The World Bank JSDF - Strengthening Preparedness and Response to COVID-19 at the Grassroots level in Vietnam (P174401) REPORT NO.: RES54739 RESTRUCTURING PAPER ON A PROPOSED PROJECT RESTRUCTURING OF JSDF - STRENGTHENING PREPAREDNESS AND RESPONSE TO COVID-19 AT THE GRASSROOTS LEVEL IN VIETNAM APPROVED ON AUGUST 11, 2021 TO INSTITUTE FOR SOCIAL DEVELOPMENT STUDIES HEALTH, NUTRITION & POPULATION EAST ASIA AND PACIFIC Regional Vice President: Manuela V. Ferro Country Director: Carolyn Turk Global Director: Juan Pablo Eusebio Uribe Restrepo Practice Manager/Manager: Aparnaa Somanathan Task Team Leader(s): Huong Lan Dao, Anh Thuy Nguyen The World Bank JSDF - Strengthening Preparedness and Response to COVID-19 at the Grassroots level in Vietnam (P174401) ABBREVIATIONS AND ACRONYMS CHS Commune Health Station IRI Intermediate Result Indicator ISDS Institute for Development Studies PDI Project Development Indicator PDO Project Development Objectives PMU Project Management Unit RF Results Framework SECP Social and Environment Commitment Plan TAG Technical Advisory Group TOT Training of Trainers The World Bank JSDF - Strengthening Preparedness and Response to COVID-19 at the Grassroots level in Vietnam (P174401) BASIC DATA Product Information Project ID Financing Instrument P174401 Investment Project Financing Environmental and Social Risk Classification (ESRC) Moderate Approval Date Current Closing Date 11-Aug-2021 31-Dec-2024 Organizations Borrower Responsible Agency Institute for Social Development Studies Institute for Social Development Studies Financing (in USD Million) FIN_SUMM_PUB_TBL SUMMARY Total Project Cost 0 Total Financing 0 Financing Gap 0 DETAILS -NewFin3 Project Development Objective (PDO) Original PDO The development objective is to strengthen the capacities of communities, including the community leaders, health and other sectors and civil society organizations, and vulnerable populations in their preparedness and response to the COVID-19 pandemic as well as for other health emergencies in the project’s provinces. OPS_TABLE_PDO_CURRENTPDO The World Bank JSDF - Strengthening Preparedness and Response to COVID-19 at the Grassroots level in Vietnam (P174401) Summary Status of Financing (US$, Millions) Net TF Approval Signing Effectiveness Closing Commitment Disbursed Undisbursed TF-B6532 11-Aug-2021 23-Aug-2021 22-Nov-2021 31-Dec-2024 2.75 .67 2.08 Policy Waiver(s) Does this restructuring trigger the need for any policy waiver(s)? No I. PROJECT STATUS AND RATIONALE FOR RESTRUCTURING A. Project status 1. The Strengthening Preparedness and Response to COVID-19 at the Grassroots Level in Viet Nam project (TF0B6533) was prepared during the time when COVID-19 was at the peak globally. The financing was part of an emergency support by the Government of Japan for countries in the East Asia and Pacific Region to respond to COVID-19 and to better prepare for future pandemics and health emergencies. The project was approved by the Regional Vice-President on August 11, 2021; the Grant Agreement was signed on August 23rd, 2021, and the project became effective on November 25, 2021. The project then was officially approved by the Government of Vietnam (through Vietnam Union of Science and Technology Association) on January 19, 2022. The total project amount is US$2.85 million, of which US$2.75 million is from the Japan Social Development Fund (JSDF) and US$100,000 is a contribution from the Institute for Social Development Studies (ISDS). The project is managed and implemented by ISDS, in collaboration with the Ministry of Health and three Provincial Departments of Health in Vinh Phuc, Khanh Hoa and Long An provinces. 2. At the time of restructuring, the project has been on track towards achieving the project development objectives. The development objectives and design remain highly relevant, and implementation progress is satisfactory. Project activities have been implemented according to the overall and annual workplans. Disbursement rate was 20 percent as of May 2023. The World Bank JSDF - Strengthening Preparedness and Response to COVID-19 at the Grassroots level in Vietnam (P174401) 3. The project organization has been well established from the central to local levels. Key project staff and consultants have been on board to ensure adequate personnel to manage the project and to implement activities with quality and in a timely manner. A technical advisory group (TAG) has been established and membered by national lead pandemic response experts from the Ministry of Health and related agencies. A baseline survey was completed with good quality, which has provided updates to the Results Framework (RF) and served as formative research to design communication and intervention packages. All the technical guidelines and trainings of trainers (TOT) have been completed. Eight groups for vulnerable people have been established and activated with training and communication activities. 