Palestinian Ministry of Health Addendum to the Original Stakeholder Engagement Plan (SEP) FOR WEST BANK AND GAZA HEALTH SYSTEM EFFICIENCY AND RESILIENCE PROJECT (P180263) ADDITIONAL FINANCING April 2024 HSERP-Addendum Stakeholder Engagement Plan (SEP) 1 INTRODUCTION In accordance with the World Bank Environmental and Social Framework’s (ESF’s) Environmental and Social Standard 10 (ESS10), a stakeholder engagement plan (SEP) needs to be prepared and implemented for all Bank supported investment policy financing (IPF) projects. A SEP for the Parent project West Bank and Gaza Health System Efficiency and Resilience PROJECT (P180263) was disclosed on February 15th, 2023, and is available at https://site.moh.ps/Index/CategoryView/CategoryId/23/Language/ar). 1.1 PROJECT DESCRIPTION AND COMPONENTS For the Additional Financing (AF), components 1 and 2 have been scaled up as follows: Component 1 includes delivering essential primary health services, strengthening information systems and the quality of PHC, and enhancing family and mental health services in Gaza; and Component 2 involves procuring medical equipment to expand hospital capacity in high-need areas, strengthening management and quality of care in hospitals, delivering rehabilitation and reconstructive surgery services, and undertaking recovery and reconstruction of public hospital infrastructure in Gaza. Component 3, a new component focusing on strengthening pandemic preparedness and response, is added in the AF. The project will also have two additional components, one focused on Project Implementation and Monitoring which will finance necessary human resources and running costs for the Project Management Unit (PMU), and another on Contingent Emergency Response (CERC) which will improve the Palestinian Authority's (PA) ability to respond effectively in the event of an emergency in line with World Bank procedures on disaster prevention and preparedness. For further details on the project’s subcomponents please refer to the Project Appraisal Document (PAD) publicly available at: https://documents1.worldbank.org/curated/en/ 2. OBJECTIVES OF THE STAKEHOLDER ENGAGEMENT PLAN The overall objective of the SEP is to define a program for stakeholder engagement, including public information disclosure and consultation throughout the entire project cycle. The SEP outlines the ways in which the project team will communicate with stakeholders and includes a mechanism by which people can raise concerns, provide feedback, or make complaints about project activities or any activities related to the project. The Addendum should be read and applied in conjunction with the parent project SEP. 3. STAKEHOLDER IDENTIFICATION AND ANALYSIS 3.1 STAKEHOLDER ENGAGEMENT METHODOLOGY This Addendum will apply the following stakeholder engagement principles: openness, informed involvement, sensitivity and inclusivity and flexibility. A description of those principles is provided in the parent project SEP page 9. Significantly, conventional face-to-face interactions are currently hindered by the ongoing war in Gaza and the dangerous circumstances in the West Bank, and these obstacles will persist for some time. Therefore, until more conventional means of involvement are feasible, other types of engagement, particularly phone-based and email contact, will be used. 2 HSERP-Addendum Stakeholder Engagement Plan (SEP) 3.2. Affected parties and other interested parties Affected parties under the AF include at-risk populations and population affected by the conflict in Gaza which include at least 1,000,000 children and a total of 1.4 million internally displaced persons (IDPs), medical and emergency personnel in medical, laboratory and testing facilities, and health agencies across Gaza; patients with chronic diseases; primary healthcare staff; hospital staff and other parties that may be directly impacted by project activities such as hospitals and primary care clinics. Other interested parties under the AF include (but are not limited to) institutional actors such as Ministry of Finance, Ministry of Agriculture, Environmental Quality Authority, Ministry of Social Development, Ministry of Women’s Affairs, Non-Governmental Organizations (NGOs) and Community Based Organizations (CBOs), and International NGOs (INGOs) providing health services, UN agencies (WHO, FAO, UNICEF, UNRWA) and the local media. 