Summary of Terminal Evaluation
I. Outline of the ProjectCountry: People's Republic of China

Project title: Project on Capacity Building for
Occupational Health

Issue/Sector: Social Security/Labor andemployment

Cooperation scheme: Technical Cooperation

Division in charge: Human Development
Department Social Security Team, Higher
Education and Social Security Group

Total cost: 420 million yen

Periodof
Cooperation(R/D): 31st March 2011-30th
March 2016

Partner Country’s Implementing Organization:
State Administration of Work Safety, China Academy of
Safety Science and Technology, National Health andFamily Planning Commission, and Chinese Center for
disease control and prevention
Supporting Organization in Japan:：Ministry of Health,Labour and Welfare
Other Relating Organizations:

1. Project Background
The frequent occurrence of occupational diseases in recent years has emerged as a serious social
problem in the People's Republic of China. In 2013, 26,393 cases of occupational disease(pneumoconiosis: 23,152, acute occupational poisoning: 637, chronic occupational poisoning: 904, andother occupational diseases: 1,700) emerged in China, with pneumoconiosis accounting for 87.70
percent of the total cases. Under these circumstances, the government of China has strengthened its
measures by developing "Occupational Disease Prevention and Control Act” (enacted and enforced in
2002, revised in 2011) and "National Prevention and Control Plan for Occupational Disease”(2009-2015). However, the measures against the occupational diseases were not fully functional due to① the lack of related laws and standards, ② insufficient capacity of supervision/management andcollecting/analyzing information, and ③organizations’ lack of knowledge regarding occupational
diseases.
Against this background, the government of China requested the government of Japan a technicalcooperation project for the purpose of strengthening supervision and management, technical services,
information collection and analysis, and health awareness and management ability regarding
occupational diseases in the workplace. Consequently, the Japan International Cooperation Agency(JICA) has been implementing the “Project on Capacity Building for Occupational Health" (hereinafter,
the Project) from March 2011 to March 2016 with Chinese counterparts, the State Administration ofWork Safety and the National Health and Family Planning Commission.
The Project has developed teaching materials and provided training to supervisors and managers inorder to achieve its purpose to "enhance working environments and health management in the model
area to prevent against occupational disease caused by dust and organic solvents.” Prior to the Project’s
completion in March 2016, this Terminal Evaluation was implemented to verify the progress of projectix

activities and results of outputs as well as to draw recommendations from the Project.
2. Project Overview(1) Overall Goal
The measures of occupational health developed by the Chinese side based on the results of the model3
area are introduced in other areas in China.
(2) Project Purpose
Enhance working environments and health management in the model area to prevent against
occupational disease caused by dust and organic solvents.
(3) Outputs
Output 1: Improve the capacity of central governments and related technical institutions for work
environment management and health management against dust and organic solvents.
Output 2: Improve the capacity of relevant government and related technical institutions in the model
area for work environment management and health management against dust and organic
solvents.
Output 3: Improve the awareness and self-management skills in the work environment and healthmanagement spheres of companies and employees in the model area to prevent against
occupational health risks.
(4) Inputs (at the time of evaluation)
Japanese side: Total cost 420 million yen
Long-term Experts: 4 person
Equipment: 6,569,000 yen
Short-term Experts: 33 person
Local cost: 68,147,000 yen
Training in Japan and third country: 213 person
Chinese side:
Counterparts (C/P) 61 person
Project office/facilities
Local cost: 95,978,000 yen
II. Evaluation Team
Members of
Evaluation
Team

3

Function

Name

Designation

Team Leader and Ayumi
Evaluation
Yuasa
Planning

JICA, Human Development Department, Social
Security Team, Higher Education and Social Security
Group, Advisor

Occupational
Health Policy

Ministry of Health, Labour and Welfare, Labor
Standards Bureau, Industrial Safety and Health
Department, Chemical Hazards Control, Senior
Analyst

Yukio
Yanagawa

Model Area: Suzhou city, Jiangsu provincexPeriod of
Evaluation

Occupational
HealthManagement

Kenji
Miyamoto

Japan Labour Health and Welfare Organization,
Hokkaido Chuo Rosai Hospital, Director