4. Detailed project implementation progress by components a. Component 1 - Building capacities at the grassroots level in preparedness for and response to COVID- 19 and other health emergencies. Activities under this component have been implemented as planned so far. Key project technical documents and guidelines, including: (i) guideline for developing inter-sectoral collaboration plan on preparedness for and response to COVID-19 and other health emergencies at the grassroots level; (ii) manual on prevention of cross-infection at community health stations (CHS); (iii) manual on continuing provision of essential healthcare services at CHSs during pandemics; and (iv) manual on supporting patient management, treatment support and patient referral for cases being infected with COVID-19, were developed and then were used to train for local people. Up to now, all five TOT courses and ten roll-out training courses were completed. List of equipment, both communication and medical equipment, for Commune Health Stations (CHS) was developed based on the actual needs of local CHSs and consulted with related stakeholders. The procurement of the equipment will be done during 2023. b. Component 2 - Raising awareness and knowledge towards changing attitudes and behavior of the community through risk communication. This component supports outreach communication activities focusing on the awareness, knowledge, and attitudes for behavioral changes of citizen and community on health emergency preparedness and response against COVID-19 and other pandemics. The implementation of this component has been in good progress. A set of manuals, including a manual on risk communication for front-line workers, and communication materials for the community was developed and was consulted with the project provinces and reviewed by the TAG members and experts from health sector. The manuals were finalized and are being trained for people at community level. The World Bank JSDF - Strengthening Preparedness and Response to COVID-19 at the Grassroots level in Vietnam (P174401) c. Component 3 - Developing and piloting models to support the most vulnerable groups. This component supports the development and piloting of three to four models to support different vulnerable groups in selected provinces. In the last six months, eight vulnerable groups have been established for the project support in three project provinces, including: (i) three groups for people affected by HIV (PAHIV) which include people living with HIV, drug users, female sex workers, men who have sex with men, and transgender people; (ii) one group for migrant workers (via guest house owners); (iii) two groups for ethnic minority people; and (iv) two groups for elderly people. Official information about COVID-19 and other communicable diseases was shared regularly via these group communication channels and meetings. The groups’ activities are monitored and supported via Zalo, phone, and emails of the group core members. d. Component 4 - Project management and administration, monitoring, evaluation, and knowledge dissemination. The implementation of the project management is satisfactory to the Bank. The PMU has field trips to all 27 Project communes and has provided regular support to the local teams to implement project activities. B. Rationale of the Project Restructuring 5. The project restructuring consists of the revision of the Results Framework (RF), and reallocation of project proceeds from civil works to goods. 6. The project was designed when the COVID-19 pandemic was at peak, so at the time of project preparation, the task team was not able to conduct comprehensive baseline surveys and used only available and best estimated data to set the baseline values and annual targets. In the first year of the project implementation, a comprehensive baseline survey was conducted and resulted in actual baseline values. Therefore, the annual targets need to be adjusted in line with the changed baseline values. 