The World Bank Health and Gender Support Project for Cox’s Bazar district (P171648) REPORT NO.: RES59800 RESTRUCTURING PAPER ON A PROPOSED PROJECT RESTRUCTURING OF HEALTH AND GENDER SUPPORT PROJECT FOR COX’S BAZAR DISTRICT APPROVED ON MARCH 31, 2020 TO THE PEOPLE’S REPUBLIC OF BANGLADESH HEALTH, NUTRITION & POPULATION SOUTH ASIA Regional Vice President: Martin Raiser Country Director: Abdoulaye Seck Regional Director: Nicole Klingen Practice Manager: Feng Zhao Task Team Leaders: Bushra Binte Alam, Sabah Moyeen The World Bank Health and Gender Support Project for Cox’s Bazar district (P171648) ABBREVIATIONS AND ACRONYMS GBV Gender-Based Violence HGSP Health and Gender Support Project for Cox’s Bazar District HNP Health, Nutrition and Population IDA International Development Association MoHFW Ministry of Health and Family Welfare PDO Project Development Objective UN United Nations UNOPS United Nations Office for Project Services The World Bank Health and Gender Support Project for Cox’s Bazar district (P171648) BASIC DATA Product Information Project ID Financing Instrument P171648 Investment Project Financing Environmental and Social Risk Classification (ESRC) Substantial Approval Date Current Closing Date 31-Mar-2020 30-Jun-2024 Organizations Borrower Responsible Agency The People’s Republic of Bangladesh Project Development Objective (PDO) Original PDO Improve the access to and utilization of HNP and GBV response services among the host and the displaced Rohingya population in Cox’s Bazar district. OPS_TABLE_PDO_CURRENTPDO Summary Status of Financing (US$, Millions) Net Ln/Cr/Tf Approval Signing Effectiveness Closing Commitment Disbursed Undisbursed IDA-D5920 31-Mar-2020 04-Jun-2020 22-Jun-2020 30-Jun-2024 150.00 133.59 15.07 Policy Waiver(s) Does this restructuring trigger the need for any policy waiver(s)? No The World Bank Health and Gender Support Project for Cox’s Bazar district (P171648) I. PROJECT STATUS AND RATIONALE FOR RESTRUCTURING 1. The Bangladesh Health and Gender Support Project for Cox’s Bazar District (HGSP) was approved by the World Bank’s Board of Executive Directors on March 31, 2020, and became effective on June 22, 2020. The project is financed by an International Development Association (IDA) grant in the amount of SDR 109.3 million (US$150 million equivalent). The Project Development Objective (PDO) is to “improve the access to and utilization of health, nutrition and population (HNP) and gender-based violence (GBV) response services among the host and the displaced Rohingya population in Cox’s Bazar district”. 2. The HGSP is implemented by the Ministry of Health and Family Welfare (MoHFW) and supports its national sector program for 2017–2024. The MoHFW has contracted five United Nations agencies to implement specific project activities collectively amounting to US$133.5 million. The choice of these agencies is consistent with their comparative advantage in similar refugee and fragility related contexts. 3. The project was rated Satisfactory for both Progress towards achievement of PDO and Overall Implementation Progress in the most recent Implementation Status Report (December 2023). All three PDO indicators have achieved their end of project targets and fourteen of the sixteen intermediate results indicators have achieved their end target with the remaining two on track. As of February 08, 2024, the project has disbursed US$122.8 million and it is expected to disburse the remaining amount by the project closing date of June 30, 2024. 4. The project was previously restructured in February 2023 to (i) extend the closing date; (ii) reallocate between disbursement category 1 and 2; (iii) include civil works under category 1; and (iv) modify indicators and targets. This proposed restructuring responds to a request received from the Economic Relations Division of the Ministry of Finance, dated January 24, 2024 to reallocate financing from disbursement category 1 to category 2. The proposed changes were discussed and agreed with the MoHFW during the last implementation support mission in November 2023. 5. The rationale for the restructuring is to allow the MoHFW to procure first-line tuberculosis drugs, medical equipment, and other surgical consumables through the United Nations Office for Project Services (UNOPS). This request for drugs and other items has come from the field as the access and utilization of services in the facilities has increased due to the availability of human resources in Cox’s Bazar through this project. As the project closes in June 30, 2024, the Government wants to ensure that there is no stock out of drugs in the facilities especially those providing services at the camps (as these are provided by the project financing) and no disruption of services (both within the host and DRP communities) at least for a few months after project closing and the effectiveness of the follow on project. 6. Due to recent amendments to some of the other UN contracts, the UN category 2 ceiling has been reached. To continue providing uninterrupted services, the category 2 allocation needs to be increased which will be directly reduced from the share of financing under MoHFW’s execution (category 1). II. DESCRIPTION OF PROPOSED CHANGES 7. This Restructuring Paper proposes to reallocate financing between disbursement category 1 and disbursement category 2. Specifically, to increase the category 2 allocation by SDR 3,237,823.77 which will be directly reduced from the category 1 allocation. ES NOTE TABLE The World Bank Health and Gender Support Project for Cox’s Bazar district (P171648) III. SUMMARY OF CHANGES Changed Not Changed Reallocation between Disbursement Categories ✔ Implementing Agency ✔ DDO Status ✔ Project's Development Objectives ✔ Results Framework ✔ Components and Cost ✔ Loan Closing Date(s) ✔ Cancellations Proposed ✔ Disbursements Arrangements ✔ Disbursement Estimates ✔ Overall Risk Rating ✔ Legal Covenants ✔ Institutional Arrangements ✔ Financial Management ✔ Procurement ✔ Implementation Schedule ✔ Other Change(s) ✔ Economic and Financial Analysis ✔ Technical Analysis ✔ Social Analysis ✔ Environmental Analysis ✔ IV. DETAILED CHANGE(S) OPS_DETAILEDCHANGES_REALLOCATION _TABLE REALLOCATION BETWEEN DISBURSEMENT CATEGORIES Financing % Current Allocation Actuals + Committed Proposed Allocation (Type Total) The World Bank Health and Gender Support Project for Cox’s Bazar district (P171648) Current Proposed IDA-D5920-001 | Currency: XDR iLap Category Sequence No: 1 Current Expenditure Category: Gds,Ex veh N/CS, Trn IOC, works 7,000,000.00 0.00 3,762,176.23 100.00 100.00 Current Expenditure Category: Gd,Ex veh inc Sp VehN/CS,Trn IOC and UN iLap Category Sequence No: 2 payments 102,300,000.00 102,265,139.62 105,537,823.77 100.00 100.00 iLap Category Sequence No: 3 Current Expenditure Category: Emerg Expnd Part 4 0.00 0.00 0.00 0.00 0.00 Total 109,300,000.00 102,265,139.62 109,300,000.00 .