Evaluation finale du projet UPOPS

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Evaluation Plan:
2015-2020, Madagascar
Evaluation Type:
Final Project
Planned End Date:
12/2019
Completion Date:
01/2020
Status:
Completed
Management Response:
Yes
Evaluation Budget(US $):
40,000

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Title Evaluation finale du projet UPOPS
Atlas Project Number: 00092732
Evaluation Plan: 2015-2020, Madagascar
Evaluation Type: Final Project
Status: Completed
Completion Date: 01/2020
Planned End Date: 12/2019
Management Response: Yes
UNDP Signature Solution:
  • 1. Poverty
Corporate Outcome and Output (UNDP Strategic Plan 2018-2021)
  • 1. Output 1.1.2 Marginalised groups, particularly the poor, women, people with disabilities and displaced are empowered to gain universal access to basic services and financial and non-financial assets to build productive capacities and benefit from sustainable livelihoods and jobs
SDG Goal
  • Goal 12. Ensure sustainable consumption and production patterns
SDG Target
  • 12.4 By 2020, achieve the environmentally sound management of chemicals and all wastes throughout their life cycle, in accordance with agreed international frameworks, and significantly reduce their release to air, water and soil in order to minimize their adverse impacts on human health and the environment
Evaluation Budget(US $): 40,000
Source of Funding: GEF
Evaluation Expenditure(US $): 30,000
Joint Programme: No
Joint Evaluation: No
Evaluation Team members:
Name Title Email Nationality
Peder Bisbjerg Consultant international pedergregersbisbjerg@hotmail.com
GEF Evaluation: Yes
GEF Project Title: Reducing UPOPs and Mercury Releases from the Health Sector in Africa
Evaluation Type: Terminal Evaluation
Focal Area: Persistent Organic Pollutants
Project Type: FSP
GEF Phase: GEF-5
GEF Project ID: 4611
PIMS Number: 4865
Key Stakeholders: Ministry of environment, ministry of health
Countries: MADAGASCAR
Lessons
Findings
Recommendations
1

Before the completion of the project, the four project teams should engage in intensive consultations with relevant local authorities (such as district/regional environmental authorities, public health offices and district/local councils). In particular, they should arrange visits of the autoclave treatment facilities by the local authorities and share with them reports and other information on testing of performance of the HCW sterilization.

2

Before the completion of the project, the UNDP COs in the four countries in cooperation with the national PIUs should establish institutional mechanisms for a post-project monitoring of performance of the autoclaves and periodic collection of information about amounts of HCW treated.

3

As part of the post-project monitoring, the four countries should evaluate merits of the post-treatment on final disposal of autoclaved HCW and gather experience from operation and maintenance of the shredding and compacting devices. The lessons learned should be disseminated through relevant UNDP outreach channels

4

Relevant health authorities in the project countries should collect and disseminate experience from working cluster HCW treatment systems including formulas for calculation of tariffs for transportation of HCW and treatment at the autoclave cluster treatment centres

5

In order to ensure continued after-warranty repair service of the installed autoclaves, the national health authorities and the project model HCFs in the four countries should establish national autoclave maintenance teams and/or contracting local external repair service companies. UNDP COs should be of assistance for identification of reliable local suppliers of necessary spare parts for the autoclaves

6

Relevant health authorities in the four countries should establish procedures for sound post-project management of the central storage of mercury HCW and cooperate with holders of mercury waste in other sectors in order to identify final disposal option in line with provisions of the Minamata Convention

7

Relevant health authorities in the four countries should assist national health training institutions to secure financing for continuation of training and re-training courses with HCWM modules for health workers

1. Recommendation:

Before the completion of the project, the four project teams should engage in intensive consultations with relevant local authorities (such as district/regional environmental authorities, public health offices and district/local councils). In particular, they should arrange visits of the autoclave treatment facilities by the local authorities and share with them reports and other information on testing of performance of the HCW sterilization.

Management Response: [Added: 2020/03/03]

The management accepts the recommendation : Following the recent change in government (MOH and MOE) and municipalities (Antananarivo, Manjakandriana, Toamasina), the project will organize an on-site visit of the autoclaves at CHU JRA, CHU JRB and CHRD Manjakandriana and will include also journalists for the communication of the project results. The municipality of Toamasina will be involved in the commissioning of the new autoclave at CHU Analakininina to facilitate the final disposal of the treated wastes. The factsheets and booklets informing on the non-incineration treatment of wastes and the main results of the project will be shared to the local authorities and journalists

Key Actions:

Key Action Responsible DueDate Status Comments Documents
Organize on-site visits in Antananarivo and Toamasina
[Added: 2020/03/03]
Technical and Communication consultant 2020/04 Not Initiated
Involvement of Toamasina municipality in the commissioning of new autoclave at CHU Toamasina
[Added: 2020/03/03]
Project, CHU Analakininina, CHU Morafeno, DRSP Atsinanana 2020/04 Initiated History
2. Recommendation:

Before the completion of the project, the UNDP COs in the four countries in cooperation with the national PIUs should establish institutional mechanisms for a post-project monitoring of performance of the autoclaves and periodic collection of information about amounts of HCW treated.

