West Bank and Gaza Education and Health rehabilitation project – World Bank project document

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.