7. Additionally, some project development indicators (PDIs) and intermediate results indicators (IRIs) are no longer relevant given the pandemic situation has changed. Two PDIs will be updated with actual baseline values and targets, and indicators definition of one PDI and two IRIs will be revised to make them clearer. Two IRIs will be dropped from the RF and one new IRI which is considered measurable and more relevant to the new context, will be added (see Annex 1 for details) . The World Bank JSDF - Strengthening Preparedness and Response to COVID-19 at the Grassroots level in Vietnam (P174401) 8. The World Bank task team has agreed with the CPMU that support for civil works is no longer needed, as the central Government and local authorities already provided financial support and mobilized other emergency resources for repairing and upgrading of CHSs during COVID-19 period. During the project preparation and at the peak of the COVID-10 pandemic, there were needs for small repairs and renovations of CHSs to establish a triage arrangement and/or separate consultation rooms for suspected patients with COVID-19 or other infectious diseases. Instead, the communes have requested more support for medical and communication equipment. This reallocation is in conformity with the JSDF’s thresholds for expenditure categories that are only required for consulting service and operating costs. 9. Environment and Social Safeguards (ESS). There have been no non-compliance or implementation issues in ESS. The Social and Environment Commitment Plan (SECP) was revised and updated according to the project restructuring. The revised SECP has been reviewed and cleared by the Bank. II. DESCRIPTION OF PROPOSED CHANGES 10. Results Framework a. Update the baseline values of two PDIs. b. Update the annual targets and end-targets of one PDI and one IRI. Since the baseline values change the annual targets will change accordingly as they are set as percentage increases of the baseline values. c. Drop two IRIs and add two new ones with more relevant and measurable indicators. d. Revise definitions of one PDI and two IRIs to make them clearer. Table 1. Proposed revised PDIs and IRIs Description of Definition of Indicator Baseline End Target Justification for revision No Indicator Original Revised Original Revised Original Revised The inter- sectoral collaboration 27 plan for contextualized, COVID-19 and local-appropriate other health plans for inter- emergencies sectorial preparedness collaboration for and response COVID-19 and at community other health level, which emergencies follows preparedness project's and response at The plan is guideline is community level approved by approved by are developed the local the local no no no no Definition is revised to better PDI 1 and approved authority authority change change change change reflect the project's intervention. The World Bank JSDF - Strengthening Preparedness and Response to COVID-19 at the Grassroots level in Vietnam (P174401) Percentage of health staff at the CHSs who have good knowledge in COVID-19 and pandemic response and no no The baseline value is changed as PDI 2 preparedness no change no change 30 28 change change the results of baseline survey Percentage of people who have good knowledge The baseline value is changed as in COVID 19 and 20 37 40 60 the results of baseline survey. pandemics The end target is increased in prevention and accordance with the increased PDI 3 response no change no change baseline value Cumulative Cumulative number of number of on-desk simulation simulation Number of exercises on exercises on simulation health health no no 9 27 exercises on emergency emergency change change With the new context of COVID- health response that response that 19 in Vietnam, no "real" emergency are are simulation exercise will be done response that are implemented implemented but "on-desk". The definition of implemented at at the in the project the indicator is revised to reflect IRI 1 the community community communes the change. Cumulative number of Cumulative health staff at number of the CHS that health staff at receive the CHS that Number of health training/retrai receive staff that receive ning on training/refre training on prevention of sh training on no no no no prevention of cross- prevention of change change change change cross- contaminatio contaminatio contamination at n at health