Environmental and social system assessment (ESSA)

The development objective of the Health, Nutrition and Population Sector Support Program for Bangladesh of the PforR is to strengthen the HNP sector’s core management systems and improve delivery and utilization of essential HNP services, with a focus on selected geographical areas. Some of the negative impacts and mitigation measures are includes : (i) Medical Waste Generators by and large do not maintain any proper record of the different streams of MW generated. Inadequate number of color-coded bins, often improperly placed, results in different waste streams getting mixed; (ii) needles and syringes were not destroyed before disposal; (iii) waste containing chemical substances leftover laboratory solvents, disinfectants, photographic developers and fixers; (iv) poor infection control and occupational health and safety practices due to lack of usage of Personal Protective Equipment (PPE) and lack of training, awareness and understanding of health risks of such poor practices can contribute to increased risk of infection in healthcare facilities; (v) small and ethnic vulnerable community (tribal people) have their own practices and may not be able to access mainstream services; (vi) inadequacy of essential specialists at the District level public hospital; (vii) operate within an adequate legal and regulatory framework to guide environmental and social impact assessments at the program level; (ix) lack of awareness of healthcare staff and workers with regard to occupational safety and infectious waste management practices, inadequate transfer of knowledge to ward boys and sweepers from the healthcare staff ; (x) ensures that small ethnic and vulnerable community (tribal people) can participate in devising opportunities to benefit from exploitation of customary resources or tribal knowledge, the latter (tribal knowledge) to include the consent of the small ethnic and vulnerable community (tribal people). (xi) avoid exacerbating social conflict, especially in fragile states, post-conflict areas, or areas subject to territorial disputes.