The World Bank Angola Health System Performance Strengthening Project (HSPSP) (P160948) REPORT NO.: RES34064 RESTRUCTURING PAPER ON A PROPOSED PROJECT RESTRUCTURING OF ANGOLA HEALTH SYSTEM PERFORMANCE STRENGTHENING PROJECT (HSPSP) APPROVED ON MARCH 29, 2018 TO REPUBLIC OF ANGOLA HEALTH, NUTRITION & POPULATION GLOBAL PRACTICE EAST AND SOUTHERN AFRICA Regional Vice President: Victoria Kwakwa Country Director: Albert G. Zeufack Senior Global Practice Director: Juan Pablo Uribe Practice Manager/Manager: Francisca Ayodeji Akala Task Team Leader: Renzo Sotomayor, Joao Pires The World Bank Angola Health System Performance Strengthening Project (HSPSP) (P160948) ABBREVIATIONS AND ACRONYMS AF Additional Financing CERC Contingent Emergency Response Component DNSP Cabinet of Studies, Planning, and Statistics GAVI Global Alliance Vaccine Initiative GEPE National Department of Public Health GoA Government of Angola HSPSP Health System Performance Strengthening Project IBRD International Bank for Reconstructions and Development IP Implementation Progress ISR Implementation Status and Results Reports LA Loan Agreement MHSS Municipal Health Services Strengthening MINFIN Ministry of Finance MINSA Ministry of Health PAD Project Appraisal Document PDO Project Development Objective PIU Project Implementation Unit RBF Results Based Financing RF Results Framework TF Trust Fund WB World Bank The World Bank Angola Health System Performance Strengthening Project (HSPSP) (P160948) BASIC DATA Product Information Project ID Financing Instrument P160948 Investment Project Financing Original EA Category Current EA Category Partial Assessment (B) Partial Assessment (B) Approval Date Current Closing Date 29-Mar-2018 30-Sep-2023 Organizations Borrower Responsible Agency Republic of Angola Project Development Objective (PDO) Original PDO The Project Development Objective (PDO) is to increase the utilization and the quality of health care services in target provinces and municipalities. OPS_TABLE_PDO_CURRENTPDO Summary Status of Financing (US$, Millions) Net Ln/Cr/Tf Approval Signing Effectiveness Closing Commitment Disbursed Undisbursed IBRD-88350 22-Mar-2018 28-Jun-2018 24-Oct-2018 30-Sep-2023 110.00 104.44 5.56 TF-B0225 29-Mar-2018 12-Jul-2019 12-Jul-2019 30-Sep-2023 9.70 7.06 2.64 Policy Waiver(s) Does this restructuring trigger the need for any policy waiver(s)? No The World Bank Angola Health System Performance Strengthening Project (HSPSP) (P160948) I. PROJECT STATUS AND RATIONALE FOR RESTRUCTURING A. Project Status 1. The Angola Health Systems Performance Strengthening Project (HSPSP) was approved by the Board of Directors of the World Bank (WB or the ‘Bank’) on March 22, 2018, with financing of US$110 million provided by the International Bank for Reconstruction and Development (IBRD). An additional financing of US$9.7 million, contributed by the Global Alliance Vaccine Initiative (GAVI) Trust Fund (TF) for Child Health Expansion, was approved by the Bank on July 12, 2019, resulting in a total project financing of US$119.7 million. The HSPSP was declared effective on October 24, 2018 and has a closing date of September 30, 2023. Despite facing several challenges related to implementation, as of April 19 , 2023, the disbursement rate was 94.72% for the IBRD Loan and 72.46% for the TF GAVI Grant. Of the total project funds, US$8.48 million remains to be disbursed over the next 6 months. The current annual work plan has been revised and budgeted in line with the available funds and implementation time-frame. Most of the remaining funds will be directed to the municipalities to support the implementation of primary health care (PHC) interventions and provision of essential medical material. 2. The Project Development Objective (PDO) is to increase the utilization and the quality of health care services in target provinces and municipalities. The HSPSP has four components: Component 1 (US$74.7 million) aims to improve healthcare service delivery in 34 municipalities in 10 provinces, focusing on the continuum of reproductive, maternal, newborn, child, and adolescent health services1; Component 2 (US$35 million) aims to strengthen the health system at the central level to support the delivery of health services nationwide; Component 3 is a zero-dollar Contingent Emergency Response Component (CERC) to facilitate an emergency response, if required; and Component 4 (US$10 million) aims to support project management, monitoring and evaluation. 