The World Bank Honduras COVID-19 Emergency Response Project (P173861) REPORT NO.: RES54978 RESTRUCTURING PAPER ON A PROPOSED PROJECT RESTRUCTURING OF THE HONDURAS COVID-19 EMERGENCY RESPONSE PROJECT APPROVED ON APRIL 15, 2020 TO THE REPUBLIC OF HONDURAS HEALTH, NUTRITION & POPULATION GLOBAL PRACTICE LATIN AMERICA AND CARIBBEAN REGION Regional Vice President: Carlos Felipe Jaramillo Country Director: Michel Kerf Regional Director: Luis Benveniste Practice Manager/Manager: Michele Gragnolati Task Team Leader(s): Nicolas Collin Dit De Montesson, Courtney Price Ivins The World Bank Honduras COVID-19 Emergency Response Project (P173861) ABBREVIATIONS AND ACRONYMS AF Additional Financing BFP Bank-Facilitated Procurement COVAX COVID-19 Vaccines Global Access COVID-19 Coronavirus Disease 2019 E&S Environmental and Social ESF Environmental and Social Framework GoH Government of Honduras ICU Intensive Care Unit IDA International Development Association INVEST-H Strategic Investments Honduras (Inversión Estratégica de Honduras) ISR Implementation Status and Results Report MPA Multiphase Programmatic Approach PDO Program Development Objective PIU Project Implementation Unit PPE Personal Protective Equipment SEFIN Ministry of Finance (Secretaria de Finanzas) SESAL Ministry of Health (Secretaria de Salud) SPRP Strategic Preparedness and Response Program UNOPS United Nations Office for Project Services The World Bank Honduras COVID-19 Emergency Response Project (P173861) BASIC DATA Product Information Project ID Financing Instrument P173861 Investment Project Financing Environmental and Social Risk Classification (ESRC) Substantial Approval Date Current Closing Date 15-Apr-2020 30-Apr-2023 Organizations Borrower Responsible Agency Republic of Honduras Multiphase Programmatic Approach (MPA) Program Development Objective The Program Development Objective is to prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness Multiphase Programmatic Approach (MPA) Status (Public Disclosure) Status and Key Decisions (Public Disclosure) COVID-19 MPA Considerable efforts continue to be made to advance the implementation of the 87 MPA operations. As of March 15, 2023, 88 MPA-projects had been approved with a total commitment of US$4.3 billion. One operation (Guatemala) was cancelled in mid-September 2021, at the request of the Government. Six parent projects were restructured to include vaccine-related procurement. Twenty-three (23) operations are being implemented in Fragile and Conflict-affected situations. Total disbursements as of March 15, 2023, amount to US$3.88 billion or 91% of overall commitments. This amount does not include disbursements under MPA-V operations which are reported together with AF-V operations. Loans and Credits denominated in SDRs and Euros are being affected because of fluctuations between the SDRs and Euros against the US dollar. Four country operations closed by the end of FY22 and other seven operations closed by the end of The World Bank Honduras COVID-19 Emergency Response Project (P173861) the CY. Individual COVID-19 MPA operations will not have to complete an ICR. Instead, one ICR will be prepared for the entire COVID-19 MPA Program based on final ISRs prepared by country operations’ teams. Seventy (70) country projects or 80 percent of projects approved have reached 70-100+ percent disbursement (reasons for >100% disbursements relate to fluctuations between the Euro and the SDR against the US$). Out of the 70 operations, 57 operations or 81 percent have disbursed over 90+% of commitments. Out of the 70 operations, 38 operations are fully disbursed, and 16 operations have disbursed 95-99 percent of commitments. There are six operations with disbursements of 50 percent or less. Out of these six operations, one has not disbursed (AFW), and one operation has disbursed 30 percent (AFW). The projects are benefitting around 3.7 billion people or 50% of the global population. When countries with AF-V operations are counted, the projects are benefitting 4.1 billion of 51 percent of the global population. This is because some countries that don’t have a parent project have AF-V operations. Of the 87 active projects: (i) 33 are in Africa – 12 in AFE and 21 in AFW; (ii) 12 in East Asia; (iii) 14 in Europe and Central Asia; (iv) 11 in Latin America and the Caribbean; (v) 8 in Middle East and North Africa; and (vi) 9 in South Asia. Eighty-six (86) or 99% of projects approved are disbursing. ECA has the highest percentage of disbursements (97%), followed by MNA (96%), SAR (94%), LAC (92%), EAP (89%), AFE and AFW (77%). AFE lower disbursements compared to other regions are a result of low disbursements under two operations. In the case of AFW low disbursements are a result of no disbursements under one operation and only 30 percent under another. Retroactive Financing (RF) represents 20 percent of commitments. SAR has the highest