The Ministry of Health of the Republic of Serbia Nemanjina 22-26, 11000 Belgrade SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK (ESMF) DRAFT DOCUMENT B E L G R A D E, February 2021 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF EXECUTIVE SUMMARY 7 1. INTRODUCTION AND BACKGROUND 9 1.1.Purpose of the ESMF 10 2. PROJECT DESCRIPTION 11 2.1.Project overview 11 2.2.Project Components 11 2.2.1. Component 1: Emergency COVID-19 Response 11 2.2.2. Component 2: Implementation Management and Monitoring and Evaluation 13 2.3.Environmental and Social Risk Classification 13 2.3.1. Environmental risk 13 2.3.2. Social Risk 14 2.4.Project Beneficiaries 15 2.5.Exclusions 15 3. POLICY, LEGAL AND ADMINISTRATIVE FRAMEWORK 16 3.1.Overview 16 3.2.Reaching environmental standards in Serbia 16 3.3.Relevant Government Policies, Acts, Rules, Strategies and Guidelines 16 3.4.Relevant Institutions 17 3.5.EIA procedure in the Republic of Serbia 18 3.6.Provisions of Environmental and Social Standards of the World Bank 19 3.7.WB Environment and Social Framework and Environmental and Social Standards (ESF/ESS). 19 3.8.Environment, Health and Safety Guidelines (EHSG) 24 3.9.International Treaties and Conventions. 24 3.10. World Health Organization (WHO) Guidance 24 3.11. Comparison between GoS and World Bank policies and recommendations 25 3.12. The World Bank Group‘s Environmental Health and Safety Guidelines 31 3.13. The Environmental, Health and Safety Guidelines for Health Care Facilities 32 3.14. World Health Organization (WHO) Protocols 32 3.14.1. Infection Prevention and Control/WASH 32 3.14.2. Rational use of personal protective equipment for coronavirus disease (COVID-19) 32 3.14.3. Laboratories testing 32 3.14.4. Risk Communication and community engagement: Risk Communication and Community Engagement (RCCE) readiness and response to the 2019 novel coronavirus (2019-nCoV) 33 3.14.5. WHO Safe management of waste generated from health care activities, 2014 33 4. BASELINE DATA 34 4.1.Baseline Country and environmental background 34 4.2.Air Quality 34 4.3.Water 34 4.4.Climate change and Floods 35 4.5.Waste management 36 4.5.1. Health care Waste Management 37 4.5.2. Treatment and disposal of medical waste in Serbia 40 4.5.2.1. Thermal treatment of medical waste by incineration and co-incineration 40 4.5.2.2. Thermal treatment of medical waste by disinfection / sterilization 40 4.5.2.3. Treatment of infectious waste and sharp objects 40 4.6.Chemicals 41 4.7.Social baseline and background 41 4.7.1. Socio Economic Trends in the Republic of Serbia 41 4.7.2. Education and skills 42 4.7.3. Gender and gender equality 42 4.7.4. Labor and informal employment 43 4.7.5. Population in rural areas 44 4.8.Health Care 44 4.9.Status of Covid-19 in Serbia as at the 23rd November 2020 45 2 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF 5. POTENTIAL ENVIRONMENTAL AND SOCIAL RISKS, IMPACTS AND MITIGATION MEASURES 46 5.1.Environmental and Social Risk and Impacts 46 5.2.Mitigation Measures 48 5.2.1. Planning and design stage 48 5.2.1.1. Procurement of goods and supplies 48 5.2.1.2. Rehabilitation work at existing HCFs 49 5.2.1.3. Medical waste management and disposal 49 5.2.1.4. Protecting healthcare workers 50 5.2.1.5. Containment of COVID-19. 50 5.2.1.6. Communication Approaches and Strategy 50 5.2.1.7. Access to appropriate and timely medical services, hand hygiene and PPEs 50 5.2.2. Construction Stage 51 5.2.2.1. Construction work at existing HCFs 51 5.2.2.2. Issues specific to labor and working conditions 52 5.2.2.3. Stakeholder Engagement and Grievance Mechanism. 52 5.2.3. Operational Stage 52 5.2.3.1. Medical waste management and disposal. 52 5.2.3.2. Protecting healthcare workers 52 5.2.3.3. Containment of COVID-19 53 5.2.3.4. Stakeholder Engagement and Grievance Mechanism 53 5.2.4. Decommissioning Stage 53 6. ENVIRONMENTAL AND SOCIAL RISK MANAGEMENT 68 6.1.Categorization of subprojects 68 6.2.Environmental and Social Screening 68 6.3.Environment and Social Assessment and ES Instruments 68 6.4.Preparation of Environmental and Social Management Plans (ESMPs) for all expansion, rehabilitation and upgrading subprojects in HCF 69 6.5.Environmental and Social Management via Bid Documents 71 6.6.Consultation and Disclosure 71 6.7.Review and Approval 71 6.8.Implementation 71 6.9.Monitoring and Reporting 72 6.9.1. Monitoring 72 6.9.2. Reporting 72 7. STAKEHOLDER ENGAGEMENT AND DISCLOSURE 73 7.1.Existing Stakeholder Engagement Process 73 7.2.Strategic engagement with the Vulnerable Groups 74 7.3.Stakeholder Engagement Strategy during COVID-19 crisis 75 7.4.Grievance Redressed Mechanism (GRM) 76 7.5.Handling of GRM related to SEA/SH 77 7.6.World Bank Grievance Redress System 77 8. LABOR MANAGEMENT PROCEDURES 78 8.1.Overview of labor use on the project 78 8.2.Timing of labor requirements: 79 8.3.Number of Project Workers and civil servants 79 8.4.Characteristics of Project Workers 80 8.5.Assessment of key potential labor risks 81 8.6.Brief Overview of Labor Legislation: Terms and Conditions 82 8.7.Brief Overview of Labor Legislation: Occupational Health and Safety (OHS) 86 8.8.Responsible staff 88 8.9.Policies and Procedure 90 8.10. COVID-19 Prevention Measures 91 8.11. Age of employment 96 8.12. Terms and Conditions 97 8.13. Grievance Redress Mechanisms 98 3 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF 8.14. Contractor‘s Management 99 8.15. Budget 100 9. IMPLEMENTATION ARRANGEMENTS 101 9.1.Overall project management and coordination 101 9.2.Monitoring, Evaluation and Reporting 102 10. ANNEXES 104 ANNEX 01: EXCLUSION LIST OF PROJECT / ACTIVITIES 105 ANNEX 02: SCREENING FORM FOR POTENTIAL ENVIRONMENTAL AND SOCIAL ISSUES 106 ANNEX 03A: ENVIRONMENTAL AND SOCIAL MANAGEMENT PLAN (ESMP) TEMPLATE 110 ANNEX 03B: ESMP CHECKLIST 122 ANNEX 03C: FORMAT FOR ENVIRONMENTAL AND SOCIAL MANAGEMENT AND MONITORING PLAN 132 ANNEX 04: INFECTION CONTROL AND MEDICAL WASTE MANAGEMENT PLAN (ICMWMP) TEMPLATE 134 ANNEX 05: INFECTION AND PREVENTION CONTROL PROTOCOL 139 ANNEX 06: WATER, SANITATION AND HYGIENE (WASH) PROTOCOLS FOR HEALTHCARE FACILITIES TREATING COVID-19 PATIENTS 141 ANNEX 07: RESOURCE LIST: COVID-19 GUIDANCE 144 ANNEX 08: WB INTERIM NOTE: COVID-19 CONSIDERATIONS IN CIVIL WORKS PROJECTS 146 ANNEX 09: GENERAL CHECKLIST COVERING OHS, CHS, HYGIENE & SANITATION, DISEASES SAFETY TO SAFEGUARD AGAINST COVID-19 DURING EXECUTION OF WORKS 156 ANNEX 10: ENVIRONMENTALLY SUSTAINABLE PROCUREMENT GUIDELINES 159 ANNEX 11: SERBIAN ES REGULATORY FRAMEWORK 160 ANNEX 12: REPORTING TEMPLATE – TRACKING ENVIRONMENTAL AND SOCIAL PERFORMANCE 165 ANNEX 13: WHO AND OTHER RELATED GUIDANCE RELATED TO ESS3 167 ANNEX 14: GUIDELINES FOR PROTECTING PHYSICAL CULTURAL RESOURCES 168 ANNEX 15: LABOR AND WORKING CONDITIONS COMPLIANCE REPORT (to be used by third parties engaging contracted workers) 169 ANNEX 16: THIRD PARTIES STATEMENT (POTENTIAL CONTRACTORS AND SERVICE PROVIDERS) ON COMPLIANCE WITH PROVISIONS OF LABOR LEGISLATION and THE PROJECT`S LMP 171 ANNEX 17: GENERIC MONITORING PLAN FOR ENVIRONMENTAL AND SOCIAL PARAMETERS FOR CONSTRUCTION PHASE OF SUBPROJECTS 172 ANNEX 18: ENVIRONMENTAL SAFEGUARDS PREPARATORY TASKS TRACKING SHEET 175 ANNEX 19: ENVIRONMENTAL AND SOCIAL COMPLIANCE MONOTORING CHECKLIST FOR SUBPROJETS IN IMPLEMENTATION 176 ANNEX 20: SPECIAL MONITORING CHECKLIST FOR ENSURING SAFE CONDITIONS FOR WORKERS AND PUBLIC DURING CONSTRUCTION PROJECTS 177 ANNEX 21: REPORT ON PUBLIC CONSULTATIONS 179 4 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF List of Abbreviations BSL Biosafety Level CDC Centre for Disease Control and Prevention CEDAW Convention on Elimination of all Forms of Discrimination against Women COVID-19 Coronavirus Disease 2019 CT Computed tomography EHS Environmental, Health and Safety EHSG World Bank Group Environmental, Health and Safety Guidelines EIA Environment Impact Assessment EPR Environment Protection Rules ERP Emergency Response Plan ES Environmental and Social ESCP Environment and Social Commitment Plan ESF Environmental and Social Framework ESHS Environmental, Social, Health and Safety ESIA Environmental and Social Impact Assessment ESMF Environmental and Social Management Framework ESMP Environmental and Social Management Plan ESSs Environmental and Social Standards EU European Union FAQ Frequently Asked Questions FIDIC International Federation of Consulting Engineers GDP Gross domestic product GIIP Good International Industry Practice GoS Government of Serbia GRM Grievance Redress Mechanism HCF Healthcare Facility HCW Healthcare Waste HIF Health Insurance Fund HIV Human Immunodeficiency Virus HMIS Health management information system HVAC Heating, Ventilation and Air Conditioning IBRD International Bank for Reconstruction and Development ICU Intensive Care Unit ICMWMP Infection Control and Medical Waste Management Plan IDA International Development Association IEC Information, Communication and Education IEE Initial Environment Examination IPF Investment Project Financing ILO International Labor Organization LMP Labor Management Procedures M&E Monitoring and evaluation MEP Ministry of Environmental Protection MOF Ministry of Finance MOH The Ministry of Health of the Republic of Serbia MPA Multiphase Programmatic Approach NGO Non-Governmental Organization OHS Occupational Health and Safety OP Operational Procedure 5 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF PAPs Project Affected Person PCU Project Coordination Unit PDO Project Development Objective PPE Personal Protective Equipment RCCE Risk Communication and Community Engagement RoS Republic of Serbia RPF Resettlement Policy Framework SARI Severe Acute Respiratory Infection SARS Severe Acute Respiratory Syndrome SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 SEA Sexual Exploitation and Abuse SEP Stakeholder Engagement Plan SH Sexual Harassment SPRP Strategic Preparedness and Response Program UNICEF United Nations Children‘s Fund WB World Bank WHO World Health Organization WWTP Wastewater Treatment Plant 6 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF EXECUTIVE SUMMARY 1. Background An outbreak of COVID-19 caused by the 2019 novel coronavirus (SARS-CoV-2)1 has been spreading rapidly around the world since December 2019, when the initial cases were diagnosed in Wuhan, Hubei Province, China. Since the beginning of March 2020, the number of cases outside China has increased thirteenfold and the number of affected countries has tripled. On March 11, 2020, the World Health Organization (WHO) declared a global pandemic as COVID-19 rapidly spread across the world. Since 31 December 2019 and as of 23 November 2020, 58 767 143 cases of COVID-19 (in accordance with the applied case definitions and testing strategies in the affected countries) have been reported, including 1 388 661 deaths in 219 countries. Chapter 1 presents a brief background of the project and outlines the rationale and purpose of the Environmental and Social Management Framework (ESMF). It also describes the scope of the framework as it relates to the methods and procedures for E&S assessment. As one of the limitations of the ESMF, detailed data collection, and field-level verification on the E&S parameters/setting was not possible due to the COVID-19 pandemic lockdown. ESMF is based on virtual discussion and meetings (Webex, email, and telephone) with the project staff, secondary information (website, reports, and bulletins) and other available desktop data. Chapter 2 describes the two components of the project, namely, (i) Emergency COVID-19 Response and (ii) Implementation Management and Monitoring and Evaluation. The Section presents the environmental and social risk classification of the project based on issues such as sensitivity, the scale of the project, the nature, and magnitude of the potential environmental and social risks and impacts and the capacity of MOH. The criteria for inclusion and exclusion of subprojects based on their risks profile is also provided in this section. Chapter 3 presents national and international policies and regulatory frameworks that are relevant in guiding the design and implementation of the project activities, and in managing the potential environmental and social impacts that may be caused by these activities. The first part of the Section reviews the applicable national and international E&S regulatory frameworks concerning project components and activities. The second part discusses the World Bank‘s Environmental and Social Standards (ESSs) that are relevant to the assessment and management of E&S risks and impacts of the project, including the ESS1 (Assessment and Management of Environmental and Social Risks and Impacts); ESS2 (Labor and Working Conditions); ESS3 (Resource Efficiency and Pollution Prevention and Management); ESS4 (Community Health and Safety); and ESS10 (Stakeholder Engagement and Information Disclosure). It further identifies and analyzes the gaps between the ESF requirements and the national regulatory framework. Moreover, the Section also touches upon the healthcare waste management and infectious disease control protocols of other relevant international agencies, particularly WHO. Chapter 4 provides general information about the baseline E&S conditions and characteristics of the project‘s area of influence, such as water resources, air quality, solid waste management, and health care waste management, among others. It also analyzes the current medical waste management practices in Serbia along with the potential hazards on the environment and the public health in the context of the COVID-19 pandemic. The current procedures of testing of COVID-19 that are being adopted in Serbia. It also presents detailed information regarding the socio-economic characteristics and status of the country. Chapter 5 identifies potential E&S risks of the project and the mitigation measures. Based on preliminary assessments, the project presents substantial environmental risks and impacts such as occupational health and safety for frontline healthcare workers and staff, dust and noise during rehabilitation works, and the management of medical waste generated from quarantine and isolation centers, laboratories, and screening centers. The project also presents substantial social risks and impacts: the marginalization of poor and vulnerable people in terms of access to relevant information and healthcare services, management of medical waste on landfills, which may pose a serious threat to community health and safety, and the rise in social tensions due to mandatory isolation and quarantine, and restrictions on transmission amplifying events, such as festivals. Further, the Section prescribes a range of generic mitigation measures to deal with the identified E&S risks and impacts, including various 7 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF measures to raise awareness, knowledge, and understanding among the general population about the risk and impact of the project activities. Chapter 6 outlines the procedures and steps that will be taken to screen for E&S impacts of project activities and to prepare site and activity-specific management plans to address impacts. The Section also briefly talks about the procedures for consultations with the project stakeholders and disclosure project- related information. Chapter 7 details the principles and procedures that will be adopted by the MOH and implementing partners to carry out stakeholder consultations and public disclosure of information related to the subproject among the project-affected communities and stakeholders. Due to restrictions put in place in travel and public gathering, the section adopts alternative means for stakeholder engagements and consultations in line with the WHO protocol, WB‘s technical notes, and the government policy. The MOH will rely on online channels, video conferencing tools, and social media for identifying potential stakeholders and undertaking consultations. Furthermore, the ESMF adopts strategic approaches to ensure the full and effective participation of vulnerable groups in the E&S assessment and implementation of the mitigation measures in the subprojects. Similarly, the ESMF proposes a functional GRM system, capable of addressing concerns of local communities through a transparent process that is culturally appropriate and readily accessible to all segments of the affected communities. Chapter 8 explains Labor Management Procedures which have been developed to guide Labor use under the Project systematically compliant to ESS2. The project will involve the use of civil servants, direct and contracted workers. Healthcare facility workers, although they do not strictly fall under the ESS2 definition of project workers, have been included in the LMP due to the occupational health and safety risks to which they can be exposed during the COVID-19 pandemic. The LMP specifies the policies and procedures to be followed during project implementation to minimize and prevent labor and OHS risks to project workers, including healthcare facility workers. Chapter 9 explains the overall project management and institutional arrangements required for the effective implementation of the project. Thus, the Section highlights the roles and responsibilities of various agencies within the Ministry of Health of the Republic of Serbia ( MOH), which is also the principal implementing agency of the project. The Section also analyzes the ESMF implementation capacity of the MOH and recommends several measures, including capacity enhancement activities and management of additional experts to ensure effective implementation of the ESMF. The Section, which also provides procedures for compliance monitoring and reporting, has made the Department of Health Services responsible for reporting and supervising the implementation of the ESMF. 8 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF 1. INTRODUCTION AND BACKGROUND An outbreak of COVID-19 caused by the 2019 novel coronavirus (SARS-CoV-2)1 has been spreading rapidly around the world since December 2019, when the initial cases were diagnosed in Wuhan, Hubei Province, China. Since the beginning of March 2020, the number of cases outside China has increased thirteenfold and the number of affected countries has tripled. On March 11, 2020, the World Health Organization (WHO) declared a global pandemic as COVID-19 rapidly spread across the world. Since 31 December 2019 and as of 23 November 2020, 58 767 143 cases of COVID-19 have been reported, including 1 388 661 deaths in 219 countries. In Serbia, as of November 29, 2020, 163,035 cases including 1,484 COVID -19 related deaths have been reported. Given the fluidity of the situation this document does not seek to provide additional data on the outbreak and quantifications of the impacts but seeks to present an inclusive, flexible yet meaningful and comprehensive assessment and management of Environmental and Social risks attributable to Project activities. COVID-19 is one of several infectious diseases that in recent decades have emerged from animals that are in contact with humans, resulting in major outbreaks with significant public health and economic impacts. With COVID-19, scientists are still trying to understand the full picture of the disease symptoms and severity. Reported symptoms in patients have varied from mild to severe, and can include fever, cough, and shortness of breath, while 3.7 percent of the people worldwide confirmed as having been infected have died. In response to the GoS request for combating the COVID-19 pandemic, the World Bank is providing an amount of US$ 100.00 m IBRD/IDA financing to assist the government to implement the Serbia COVID- 19 Emergency Response Project. The project focuses on enhancing the capacity of the government to provide optimal medical care, maintain essential health services, and to minimize risks for patients and health personnel, including training for health staff and front-line workers on risk mitigation measures, and providing them with the appropriate protective equipment and hygiene materials. The Project Development Objective (PDO) is to respond to the threat posed by COVID-19 and to strengthen the national health system for public health preparedness in Serbia. The PDO will be achieved through the implementation of activities that support prevention of SARS-CoV-2 transmission combined with activities that strengthen the health system‘s capacity for disease management. The PDO will be monitored through the following PDO-level outcome indicators: o Number of acute health care facilities with isolation capacity; o Number of designated laboratories with COVID-19 diagnostic equipment, test kits and reagents; o Personal and community non-pharmaceutical interventions adopted by the GoS. While the nature of the project activities is known in general, the specific details on designs and locations of the activities are yet to be defined. Therefore, the nature and scale of their impacts will be known during implementation when the activities are prioritized, identified, and prepared. In this context, this Environment and Social Management Framework (ESMF) will provide guidance and procedures for screening, assessing, managing the environmental and social risks and impacts of the project, and integrate mitigation measures in various stages of the subproject cycle. The ESMF forms part of the MOH‘s existing environmental and social management approach for addressing the potential risk and impacts of this project. This ESMF illustrates policies, procedures and directives on how to assess specific ES risks and provide guidance to mitigate them. The ESMF also provides guidelines for screening subprojects for ES risks by the implementing agency. During implementation, site-specific ES assessments will be carried out in accordance with this ESMF and ESMPs (or ESMP checklist) will be prepared and implemented prior to the commencement of the specific works. The site specific assessments will help adoption of mitigation measures against the ES risk and impacts (through preparation of ESMP, Template at Annex 03) and to address the issues of inclusion, social vulnerability of certain groups, gender and SEA/SH, consultation and communication strategy and any other issues identified via the assessment and the stakeholder consultations. 9 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF 1.1. Purpose of the ESMF The framework describes the procedures for the assessment and management of the environmental & social risk and impacts associated with the project activities with the following objectives: o Establish clear procedures and methods for environmental and social assessment, planning, review, and approval of subprojects to be financed under the Project. o To provide pragmatic guidance/solutions on the implementation of the environmental and social management measures and provide a plan for monitoring the implementation of environmental and social standards; o Specify institutional arrangements, including appropriate roles and responsibilities for managing, reporting and monitoring environmental and social concerns of the project activities and; o Provide guidance and strategy for stakeholder engagement for the identification and management of the environmental & social issues, impacts, and risks associated with the project; o Determine the other institutional requirements, including plans for training and capacity building of key stakeholders needed to successfully implement the provisions of the ESMF. To address the potential environmental and social impact attributable to the Project, this Environmental and Social Management Framework (ESMF) is developed with its objective to identify, assess, evaluate and manage impacts in a manner consistent with the relevant WB Environmental and Social Standards (ESS), relevant EU requirements (those transposed to the national legislation) and national legal requirements and standards. The ESMF has designed steps, processes, and procedures for screening, preparation and implementation, risk commensurate assessment, management, reporting and monitoring of environmental and social risks and impacts of each Subproject compliant to the WB ESF requirements. All of the activities to be financed under the Project will be subject to the project specific environmental and social screening, following the procedures laid out in this Framework. The screening aims at identifying ES risks to potential impacts at the subproject‘s levels so adequate avoidance, minimization or offset measures as the case may be are applied. This ESMF is intended to be used as a practical tool during program formulation, design, implementation, and monitoring of Project activities. The purpose of this framework is to specify the procedures that the Project stakeholders will follow during implementation, with the objective that all activities supported under the Project will be environmentally and socially sound and sustainable, consistent with WB Standards, ESF and Serbian national legislation. In the case they differ, the stricter one prevails. This ESMF includes templates for the Environmental and Social Management Plan (ESMP) (Annex 03) and the Infection Control and Medical Waste Management Plan (ICMWMP) (Annex 04). The ESMP template identifies potential environmental, social, health and safety issues associated with the construction and operation of healthcare facilities in response to COVID-19. The ICMWMP template focuses on infection control and healthcare waste management practices during the operation of healthcare facilities. The ESMP, ESMP Checklist and ICMWMP should set out appropriate measures for infection control and waste management during operation of the relevant healthcare facilities. For the Serbia COVID-19 project, an Environment and Social Commitment Plan (ESCP) detailing material measures and action for the Borrower‘s to adopt, Stakeholder Engagement Plan (SEP) to illustrate engagement procedure and provision of grievance redress mechanism have already been prepared and will be disclosed with ESMF. Finally, the ESMF provides guidance for the process and the content of Environmental and Social Impact Assessment (ESIA), Environmental and Social Management Plans (ESMPs) and ESMP Checklists for all subprojects which will be implemented under the Project as well as Environmental and Social Audits for projects that have already commenced. 