3. The Project Development Objective (PDO) and Implementation Performance (IP) ratings, after a challenging period from July 2019 to December 2022, have improved to Satisfactory and Moderately Satisfactory, respectively, as noted in the latest Implementation Status and Results Reports (ISR) dated December 2022. During the life of the project, public health emergencies and administrative challenges have occurred that affected the project’s implementation. First, the drought that severely affected Angola’s southern provinces, followed by the COVID-19 pandemic, were events that demanded a project’s response and motivated two CERC activations in July 2019 and July 2020, respectively. Second, in April 2021, the Government of Angola (GoA) requested a suspension of all project- related activities and expenditures based on allegations of misuse of funds by the previous Project Implementation Unit (PIU) management team. As a result, the PDO and IP ratings were downgraded to Moderately Satisfactory (MS) and Moderately Unsatisfactory (MU), respectively. Under these circumstances, the necessary restructurings following the CERC activations were delayed. Following an intense dialogue and a World Bank mission in November 2021, the GoA and the World Bank worked on reorganizing the PIU structure and governance, hired new staff, and provided capacity building and training activities for the new PIU staff. The implementation of the HSPSP and the communication with the GoA have since improved. 4. Overall, the HSPSP has made remarkable progress towards achieving its PDO by increasing the utilization and quality of health care services in the target municipalities. The main HSPSP contribution so far is the strengthening of the capacity of municipalities to deliver better health services, which has led to significant improvements in terms of access and quality of care. For instance, the HSPSP has supported the procurement of essential drugs, capacity 1 The HSPSP originally included 21 municipalities in 7 provinces. The GAVI TF for Child Health Expansion allowed the project to expand its coverage to 34 municipalities in 10 provinces. The World Bank Angola Health System Performance Strengthening Project (HSPSP) (P160948) building of health professionals, delivery of sexual and reproductive health (SRH) interventions, and health system strengthening. In May 2022, the Mid-Term Review (MTR) showed that the project beneficiaries at the municipal level considered the HSPSP investments as being instrumental in providing healthcare services, ensuring quality of care, and strengthening the management of healthcare facilities. Furthermore, data collected at the provincial levels shows that, in the HSPSP supported municipalities, the COVID-19 pandemic caused fewer disruptions to the delivery of health services, compared to the municipalities not supported by the project. In addition, HSPSP has supported a robust response to several, unanticipated public health emergencies. 5. HSPSP was called upon to respond to two urgent requests from the Ministry of Health (MINSA) to support the national response to public health emergencies, resulting from the drought in the south of Angola and the COVID- 19 pandemic (total amount of US$42 million). These urgent requests from the MINSA necessitated the activation of the CERC twice. The first time it was activated (CERC I) was in July 2019 for US$12 million to finance nutrition related interventions under the GoA’s emergency plan to reduce the impact of the drought in affected communities in the southern provinces of Angola. CERC I’s main achievements included the screening of more than 100,000 children treated for malnutrition, the delivery of more than 260 tons of supplementary food to the most affected districts, and capacity building of health professionals and community health and development workers to treat and identify cases of malnutrition. In July 2020, the CERC was activated for a second time (CERC II) for US$30 million to finance the multisectoral response to the COVID-19 pandemic and continue supporting the response to the protracted drought and nutritional crisis in the south of the country. The main activities financed in preparation for the onset of the pandemic under the CERC II included the training of more than 300 rapid response teams in case management, contact tracing and biosecurity measures, procurement of PPE, laboratory equipment, and reagents used for diagnostics, and continued support related to nutrition interventions in the drought affected south of the country and the socioeconomic hardship resulting from the loss of income due to restrictive measures implemented with the objective of containing the spread of COVID-19. In both CERC activations, the funds were drawn from Component 1 amounting to a total of US$42 million, reducing Component 1 available financing from US$74.7 million to US$32.7 million. B. Rationale for Restructuring 6. Given the public health emergencies that triggered the CERC activations, and the consequent diversion of HSPSP funds to respond to the emergencies, the HSPSP needs to be modified to reflect the changes. The