Indigenous Peoples Development Planning Document. PHI : Support for the Sustainable Health Care Project

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Indigenous Peoples Development Planning Document Indigenous Peoples Development Framework Document Stage: Draft Project Number: 41664 August 2008 PHI : Support for the Sustainable Health Care Project The indigenous peoples development framework is a document of the borrower. The views expressed herein do not necessarily represent those of ADB s Board of Directors, Management, or staff, and may be preliminary in nature.

INDIGENOUS PEOPLES DEVELOPMENT FRAMEWORK A. Project and Project Components I. PROJECT BACKGROUND 1. The Development Bank of the Philippines (DBP) is developing a new credit facility for the health sector to be funded by Asian Development Bank (ADB) under the proposed the Support for the Sustainable Health Care Investment Project (the Project), Kreditanstalt für Wiederaufbau, and DBP. The credit facility will be available to provincial government and private sector. Private sector includes individuals, non-government organization (NGOs) and cooperatives, civic or religious foundations, and corporations. As the Project is national in scope and specific sub-loans cannot be determined in advance, in accordance with Operations Manual section F3/Operational Procedures Para 20, an Indigenous People s Framework (IPF) has been prepared. 2. The purpose of the loan is to meet pent up demand for basic health services. The credit facility supports holistic development of health systems to increase access and efficiency and reduce both provider and user costs. The Project brings basic health care services of improved quality closer to the clients while reducing transportation and other costs. It increases the efficiency of health services provided resulting in reduced out-of-pocket expense for the patient expenses or for the public sector, enabling provision of more health services for the budget. Full details are discussed in Appendix 14 and 15 on Financial and Economic Analysis. 3. Eligible sub-loans support delivery of basic health services. The Project funds will support private financing of (i) doctor practices and lying-in clinics, (ii) laboratory and diagnostic centers linked to other The Project investments, (iii) health sector business solution companies, (iv) drug procurement and distribution companies for distribution of generic drugs, and (v) public sector investment rehabilitating rural health units and expanding the capacity of over utilized secondary and tertiary. Eligible public sector investments must be included in the Provincial Health Investment Plan. B. Description of Indigenous People in the Philippines 4. Indigenous People (IP) in the Philippines were estimated to comprise 16% of the total population, including 110 ethno linguistic groups distributed throughout the archipelago. 1 IPs are people present inside of current Philippine boundaries prior to colonialization by the Spanish who have maintained different customs, language apart from the mainstream and self-organization from the mainstream. 2 Most IPs are land based agriculturalists although others such as the Bajau are maritime dwellers whose ancestral territory covers much of littoral Southeast Asia. C. Legal Framework 5. The Republic Act No. 371 known as the Indigenous People s Rights Act (IPRA) of 1997 was enacted based on consultation, agreements on ancestral domain and lands, and international agreements on domain rights of IPs. The IPRA recognizes, promotes, and protects the rights of IPs related to (i) ancestral domain and lands, (ii) self-governance and empowerment, (iii) social justice and human rights, and (iv) cultural integrity. 6. The National Commission on Indigenous People (NCIP) was established in 1999 with a mandate to: protect and promote the interest and well being of the Indigenous Cultural 1 Source: National Commission on Indigenous People (NCIP) website for the number of IP (11.7 million): http://www.ncip.gov.ph/resources/ethno_region.php and ADB Key Indicators 2001 for the estimated 1998 population (75.2 million: http://www.adb.org/documents/books/key_indicators/2001/default.asp 2 Section 3 of the IPRA provides the full legal definition.