percentage of RF at 37 percent, followed by ECA at 18 percent. IDA represents 39 percent and IBRD 41 percent of disbursements. Streamlined procedures, delegated approvals, coupled with flexible project design and intensified efforts across the Bank have contributed to the progress. Implementation is being guided by Bank teams working in parallel with other health related projects, including Additional Financing operations supporting vaccine procurement and deployment efforts. Notwithstanding challenges of implementation, the MPA is on track to achieve its PrDO, which is to prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness. COVID-19 MPA Additional Financing The Additional Financing (MPA AF-V) to the COVID-19 Strategic Preparedness and Response Program utilizing the Multiphase Programmatic Approach (COVID-19 MPA) was approved by the Board on October 13, 2021. The AF-V was approved with an envelope of US$12 billion ($6 billion from IDA and $6 billion from IBRD) in financing. On June 30, 2021, President Malpass announced the expansion of financing available for COVID-19 vaccine financing to $20 billion over the next 18 months, adding $8 billion to the previously announced $12 billion. The AF-V is expected to enable vaccination for up to 750 million people, with potential surge capacity for an additional 250 million people in the poorest countries while scaling support to strengthen immunization delivery, with design flexibility at the country level. The AF-V is a scale-up of planned vaccination activities anticipated and supported under the COVID-19 MPA and a key contribution to the WBG’s overall COVID-19 response. As of early March 2023, 634 million doses have been purchased and 503 million have been delivered with Bank financing to 56 countries. The World Bank Honduras COVID-19 Emergency Response Project (P173861) As of March 15, 2023, the Bank had approved 116 operations (including MPA-V operations) to support vaccine procurement and rollout in 80 countries amounting to $10.1 billion. However, the Costa Rica operation was cancelled in early March 2023 at the Government’s request. There are now 115 operations with a commitment of $9.92 billion. The 115 operations approved, include 6 operations that involved restructuring of parent projects (Bhutan, Cameroon, North Macedonia, Philippines, and Pakistan) and in the case of Lebanon, restructuring of the Health Resilience Project. Of the 116 approved operations: (i) 64 are in Africa – 29 in AFE and 35 in AFW; (ii) 10 in East Asia and the Pacific; (iii) 11 in Europe and Central Asia; (iv) 12 in Latin America and the Caribbean; (v) 9 in Middle East and North Africa; and (vi) 9 in South Asia. Thirty-two operations are being implemented in Fragile and Conflict-affected situations. IDA continues to represent 42 percent and IBRD 58 percent of disbursements. Total disbursements under these projects as of March 15, 2023, amount to US$5.65 billion or 57 percent of overall commitments. Disbursements under MPA-V operations are included in this total while disbursements under the six restructured projects are counted under parent projects. Disbursements under AF-V operations have slowed down in the past months because of excess donor funding for vaccines’ procurement and lower needs than anticipated for IBRD/IDA funds for the procurement of vaccines. Thirty-five (35) or 30 percent of AF-V and MPA-V operations have disbursed 70 percent or more of their commitments. Out of the 35, twelve operations have disbursed 90+ percent. Out of the twelve, three operations are fully disbursed, and six operations have disbursed 98-99 percent of commitments. Eighty-five (85) operations or 73 percent of total operations approved are disbursing. Retroactive Financing (RF) represents 37 percent of overall commitments. High levels of RF have been authorized under different operations - Ukraine (100%), Panama and Turkey (90%), Argentina and Guyana (80%), and Belize, and Sri Lanka (70%). One hundred and twelve (112) loan/financing agreements or 97 percent of projects approved have been signed. One hundred and ten (110) loan/financing agreements or 95 percent of projects approved have become effective. As with the MPA operations, streamlined procedures, delegated approval, wide use of Bank Facilitated Procurement, coupled with flexible project design, and intensified efforts across the Bank have contributed to the rapid design, processing, and implementation of the operations. OPS_TABLE_PDO_CURRENTPDO Project Development Objective (PDO) Original PDO To detect and respond to the threat posed by COVID-19 in the Republic of Honduras. OPS_TABLE_PDO_CURRENTPDO Summary Status of Financing (US$, Millions) Net Ln/Cr/Tf Approval Signing Effectiveness Closing Commitment Disbursed Undisbursed IDA-68680 16-Apr-2021 30-Jun-2021 30-Sep-2021 30-Apr-2023 20.00 7.47 12.53 IDA-66260 15-Apr-2020 23-Apr-2020 28-May-2020 30-Apr-2023 