World Bank has agreed with the MINSA and the Ministry of Finance (MINFIN) to a Level 2 restructuring of the HSPSP. This restructuring would, first and foremost, formalize the reallocations made in the component costs to allow the implementation of CERC activities. In addition, the Results Framework (RF) will be revised to include new indicators, aligned with emergency preparedness and response in line with the activities implemented through the CERC activations. Doing so will facilitate the effective monitoring and evaluation of the project. Given the delays in implementation, the project’s closing date will also be extended to allow sufficient time for the implementation of the revised project activities and disbursement of remaining funds. II. DESCRIPTION OF PROPOSED CHANGES C. Proposed Changes 7. This paper seeks management approval for a Level 2 restructuring with the following proposed changes: (a) Reallocation of costs between components and disbursement categories: The HSPSP will retain the same components; however, US$42 million from Component 1 will be reallocated to Component 3. Activities under components 1.1 and 1.2 have been scaled down to allow for the reallocation of resources to component 3. The World Bank Angola Health System Performance Strengthening Project (HSPSP) (P160948) Correspondingly, funds across Categories will also be reallocated. Table 1 and Table 2 below present a summary of the revised reallocation of loan proceeds per component and per category, respectively. Table 1. Revised Component Reallocation Component Original CERC Revised Cost Changes Cost (US$ (US$ (US$ million) million) million) 1 – Improving the Quality of Health Services Delivery in Target Provinces 74.7 -42.0 32.7 1.1. Improving the Quality of Maternal and Child Health Services at the 54.7 -32.0 22.7 Provincial and Municipal Level 1.2. Piloting Performance-Based Financing 20.0 -10.0 10.0 2 – Strengthening System-wide Enabling Factors that Support Delivery of 35.0 0.0 35.0 Quality Health Services 3 – Contingent Emergency Response Component - CERC 0.0 +42.0 42.0 4 – Project Management and Monitoring and Evaluation 10.0 0.0 10.0 Table 2. Amendment of Loan Proceeds by Category Category Current Changes Amended Allocation (US$) Allocation (US$) (US$) 1. Goods, works, non-consulting services, consulting services and 43,095,000 +18,377,731 61,472,731 training under parts 1.1,1.2,1.3(a),1.3(b),1.3(c),1.3(d),1.4,2.1,2.2, 2.3,2.4,3 and 4.01 of the project 2. PBF payment under part (b)ii) 20,000,000 -14,300,000 5,700,000 The World Bank Angola Health System Performance Strengthening Project (HSPSP) (P160948) 3. Refund of the Preparation Advance 4,630,000 -4,077,731 552,269 4. Front-end Fee 275,000 0 275,000 5. Interest Rate Cap or Interest Rate Collar premium 0 0 0 6. Emergency Expenditures under part 2.5 of the project 42,000,000 0 42,000,000 Total 110,000,000 0 110,000,000 (b) Modification to the Results Framework (RF): The RF will be revised with the inclusion of two PDO level indicators and four intermediate results indicators related to the public health emergencies supported by CERC I and CERC II interventions. The proposed new PDO level indicators are: i) Number of children treated for severe and moderate acute malnutrition; and ii) Number of COVID-19 samples processed using reverse transcription polymerase chain reaction (RT-PCR). The proposed intermediate indicators linked to the CERC activations are: (CERC I) i) Number of Community Health Development Agents (ADECOS) trained in the screening of moderate acute malnutrition (MAM) and referral of acute malnutrition cases; and ii) Number of Health Facilities provided with nutrition treatment related materials. The CERC II intermediate indicators are: i) Number of rapid response teams trained in case management, contact tracing, and biosecurity measures; and ii) Number of laboratories with SARS-COV2 diagnostic capability (equipped with reagents and test kits). In addition, as recommended by the MTR, some of the original RF indicators will be revised to better measure the outputs and outcomes attributed to the activities financed by HSPSP. As part of this exercise, three indicators in total will be removed from the RF. The three indicators proposed to be removed, with the reasons why, are: 1. Number of municipalities with multiyear proforma indicative budget allocation for child health at the municipal level; removed due to the lack of progress in implementing the governmental tool for tracking this very specific financial information at the municipal level; 2. ii) Development of a protocol and tool for certifying health posts, health centers, and municipal hospitals; removed because this protocol should be part of a deeper health reform, involving policy changes that are not currently in progress, and; 