Communities (ICCs)/IPs (sic) 3 with due regard to their beliefs, customs, traditions and institutions. As of 2002, it had 1,500 staff in 12 regional offices, 46 provincial offices, and 108 community centers. The Medium Term Plan for IP in the health sector prioritizes meeting health needs through promotion of Philippine Health Insurance Corporation, establishment of IP community health centers, promotion of nutrition posts, and provision of scholarships for training of IPs to become midwives. 7. The NCIP is mandated to: issue appropriate certification as a pre-condition to the grant of permit, lease, grant (sic), or other similar authority for the disposition, utilization, management and appropriation thereof on any part or portion of the ancestral domain taking into consideration the consensus (sic) approval of the ICCs/IPs concerned. 4 Consensus approval is defined as Free and Informed Prior Consent (FIPC). 8. NCIP Administrative Order No. 1/2006 on the FIPC Guidelines of 2006 prescribes the detailed steps required to secure an FIPC taking into account the nature of the activity to be introduced. The guidelines encompass: who gives the FIPC, field based investigation procedures to plan the FIPC, fees, FIPC team composition, validation of the list of elders, determining the customary decision making process, duration for completion, posting of notices, serving of invitations, number of meetings, issuance of a resolution of consent or non consent, and reporting to the NCIP. The consent is recorded in a Memorandum of Agreement (MOA) detailing the conditions, requirements, responsibilities, benefits, penalties, and grievance procedures agreed. The guidelines prescribe the format of the MOA including location, involved parties, duration, mitigation measures required, monitoring and evaluation, remedies and penalties, grievance process, posting of a bond of at least 1% of the investment costs to ensure any damages can be covered. Complaints related to the MOA are submitted for resolution by the NCIP regional office. The guidelines also provide a process for appeal. The NCIP issues a Certificate of Precondition when all guideline requirements have been met. The procedure for securing the FIPC is of equivalent standard with ADB Operations Manual F3/Operational Procedure section C on Consultation, Participation, and Disclosure. 9. A full FIPC is required for large scale developments affecting natural resources, mineral and energy exploration, programs leading to displacement of IPs, resettlement of migrants into ancestral lands. Management of critical or protected areas, industrial land use, large scale tourism or agriculture projects. A less intensive process is required for small scale resource exploitation or utilization of natural resources, research with the intent to publish, unsolicited socio-economic government projects unless coordinated with the NCIP, activities affecting spiritual customs, feasibility studies for projects requiring a full FIPC, establishing temporary or permanent military facilities, and other analogous activities. The proponents bear all associated costs including that of the NCIP and IPs. The Project eligible investments are not included in the list of activities requiring an FIPC except as such other activities analogous to the foregoing nature. 5 10. The guidelines also recognize ownership rights of non-ips within ancestral domains. 6 If, in the exercise of these rights, any grievances arise, the local council of elders decides what mitigation is required. Non-IP migrants activities must obtain approval through an FIPC or community process. 7 3 Citation: IPRA Chapter 8. IPRA chapter 2 defines ICCs and IPs as Indigenous People. 4 IPRA section 44 (m). 5 NCIP Administrative Order No. 1/2006 part II section 6.b.8 6 NCIP Administrative Order No. 1/2006 Part I section 5J: Recognition and Exercise of Ownership Rights Over Titled Properties within Ancestral Domain Areas. 7 NCIP Administrative Order No 1/2006 Part IV Section 36. Regulation of Entry of Migrants and Other Entities

11. The Department of Environment and Natural Resources (DENR) and NCIP has guidelines on harmonizing policies and procedures to address the rights of IP with respect to the IPRA. 8 DENR classified Environmentally Critical Areas (ECA) includes areas which are traditionally occupied by cultural communities or tribes. 9 DENR, however, issues permits independently of other agencies hence an FIPC not needed for environmental impact assessment (EIA) Review. Instead, NCIP will be advised of the Project s socio-cultural and economic impacts and benefits on IPs for consideration in issuance of FIPC and in drafting of IP Development Plan after Environmental Compliance Certificare is issued. 