10 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF 2. PROJECT DESCRIPTION 2.1. Project overview This project will complement Serbia‘s successful initial COVID-19 suppression effort and enhance its preparedness for on-going re-opening of society by supporting ongoing activities and investments by purchasing critically needed equipment, building surveillance capacity, and providing technical support, including training and communication support for Nonpharmaceutical intervention (NPI), and implementation support. Specifically, the project will finance activities aimed at (a) limiting local transmission of COVID-19 through containment strategies and enhancement of disease detection capacities by providing technical expertise and laboratory equipment and by putting in place systems to ensure prompt case finding, contact tracing, and reporting, consistent with WHO‘s guidelines in the SPRP; (b) developing and operationalizing social distancing measures through laws, regulations, and other preventive actions; (c) strengthening the health system‘s capacity to mobilize surge response by training and equipping front-line health workers and building system capacity for hospital and after- hospital care; and (d) enhancing the communication infrastructure to transparently disseminate information from national to state and local levels and developing and testing messages and materials to be used in a pandemic or emerging infectious disease outbreak. Achieving these goals will require close collaboration between the MOH, the National Health Insurance Fund (HIF), funding partners, and UN Agencies to ensure complementarity and to leverage the strengths of all partners. Within the overall GoS and development partner support and considering the fluid context of the COVID-19 epidemic in Serbia (and globally), the project is designed to have maximum flexibility to allow funds flow to finance necessary activities as they arise. Financing options will include retroactive financing of eligible expenditures related to COVID-19 that have already been incurred. The component will enable Serbia to mobilize surge response capacity through trained and well-equipped front-line health workers. The funds are programmed for substantial support to the additional needs that the Government forecasted based on the expected future waves of the COVID-19 epidemic. Such forecast is also based on The MOH‘s diligent situational assessment of imaging equipment available through the optimization plan and the draft medical equipment maintenance plan. 2.2. Project Components 2.2.1. Component 1: Emergency COVID-19 Response This component will provide immediate support to Serbia to enable limiting the local transmission of SARS-CoV-2 through containment strategies. It will support enhancing disease detection capacities by providing technical expertise, front-line health care equipment and materials, and laboratory equipment and systems to ensure prompt case finding and contact tracing, consistent with WHO‘s SPRP.40 Financing options will include retroactive financing of eligible expenditures related to COVID-19 that have already been incurred. The component will enable Serbia to mobilize surge response capacity through trained and well-equipped front-line health workers. Bank financing targets areas for effectively mitigating and containing the COVID-19 epidemic. More extensive testing, better diagnosing, and much-strengthened treatment capacity will facilitate opening the economy earlier and in a more controlled fashion in the current epidemic wave and in subsequent waves. Key strategic needs for Bank financing are (a) equipment for testing for the virus, (b) equipment for diagnosing COVID-19, and (c) considerably strengthened ICU capacity to deal with an influx of COVID-19 patients. Human resources and equipment and supplies related to PPE are mostly provided by the GoS with some support from development partners, although here also the Bank complements. Supported activities, to be implemented in close collaboration with the MOH, the National HIF, and the UN to ensure complementarity and to leverage other partners‘ activ ities and interventions, are divided among three subcomponents. Subcomponent 1.1: Case Detection, Confirmation, Contact Tracing, Recording, Reporting. This subcomponent will help (a) strengthen disease surveillance systems, national reference and public health laboratories, and epidemiological capacity for early detection and confirmation of cases; (b) combine the detection of new cases with active contact tracing; (c) support epidemiological investigation; (d) 11 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF strengthen risk assessment; and (e) provide on-time data and information for guiding decision-making and response and mitigation activities. Additional support will be provided to strengthen Serbi a‘s health management information system (HMIS) to facilitate recording and on-time virtual sharing of information. Specifically, the project will implement the following: (a) two additional regional COVID- 19 laboratories will be established—one at the University Clinical Centre of Vojvodina in Novi Sad and one at the University Clinical Centre in Kragujevac—with a capacity of 1,000 samples daily, increasing Serbia‘s total SARS-CoV-2 testing capacity to over 9,000 tests per day; (b) additional protective gear will be provided to address needs identified by the HIF; (c) the COVID-19 human and veterinary labs will be integrated into one electronic medical records system; (d) two walk-in testing points will be established—one in Belgrade‘s Nikola Tesla Airport and one in Constantine the Great Airport in Nis—in addition to drive-through testing points at 10 selected border crossings. Training as needed is incorporated. For instance, setting up the walk-in and drive-through test sites also includes making them operational (training, supervision, etc.). A detailed micro-costing will be made during implementation and will be formalized in an updated, detailed Workplan and Budget. Also, the budgets proposed are indicative, and changes might occur when there is need to shift from one budget to the other because priorities change, or more detailed cost information becomes available. Subcomponent 1.2: Physical Distancing Measures and Communication Preparedness. Sub- component 1.2 combines activities listed in Component 1 o f the global MPA PAD under ‗Social Distancing Measures‘ and ‗Communication Preparedness‘. Physical distancing measures. An effective measure to prevent contracting a respiratory virus, such as SARS- CoV-2, is to limit contacts with other people—"physical distancing.‖ Financing will be made available for Serbia to develop guidelines on social distancing measures (e.g., in phases) to operationalize existing or new laws and regulations, support coordination among sectoral ministries and agencies, and support the MOH in protecting health workers and other personnel involved in pandemic control activities. Additional preventive actions will be supported that will complement physical distancing—for example, personal hygiene promotion, including promoting handwashing; distribution and use of masks; and promotion of increased awareness and community participation in slowing the spread of the pandemic. Specific interventions for vulnerable communities —including Roma populations, residents of women‘s shelters, and prisoners— will be supported as needed. Specifically, the project will build on what has been done so far, and on the lessons that are emerging about the efficacy of NPIs in the Serbian context. Communication preparedness. Activities will include developing and testing messages and materials to be used in a pandemic or emerging infectious disease outbreak, and enhancing communication infrastructure to disseminate information from the national to the state and local levels and between the public and private sectors. Communication activities will support cost-effective and sustainable methods such as promotion of handwashing through various communication channels (mass media, counseling, schools, workplaces), and by integrating them into specific interventions and into the ongoing outreach activities of ministries and sectors, especially the ministries of health, education, agriculture, and transport. Support will be provided for information and communication activities to increase the attention and commitment of GoS and the private sector and civil society; to raise awareness, knowledge, and understanding among the general population about the risk and potential impact of the pandemic; and to develop multisectoral strategies to address the pandemic. In addition, support will be provided for (a) the development and distribution of basic communication materials for the general public, such as question-and-answer sheets and fact sheets in appropriate languages on COVID-19 and general preventive measures; (b) information and guidelines for health care providers; (c) training modules (web-based, printed, and video); (d) presentations, slide sets, videos, and documentaries; and (e) symposia on surveillance, treatment, and prophylaxis. A specific example of this is a communication campaign on the walk-in testing sites at the two airports and the drive-through testing sites at designated border crossings. Support for community engagement will also help ensure the following: o Engagement of communities in assessing needs and formulating priorities, with specific strategies to ensure that vulnerable groups (elderly, people with disabilities, immune compromised and poor) have access to the channels to articulate their needs. 12 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF o Establishment of a participatory monitoring and reporting mechanism to enable communities to help monitor the COVID response at the local level and provide feedback on gaps in services (information availability, access to PPE/testing/relevant care, equal treatment, etc.). o The challenges of implementation presented by social distancing and isolation are addressed through the development of consolidated, accessible, and safe digital solutions that promote and support community feedback throughout the project. Subcomponent 1.3: Health System Strengthening. Assistance will be provided to the health care system for preparedness planning to provide optimal medical care, maintain essential community services, and minimize risks for patients and health personnel, including training health facilities staff and front-line workers on risk mitigation measures and providing them with appropriate protective equipment and hygiene materials. Strengthened clinical care capacity will be achieved through financing the establishment and refurbishment of specialized units in selected hospitals, preparation of treatment guidelines, and conduct of clinical training of health workers. Strategies will also be developed to increase hospital bed availability, including deferring elective procedures, stringent triage of patients in all health facilities and before admission, and earlier discharge with follow-up by home health care personnel. Specifically, the project will procure (a) emergency vehicles to transport infected persons to designated isolation places; (b) ICU beds and ICU equipment; (c) mobile X-ray machines; (d) computed tomography (CT) scanners; and (e) X-ray devices to be installed in community health centers. 2.2.2. Component 2: Implementation Management and Monitoring and Evaluation For project management, the existing PCU of the MOH for the ongoing Second Serbia Health Project (SSHP) will be responsible for coordinating project activities and carrying out the fiduciary tasks of procurement and financial management (FM). As required, the PCU will be strengthened through the recruitment of additional staff and consultants. The project will cover the costs associated with project management and coordination. The subcomponent will also support the M&E of prevention and preparedness, building capacity for clinical and public health research and joint learning across and within countries. It will also support training in participatory M&E at all administrative levels, evaluation workshops (considering social distancing measures, or virtual evaluation), and development of an action plan for M&E and replication of successful models. The project will strive for environmentally sound implementation. Medical waste management will get special scrutiny because of the volume of medical waste that will be generated; for instance, the procurement of medical waste autoclaves/grinders could be an option. New equipment will be procured only from companies that produce it through ecologically sound methods. Old X-ray machines and CT scanners - replaced by new ones procured by the project – will be disposed of through certified environmentally sound practices. 2.3. Environmental and Social Risk Classification The project will have long-term positive impacts, both socially (curbing the disease spread, improved COVID-19 surveillance, monitoring etc.) and environmentally (improved medical waste management), but there is a number of substantial short-term risks that need to be considered. 2.3.1. Environmental risk The environmental risks are considered Substantial due to concerns on disposal and management of medical waste and biohazards, and the resource constraints in responding to epidemics and the medical, environmental, and social impacts that come with these types of operations. Other environmental risks and potential impacts include: (i) occupational health and safety (OHS) concerns to direct and contracted workers, laboratory technicians, and medical crews in the specimen collection and handling, testing and handling of supplies; (ii) disposal of hazardous waste generated from isolation centers, laboratories, and screening posts could include contaminated fluids (e.g. blood) and infected materials such as reagents, syringes, and lab solutions; and (iii) air, noise, water emissions, waste generation, OHS issues during minor rehabilitation/refurbishing works. To mitigate these risks the MOH is prepared this Environmental and Social Management Framework (ESMF) as the guiding instrument in addressing and mitigating community, environmental and OHS risks in Project implementation. 13 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF The ESMF includes (i) rules and procedures for safe collection, transport, storage and disposal of contaminated and other medical waste; (ii) rules and procedures in line with the national regulation, international good practices and WHO standards on COVID-19 response on controlling viral contagion in healthcare facilities, (iii) procedures and measures addressing risks for planned civil works at healthcare facilities. Furthermore, the ESMF also includes a review of relevant parts of WHO COVID-19 quarantine guidelines and COVID-19 biosafety guidelines to cover all relevant OHS and Community risks and measures. In addition to the ESMF, the client will implement the activities listed in the ESCP. The project will support minor rehabilitation works (repair) of Intensive Care Unit (ICUs) in selected hospitals. The location of ICUs will be selected based on existing services and human resources capacities and expanding geographical access to health care services in order to ensure equitable access to highly specialist care across the country. All works will be interior and implemented within the existing footprint of the target facilities; thus, the environmental impacts are expected to be low in magnitude, reversible, predictable and temporary. As asbestos is widely used material in Western Balkans, the ESMF includes related mitigation measures for civil works as well as exclusion criteria for establishing medical units in asbestos-risk environment. 2.3.2. Social Risk The social risks are considered Substantial. The risks and impacts are considered temporary, predictable and can be readily managed through the Project design features and instruments designed within the Project. In addition, the Project will largely have long term positive social impacts insofar as it should improve COVID-19 detection, monitoring, treatment and containment. However, without adequate controls and procedures project activities ranging from medical facility operation to on the ground public engagement exercises can add to the risk of transmission and spread from quarantined /hospitalized persons to medical and support staff. Component 1 activities are the source of all social risks of the Project. The activities pose increased health and safety risks for project workers, particularly those working in medical, quarantine and laboratory facilities, stemming from improper disposal of medical waste, contacts with infected persons, and/or inadequate OHS measure. The risks of infection in addition to above groups pose a risk to the public at large as well. Access to Personal Protective Equipment (PPE), procedures around medical waste disposal, relevant OHS measures and clear communication of risks and prevention measures to all persons at risk is required. Another central social risk is around vulnerable and disadvantaged groups (elderly, disabled, chronically diseased, people with no health insurance, migrants, single parent headed households, economically marginalized and disadvantaged groups especially residing in geographically challenging areas, Roma, residents of shelters/care facilities, prisoners) who could experience inequitable access to project supported facilities and services because of their qualifying characteristics which could lead to social unrest and tensions and possible increase of their vulnerabilities. The potential risk of contamination on waste pickers (secondary raw materials collectors) who are primarily Roma has also been identified as a risk and will be addressed both through direct mitigation measures as designed under specific ESS4 risks but also through tailored outreach, communication and communication strategies and targeted information sessions will be tailored for these groups on COVID-19 to inform them about the virus, the diseases it causes and how to protect themselves from infection with increased emphasis on hand and general hygiene, respiratory etiquette, and use of PPE. Sexual exploitation, Abuse and Sexual Harassment (SEA/SH) risk associated with this Project and in Serbia is assessed as low, yet the grievance redress mechanism (GRM) shall be strengthened with procedures to handle allegations of SEA/SH violation risks. The ESMF has incorporated the requirement for WHO Code of Ethics and Professional Conduct for all workers, as well as provision of gender sensitive infrastructure and segregated toilets in workplaces, isolation/quarantine centers. The ESMF has measures to ensure female front-line workers are kept safe and free from pressure in health facilities, and in designated quarantine locations. Health care workers shall be trained to properly identify SEA/SH risks and cases and facilitate appropriate and timely referrals. The SEP has specific outreach techniques designed for elderly women. Social risks associated with Component 1 will be addressed through the ESMF which has incorporated the Labor Management Procedures (LMPS), SEP (including the GRM) in line with the applicable 14 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF Environmental and Social Standards (ESS) of the WB‘s ESF and the WHO COVID -19 WHO guidance tools for COVID-19 preparedness and response. The Borrower has committed to this through the Environmental and Social Commitment Plan (ESCP). The Project incorporates budget for outreach activities and community engagement strategies in component 1, which will be guided by the SEP, and which will minimize the risk of exclusion of the vulnerable individuals and groups, both with regard to accessing project benefits but also to be included in the Project Monitoring & Evaluation (M&E). 2.4. Project Beneficiaries The expected project beneficiaries will be the Serbian population at large, given the encompassing nature of the disease. The primary project beneficiaries will be infected people, at-risk populations (particularly the elderly and people with underlying comorbidities), medical and emergency personnel, medical and testing facilities, and public health agencies engaged in the response in Serbia. The entire population of Serbia— 6 945 235 persons, 27.7 percent of whom are older than 60 years (age bracket in which case fatalities are concentrated)—is expected to benefit from project interventions 2.5. Exclusions To avoid/minimize risks and impacts of the project activities, certain activities are not eligible for support under the project due to the potential for causing high social and environmental risks and impacts that are diverse, irreversible, or unprecedented are excluded. These activities are: o A listed in the World Bank Group IFC Exclusion List given in Annex 01 o Activities that may cause long term, permanent and/or irreversible adverse impacts (e.g. loss of major natural habitat) o Activities that have a high probability of causing serious adverse effects to human health and/or the environment (e.g. constructing new hospitals without Effluent Treatment Plants, related to general wastewater treatment, not COVID-19, establishing medical units in asbestos-risk environment. o Activities that may affect lands or rights of minorities, o Activities that may have significant adverse social impacts and may give rise to significant social conflict, o Activities that may involve any resettlement (temporary or permanent) or land acquisition/use restriction or adverse impacts on cultural heritage , o Any other activities where during screening high adverse social and environmental risk and impacts are identified 15 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF 3. POLICY, LEGAL AND ADMINISTRATIVE FRAMEWORK 3.1. Overview Republic of Serbia, having acquired the EU candidate country for membership status, is taking a huge effort to reach environmental standards in line with the EU acquis1. A set of environmental legal framework adopted during the last decade contributed to Serbia coming closer to desired environmental standards. However, a negotiating Chapter 27, Environment and Climate change 2, still remains technically, financially and administratively the most complex and challenging one, with more than 750 different legal acts needed to be produced and adopted and over 10 billion euros of investments needed to be undertaken. The legal, legislative and institutional framework for the prevention health care system and the environmental protection in Republic of Serbia is founded on the Constitution of Serbia, which stipulates the right to a healthy environment and the duty of all, in line with the law, to protect and enhance the environment. Currently, the majority of these are harmonized with EU legislation. 