3. iii) MICS survey conducted in 2020; removed as it became part of the Regional Disease Surveillance Systems Enhancement (REDISSE) Program. In addition, the targets for the indicators will be increased to reflect the MINSA improvements in tracking data as a result of the strengthening of the DHIS2 platform at the district level. The increased targets also take into account the substantial progress made at district level, and the proposed project extension until September 2024. (c) Extension of Project closing date: Considering that, of the total project funds, US$8.48 million remains to be disbursed over the next 6 months, the project closing date will be extended by 12 months from September 2023 to September 2024, allowing sufficient time for the HSPSP to properly implement the revised activities programed in the annual work plan for the calendar year 2023. The World Bank Angola Health System Performance Strengthening Project (HSPSP) (P160948) III. SUMMARY OF CHANGES Changed Not Changed Results Framework ✔ Components and Cost ✔ Loan Closing Date(s) ✔ Reallocation between Disbursement Categories ✔ Implementation Schedule ✔ Implementing Agency ✔ DDO Status ✔ Project's Development Objectives ✔ PBCs ✔ Cancellations Proposed ✔ Disbursements Arrangements ✔ Disbursement Estimates ✔ Overall Risk Rating ✔ Safeguard Policies Triggered ✔ EA category ✔ Legal Covenants ✔ Institutional Arrangements ✔ Financial Management ✔ Procurement ✔ Other Change(s) ✔ Economic and Financial Analysis ✔ Technical Analysis ✔ Social Analysis ✔ Environmental Analysis ✔ IV. DETAILED CHANGE(S) The World Bank Angola Health System Performance Strengthening Project (HSPSP) (P160948) OPS_DETAILEDCHANGES_COMPONENTS_TABLE COMPONENTS Current Current Proposed Proposed Cost Action Component Name Component Name Cost (US$M) (US$M) Improving the Quality of Health Improving the Quality of Services Delivery in Target 74.70 Revised Health Services Delivery in 32.70 Provinces Target Provinces Strengthening System-wide Strengthening System-wide Enabling Factors that Support Enabling Factors that Support 35.00 No Change 35.00 Delivery of Quality Health Delivery of Quality Health Services Services Contingent Emergency Response Contingent Emergency 0.00 Revised 42.00 Component (CERC) Response Component (CERC) Project Management and Project Management and 10.00 No Change 10.00 Monitoring and Evaluation Monitoring and Evaluation TOTAL 119.70 119.70 OPS_DETAILEDCHANGES_LOANCLOSING_TABLE LOAN CLOSING DATE(S) Original Revised Proposed Proposed Deadline Ln/Cr/Tf Status Closing Closing(s) Closing for Withdrawal Applications IBRD-88350 Effective 30-Sep-2023 30-Sep-2024 30-Jan-2025 TF-B0225 Effective 30-Sep-2023 30-Sep-2024 30-Jan-2025 OPS_DETAILEDCHANGES_REALLOCATION _TABLE REALLOCATION BETWEEN DISBURSEMENT CATEGORIES Financing % Current Allocation Actuals + Committed Proposed Allocation (Type Total) Current Proposed IBRD-88350-001 | Currency: USD iLap Category Sequence No: 1 Current Expenditure Category: Gds,Wks,Ncs,Cs,Trg,OC 43,095,000.00 47,075,326.59 61,472,731.00 100.00 100.00 iLap Category Sequence No: 2 Current Expenditure Category: PBF payment prt 1b(ii) The World Bank Angola Health System Performance Strengthening Project (HSPSP) (P160948) 20,000,000.00 3,679,076.45 5,700,000.00 100.00 100.00 iLap Category Sequence No: 3 Current Expenditure Category: PPF REFINANCING 4,630,000.00 552,268.18 552,269.00 100 iLap Category Sequence No: 6 Current Expenditure Category: Emergency Expe prt 3 42,000,000.00 35,947,754.91 42,000,000.00 100.00 100.00 iLap Category Sequence No: FEF Current Expenditure Category: FRONT END FEE 275,000.00 275,000.00 275,000.00 Total 110,000,000.00 87,529,426.13 110,000,000.00 . The World Bank Angola Health System Performance Strengthening Project (HSPSP) (P160948) . Results framework COUNTRY: Angola Angola Health System Performance Strengthening Project (HSPSP) Project Development Objectives(s) The Project Development Objective (PDO) is to increase the utilization and the quality of health care services in target provinces and municipalities. Project Development Objective Indicators by Objectives/ Outcomes RESULT_FRAME_TBL_PDO Indicator Name PBC Baseline End Target Increase quality of health care services Percentage of pregnant women who receive four antenatal 17.40 36.00 (ANC) consultations (Percentage) Rationale: Action: This indicator has been Revised No changes. Pregnant women who are HIV positive who deliver at health 10.50 40.00 facilities and receive ART (Percentage) Rationale: No changes. Action: This indicator has been Revised Percentage of pregnant women receiving two tetanus vaccines 30.50 48.00 during pregnancy (Percentage) Rationale: Action: This indicator has been Revised No changes. The World Bank Angola Health System Performance Strengthening Project (HSPSP) (P160948) RESULT_FRAME_TBL_PDO Indicator Name PBC Baseline End Target Percentage of provinces targeted by the PFSS without stock outs 0.00 70.00 of contraceptives (Percentage) Rationale: Indicator modified, as recommended by MTR, to ensure that indicators measure the outputs and outcomes of the project Action: This indicator has been Revised funded activities. Increase utilization of health care services Pregnant women who are HIV positive that deliver at a health 0.00 13,045.00 facility (cumulative) (Number) Rationale: Action: This indicator has been Revised The end target was revised and increased due to the progress made by the project and to reflect the new 2024 closing date. Number of reproductive health consultations conducted through 0.00 64,013.00 Mobile Brigades (cumulative) (Number) Rationale: Action: This indicator has been Revised The end target was revised and increased due to the progress made by the project and to reflect the new 2024 closing date. Number of under 5 child health consultations in the 21 PFSS 0.00 4,257,830.00 municipalities (cumulative) (Number) Rationale: The end target was revised based on actual data provided by improved health information system and to reflect the new Action: This indicator has been Revised 2024 closing date. Number of child health consultations in the 13 Child Health 1,227,000.00 6,000,000.00 Expansion municipalities (cumulative) (Number) Action: This indicator has been Revised Rationale: The World Bank Angola Health System Performance Strengthening Project (HSPSP) (P160948) RESULT_FRAME_TBL_PDO Indicator Name PBC Baseline End Target The end target was revised and increased due to the progress made by the project and to reflect the new 2024 closing date. Respond to disasters and public health emergencies (Action: This Objective is New) Number of children treated for severe and moderate acute 0.00 33,000.00 malnutrition (Number) Rationale: CERC1: This indicator is new and contributes to achieving the updated/proposed PDO by responding the nutrition crisis Action: This indicator is New caused by the droughts in the south of Angola . Number of COVID-19 samples processed using reverse 0.00 1,400,000.00 transcription polymerase chain reaction (RT-PCR) (Number) Rationale: CERC 2: This proposed indicator contributes to achieve the updated/proposed PDO by responding to public health Action: This indicator is New emergency related to the COVID 19 pandemic. PDO Table SPACE Intermediate Results Indicators by Components RESULT_FRAME_TBL_IO Indicator Name PBC Baseline End Target Improving the Quality of Health Services Delivery in Target Provinces Health units implementing the minimum package of maternal 0.00 60.00 and child health services (Number) Action: This indicator has been Revised Rationale: The World Bank Angola Health System Performance Strengthening Project (HSPSP) (P160948) RESULT_FRAME_TBL_IO Indicator Name PBC Baseline End Target The closing data of the indicator end target was revised to 2024. Health Centers at Municipalities implementing operational plans 0.00 34.00 for Health Waste Management (Number) Rationale: This indicator was revised, as recommended in the MTR, to ensure that indicators measure the outputs and outcomes of the Action: This indicator has been Revised project funded activities. Number of Municipalities implementing patient feedback 0.00 34.00 mechanisms (Number) Rationale: This indicator was revised, as recommended in the MTR, to ensure that indicators measure the outputs and outcomes of the Action: This indicator has been Revised project funded activities. Number of health facilities that provide TB diagnosis (Number) 0.00 68.00 Rationale: Action: This indicator has been Revised The end target was revised and increased due to the progress made by the project and to reflect the new 2024 closing date. Percentage of female adolescents ages 12-15 that had a family 5.00 14.00 planning consultation (Percentage) Rationale: Action: This indicator has been Revised The end target was revised and increased due to the progress made by the project and to reflect the new 2024 closing date. Number of female adolescents ages 12-15 that had a family 0.00 26,000.00 planning consultation (Number) The World Bank Angola Health System Performance Strengthening Project (HSPSP) (P160948) RESULT_FRAME_TBL_IO Indicator Name PBC Baseline End Target Action: This indicator has been Revised Number of women (ages 15-49) who had a family planning 93,433.00 181,328.00 consultation (Number) Rationale: Data updated. Action: This indicator has been Revised Percentage of women (ages 15-49) who had a family planning 13.00 22.00 consultation (Percentage) Action: This indicator has been Revised Children under-1 receiving Pentavalent third dose (Penta3) 320,000.00 1,500,000.00 (Number) Rationale: Action: This