3.3. Disadvantaged/vulnerable individuals or groups Disadvantaged and vulnerable groups may include (but are not restricted to) the general population, including women, children, and the elderly, who often face significant risks during conflicts due to violence, displacement, and limited access to essential services , People with Disabilities, Economically Disadvantaged, and Healthcare Workers both in Gaza and West Bank, etc. 4. STAKEHOLDER ENGAGEMENT PROGRAM 4.1. Summary of stakeholder engagement done during project preparation For the Parent Project, a series of stakeholder engagement activities took place during project preparation in late in 2022 and early 2023. These included consultations with relevant MoH departments, as well as OIPs such as the UNICEF, UNFPA, ICRC and MoF. Further details of Parent Project engagement activities are available in the Parent Project’s SEP disclosed in February 2023 and available at: https://site.moh.ps/Content/File/771aA89rU6HRSrXmM7R9kBca_quJWCa1V9lcw4DyFkunww3GT.p df. The Parent project SEP was also updated following the activation of the CERC. A summary of the stakeholder engagement activities for the CERC activation is provided in the SEP disclosed on December 12, 2023 and available at https://site.moh.ps/index/ArticleView/ArticleId/6519/Language/ar. Following the activation of the CERC component in the aftermath of October 7th and the ongoing conflict in Gaza, the SEP has been updated to reflect the stakeholder engagement needs. Such engagement activities took place between October and November 2023 on a variety of topics including (among others) the health sector emergency response, health needs in Gaza, reallocation of funds, activation of CERC, and logistics and priorities. These activities where attended by different stakeholders representing identified PAPs and OIPs in the SEP. Details of the CERC activation stakeholder engagement activities can be accessed through the CERC Updated SEP: https://site.moh.ps/Content/File/2cezQlP4AlE1B9Xy63znIhiU_laIPPIW92nLrGdT534ecA8pJ.pdf For the AF, different stakeholder engagement activities initiated in late 2023 took place between the MoH PMU, World Bank, and PAPs and OIPs. The table below provides a summary of the stakeholder engagement activities for the AF that took place between February 2024 and end of March 2024. 3 HSERP-Addendum Stakeholder Engagement Plan (SEP) Table 1: Summary of Stakeholder Engagement Activities Conducted for the HSERP AF Stakeholder Meeting Topic Date Humanity and Inclusion (HI), Medical Relief Society Bi-Lateral Discussions on Current Response Activities: (PMRS), Near East Council Scope of Activities conducted, implementation of Churches (NECC), Gaza modalities on the field, operational plans and lessons Community Mental Health learnt, field partners and field mobilization, reporting Programme & World Bank mechanisms. E&S Meeting: Preparation of updated and streamlined PMU and World Bank ESF instruments for HSERP AF February 04, 2024 Discussion on PHC Component: Review of proposed interventions and feedback on the activities relevant to MoH’s PHC and PMU PHC February 04, 2024 Feedback on AF Project Activities and Scope: Review of proposed activities, components, and structure of the MoH, PMU, and World AF in line with the Pandemic Fund and proposed Bank interventions February 06, 2024 PPR Activities: Discussion on proposed activities for Pandemic prevention, preparedness, and response (PPR) MoH, PMU, and WHO under the PF February 06, 2024 MoH, PMU, and Laboratories Activities: Review of laboratories activities Paramedical Services and the proposed interventions under the AF February 11, 2024 Services Purchase Unit (SPU), PMU Needs Assessment: Review of SPU insurance activities February 28, 2024 coordination regarding NCD, emergency and trauma, mobile clinics and mental health related activities Health Cluster among all health actors March 05, 2024 General Administration of Central Laboratries, General Administration of Warehouses, Focal point of PPR Baseline Assessment: Review of needs and baseline Antimicrobial Resistance, conditions all stakeholders consulted with, and review Planning and Policy Unit, of proposed activities in line with each of their IHR focal Point, Unit of respective activities. (bi-lateral meetings with listed Public Health, PMU stakeholders) March 17 – March 21, 2024 FAO & Ministry of PRR Action Plan and Processes: Consultation and review Agriculture, MoH, and of PRR activities relevant to the scope of the PMU stakeholders March 20, 2024 Bi-lateral engagement to review the HSERP AF and the proposed activities. PRCS provided feedback on the proposed activities and provided an overview of their current activities in responding to the emergency. Palestine Red Crescent PRCS provided feedback on the project components and Society (PRCS) & World activities, they stressed the importance of the early Bank detection system, however they