3.2. Reaching environmental standards in Serbia The Republic of Serbia is taking a huge effort to reach good environmental standards. A set of environmental laws adopted during the last two decades contributed to Serbia coming closer to desired environmental standards. The standards of good environmental practice are applied throughout the country, and progress is particularly visible within the energy and transport sector, also due to the fact that several large projects were financed by different International Financing Institutions (IFI), which implemented a strict environmental system. 3.3. Relevant Government Policies, Acts, Rules, Strategies and Guidelines Environmental protection in Republic of Serbia is regulated by a set of laws and secondary laws, the most important of which are provided in Annex 11. Full List of regulations in the field of environmental protection in the Republic of Serbia is accessible at following website: https://www.ekologija.gov.rs/wp- content/uploads/inspekcija/List_of_regulations.pdf In 2015 a Post-screening Document for the transposition and implementation of Chapter 27 - Environment and Climate Change has been adopted, containing preliminary plans and deadlines, as well as the assessment of the necessary financial resources needed for achieving full implementation of the pertinent EU legislation. An overview of laws and regulations that have relevance for environmental and social issues for the Serbia Emergency COVID-19 and Health System Preparedness Project is as follows (see Table 3.1 and Table 3.2) and detail information relevant and applicable laws are provided in detail in Annex 11. Table 3.1 An overview of relevant laws and regulations • The Constitution of Serbia (‘‘Official Gazette of RoS‘‘, No. 98/06) • Law of Health Care (‘‘Official Gazette of RoS‘‘ No. 25/19), • Law on Medicines and Medical Devices (‘‘Official Gazette of RoS‘‘, No.30/10, 107/12, 113/17 – other law and 105/17 – other law) • Law of Ionizing radiation and on Nuclear Safety (‗‘Official Gazette of RoS‘‘ No 95/18, 10/19), • Rulebook on the management of waste containing asbestos ("Official Gazette of RS", No. 75/10) • Rulebook on medical waste management ("Official Gazette of RS", No. 48/19) 1 The Acquis Communautaire is the accumulated body of European Union (EU) law and obligations from 1958 to the present day. It comprises all the EU's treaties and laws (directives, regulations, decisions), declarations and resolutions, international agreements and the judgments of the Court of Justice. 2 http://eukonvent.org/wp-content/uploads/2018/07/Izve%C5%A1taj-o-napretku-Srbije-2018_engleski.pdf 16 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF • Rules on limits of exposure to ionizing radiation and measurements to assess the level of exposure to ionizing radiation (Official Gazette RoS, No. 86/11), • Regulation on the limits of radioactive contamination of person, workplace and environment and the methods of decontamination (Official Gazette RoS, No 38/11), • Law on Environmental Protection (―Official Gazette of RoS‖ No. 135/04, 36/09, 72/09, 43/11, 14/16 and 95/2018), • Law on Environmental Impact Assessment (―Official Gazette of RoS‖ No. 135/04, 36/09), • The Law on Waste Management (―Official Gazette of RoS‖ No. 36/09, 88/10, 14/16 and 95/18), • The Law on Occupational Safety and Health (―Official Gazette of RoS‖ No. 101/05, 91/15 and 113/17), • Law on Planning and Construction (―Official Gazette of RoS‖ No. 72/09, 81/09, 56/10, 24/11, 121/12, 42/13, 50/13, 98/13, 132/14, 145/14, 83/18, 31/19, 37/19 and 9/20), • Law on Nature Protection, (―Official Gazette of RoS‖ No. 36/09, 88/10, 91/10, 14/16 and 95/18), • Law on Strategic EIA (―Official Gazette of RoS‖ No. 135/04, 88/10) Table 3.2 Regulations established on the basis of the Law on EIA: • Decree on establishing the List of Projects for which the Impact Assessment is mandatory and the List of projects for which the EIA can be requested (―Official Gazette of RoS‖ No.114/08) • Rulebook on the contents of requests for the necessity of Impact Assessment and on the contents of requests for specification of scope and contents of the EIA Study (―Official Gazette of RoS‖ No. 69/05) • Rulebook on the contents of the EIA Study (―Official Gazette of RoS‖ No. 69/05) • Rulebook on the procedure of public inspection, presentation and public consultation about the EIA Study (―Official Gazette of RoS‖ No. 69/05) • Rulebook on the work of the Technical Committee for the EIA Study (―Official Gazette of RoS‖ No. 69/05) • Law on confirmation of convention on information disclosure, public involvement in process of decision making and legal protection in the environmental area (―Official Gazette of RoS‖, 38/09) 3.4. Relevant Institutions The following is a general description of competences of the various institutions involved in and relevant for the environmental sector. Only main competences are included. The environmental policy and climate change sector a large number of institutions are active at national, provincial and local level. The Ministry of Environmental Protection (MEP) is the key institution in Republic of Serbia responsible for formulation and implementation of environmental policy matters. The other aspects of environmental management related to the environmental aspects of projects are dealt with several other institutions, among which are Serbian Radiation Protection and Nuclear Safety Agency (SRPNSA), Serbian Environmental Protection Agency, Institute for Natural Protection (INP), Institute of Occupational Health of Serbia, Labor Inspectorate, OHS Inspectorate and the Ministry of Construction, Transport and Infrastructure (MCTI). The Medicines and Medicals Devices Agency of Serbia (MMDAS) has an important role in obtaining the necessary approval for putting on the market medical equipment. 17 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF 3.5. EIA procedure in the Republic of Serbia The Environmental Impact Assessment procedure in the Republic of Serbia as governed by the Law on Environmental Impact Assessment, is harmonized with European EIA Directive (85/337/EEC, 97/11/EC, 2003/35/EC and COM 2009/378 as codified by the Directive 2011/92/EU). The EIA Law defines procedures of impact assessment for activities that may have significant effects on the environment, the contents of the Environmental Impact Assessment (EIA) Study, the required engagement of authorities and organizations concerned, citizen engagement, transboundary exchange of information for projects that may have transboundary impacts, supervision and other issues of relevance to impact assessment. Impact assessment is carried out for future and projects under implementation, changes in technology, reconstruction, capacity enhancement, closure and decommissioning activities and for removal of projects that may have significant impact on the environment. The EIA is applicable to the industry, mining, energy production, transport, tourism, agriculture, forestry, water management, waste management and utility services sectors, as well as for all the projects that are planned in areas of protected natural resources of special value and within the protected zones of immobile cultural resources. The Government of the Republic of Serbia (GoS) has adopted lists sensitized by risks3 : Table 3.3 Project dividing in term of its environmental sensitivity LIST I LIST II Projects for which an impact assessment is Projects for which an impact assessment may be mandatory. Those are the projects with required. significant environmental and social impacts. For these the PCU or PITs as relevant will be required to submit a Request for Decision about the Need for Environmental Impact Assessment to the relevant institution. Based on the outcome of the process a Decision whether an E(S)IA is required or not will be issued. This is applicable to all activities not listed within the LIST I in context of the Project. Finally, for any project activity adjacent to or within the nature/cultural protected area an EIA might be required based on the conditions and opinions obtained from the relevant institutions. Depending on the geographical location these are the Institute for Nature Protection (INP), Provincial Institute for the Nature Protection (PINP), Institute for Protection of Cultural Monuments (IPCM) Diagram/flow chart for the national EIA procedure is shown in Figure 1 below: 3 https://www.paragraf.rs/propisi/uredba_o_utvrdjivanju_liste_projekata_za_koje_je_obavezna_procena_uticaja_i_liste_projekata_za_koje_se_m oze_zahtevati_procena_uticaja_na_zivotnu_sredinu.html 18 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF Figure 1: EIA flowchart under country law 3.6. Provisions of Environmental and Social Standards of the World Bank In addition to the applicable national regulation, the following WB ESSs are considered relevant in managing the environmental and social impacts of the project and sets out the requirements for MOH relating to the identification and assessment of environmental and social risks and impacts associated with the project. 3.7. WB Environment and Social Framework and Environmental and Social Standards (ESF/ESS). Since October 01, 2018, all WB funded Investment Project Financing (IPF) are required to follow the Environmental and Social Framework (ESF) consisting ten (10) Environmental and Social Standards (ESS). These ESSs set out their requirement for the borrowers relating to the identification and assessment of ES risks and impacts associated with any project. A brief description of the ten (10) ESSs including their relevance to the project is presented below: ESS1 Assessment and Management of Environmental and Social Risks and Impacts ESS1 is relevant for the Project. This standard clarifies the borrower‘s responsibilities in identifying and managing the ES risks of the project. The project will provide health services in response to the global COVID-19 outbreak. Given the nature of how the disease spreads and the medical requirement and resources needed to address the issue, the health-care workers, the community members and the environment are likely to be exposed to health risks from medical, solid and liquid wastes generated from the health facilities (if not properly treated and managed) and the interaction among the potential COVID- 19 cases and general public. This ESS illustrates the various ES instruments that will be prepared to address the issues of ES risks and impacts. 19 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF ES risks and impacts are expected to be significant in the project. The Project activities generate some adverse ES impacts as it aims to strengthen bio-safety measures in selected hospitals with better health care waste management, bio-hazard management measures - autoclaves, handling of infected materials, and management of corpses suspected/infected with the disease. Considering that the project‘s major activities will be executed in the existing premises of the hospitals, it is critical to maintaining the health and safety of health workers, patients including those infected by COVID-19, hospital staff, visitors, and nearby communities throughout the project lifecycle. The sub-component also involves civil works for repair and renovation of existing infrastructure, and it may create additional ES issues, particularly with an increase in environmental pollution with waste, noise, dust, air pollution, and workers‘ health and safety issues. However, all the potential environmental risks and impacts are predictable, expected to be temporary and reversible, low in magnitude, and site-specific. This Environmental and Social Management Framework has been drafted to identify risks and impacts and recommend mitigating measures. The project will have positive environmental and social impacts as it should improve COVID-19 surveillance, monitoring, and containment. However, the project could also cause significant environmental, health, and safety risks due to the dangerous nature of the pathogen and reagents and other materials to be used in the project supported HCFs. Other risks, associated with site specific rehabilitation of health facilities, are identified/identifiable and easily mitigable. To manage these risks, during Project preparation phase, the MOH has prepared following major instruments: a. This ESMF, which includes a template for site specific Environmental and Social Management Plans (ESMP) and ESMP Checklist (Annex 03), and a template for an Infection Control and Medical Waste Management Plan - ICMWMP, (Annex 04), so that the ICUs, laboratories, and quarantine facilities to be supported by the Project will apply international best practices in COVID-19 diagnostic testing and other COVID-19 response activities. b. A Stakeholder Engagement Plan (SEP) for effective outreach and citizen participation, a SEP has been prepared and disclosed both in country on the MOH website and on the World Bank website4. During Project implementation the PCU and HCFs will prepare and implement the necessary environmental and social instruments for activities financed under the project. The scope of this Emergency COVID-19 Project requires the following three types of environmental and social instruments: i. ESMPs or ESMP Checklist – after the screening, ESMPs or ESMP checklists will be prepared for any small-scale works to be conducted at an associated health care facility including rehabilitation needed for installation of procured medical equipment, establishment and refurbishment of specialized units in selected hospitals, minor rehabilitation works (repair) of ICUs in selected hospitals, the creation or the rehabilitation of two regional COVID-19 laboratories, and for installation of walk-in and drive through testing points at different points of entry. Once approved, the ESMP will be included as an integral part of any works or supervision contract for the activity. ii. Infection Control and Medical Waste Management Plans (ICMWMPs) – each health care facility will prepare and implement an Infection and Control Waste Management Plan (ICMWMP), based on the template found in Annex 04 of the ESMF which covers environmental and social infections control measures and procedures for the safe handling, storage, and processing of COVID- 19 waste materials in order to prevent, minimize, and control environmental and social impacts during the operation of project-supported laboratories and medical facilities. Given the potential lack of testing availability in some areas of Serbia, ICMWMP protocols for individual health care facility will be implemented on the assumption that the COVID-19 pathogen is present and that all healthcare workers and patients are potential carriers. 4 http://documents1.worldbank.org/curated/en/868771588965540248/pdf/Stakeholder-Engagement-Plan-SEP-Serbia-Emergency- COVID-19-Response-Project-P173892.pdf 20 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF iii. Updated Stakeholder Engagement Plan (SEP) – a SEP has been prepared for the project and it is applicable to all project financed activities. The SEP will be updated to include details on the GRM and a detailed engagement Program. iv. Grievance Redress Mechanism (GRM) – the PCU will build upon the existing GRM in place for the SSHP to enable stakeholders to air their concerns/comments/suggestions, if any. Project stakeholders and citizens can also submit complaints regarding the violation of project policies, guidelines, or procedures, including those related to procurement, health and safety of community/contract workers and gender violence. The GRM will be sensitized for uptake of SEA/SH grievances. To achieve the above mentioned positive environmental and social impacts, the aforementioned areas of risks must be addressed and mitigated as discussed below: a. Medical Waste Management and Disposal. Given that the medical waste generated by laboratories and health care facilities is a potential vector for the contagion, improper handling of medical waste runs the risk of further spread of the disease. Therefore, the ESMF includes an ICMWMP template specifically designed for COVID-19 identification, testing, and treatment. b. Worker Health and Safety. Workers in healthcare facilities are particularly vulnerable to contagions like COVID-19. Healthcare-associated infections due to inadequate adherence to occupational health and safety standards can lead to illness and death among health and laboratory workers as well as the wider spreading of the disease within communities. The ICMWMP contains detailed procedures, based on WHO guidance, for protocols necessary for treating patients and handling medical waste as well as environmental health and safety guidelines for staff, including the necessary PPE (masks, gloves, aprons, surgical scrubs, etc.). Proper disposal of sharps (see medical waste above), disinfectant protocols, and regular testing of healthcare workers is included. c. Community Health and Safety. The SEP is a key instrument for outreach to the community at large on issues related to social distancing, higher risk demographics, self- quarantine, and quarantine. It is critical that these messages be widely disseminated, repeated often, and clearly understood. Each HCF will apply infection control and waste management planning following the requirements of this ESMF, national law, and relevant EHS Guidelines satisfactory to the Bank. ESS10 Stakeholder Engagement and Information Disclosure ESS10 is relevant for the Project. This ESS illustrates the need and ways stakeholders will be engaged throughout project preparation and implementation. Ministry of Health ( MOH) will engage in meaningful consultations with all stakeholders throughout the project lifecycle, paying special attention to the inclusion of women and vulnerable and disadvantaged groups. The project will address the issue of containment and treatment of COVID-19 which is very infectious, face to face communication and meeting/ gathering/ conferring in a closed place with a significant number of individuals will be avoided. In compliance with the ESS10, the Stakeholder Engagement Plan (SEP) was prepared and disclosed during the project preparation. It 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 and any activities related to the project. The project will ensure that it will adopt a consistent, comprehensive, coordinated, and culturally appropriate approach for engaging stakeholders and disclosing project related information. For the project, targeted stakeholders include all the patients including those infected by COVID-19, health workers, hospital staff, medical equipment manufacturers and suppliers, public and private academic medical institutions, medical teachers and students, faculty members, management staff, research institutes, and federal and provincial governments. To implement the approach, the project has prepared the Stakeholder Engagement Plan (SEP) and implemented to ensure that stakeholder engagement activities are effective and meaningful. ESS2 Labor and Working Conditions 21 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF ESS2 is relevant for the Project. This ESS deals with labor related issues. The healthcare providers, staff and relevant workers, those treating coronavirus patients in the hospital are among the most important individuals in the fight against this virus and they may be gotten hit hardest by the virus. Given the nature of the outbreak, safety of healthcare workers is utmost important, and for the greater interest community. The project will include minor repair and renovation work in health facilities, which will require employment of local labor and their number is not expected to be significant. Healthcare-associated infections due to inadequate adherence to occupational health and safety standards can lead to illness and death among health and laboratory workers. Infections associated with the healthcare due to inadequate application of OHS standards can result in illness, including fatalities, as well as further spread of the disease in the community. The social risks and impacts to frontline health workers, construction workers, and technicians involved in constructing new facilities in the hospitals that are in operation and providing medical services to COVID-19 patients are expected to be substantial. Thus, serious attention is required to ensure the safety of frontline health workers and other workers who will be involved in different activities. In the absence of huge construction activities, chances of huge labor influx-related social impacts are unlikely . However, repair and renovation of existing infrastructure particularly for ICU beds, safe water, and sanitation, as envisaged in subcomponent 1.2, will involve commensurate workforce and technicians. The majority of the ―direct workers‖ will be contracted locally while technical ―contacted workers‖ for installing sophisticated medical equipment may be hired from within the country or abroad. A Labor Management Procedure (LMP) with strong application of Occupational Health and Safety (OHS) measures , assessments of labor risks, policies and procedures, age of employment, terms and conditions and a Grievance Redress Mechanism (GRM) inter alia, is embedded in this ESMF. The necessary protocols for treating patients and handling medical waste, disinfectant protocols, regular testing of healthcare workers, requirements for proper disposal of sharps, along with the environmental health and safety guidelines for staff and necessary Personal Protective Equipment (PPE), will be included in Infection Control and Medical Waste Management Plan (ICMWMP) to be adopted by and then implemented by specific facilities and laboratories participating in the Project. ESS3 Resource Efficiency and Pollution Prevention and Management ESS3 is relevant for the Project. The project is likely to generate a significant amount of medical, solid and liquid wastes. These may affect the health of care givers, local communities and the environment. In line with the guidance of this ESS an Infection Control and Medical Waste Management Plan (ICMWMP), (including medical, solid and liquid waste management) will be prepared, per template in Annex 04, to assess and manage waste of different kinds (solid, liquid, medical, hazardous and nonhazardous). The plan will include separation of different kinds of waste, collection, treatment, reuse, recycle and transportation, storage and final disposal of wastes in approved sites/ through incineration/ other methods as per ESS3 and related ESHGs, GIIP, WHO guidelines and national law. Proposed repair and renovation of existing infrastructure particularly for ICU beds and installation of associated equipment and infrastructures for waste storage and treatment might increase noise, dust, and air pollution as well as generation of hazardous and non-hazardous waste and could expose construction and health workers and community to health risk Given that most of the activities have been planned in the hospitals that are in operation, the pollution issues are likely to be more complex. Projects involving construction/civil works require involvement of workforce, together with suppliers and supporting functions and services. There may be different contractors permanently present on site, carrying out different activities, each with their dedicated workers. As such there will also be a regular flow of parties entering and exiting the site; support services, such as catering, cleaning services, equipment, material and supply deliveries, and specialist sub-contractors, brought in to deliver specific elements of the works. Besides, serious attention in the management of solid waste, which will most likely include chemicals and equipment from laboratories and testing facilities; contaminated PPE; pharmaceutical wastes; contaminated food wastes and cleaning supplies; sharps and other used medical instruments, particularly in the handling of infected materials and corpses suspected/infected with the disease. Similarly, there will be a need for a proper plan to deal with the management of the solid wastes produced during construction and installation of equipment, particularly the packaging materials that come with the equipment. Given 22 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF the nature of the activities of the project, issues related to the consumption of water seems too nominal. However, water efficiency technology will be adopted in construction. Similarly, medical equipment that will be installed in the new infrastructure will be energy efficient. For a detailed mitigation measures related to construction activities refer to World Bank Interim Note on COVID-19 Considerations in Construction/Civil Works Projects.