20.00 16.15 3.85 The World Bank Honduras COVID-19 Emergency Response Project (P173861) Policy Waiver(s) Does this restructuring trigger the need for any policy waiver(s)? No 1. This Restructuring Paper seeks the Regional Vice President’s approval of a Level II Restructuring to (a) extend the closing date of the IDA credits (6626-HN and 6868-HN) financing the Honduras COVID-19 Emergency Response Project (P173861) from April 30, 2023 to October 30, 2024; (b) reallocate credit proceeds from vaccines procurement to health system strengthening, given donations received from COVAX and other bilateral donors; and (c) adjust the target of the PDO indicator tracking national vaccination coverage in the Project’s Results Framework. The Project’s implementation schedule and disbursement estimates would also be revised to reflect the new closing date. If approved, this would be the Project’s second restructuring, for a cumulative closing date extension of 18 months for the Additional Financing (AF) IDA Credit (6868-HN) and 30 months for the original IDA credit (6626-HN). I. PROJECT BACKGROUND AND STATUS 2. The Honduras COVID-19 Emergency Response Project (P173861), prepared under the Strategic Preparedness and Response Program (SPRP), in an amount of US$20 million (IDA Credit-6626-HN) was approved by the World Bank Board of Directors on April 15, 2020 and declared effective on May 28, 2020. The Project is composed of two components: (i) Emergency COVID-19 response and (ii) Implementation management and monitoring and evaluation. The Project aims to strengthen epidemiologic surveillance and diagnostic capacity of the Ministry of Health (Secretaría de Salud- SESAL) and strengthen public health services to cope with the increased demands posed by COVID-19. An AF of US$20 million (IDA Credit-6868-HN) to support the Government of Honduras (GoH) with the procurement and deployment of COVID-19 vaccines was approved by the World Bank Board of Directors on April 16, 2021, and declared effective on September 30, 2021. The primary objectives of the AF are to enable affordable and equitable access to COVID-19 vaccines, to help ensure effective vaccine deployment in Honduras through vaccination system strengthening, and to further strengthen preparedness and response activities financed by the parent IDA credit. A second restructuring of the Project was approved on April 29, 2022, to extend the closing date of the original IDA credit by one year (from April 30, 2022 to April 30, 2023), to align with the closing date of the AF. 3. In the last Implementation Status and Results (ISR) Report filed March 17, 2023, the Project’s progress towards achievement of the Project Development Objective (PDO) was rated Satisfactory, and overall Implementation Progress was rated Moderately Satisfactory. With 59 percent of the total financing envelope disbursed (US$23.6 million of US$40 million)1, the Project has helped close critical gaps in the COVID-19 response by financing the procurement and delivery of Personal Protective Equipment (PPE) and medical, laboratory and surveillance equipment. All three PDO indicators have now been achieved: two have surpassed final targets (92 percent of Intensive Care Unit beds in priority units are fully equipped and operational compared to an end-target of 72 percent, and 67 percent of the population over 6 months of age fully vaccinated as of March 3, 2023 (60 percent of the total population) compared to an end-target of 25 percent), and the remaining PDO indicator (national laboratory fully equipped with diagnostic equipment, test kits, and reagents) 1This includes US$16.15 million from the original US$20 million IDA credit, and US$7.47 million from the additional US$20 million IDA credit. The World Bank Honduras COVID-19 Emergency Response Project (P173861) has been met. As of March 2023, 100 percent of the total PPE purchased under the project has been distributed to all 20 health regions and 32 hospitals based on SESAL’s prioritization and evolving needs. The World Bank team has also provided technical support to facilitate digitalization to improve quality and utilization of vaccination data for decision-making. 