Project Name

Project Name
Project ID
Implementing Agency
Environment Category
Date PID Prepared
Date of Appraisal
Date of Board Approval
Report No.: AB5869
Additional Financing for the 2nd Health System Modernization
Project (APL2) in Support of the 2nd Phase of the Health Sector
Health (86%);Central government administration (11%);Tertiary
education (3%)
Ministry of Health
[ ] A [X] B [ ] C [ ] FI [ ] TBD (to be determined)
July 6, 2010
September 17, 2010
December 21, 2010
1. Country and Sector Background
The economic framework has had strong fundamentals. Until 2009, growth averaged over
10% per annum, and fiscal deficits and public debt were modest. 2009 has been a difficult
year for Armenia, including a fall in GDP estimated at about 15%. The country has
experienced its most severe economic crisis since the early years of transition, with a
dramatic contraction in economic growth and an increase in poverty that threatens to reverse
the earlier gains in living standards. Consequently, poverty and unemployment are expected
to rise. At the same time, the basic economic and financial sector framework remains sound,
and growth is expected to return to positive territory in 2010.
2. Objectives
The objective of the Project is to strengthen the Ministry of Health’s (MoH) capacity for more
effective system governance, scaling up family medicine-based primary health care and
upgrading selected healthcare service delivery networks in Administrative unit in Armenia
(marzes) to provide more accessible, quality and sustainable health care services to the
3. Rationale for Bank Involvement
The Government of Armenia has requested the Bank to provide additional financing (AF) to
scale up the activities initiated by the ongoing project. The AF, which has the strong support of
the Government of Armenia (GoA), is a better mechanism to maximize development impact and
results than a repeater project, a completely new operation, or non-lending instruments.
4. Description
Component A: Family Medicine Development. This component will continue supporting the
strengthening of institutional capacity to train well-qualified family physicians and nurses as first
line PHC providers and improve their physical and material working environment.
Component B:
Hospital Network Optimization. This component will support the
implementation of the optimization plans in the remaining eight marzes by upgrading the
facilities and refurbishing them with modern the medical and waste management equipment.
Component C: Institutional Strengthening. This component will help to strengthen the capacity
of the Ministry of Health, its allied agencies and the State Medical University to better plan,
monitor and evaluate for effective system governance and improve the skills base of the health
Component D: Project Management. The objective of this component is to provide institutional
support to the MOH and Project Unit related to the operations, audits, project monitoring and
5. Financing
International Bank for Reconstruction and Development
6. Implementation
Project design and implementation arrangements will remain the same, including the same
financial management and procurement arrangements. The AF will be implemented by the
Ministry of Health supported by the Health Project Implementation Unit, which has extensive
capacity to fulfill Bank’s requirements.
7. Sustainability
The AF will continue to support Government’s health reform agenda as it moves towards the
second generation of health sector reforms.
8. Lessons Learned from Past Operations in the Country/Sector
The AF will continue to build on the positive results from Phases 1 and 2 of the Adaptable
Program Lending (APL) series.
9. Safeguard Policies (including public consultation)
Adequate attention has been paid to date to safeguards requirements under the APL series,
including appropriate site-specific Environmental Management Plans (EMPs) and the
preparation of a draft Health Care Waste Management Plan under APL1 and APL2. Works have
been carried out on existing hospital sites; safeguard checklists duly filled; and mitigation
measures, as stated in EMP, have been followed. The proposed scale-up activities will not trigger
any safeguard policy not triggered by the original Project. The AF will support civil works of the
same nature and magnitude as the original Project and the environmental procedures outlined in
the existing Framework Environmental Management Plan (EMP) will remain applicable.
10. List of Factual Technical Documents
Project Appraisal Document for the Health System Modernization Project (APL2) –
Report No. 38149-AM dated February 7, 2007;
Environmental Management Plan, Disclosed July 15, 2010;
Country Partnership Strategy (CPS, 2009-2012).
11. Contact point
Contact: Susanna Hayrapetyan
Title: Sr Health Spec.
Tel: 5251+250
Fax: (202) 477-0574
Email: [email protected]
Location: Yerevan, Armenia (IBRD)
12. For more information contact:
The InfoShop
The World Bank
1818 H Street, NW
Washington, D.C. 20433
Telephone: (202) 458-4500
Fax: (202) 522-1500
Email: [email protected]