(Annex 08), Table 5.1 and Annex 03 of this ESMF document. ESS4 Community Health and Safety ESS4 is relevant for the Project. This ESS illustrates the need and requirement for community health and safety issues. Project activities under this project may give rise to a number of risks for community health and safety. The project would support the provision of health services to deter the COVID-19 outbreak through various health facilities. The project will generate both non-hazardous and hazardous waste throughout the renovation and provision of medical service phases. All waste management activities will be guided by this ESS. The Infection Control and Medical Waste Management Plan (ICMWMP) will address minimizing exposure to medical waste to the community. Community awareness raising activities and preparedness will be addressed through the Stakeholder Engagement Plan (SEP). Implementation of project activities, particularly civil works, may have community health and safety implications. Given the highly contagious nature of the COVID-19 diseases, there is a need to take maximum precautions to control the possible spread of diseases in the community. Thus, the ESMF includes the assessment of risks and impacts to the community such as excessive construction noise and dust levels, site safety awareness, and access restrictions and mitigation measures by adopting adequate OHS and community health and safety protocols for WBG EHS Guidelines. Given the complexity and the concentrated number of workers, the potential for the spread of infectious disease in projects involving construction is extremely serious, as are the implications of such a spread. Projects may experience large numbers of the workforce becoming ill, which will strain the project‘s health facilities, have implications for patients, local emergency and health services, and may jeopardize the progress of the construction work and the schedule of the project. Also, relationships with the community can be strained or difficult and conflict can arise, particularly if people feel they are being exposed to disease by the project or are having to compete for scarce resources. The project must also exercise appropriate precautions against introducing the infection to local communities. In such circumstances, carefully planned construction works in order to avoid implications on health worker and patients are crucial for successful project implementation. It is unlikely that quarantine and isolation centers are to be protected by security personnel, yet it will be ensured that if security personnel are engaged they follow a strict code of conduct and avoid any escalation of situation, taking into consideration the above noted needs of quarantined persons as well as the potential stress related to it. If Serbia`s military or police forces are mobilized as part of the government`s response to the emergency, the Project will take measures to ensure that, prior to deployment such personnel are: (i) screened to confirm they have not engaged in past unlawful or abusive behaviors, including sexual exploitation and abuse (SEA), sexual harassment (SH) or excessive use of force; (ii) adequately instructed and trained, on a regular basis, on the use of force and appropriate behavior and conduct (including in relation to SEA and SH), as set out in the ESMF; and (iii) deployed in a manner consistent with applicable national law. ESS5 Land Acquisition, Restrictions on Land Use and Involuntary Resettlement ESS5 is not currently relevant for the Project as it will not support construction or rehabilitation works of sizable extent beyond physical footprints of existing facilities. Minor works are expected to facilitate establishment segregation of isolation units or quarantine wings in hospitals from other units, or refurbishment and adaptation of non-medical facilities into ad-hoc quarantine/isolation facilities. These however will be within the existing right of way, on vacant state-owned land, without the need for land acquisition and involuntary resettlement impacts. 23 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF ESS6 Biodiversity Conservation and Sustainable Management of Living Natural Resources ESS6 is not currently relevant for the Project. This ESS is about risks and impacts of project activities on biodiversity and living natural resources. The project is not likely to adversely affect any biodiversity or living natural resources. ESS7 Indigenous Peoples/Sub-Saharan African Historically Underserved Traditional Local Communities ESS7 is not relevant for the Project. Issues related to indigenous peoples is guided by this ESS. Given the fact that there are no indigenous people in Serbia this standard is not applicable for the Project. ESS8 Cultural Heritage ESS8 is not currently relevant for the Project. This project is unlikely to adversely affect any cultural heritage because no activities with a likely impact on intangible cultural heritage are under consideration. There are no significant construction activities anticipated and any physical works will be limited to rehabilitation or upgrading of existing facilities, entirely within their existing footprint. As a prevention measure, in case if any new activities arise, a Chance Finds procedure are included in the ESMF as Annex 14. ESS9 Financial Intermediaries ESS9 is not relevant for the Project. The proposed project will not involve any financial intermediaries. 3.8. Environment, Health and Safety Guidelines (EHSG) The EHSG are technical reference documents with general and industry-specific examples of Good International Industry Practice (GIIP) and are referred to in the ESF. The EHSG contain the performance levels and measures that are normally acceptable to the World Bank Group (WBG), and that are generally considered to be achievable in new facilities at reasonable costs by existing technology. The WBG requires borrowers to apply the relevant levels or measures of the EHSG. When host country regulations differ from the levels and measures presented in the EHSG, projects will be required to achieve whichever is more stringent. In the case of the present Project the General EHSG will apply. The Implementing Agency (IA) will pay particular attention to EHS 1.5 Hazardous Materials Management; EHS 2.5 Biological Hazards; EHS 2.7 Personal Protective Equipment (PPE); EHS 2.8 Special Hazard Environments; EHS 3.5 Transportation of Hazardous Materials; and EHS 3.6 Disease Prevention. A separate EHSG on Health Care Facilities will also apply to this Project intervention. It illustrates waste management, air quality and wastewater disposal guidelines related to HCFs. All activities financed through the Project are subject to the World Bank Group Environmental, Health and Safety (EHS) Guidelines including those on healthcare facilities, waste management, hazardous materials management, and construction and decommissioning. 3.9. International Treaties and Conventions. Serbia is also a signatory to a number of International Conventions and Treaties including Basel Convention for hazardous wastes and disposal. 3.10. World Health Organization (WHO) Guidance The WHO is maintaining a website specific to the COVID-19 pandemic with up-to-date country and technical guidance. As the situation remains fluid it is critical that those managing both the national response as well as specific HCF and programs keep abreast of guidance provided by the WHO and other international best practice. WHO resources include technical guidance on: (i) laboratory biosafety, (ii) infection prevention and control, (iii) rights, roles and responsibilities of health workers, including key considerations for occupational safety and health, (iv) water, sanitation, hygiene and waste management, (v) quarantine of individuals, (vi) rational use of PPE, (vii) oxygen sources and distribution for COVID- 19 treatment centers. Additional guidance is listed in Annex 08-Resource List: COVID-19 Guidance. 24 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF 3.11. Comparison between GoS and World Bank policies and recommendations The analysis shows that there are several gaps in Serbia‘s legal instruments and WB‘s ESF for environmental and social risk management of development projects. Hence, some recommendations have been proposed to bridge the gaps between the ESSs and Serbia Government policies and legal requirements for environmental and social risk management of development projects in table presented below. 25 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF Table 3.4: Comparison between GoS and World Bank policies and recommendations ESF Objectives National Laws and Requirements Gaps Recommended Actions ESS 1: Assessment and Management of Environmental and Social Risks and Impacts Objectives of ESS 1 are: to identify, evaluate and Law on EIA Public consultations on Detailed ES Screening shall be manage the environment and social risks and Decrees and lists project design carried out followed by detailed impacts of the project in a manner consistent with ESS 1 requires the Borrower will assess, Social impact assessment is ESMP, ESMP Checklist and the ESSs. manage and monitor the environmental not required ICMWMP for subprojects to and social risks and impacts of the project Small scale activities that bridge the gap between WB and throughout the project life cycle to meet may not require activities as GoS requirements. the requirements of the ESSs in a manner per Serbian law but require an The ESMP so prepared shall be and within a timeframe acceptable to the ESMP, ESMP Checklist or made an integral part of the Bank. ES audit as per Bank ESF bidding document so that the The Borrower will: (a) Conduct an Associated facilities are not Contractor shall adhere to the environmental and social assessment of covered provisions prescribed in the the proposed project, including ESMP during the execution of the stakeholder engagement; (b) Undertake project. stakeholder engagement and disclose Each health care facility (HCF) appropriate information following ESS10 will prepare and implement an (c) Develop an ESCP, and implement all Infection and Control Waste measures and actions set out in the legal Management Plan (ICMWMP), agreement including the ESCP; and (d) based on the template found in Conduct monitoring and reporting on the Annex 04 of the ESMF which environmental and social performance. covers environmental and social infections control measures and procedures for the safe handling, storage, and processing of COVID-19 waste materials in order to prevent, minimize, and control environmental and social impacts during the operation of project-supported laboratories and medical facilities. Given the potential lack of testing availability in some areas of Serbia, ICMWMP protocols for individual health care facility (Annex 05) will be implemented 26 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF ESF Objectives National Laws and Requirements Gaps Recommended Actions on the assumption that the COVID-19 pathogen is present and that all healthcare workers and patients are potential carriers. Stakeholder engagement and public consultations in accordance with the Project Level Stakeholder Engagement Plan (SEP) and Subproject specific SEPs Conduct Social Impact Assessment For retroactive financed subprojects E-S AUDIT is required in order to review the status and record of measures that were undertaken, identify any outstanding issues and propose gap filling measures, if needed Prepare any other ES management instruments in line with the WB ESF and this ESMF. ESS 2: Labor and Working Conditions The Objectives of ESS 2 are: To promote safety and Various laws, policies and code of The gaps are limited to Grievance mechanism for project health at work. To promote the fair treatment, non- practices are applicable . These laws and requirement for a Labor workers shall be established discrimination and equal opportunity of project policies are aligned with the international Grievance Mechanism to be Project activities will require workers. To protect project workers, including standards, namely ILO Conventions and made available and engagement of direct and vulnerable workers such as women, persons with EU Directives, as the terms, conditions consultation with workers on contracted workers. disabilities, children (of working age, in accordance and instruments proposed in the OHS related issues. Both groups will be subject to the with this ESS) and migrant workers, contracted international conventions and directives Project LMP and the World Bank workers, community workers and primary supply are incorporated into the Labor Law of Group Environment, Health and workers, as appropriate. Serbia Safety Guidelines. Contractors will be required to develop Code of Conducts and SEA/SH Code of Conduct which must be read, understood and signed by all workers. 27 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF ESF Objectives National Laws and Requirements Gaps Recommended Actions ESS 3: Resource Efficiency and Pollution Prevention and Management The Objectives of ESS 3 are in general Law on Environmental Protection Regular monitoring is not Resource efficiency and pollution implementing technically and financially feasible ("Official Gazette of RoS 135/04, 36/09, required. prevention in any development measures for improving efficient consumption of 72/09, 43/11, 14/16 and 95/18) project need to be emphasized energy, water and raw materials, as well as other Law on integrated environmental during the design and resources. pollution prevention and control implementation of the projects. Where benchmarking data are available, the ("Official Gazette of RoS 135/04 and Reference shall also be made to Borrower will make a comparison to establish the 25/15) Annex 13 WHO and other related relative level of efficiency. Law on waters ("Official Gazette of RoS Guidance related to ESS3: When the project is a potentially significant user of 30/10, 93/12, 101/16, 95/18) Resource Efficiency and Pollution raw materials, in addition to applying the resource Law on protection and sustainable use of Prevention and Management efficiency requirements of this ESS, the Project will fisheries ("Official Gazette of RoS 28/14 while preparing the SS-ESMPs. adopt measures specified in the WB EHSGs to and 95/18) A. Transportation and support efficient use of raw materials, (The Law on Plant Protection Products management of samples, medical Borrower will seek to reduce or eliminate the use of ("Official Gazette of RoS 41/09). goods and expired chemical toxic or hazardous raw materials.) Law on Energy Efficiency (25/13) products The Borrower will avoid the release of pollutants or, Law on Waste Management (―Official B. Energy and resource when avoidance is not feasible, minimize and Gazette of RoS‖ No. 36/09, 88/10, 14/16 efficiency during refurbishment control the concentration and mass flow of their and 95/18) and operation of health facilities release using the performance levels and measures Basel Convention on Transboundary C. International Best Practice specified in national law or the EHSGs, whichever is Movement of Hazardous Wastes and their Guidance for Environment more stringent. Disposal Official Journal of FRY, Management in HCFs The Borrower will avoid the generation of International Treaties, No. 2/99, In addition to national legislation hazardous and nonhazardous waste. Where waste The Aarhus Convention (‖ Official adherence, adopt and implement generation cannot be avoided, the Borrower will Gazette of RoS- International Treaties‖, the WB EHSG and measures as minimize the generation of waste, and reuse, recycle No. 38/09) the Protocol on Pollutant prescribed in this ESMF to and recover waste in a manner that is safe for human Release and Transfer Register to the achieve the highest of the health and the environment. Where waste cannot be Aarhus Convention standards. reused, recycled or recovered (due to contamination Cary out regular monitoring of or other reason), the Borrower will treat, destroy, or ESAs implementation. dispose of it in an environmentally sound and safe manner that includes the appropriate control of emissions and residues resulting from the handling and processing of the waste material. ESS 4: Community Health and Safety 28 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF ESF Objectives National Laws and Requirements Gaps Recommended Actions The Objectives of ESS 4 are to anticipate and avoid Law on planning and construction In substance the gaps between Although the Project aims to adverse impacts on the health and safety of project- (―Official Gazette RoS‖ Nos. 72/09, the national requirements and improve the lives of previously affected communities during the project life-cycle 81/09 - correction, 64/10 - decision of the the ESS are not substantial. affected communities, it needs to from both routine and non-routine circumstances. CC, 24/11, 121/12, 42/13 – CC decision, However, mitigation and be ensured that Project activities 50/13- CC decision, 132/14, 145/14, prevention measures shall be do not pose any unintended To promote quality and safety, and considerations 83/18, 31/19, 37/19-other law, and 9/20) required in the form of site- negative consequences on relating to climate change, in the design and Decree on health and /safety and OHS at specific Contractor communities. construction of infrastructure, including dams. construction sites management plans. In case The Contractors will prepare plans Law on Roads (―Official Gazette RoS‖ double standards are detected such as (but not limited to): To avoid or minimize community exposure to no 41/18 and 95/18) within the ESF and national Health and Safety Policy (HSP); project-related traffic and road safety risks, diseases Law on Road Safety (―Official Gazette requirements the more Relevant procedures and and hazardous materials. RoS‖ no 41/09, 53/10, 101/11, 32/13, stringent will prevail. references to Method, preparation 55/14, 96/15, 9/16, 24/18, 41/18, 87/18, of all pertaining parts of To have in place effective measures to address 23/19 and 128/20) Construction H&S Management emergency events. Rulebook on technical standards for Plan (OHS, community safety universal access (―Official Gazette RoS plan, traffic management plan, To ensure that the safeguarding of personnel and 22/15) hazardous materials safety plan, property is carried out in a manner that avoids or Fire protection act ("Official Gazette of training programme, emergency minimizes risks to the project-affected communities. RoS", Nos. 111/09, 20/15, 87/18 and preparedness and response etc.) 87/18 - other law H&S training requirements and plan(s). H&S operational control; Security of the Construction worksites, Traffic Management Plans etc. to address the impacts on local communities of moving construction equipment; measures and actions developed to assess and manage specific risks and impacts outlined in the ESMF and subsequent ESMPs. Each HCF will prepare its own ICMWMP. Noise prevention and mitigation measures should be Law on environmental Noise protection Serbia has a good level of The preferred method for applied where predicted or measured noise impacts (―Official Gazette RoS‖ NO. 36/09, alignment with EU rules on controlling noise from stationary 29 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF ESF Objectives National Laws and Requirements Gaps Recommended Actions from a project facility or operations exceed the 88/10). noise but implementation is at sources is to implement noise applicable noise level guideline at the most sensitive A number of rulebooks, decrees to serve an early stage control measures at source. point of reception. the implementation of the Law. Noise reduction options considered in addition to the national requirements are those provided in the WB EHSG ESS 10: Stakeholder Engagement and Information Disclosure /The Objectives of ESS 10 are: The Republic of Serbia citizen While all acts spell out a right SEP Prepared To establish a systematic approach to stakeholder engagement commitments do not reside to access to information held Subproject Specific SEPs engagement that will help Borrowers identify under a single self-standing law or by public authorities, the ESS compliant to the SEP prepared stakeholders and build and maintain a constructive regulation. However, the recognition of recognizes the importance of prior to activities have taken place relationship with them, in particular project-affected importance of citizen engagement is open and transparent and adequately implemented. parties. embedded in the legal system and clearly engagement vis- à-vis project To assess the level of stakeholder interest and recognized by the mandatory procedures stakeholders by the project support for the project and to enable stakeholders‘ provided by individual laws views to be taken into account in project design and environmental and social performance. 30 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF 3.12. The World Bank Group’s Environmental Health and Safety Guidelines The Environmental, Health, and Safety (EHS) Guidelines of the World Bank Group 5 are technical reference documents with general and industry-specific examples of Good International Industry Practice (GIIP) and applied as required by their respective policies and standards. The EHS Guidelines contain the performance levels and measures that are generally considered to be achievable in new facilities by existing technology at reasonable costs. Application of the EHS Guidelines to existing facilities may involve the establishment of site-specific targets, with an appropriate timetable for achieving them. The applicability of the EHS Guidelines should be tailored to the hazards and risks established for each project based on the results of an environmental assessment in which site-specific variables, such as host country context, the assimilative capacity of the Defined as the exercise of professional skill, diligence, prudence and foresight that would be reasonably expected from skilled and experienced. Some of the applicable guidelines for the project under General Environmental Health and Safety is discussed below: Table 3.5: EHS guidelines and its applicability EHS guidelines Applicability/discussion EHS 1.5 – Hazardous The World Bank Group ESH Guidelines for Hazardous Waste is Materials Management; applicable and can be used for guidance on the management of infectious and other forms of health care waste which are categorized as hazardous. These guidelines apply to projects that use, store, or handle any quantity of hazardous materials, defined as materials that represent a risk to human health, property, or the environment due to their physical or chemical characteristics. EHS 2.5 – Biological Hazards; Biological agents represent the potential for illness or injury due to single acute exposure or chronic repetitive exposure. The guidelines provide sets of measures for preventing Biological hazards. EHS 2.7 – Personal Protective Personal Protective Equipment (PPE) provides additional Equipment (PPE); protection to workers exposed to workplace hazards in conjunction with other facility controls and safety systems. The guideline provides measures on using the PPE effectively for protecting the workers EHS 3.5 – Transportation of This guidance note provides procedures for transportation of hazardous Hazardous Materials; and materials which needs to comply with local laws and international requirements applicable to the transport of hazardous materials. EHS 3.6 – Disease Prevention. This guidance note provides intervention for the control of the communicable diseases and vector borne diseases at the project level. The recommended interventions includes surveillance and active screening and treatment of workers, training health workers, providing health services, educating project personnel and area residents on risks, prevention, and available treatment; monitoring communities during to detect and treat cases and following safety guidelines for the storage, transport, and distribution of pesticides to minimize the potential for misuse, spills, and accidental human exposure etc. The World Bank Group EHS This guideline includes information relevant to the management of Guidelines for Health Care EHS issues associated with health care facilities (HCF) which includes Facilities are also applicable a diverse range of facilities and activities involving general hospitals and can be used for guidance and small inpatient primary care hospitals, as well as outpatient, for the design and operation of assisted living, and hospice facilities. Ancillary facilities may include HCFs. medical laboratories and research facilities, mortuary centers, and blood banks and collection services. 