PESH AWAR: World Bank has asked health department to ensure that all female patients are accompanied by female staff or a family member during medical examination as a standard operating procedure for all healthcare facilities.

World Bank has written a letter to health secretary regarding compliance of environmental and social safeguard and gender policies in the health facilities contracted under Khyber Pakhtunkhwa Human Capital Investment Project (KPHCIP) in four selected districts.

The project, approved in 2020 with a grant of $85 million, is meant to improve availability, utilisation and quality of primary healthcare services, carry out minor works and provide technical assistance, essential equipment and supplies to support delivery of primary health services through training, online refresher courses and development of distant learning system at basic health units and rural health centres.

The letter said that an assessment of the project was being rolled out and its team would like to request that the department issue interim guidelines to health facilities that women patients were attended by female staff or women patients should be allowed tobe accompanied by male member of their families.

It said that KPHCIP continued to face significant implementation challenges as the progress towards achievement of its development objective remained moderately unsatisfactory. The project`s ratings for implementation progress, financial management, procurement and project management have been downgraded and also currently have a moderately unsatisfactory rating for environmental and social safeguards.

The letter said that restructuring of the project was completed in March 28 last year, but its overall implementation progress continued to significantly lag behind the expected timelines.

It said that the two project management units (PMUs) on health and education were working tirelessly with the World Bank team to address key challenges, change the pace of the project and ensure that its activities were implemented before its closure by June 30, 2025.

Taking into account the moderately unsatisfactory ratings for the project`s environmental and social performance and with the aim to support the project to improve its performance on environmental and social framework (ESF), the WB team will be undertaking an assessment of three randomly selected health facilities that have been contracted out by health department.

The assessment is meant to determine to what extent ESF requirements on occupational health and safety are adhered to in line with the policy documents by private providers hired under the project. As a next step, during the next two months, WB consultants will be conducting a rapid assessment of three randomly selected facilities and will beproviding a report after triangulation of data.

`We will share the list of the three facilities and the names of consultants soon. In this regard we would request you to issue a letter to the team to ensure that there is no impediment for this exercise and the team is facilitated in carrying out this exercise. It would be useful if you can nominate a focal person from your office to coordinate with the Bank team,` said the letter.

It said it would be important to better understand the situation on risk management in the overall health sector and in particular to ensure prevention measures were adhered to. `As next steps we would like to extend this exercise to the rest of the health facilities to ensure that guidelines, policies and SOPs related to environmental and social management and gender are adhered to from an occupational health and safety perspective,` it added.

The letter said that it could include SOPs on how medical staff engaged with patients, provision of clear information to people, primarily female patients of their right to be accompanied by a female nurse or staff member or family member during examinations and giving them information on how to lodgecomplaints, etc.

The newlyposted health secr e t a r y , Shahidullah Khan, told Dawn that he hadn`t assumed charge of his office and couldn`t comment on the letter.