E4297 v1 HSSP2 AF: Cover Note for Disclosing Environmental Management Plan The Second Health Sector Support Program (HSSP2) aims to support the Government's Health Strategic Plan (2008-2015, HSP2) by seeking to improve health outcomes through strengthening institutional capacity and mechanisms by which the government and Program Partners can achieve more effective and efficient sector performance. The Additional Financing (AF) in the amount of USD13,449,700 would: (i) support further progress on maternal and child health, while increasing focus on key sector priorities, including nutrition, newborn health, equity, service quality, non- communicable diseases, and family planning; (ii) further strengthen the Ministry of Health’s (MOH) medium-term planning process and alignment with Annual Operational Plans (AOPs) and increase allocation of HSSP2 financing and the Royal Government of Cambodia (RGC) budgets to service delivery level; (iii) continue to finance the existing Health Equity Funds (HEFs) and scale up to reach national coverage by 2015, and support development of a national institutional framework for social health insurance; and (iv) build capacity to shift to national institutions and systems linked to national Public Financial Management (PFM) and decentralization and de-concentration reforms. The World Bank Operational Policy on Environmental Assessment (OP 4.01) will continue to apply to the AF. The nature, scale and scope of environmental and pest impacts that may occur under the AF are expected to be the same as those under the original project. The Environmental Management Plan, The Health Care Waste Generation and Management Plan, and Pest Management and Monitoring Plan (PPMP) that were developed under the original project will continue to be used under the AF. These safeguard instruments have been implemented adequately under the original project.  Environmental Management Plan. The experience in HSSP2 confirmed that civil works and the corresponding environmental impacts were minimal and temporary, limited to the construction phase, which has been mitigated through good construction practices. The impacts are monitored by the construction supervision firm, MOH officials and the task team. The civil works contracts also contain a provision on the use of asbestos-free building materials which is closely monitored. As with the parent project, The AF will not affect natural habitats and forests.  The Health Care Waste Generation and Management Plan. Guidelines under the existing Health Care Waste Generation and Management Plan are deemed adequate and compliance during HSSP2 has been good. Training of Trainers on Health Care Waste Management Guideline has been carried out by Department of Hospital Services (DHS) at provincial level. This training will continue under the AF.  Pest Management and Monitoring Plan (PMMP). This plan covers the risks associated with the purchase and use of larvacides for control of Dengue. The larvicides are considered to pose very low risks to humans if used correctly and certified by WHO’s Pesticide Evaluation Scheme (WHOPES). The products are transported in safe containers provided by the vendors and used containers are disposed of according to best practice; they are not used for storage or other purposes.