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Project Management & Accountability
A transparent, three-tier governance structure — from the MOH Steering Committee down to provincial implementing units — managing BAHP’s $24.95 million investment and delivering results for border and migrant communities across Champasak, Phongsali, and Savannakhet, 2024–2029.
Organisational Structure
Project Governance Ecosystem
BAHP is governed through three tiers, from strategic direction at the ministerial level down to on-the-ground execution in the three project provinces — a structure designed to keep the $24.95 million investment accountable to both the Lao PDR Government and ADB.
Tier 1 — MOH Steering Committee
Chaired by the Minister of Health. Provides strategic direction and resolves high-level constraints that fall outside the PMU’s authority. Includes the Ministry of Finance (MOF) and Ministry of Planning and Investment (MPI) as needed.
Chair: Minister of Health
Tier 2 — DPF & PMU
The Executing Agency. The Director General of the MOH Department of Planning and Finance (DPF) serves as Project Director. The embedded Project Management Unit (PMU) handles day-to-day procurement, disbursement, and ADB communication.
Executing Agency
Tier 3 — The PIUs
Four National Implementing Agencies (Cabinet, DHP, DHR, DPF) and three Provincial Health Offices (Champasak, Savannakhet, Phongsali) — the Project Implementing Units responsible for on-the-ground execution and reporting.
4 National IAs
3 PHOs
ADB Supervision Missions
ADB conducts biannual review missions. Findings are documented in Back-to-Office Reports and posted on ADB’s project page. A midterm review is scheduled at the project’s mid-point (2026–2027), with a project completion review following loan closing in 2029.
Accountability
The Responsibility Matrix
Who does what, across the project cycle — from planning and budgeting through to financial audit.
Level
Planning & Budgeting
Execution & Procurement
Monitoring & Reporting
Financials & Audit
ADB
—
—
Biannual review missions
—
MOH Steering Committee
Approve plans
—
—
Submit audited accounts within 6 months of FY end
DPF / PMU
Consolidate plans
Manage all procurement & safeguards
Synthesize & ensure DMF compliance
Manage advance accounts & withdrawal applications
PIUs (National & Provincial)
Prepare annual plans
Implement local activities
Submit monthly/quarterly reports
Manage subaccounts
Financial Architecture
$24.95 Million Total Investment
BAHP’s total investment breaks down by cost category, by output, and by funding source — combining ADB concessional financing with a Government in-kind contribution.
$20.20M
Base Cost
$4.17M
Contingencies
$0.58M
Financial Charges
$24.95M
Total Investment
Allocation by Output
Output 1 — Infrastructure
Upgraded health infrastructure: engineering design, construction of 5 hospitals, and medical equipment.
$15.77M
Output 2 — Migrant & Gender Care
Gender-responsive migrant care: SEZ health services, GBV clinical care, and community programs.
$2.30M
Output 3 — Digital EMR
Digital EMR and Unique Health Identifier rollout across 11 hospitals for continuity of care.
$2.13M
Funding Source
ADB OCR Loan
$20.00M — 80%
80% of ADB financing — Ordinary Capital Resources concessional loan.
ADB ADF Grant
$4.95M — 20%
20% of ADB financing — Asian Development Fund grant.
Government In-Kind Contribution
In addition to the $24.95M ADB-financed package, the Lao PDR Government contributes a separate $0.25M in-kind — covering counterpart staff time and facilities.
Strategic Funding Mechanisms
Loan vs. Grant — Two Different Jobs
The OCR Loan and the ADF Grant are structured to do fundamentally different work within BAHP.
$20M OCR Loan — “The Foundation”
Purpose: heavy capital expenditure and system building.
Civil works — 5 hospitals
Heavy medical equipment
Engineering design
Core consulting services
Terms: 32-year term, 8-year grace period.
$4.95M ADF Grant — “The Catalyst”
Purpose: targeted social impact and recurrent support.
SDG 5 Gender Agenda
Community-based activities
Health worker scholarships
Recurrent admin costs
Terms: Non-repayable Special Funds resources.
Disbursement Architecture
Funds Flow, Step by Step
Money moves from the national treasury down to the point of activity through a controlled chain of advance accounts and subaccounts, keeping Loan and Grant resources separately traceable throughout.