provided comments on March 25, 2024 the urgency of the information system compared to 4 HSERP-Addendum Stakeholder Engagement Plan (SEP) Stakeholder Meeting Topic Date other needs. PRCS highlighted the need of cross-sectoral interventions, especially in relation to WASH as various diseases are being reported originate from WASH conditions. PRCS provided lessons learnt from COVID-19 and other emergencies in relation to PHC and the role of NGOs and the private sector to assist MoH in handling the emergency. Additionally, PRCS highlighted the need to coordinate efforts and procurement to avoid duplication, and to check the list of “permitted� medications and equipment to ensure that purchased goods can enter Gaza. Other discussion points included the need of infrastructure rehabilitation for hospitals and PHC, especially with solutions such as solar energy. PRCS stressed the need to address nutrition in projects, and provided an overview of the Amal and Quds hospital which are heavily impacted in Gaza. Consultation and Review of proposed activities and WHO & Health Cluster, components under the HSERP AF. Email sent with PMU & World Bank proposed activities for feedback March 24, 2024 Consultation and review of proposed activities under the HSERP AF. Partiuclar discussion took place regarding GBV (SEA/SH) response and the emergency needs in the West Bank and Gaza. SAWA provided an overview of the current situation in the West Bank and Gaza in relation to GBV support and response. SAWA stressed the lack of medicines, hygiene kits, and also mental health medications. SAWA stressed the importance of MHPSS interventions but highlighted that even service providers require MHPSS. SAWA highlighted that till date there is no official partner on SAWA (NGO) & World Bank ground as communities are still displaced. March 25, 2024 Consultation bi-lateral call regarding the HSERP AF proposed activities and components. Juzoor provided an overview of their interventions and current support. Juzoor stress on the importance of integration of MHPSS Juzoor (NGO) & World in the project’s activities, especially regarding MHPSS Bank first aid. March 25, 2024 Vulnerable groups within the communities affected by the project will be further confirmed and consulted, during the detailed design of sub-projects, through dedicated means (as appropriate). 4.2. Summary of project stakeholder needs and methods, tools, and techniques for stakeholder engagement Stakeholders needs and methods, tools and techniques are described in the Parent project SEP. A table summarizing the needs and methods is attached to this document as Annex 1. 5 HSERP-Addendum Stakeholder Engagement Plan (SEP) 4.3. Stakeholder engagement plan Activities for the AF are covered in the Stakeholder Engagement Plan in the original SEP prepared for the Parent project available at https://site.moh.ps/Content/File/771aA89rU6HRSrXmM7R9kBca_quJWCa1V9lcw4DyFkunww3GT.p df. This addendum should be read and applied along with the original SEP. This addendum to the original SEP for the AF and the Environmental and Social Commitment Plan (ESCP) for AF will be publicly disclosed on Ministry of Health website and on the Bank’s system. Project documents including updates and details about the project Grievance Mechanism will also be posted on the MoH website. Printed material (manuals, brochures, posters, etc.) will be prepared and used based on identified needs. English and Arabic languages will be used to disclose information on project website. 4.4. Reporting back to stakeholders Stakeholders will be kept informed as the project develops, including reporting on project environmental and social performance and implementation of the stakeholder engagement plan and Grievance Mechanism, and on the project’s overall implementation progress. 5. Resources and Responsibilities for implementing stakeholder engagement activities 5.1. Resources The MoH will be in charge of the implementation of the stakeholder engagement activities. The EHSO will implement and review this plan every six months to determine if any changes to stakeholder categories or engagement activities are required. The EHSO will be supported by the Health Specialist, who provides technical support for the implementation of activities in both WB&G, as well as ensures effective monitoring and evaluation. The budget allocated for the implementation of the engagement activities under the AF is estimated to $12,000 for the entire project duration and shall be revised accordingly. A detailed budget of the cost of the activities is provided in Annex 2. 