systems, and flood drainage.
The Urban Climate Change Resilience Trust Fund, financed by the
Rockefeller Foundation and the governments of Switzerland and the United
Kingdom, will provide a US$ two million grant, to be administered by ADB.
The Bangladesh government will contribute US$ 30 million toward the cost of
the additional financing, while the United Nations Population Fund will
provide US$ 1.5 million in-kind technical support. The project is expected to
be completed by March, 2023.