Announcement of the Dominican Republic Receives Five Million Dollars Loan for Population and Family Health Project on September 16, 1976

• VVOrld Bank 1818 H Street, N.W., Washington, D.C. 20433, U.S.A. • Telephone: (202) 393-6360 Bank News Re lease No. 77 / 18 Sept e mb e r 16 , 19 76 THE DOMINICAN REPUBLIC RECEIVES $5 MILLION LOAN FOR POPULATION AND FAMILY HEALTH PROJECT The World Bank today announced the approval of a $5 million loan for a population and family health project in the Dominican Republic. The project, which wil 1 have a total cost of $7.5 mil lion, is designed to assist the Government implement a shift of emphasis from curative to preventive health services, aimed at increasing coverage and reducing fertility rates while enhancing the health of the pop- ulation, particularly of mothers and children in rural areas. Because of the constraints imposed by the acute shortage of trained personnel, improve- ment in clinical facilities and services wi 11 be concentrated initially in two of the six Health Regions of the country (Region I and V), which are currently the most deficient in adequate health services. Similar improvements wi 11 be extended to other Regions at a later stage as trained health personnel become available. ~ The project wi 11 help finance the construction and equipping of 26 rural health clinics in Regions I and V and one health sub-center in Region V, in locations strategically selected to provide services to the rural and semirural population which now have only minimal access to health and family planning servicese In addition, radio communication equipment and ve- hicles wi 11 be financed to ensure rapid referral of emergency cases from the rural clinics to major hospitals. Since the implementation of the extension of health services wi 11 take at least three years, the project will help finance a program for community-based distribution of contraceptives (CBD) in localities lacking health services. As these become avai lable 1 the CBD program wi 11 move to other localities without services. In order to prepare for an extension of family planning and preventive health services throughout the heal th care system, the project wi 11 help increase the number and quality of nursing personne1 nationwide through training and technical assistance programs benefiting the Secretariat of State of Public Health and Social Assistance (SESPAS), the National Council for Family Planning (CONAPOFA), the universities and nursing schools. The project includes fellowships for auxiliary, technical and graduate nurses, and for planning and programming staff of SESPAS/CONAPOFA; and teaching materials and vehicles for nursing schools~ The technical assistance financed under the project includes advisory services to universities, CONAPOFA and to SESPAS on health services delivery, information systems and statistics; on design, management and operation of re-oriented community health care and family planning services; on research on family planning programs; for curriculum reform so that community health care and family planning are adequately covered at the university level; and for project preparation and implementationc • I ... NOTE: Money figures are expressed in US dollar equivalents  - 2 The project is part of a national family planning effort aimed at reducing the total ferti 1 i ty rates from 7.1 in 1970 to 3.4 in the year • 2,000 so that total population will be 8~8 mil lion by that year, instead of 12.3 million which would result if fertility remained constant. The project will also assist in bringing about improvements in the delivery of health services by improving the quality and increasing the number of health personnel. It is estimated that in Regions I and V the project wi 11 make it possible to provide effective health and family planning services to about 800,000 people by 1981, compared with 115,000 that could be expected without the project. Institutional improvements in health services, initially concentrated in those Regions wi 11 serve as a useful model to extend such benefits to other rural areas at a later stage. The loan made to the Dominican Republic is on standard Third Window terms of 25 years, including 7 years of grace, with interest at 4.9 percent per annum. An additional 4 perce.,~ •,till be paid to the Bank by the Interest Subsidy Fund, representing the difference between the Bank's standard rate and the charge to the Bo r row e r o • - 0 - •  FORM NO. 112·1 {ti-16) T ECHN I CA L DAT A ·* . .. ~ . PROJECT: Population and Family Health • COUNTRY: Dominican Republic TOTAL COST: $7. 5 rn i l l ion BANK FINANCING: $5 million, 25 years, including 7 years of grc3ce, with interest at 4.9 percent per annun (Thi rd Window Terms). OTHER FINANCING: Government of the Dominican Republic. IMPLEMENTING ORGANIZATION: Project Implementation Unit, Secretariat of State of Public Health and Social Assistance (Secretaria de Estado de Salud Publica y Asistencia Social. Avenida San Cristobal Esquina Tiradentes Santo Domingo, D.N., Dominican Republic. PROJECT DESCRIPTION: Shift of emphasis from curative to preventive health services, including family planning, in Regions I and V and preparation for future extension to the other Health Regions. In these two regions, construction and equipment of 26 rural health clinics and one health sub-center; provision of special equipment, vehicles, training activities, fellowships and travel .Jllo1;,1ances. Establishrr.ent of a strong program of family planning, training and motivation in the v1hole country through provision of special equipment, vehicle and travel allrnvances for six family planning training coordinators and support staff, financing of operating costs for field worker training and for conferences and seminars and operating costs for a program of community-based distribution of contraceptives in rural areas not yet covered with health services. Expenses for project preparation and administration and external auditing services. Technical assistance for health service delivery, health administration, information systems and statistics, research, maintenance training program, physical facilities evaluation, procurement, and curricula modification. Provision of equipment, vehicles and fellowships to nursing schools to alleviate nursing perennial shortages. PROCUREMENT: Contracts for civil works of $200,000 or mor0 and for $80,000 or more for furniture and equipment, special equipment, and vehicles will be awarded under international competitive bidding. Contracts for less than these amounts and up to an aggregate of $400,000 for civil works and $200,000 for furniture and equipment, special equipment and vehicles, will be awarded on the basis of competitive bidding advertised locally and in accordance with the Borrowers' normal procedures. Domestic manufacturers of furniture and equipment wi 11 be al lrn-,ecl a preferential margin of 15 percent of the CIF cost of competing imports or the current applicable import duty, whichever is lower. CONSULTANTS: The implementing organization wi 11 require sixty- eight man-months of senior and 24 man-months of a associate advisory services for health services administration, comprehensive community .1-iealth research, curricula modification, program evaluation and facility maintenance. ESTIMATED COMPLETION DATE: 1980 - 0 -