5 https://www.ifc.org/wps/wcm/connect/topics_ext_content/ifc_external_corporate_site/sustainability-at-ifc/policies-standards/ehs- guidelines 31 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF 3.13. The Environmental, Health and Safety Guidelines for Health Care Facilities6 include information relevant to the management of EHS issues associated with health care facilities which includes a diverse range of facilities and activities involving general hospital and small inpatient primary care hospitals, as well as outpatient, assisted living, and hospice facilities. The Borrower will pay attention to the following guidelines:  Waste Management  Occupational Health and Safety  Community Health and Safety 3.14. World Health Organization (WHO) Protocols The WHO has a dedicated website7 specific to the COVID-19 pandemic with the up-to-date country and technical guidance. As the situation remains fluid those managing the national response as well as specific health care facilities and programs must keep abreast of guidance provided by the WHO and other international best practices. More than 100 documents about COVID-19 have been published and more than half of them are detailed technical guidance. These documents were developed with an aim to support national preparedness and response for COVID-19. Some of the guidance documents of WHO relevant in context to COVID 19 have been discussed below: 3.14.1. Infection Prevention and Control/WASH Water Sanitation hygiene and waste management for the COVID-19 virus guidance8: This guidance document provides all the best practices related to water, sanitation, hygiene, and waste management to be adopted to contain the virus and stop human-human transmission. Furthermore, it provides recommendations to strengthen WASH services along with improving existing practices. Infection prevention and control during health care when novel coronavirus (nCoV) infection is suspected: This document provides various approaches and strategies to be adopted for infection prevention and control when a novel coronavirus is suspected. Further, this document provides all the practical steps that should be followed inside and outside of health care institutions for containment through infection prevention practices. Infection Prevention and Control for the safe management of a dead body in the context of COVID-19: This guidance provides supports to all the supervisors of health care facilities, mortuaries, religious and public health authorities, and families responsible for the management of the dead bodies of persons due to suspected or confirmed COVID-19. 3.14.2. Rational use of personal protective equipment for coronavirus disease (COVID-19) This document provides recommendations for the rational use of Personal protective equipment in health care and other settings. It supports decision-makers of facilities to identify the ones in need of safety and equipment to enhance occupational health and safety. Similarly, this document aids to address the context of severe PPE shortage. Consideration for quarantine of individuals in the context of containment for coronavirus disease (COVID-19): This document aims to provide guidance for the government agencies for adopting measures for individuals in the context of COVID-19. This is developed for effective infection prevention and control during establishing local or national policy for the quarantine of individuals. 3.14.3. Laboratories testing WHO interim guidance for laboratory testing: 6 Available: https://www.ifc.org/wps/wcm/connect/960ef524-1fa5-4696-8db3-82c60edf5367/Final%2B- %2BHealth%2BCare%2BFacilities.pdf?MOD=AJPERES&CVID=jqeCW2Q&id=1323161961169 7 https://www.who.int/emergencies/diseases/novel-coronavirus-2019 8 https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance-publications?publicationtypes=d198f134- 5eed-400d-922e-1ac06462e676 32 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF This document9 guides the laboratories and related stakeholders responsible for the laboratory testing of COVID-19 in the usage of diagnostic testing in various scenarios of COVID-19 outbreak and rational use of the testing kits and reagents to achieve maximum certainty of the testing. WHO interim guidance for laboratory biosafety related to COVID-19 virus: This document10 guides laboratory biosafety during performing various testing and handling of the COVID-19 virus. It further provides the safe handling approaches during packaging and shipment of specimens to the reference laboratories. 3.14.4. Risk Communication and community engagement: Risk Communication and Community Engagement (RCCE) readiness and response to the 2019 novel coronavirus (2019-nCoV) This document11 consists of checklists for risk communication and community engagement preparedness and initial response for the virus. This further guide on implementing effective RCCE strategies for protecting public health through early response to the virus. 3.14.5. WHO Safe management of waste generated from health care activities, 2014 This handbook12 is developed to assist health care facilities and government agencies responsible for the management of the waste generated from various health care activities provides various approaches to the safe and sustainable management of health care waste. It provides all the required practical strategies and methodologies for addressing health care waste management issues, ensuring safety to medical professionals, the environment, and public health. Likewise, it provides clear methodological approaches for the safe management of waste during emergencies. 9 https://apps.who.int/iris/handle/10665/331329 10 https://apps.who.int/iris/handle/10665/331138 11 https://www.who.int/publications/i/item/risk-communication-and-community-engagement-readiness-and-initial-response-for-novel- coronaviruses 12 https://www.euro.who.int/__data/assets/pdf_file/0012/268779/Safe-management-of-wastes-from-health-care-activities-Eng.pdf 33 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF 4. BASELINE DATA This section provides an overview of the baseline environmental and social characteristics of the project area. Considering that the project has a national footprint with various types of investments across the country, the section is limited to discussing only key environmental and socioeconomic characteristics – at national and provincial levels – especially where they are relevant to helping establish the potential impacts of the project investments. The baseline presented is drawn from secondary data. 4.1. Baseline Country and environmental background Serbia is landlocked country rapidly managing evolving political and economic background after having passed through dramatic transitions and is now a candidate country for the accession to the European Union. Demographically, the Serbian population is getting smaller, older, and rapidly losing potential human capital to develop the economy. The country showed a negative growth rate of -4.5 per 1,000 of the population between 2007 and 2017. During the same timeframe, proportions of different age ranges also declined. For example, the percentage of young people (0-14) fell from 15.5% in 2007 to 14.4% in 2017, while the percentage of the population aged 65 and over increased from 17.2% (2007) to 19.6% (2017). The average age of the population has also increased from 40.9 years in 2007 to 43 years in 2017. Longer term projections show that the population of Serbia would be lower in 2041 than in 2011. Another important demographic factor influencing the country‘s developmental trajectory is the loss of skilled professionals through migration. The Organization for Economic Co-operation and Development (OECD) estimates that around 245,000 people migrated from Serbia between 2012 and 2016. Serbia has a population of 6 945 235 million across nearly 88,499 square kilometers of territory with a rural population accounting for 40.6 percent. Despite its small size, however, the environment of Serbia is highly diverse compared to other countries in Europe. The reasons for this comparative richness include: the variety of climate, topography, and geology and the long- term ecological and evolutionary history of the region as a biological crossroads. 50% of the total population live in rural areas, and 17% derive their living from agriculture and associated industries. The ROS has three major landforms – the plain areas in Vojvodina and the flood plains of the Danube, Sava and Drina rivers; the Morava valley in its main-stream and two southern arms; and the mountainous areas which cover most of the country south of the Sava and Danube. The water resources in addition to rainfall are dominated by the river inflows from upstream riparian sources estimated at 85% of available water. The balance is derived from the River Morava from within the country. Due to seasonal variations there are some 160 storage dams, some of which have hydro-electric generation facilities. 4.2. Air Quality The Republic of Serbia has 8 established agglomerations: Belgrade, Novi Sad, Nis, Bor, Uzice, Kosjeric, Smederevo and Pancevo. The pollutants that are being monitored are: SO2, NO2, PM10, PM2.5, CO, Pb and C6H6. The quality of air has been listed into 3 categories: 1) in line with the border values, 2) above the border values but in the tolerance zone, 3) above the tolerance zone for more than 1 pollutant monitored. Sectors from which the monitored pollutants originate from are classified in the following categories: production and distribution of energy, fugitive emissions, air water and rail transportation, the usage of energy in industry and industrial processes, use of solvents and industrial products, waste, heating power plants with the capacity less than 50 MW and individual boiler rooms, agriculture, road transportation. For SO2 and NO2 the major source of pollution was the production of electrical and heat energy, together with road transportation. The PM10 and PM2.5 were the major pollutants coming from other stationary fuel burning facilities, and they were also the main cause of 3rd category of air quality (the non-compliant) for the following agglomerations: Belgrade, Pancevo, Smederevo, Kosjeric and Uzice. Air Quality assessment is done in accordance with the requirements of the EU directives. 4.3. Water The Republic of Serbia abounds in waters that are its great natural wealth and has a dense river network, numerous lakes and numerous sources of hot and mineral water. Water quality in Serbia differs significantly from one region to the next. Monitoring data have identified presence of: ammonia, nitrates, 34 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF sulfides, iron and mineral oils in the Tisa River Basin; evaporable phenols and manganese in wells in the area of Backa; and, in some cases, suspended solids – for example, in the South Morava Basin. Throughout Serbia, the most problematic physicochemical water quality parameters are turbidity, iron, manganese, nitrates. In Central Serbia the main problem is bacteriological contamination. 50% of municipal water supply systems provide water with adequate physic-chemical and microbiological quality as measured against national parameters. Existing systems for water supply require reconstruction to reflect the capital maintenance backlog which has arisen over years. Greatest constraint for implementation of EU Drinking Water Directive is poor condition of infrastructure, as a consequence of the comparatively weak financial conditions of the Public Utility Companies, insufficient financing from the Local Self Government Units, state budget and other sources. The Water supply system is reasonably well developed. A total of 81% of the population has access to public water supply. The percentage is lower in central Serbia (71%). In certain parts of the country (e.g. parts of Vojvodina and the Velika Morava Valley), water quality is not satisfactory, while other parts (e.g. Sumadija, southern Serbia and part of Banat) have both water quality and water quantity issues. According to the draft Water Pollution Protection Plan, about 55% of the overall population has access to public sanitation. Almost 75% of the population lives in settlements larger than 2000 inhabitants, in which the average connection rate to sewers is 72%, with about 27% connected to septic tanks. In settlements with less than 2000 inhabitants, the connection rate to sewers is less than 5% on average. Today, underground waters are supplying 65% of water needs for households and industries in Republic of Serbia, and in Vojvodina this is the only way of water supplying. It is estimated that 29% of the surface area of the country and 2.67 million ha (or 52%) of agricultural land is affected by poor drainage. Drainage infrastructure was affected, including both collector canals and pump stations used to help discharge the excess water collected on lower land when it cannot flow by gravity to the recipient river. Substantial attention is needed to these flood protection facilities in order to reduce increased risks of flooding. It is estimated that some 1.57 million ha, especially in areas adjacent to the large flood plain rivers, are subject to flooding. Of this area, 1.45 million ha are in Vojvodina and the plains east of Belgrade; the rest are in Central Serbia. 4.4. Climate change and Floods Serbia faces significant environmental challenges and climate-related risks. The country is prone to natural disasters such as floods and droughts, which can cause significant damage to infrastructure and livelihoods, especially among vulnerable groups . Climate change may intensify the frequency and scale of natural disasters. In 2014, a low-pressure cyclone hit Serbia, bringing the heaviest rain in the 120 years of record-keeping. The event affected over 1.6 million people in Serbia and caused several fatalities, mostly due to high levels of fast flowing rivers. The damage for Serbia was estimated at EUR 1.55 billion. Moreover, rising temperatures are of increasing concern. Temperatures in August over the last several years were above 42°C. Meanwhile, low efficiencies in energy, transport, water, waste management, and agriculture are producing a high carbon footprint, significant losses of extracted water, and elevated levels of air pollution in major cities. Addressing environmental challenges together with climate change is essential to sustain progress and ensure long-term economic development. According to the World Meteorological Organization, the estimated effects of climate change on Serbia will be of medium range. Serbia, as well as south-east Europe, is likely to have hotter summers, decreased precipitation and, therefore, an increased risk of summer drought. According to data trend over the past 35 years an increase of yearly air temperature by 1°C is noted in the last 100 years. Shorter periods have greater positive values which means that the increase of temperature at yearly level has intensified over the last couple of decades. Although there are periods with positive and negative trends, since 1982 negative trends ceased and only an increase in temperatures was noted and it lasts still today. The Serbian Agency for Environmental Protection (SEPA) is monitoring the green-house gas emissions (GHG) and is in charge of its inventory. The most substantial contribution to the total emissions of ozone precursors (NOx, CO, CH4, NMVOC) is being given by "Road Traffic" about 18.6% for CO, "Heat output less than 50 MW and individual heating‖ (CO - 66.7%, NMVOC with 20.5%). Negligible share in NMVOC emissions also include "Fugitive emissions" 27.3%, "Solvent use and industrial products ‖19.4% and ―Agriculture‖ with 14.3%. 35 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF The number of people affected by flooding is estimated at about 200,000 on average per year, at an estimated cost of US$1 billion in GDP. Serbia ranks fourth among European and Central Asia countries in output affected by a 100-year flood. 4.5. Waste management Regarding waste management, there is a good level of alignment with the EU acquis and the new Law on Waste Management is fully harmonized with the EU acquis Communautaire, and the numerous sub-laws that are currently being developed. The most acute problem is hazardous waste, which is not separately collected and disposed of – currently it is processed in regular waste disposal sites. In general, over 50% of disposal sites do not meet the technical requirements of sanitary landfills, and are actually just fenced and mapped dump areas. There are illegal dump sites of various sizes in rural areas. Moreover, leakage from these dump sites poses a threat to groundwater, surface water and soil, due to the high content of organic matters and heavy metals. Untreated municipal and industrial waste waters are still the greatest source of pollution. The response of pollutants is still unsatisfactory for fulfillment of their legal obligations and reporting about emissions in waters. According to a report by the Serbian Environmental Protection Agency (SEPA) on waste management between 2011-2017, a total of 2.15 million metric tons of waste was generated, of which 1.80 million metric tons, or 83.7%, was collected by municipal public utilities. The median daily amount of municipal waste landfilled per capita was 0.84 kg, and the annual figure was 0.30 metric tons. This does not include some 20% of generated municipal waste which ends up in illegal dump sites. In 2017 construction waste and demolition waste was estimated at 1700 thousand tons, while in 2019 the greatest share of generated hazardous waste was from the mining and quarrying at a share of 29.2% of total generated waste which is an increase of 39,2% when compared to the 2018 data. A total of 15.686.066 tons in Mining and quarrying and 1.569 tons from construction waste was generated. In the waste management sector, the most visible and probably the most complex problems concern municipal waste management, where Serbia lags seriously behind comparable countries in Central and Eastern Europe in virtually all stages of the process – from collection to disposal, while municipal waste treatment hardly even exists. Statistics in Serbia is devastating – the percentage of municipal waste recycled, according to official data, was about 3% in 2016, while the bulk of the generated waste ended up in landfills. For the time being, the quantities of hazardous chemical wastes and industrial effluent sludges collected separately and reported by the generators of industrial and commercial wastes in Serbia seem to be low. For the time being, the quantities of used oils collected separately and reported by the generators of industrial and commercial wastes in Serbia seem to be low. In addition, there is no exact data available on the used oils generated by households and similar establishments. It is expected that the collected and reported quantities of used oils will rise in the coming years. As stated in the draft Serbian National Waste Management Plan for Waste Oils, with the implementation of increasing environmental standards in Serbia, e.g. by widely used oil/water separators at petrol stations, garages etc. relevant additional amounts of oil containing wastes from these installations will be generated. In the draft Serbian Waste Management Plan for Hazardous Construction and Demolition Waste forecasts have been made for the quantities of hazardous construction and demolition waste generated in 2020 in Serbia. The forecasts are based on the assumption, that the GDP of the construction sector in Serbia will increase 5% annually. In addition, an assumed lack of reporting of 35% was taken into account. The results of the forecast are shown in Table 4.1 below. Table 4.1: National forecast for hazardous construction and demolition waste. Waste code Reported Amount (t) 2014 Estimated Amount (t) 2020 Mixed C&D 2 4 Wood 202 365 Metals 8 14 36 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF Waste code Reported Amount (t) 2014 Estimated Amount (t) 2020 Cables 37 67 Soil 1,812 3,278 Asbestos 6 11 Tar 89 161 Asbestos Cement 103 186 Total Hazardous 2,259 4,087 Waste management in Serbia consists of a set of activities of joint interest which comprise implementation of prescribed action plans to be carried out within waste collection, transport, storing, treatment and disposal, including supervision of these activities and responsibility for waste management facilities and aftercare. Basic activities are: o Selection at the collection of hazardous waste o Categorization and characterization of collected waste. o Securing conditions for temporary storage of waste, particularly hazardous waste, preventing soil and water pollution o Measuring and recording waste o Implementing measures for the prevention of the creation and reduction of the amounts of created waste o Recycling of collected waste o Handover of waste for treatment to licensed companies. o Reporting to the Ministry and Environmental Protection Agency on waste flow o Close cooperation with competent bodies 4.5.1. Health care Waste Management Healthcare Waste Management (HCWM) system was introduced in the Republic of Serbia since 2007 with the support of the European Union. Since then, the amounts of waste treated, prior to landfill, have steadily increased and more and more healthcare institutions adopted HCWM systems. In parallel large numbers of healthcare workers were trained in proper HCWM. Although there is a Rulebook on Medical Waste Management (Official Gazette of the RS No 48/2019) that regulates the manner and procedures of medical waste management as well as the contents of the plan of medical waste management from facilities where human health care is provided, still the whole HCWM system is not fully functional for al facilities and regions. Any identified gaps in the medical waste management system will be addressed through the ESMF and mainly through the Infection Control and Medical Waste Management Plan (ICMWMP). In 2009, the Law on Waste Management was adopted in the Republic of Serbia, and it is currently in effect. In 2010, the MOH and MEP adopted a Rulebook on Healthcare Waste Management, which is substituted with a new Law in 2019. This is the key regulation of the Republic of Serbia concerning healthcare waste management and these two legal acts define the basis for the organized and proper healthcare waste management in the Republic of Serbia. Newly defined healthcare waste management system was introduced from 2007 till 2009, complying with the relevant legislation, the Law on Environmental Protection and Law on Protection of Contagious Diseases in the Republic of Serbia. Newly established HCWM was in line with Serbian National Strategy on waste and EC cooperation strategies in terms of public health and environmental protection. Healthcare waste management is continuously improving in the Republic of Serbia and is well established in more than 85% of healthcare facilities. The Government of Serbia, with the support of their partners, has embarked on the development and improvement of a sound HCWM system. Within this framework, a number of initiatives has been taken in the Republic of Serbia including EU supported CARDS project ―Technical Assistance for Health Care Waste Management‖, and EU supported IPA project ―Technical assistance for Treatment of Healthcare Waste in Serbia‖. Delivery of 37 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF the equipment for the sterilization of infectious healthcare waste was implemented by two particular supply contracts financed by EU from 2007 till 2011. The mentioned initiatives have established a solid basis for environmentally sound HCWM with a network of Central Treatment (CTPs) and Local Treatment Points (LTPs). There are 82 healthcare facilities in the public healthcare sector of Serbia for the treatment of infectious healthcare waste. District model is implemented and its provides a capacity for the treatment of 5.000 tons of infectious healthcare waste on annual basis. CTPs have been established mainly in general hospitals typically in the main town or city at a District level while LTPs have been established in remote health care facilities (HCFs). CTPs are provided with vehicles in order to collect and treat infectious waste from a number of HCF while LTP typically treat, in addition to their own waste, waste from only a limited number of HCFs. On basis of data collected, it has been concluded that with a population of just over seven millions, Serbia generates between 4,500 and 5,000 tons of infectious waste on an annual basis in the public healthcare sector. 