West Bank and Gaza Education and Health – World Bank project – Information paper

Project Name        West Bank and Gaza-Education and Health…
                         Rehabilitation Project (EHRP)

Region                        Middle East and North Africa

Sector                        Education / Health

Project ID                    LENP35996

Borrower                      Palestinian Economic Council for
                              Development and Reconstruction (PECDAR)

Implementing Agencies         Ministries of Education and Health  

Date PID Prepared             February 15, 1995
          
Projected Board Date          April 27, 1995

1.   Introduction:  Human resource development is a major factor in developing and sustaining economic growth.  Quality education and health care are essential for the development and maintenance of a stable social environment and the formation of a society that can look optimistically to the future.  The proposed project aims to assist the people of West Bank and Gaza (WBG) realize these objectives.

2.   Country and Sector Background:  With a combined area of about 6,000 square kilometers, the WBG has a population (1992) of about 2.2 million.  Following the Declaration  of Principles in September 1993 between the PLO and the Israeli Government, the Palestinian Authorities have assumed responsibility for the provision of education and health services, and have developed national plans for both sectors.  Economic and political dislocation, and the absence of appropriate and effective institutions have so far limited the effective implementation of these plans.  The economy of the WBG is under severe strain, with conditions in Gaza generally worse than in the West Bank.  Both the availability and quality of education and health services are threatened, and further work is needed to operationalize sectoral plans.  Deteriorating infrastructure, lack of quality control and fragmentation of service provision affect both sectors.

3.   Education services are provided by the Palestinian Authority (PA), UNWRA, and a small number of private operators.  School
buildings are poorly maintained, inadequate in number and lacking in equipment.  The educational system has two distinct curricula, the West Bank using the Jordanian curriculum and Gaza using the Egyptian curriculum.  Since the beginning of the Intifada there have been frequent school closings, an increase in dropout rates, a breakdown in discipline and a decline in student achievement.  The newly formed MOE does not as yet have the adequate capacity for monitoring standards and evaluating services.

4.   Health services provided through government, NGO, private and United Nations providers (UNRWA) are variable in geographic coverage and quality.  The health infrastructure is in need of repair and upgrading, and there are shortages of some personnel.  Considering the overall investment in the sector, services are generally poor.   Primary health facilities are inadequate; services are not coordinated; and there is no adequate referral system.  The recent unrest has left the population with unmet rehabilitation and mental health needs.  Health sector data collection, and training and institutional standards are uncoordinated.

5.   Past Experience in the Country/Sector:  The Bank is administering two activities in WBG: (a) the Holst Fund (HF)–US$112 million (to support recurrent expenditures); (b) the Technical Assistance Trust Fund (TATF)–US$ million; and (c) is providing funding for a third, the Emergency Rehabilitation Project (ERP-1)–US$118 million for the reconstruction of priority infrastructure in education, power, water and sanitation, and roads.  All three operations are being executed by PECDAR.

6.   Project Objectives: The main objective of the proposed project is to assist the Palestinian Authority meet urgent needs in the health and education sectors through: a) rehabilitation of the neglected physical infrastructure of the education and health sectors so that essential services can continue without interruption; and b) laying the groundwork for future development in the sectors and building up the capacities of the Ministry of Education (MOE) and Ministry of Health (MOH).  

7.   Project Description:  In education (estimated outlay–US$50 million), the preservation and improvement of physical infrastructure would be undertaken through the rehabilitation, construction, and equipping of classrooms, including maintenance.  Quality of service provision would be improved through the provision of instructional materials and workshops.  Institutional development of the MOE would include training for management skills, the development of an education information system and technical assistance to expand planning, monitoring and assessment capacity.

8.   In health (estimated outlay–US$50 million), the proposed components are based on the priorities, programs and projects
identified in the National Health Plan.  Physical infrastructure needs would be addressed through the rehabilitation, construction, maintenance and equipping of primary health care centers and major hospitals.  System delivery improvements would target the elimination of identified skill gaps through a program of in-service training for medical and allied personnel.  The institutional development of the MOH and primary health care system would be addressed through administration and management training and the provision of technical assistance to develop a health information system.  

9.   Project Financing:  The estimated total project costs of US$100 million equivalent (capital investments and incremental recurrent expenditures) would be financed through: (a) a Trust Fund credit on IDA terms of US$20 million; and (b) co-financing of about US$80 million.  Coordination with ongoing donor activities will be pursued, and the project will build upon preparatory work already initiated by UNESCO, UNRWA, UNICEF, and other agencies.  The project team is developing detailed design and cost breakdowns for each component to provide donors with sufficient information to assist in their decision-making.

10.  Project Implementation:  The project would be implemented over a three-year period, beginning in mid-1995 with PECDAR as the Borrower.  The MOE and MOH will implement their respective components.  Resources from the Holst Fund and the TATF will also be used to assist these agencies further develop their implementation capacity.  

11.  Project Sustainability:  Project benefits are regarded as sustainable for several reasons.  First, the society and the PA place a high priority on education, both intrinsically and as a "value added" dimension to labor productivity.  Within the education sector, the highest priority is accorded to primary education and to literacy.  Second, a financing plan will be developed to ensure that recurrent costs generated by the project (particularly the civil works component) will be sustainable.  Third, the investments under this project will provide continuity of existing services.  Fourth, efforts to improve the internal efficiency of both sectors will also contribute to project sustainability.

12.  Environmental Aspects:  The proposed project has been classified as Category B.  Most construction activities under the project will be on a small scale (rehabilitation of existing education and primary health care facilities).  However, for the larger works in selected hospitals, special attention would be given to the proper disposal of solid waste materials which will result from construction and the safe disposal of medical waste.  The project will provide training on these issues.

13.  Poverty Alleviation:  The project addresses this issue through: (a) targeting schools and health facilities in the most dilapidated condition (in general, these facilities are in the low-income areas); and (b) improving the quality of health and education services.  Rationalization of the health and education systems in the long term should provide more equitable access for the poor, as well as improved services.

14.  Project Benefits:  In education and health, the major benefits would derive from: (a) interventions to strengthen the institutional capacity of the MOE and the MOH; (b) the upgrading and maintenance of existing facilities that would result in the improved quality of service delivery; and (c) the provision of training and technical assistance to improve administrative and clinical skills.

Contact Point:      Public Information Center
                    The World Bank
                    1818 H Street N.W.
                    Washington D.C. 20433
                    Telephone No.: (202)458-5454
                    Fax No.: (202)522-1500

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Note:  This is information on an evolving project.  Certain components may not necessarily be included in the final project.