Occupational
HealthEnvironmental
Improvement

AkihiroAraki

Japan Industrial Safety and Health Association,
Occupational Health Research and Development
Center, Deputy Director

Evaluation andAnalysis

Haruo Ito

ICONS Inc. Senior Consultant

August 31st, 2015-September
17th, 2015

Type of Evaluation: Terminal Evaluation

III. Results of Evaluation
1. Project Performance(1) Input and Activities
Inputs from both Japanese and Chinese sides have been provided as planned, and those inputs
contributed to the generation of the project outputs. Over a five-year period, the Project planned to
implement the capacity development of relevant institutions in central government (Output 1), relevant
institutions in the model area of Suzhou City (Output 2), and companies in the model area (Output 3). At
the time of the Terminal Evaluation, all activities have been implemented as planned, and capacity
development through supporting model companies (Output 3) is in progress based on the achievementsof the first half of the Project at the central level and in the model area (Output 1 and 2).
(2) Outputs
Output 1: Improve the capacity of central governments and related technical institutions for work
environment management and health management against dust and organic solvents. :Achieved
Indicators of Output 1 have all been achieved. The Project serves many trainees through the
instruction of short- and long-term Japanese experts as well as through study teams. Trainees’ level ofcomprehension and ability to utilize the knowledge provided through the training are sufficient.
Furthermore, training materials and reports on the “Pneumoconiosis and Organic Solvents Poisoning
Case Study Meeting” developed as a result of the training and project activities in the model area havebeen fully utilized. Therefore, certain improvements on the capacity of counterparts in central
institutions have been identified.
Output 2: Improve the capacity of relevant government and related technical institutions in the model
area for work environment management and health management against dust and organic
solvents. : Achieved
Indicators of Output 2 have all been achieved. The Project serves many trainees (total of 101
participants from central ministry and total of 863 participants from related agencies) through the
instruction of short- and long-term Japanese experts as well as through study teams. Trainees
sufficiently comprehended the training contents, and have also utilized their knowledge to develop
training materials, provide training, and carry out pneumoconiosis diagnoses. The capacity ofxigovernment institutions in the model area on work environment management and health management
has been improved through the implementation of training and the supervision of model companies.
Output 3: Improve the awareness and self-management skills in the work environment and healthmanagement spheres of companies and employees in the model area to prevent against
occupational health risks. : Achieved
Indicators of Output 3 have all been achieved. Fifty model companies were selected to implement
activities that seek to strengthen occupational safety and health management, and the baseline survey
was administered to these model companies (Indicator 3-1). In addition, all of these model companies
developed an improvement plan (Indicator 3-2), and each of these plans has been implemented.
“Corporate Occupational Health Management Personnel Training” has been implemented by utilizing
the training materials developed by the State Administration of Work Safety in Suzhou City. Moreover,it was confirmed that the examination following the training sessions in Nanjing in Jiangsu Province
showed participants’ high comprehension of occupational health management.
(3) Project Purpose
Enhance working environments and health management in the model area to prevent against
occupational disease caused by dust and organic solvents. : Achieved
The achievement of all indicators of the Project Purpose has been verified. All related government
personnel to the Project in central institutions and officials in the model area (target 80%) replied that
their work environment and health management capacity has been strengthened (Indicator 1). Althoughsome model companies reported difficulties in implementing their improvement plans due to insufficientawareness of occupational health and a lack of facilities, 86% of model companies (target 80%) have
implemented their improvement plans (Indicator 2). In fact, an end-line survey revealed that 92% ofmodel companies (target 80%) have improved their working environment (Indicator 3). In addition, theregular implementation of health checks and the increase of health checks prior to hiring in modelcompanies have been identified (Indicator 4).
(4) Overall Goal
The measures of occupational health developed by the Chinese side based on the results of the model
area are introduced in other areas in China.
A portion of the Overall Goal indicators has already been achieved at the time of terminal evaluation.
The China Academy of Safety Science and Technology and the State Administration of Work Safety in
Jiangsu Province implemented “Corporate Occupational Health Management Personnel Training” inNanjing of Jiangsu Province, which is outside of the model area, as efforts of the work safety sector. In
addition, this training is being planned for companies in Foshan City of Guangdong Province. The
future implementation of the “Debriefing Seminar of Improvement Cases of Occupational Health” andthe distribution of reports of this seminar to other areas for sharing outcomes from the model company
have been planned.
Also in the health sector, the “Pneumoconiosis Case Study Meetings” were implemented in areas
outside of the model area, such as in Xuzhou City of Jiangsu Province and Qingdao City of Shandong
Province, by utilizing the “Instructions for Holding the Pneumoconiosis Case Study Meetings”
developed by the Project. Thus, these instructions have the potential to be implemented in similar casexii