20% of these quantities of infectious waste were originated from the treatment of out- patients, 75% from the treatment of in-patients and 5% from micro-biological laboratory tests. The Institute for Public Health ―Dr. Milan Jovanovic Batut‖ is collecting data on infectious waste generation and treatment from the Central Treatment Points (CTPs) and Local Treatment Points (LTPs). On the basis of these data approximate waste generation rates per out-patient visit, per bed day and per micro-biological test can be determined. . The data are presented in Table 4.213. Table 4.2: waste generation rates per out-patient visit, per bed day and per micro-biological test Occurrence Amount Unit Out-patient visit 0.01 Kg/visit Waste generation in Primary HCF 12 Kg/day In patient treatment 0.26 Kg/bed/day Micro-biological test 0.004 to 0.4 Kg/test Waste Generation in micro-biology From 250 to 14,000 Kg per laboratory per year While in 2009 only one third of this waste was treated prior to disposal, this fraction has increased to two thirds in 2011. The data also show that more than 90% of healthcare facilities have developed individual healthcare waste management plans. In every healthcare facility there are at least 2 people trained in healthcare waste management, and in total there are approximately 3000 staff members who received formal HCWM training, provided through the Institute for Public Health. The first EU funded project was named ―Technical Assistance for Healthcare Waste Management‖ and this project developed a basis of proper infectious HCWM in the healthcare sector, in cooperation with the Ministry of Health ( MOH), the Ministry of Environmental Protection (MEP) at the time and the Veterinary Directorate. This first technical initiative directly targeted 55 healthcare institutions (hospitals, primary healthcare centres and public health institutes) and provided support by supplying autoclaves, which were delivered to institutions in all 25 administrative districts. All of these institutions were in need of an organized and safe health waste management system. In parallel, the Ministry of Health and Ministry of Environmental Protection were provided support in drafting the appropriate by-laws on Healthcare Waste Management and on Pharmaceutical Waste. In this way, the project managed to touch upon the priority needs of all the key healthcare waste producers and initiate the implementation of the necessary changes. The second project was EU funded project named ―Technical Assistance for the Treatment of Healthcare Waste in Serbia‖. This project provided technical support to the above mentioned Ministries in order to strengthen the established HCWM system in Serbia. Apart from its objective to reinforce the infectious healthcare waste treatment in Serbia, this project is also tackling the management of other hazardous healthcare waste streams. 13 file:/// /Development_of_healthcare_waste_management_in_Serb.pdf 38 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF No systematic data of generated and treated medical waste at national level is available. The term medical waste (MW) refers to all the waste generated within health-care facilities, research centers and laboratories. It consists of materials ranging from used needles to body parts, diagnostic samples, blood, chemicals, pharmaceuticals, and radioactive materials. From 10% to 25% of all MW is hazardous and may cause a variety of environmental and health risks. A quarter of all MW in Serbia is hazardous, and infectious MW is the largest part of it. Annual production of infectious waste in Serbia is between 4,500 and 5,000 tons. Since 2006, the national system for safe MW management has been put into place and all infectious MW has been sterilized. Serbia has reduced the amount of hazardous MW by 50% by introducing a waste separation process in healthcare facilities. Needles, syringes, bandages, gauze, swabs smeared with blood, scalpels – for years were thrown together with other waste, mixed with municipal waste and disposed at the city landfill. Until 2008, there was no system of infectious medical waste management in Serbia. In Belgrade health care centers alone, 1kg of hazardous medical waste remains from 100 interventions. Figure 1 - Infectious waste treatment unit in the Republic of Serbia (A-autoclave, V-vehicle) Figure 2 - Transport of Infectious Waste in the Republic of Serbia 39 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF The Law on Waste Management classifies all pharmaceutical waste as hazardous and states that all pharmaceutical waste shall be treated as hazardous waste while the Rulebook on HCWM distinguishes non-hazardous pharmaceutical waste, potentially hazardous pharmaceutical waste and hazardous pharmaceutical waste. The results of the questionnaire show significant differences between the types of HCFs. With one exception, primary HCFs report lower accumulated pharmaceutical waste amounts than health centres and general and special hospitals. Clinic Centers typically report the largest amounts of accumulated pharmaceutical waste and Institutes for Public Health the lowest. An overview of these figures is provided in the table 4.3 below Table 4.3 . Average waste generation by Healthcare Institutions Healthcare Facility Average reported pharmaceutical waste generation Primary Health Centres 20 kg/yr Special Institutes 20 kg/yr General and Special Hospitals 25 kg/yr Clinical Centres 100 kg/yr IPHs 1kg/yr 4.5.2. Treatment and disposal of medical waste in Serbia Medical wastes generated during project implementation will be finally disposed /treated in accordance with the procedures prescribed within the Rulebook on Medical Waste Management (Official Gazette of the RS No 48/2019). 4.5.2.1. Thermal treatment of medical waste by incineration and co-incineration Thermal treatment of medical waste by incineration or co-incineration is performed in plants provided for that purpose, under the conditions prescribed by the permit, in accordance with the law governing waste management, regulation governing emission limit values for air, water and soil, special a regulation governing the thermal treatment of waste and a regulation governing the integrated prevention and control of environmental pollution. With waste generated after the incineration or co-incineration process, as well as waste generated after the process of catalytic depolymerization, pyrolysis, gasification, plasma combustion, etc. act in accordance with the regulation governing the category, testing and classification of waste, the regulation governing the disposal of waste in landfills and the law governing waste management. 4.5.2.2. Thermal treatment of medical waste by disinfection / sterilization The operator performing the treatment of infectious waste by the disinfection / sterilization procedure, is obliged to perform waste testing after treatment, in accordance with the rules of the profession, in accordance with the regulation governing the category, testing and classification of waste, to determine that the treatment has become non-hazardous. Waste generated in the process of disinfection / sterilization is treated in accordance with the regulation governing the category, testing and classification of waste, the regulation governing the disposal of waste in landfills and the law governing waste management. 4.5.2.3. Treatment of infectious waste and sharp objects The treatment of infectious waste and sharp objects is performed by incineration, co-insemination and other thermal treatment procedures in plants intended for thermal treatment of waste, in accordance with the best available techniques, such as catalytic depolymerization, pyrolysis, gasification, plasma combustion, etc. Treatment of infectious waste and sharp objects is also performed by methods of disinfection / sterilization in autoclaves, i.e. sterilizers, grinding or crushing in crushers and other recognized methods that achieve the removal of hazardous properties, reducing the volume and unrecognizability of waste. Waste generated after the treatment of infectious waste and sharp objects, which has become non- hazardous and unrecognizable, is treated in accordance with the regulation governing the category, testing 40 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF and classification of waste, the regulation governing the disposal of waste in landfills and the law governing waste management . 4.6. Chemicals There is a high level of alignment with the acquis on chemicals. A national poison control centre and sanction regime to ensure compliance are in place. Alignment is still pending for legislation on animal experiments, asbestos and biocides. As of 2018, metallic mercury is prohibited for professional use. Serbia needs to boost its administrative capacity to implement the legislation in these areas, and ensure proper monitoring of persistent organic pollutants. In August 2018, Serbia submitted its national implementation plan for the implementation of the Stockholm Convention on Persistent Organic Pollutants. National legislation implementing the GHS was adopted on 29 June 2010. It was published in the Official Gazette of the Republic of Serbia on 10 September 2010 and entered into force on 18 September 2010. The competent authority for implementation of this legislation is the Serbian Chemicals Agency. This GHS implementing legislation aligns Serbian system of classification, labeling and packaging of chemicals with the United Nations Globally Harmonized System (GHS) and is in compliance with EU CLP Regulation (Regulation (EC) 1272/08). A lot of GHS capacity building activities were undertaken in the last years through activities within the project ―Chemicals Risk Management in Serbia‖ with the Swedish chemicals agency in order to establish effective implementation/enforcement of new legislation. Two systems of classification and labeling are introduced into the national legislation: (i) System of classification, packaging and labeling of hazardous substances and preparations in accordance with Directives 67/548/ EEC and 99/45/EC (Classification, packaging and labeling of dangerous substances and preparations ‐ DSD/DPD) and (ii) Globally Harmonized System of Classification and Labeling of Chemicals in accordance with Regulation 1272/08 (Globally Harmonized System of Classification and Labeling of Chemicals ‐ GHS). 4.7. Social baseline and background 4.7.1. Socio Economic Trends in the Republic of Serbia The estimated number of populations in the Republic of Serbia in 2019 is 6 945 235. Observed by sex, 51,3% are women (3 561 503), and 48,7% men (3 383 732). Depopulation trend continued, meaning that the population growth rate, relative to the previous year, is negative and amounts to -5,4‰. 14 Demographically, Serbia is characterized by a strong depopulation trend (between January 1, 2014 and January 1, 2018, the Republic of Serbia lost 147,736 persons), low fertility, relatively high (in European terms) specific mortality rates, high average age population (43 years) and unfavorable age structure. The trend of increasing life expectancy at birth for both sexes continued. The achieved value of this indicator is 77.9 years for women and 73 years for men in 2017. Despite the historical maximum reached, life expectancy in the Republic of Serbia is shorter than the EU average by over five years. The elderly dependency index in 2017 was 29.7% with projections of reaching a value of 36.3% in 2041. Rough estimates based on data from different statistical sources indicate an average annual negative external migration balance of at least 15,000 persons (data from countries that most often accept migrants from the Republic of Serbia, the Statistical Office of the Republic of Serbia and the Commissariat for Refugees and Migration). The Serbian Labor Force Survey reports that employment in the Republic of Serbia increased by 75,300 (+ 2.8%) in 2017, which is half the growth recorded in 2016 (by 145,200 and +5, respectively), 6%). The decrease in the unemployment rate, started in 2013 and continued into 2019. The unemployment rate in Q1 of 2020 is 9,7% and is the same when compared to Q4 2019. 14 https://www.stat.gov.rs/en-US/vesti/20200701-procenjen-broj-stanovnika-2019/?s=1801 41 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF Poverty remains significant, both in absolute terms (the share of persons whose consumption is below the threshold needed to meet their existential needs - 7.3% in 2016), and relatively high (the share of persons at risk of poverty is 25.5% in 2016). The at-risk-of-poverty rate by most common status in the labor market (lasting more than six months) indicates that the unemployed are in the worst position (48.0%, i.e. almost every other unemployed is at risk of poverty). Employment significantly reduces the risk of poverty, but the quality of employment remains a key factor in ending poverty (the self-employed have a significantly higher at-risk-of-poverty rate than employees at the employer, 32.4% vs. 9.0%). Retirees are in the most favorable position, after employees with employers, with a risk of poverty which is approximately at the level of total employees (15.4%). Education is a decisive factor for a person's economic status and ability to generate income, and it is therefore not surprising that lower-educated people are above average at risk of poverty. The highest at-risk-of-poverty rate in 2016 - 2018 period was in the population with primary education and lower than primary school (39.1%), and the lowest in the at- risk-of-poverty population with high school or university education (10.3%). This distribution of the population at risk of poverty by level of education clearly indicates that education is important, since the labor market rewards highly educated people. 4.7.2. Education and skills The 2011 Serbia census identified 164,884 or 2.68 % of illiterate residents in Serbia. The number was halved compared to the 2002 census. A total of 850,000 residents, or 14 percent of the population, have no formal education or only few elementary school grades. Incomplete elementary school education has 677,000 residents of Serbia, or 11 percent. In the Republic of Serbia, 51% of persons aged 15 and over are computer illiterate, that is, 34.2% of persons are computer literate, while 14.8% are partially computer literate (May 2019). 2011 research show that 18.5% of rural women did not complete high school education because pressures by the family to stay and work in the household or on the farm, 26% because of the attitude of the family that women do not need to attain higher education levels, 18% because of a lack of financial resources, and 10% because of early marriage and family care. Differences in educational attainments are much more prominent when adult population of urban and rural areas are compared. Data from population census indicate less favorable education structure of population in rural areas with higher share of persons without any school particularly among women (these are mainly older women). On the other hand, share of persons with higher and university education is much lower among rural than urban population. 4.7.3. Gender and gender equality Out of the total population of Serbia, 51.3% are female and 48.7% are male inhabitants. The Constitution of the Serbia proclaims principles of gender equality. Although the Constitution fails to mention gender pay equality, articles of The Labor Law treats rights of men and women equally, including right of equal pay. Additionally, according to provisions of this Law, a working woman has the right of absence from work due to pregnancy and childbirth, maternity leave, and absence from work for child care, for a total of 365 days. This length of maternity leave is usually used in full, making it one of the lengthiest in the world. The right of employment is also proclaimed equal, but because of maternity leave provisions young women in certain cases will be discriminated in employment possibility, although it is illegal to ask questions about maternity plans during job interviews. This particularly applies to employment in small and moderate private enterprises. Measured by the European Institute for Gender Equality (EIGE) Gender Equality Index, according to 2016 data, the value of Index for Serbia was 56, which was significantly behind the EU-28 average of 66. The most prominent inequalities are in the domains of money, time and power, indicating lower economic standard of women, carrying out disproportionately unpaid household work and care for family, and insufficient participation in decision making in positions of political, economic and social power. The labor market participation is much lower for women than for men, as indicated by activity, employment, unemployment and inactivity rates. There is also prominent gender segregation on the labor market, with women concentrating more in the sectors related to social services and men in the sectors of manufacturing, construction, and ICT. As in countries across the region, women and men also have different specializations in university, which contributes to the segregation seen in the labor market and the differences in labor market outcomes. Women constitute 89 percent of graduates in education, 75 percent in health, and 74 percent in 42 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF humanities and the arts. However, they make up only 35 percent of graduates in engineering, manufacturing, and construction. Domain of health. Health status refers to all aspects of women‘s and men‘s physical and psychological health. The second sub-domain looks at behaviors, predominantly from the perspective of risks that can affect health, while the third sub-domain focuses on access to health services and structures (EIGE, 2013a: 28-29). Serbia is 10 percentage points behind halfway to gender equality. The Serbian Gender Equality Index10 reveals that gender inequalities are prominent and indicates that Serbia is lagging behind the EU-28 average in overall gender equality. However, The smallest gap is recorded in the domain of health, The moderate gap between Serbia and the EU-28 in the domain of health compared to some other domains is partly a legacy of broadly free healthcare coverage. The share of persons who perceive their health as good or very good is lower among women than men, but women live longer and live longer healthy lives than men. There are not prominent gender gaps in the access to the healthcare. In 2014, slightly more women with unmet needs for medical examinations were recorded compared to men (0.7 percentage points). Unmet needs for dental examination were present slightly more among women than men in both years (gender gap of 2.8 percentage points in 2012 and 1.5 percentage points in 2014 in favour of men).15 4.7.4. Labor and informal employment The incidence of informal employment is the highest among the youngest age group (15-19 years), of whom 76% are employed informally. Incidence of informal employment tends to decrease with age. This can be accounted to the low level of professional experience of the youngest age group. Informal employment rates tend to rise again for older workers, with 50% of employees over 55 being informally employed. Broken down by age group, young men and older women are over-represented in informal employment. The Labor Inspectorate reports that 52.375 informal employment cases have been confirmed during the inspections conducted between 2017 and 2019 following which a total of 45.207 was transformed to formal employment. The labor market has recovered from post-crisis job losses. From 2014 to 2018, Serbia created around 240,000 net new jobs. The unemployment rate declined from close to 20 percent in 2014 to below 11 percent in 2019 (among people aged 15-64), and the employment rate now surpasses pre-crisis levels. Many of the new jobs have been full-time wage jobs in the formal private sector. Recent labor market improvements have also benefited women, older workers, and the youth. Job creation was the strongest in services and industry. Earnings increased alongside the number of jobs, as real wages in the private sector grew by more than 6 percent in 2014–17 and by more than 4 percent in 2018. Despite recent labor market improvements, many people in Serbia are not working or searching for a job. Among people aged 15-64, Serbia‘s activity rate (67.8 percent) and employment rate (58.8 percent) remain far below those of neighboring EU countries. Inactivity and unemployment are even worse among poor households: only 22.4 percent of the working-age poor are employed, compared to 53.0 percent of working-age non-poor. As a result of inactivity and unemployment, the average male and female worker in Serbia loses about 20 years and 25 years, respectively, of his and her potential productive lifetime (ages 15–64). Many job seekers are long-term unemployed: 75 percent of unemployed workers wait more than one year to find a job. Serbia is underutilizing its full potential workforce while firms demand more workers with the right skills. With a declining working-age population due to aging and outmigration, it is important that Serbia uses its available workforce effectively. When broken down by region, the largest number of informally employed workers is located in Vojvodina, and the smallest number in Belgrade. The highest share of informally employed workers of the total number of workers is in West Serbia and Sumadia (33.7%), followed by South and East Serbia (27.7%), Vojvodina (21.2%), and Belgrade (11.9%). These differences can, to large extent, be explained by the higher share of agricultural workers in these regions, and their higher propensity to work in the informal sectors. Of those informally employed the vast majority can be found in the agricultural sector (59.5% of all informally employed), followed by construction (7.1%). In other sectors, the share of informal work is 15 http://socijalnoukljucivanje.gov.rs/wp-content/uploads/2016/02/Izvestaj_Indeks_rodne_ravnopravnosti_2016_EN.pdf 43 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF less than 20%. The construction industry has a 34.9% share of informal employment in total sector employment and a 7.1% share of sectorial informal employment in total informal employment. The poverty rate, measured as income per capita below the standardized upper-middle-income country poverty line of US$5.5/day in 2011 purchasing power parity (PPP), fell from 26.7 percent in 2013 to 20.8 percent in 2017. An increase of 1 percent in GDP was associated with about a 4 percent reduction in the poverty headcount rate, higher than the elasticities in neighboring Western Balkan countries. Consistent with the labor market recovery, increased labor income contributed the most to the observed reduction in poverty, followed by pensions. Household income increased and the poverty rate fell because of overall economic growth and its strong impact on households in the bottom of the income distribution. 