Maldives: COVID-19 Emergency Response and Health Systems Preparedness Project

OBJECTIVE

To respond to and mitigate the threat posed by COVID-19 and strengthen national systems for public health preparedness in the Maldives.

DESCRIPTION

This Project was supported under AIIB’s COVID-19 Recovery Facility (Facility) and co-financed with the World Bank until December 31, 2023.

The Project has the following four components:

1. Emergency Response for COVID-19 Prevention: Procurement of essential protective equipment and other essential items to protect healthcare workers and patients; risk communication, community engagement and behavior change, including social distancing measures and associated mitigation strategies.
2. Emergency Health System Capacity Strengthening for COVID-19 Case Management: Strengthening the centralized and decentralized health system capabilities for disease surveillance, case management and infection prevention and
3. Implementation Management and Monitoring and Evaluation: Strengthening of public institutions for the coordination and management of the project, including central and regional arrangements for coordination of activities, financial management, procurement and social and environmental management.
4. Contingent Emergency Response Component: This zero-dollar component is being added to ensure additional flexibility in response to the current and any potential emergency that might occur during the lifetime of this

By December 2023, the Project has achieved the following results:

• 70% of hospitals with adequate personal protective equipment within a given
• Five regions with ICU
• 70% of health professionals trained in infection prevention and control per Ministry of Health approved protocols.
• Five designated laboratories with staff trained to conduct COVID-19
• 80% of hospitals that have submitted complete monthly reports on the number of suspected cases identified, number of cases tested, number of contacts traced, the presence of personal protective equipment, the presence of an isolation

The Government of Maldives requested AIIB to continue financing the Project on a stand-alone basis to complete the remaining activities as follows:

1. A quarantine facility that is adjacent to Kulhudhuffushi Regional Hospital (KRH). Dh. Kulhudhuffushi is situated 277 km away from the capital city of Malé. It has the second- largest patient catchment area after the Capital Malé. The potential number of beneficiaries exceeds 75,000, comprising the residents of the island and nearby atolls. This Project activity aims to address the critical shortage of quarantine facilities for highly contagious and transmissible diseases. Additionally, this facility can serve as patient accommodation for those traveling from other islands. It aims to construct a two-story medical facility with 14 individual and separated wards, along with ancillary services for staff.
2. Infection Prevention and Control (IPC) Training. The objective is to provide infection prevention training to 70% of the doctors, nurses, and healthcare This training will provide healthcare workers with the ongoing IPC education. The aim is to instill a risk-management mindset in all aspects of patient care. This will help to minimize the possibility of infection propagation amongst healthcare workers, patients, and visitors. To achieve this, a consistent method for auditing infection prevention and control systems, procedures, and adherence will be developed at medical facilities.
3. Project Management. The existing project management unit (PMU) will continue to operate to oversee daily coordination, contract management, payment process, and the implementation aspects of the Project. To perform its duty, PMU requires an internal auditor, a financial management specialist, a social and environmental specialist, a monitoring and evaluation specialist, and a civil engineer.

ENVIRONMENTAL AND SOCIAL INFORMATION

Applicable Policy and the Instruments. AIIB’s Environmental and Social Policy (ESP) will apply for the remaining project activities over the extended loan period. The Project is classified as Category B due to limited but manageable environmental and social (E&S) risks and impacts. The E&S instruments including Environmental and Social Management Framework (ESMF), Environmental and Social Commitment Plan (ESCP), Environmental and Social Management Plan (ESMP), Stakeholder Engagement Plan (SEP) and Labor Management Procedure (LMP) will remain the same.

E&S Aspect and Monitoring Arrangement. Minimal E&S impacts are anticipated in relation to the Kulhudhuffushi quarantine facility as it is located within an already existing hospital and involves setting up prefabricated units, requiring mostly site management during civil works and facility operation after completion. To this end, the WB had cleared an ESMP in 2022, although no work had begun. Once the Project work starts on the ground, the borrower will monitor the ESMP implementation every 2 weeks and share monitoring updates with the Bank from the first month of implementation.

Project Grievance Redress Mechanism (GRM). The Project will utilize the existing grievance mechanism. An information system has been established to track and monitor the redressal and resolution of complaints. The Project’s GRM remains functional and GRM-related training has been completed for the designated regions with focal points appointed. The overall GRM remains functional and sufficiently robust for AIIB to depend on over the extended loan period.