study meetings in areas outside of Suzhou City.
2. Summary of Evaluation Results(1) Relevance: High
Relevance of needs of target group
Pneumoconiosis and occupation poisoning dominate more than 90% of the occupational diseases
reported in China, and these issues should be coped with preferentially. In addition to those risk factors,
the Project’s trainings have also addressed other risk factors, such as physical factors (vibration, noise,and temperature environment), ergonomics, and workers’ health instruction after the Project Mid-term
Review. Moreover, Suzhou City in Jiangsu Province, selected as a model area where economic
development is progressing, has also presented remarkable issues in the occupation health realm. The
selection of Suzhou City as the model area is also relevant because appropriate implementation
organizations for the Project were established in Suzhou City ahead of other areas in China.
Relevance of the national policy of China
The Project Purpose and Overall Goal are consistent with " National Prevention and Control Plan for
Occupational Disease” (2009-2015). In the model area of Suzhou City, "Prevention and Control Plan for
Occupational Disease in Suzhou City” (2009-2015) aims toward the reduction of pneumoconiosis andorganic solvent poisoning incidences, as well as the increased number of health checks.
Relevance of the cooperation policy of JapanThe Project is regarded as supporting the strengthening of the legal system and governance in order torevitalize the private sectors whose market economy is based on supporting reform and the opening up
of markets, which are prioritized in the economic cooperation of the Government of Japan (August2010) in China.
(2) Effectiveness: HighAchievement of the Project Purpose
All indicators of the Project Purpose have been achieved. These indicators are as follows: the capacity
development of officials and related personnel in the central governments and governments of the model
area (Indicator 1), the implementation of the improvement plans in model companies (Indicator 2), theimprovement of the working environment in model companies (Indicator 3), and the increased numberof initial and regular employment health checks (Indicator 4).
Contribution of each output to the achievement of the Project Purpose
The capacity development of the government officials at the central level (Output 1), government
officials in the model area (Output 2), and government officials through the activities in the modelcompanies (Output 3) contributes to the achievement of the Project Purpose. Therefore, thecause-and-effect relationship between each output and the Project Purpose is clear.
(3) Efficiency: HighAchievement of outputs and the appropriateness of inputs
It was confirmed that the timing of inputs, such as the dispatch of experts and training in Japan,xiiiwas appropriate. With regard to training in Japan, the purpose of the training curriculum was clearly
identified, and the target levels of the contents were also suitable. In addition, the knowledge obtainedby the training sessions has accumulated in related institutions as participants share and report contentsof the Project, and training results are also effectively utilized. The training of short-term experts has
produced a number of participants despite a limited number of training days. In addition, given thattraining fees (travel and accommodation) are shared with the Chinese side, training management has
been efficient.
Coordination of related organizations
Effective coordination with related institutions was identified, especially in Suzhou City. For
example: ① Suzhou City CDC officials served some lecturers in the “Corporate Occupational HealthManagement Personnel Training” organized by the Suzhou City Administration of Work Safety, and ②
the Suzhou City Administration of Work Safety also introduced companies to the Suzhou City CDC for
the “Pilot Projectof Workers Health Instruction”.
Utilize other project resources
To effectively utilize the experience of the JICA project in another country, a third-country training
program (a technical exchange program) was implemented at the National Institute of Occupational
Safety and Health in Malaysia.
(4) Impact: Relatively High
Prospect of Overall Goal achievement
The indicators of the Overall Goal are set as the implementation of training and case study meetings,
as well as the use of results from model companies outside of the model area. Some efforts toward thefuture achievement of the Overall Goal have been identified as work safety sectors have already carriedout the “Corporate Occupational Health Management Personnel Training” for companies in Nanjing of
Jiangsu Province (outside of the model area). The same training is also planned to be implemented for
Foshan companies in Guangdong Province. In addition, the health sectors also carried out the“Pneumoconiosis Case Study Meeting” outside of the model area, specifically in Xuzhou City in Jiangsu
Province and Shandong City in Qingdao Province.
In addition, it is expected that the Project will continue efforts to promote the effective use of such
resources as training materials and case study committee reports that have already been distributed toother Chinese provinces.
Other impacts
Following are some cases that illustrate the positive impacts of the Project.
① The dust-proof respirator exhaust technology laboratory was installed in the China Academy of
Safety Science and Technology, and is used not only for laboratory practice but also for humanresource development through providing practical training.
② Some related regulations and standards in China have been developed mainly by training
participants in Japan by referring to Japanese regulations and the results of model companies.
③ In response to the results of the “Corporate Occupational Health Management Personnel