indicator has been Revised The end target was revised and increased due to the progress made by the project and to reflect the new 2024 closing date. Children receiving first dose of Measles and Rubella (MR 1st 301,000.00 1,500,000.00 dose) (Number) Rationale: Action: This indicator has been Revised The end target was revised and increased due to the progress made by the project and to reflect the new 2024 closing date. People who have received essential health, nutrition, and 0.00 2,480,000.00 population (HNP) services (CRI, Number) Rationale: Action: This indicator has been Revised The end target was revised and increased due to the progress made by the project and to reflect the new 2024 closing date. The World Bank Angola Health System Performance Strengthening Project (HSPSP) (P160948) RESULT_FRAME_TBL_IO Indicator Name PBC Baseline End Target Number of children immunized (CRI, Number) 0.00 1,600,000.00 Rationale: Action: This indicator has been Revised The end target was revised and increased due to the progress made by the project and to reflect the new 2024 closing date. Number of women and children who have received basic 0.00 80,000.00 nutrition services (CRI, Number) Rationale: Action: This indicator has been Revised The end target was revised and increased due to the progress made by the project and to reflect the new 2024 closing date. Number of deliveries attended by skilled health personnel 0.00 800,000.00 (CRI, Number) Rationale: Action: This indicator has been Revised The end target was revised and increased due to the progress made by the project and to reflect the new 2024 closing date. Number of municipalities with multiyear proforma indicative 0.00 13.00 budget allocation for child health at municipal level (Number) Rationale: Action: This indicator has been Marked for Deletion Indicator removed, per MTR recommendations, as it is not currently under the project scope of activities/actions. Strengthening System-wide Enabling Factors that Support Delivery of Quality Health Services Technical Health Training Schools implementing new curricula 0.00 11.00 (Number) Action: This indicator has been Revised Development of a training module on adolescent-friendly No Yes reproductive health services (Yes/No) The World Bank Angola Health System Performance Strengthening Project (HSPSP) (P160948) RESULT_FRAME_TBL_IO Indicator Name PBC Baseline End Target Action: This indicator has been Revised Health personnel trained in adolescent-friendly reproductive 0.00 230.00 health services (Number) Action: This indicator has been Revised Municipalities with staff trained on the operational and 0.00 34.00 budgetary planning tool (FPOM) (Number) Action: This indicator has been Revised Development of a protocol and tool for certifying health posts, No Yes health centers, and municipal hospitals (Yes/No) Rationale: This indicator was removed, as recommended in the MTR, to ensure that indicators measure the outputs and outcomes of Action: This indicator has been Marked for Deletion the project funded activities. Emergency operations center reactivated (Yes/No) No Yes Action: This indicator has been Revised MICS survey conducted in 2020 (Yes/No) No Yes Rationale: Action: This indicator has been Marked for Deletion Activity was moved to a different project therefore this indicator is no longer pertinent, it was removed. Contingent Emergency Response Component (CERC) (Action: This Component is New) Number of community health development agents (ADECOS) trained in screening of moderate acute malnutrition (MAM) and 0.00 400.00 referral of acute malnutrition cases (Number) The World Bank Angola Health System Performance Strengthening Project (HSPSP) (P160948) RESULT_FRAME_TBL_IO Indicator Name PBC Baseline End Target Rationale: This CERC 1 indicator is new and contributes to the achievement of the PDO level indicator related to the nutrition crisis in Action: This indicator is New the the southern region of the Angola caused by the droughts. Number of Health facilities provided with nutrition treatment 0.00 230.00 related materials (Number) Rationale: Action: This indicator is New This is an indicator for CERC 1 activated to respond to droughts and malnutrition. Number of rapid response teams trained in case management, 0.00 300.00 contact tracing and bio security measures (COVID19) (Number) Rationale: Action: This indicator is New This indicator is new and is connected to the CERC 2 activation to respond to the COVID-19 pandemic. Number of laboratories with SARS-COV-2 diagnostic capability 0.00 18.00 (Number) Rationale: Action: This indicator is New This indicator is new and is connected to the CERC 2 activation to respond to the COVID-19 pandemic. IO Table SPACE The World Bank Angola Health System Performance Strengthening Project (HSPSP) (P160948)