4. COVID-19 status. As of March 7, 2023, Honduras had registered 472,520 COVID-19 cases with 11,111 deaths. The country has seen a steady decrease in the daily caseload and mortality rate since March 2022. Honduras’ COVID-19 vaccination activities have accelerated due to increased vaccine availability, and continuation of mass vaccination activities (“vacunatón”). The country is now offering booster doses to all adults and has reopened schools. The Government has also initiated pediatric COVID-19 vaccinations for children 5-11 years old. As of March 3, 2023, 67 percent of the population of 6 months of age had received two vaccine doses; 3.4 million had received one booster (57 percent of the targeted population), and 841,709 had received a second booster (35 percent of those targeted). For the pediatric vaccine, 72 percent of children aged 5-11 had received their first dose and 60 percent had received their second dose. Adult vaccination has now reached a plateau due to persistent vaccine hesitancy in certain regions, and the need to extend mobile outreach. The country is also planning to acquire and distribute vaccines to children 6 months to 5 years of age. 5. Although all PDO-level indicators have been met, there are moderate shortcomings in implementation progress resulting from: (a) lengthy delivery times and processes to ensure preparedness for installation and maintenance of medical equipment; (b) a slow government transition in 2022 following the 2021 general elections, which led to high management turnover across SESAL directorates, and concentrated decision-making processes at the Ministerial level; (c) institutional and administrative delays associated with the original Project Implementation Unit (PIU), Strategic Investments of Honduras (INVEST-H) and with the slow transition of the implementation from INVEST-H to SESAL in October 2021; (d) changing Government priorities and coordination challenges with donors, leading to frequent changes in the procurement plan for supplies; and (e) global shortages and market disruptions due to the pandemic. Whilst these prior challenges have since been resolved, their associated delays have hampered the Project’s ability to complete project- financed activities within the current implementation schedule, particularly those related to digitalizing health information systems and strengthening patient care capacity. 6. Project management. Project management and monitoring and evaluation performance both continue to be assessed as Satisfactory, as validated in the latest ISR filed on March 17, 2023. The PIU is fully staffed with requisite experience, and the implementation arrangements currently in place are deemed appropriate. The Recipient has no audits that are overdue or that were deemed unsatisfactory by the Bank, nor is the Project subject to suspension of disbursements. Procurement and Financial Management ratings were also rated as Satisfactory in the last ISR (March 2023), and the performance of the Recipient continues to be Satisfactory. The Project is compliant with most legal covenants, with partial compliance of select E&S covenants (namely carrying out the project in compliance with E&S Standards and the Environmental and Social Commitment Plan, and on GRM reporting). However, overall Environment and Social (E&S) performance rating continues to be assessed as Moderately Satisfactory. 7. Environment and Social. The Project’s E&S instruments were updated as part of the Project’s 2021 restructuring to include the corresponding risk management analysis pertaining to the vaccine activities supported by the AF. Revised ESF instruments were finalized and disclosed on the Client’s and Bank's respective websites in September 2021. SESAL has recently advanced on key E&S activities, including: (a) preparation of needs assessment forms, terms of reference, and standard E&S management plans and waste management plans; (b) assessment of hospital waste management and equipment needs and technical specifications for 17 hospitals and preparation of a draft standard lab waste management plan; (c) development of a standard code of conduct for project workers; and (d) preparation of standard forms and development of a new grievance redress mechanism (GRM) platform specifically related to vaccination deployment (now operational). SESAL will continue to maintain a PIU during project implementation, with qualified staff and resources to support management of Environmental, Social, Health and Safety risks and impacts of the Project, including environmental The World Bank Honduras COVID-19 Emergency Response Project (P173861) and social specialists with qualifications and experience acceptable to the World Bank. 8. Whilst measures established within the E&S Commitment Plan prepared by the PIU for the vaccination deployment campaign have been adequately implemented, the Client and Bank have agreed to a series of timebound actions to further strengthen E&S risk management and ensure full compliance with legal covenants. These include: (a) strengthening the GRM for vaccination deployment activities, such as the installation of fix and mobile complaint boxes, as well as the GRM channels for activities related to provision of hospital equipment; (b) addressing remaining deficiencies in solid waste management systems (including limited required separation of waste generated by vaccination activities in health service establishments prior to the transfer of waste to the final disposal sites); and (c) reducing safety and security risks for Project workers exposed to areas of high crime and violence in