xivTraining” for the companies in Suzhou City, the Administration of Work Safety at the district andcounty levels under the Suzhou Administration of Work Safety implemented the same training
for 7,000 company participants.
④ Each model company in Suzhou City has invested about 40 million yuan towards the
improvement of working environments.
⑤ “The Pneumoconiosis Diagnostic Manual”, which is expected to contribute to appropriate
pneumoconiosis diagnosis in compliance with diagnostic procedures, has been developed on thebasis of the Project results.
⑥ The "Workers Health Instruction,” which resulted from the training in Japan, was referred to in
the contents of the "Health Promotion Demonstration Enterprises in Jiangsu Province.”(5) Sustainability: High
Political aspect
The results of the Project, such as “strengthening training and management ability of occupational
health management personnel,” “establishing a foundation of corporate occupational health,” and“promoting experience exchanging meetings relating to the corporate occupational health at the local
level” are expected to be incorporated in the 13th five-year plans of "Occupational Disease Prevention
Treatment Plan" and "National Prevention and Control Plan for Occupational Disease." Both of theseplans are currently being developed by the State Administration of Work Safety. Therefore, the politicalsustainability of the Project is evaluated as high.
Institutional and financial aspects
The training developed by the Project has been budgeted for next year’s programs: the Suzhou
Administration of Work Safety and the Chinese Center for Disease Control and Prevention. The China
Academy of Safety Science and Technology also included the Project’s training into its future action
plan. In addition, as the Suzhou Administration of Work Safety and its jurisdictional Administration ofWork Safety units at the district and county levels implemented the training for 7,000 corporate
participants funded by their own budget, the financial sustainability is judged as high.
Technical aspect
As has been previously described in section “1. Project Performance, (3) Outputs,” the improvementof the capacity of relevant governments and technical institutions on supervision of work environmentand health management was identified at both the central level and the model area.
3. Factors Promoting the Realization of Effects(1) Planning Factors
Flexible process based on needs (expansion to other risk factors)
The Project has flexibly responded to other risk factors such as physical factors (vibration, noise, andthermal environment), ergonomics, and the health instruction of workers. In addition to pneumoconiosis
and organic solvents. This flexible provision of training, which meets the training needs of counterpart
institutions, has enhanced their motivation.

