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Outline of the Project

Project Title

The Project for Improving Quality of Health Care Services

Recipient country

Lao P.D.R

Signed date(on R/D)

14th September 2015

Project Site(s)

Vientiane and Southern Four (4) Provinces (Champasak, Salavan, Sekong, and Attapeu), the Lao PDR


21st February 2016 to 20th February 2021 (5 years)

Implementing Agencies

the Department of Health Care and Rehabilitation (DHR), the Cabinet, the Department of Hygiene and Health Promotion (DHHP), the Department of Health Professional Education (DHPE), the Department of Finance (DOF), the Food and Drug Department (FDD), the Department of Planning and Cooperation (DPC), the Department of Personnel (DOP), the University of Health Science (UHS) and the National Health Insurance Bureau (NHIB) of the Ministry of Health (MOH)


In the Lao PDR, the national health status had been improving steadily over the past decades. Despite the progress made, Maternal Mortality Ratio (MMR) and Under Five Mortality Rate (U5MR) still remained the highest among ASEAN countries, where the estimation of MMR to be 220 per 100,000 live births (2013) and U5MR to be 79 per 1,000 live births (2011).

In the previous project, "Project for Strengthening Integrated Maternal, Neonatal and Child Health Services", JICA supported Provincial Health Offices (PHOs) and District Health Offices (DHOs) to improve the coverage of maternal, neonatal and child health (MNCH) services targeting southern four (4) provinces (Champasak, Salavan, Sekong and Attapeu) through: (a) appropriate management of MNCH program by the Provincial and District Health Offices; (b) improvement of capacity of health service providers for integrated MNCH services; and (c) promoting of the utilization of integrated MNCH services in collaboration with the community.

The MOH launched the Health Sector Reform (HSR, 2013-2025) aiming to achieve universal health coverage (UHC) by 2025. In the draft document of the second phase of HSR (2016-2020), improvement of the quality of the essential health care services is demanded. Under the circumstances, the MOH requested JICA for a technical cooperation project to improve the quality of health care services, of which MNCH is an entry point.

Outline of the project

It is narrative summary in PDM version 2.0 has been revised based on discussion at 2nd Joint Coordinating Committee meeting on 15th August 2018,attached with Minutes of Meeting signed on 17th January 2019.

Overall Goal

Quality services are provided by health facilities in the Lao PDR.

Project Purpose

Starting with improvement of maternal, newborn and child health (MNCH) as an entry point, quality health services are provided at provincial and district hospitals in the four (4) southern provinces.


  1. Quality Criteria for hospitals were developed.
  2. Quality evaluation for hospitals is operated.
  3. Continuous Quality Improvement (CQI) activity is conducted by hospitals.
  4. "QHC Model"[1] is documented.
  5. "QHC Model" is proposed to the Ministry of Health, Lao PDR.

Project Activities

0-1. To develop activity plan with reviewing the current activities on quality of healthcare services in the Lao PDR.
0-2. To conduct a baseline survey on the medical services at the initiative of the DHR.
1-1. To specify the target service with Process Map.
1-2. To develop HQC and Evaluation Sheet for PHs and DHs.
1-3. To develop and implement Evaluation Sheet for Patient Experience and Satisfaction.
1-4. To introduce HQC and Evaluation Sheet to PHs and DHs.
1-5. To update HQC and Evaluation Sheet for PHs and DHs periodically.
2-1. To develop SOPs for self-evaluation of HQC in provincial and district hospitals.
2-2. To develop SOPs for external-evaluation of HQC in provincial and district hospitals.
2-3. To modify SOPs for updated HQC (by Activity 1.4).
2-4. To develop TOR of people in charge of Hospital Quality Management (e.g. Quality Committee) in provincial and district hospitals, and update the TOR periodically.
3-1. To standardize target services in provincial and district hospitals (by developing SOPs, Checklist, rule etc.).
3-2. To conduct daily management and continuous quality improvement (CQI) activities for improvement opportunities identified by provincial hospitals.
3-3. To hold opportunities for learning CQI from others (study tour, cross visit etc.) for provincial and district hospitals.
3-4. To conduct technical trainings[2] in provincial and district hospitals.
3-5. To develop modules for technical trainings.
4-1. To establish writing and editing committee of "QHC Model Guidebook".
4-2. To make writing and editing schedule of "QHC Model Guidebook".
4-3. To write and organize manuscripts of "QHC Model Guidebook".
4-4. To hold writing committee meeting.
4-5. To document four provinces' experiences on implementation of "QHC Model".
4-6. To approve a case document of "QHC Model" by each of provinces.
4-7. To compile case documents of "QHC Model" in four Southern provinces.
5-1. To suggest a "QHC Model" to Ministry of Health.
5-2. To hold the seminar of introducing "QHC Model" inviting all provinces in Lao PDR.
5-3. To hold Forum in Lao PDR to share practical experience of quality improvement in health facilities.
5-4. To advertise, share and study "QHC Model".
5-5. To encourage budgeting for activities and assignment of human resources in order to sustain "QHC Model" in provincial level.


Lao Side

  1. Counterpart
    (1) Project Director
    (2) Project Manager
    (3) Project Coordinator
    (4) Relevant staff from Ministry of Health, Provincial Health Office, District Health Office, Provincial Hospital, District Hospital and Health Cetenr for project activities
  2. Facility and equipment
    Project offices in Champasak Provincial Health Office and Ministry of Health in Vientiane.
  3. Local cost
    Pesonnel cost for counterparts, Expences for travel and consumable, Running cost (water, electricity and internet access etc.)

Japan Side

  1. Dispatch of JICA experts
    (1) Long-term JICA experts
    -Chief Advisor
    -Project Coordinator/Organizational Collaboration
    -MNCH Expert (Perinatal care)
    -Nursing Expert
    (2) Short-term JICA experts
    -Chief Advisor
    -Quality Management
    -Others who have speciality for project activities
  2. Training (in Laos, Third countries and Japan)
  3. Provision of Equipment
  4. Operartional Costs
  5. Others

Explanatory note

  • [1] The QHC Model is a repeated cycle of three steps that activate and sustain Continuous Quality Improvement (CQI) in hospitals in Lao PDR. The QHC Model consists of (1) development and update of hospital quality criteria, (2) regular quality assessment and (3) Continuous Quality Improvement (CQI) with accelerating mechanisms of (i) training to strengthen knowledge and skills of health staff and (ii) opportunities to share practical experiences and learning experiences.
  • [2] Targets of Technical Training
    (1) Hospital Quality Management
    (2) EmOC, EENC and Operation of Related Equipment
    (3) Nursing
    (4) Administration


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