Nepal COVID-19 Emergency Response and Health Systems Preparedness (CERHSP) | 2021 MOHP

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The Nepal COVID-19 Emergency Response and Health Systems Preparedness (CERHSP) Project (P173760) aims at strengthening the country’s health systems and improving its overall epidemiological capacity to undertake surveillance and response to COVID-19 and other infectious diseases. The Project Development Objective (PDO) of the parent project and the AF is to prevent, detect, and respond to the threat posed by COVID-19 and to strengthen national systems for public health preparedness in Nepal. The PDO will be
achieved by:

1. supporting emergency COVID-19 response for better case detection, confirmation, contact tracing, recording and reporting and strengthening the capacity of critical hospital and laboratory infrastructure in response to COVID-19 and other public health emergencies;
2. supporting risk communication and community engagement;
3. implementation management and monitoring and evaluation; and
4. enabling the government, following an eligible crisis or event, to re-allocate project funds to support additional emergency response through Contingency Emergency Response Component (CERC)

The AF proposes to scale up these activities, support new investments to bring immunization
systems and service delivery capacity to the level required to successfully deliver COVID-19 vaccines, and
to provide funds for the purchase, delivery, and distribution of the vaccines. The implementation of the project activities presents notable environmental and social risks and impacts (see section 5) for which mitigation measures are required as per the relevant World Bank ESSs.

Project Plan

The project comprises four components.

Component 1: Emergency COVID-19 Response dedicated towards
enhancing the capacity of the MoHP and its implementing bodies with technical and material assistance
for case detection, confirmation, contact-tracing, recording and reporting (sub-component 1.1), and for
health systems strengthening at all levels of the federation such that at least 135 new/rehabilitated ICU
beds would be established in public health facilities with personal protective equipment (PPEs) to manage
the case load (sub-component 1.2);

Component 2: Community Engagement and Risk Communication to
ensure the Nepali population is empowered with timely and relevant information to prevent and manage
COVID-19 infections as well as to promote health during the pandemic;

Component 3: Implementation
Management and Monitoring and Evaluation to strengthen the MoHP and its coordinating structure and
implementation divisions for exercising requisite technical, fiduciary as well as environmental and social
due-diligence in the COVID-19 health sector response and knowledge management and learning. Under
this component, environmental and social specialists will be hired to augment existing capacity of the
ministry to manage the environmental and social aspect of the operation, track and report on the
Environmental and Social Commitments of the project to the World Bank;

Component 4: Contingency Emergency Response Component (CERC) to finance response, in the face of an eligible emergency or crisis, if required.

The activities under the various components are targeted at the Nepal federation and implemented proportionally at the federal, provincial and local levels based on epidemiological needs of the country. In all, about 194 hospitals (including the Patan, Bir and Sukraraj hospitals) with over 1146 ICU beds are designated for COVID-19 case management facilities. With funds and technical support from the
parent project, the MoHP enhanced Case Investigation and Contact Tracing (CICT) systems at the national
and provincial levels; strengthened over 47 acute care health facilities with isolation capacity; increased
the national COVID-19 testing capacity from one public laboratory (national public health laboratory) to
82 laboratories across the country; and financed over 40 new/rehabilitated ICU beds and facilities in
selected public hospitals for managing public health emergences. Official statistics indicate that Nepal
carried out 2,165,985 RT-PCR tests as of March 1, 2021, 274,216 of them testing positive for the disease.
About 98.6% (270,471) patients have been treated and discharged whilst 968 remain under isolation and
treatment. Risk communication messages are being delivered to the public through multiple channels
including media briefings, radio, televisions, mobile and online applications, and posters at locations in
cities and villages across the country. In addition, two call centers have been established to share reliable
information about COVID-19 with citizens and to handle complaints made through the call centers.

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