Management Response: [Added: 2020/03/03]

The management accepts the recmmendation : health and environment department of MOH (Service Santé Environnement) is monitoring the operation of the autoclaves since end of 2018 to follow up the environmental commitment program for their environmental authorization and will be asked to continuously receive the data of HCW treated sent in quarterly basis by each model hospital

Key Actions:

Key Action Responsible DueDate Status Comments Documents
Share with MOH SSENV the template for the data collection and analyses for autoclave operation
[Added: 2020/03/03]
Staff project 2020/04 Not Initiated
3. Recommendation:

As part of the post-project monitoring, the four countries should evaluate merits of the post-treatment on final disposal of autoclaved HCW and gather experience from operation and maintenance of the shredding and compacting devices. The lessons learned should be disseminated through relevant UNDP outreach channels

Management Response: [Added: 2020/03/03]

The management accepts the recommendation : The focal points of the model hospitals will share to the UNDP and the national directors of the project at MOH and MOE a report on the shredder operation and utility for the final disposal of HCW after 3 months of use at the hospitals.

Key Actions:

Key Action Responsible DueDate Status Comments Documents
Provide a template of the report on shredders operation and utility to the focal points of the hospitals (CHU JRA, CHU JRB, CHRD Manjakandriana, CHU Analakininina, CHU Morafeno)
[Added: 2020/03/03]
Technical consultant 2020/04 Not Initiated
4. Recommendation:

Relevant health authorities in the project countries should collect and disseminate experience from working cluster HCW treatment systems including formulas for calculation of tariffs for transportation of HCW and treatment at the autoclave cluster treatment centres

Management Response: [Added: 2020/03/03]

The management accepts the recommendation : The CHU JRA Ampefiloha having the autoclave of 1300L is updating a standard tariff for treatment and transportation of wastes (CHU JRA is transporting and treating in the autoclave the HCW of CHU MET Tsaralàlana another model hospital in Antananarivo twice a week). The CHU JRB Befelatanana, CHRD Manjakandriana and CHU Analakininina will duplicate and adapt this formula to determine the standard tariff for transportation and treatment of HCW in autoclave. Indeed, each model hospital with non-incineration treatment of HCW was equipped with autoclave and minivan.

Key Actions:

Key Action Responsible DueDate Status Comments Documents
Share the updated standard tariff for treatment and transportation of wastes of CHU JRA to CHU JRB, CHRD Manjakandriana and CHU Analakininina
[Added: 2020/03/03]
Technical consultant 2020/04 Initiated History
5. Recommendation:

In order to ensure continued after-warranty repair service of the installed autoclaves, the national health authorities and the project model HCFs in the four countries should establish national autoclave maintenance teams and/or contracting local external repair service companies. UNDP COs should be of assistance for identification of reliable local suppliers of necessary spare parts for the autoclaves

Management Response: [Added: 2020/03/03] [Last Updated: 2020/03/03]

The management accepts the recommendation : A network between the pool of local experts in the autoclave for HCW composed of technicians of MOH (SEM equipment maintenance department, SSENV health and environment department, engineers of CHU JRA, CHU JRB and CHU Analakininina) has been set up at this end of project. The videos on maintenance preventive and corrective prepared by Madagascar are available to provide support to the pool of local experts in autoclave. The local agent representating Mediclave/TTM, Medical International is also available in Antananarivo and Toamasina but the model hospitals has to pay the cost of their interventions beyond the warranty time of the autoclaves (exceeded for the 3 autoclaves of the 1st phase) and can facilitate the replacement of the spare parts donated by the project (for 10 years).    

Key Actions:

Key Action Responsible DueDate Status Comments Documents
Revision of the standard tariff for non incineration treatment and transportation of wastes ongoing at CHU JRA
[Added: 2020/03/03]
Staff project, MOH 2020/04 Not Initiated
6. Recommendation:

Relevant health authorities in the four countries should establish procedures for sound post-project management of the central storage of mercury HCW and cooperate with holders of mercury waste in other sectors in order to identify final disposal option in line with provisions of the Minamata Convention

Management Response: [Added: 2020/03/03]

the management accepts the recommendation : The project will prepare the formal documentation for the transportation of mercury wastes for final disposal outside the country in close collaboration with Minamata Convention. A discussion on the exportation of mercury wastes for final disposal is ongoing and should be continued by the Minamata Convention focal point (national director at MOE) with the focal points at CHU JRA (temporary storage) beyond the closure of the project. UNDP IRH and CO are asked to provide support to Minamata Convention in the exportation and final disposal of mercury wastes from Madagascar

Key Actions:

Key Action Responsible DueDate Status Comments Documents
Prepare the formal documentation and liaise with potential company Remondis Blackforest for the final disposal
[Added: 2020/03/03]
Staff project 2020/04 Initiated
7. Recommendation:

Relevant health authorities in the four countries should assist national health training institutions to secure financing for continuation of training and re-training courses with HCWM modules for health workers

Management Response: [Added: 2020/03/03]

The management accepts the recommendation : The national curricula for in service training in best environmental practices on HCWM with the training materials will be donated to each model hospital and SSENV MOH to permit a continuous refresher training and first training for new staff. The national trainers on HCWM come from model hospitals and specific division of MOH including SSENV MOH and will facilitate the continuation of the training beyond the project closure

Key Actions:

Key Action Responsible DueDate Status Comments Documents
Donate the remaining training materials on BEP HCWM to model hospitals and MOH SSENV
[Added: 2020/03/03]
Staff project 2020/04 Not Initiated

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