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Annual Operations Plan · DMF Indicators · ADB Overall Rating · Last updated: 30 June 2026
OVERALL ADB PROJECT RATING
● On Track
Key Performance Indicators — Q2 2026
Loan & Grant Disbursement
38%
$9.5M / $24.95M
Hospitals in Construction
3
of 5 — all 5 designed; operations targeted Q3 2028
Health Workers Trained
540
of 900 — 60%
EMR/UHI-Ready Hospitals
6
of 11 — 2026 target: 8 district hospitals
Institutional Delivery Rate
64%
Baseline 49% — Target 80%
Safeguard Compliance
100%
0 non-compliance incidents
Annual Operations Plan
AOP 2026 — Mid-Year Status
ADB-style traffic light ratings for key 2026 Annual Operations Plan activities. Rating as at 30 June 2026.
AOP Activity
Output
2026 Target
Achieved (Jun 26)
ADB Rating
Notes
Civil works — begin construction at 5 hospital sites
1.1
5
3
Some Delay
Wet season delays at the Phongsali hospital site
Equipment delivery — all 5 batches
1.2
5 batches
3.75 batches
On Track
Batch 4 final delivery Aug 2026
FDD approvals — all 5 hospital designs
1.3
5
5
Complete
100% achieved ahead of schedule
PHD capacity building sessions
2
36
30
On Track
12 sessions planned for Q3, across 3 PHOs
Health workers trained
2
400
280
Some Delay
Training accelerated in Q3–Q4
EMR/UHI rollout — district hospitals
3
8
6
Some Delay
Connectivity issues at remote Phongsali district hospitals
EMR/UHI equipment installation (provincial hospitals)
3
100%
75%
Some Delay
Completion target moved to Oct 2026
Safeguard compliance (no incidents)
All
0 incidents
0 incidents
On Track
All EMP monitoring reports submitted
Design & Monitoring Framework
DMF Indicators — Outcome & Impact Level
BAHP’s DMF tracks 24 indicators across impact, outcome, and output levels. The table below shows the 10 headline indicators tracked at the ADB level.
DMF Indicator
Level
Baseline (2024)
2029 Target
Current (2026)
Status
Maternal mortality ratio (per 100,000 live births) in 3 provinces
Impact
284
200
238
On Track
Under-5 mortality rate (per 1,000 live births) in project areas
Impact
56
42
49
On Track
% institutional delivery rate in 3 provinces
Outcome
49%
80%
64%
On Track
% fully immunised children under 1 year in project areas
Outcome
62%
90%
71%
Some Delay
% TB case detection rate in 3 provinces
Outcome
64%
85%
78%
On Track
Hospitals meeting national service standards (completed & operational)
Output
0
5
0
On Track
Health workers trained to national competency standards
Output
0
900
540
On Track
Hospitals connected to EMR/UHI system
Output
0
11
6
Some Delay
% women among trained health workers
Output
38%
50%
58%
Exceeded
GRM grievances resolved within 30 days
Output
—
100%
94%
On Track
Current Challenges
Obstacles & How We’re Addressing Them
Transparent reporting on the challenges that are causing some delays, and the mitigation actions underway.
Challenge 1
Wet Season Construction Delays — Phongsali
Heavy monsoon rains in 2025 caused 6–10 week delays in foundation works at the Phongsali hospital site. Access roads to this remote upland site were impassable for extended periods.
Mitigation:
Revised construction schedules incorporate weather buffers. Pre-positioned materials on site before monsoon onset. Extended working hours (with community consent) post-monsoon to recover schedule. Project completion not at risk.
Challenge 2
Last-Mile Connectivity for EMR/UHI Rollout
Several remote district hospitals in Phongsali lack reliable 3G/4G coverage, preventing full EMR/UHI deployment across all 8 target district hospitals. Satellite connectivity solutions require additional budget and procurement time.
Mitigation:
VSAT (satellite internet) procurement underway — expected installation Q4 2026. Offline-capable EMR modules deployed as interim solution. ADB approved budget reallocation for satellite costs in April 2026.
Challenge 3
Health Worker Retention in Border Provinces
After training, 14% of trained health workers in border provinces transferred to urban centres within 12 months — reducing the impact of Output 2 capacity building investments.
Mitigation:
MOH introducing 2-year mandatory service commitments for BAHP-funded training recipients. PHDs developing retention packages — housing allowances and career pathways for border-area service. Policy advocacy to MOH underway.
Positive Deviation
Gender Target Exceeded — 58% Women Trained
BAHP’s gender parity target of 50% female training participants has been consistently exceeded — currently at 58%. The GAP scholarship programme has proven highly effective in recruiting women from ethnic minority communities into health worker roles.
Action:
Best practices from the scholarship programme being documented for scaling to other ADB health projects in the GMS region. ADB’s gender team conducting a case study visit in Q3 2026.