urban centers and for those who were deployed to remote areas during vaccination campaigns. There are no outstanding E&S measures expected by the scheduled closing date. II. RATIONALE FOR RESTRUCTURING 9. On March 10, 2023, the Ministry of Finance (Secretaría de Finanzas, SEFIN) submitted a formal request (No. DGCP-FE-0248/2023) to the World Bank for an 18-month extension of both IDA Credit 6626-HN and IDA Credit-6868- HN under the Project. Considering previous implementation delays, this proposed closing date extension would enable allocation of the undisbursed balance (US$16.4 million of US$40 million) to address critical unfulfilled needs and opportunities, namely the digitalization of health information system as well as the expansion of vaccination coverage using the new bivalent COVID-19 vaccines to ensure the inclusion of all population groups, and the strengthening of patient care capacity. a. Digitalizing the Health Information System. The project is supporting the implementation of Smart-Paper Technology (SPT) to digitalize vaccination records, which had been piloted in 2021 with World Bank support. The full 18-month proposed closing date extension is necessary to enable the nationwide scale up and institutionalization of this technology, a critical contribution to both COVID-19 and routine immunization systems to enable timely data for decision-making. The timeline for the roll out of this support is outlined in Table 1. Table 1. Timeline for digitalization activities Activity Timeline Pilot of Smart Paper Technology supported by the World Bank 2021 (completed) Agreements reached around nationalizing SPT for vaccination data, as part 2022 (completed) of broader digital health information strategy Through April 2023 (would be Contract established for initiation, and SPT scanner procurement completed extended with this restructuring) Scanner and software installation with technical assistance and training May-June 2023 Cascade training and capacity building to decentralized service delivery July-September 2023 levels Ongoing support for incremental roll out October 2023-October 2024 b. Expanding COVID-19 Vaccinations. In the emergency context in which the AF was prepared and, considering global vaccine shortages and prevailing recommendations to target vulnerable groups and healthcare workers, the initial vaccination targets were set conservatively at 25 percent of the population. However, with The World Bank Honduras COVID-19 Emergency Response Project (P173861) vaccines now widely available, national targets have increased, aiming to reach 65 percent of the population. Reaching this target requires large-scale outreach to target coverage inequity (particularly in remote areas and for marginalized groups, including populations of African and indigenous descent), with tailored communications strategies to overcome hesitancy. In response, the Project has supported the hiring of temporary personnel for mobile vaccination teams (approximately 800 people), as SESAL indicated they did not want to engage an intermediary firm to do so. After overcoming the administrative and logistical challenges that this entailed, the mobile campaign successfully vaccinated of over 382,855 people since its inception in November 2022 by February 6, 2023. SESAL would now like to use this structure to expand the campaign to the most populous health regions (Distrito Central and Francisco Morazán), while continuing to reach the last mile of vaccination coverage in remaining regions. Vaccine deployment will also include bivalent pediatric vaccines which have only recently been made available by pharmaceutical manufacturers, with 324,000 doses to be procured by the Project. c. Strengthening Patient Care Capacity. The proposed extension would also allow for the completion of key pending acquisitions with the required time for delivery, installation, and training, particularly for CT scanners, which are in critical demand in the country to provide patient care. Support from Bank Facilitated Procurement (BFP) will continue to mitigate risks of procurement-related delays and coordination challenges. 10. The Project objectives and activities continue to be achievable and highly relevant to the priorities of Honduras, particularly for health system strengthening. This proposed restructuring is fully aligned with one of the key recommendations resulting from the Global COVID-19 MPA Midterm Review, namely the proposal to take stock of performance and revisit the adequacy of project activities based on emerging evidence and evolving needs of the country. Successful execution of remaining activities with the project extension will be enabled by a PIU that has demonstrated strong performance since its establishment in October 2021, with procurement processes at advanced stages for all the remaining project financing. III. DESCRIPTION OF PROPOSED CHANGES 