Environmental and Social Management Framework for Tanzania ...

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EXECUTIVE SUMMARY Introduction The World Bank is supporting the Regional Health Systems Strengthening and TB Support Project (part of the Africa Regional Communicable Disease Control and Preparedness Program), which aims at controlling and/or eliminating priority communicable diseases on the continent. Kenya, Tanzania and Uganda, which are part of the twenty-two high burden countries worldwide, will initially participate in this project. Other countries will be eligible to participate in a second phase, provided they meet the eligibility criteria. Project Components The project has two components as follows: Component 1 (US$42.5 million) for Specialized Diagnostic Services for TB and Other Communicable Diseases, will focus on improving access to quality diagnostic techniques for TB and other communicable diseases, by strengthening national public health laboratories as well as specialized satellite laboratories; and putting in place systems for laboratory management and surveillance. This would involve funding three mutually complementary activities of Networking National TB Reference Laboratories, Networking Central Public Health Laboratories and Networking Satellite Diagnostic and Treatment Centres. Component 2 (US$16.5 million) for Regional Capacity Building for Management and Monitoring of Communicable Diseases, aims at strengthen regional capacity to manage and monitor communicable diseases. This would be accomplished by Supporting the Re-establishment of the East Africa Integrated Disease Surveillance Network; Providing Regional Training to Improve Availability of Qualified Laboratory Staff; and Joint Operational Research, Knowledge Sharing and Coordination at the Regional Level. Project Development Objectives The development objective of the project is to strengthen regional capacity for the diagnosis, management, and surveillance of TB and other communicable diseases. The project is aimed at improving access, quality, and efficiency of TB diagnostic services, using an integrated approach to laboratory strengthening. The project will ultimately contribute to improving health outcomes in the participating countries. The specific objectives are to: • establish additional Supranational Reference Laboratories in strategic locations, for quality assurance, training, and capacity building; • introduce modern diagnostic techniques (drug resistance surveillance and compliance with bio-safety and infection control standards); • and develop and test alternative service delivery models to promote private sector involvement. Project’s Areas of Influence The project will involve upgrading, rehabilitation, and/or construction of laboratories. The civil works as well as generation of medical waste form these laboratories will vii
have negative environmental and social consequences. Therefore the project has triggered OP/BP 4.01(Environmental Assessment) and has been assigned to the World Bank environmental category B. Potential safeguard issues and areas of influence will be on the environmental components of soil, air and water, and vegetation. Issues on social components will relate to traffic accidents, safety of workers and potential for spread of TB and HIV and AIDS. The areas to be affected by the social components include public places where people gather in large numbers; poorly ventilated public places and laboratories; points or places of collection, transportation, storage and analysis of specimens; as well as places for disposal of laboratory and hospital waste. To ensure that these consequences or impacts are avoided, minimized or mitigated, this Environmental and Social Management Framework, (ESMF) has been prepared to conform to; and to be in line with the requirements of the participating countries as well as the World Bank. Objectives of the ESMF This Environmental and Social Management Framework (ESMF) is prepared to ensure proper assessment and mitigation of potential adverse environmental and social impacts, for the construction and rehabilitation of the laboratories. It includes issues related to operation of the laboratories and those which need to be addressed for laboratory waste management. Among other things, the ESMF outlines an environmental and social screening process, focusing on the completion of the Environmental and Social Screening Form. It includes an Environmental and Social Management Plan (EMP), guidelines for monitoring and development of appropriate monitoring indicators, capacity building measures for environmental management and cost estimates for the environmental work. It also includes (as appendices) Environmental Guidelines for Contractors, a summary of the Bank’s Safeguard Policies, an Environmental and Social Checklist and Generic EIA Terms of Reference, to be used in the event that the screening results indicate the need for preparation of an EIA report. The EIA recommendations will be incorporated into the design and cost estimates of the Regional Health Systems Strengthening and TB Support Project. Justification for the ESMF For the Regional Health Systems Strengthening and TB Support Project, the precise type and location of proposed project activities are not known at this time. Therefore the potential social and environmental impacts of the project activities cannot be identified and mitigation measures determined in the context of a traditional EIA, for the specific sub-projects. This ESMF provides generic impacts and mitigation measures associated with the construction, rehabilitation and operation of health care laboratory facilities. Specific sub-project activities, their impacts and mitigation measures will be identified once the project sites have been located. The ESMF therefore, complements the EIA procedures for meeting the environmental and social management requirements, and the Healthcare Waste Management Policy Guidelines developed for the participating countries. The ESMF viii
Page 1 and 2: REGIONAL HEALTH SYSTEMS STRENGTHENI
Page 3 and 4: TABLE OF CONTENTS TABLE OF CONTENTS
Page 5 and 6: The Environmental Management Act (2
Page 7: NIMR National Institute for Medical
Page 11 and 12: suitable. The World Bank environmen
Page 13 and 14: CHAPTER 1 INTRODUCTION 1.1 PROJECT
Page 15 and 16: 1.2.2 Uganda: In line with the 2008
Page 17 and 18: specimen to designated laboratories
Page 19 and 20: The regional project would fund a f
Page 21 and 22: 1. Supporting the Re-establishment
Page 23 and 24: documented and disseminated. Region
Page 25 and 26: surveillance and outbreak preparedn
Page 27 and 28: To ensure that these consequences o
Page 29 and 30: • identification and analysis of
Page 31 and 32: CHAPTER 2 LEGAL, REGULATORY, AND AD
Page 33 and 34: In addition; land, housing, infrast
Page 35 and 36: CHAPTER 3 IMPACT IDENTIFICATION AND
Page 37 and 38: 5. Conformity with and Support to t
Page 39 and 40: washed away into drains and nearby
Page 41 and 42: 2. Vegetation Destruction of trees
Page 43 and 44: Table 4.1: Generic Environmental an
Page 45 and 46: Project Stage / Environmental Compo
Page 53 and 54: CHAPTER 5 ENVIRONMENTAL AND SOCIAL
Page 55 and 56: 5.3 MONITORING INDICATORS Monitorin
Page 57 and 58: Mitigation Measures † Monitoring
Page 59 and 60:
6.4 CONDUCTING A LIMITED EIA OR FUL
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The Environmental Screening results
Page 63 and 64:
The proposed guidelines will detail
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Training operatives and project sta
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CHAPTER 8 CONCLUSION AND RECOMMENDA
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REFERENCES 1. Government of the Uni
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ANNEXES ANNEX 1: ENVIRONMENTAL AND
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No Description Yes No Not known PAR
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No Description Yes No Not known or
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Date: ………………………
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Use of construction timber for supp
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ANNEX 4: LIMITED ENVIROMENTAL ASSES
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ANNEX 5: ENVIRONMENTAL GUIDELINES F
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• Health and safety of workers sh
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including the indicators to be used
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OP/BP 4.36 Forests OP 4.09 Pest Man
Page 91 and 92:
OP/BP 4.10 Indigenous Peoples OP/BP
Page 93 and 94:
OP 7.60 Projects in Disputed Areas
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M. Mwasekaga, Senior Laboratory Pro
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The Policy identifies HIV and AIDS
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The National Health Laboratory Stra
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phenomenon that may affect the quan
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In each city, municipality, distric
Page 105 and 106:
land and not on restricted land res
Page 107 and 108:
Compensation under Section 156 of t
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