1
MOF / Central Bank
The Ministry of Finance and Central Bank split incoming ADB financing into two dedicated USD accounts.
2
Loan & Grant Advance Accounts (USD)
Separate advance accounts are maintained for the OCR Loan and the ADF Grant, each in US dollars.
3
MOH DPF / PMU Subaccounts
Both accounts flow into PMU-managed subaccounts, which make direct payments to major suppliers, consultants, and contractors.
4
PHO Subaccounts — Phongsali, Champasak, Savannakhet
Provincial Health Office subaccounts receive funds strictly from the Grant, for community and cross-border activities.
Block Grants — $60,000/Year per PIU
PIUs receive $60,000 per year in block grants for community and cross-border activities. Funds are disbursed once the MOH Technical Advisory Group approves an annual costed workplan.
Grant Funds Only, at Provincial Level
Provincial Health Office subaccounts in the 3 project provinces are funded strictly from the ADF Grant — capital-intensive Loan-funded works are contracted and paid centrally through DPF/PMU.
Execution & Readiness
The External Talent Landscape
A dedicated bench of individual consultants and specialist firms supports the PMU across engineering, safeguards, gender, finance, and digital health.
Individual PMU Consultants — International
Chief Technical Advisor
Procurement
Hospital Architect
Gender
Hospital Management
Individual PMU Consultants — National
Deputy CTA
Procurement
Civil Engineer
Environmental
Gender
Migrant Health
IT Coordinator
Strategic Consulting Firms
DDCS Firm
Detailed Design & Construction Supervision for the 5 hospitals under Output 1.
M&E Firm
Baseline/endline surveys and pilot evaluations across the project’s outputs.
Accounting Firm
5-year financial reporting, monitoring, and disbursement support to DPF/PMU.
Digital Health Firm
Software design and EMR/UHI rollout support across all 11 hospitals under Output 3.
Equipment Master Plan Firm
On-site assessments and 5-year costed equipment plans for the 5 hospitals.
From Readiness to Delivery
Launch Sprint & 5-Year Master Execution Timeline
BAHP moved from recruitment to ADB Board Approval to Loan Effectiveness in under a year — then into a structured, 3-track execution timeline running to 2029.
Project Readiness & Launch Sprint (2023–2024)
Q4 2023
Recruitment Kickoff
Recruitment initiated for the DDCS Consultant and key individual PMU consultants (Chief Technical Advisor, Procurement).
Q1 2024
ADB Board Approval
ADB’s Board of Directors approved BAHP financing in March 2024.
Q2 2024 — The Launch Window
Signing, Effectiveness & DDCS Approval
Advance procurement via RFQ for the Accounting Firm and PMU equipment; Loan Signing (May); Loan Effectiveness declared (May); ADB no-objection and Executing Agency approval for the DDCS firm (June).
5-Year Master Execution Timeline (2024–2029)
Output 1 — Infrastructure
Q2 2024 — Design 5 hospitals
Q3 2025 — Begin construction in Phongsali
Q4 2025 — Construction begins in Champasak & Savannakhet
Q3 2028 — Hospitals commence operations
Output 2 — Migrants & Gender
Q3 2024 — Form the MOH Technical Advisory Group
Q4 2024 — Assess female migrants in SEZs
Q3 2025 — Pilot the SEZ healthy workplace model
2025 → project end — Ongoing community block grants
Output 3 — Digital EMR
Q4 2024 — Develop EMR/UHI software
Q1 2026 — Install equipment in provincial hospitals
Q2 2026 — Roll out EMR in 8 district hospitals
Financial Management
Risk & Mitigation
A frank baseline assessment, matched with a concrete mitigation protocol agreed at design.
Baseline Assessment
Substantial Risk (Pre-Mitigation)
Limited staffing capacity, and weaknesses in budgeting, internal audit, and financial information systems at local levels.
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Mitigation Protocol
3 Measures
Outsourced expertise: an independent Accounting Services Firm engaged within 3 months of effectiveness.
Standardization: a unified Project Financial Management Manual prepared and rolled out before effectiveness.