4.7.5. Population in rural areas In 2018, 122 193 persons internally migrated within the Republic of Serbia. The average age of persons who changed residence was 34.2 years (34.8 for men and 33.6 for women). The capital (Belgrade) region and northern Vojvodina region had a positive migration balance in 2018. In 2018 most of the persons moved from one municipality/city to another within the same area (39.1%), and at least from one to another settlement within the same municipality/city (23.6%). The largest number of migration movements was recorded in the territory of the Belgrade area, 50 982 (41.8%) immigrants and 44 004 (36.0%) emigrants. The South and East regions of Serbia, had a negative population trend and a deprivation of 3236 persons compared to the same period in 2017.This confirms that despite rural development measures the rural areas still struggle with depopulation. Economic growth has disproportionately benefited rural and low-income households. In Serbia, the income of the poorest 40 percent grew by an annualized average of 3.9 percent between 2013 and 2017, higher than the income growth of 1.5 percent for the whole population. Previously rural areas had been particularly hurt following the global financial crisis. Between 2013 and 2017, with economic and jobs recovery, the poverty headcount ratio decreased by 9.6 percentage points in thinly populated areas, 6.0 and 2.9 percentage points in intermediate and densely populated areas, respectively. However, thinly populated areas continue to house more than half of the country‘s poor. 4.8. Health Care The number of critical health facilities has been growing in Serbia, though the pace of growth has been slow. Table 4.4: Number of Public Health Facilities*16 and the health workforce 2013/14 2014/15 2015/16 2016/17 2017/18 2018/19 **17 Hospital 106 106 106 106 106 106 Primary health***18 158 158 158 158 158 158 Hospital beds** 38845 38845 38845 38819 38839 38839 Doctor 21413 Nurse/ANM 45787 Table 4.5: Number of Health Facilities Type of Health Facility In Serbia 105 Public Hospitals** 158 Primary Health Care Center*** 16 * do not include the territory of the Autonomous Province of Kosovo and Metohija 17 ** includes the capacities of military hospitals that are included in the plan of the public health network (3 hospitals, 18 *** includes public health centers that are part of health centers together with hospitals 44 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF 4.9. Status of Covid-19 in Serbia as at the 23rd November 2020 As of 27 November 2020, 148 214 cases of COVID-19 have been reported in Serbia, including 1 366 deaths. Other relevant COVID data in Serbia are presented on figure 2 bellow. Figure 2. Information about COVID-19 in the Republic of Serbia as of November 23, 2020 The following country-wide measures from the Serbian Government are in effect: • Effective November 17, all services, including bars, restaurants, cafés, stores, supermarkets, shopping malls, theaters, and cinemas will be closed from 9:00 p.m. to 5:00 a.m. These restrictions do not apply to pharmacies, gas stations, and food delivery services. • Ban on public gatherings involving more than 5 people, indoors or outdoors. • No more than one person per 4 square meters is allowed indoors. • The use of face coverings is required in all indoor locations, as well as outdoors when required physical distancing is not possible, for example waiting in line to enter stores or at bus stops. Face coverings are recommended elsewhere outdoors. • Visits to patients in hospitals are banned. • Visits to elder-care homes are limited to 15 minutes. • The recommended distance between people outdoors is 1.5 meters. 45 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF 5. POTENTIAL ENVIRONMENTAL AND SOCIAL RISKS, IMPACTS AND MITIGATION MEASURES This Section presents the potential environmental and social impacts that the implementation of the activities under component 1 and component 2 will bring about. It outlines specific actions and measures to address those risks and impacts. The PCU will be primarily responsible for ensuring the environmental and social risks are mitigated at each stage of the project operation. 5.1. Environmental and Social Risk and Impacts The overall environmental and social risks are considered Substantial. The Project is expected to have overall positive environmental and social impacts as it should improve COVID-19 surveillance, monitoring and containment as well as provide targeted support for the more vulnerable households. Both the environmental and social risks are considered ‗Substantial‘ because of the current uncertainty around project locations and specific activities, occupational health and safety issues and the issue of medical waste management. Nonetheless, due to the dangerous nature of the pathogen and response activities that include management of chemicals, contaminated waste, and civil works, etc., there is are wide-ranging environmental and social risks and impacts that will need to be assessed and managed through a risk- based approach. However, although the project will have long-term positive impacts, both socially and environmentally, but there is a number of substantial short-term risks that need to be considered. The project will finance medium scale infrastructure works for the upgradation, expansion and rehabilitation of existing healthcare facilities in order to provided added capacity around the country. The project will also partake in systemic strengthening of COVID 19 response and the procurement including PPE and equipment for the management of HCW. These interventions are expected to take place on the property of existing facilities; therefore, they will be mostly contained activities and environmental issues (and impacts thereof) are not expected to cause significant environmental harm or social risks in terms of compromising community health and safety. The physical works envisaged are of small to medium scale and the associated environmental and social impacts are expected to be temporary, predictable, and easily mitigable. The PCU will be primarily responsible for ensuring the environmental and social risks are mitigated at each stage of project operation. The Generic ESMP presented in Table 5.1 presents an in-depth overview of potential Environmental and Social issues associated with the project. The main environmental and social risks identified are: (i) occupational health and safety (OHS) for medical staff, laboratory staff and communities in the course of detection, transportation of patients/tests/chemicals and reagents, and treatment stages of the COVID-19 cycle; and (ii) risks related to collection, transportation and disposal of medical waste management. (iii) possible construction impacts (due to short term reconstruction works in already existing hospitals) related to air, water, noise, traffic safety, OH&S for workers and community health and safety. Despite the beneficial impacts, the project is expected to extend notable environmental and social risk impacts, including: o Impacts related to the Occupational Health and Safety (spread of the virus among healthcare workers); Workers in healthcare facilities, quarantine centers and laboratories are particularly vulnerable to contagions like COVID-19. Healthcare-associated infections due to inadequate adherence to occupational health and safety standards can lead to illness and death among health and laboratory workers. Infections associated with the healthcare due to inadequate application of OHS standards can result in illness, including fatalities, as well as further spread of the disease in the community. o Impacts related to collection and disposal health care waste and solid and liquid waste from laboratories; A part of the further virus spread risk is management of medical waste generated in laboratories, intensive care, testing units and other facilities. If not adequately handled and treated, the waste can also become a vector in spread of COVID-19. To tackle these risks, this ESMF includes template for ICMWMP that contain detailed procedures for protocols necessary for treating 46 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF patients and handling medical waste as well as environmental health and safety guidelines for staff, including the necessary personal protective equipment (PPE) based on WHO guidance as well as international good practices in COVID-19 diagnostic testing and other response. o Impacts related to the rehabilitation of existing healthcare facilities; Environmental risks are related to minor civil works for establishment and refurbishment of specialized units in selected hospitals as well as works to accommodate new equipment. For these works this ESMF includes templates for site-specific ESMP and ESMP Checklist as well as screening, preparation, review and consultation procedures with clearly distributed responsibilities. The envisaged work will be small- scale civil works (rehabilitation, adaptation, refurbishing) on interiors to accommodate new units and/or equipment. Expected impacts from these activities will be typical for small construction works, therefore predictable and readily mitigated, localized, impacts that include, but are not limited to: emission or dust, emission of noise, waste waters, construction waste and small quantities of hazardous waste and risks to workers (OHS) and users of facilities. Access to Personal Protective Equipment (PPE), procedures around medical waste disposal, relevant OHS measures and clear communication of risks and prevention measures to all persons at risk is required. - Possible risks of exclusion of Vulnerable Groups Access to Project supported Services and Facilities. A key social risk related to vulnerable and disadvantaged groups (elderly, disabled, chronically diseased, people with no health insurance, migrants, single parent headed households, economically marginalized and disadvantaged groups especially residing in geographically challenging areas, Roma, residents of shelters/care facilities, prisoners)who could experience inequitable access to project supported facilities and services because of their qualifying characteristics which could lead to social unrest and tensions and possible increase of their vulnerabilities) are unable to access facilities and services designed to combat the disease, in a way that undermines the central objectives of the project. Real or perceived inequities also have the potential to lead to conflicts and citizen unrest, and may possibly increase their vulnerability. To mitigate this risk the MOH is committed to the provision of services and supplies to all people, regardless of their social status based on the urgency of the need, in line with the latest data related to the prevalence of the cases. Roma population have been identified as having a higher infection risk due to their living environment which is crowded and often lacks amenities like running water and waste disposal, thereby compromising hygiene. Their common engagement in activities in the green economy such as collection of secondary raw materials (waste picking) also may expose them to the infection risks This will be mitigated by providing active outreach and targeted information sessions for these groups on COVID-19 to inform them about the virus, the disease it causes and how to protect themselves from infection; increase emphasis on hand hygiene and respiratory etiquette, promote enhanced hygiene. Ensure the engagement is guided by the Roma mediation specialist from the PCU, and that contact and engagement strategies are planned together with empowered group leaders. Ensure that children within the community receive age friendly information especially on personal hygiene and handwashing importance. Use picturesque didactic brochures to present the risk of infection and Do`s & Don‘ts. In addition, the SEP has identified further specific vulnerable groups with regard to project activities and includes strategy for targeted consultations with vulnerable groups to understand concerns/needs in terms of accessing information, medical facilities and services and other challenges they face at home, at work places and in their communities and inclusion in Project M & E. o Gender risks. There is low risk associated with the Project and in the Country in relation to Sexual exploitation, Abuse (SEA) and Sexual Harassment yet promotion of avoidance of SEA relying on the WHO Code of Ethics and Professional Conduct for all workers in the quarantine facilities and provision of gender sensitive infrastructure and segregated toilets shall be included in the ESMF. Health care workers shall be trained to properly identify SEA/SH risks and cases and facilitate appropriate and timely referrals. o Community health and safety related risks. All project activities ranging from the operation of laboratories to community engagement activities present a risk of transmission in the community. The operations of laboratories and health centers have a high potential of infecting the community at large if they are not properly managed and controlled. The project anticipates the establishment of specialized units in selected hospitals for COVID-19 patients and establishment of mobile health care facilities to address the need to minimize virus transmission. The operation of quarantine areas and mobile centers needs to be implemented in such a manner that staff, patients, and the wider 47 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF public are treated in line with international guidance provide by WHO for COVID-19 response. In case quarantine and mobile health care facilities are to be protected by security personnel, it will be ensured that the security personnel follow strict rules of engagement and avoid any escalation of the situation, taking into consideration the guidance provided in the World Bank technical note, ―Use of Military Forces to Assist in COVID-19 Operations: Suggestions on How to Mitigate Risks." 5.2. Mitigation Measures 5.2.1. Planning and design stage Key ES issues that should be considered at the planning and design stage may include considering the following features of the subproject: o Location, type and scale of healthcare facilities and associated waste management facilities, including waste transport routes.  Location of facilities: In addition to normal considerations regarding proximity to sensitive areas such as a cultural heritage site or a nature reserve, the environmental and social assessment should examine nearby sensitive social receptors such as a residential area or school and availability of municipal services such as public water supply, sewage and waste collection services at the location.  Type and scale of facilities: The assessment should identify and examine the salient characteristics and carrying/disposal capacity of a targeted facility. The assessment should consider the waste processing and transportation arrangements, operational procedures and working practices, and the required capacity of the type of disposal facility needed for the volume of the wastes generated. For example: a general hospital, a high-level biosafety laboratory for coronavirus testing; a temporary hospital or quarantine area, a pyrolytic incinerator or a hazardous waste landfill for medical waste disposal.  Quarantine and isolation centers: These may be located at Point of Entry, border, urban and/or rural areas. Tents may be used. The GoS is considering setting-up makeshift structures (in the form of tents) within existing GoS structures/plots for isolation centers and these will likely include schools, sport stadiums, gymnasiums, etc. Requirements on food, water, fuel, hygiene, infection, SEA/SH prevention and control, and monitoring the health of quarantined persons should be considered. o Proper design and functional layout of healthcare facilities, which may involve several aspects: i) structural and equipment safety, universal access19; ii) nosocomial infection20 control; iii) waste segregation, storage and processing. Internationally recognized guidelines are available and should be referenced. o No land acquisition is envisaged since civil work involved will be refurbishment and rehabilitation of healthcare facilities. No new infrastructure has been planned to be built either on public or private property. Existing waste management facilities will be used for waste disposal and no additional waste management facilities/ dumpsite/ landfill will be required. o Proper identification of the needs for workforce for planned construction interventions as well as type of needed workers; 5.2.1.1. Procurement of goods and supplies The Project will engage in the procurement of goods and supplies e.g. equipment such as ventilators or PPE or cleaning materials, etc., and the PCU will be responsible for ensuring that the required technical specifications are met as per WHO guidelines and GIIP. This will involve:  Preparation of technical specifications on the PPE for healthcare workers and service staff (e.g., cleaners) according to WHO interim guidance on rational use of PPE for coronavirus disease 2019 19 Refer to ESS 4 Community Health and Safety 20 Nosocomial infection can be descried as an infection acquired in hospital by a patient who was admitted for a reason other than that infection. Also called “hospital acquired infection”. 48 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF  Distribution of goods or services on basis of need, while ensuring that the distribution systems is not compromised due to elite capture  Measures to ensure that the disadvantaged and vulnerable groups have equal if not better access to these resources.  Collection of samples, transport of samples and testing of the clinical specimens from patients will be performance in accordance with WHO interim guidance Laboratory testing for coronavirus disease 2019 (COVID-19) in suspected human cases.  Tests will be performed in appropriately equipped laboratories (specimen handling for molecular testing requires BSL-2 or equivalent facilities) by staff trained in the relevant technical and safety procedures.  Inclusion of the relevant specification, process and procedures in the site-specific ESMP based on the generic ESMP presented in Annex 9. 5.2.1.2. Rehabilitation work at existing HCFs The PCU will screen each HCF for potential environmental and social risks per World Bank Group EHS Guidelines, WHO COVID-19 Guidelines and the screening form contained in Annex 8. Screening will include:  Determination of any needed design changes in the facility or its operation such as ICUs, isolation facilities, structural and equipment safety, universal access, nosocomial infection control, medical waste disposal, etc.;  Identification of the scope of works expected (i.e. wards rehabilitated into ICUs, installation of box chambers, installation/augmentation of water supply and installation of sanitary stations, rehabilitation or installation of medical waste incinerators, etc.  Incorporate universal access standards  Determination that utilities (power, water, heat, etc.) are adequate for planned works;  Identification of how such works might interfere with normal operation of the HCF;  Determination if works are eligible for financing - for example, activities excluded from financing under the project include those requiring the acquisition of land or works conducted in wards or areas where patients are being treated where asbestos insulation or pipe lagging was used in original construction (a list of excluded activities is found in Annex 30);  Determination as to whether external or additional security personnel are needed;  Preparation of a site-specific ESMP based on the Generic ESMP presented in Annex 9. 5.2.1.3. Medical waste management and disposal The PCU will screen each HCF‘s medical waste management and disposal practices to determine if they are in keeping with the World Bank Group‘s EHS Guidelines and current WHO Guidelines for COVID- 19. The screening will be conducted based on the screening form found in Annex 8 and include:  Identification of current methods of medical waste management and disposal at the HCF;  Identification of any on-site facilities for disposal of medical waste  Identification of any off-site disposal of medical waste, including how material is gathered and stored, routes taken to the disposal facility, and disposal procedures;  Review of protocols for dealing with medical waste specifically related to infectious diseases like COVID-19;  Review of training procedures for healthcare workers and other relevant HCF employees for medical waste management and disposal;  Preparation of an ICMWMP, based on the Generic ICMWMP contained in Annex 10, for the HCF. 49 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF 5.2.1.4. Protecting healthcare workers The PCU will conduct a review of the HCF‘s protocols for protecting healthcare workers from infections disease based on current WHO Guidelines for COVID-19 and the Infection and Prevention Protocol contained in Annex 11. The review will include:  Determination if training given to healthcare workers and other HCF employees is adequate;  Determination if HCF staff are trained on how to deal with the remains of those who might die from COVID-19, including those conducting autopsies;  Determination if adequate stores of PPE are available on-site; and  Identification of supply lines for required PPE. 5.2.1.5. Containment of COVID-19. The PCU will also conduct a review of the HCF‘s protocols for dealing with the general public based on current WHO Guidelines for COVID-19 and the Infection and Prevention Protocol contained in Annex 11. The review will include:  Review of identification, testing, and treatment protocols for those exposed to or suspected of being infected with COVID-19 for groups of higher sensitivity or vulnerability like the elderly, those with preexisting conditions, heavy smokers, or the very young;  Updating visiting rules and regulations for families and friends of patients;  Briefing procedures for families and friends of COVID-19 patients on how the disease is spread and how to minimize that spread;  Briefings available for the general public on COVID-19; and  Ensuring those HCF employees and any outside personnel charged with handling remains of patients who have died from COVID-19 are familiar with WHO Guidelines. 5.2.1.6. Communication Approaches and Strategy It is critical to communicate to the public what is known about COVID‑19, what is unknown, what is being done, and actions to be taken on a regular basis. Further, getting feedback from stakeholders and using their grievances, suggestions, in design and implementation of project activities would also be important.  Under Subcomponent 1.2: ―Physical Distancing Measures and Communication Preparedness‖ information and communication activities prepared to increase the attention and commitment of government, private sector, and civil society, and to raise awareness, knowledge and understanding among the general population about the risk and potential impact of the pandemic and to develop multi-sectoral strategies to address the pandemic.  As detailed in the SEP prepared separately, stakeholders will be consulted primarily by using online platform, to receive their feedback and suggestions on project design and preparation. Also, there will be GRM by which people can raise concerns, provide feedback, or make complaints about project and any activities related to the project. 