10 The NCIP would be able to obtain the initial environment examination (IEE) or IEE checklist from DENR as inputs to the FIPC. D. Project Impacts on Indigenous People 12. While the The Project is national in scope, the activities will be location specific. The impact of the proposed loan on IPs will depend on the nature and location of eligible investments proposed by sub-loan borrowers interested in accessing the credit facility. The location includes IP locations such as Tribal Barangays, IP Ancestral Domains or proposed Ancestral Domains. Subloan proponents may be IPs, non-ips, or other organizations. 13. There will be no displacement or involuntary resettlement (IR) associated with the Project sub-loans. Public and private sub-loan eligibility conditions require the proponent (i) fully own the investment site, and (ii) the site is unencumbered. The resettlement framework (RF) in Supplementary Appendix D describes the mechanisms for ensuring compliance with the Involuntary Resettlement Policy (IRP). 14. Sub-loans categorized as Environmentally Critical Projects are not eligible for the Project financing. Eligible types of investments will not result in small scale resource exploitation or utilization of natural resources that necessitate an FIPC. 15. The types of eligible investments and their ADB IP Policy and IPRA compliance requirements are shown in Table 1. Table 1: Project Potential Investments, IP Impacts, Requirements under Administrative Order No. 1/2006 FIPC Guidelines Investment Impact Compliance requirements Public Hospital modification None Eligible investments intended to existing facilities to keep pace with population growth and con-commit tent increase in hospital services. Although new construction instead of rehabilitation may be required due to the structural condition of the facility, it will be done within the existing site Or in another site wholly owned by the LGU and free of encumbrances 11. The investment will not result in an expansion of the service area or change in the types of services delivered. No FIPC is required. Public Rural Health Unit Rehabilitation None As with the hospital, the investment restores the level of intended or previous access. No FIPC is required. Private Diagnostic Laboratory Possibly significant If the proponent is establishing a facility in an Ancestral Domain and the proponent is not an IP or non-ip resident, the NCIP regional office must determine whether an FIPC or a less formal community approval is required. Establishment or upgrading Possibly significant If the proponent is establishing a new practice or clinic in an 8 Joint DENR Memorandum Circular 2003 on Harmonization of the Implementation of the IPRA and Environmental and Natural Resources (ENR) Laws and Policies. 9 DENR Revised Procedural Manual of 2007 EIA coverage and requirements screening checklist page 53 10 Environmental Management Bureau Circular 1/2007 on Environmental Assessment Review Manual appendix 1 on Relationship of EIA Findings to Requirements of Other Agencies Involved in the Project. 11 See para 13

Investment Impact Compliance requirements of private medical practice or lying-in clinic: General Practitioner and Obstetrician Gynecologist approval is required. Ancestral Domain and the proponent is not an IP or non-ip resident, the NCIP regional office must determine must determine whether an FIPC or a less formal community Upgrading of private midwife practice None The midwife must be in practice to be eligible for the credit facility. She will either be a non-ip with land rights in ancestral lands or an IP. No consent is required for her to upgrade an existing concern. Generic Drug Outlet None The outlet will be located inside an existing concern in a local Pharmacy Development of business solution services, drug procurement and distribution Possibly Significant Possibly significant cooperative or business. As for establishment of a private medical practice or lying in clinic. As for establishment of a private medical practice or lying in clinic. 16. The Project is expected to have little or no impact on IPs. Eligible public sector sub-loans will not have an IP impact as there are required to maintain or restore level and type of service already provided. Private commercial sector sub-loans are not expected in most IP areas because remote and low population density areas generate little demand. Private charitable organizations with outreach to IP areas generally meet their capital requirements from their membership. Credit demand may exist in the population centers of special areas where large parts or the entire province 12 has been designated as an IP area. An FPIC, however, is only required if the proponent is a As loan operational guidelines require the proponents to hold title to the proposed project site, sub-loan proposals from migrants are unlikely to qualify. II. OBJECTIVE OF THE IPF 17. The IPF describes how ADB policy on IP will be complied including DBP s role as the Financial