5.2. Management functions and responsibilities The proposed AF will rely on the existing implementation arrangements under the parent project. Consultations under Component 3 will be conducted by the respective UN agencies: WHO and FAO for subcomponent 3.1 and UNICEF for subcomponent 3.3. The PCU/EHSO at MoH will be responsible for M&E and submitting E&S progress reports. Input from MOH, WHO, UNICEF, and FAO will be included into joint progress reports for the Pandemic Fund. The project coordination function would therefore rely on MoH’s proven capacity in managing and implementing World Bank-financed projects. The stakeholder engagement activities will be documented as part of the Project progress reporting requirements, and as indicated in the project ESCP. 6. Grievance Mechanism A GM is available for the HSERP project and details are available in the original project SEP (https://site.moh.ps/Index/CategoryView/CategoryId/23/Language/ar) on page 29. The Additional financing will use the GM assigned for the parent project. Grievances will be handled at the project’s level by the EHSO. The project coordinator in Gaza will be responsible for receiving any grievances that are communicated or registered in person and will refer them to the EHSO. The project coordinator will also follow up on resolving grievances on ground in consultation with the EHSO. 6 HSERP-Addendum Stakeholder Engagement Plan (SEP) Details of the GM processes (including for GBV/SEA/SH related complaints) are available in the original SEP on p. 29. A complaint form for submitting grievances is included in the Parent project SEP. Where project activities are being implemented through UN agencies, the AF will also use the GM developed for the UNICEF and WHO operations, known as the Complaint Feedback Mechanism (CFM). The project GM and CFM are based on common principles and share similar processes and policies for receiving and handling complaints and feedback, as well as for data protection, including any inter- agency referral mechanisms needed. The UNICEF, WHO, FAO, Ministry of Agriculture and Ministry of Health will be using their existing GMs during the implementation of the pandemic prevention, preparedness, and response activities. The GM and CFM will be disclosed and announced to the public through the appropriate channels and utilizing the methods, tools, and techniques described in the SEP/SEP Addendum. Under Component 1, the MoH will also contract NGOs to implement mental health and psychosocial support services. These NGOs will provide GMs for the project stakeholders/beneficiaries and for their workers and these GMs will be effective and functional prior to the start of implementation of these NGO activities. The MoH GM may also be utilized in cases where the NGO systems are not available or fully effective. The implementing agencies will share logs of grievances received through the GM or CFM with the PMU in accordance with agreed protocols. Grievances relating to GBV (SEA/SH) will be handled/processed differently in line with procedures for SEA/SH related complaints and additional requirements such as for confidentiality will be maintained for all such cases. A labor GM is already established and available for the parent project. In addition, the labor GM shall also be available at the level of the Pandemic Fund partners (i.e. WHO, FAO and UNICEF), who will be required to develop and establish labor GMs for their workers. Details of the workers’ GM are included in the Project’s LMP available at:https://site.moh.ps/Index/CategoryView/CategoryId/23/Language/ar 7.1. Summary of how SEP implementation will be monitored and reported Monitoring and Reporting mechanisms are described in the original SEP. Link to the original SEP is provided above. 7 HSERP-Addendum Stakeholder Engagement Plan (SEP) ANNEXES Annex 1: Description of the proposed methods needs, tools and techniques of engagement that will be undertaken by the project. Stakeholder Specific Needs (accessibility, large print, childcare, Consultation Methods Group daytime meetings) • Arabic Language Executive Summaries if documents are prepared in English, or complete translation of All Stakeholders • MoH Website Information Disclosure documents when possible. • Announcement of disclosure over social and mass media. • Virtual or tele-meetings in areas of conflict and where there are accessibility restrictions • Emails • All materials to be shared in Arabic • Nontechnical summary documents • Printed material to be in large font • Flyers • Information to be shared in formats accessible to Patients and their representative groups non-literate and low-literate audiences (e.g., Patient Friend’s Benevolent Society, • Posters • Meetings