n at health health facilities facilities and facilities and and maintenance maintenance maintenance of essential of essential of essential services for services for services for people during people during people during The definition is revised to reflect IRI 2 epidemics epidemics epidemics better the project's interventions. Number of Commune Health The indicator is dropped based Stations that on actual situation during the receive project’s project implementation. After the support to outbreaks of pandemic in 2021, establish a the CHSs have already received designated infrastructure support from other examination sources to arrange examination room for room suspected COVID - 19 cases suspected COVID- or communicable disease 19 and patients. No infrastructure communicable support from the project is IRI 3 disease patients needed. The World Bank JSDF - Strengthening Preparedness and Response to COVID-19 at the Grassroots level in Vietnam (P174401) Number of communication IRI 4 packages that are The indicator is dropped and (origin developed and replaced by a new indicator IRI 4 al) disseminated as below Cumulative number of Cumulative communicati number of on packages communicati (poster, on event New indicator is added to replace Number of banner, implemented old IRI 4 to better reflect the communication leaflet) that by project project's intervention. The events are communes baseline and end targets are set implemented by developed such as video based on the results of the IRI 4 Project and clip, drawing baseline survey and committed (new) communes disseminated contests 0 0 0 54 outputs of the project. Number of community innovation models for This indicator is dropped and IRI 8 COVID-19 and replaced by new IRI 8 below to (origin other health reflect better the project's al) emergencies intervention. Cumulative number of networks of vulnerable Number of populations networks of established to vulnerable support these populations populations established to to be able to respond to respond to COVID-19 and COVID-19 and IRI 8 other health other health This indicator is added to replace (new) emergencies emergencies 0 0 0 8 the original IRI 8. 11. Reallocation of expenditure categories a. US$ 135,000 from Works category will be cancelled. b. Additional amount of US$ 135,000 will be added to the Goods category, making the total amount for Goods to US$384,000. c. Other categories will be kept unchanged. Table 2. Reallocation of expenditure categories Category Amount of the Proposed revision Difference Percentage of Grant Allocated of the Grant Expenditure to (expressed in Allocation (in be Financed USD) USD) (inclusive of Taxes) The World Bank JSDF - Strengthening Preparedness and Response to COVID-19 at the Grassroots level in Vietnam (P174401) (1) Consulting services 547,610 547,610 0 100% (2) Training and Workshop 1,430,788 1,430,788 0 100% (3) Goods 249,400 384,400 + 135,000 100% (4) Works 135,000 0 - 135,000 - (5) Incremental Operating 387,202 387,202 0 100% Cost TOTAL AMOUNT 2,750,000 2,750,000 0 III. SUMMARY OF CHANGES Changed Not Changed Results Framework ✔ Reallocation between Disbursement Categories ✔ Implementing Agency ✔ Project's Development Objectives ✔ Components and Cost ✔ Loan Closing Date(s) ✔ Cancellations Proposed ✔ Additional Financing Proposed ✔ Disbursements Arrangements ✔ Disbursement Estimates ✔ Change in Overall Risk Rating ✔ Legal Covenants ✔ Institutional Arrangements ✔ Financial Management ✔ Procurement ✔ Implementation Schedule ✔ Other Change(s) ✔ The World Bank JSDF - Strengthening Preparedness and Response to COVID-19 at the Grassroots level in Vietnam (P174401) Economic and Financial Analysis ✔ Technical Analysis ✔ Social Analysis ✔ Environmental Analysis ✔ IV. DETAILED CHANGE(S) OPS_DETAILEDCHANGES_RESULTS_TABLE RESULTS FRAMEWORK Project Development Objective Indicators PDO_IND_TABLE • 27 contextualized, local-appropriate plans for inter-sectorial collaboration for COVID-19 and other health emergencies preparedness and response at community level are developed and approved Unit of Measure: Number Indicator Type: Custom Baseline Actual (Current) End Target Action Value 0.00 0.00 27.00 No Change Date 01-Jul-2021 30-Nov-2022 31-Dec-2024 Percentage of health staff at the CHSs who have good knowledge in COVID-19 and pandemic response and preparedness Unit of Measure: Percentage Indicator Type: Custom Baseline Actual (Current) End Target Action Value 28.00 