Institution, screening of potential IP impacts, required actions, verification process, financing arrangements, reporting, and monitoring and evaluation. III. STRATEGY FOR IP PARTICIPATION 18. All sub-loan proposals will be screened taking into account the investment type, site location, service area, and status of the proponent as IP or non-ip. Where required sub-loan proponents will be required to follow NCIP guidelines on FIPC and securing evidence of compliance from the regional NCIP office will be a pre-condition for credit approval. IV. INSTITUTIONAL AND IMPLEMENTATION ARRANGEMENT 19. Role of DBP, sub-loan borrowers, and wholesale institutions: DBP acts on ADB's behalf to ensure all sub-loans comply with ADB safeguard policies. Assumes all of the costs (and risks) associated with marketing, assessment, credit evaluation, monitoring, etc. The sub-loan proponent is responsible for securing all required accreditations and certifications. DPB monitors the process to ensure all regulatory requirements are met. The agreement between DBP and its on-lending partners spells out their responsibilities and reporting requirements. 20. The Program Development Unit of DBP is the Project executing agency. Lending activities will be carried out by the DBP Retail, Local Government, and Financial Institutions Units. 12 including all provinces Cordillera Administrative Region and large parts of Regions X, XI, XII, and XIII,

Table 2: DBP Responsibilities by Unit and Type of Investment Retail Retail lending Private sector: doctor practice, lying-in clinics, business solution services, pharmacies, drug distribution, Local Government Local Government Units Public sector: hospital upgrading or construction, (LGUs) Financial institutions Wholesale lending to MFIs and rural banks Rural Health Unit rehabilitation Private sector: midwives, generic drug outlets, doctor office, 21. The DBP Program Development Unit will be responsible for certifying compliance with ADB safeguards on IP. The Account Officers of the lending units: Retail, Local Government, and Financial Institutions Units will be responsible for verifying compliance. As IP impact screening will be carried out as part of the initial credit evaluation. Sub-project proposals that may require an FIPC will be flagged for monitoring by the Program Development Health Unit. 22. Performance monitoring requirements, procedures, and responsibilities will be detailed in the DBP Operating Guidelines and Procedures (OGP). These will include the responsibilities, and authorities, and reporting chain from the PD, PD Health Unit, and the Retail, Local Government, and FI units. For each type of sub-loan investment, the OGP will provide reporting templates for each stage of the sub-loan cycle, sample documentation, lists of documentation to be submitted by the borrower, and references to appropriate NCIP and ADB regulations and guidelines. The OGP will contain the format and contents of the 6-month compliance reports to ADB and the quarterly compliance reports from the partner to the Administrative Order. Loan Agreements will require compliance with NCIP Administrative Order No. 1/2006 guidelines related to agreements reached in the MOA including all monitoring and grievance procedures. 23. Each year, the DBP Regional Management Centers will submit to the Programs Department data on the location of existing, proposed ancestral domains and lands, and IP Barangays obtained from the regional NCIP offices. The information will be included in the OGP as the geographic basis for determining FIPC compliance requirements. V. BUDGET AND FINANCING 24. The resources required to comply with ADB and NCIP requirements depends on the number of sub-projects in IP areas, the nature of the activity, and whether the proponent is a Few if any are expected. In the event an FPIC is required, the proponent pays all cost associated with securing the NCIP Certificate of Precondition, implementing any specific agreements reached in the Memorandum of Agreement included the cost of implementing grievance procedures. The cost of screening and monitoring compliance will be borne by DBP and can be carried out by existing staff in conjunction with the other screening, implementation, and monitoring requirements. VI. MONITORING AND EVALUATION 25. DBP will provide a report to ADB in compliance with IP safeguard requirements every six months. The report will include copies of credit evaluation summaries, certificates of preconditions, the updated list of IP areas, and on the conduct of any grievance proceedings conducted by the NCIP. On each project review mission, ADB will examine a random sample of credit evaluation reports and, where appropriate, conduct site visits to determine if the IP screening procedures are being followed and if they are adequate and meet with regional NCIP officials on project compliance.