11. Eighteen-month extension in closing date. The Project’s restructuring would extend the closing date of the Project’s IDA credits by 18 months, from April 30, 2023 to October 31, 2024, enabling (a) acquisition of bivalent pediatric vaccines, now available from pharmaceutical manufacturers; (b) expansion of the mobile vaccination campaign established and entirely financed through the project to reduce inequities in vaccines coverage among vulnerable groups; (c) support to scale digitalization of information systems following project support of a successful pilot of Smart Paper Technology (intermediate indicator not achieved yet); and (d) finalization of acquisition and delivery of medical equipment critical for patient care (following the breakdown of the last two remaining CT scanners in public hospitals in the country). Procurement processes are at advanced stages for all remaining project financing. This proposed extension has been assessed as sufficient to complete critical activities and to fully disburse the credits, and to achieve the intended development objective and results of the project. This revised closing date remains within the COVID-19 Strategic Preparedness and Response Program (P173789) Multiphase Programmatic Approach (MPA), which closes on December 31, 2025. The Project’s implementation schedule and disbursement projections would be modified accordingly to reflect the revised implementation period and the implementation pace. 12. Reallocation across disbursement categories. To date, vaccines have been made available through donations from the US government, and through acquisition bilaterally and through COVAX. As such, the Government requested to reallocate US$2.25 million from Expenditure Category 2 of IDA 6868-HN (Goods under Part 1.(b)(iv) of the Financing Agreement, which refers to procurement of Project COVID-19 Vaccines) to Expenditure Category 2 (Goods, non-consulting The World Bank Honduras COVID-19 Emergency Response Project (P173861) services, and consulting services, Training and Operating Costs for the Project (except for goods under Part 1.(b)(iv)), to support the response to higher needs for health system strengthening activities than for vaccines purchase. This would reduce the amount of Project financing being allocated to vaccines from US$5.75 million to US$3.5 million. 13. The PDO would remain unchanged, and the Results Framework will be adjusted. The PDO “to detect and respond to the threat posed by COVID-19 in the Republic of Honduras” remains relevant. The scope of activities remains unchanged, but the PDO indicator “percentage of population vaccinated, which is included in the priority population targets, as defined in the National Plan for the Introduction of the Vaccine against COVID-19” will be modified to account for the additional 18 months of implementation and progress to date. The end target will be increased from 25 percent to 65 percent (with the sub-target on the percentage of female population vaccinated also increasing to 65 percent). This will account for the revised National Plan, and the coverage of 60 percent of the population vaccinated to date, with significant contributions from the project. 14. No changes to the implementation arrangements are proposed under this restructuring. The current PIU in SESAL, established in October 2021 following the restructuring that took place during the AF, remains in charge of project implementation and the execution of remaining funds for the project. Over the last 18 months, the PIU has been established and staffed with key qualified personnel, with a new procurement plan elaborated to meet the evolving demands of the pandemic response. IV. SUMMARY OF CHANGES Changed Not Changed Results Framework ✔ Loan Closing Date(s) ✔ Reallocation between Disbursement Categories ✔ Disbursement Estimates ✔ Implementation Schedule ✔ Implementing Agency ✔ DDO Status ✔ Project's Development Objectives ✔ MPA Program Development Objective ✔ MPA Expected Results and Indicators ✔ PBCs ✔ Components and Cost ✔ Cancellations Proposed ✔ Disbursements Arrangements ✔ The World Bank Honduras COVID-19 Emergency Response Project (P173861) Overall Risk Rating ✔ Legal Covenants ✔ Institutional Arrangements ✔ Financial Management ✔ Procurement ✔ Other Change(s) ✔ Economic and Financial Analysis ✔ Technical Analysis ✔ Social Analysis ✔ Environmental Analysis ✔ IV. DETAILED CHANGE(S) MPA PROGRAM DEVELOPMENT OBJECTIVE Current MPA Program Development Objective The Program Development Objective is to prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness EXPECTED MPA PROGRAM RESULTS Current Expected MPA Results and their Indicators for the MPA Program Progress towards the achievement of the PDO would be measured by outcome indicators. Individual country-specific projects (or phases) under the MPA Program will identify relevant indicators, including among others: • Country has activated their public health Emergency Operations Centre or a coordination mechanism for COVID-19; • Number of designated laboratories with COVID-19 diagnostic equipment, test kits, and reagents; • Number of acute healthcare facilities with isolation capacity; • Number of suspected cases of COVID-19 reported and investigated per approved protocol; • Number of diagnosed cases treated per approved protocol; • Personal and community non-pharmaceutical interventions adopted by the country (e.g., installation of handwashing facilities, provision of supplies and behavior change campaigns, continuity of water and sanitation service The World Bank Honduras COVID-19 Emergency Response Project (P173861) provision in public facilities and households, schools closures, telework and remote meetings, reduce/cancel mass gatherings); • Policies, regulations, guidelines, or other relevant government strategic documents incorporating a multi- sectoral health approach developed/or revised and adopted; • Multi-sectoral operational mechanism for coordinated response to outbreaks by human, animal and wildlife sectors in place; • Coordinated surveillance systems in place in the animal health and public health sectors for zoonotic diseases/pathogens identified as joint priorities; and • Mechanisms for responding to infectious and potential zoonotic diseases established and functional; and • Outbreak/pandemic emergency risk communication plan and activities developed and tested OPS_DETAILEDCHANGES_LOANCLOSING_TABLE LOAN CLOSING DATE(S) Original Revised Proposed Proposed Deadline Ln/Cr/Tf Status Closing Closing(s) Closing for Withdrawal Applications IDA-66260 Effective 30-Apr-2022 30-Apr-2023 31-Oct-2024 28-Feb-2025 IDA-68680 Effective 30-Apr-2023 31-Oct-2024 28-Feb-2025 OPS_DETAILEDCHANGES_REALLOCATION _TABLE REALLOCATION BETWEEN DISBURSEMENT CATEGORIES Financing % Current Allocation Actuals + Committed Proposed Allocation (Type Total) Current Proposed IDA-68680-001 | Currency: USD iLap Category Sequence No: 1 Current Expenditure Category: GO,NCS,CS,TR&OP ex Part 1.(b).(iv) 14,250,000.00 2,766,781.63 16,500,000.00 100.00 100.00 iLap Category Sequence No: 2 Current Expenditure Category: Goods under Part 1.(b).(iv) 5,750,000.00 0.00 3,500,000.00 100.00 100.00 The World Bank Honduras COVID-19 Emergency Response Project (P173861) Total 20,000,000.00 2,766,781.63 20,000,000.00 OPS_DETAILEDCHANGES_DISBURSEMENT_TABLE DISBURSEMENT ESTIMATES Change in Disbursement Estimates Yes Year Current Proposed 0000 0.00 0.00 2020 0.00 0.00 2021 14,283,250.20 14,283,250.20 2022 1,724,680.00 1,724,680.00 2023 23,992,069.80 11,111,570.47 2024 0.00 12,000,000.00 2025 0.00 880,449.33 2026 0.00 0.00 . The World Bank Honduras COVID-19 Emergency Response Project (P173861) . Results framework COUNTRY: Honduras Honduras COVID-19 Emergency Response Project Project Development Objectives(s) To detect and respond to the threat posed by COVID-19 in the Republic of Honduras. Project Development Objective Indicators by Objectives/ Outcomes RESULT_FRAME_TBL_PDO Indicator Name PBC Baseline End Target To respond to the threat posed by COVID-19 in the Republic of Honduras ICU beds in prioritized ICU units that are fully equipped and 0.00 70.00 operational (Percentage) Percentage of population vaccinated, which is included in the priority population targets, as defined in the National Plan for 0.00 65.00 the Introduction of the Vaccine against COVID-19 (Percentage) Action: This indicator has been Revised Percentage of female population vaccinated, which is included in the priority population targets, as defined in the 0.00 65.00 National Plan for the Introduction of the Vaccine against COVID-19 (Percentage) Action: This indicator has been Revised To detect the threat posed by COVID-19 in the Republic of Honduras Designated laboratories with COVID-19 diagnostic equipment, 0.00 1.00 test kits, and reagents (Number) The World Bank Honduras COVID-19 Emergency Response Project (P173861) PDO Table SPACE Intermediate Results Indicators by Components RESULT_FRAME_TBL_IO Indicator Name PBC Baseline End Target Emergency COVID-19 Response Share of prioritized health facilities receiving the volume of PPEs 0.00 100.00 planned under the project (Percentage) Health management and information system to deploy the COVID-19 vaccine is in place, including functionality for No Yes identification, registration, and follow-up with COVID-19 vaccine recipients (Yes/No) Share of vaccination leadership roles created by project financing 0.00 60.00 filled by women (Percentage) Share of regional health authorities reports on corrective measures taken based on feedback from users of health facilities 0.00 100.00 offering COVID-19 vaccination services published on SESAL's website (Percentage) IO Table SPACE Click here to enter text. The World Bank Honduras COVID-19 Emergency Response Project (P173861)