OFFICIAL DOCUMENTS The World Bank E-32, Agargaon, Sher-e-Bangla Nagar, Dhaka 1207, Bangladesh Phone: (880-2) 5566-7777, (880) 96-0440-4000 Facsimile: (880-2) 5566-7778, 5566-7779 Abdoulaye Seck Country Director for Bangladesh and Bhutan Dated: June 12, 2023 Secretary Sharifa Khan Economic Relations Division Ministry of Finance Block 8, Room 3 Sher-e-Bangla Nagar Agargaon, Dhaka Dear Secretary Khan: Bangladesh: Health Sector Support Project (Grant No. TF0A4355) Amendment to the Grant Agreement We refer to the Grant Agreement between the People's Republic of Bangladesh ("Recipient") and the International Development Association ("World Bank"), acting as administrator of the Multi-Donor Trust Fund for the Global Financing Facility in Support of Every Woman Every Child, dated August 28, 2017, as amended (the "Grant Agreement"), pursuant to which the World Bank has extended the above captioned Grant ("Grant") for the Health Sector Support Project ("Project"). We also refer to the letter from the Ministry of Finance, dated May 10, 2023, requesting restructuring of the Project. We are pleased to inform you that after due consideration, the World Bank has agreed with your request, and proposes to amend the Grant Agreement as set forth below: I. Annex to Schedule 2 to the Grant Agreement is amended to read as set forth in Annex I to this Amendment Letter. Except as specifically amended by this Amendment Letter, all other provisions of the Grant Agreement shall remain unchanged and in full force and effect. The World Bank will disclose this Amendment Letter and related information in accordance with the World Bank's Policy on Access to Information. By entering into this Amendment Letter, the Recipient consents to disclosure of this Amendment Letter and related information. Please confirm your agreement to the foregoing on behalf of the Recipient by signing and dating the form of confirmation set forth below and returning one fully countersigned original of the Amendment Letter to the World Bank and retaining one original for your records. Upon receipt by the World Bank of -2- the duly countersigned original of this Amendment Letter, this Amendment Letter shall become effective as of the date of the countersignature. Sincerely, INTERNATIONAL DEVELOPMENT ASSOCIATION By Abdoulaye Seck AGREED: PEOPLE'S REPUBLIC OF BANLADESH By: Authorized Representative Name: Md. Shahrjar Kader Sikiky Additional Secrelary Title Economic Relations Civsion minisry of FnaAG8 G(vt of The People's Repulic 4 6jayudesh Date: 0D/07/Z021 -3- Revised Annex to Schedule 2 Disbursement-Linked Indicators, Disbursement-Linked Results and Allocated Amounts Applicable to the Project Component 1. Governance and Stewardship DLI 1. Citizen feedback system is strengthened - USS750,000 DLR 1.1 DLR 1.2 GRS Assessment of guidelines are current GRS is approved (1) completed (1) US$375,000 US$375,000 DLI 2. Budget planning and allocation are improved - US$2,565,000 DLR 2.1 OPs DLR 2.2 Increase in the percentage (%) approved including from FY20 16 baseline in repair and activities and maintenance expenditure at the levels of budgets for Upazila and below (2) achievement of DLIs (1) 13 OPs Up to 119% increase DLR 2.1 DLR 2.2 US$1,785,000 (US$15,000 per US$780,000 I % increase from FY 2016 baseline) (US$60,000 per OP) Component 2. Health, Nutrition and Population Systems Strengthening DLI 3. Financial management system is strengthened - US$1,530,000 DLR 3.1 MOHFW DLR 3.2 MOPA DLR 3.3 MOF submits FMAU endorses FMAU concurs to FMAU recruitment rules to recruitment rules (1) recruitment rules (1) MOPA (1) DLR 3.1 DLR 3.2 DLR 3.3 US$286,875 US$286,875 US$956,250 DLI 4. Asset management is improved - US$141,000 DLR 4.1 Assessment and plan are approved for AMS scale-up DLR 4.1 US$141,000 DLI 5. Procurement process is improved using information technology - US$594,0000 -4- DLR 5.1 e-GP is DLR 5.2 NCTs initiated for using e-GP as procurement by percentage (%) of MOHFW (1) all specified NCT's issued by MOHFW (2) 25% ofNCTs DLR 5.1 DLR 5.2 US$150,000 US$444,000 (US$11,100 per 1% of NCTs) DLI 7. Availability of midwives for maternal care is increased - US$1,365,000 DLR 7.1 At least DLR 7.2 Number of Upazila Health 2,500 midwife posts Complexes with at least 2 accredited are created by diploma midwives (2) MOHFW and recruitment of midwives is underway (1) 150 Upazila Health Maintain 150 Complexes Upazila Health Complexes DLR 7.1 DLR 7.2 US$758,000 (US$2,526.67 per US$607,000 Upazila Health Complex) DLI 8. Information system is strengthened, including gender-disaggregated data - US$600,000 DLR 8.1 Number of Community Clinics providing complete