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(2) Implementation Process Factors
Information provision prior to training participation
The Japanese experts provide related information and background knowledge to participants prior toinitiating the training in Japan. This pre-preparation enables the improvement of training efficiency.
Utilization of appropriate training methods
The case study meetings have been identified as significantly effective as they utilize the participatory
training method in which all participants discuss the diagnosis of cases that were carefully selected inadvance. Regarding the model companies, the effectiveness of training was also improved by adopting
the training method of gathering industries in similar fields to strengthen corporate compliance withmutual surveillance (Such mutual surveillance ensures the prevention against negative practices incompanies).
Continuous education system for health workers
In the “Pneumoconiosis Case Study Meetings” in Qingdao City, participating medical staff received
certified points (3 points) from the Qingdao Medical Society. Utilizing this previously existing
continuous education system for medical personnel in the Project training has increased the participation
rate and participants’ motivation.
Dissemination of outputs to other areas
Many officials and medical staff outside of the model areas have participated in the training in Japan.
Those outside the model areas have played significant roles in carrying out the “Corporate Occupational
Health Management Personnel Training” as well as “Pneumoconiosis Case Study Meetings” within theirorganizations. This outcome is a cornerstone of the Overall Goal achievement as the project results havebeen dispersed to other areas in China.
4. Factors Impeding the Realization of Effects(1) Planning Factors
Limitations in Japanese training
In the Japanese training, participants were unable to participate in the actual administrative
supervision due to confidentiality issues, and companies that are allowed to accept visitors are very few.
As a countermeasure, the Project allocated retired Japanese labor standards inspectors as short-term
experts to China. These Japanese experts exchanged opinions with their Chinese counterparts, andaccompanied administrative supervisors in Chinese companies.
(2) Implementation Process Factors
Unsuitable specialty and personnel transfer
Training is not always efficient, because in some cases training was not aligned with participants'
specialties and there was the personnel transfer in counterpart organizations. On the other hand, theProject attempts to accumulate knowledge as an institutional recollection rather than individual
knowledge by developing training materials and procedure manuals, as well as through documenting
and sharing training results.

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5. Conclusion
The results of the Terminal Evaluation reveal that the Project has implemented its activities asplanned, and has generated expected outcomes.
First, as the needs of the target groups and policies of China and Japan have remained consistent with
the Project Purpose even at the time of the Terminal Evaluation, relevance is evaluated as high. As theresults of each output have contributed to achieving the Project Purpose, effectiveness is also evaluatedas high. Since the Project activities have been implemented as planned and generated expected outputs,
and further because the quality, quantity, and timing of the inputs are also appropriate, the efficiency of
the Project is also high. Although some efforts toward achieving the Project’s Overall Goal have been
initiated, future dissemination of the results to other areas is required, with continuous promotion oftraining developed by the Project. Therefore, the impact of the Project is evaluated as relatively high.
Because all political, institutional, financial, and technical aspects of sustainability were identified ashigh, the training and case study meetings developed by the Project are expected to be implemented in
the future. Thus, sustainability of the Project is evaluated as high.
The overall results show that the Project has been implemented smoothly, and as the Project Purpose
has been achieved, the Project will be completed in March 2016 as planned.
6. Recommendations(1) Continue training developed by the ProjectCounterpart institutions should continue training with the Project materials and trained instructors.
Moreover, those trainings should be integrated into the existing training systems and annual action plansof each related institution to ensure that necessary personnel and budgets are provided.
(2) Promote company initiatives for promoting work environment
Counterpart institutions should promote the awareness of occupational health through suchapproaches as sharing good practices, providing evidences of improvement effects, and discussing theconcerns of occupational health risks.
(3) Revise training materials
Training materials and procedure manuals developed by the Project should be revised as needed
according to the revision of relevant laws and rules, and based on the results of training.
7. Lessons Learned(1) Technical transfer related to company supervision
Counterparts who participated in the training in Japan strongly needed to observe actual corporate
supervision in Japan. However, as noted in the “Factors Impeding the Realization of Effects” section, it
was impossible for counterparts to participate in actual corporate supervision in Japan due to theprotection of confidential corporate information. There are very few companies that accept company
visits. Consequently, the Project dispatched retired Japanese labor standards inspectors to China as
short-term experts to accompany corporate supervisors and exchange opinions with counterparts. For
planning technical transfer on corporate supervision, which heavily involves confidential corporate
information, dispatching Japanese inspectors rather than counterparts participating training in Japan
could be the better measure.

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