28.00 50.00 No Change Date 31-Aug-2022 30-Nov-2022 31-Dec-2024 Percentage of people who have good knowledge in COVID 19 and pandemics prevention and response Unit of Measure: Percentage Indicator Type: Custom Baseline Actual (Current) End Target Action Value 37.00 37.00 60.00 No Change Date 31-Aug-2022 30-Nov-2022 31-Dec-2024 Number of people in the vulnerable groups, including the elderly, people living with HIV/AIDS, female sex-workers, drug users, informal workers, and ethnic minorities, who participate in the project i Unit of Measure: Number The World Bank JSDF - Strengthening Preparedness and Response to COVID-19 at the Grassroots level in Vietnam (P174401) Indicator Type: Custom Baseline Actual (Current) End Target Action Value 0.00 0.00 3500.00 No Change Date 31-Aug-2022 30-Nov-2022 31-Jan-2024 Intermediate Indicators IO_IND_TABLE Number of simulation exercises on health emergency response that are implemented at the community Unit of Measure: Number Indicator Type: Custom Baseline Actual (Current) End Target Action Value 0.00 0.00 27.00 No Change Date 31-Aug-2022 30-Nov-2022 31-Dec-2024 Number of health staff that receive training on prevention of cross-contamination at health facilities and maintenance of essential services for people during epidemics Unit of Measure: Number Indicator Type: Custom Baseline Actual (Current) End Target Action Value 0.00 0.00 630.00 No Change Date 31-Aug-2022 30-Nov-2022 31-Dec-2024 Number of Commune Health Stations that receive project’s support to establish a designated examination room for suspected COVID-19 and communicable disease patients Unit of Measure: Number Indicator Type: Custom Baseline Actual (Current) End Target Action Value 0.00 0.00 27.00 Marked for Deletion Date 01-Jul-2021 24-Feb-2022 31-Dec-2024 Number of communication events implemented by project communes. Unit of Measure: Number Indicator Type: Custom Baseline Actual (Current) End Target Action Value 0.00 0.00 54.00 Revised The World Bank JSDF - Strengthening Preparedness and Response to COVID-19 at the Grassroots level in Vietnam (P174401) Date 31-Aug-2022 30-Nov-2022 31-Dec-2024 Number of people that receive training on risk communication Unit of Measure: Number Indicator Type: Custom Baseline Actual (Current) End Target Action Value 0.00 0.00 800.00 No Change Date 31-Aug-2022 30-Nov-2022 31-Dec-2024 Number of people that participate in the project innovation communication campaigns Unit of Measure: Number Indicator Type: Custom Baseline Actual (Current) End Target Action Value 0.00 0.00 3500.00 No Change Date 31-Aug-2022 30-Nov-2022 31-Dec-2024 Number of community collaborators that participate in the project activities Unit of Measure: Number Indicator Type: Custom Baseline Actual (Current) End Target Action Value 0.00 0.00 70.00 Marked for Deletion Date 31-Aug-2022 30-Nov-2022 31-Dec-2024 Number of community innovation models for COVID-19 and other health emergencies Unit of Measure: Number Indicator Type: Custom Baseline Actual (Current) End Target Action Value 0.00 0.00 34.00 No Change Date 31-Aug-2022 30-Nov-2022 31-Dec-2024 Number of networks of vulnerable populations established to respond to COVID-19 and other health emergencies Unit of Measure: Number Indicator Type: Custom Baseline Actual (Current) End Target Action Value 0.00 0.00 8.00 No Change Date 31-Aug-2022 30-Nov-2022 31-Dec-2024 The World Bank JSDF - Strengthening Preparedness and Response to COVID-19 at the Grassroots level in Vietnam (P174401) OPS_DETAILEDCHANGES_REALLOCATION _TABLE REALLOCATION BETWEEN DISBURSEMENT CATEGORIES Financing % Current Allocation Actuals + Committed Proposed Allocation (Type Total) Current Proposed TF-B6532-001 | Currency: USD iLap Category Sequence No: 1 Current Expenditure Category: CONSULTING SERVICES 547,610.00 118,007.71 547,610.00 100.00 100.00 iLap Category Sequence No: 2 Current Expenditure Category: TRAINING AND WS 1,430,788.00 51,392.88 1,430,788.00 100.00 100.00 iLap Category Sequence No: 3 Current Expenditure Category: GOODS 249,400.00 19,204.81 384,400.00 100.00 100.00 iLap Category Sequence No: 4 Current Expenditure Category: WORKS 135,000.00 0.00 0.00 100.00 0 iLap Category Sequence No: 5 Current Expenditure Category: INCREMENTAL OPERATING COSTS 387,202.00 57,013.32 387,202.00 100.00 100.00 Total 2,750,000.00 374,463.86 2,750,000.00 The World Bank JSDF - Strengthening Preparedness and Response to COVID-19 at the Grassroots level in Vietnam (P174401)