essential data to DHIS2, including gender-disaggregated, reported for the previous CY (2) 1,000 Community 2,000 Community Clinics Clinics DLR 8.1 US$600,000 (US$200 per I I Community Clinic) Component 3. Provision of Quality Health, Nutrition and Population Services DLI 9. Post-partum family planning services are improved - US$981,750 DLR 9.1 Facility DLR 9.2 Reporting DLR 9.3 readiness criteria and training Assessment and and assessment guidelines for PPFP action plan are instrument for PPFP services are completed for services are approved (1) expansion of PPFP approved (1) services in targeted health facilities in Sylhet and -5- Chittagong divisions (1) DLR 9.4 Percentage (%) of targeted Public Health IFacilities meeting readiness criteria for delivery of PPFP services in Sylhet and Chittagong divisions, reported for the previous CY (2) DLR 9.1 DLR 9.2 DLR 9.3 US$ US$150,000 US$90,000 156,150 DLR 9.4 US$ 585,600 (US$117,120 per 1% of targeted facilities) DLI 10. Utilization of maternal health care services is increased - USS617,250 DLR 10.1 Number of normal deliveries in Public Health Facilities in Sylhet and Chittagong divisions, reported for the previous CY (2) 130,000 132,000 135,000 DLR 10.1 US$617,250 (US$ 1.554786 per I delivery) DLI 11. Emergency obstetric care services are improved - US$1,176,000 DLR 11.1 Facility DLR 11.2 assessment Assessment and instrument for action plans are CErnONC is approved for approved (1) development of CEnONC services in targeted District Hospitals in Sylhet and Chittagong divisions (1) DLR 11.3. Number of District Hospitals with capacity to provide CEmONC services in Sylhet and Chittagong divisions, reported for the previous CY (2) 5 District Hospitals 6 District Hospitals 7 District Hospitals -6- DLR I1.1 DLR I1.2 US$90,000 US$141,000 DLR 11 3 US$945,000 (US$52,500 per District Hospital) DLI 12. Immunization coverage and equity are enhanced - US$1,500,000 DLR 12.1 ImmuinLinization micro-plans for CY I7 are approved for each district in Sylhet and Chittagong divisions (1) 1 1 DLR 12.2 Number of districts reaching at least 85% coverage of measles-rubella vaccination among children ages 0-12 months in Sylhet and Chittagong divisions, reported for the previous CY (2) All 15 districts All 15 districts All 15 districts DLR 12.1 US$150,000 DLR 12.2 US$1,350,000 (US$30,000 per district) DLI 13. Maternal nutrition services are expanded - US$840,000 DLR 13.1 Technical DLR 13.2 DLR 13.3 standards for Reporting and Assessment is maternal nutrition quality assessment completed of services are guidelines for maternal nutrition approved (1) maternal nutrition service quality in services are Sylhet and approved (1) Chittagong divisions (1) DLR 13.4 Percentage (%) of registered pregnant mothers receiving specified maternal nutrition services in Sylhet and Chittagong divisions, reported for the previous CY (2) 5% 10% DLR 13.1 DLR 13.2 DLR 13.3 US$90,000 US$90,000 US$210,000 DLR 13.4 US$450,000 (US$30,000 per I% of registered pregnant mothers) DLI 14. Infant and child nutrition services are expanded - US$840,000 DLR 14.1 Technical DLR 14.2 DLR 14.3 standards for infant Reporting and Assessment is and child nutrition quality assessment completed of infant services are guidelines for infant and child nutrition approved (1) and child nutrition service quality in -7- services are Sylhet and approved (1) Chittagong divisions (1) DLR 14.4 Percentage (%) of registered infants and children aged under 2 years receiving specified nutrition services in Sylhet and Chittagong divisions, reported for the previous CY (2) 10% 15% 20% DLR 14.1 DLR 14.2 DLR 14.3 LS$90,000 US$90,000 US$214,500 DLR 14.4 US$445,500 (US$9,900 per 1% of registered infants and children aged under 2 years) DLI 15. School-based adolescent HNP program is developed and implemented - USS750,000 DLR 15.1 Revised DLR 15.2 teacher training Assessment of manual is approved current school- (1) based services in Sylhet and Chittagong divisions is jointly completed with the education sector (1) DLR 15.1 DLR 15.2 US$281,250 US$468,750 DLI 16. Emerging challenges are addressed - USS750,000 DLR 16.1 Urban DLR 16.2 Health Coordination Guidelines for Committee meets screening, referral and agrees on and treatment of actions to improve hypertension are coordination on approved (1) urban health (1) DLR 16.1 DLR 16.2 US$468,750 US$281,250 Notes: 1. These are non-scalable DLRs shall be achieved once only. The timeframe for achievement of these DLR is indicative, but no later than the Closing Date. 2. These are scalable DLRs, and the tineframe for achievement ofthese DLRs is indicative, but not later than the Closing Date.