during standard working hours Patient Friends Charity Hospital) • Focus Group Meetings (When • Time bound meetings to enable stakeholders to Possible) meet family/professional commitments • Community Feedback Mechanism • Ensure confidentiality and protection of personal (CFM) information when discussing potentially sensitive topics • • � Official letters � Official correspondence and nontechnical � Emails documents or progress reports to be shared in MoH Departments , MoH District Offices, � Nontechnical summary documents Arabic (official language) and MoH established Key Committees � Progress reports � Meetings during standard working hours � In person meetings (when possible) � Virtual or tele-meetings in areas of conflict and � Virtual Meetings and phone calls where there are accessibility restrictions � Official letters Managers and Key staff of PHCs, � Emails � Direct and bilateral engagements Government Hospitals, Laboratories, and � In-person and online meetings � Materials to be shared in Arabic MHPSS service providers � Nontechnical summary documents � Flyers � Posters � Nontechnical summary documents � All materials to be shared in Arabic � Flyers � Printed material to be in large font Health workers at PHCs, Hospitals, � Posters � Ensure confidentiality and protection of personal laboratories and MHPSS � Workers’ Feedback Mechanism information when discussing potentially sensitive topics � Focus Group Meetings (When � Meetings during standard working hours Possible) UN agencies at regional and local level � Official letters � Official correspondence (i.e. WHO, UNICEF, UNRWA, UNFPA, � Emails � Meetings during standard working hours UNOPS) � Phone calls � Continuous engagement and updates � Nontechnical summary documents � Progress reports � One to one meeting (when possible) Humanitarian and Development � Cluster working group in-person and � All materials to be shared in both Arabic and English Actors, including NGOs and CSOs (i.e. online meetings � Printed material to be in large font Palestinian Red Crescent, ICRS, PMRS) � Bilateral in-person and online � Meetings during standard working hours and GBV Redress Service Providers (i.e. meetings SAWA) � Email � Phone 8 HSERP-Addendum Stakeholder Engagement Plan (SEP) Stakeholder Specific Needs (accessibility, large print, childcare, Consultation Methods Group daytime meetings) � Flyers Community leaders, community groups � Social media such as Facebook and � All materials to be shared in Arabic such community volunteers, and the WhatsApp groups � Printed material to be in large font communities living in the targeted � In-person meetings (when possible) � Information to be shared in formats accessible to areas, including beneficiaries and � Banners non-literate and low-literate audiences vulnerable groups mentioned above as � Posters � Meetings during standard working hours well � Flyers � Time bound meetings to enable stakeholders to � Radios meet family/professional commitments � Community Feedback Mechanism � Ensure confidentiality and protection of personal (CFM) information when discussing potentially sensitive topics Health actors working in the targeted � Cluster working group in-person and � All materials to be shared in both Arabic and English areas including private sector service online meetings � Meetings during standard working hours providers � Prebid and awareness meetings online and in person � Email � Phone � Flyers Mass Media and Associated Interest � Social media such as Facebook and � All materials to be shared in both Arabic and English Groups Instagram � Meetings during standard working hours � Information Disclosure on MoH Website � In-person meetings (when possible) � Nontechnical summary documents � Community Feedback Mechanism (CFM) 9 HSERP-Addendum Stakeholder Engagement Plan (SEP) Annex 2: Estimated budget for stakeholder engagement activities for the project duration of SEP implementation Total Costs Unit Costs Budget Category Quantity (USD) Times/Years (USD) 1. Events 1a. Project Launch event 0 0 0 0 1b. PAPs meetings (virtual) 0 0 0 0 1c. In person Engagement information sessions to be conducted when the security situation on the 3 1000 3 ground allows it 3000 2. Communication campaigns 2a. Communications materials (posters, pamphlets, flyers… including design) when the security LS LS LS situation on the ground allows it 3000 2b. Information disclosure including media LS LS LS 1500 2c. Survey (to be conducted by the TPM firm) 1 1 3000 3. Trainings 3a. E.g., training on compliance with Bank’s requirements including gender-based violence 3 500 3 (GBV) 1500 TOTAL STAKEHOLDER ENGAGEMENT BUDGET: 12,000 10