Capacity building: mandatory PM/financial training for all PIUs in the first 2 years, plus regular PMU field supervision.
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Procurement
Procurement Plan — At a Glance
All procurement follows ADB’s Procurement Policy (2017). The Project Procurement Classification is Category B. A rolling 18-month procurement plan is maintained and updated after each ADB review mission, covering civil works for the 5 hospitals plus the individual consultants and strategic firms of the External Talent Landscape.
Package
Description
Method
Funding Source
Status
CW-01 to CW-05
Civil works — construction of 5 hospitals (Phongsali, Champasak, Savannakhet)
NCB
Output 1 ($15.77M)
Under Execution
GS-01
Heavy medical equipment package
ICB
Output 1 ($15.77M)
Partially Delivered
GS-02
EMR/UHI hardware & IT networking
ICB
Output 3 ($2.13M)
Contracted
CS-01
DDCS Firm — detailed design & construction supervision
QCBS
Output 1 ($15.77M)
Contracted
CS-02
Digital Health Firm — EMR/UHI software & rollout (11 hospitals)
QCBS
Output 3 ($2.13M)
Contracted
CS-03
Accounting Services Firm — 5-year FM support
QCBS
Cross-cutting
Contracted
CS-04
M&E Firm — baseline/endline surveys & pilot evaluations
QCBS
Cross-cutting
Under Execution
CS-05
Equipment Master Plan Firm — 5-year costed equipment plans
QCBS
Output 1 ($15.77M)
Contracted
NCB = National Competitive Bidding. ICB = International Competitive Bidding. QCBS = Quality- and Cost-Based Selection. Status as at 30 June 2026.
Monitoring & Evaluation
Measuring What Matters
BAHP’s M&E framework tracks indicators across the Design and Monitoring Framework (DMF), reported monthly and quarterly by the PIUs and annually to ADB. An independent midterm and project completion evaluation ensures results are independently verified.
1
Monthly PIU Reports
Each of the 4 National Implementing Agencies and 3 Provincial Health Offices submits standardised monthly progress reports covering physical works, training, equipment delivery, and safeguard compliance, via the PMU online portal.
2
Quarterly PHO Aggregation
PHO M&E officers in Champasak, Savannakhet, and Phongsali compile provincial data, verified against eHMIS/EMR data. Variance explanations are required for any indicator 10%+ off target.
3
Semi-Annual PMU Progress Report
DPF/PMU synthesizes the semi-annual project progress report covering all DMF indicators, financial disbursements, procurement status, and safeguard compliance — submitted to ADB alongside its biannual review missions, and published here.
4
Independent Evaluation
ADB-commissioned midterm review (2026–2027) and project completion report (2029) provide independent assessment of BAHP’s impact against the DMF impact statement.
Key Performance Indicators — Q2 2026
Loan & Grant Disbursement
68%
~$17.0M of $24.95M disbursed
Physical Progress (5 Hospitals)
67%
Against 2026 annual target of 70%
Equipment & EMR Rollout
82%
Medical equipment & EMR/UHI hardware procurement across the 11 EMR hospitals
Training Target Achievement
61%
2,400 of 3,900 target trained
Safeguard Compliance
100%
No non-compliance incidents reported
Appendix
Key Personnel & Operational Directory
The named leads accountable for BAHP across the Executing Agency, ADB’s core team, and ADB’s specialized oversight functions.
MOH Executing Agency
Dr. Bounserth Keoprasith
Director General, Department of Planning and Finance (DPF) / Project Director
MOH
Dr. Chansaly Phommavong
Deputy Director, Department of Planning and Finance (DPF)
MOH
ADB Core Team — Sectors Group (Human and Social Development)
Karin Schelzig
Director, Sectors Group — Human and Social Development
ADB
Rikard Elfving
Principal Social Sector Specialist / Mission Leader
ADB
Specialized Oversight Contacts
Philipp Kalpaxis
Senior Procurement Specialist
Procurement
Myra Evelyn Ravelo
Financial Management Specialist
Financial Management
Veronica Mendizabal Joffre
Senior Gender Specialist
Gender
Antoine Morel
Principal Environment Specialist
Safeguards