5.2.1.7. Access to appropriate and timely medical services, hand hygiene and PPEs Access to appropriate and timely medical services, hand hygiene and PPEs. Considering the geographic location and remoteness of some of rural areas the timely medical assistance and availability of personal protective equipment is important. The HCFs will conduct a review the HCF‘s protocol‘s for securing quick access to appropriate and timely medical services based on current WHO Guidelines for COVID-19. The review will include:  Number of ambulance teams and equipment available to cover distance locations and timelines of medical services to be reached;  The location of ICUs to be selected based on existing services and expanding geographical access to health care services in order to ensure equitable access to highly specialist care across the country;  Pain medications, antibiotics and other routine medicines needed for the ICUs; 50 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF  Staff at all ICUs are trained in COVID-19 care and infection prevention, as well as longer-term capacity building in critical care provision;  Emergency referral mechanism in rural areas to access timely medical services;  Determination if adequate stores of hand sanitizes and PPE are available in rural areas; and  Identification of supply lines for required PPE. 5.2.2. Construction Stage The PCU will ensure that all rehabilitation work done at the HCFs under the project will be carried out in compliance with a site-specific ESMP based on the template in Annex 03 of this ESMF. The PCU will develop site specific ESMPs through the E&S consultants hired for the project before the approval of each subprojects. The site-specific ESMPs will include: o Environmental risks and impacts associated with resource efficiency and material supply; construction related solid wastes, wastewater, noise, dust and emission management; hazardous materials management including construction waste and asbestos containing materials (ACM) generated from rehabilitation or minor civil works; o Occupational Health and Safety (OHS) issues; o Community health and safety issues; o Social issues, including in relation to labor influx, Sexual Exploitation and Abuse/Sexual Harassment (SEA/SH) risks, gender or disability o Labor and working conditions. Arrangements for employment and accommodation of workers to be engaged in project activities, and issues relating to working conditions (including in relation to periods of sickness and quarantine), particularly if these are impacted by emergency legislation The ESMP will form part of the Contract and the ESMF will be part of the bidding document. The key suggestions are given below: o The implementing agency to depute a qualified environment social expert/focal officer to work with the contractors, the agency officials and the WB to comply the relevant needed measures for COVID 19 Pandemic according to above guidance and National regulation. o The PIUs should review the contract document and identify the obligation the work force and what has to change to cover the COVID requirements in the enclosed documents and how to solve the issues. o For supervision, using online, mobile-friendly reporting and monitoring tool that will assist both the contractor, government and relevant stakeholders to monitor COVID-19 on construction sites, The contractors are required to complete a daily report per project, whereby all projects details, and health and safety status of employees in utilizing the online reporting and monitoring system. o To exercise social distancing, the contractor and other parties should consider specific channels of communications for consultation and stakeholder engagement activities. For a detailed mitigation measures related to construction activities refer to World Bank Interim Note on COVID-19 Considerations in Construction/Civil Works Projects.(Annex 08) 5.2.2.1. Construction work at existing HCFs The PCU will ensure that all rehabilitation work done under the project will be carried out in compliance with a site-specific ESMP prepared based on the Template ESMP presented in Annex 03 and the Template presented in Table 5.1. The PCU will also ensure that the site-specific ESMP will be included in any works or supervision contracts entered into for a specific HCF. The site-specific ESMP will include:  Environmental risks and issues such as resource efficiency and material supply;  Construction related solid wastes, wastewater, noise, dust and emission management;  Hazardous materials management;  Occupational Health and Safety (OHS) issues;  Labor influx, security personnel management, GBV/SEA risks, gender issue; and  Labor and working conditions. 51 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF 5.2.2.2. Issues specific to labor and working conditions Issues specific to labor and working conditions. The PCU will require the contractor to adhere to standards relating to:  Labor management and working conditions as laid out in the ‗Labor Management Procedure‘ prepared under the project, including in relation to periods of sickness and quarantine  Labor issues to be incorporated in the ESMP, as mentioned above.  Arrangements for employment and accommodation of workers to be engaged in project activities, and issues relating to working conditions 5.2.2.3. Stakeholder Engagement and Grievance Mechanism.  Continued engagement with stakeholders on construction-related activities to be undertaken  Information dissemination/awareness in the communities in the vicinity of the HCFs, including measures taken to ensure community health and safety, prevent the spread of infection, and contingency plan in case of an outbreak  Awareness about and access to grievance redress mechanism that will among others, address grievances relating to labor influx as well as those relating GBV/Sexual Exploitation and Abuse/Sexual Harassment (SEA/SH) 5.2.3. Operational Stage 5.2.3.1. Medical waste management and disposal. The PCU and HCFs will ensure the following: o Each HCF is operated in accordance with the Rulebook on Medical Waste Management (Official Gazette of the RS No 48/2019) and ICMWMP prepared for the project; o Waste segregation, packaging, collection, storage disposal, and transport is conducted in compliance with the ICMWMP and WHO COVID-19 Guidelines;  Onsite waste management and disposal will be reviewed regularly and training on protocols contained in the ICMWMP conducted on a weekly basis;  The PCU will audit any off-site waste disposal required on a monthly basis and institute any remedial measures required to ensure compliance; and o Waste generation, minimization, reuse and recycling are practiced where practical in the COVID-19 context. 5.2.3.2. Protecting healthcare workers The PCU and HCFs will ensure the following:  Regular delivery and proper storage of goods, including samples, pharmaceuticals, disinfectant, reagents, other hazardous materials, PPEs, etc.;  Ensure protocols for regular disinfection of public spaces, wards, ICUs, equipment, tools, and waste are in place and followed;  Ensure hand washing and other sanitary stations are always supplied with clean water, soap, and disinfectant;  Ensure equipment such as autoclaves are in working order; and  Provide regular testing to healthcare workers routinely in contact with COVID-19 patients.  No person under the age of 18 is employed for the project given the hazardous work environment.  Ensure that if health care workers are pushed to work without proper PPEs, they can access the GRM register for complaints. A Grievance Redress Mechanism (GRM) has been developed in the LMP to allow workers to raise workplace safety, assignment and other security/safety issues through multiple channels. 52 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF  Provide regular testing to healthcare workers routinely in contact with COVID-19 patients. 5.2.3.3. Containment of COVID-19 The PCU and HCFs will ensure the following: o Quarantine procedures for COVID-19 patients are maintained; o Patients in quarantine are not discriminated due to socioeconomic status, level of education, gender, disabilities and any other vulnerability. o When practical, COVID-19 patients are given access to phone or other means of contact with family and friends to lessen the isolation of quarantine; o Patients in quarantine have access to development and project related information and should be able to take part in consultation through appropriate means o The public is regularly updated on the situation and reminded of protocols to prevent the spread of COVID-19; and o Members of the general public (family and friends) who have been exposed to confirmed COVID-19 patients are tested when practical. o WHO quarantine guidelines can be found at: https://apps.who.int/iris/rest/bitstreams/1272428/retrieve For detailed HCF infection and prevention control protocol and WASH protocol guidelines are provided in the Annexes 05 and 06. OHS and labor and working conditions: A Labor Management Procedure (LMP) had been developed to address the labor risk and incorporated in chapter 8 of this ESMF 5.2.3.4. Stakeholder Engagement and Grievance Mechanism  Continued engagement with stakeholders on the operation of HCF and other project related activities as per the SEP  Information dissemination/awareness as per the ‗Risk Communication, Community engagement and Behavior Change‘ sub-component of Component 1 of the project  Awareness about and access to grievance redress mechanism that will among others, address grievances relating to labor influx as well as those relating GBV/Sexual Exploitation and Abuse/Sexual Harassment (SEA/SH) 5.2.4. Decommissioning Stage In response to the surge of COVID-19 testing and treatment, there are plans to establish temporary isolation centers in government facilities like schools, stadiums, gymnasium and open fields etc. The ES risks and assessment due to decommissioning of these make shift structure would be done in line with the Table 5.1 of the ESMP template provided in the Annex 03. If any temporary HCFs or medical waste management facilities were established under the project, they will be decommissioned after the end of the outbreak is declared in accordance with regular decommissioning procedures and international best practice. Annex 03 presents guidance on due mitigation measures which will be covered under the subproject specific ESMPs that would be developed. 53 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF Table 5.1 ES Risks & Mitigation Measures at different project execution stages S.N. Subproject/Activity ES Risk and Impacts Mitigation Measures A. Planning and Design Stage a. Procurement of Goods and High consumption of Energy, adverse impacts Adapt sustainable procurement21. Before purchasing any goods or services Supplies (in General) on human health, air pollution and emission consider these basic checklists of environmentally sustainable procurement: and generation of hazardous and general waste,  Ensure the life cycle impacts of the item were considered (i.e.: what etc. processes were used to create it, what environmental impacts does it have when used, what will happen at the end of its life?)  Ensure the supplier provides any relevant environmental information.  Ensure required ESHS measures, are into the ESHS specifications of the procurement documents and contracts with contractors and supervising firms.  Ensure that the contractors and supervising firms comply with the ESHS specifications of their respective contracts.  Environmentally Sustainable Procurement Guidelines with Example Clauses in Tenders and Contracts are enclosed as Annex 10 of this ESMF document Public health emergency Possible exclusion of vulnerable  Ensure meaningful consultation and outreach to vulnerable groups planning including groups(elderly, people with disabilities, (elderly, people with disabilities, immune compromised and poor in community engagement and immune compromised and poor) from access decision making on COVID-19 planning and response. risk communication to emergency response health services  Ensure that public health emergency mitigation plans are a gender inclusive and account for the needs of different vulnerable groups.  Reference shall also be made to the WHO ―A Strategic Framework for Emergency Preparedness‖22 and 2019 Novel Coronavirus (2019-nCoV): STRATEGIC PREPAREDNESS AND RESPONSE PLAN23 Design or redesign of health  Potential to ignore universal access for  All physical infrastructure designs should consider universal access care facilities for persons with a disability, making sure that there is access for persons with a disability; rehabilitation works  Potential to ignore measures for energy  Design and rehabilitation works should incorporate measures for and resource efficiency sustainable use of energy and water resources (e.g. consider solar wherever feasible and effective) 21 Environmentally sustainable procurements integrate the concern for social, economic, and environmental issues, and involves thinking broadly about objectives, considering long term as well as short term effects, assessing indirect as well as direct effects. 22 https://apps.who.int/iris/bitstream/handle/10665/254883/9789241511827-eng.pdf?sequence=1 23 https://www.who.int/publications/i/item/strategic-preparedness-and-response-plan-for-the-new-coronavirus 54 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF S.N. Subproject/Activity ES Risk and Impacts Mitigation Measures  Material specifications for rehabilitation works should consider general environmental concerns.  Avoid activities that will involve significant earth movement, excavation, or other activities that could have an adverse impact on cultural heritage. It seems to be the unlikely event, nonetheless by any chance if such situation occurs or identified, the works will be undertaken according to a chance finds procedure as provided in Annex 14. Health and Safety issues concerning Goods and Services b. Purchase and stocking of Surfaces of imported materials may be  Workers will wash hands regularly with soap under running water, emergency rooms, clinics, contaminated and handling during Projects should ensure that adequate handwashing facilities with soap and other medical facilities, transportation may result in spreading. (liquid), water, and paper towels for hand drying (warm air driers may be including with Laboratory an alternative), plus the closed waste bin for paper towels are available. equipment, supplies or goods. Alcohol-based hand rub should be provided where handwashing facilities cannot be accessed easily and regularly;  Ensure awareness campaigns include standard COVID-19 prevention measures: washing hands regularly with soap, maintaining physical distancing, wearing face masks as appropriate, and avoid hand contact with the face, eyes, and nose;  Carry out disinfection using 0.1% chlorine solution, where necessary. c. Purchase of PPE for Potential for procuring sub-standard quality of PPE should be: healthcare staff and workers PPE leads to the spread of infection to  Able to protect for the duration of work period in health facilities, healthcare workers and cleaners.  If reusable ones are used, then it should be able to withstand repeated laboratories, waste disposal disinfection for reuse and users should follow decontamination methods in sites. Potential for improper disposal of used PPEs the product labeling  WHO interim guidance on the rational use of PPE for coronavirus disease 2019 provided further details on the types of PPE that are required for different functions and as per the specifications.  Institute quality control measures for all PPEs that are procured  Workers must wear appropriate PPE when in active work areas e. Hand hygiene stations Increased risk of transmission of virus due to Health facilities should ensure that adequate handwashing facilities with inadequate handwashing facilities . soap (liquid), water, and paper towels for hand drying (warm air driers may be an alternative), plus the closed waste bin for paper towels are available. If water and soap hand washing facilities are not possible, alcohol-based hand rubs may be provided. WHO hand hygiene protocols to be followed. 55 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF S.N. Subproject/Activity ES Risk and Impacts Mitigation Measures g. Waste contaminated with The collection, processing, treatment, and  The healthcare waste produced during the care of COVID-19 patients COVID-19 virus disposal of health care wastes become a vector should be collected safely in designated containers and bags, labeled, for the spread of the virus. treated, and then safely disposed of.  disposal and treatment of this kind of waste should be in accordance with national law and/or with WHO guidelines;  Waste inactivation methods –  Autoclaving Waste contaminated with COVID-19 virus can be inactivated using an autoclave operating within permitted parameters. Steam treatment methods (autoclave) is being used in some health facilities in Serbia. Steam treatment should preferably be on-site, although once treated, sterile/non- infectious waste may be mutilated and disposed of in suitable waste facilities. An autoclave uses saturated steam under pressure to heat materials to a high enough temperature for a long enough period of time to inactivate the pathogen(s) of concern in the waste. Such time and steam pressure conditions will ensure that the waste material is no longer infectious, does not pose a health risk, and is not considered medical waste or a hazardous material. . Incineration Incineration is a thermal method of treatment using combustion to reduce waste to ash and flue gases. Medical incinerators with dual chambers run at extremely high temperatures, well above the relatively low temperatures needed to kill (i.e., inactivate) most pathogen organisms. Incineration, if available on-site and properly permitted, would be the best method for large or bulky items, such as mattresses (though consideration should be given to whether there are size limits for on-site incinerators) that may be associated with terminal (i.e., final) cleaning after hospital patient discharge or residential environmental remediation activities. Incineration that reduces waste to ash at any temperature inactivates almost all infectious substances (except prions, as noted previously). Combustion at or above 1,000°C/1,832°F is necessary to destroy prion infectivity.  The treatment processes should be validated and periodically tested to ensure they function properly using biological indicators (e.g.: spores) or other test assays.  For further reading refer WHO Safe management of wastes from health- 56 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF S.N. Subproject/Activity ES Risk and Impacts Mitigation Measures 24 care activities . h. Management Contaminated Improper handling of contaminated laundry in  Basic Facility Provisions and Equipment Management Laundry in HCFs HCF becomes a vector for the spread of the - HCF management must ensure the launder all HCWs personal virus. protective garments or uniforms that are contaminated with blood or other potentially infectious materials. - The facility should maintain a receiving area for contaminated textiles at negative pressure compared with the clean areas of the laundry. - Ensure that laundry areas have handwashing facilities and products and appropriate PPE available for workers. - Use and maintain (and dispose at end of lifecycle) laundry equipment according to manufacturers‘ instructions. - Damp textiles or fabrics should not be left in machines overnight to prevent microbial growth. - Disinfection of washing and drying machines in residential care is not needed as long as gross soil is removed before washing and proper washing and drying procedures are used.  Routine Handling of Contaminated Laundry - Use sterilized textiles, surgical drapes, and gowns for situations requiring sterility in patient care. - Use hygienically clean textiles (i.e., laundered, but not sterilized) in neonatal intensive care units. - Follow manufacturers‘ recommendations for cleaning fabric products including those with coated or laminated surfaces. - Do not use dry cleaning for routine laundering in health-care facilities. - Handle contaminated textiles and fabrics with minimum agitation to avoid contamination of air, surfaces, and persons. - Bag or otherwise contain contaminated textiles and fabrics at the point of use. - Do not sort or precise contaminated textiles or fabrics in patient-care areas - Use leak-resistant containment for textiles and fabrics contaminated with blood or body substances. 57 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF S.N. Subproject/Activity ES Risk and Impacts Mitigation Measures -Identify bags or containers for contaminated textiles with labels, color coding, or other alternative means of communication as appropriate. - If laundry chutes are used, ensure that they are properly designed, maintained, and used in a manner to minimize dispersion of aerosols from contaminated laundry. - Ensure that laundry bags are closed before tossing the filled bag into the chute. Do not place loose items in the chute. - Establish a facility policy to determine when textiles or fabrics should be sorted in the laundry facility (i.e., before or after washing)  Laundering Process - If hot-water laundry cycles are used, wash with detergent in water - ≥160°F (≥71°C) for ≥25 minutes. - Follow fabric-care instructions and special laundering requirements for items used in the facility. - Choose chemicals suitable for low-temperature washing at proper use concentration if low-temperature (<160°F [<71°C]) laundry cycles are used. - Package, transport, and store clean textiles and fabrics by methods that will ensure their cleanliness and protect them from dust and soil during interfacility loading, transport, and unloading. i. Management and Cleaning of Improper management of contaminated  Keep mattresses dry; discard them if they become and remain wet or contaminated Mattresses and mattresses and pillows becomes a vector for stained. Pillows the spread of the virus.  Clean and disinfect mattress covers using disinfectants that are compatible with the cover materials to prevent the development of tears, cracks, or holes in the cover.  Maintain the integrity of mattress and pillow covers.  Replace mattress and pillow covers if they become torn or otherwise in need of repair.  Do not stick needles into the mattress through the cover.  Clean and disinfect moisture-resistant mattress covers between patients using typical cleaning products.  If using a mattress cover completely made of fabric, change these covers and launder between patients.  Launder pillow covers and washable pillows in the hot-water cycle 58 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF S.N. Subproject/Activity ES Risk and Impacts Mitigation Measures between patients or when they become contaminated with body substances. i. Identification and diagnosis Collection of samples and testing for  Collection of samples, transport of samples, and testing of the clinical process COVID19 could result in the spread of disease specimens from patients meeting the suspect case definition should be to medical workers or laboratory workers or performed following WHO interim guidance Laboratory testing for during the transport of potentially affected coronavirus disease 2019 (COVID-19) in suspected human cases25. samples.  Tests should be performed in appropriately equipped laboratories (specimen handling for molecular testing requires Bio Safety Level BSL-2 or equivalent facilities) by staff trained in the relevant technical and safety procedures. National guidelines on laboratory biosafety should be followed. WHO interim guidance for laboratory biosafety related to 2019- nCoV26.  For general laboratory biosafety guidelines, refer to the WHO Laboratory Biosafety Manual, 3rd edition27. Also, refer to WBF ESS 2 and ESS 4. i. Location, type, and scale of  Occupational health and safety concerns to  The PCU will screen each HCF for potential environmental and social healthcare facilities and frontline healthcare workers and staff risks per World Bank Group EHS Guidelines, WHO COVID-19 associated waste especially on specimen collection and Guidelines28, and the screening form contained in Annex 09. management facilities handling, exposure to infectious diseases;  Determination of any needed design changes in the facility or its operation including waste transport  Dust and noise during rehabilitation/civil such as ICUs, isolation facilities, structural and equipment safety, routes, & Isolation Centers works universal access, nosocomial infection control, medical waste disposal,  Management of health care waste generated etc.; from isolation centers, laboratories, and  Identification of the scope of works expected (i.e. wards rehabilitated into screening posts could include contaminated ICUs, installation of box chambers, installation/augmentation of water fluids (e.g. blood) and infected materials like supply and installation of sanitary stations, rehabilitation or installation of reagents, syringes, lab solutions, and disposal medical waste incinerators, etc. will be an issue  Incorporate universal access standards  Risk of exclusion of representatives from  Determination of the utility capacity (power, water, heat, etc.) that are vulnerable groups including elderly, people adequate for planned works; with disabilities, immune compromised and 25 https://apps.who.int/iris/bitstream/handle/10665/331329/WHO-COVID-19-laboratory-2020.4-eng.pdf?sequence=1&isAllowed=y 26 https://www.who.int/docs/default-source/coronaviruse/laboratory-biosafety-novel-coronavirus-version-1-1.pdf 27 https://www.who.int/csr/resources/publications/biosafety/WHO_CDS_CSR_LYO_2004_11/en/ 28 https://apps.who.int/iris/bitstream/handle/10665/331603/WHO-2019-nCoV-SARI_treatment_center-2020.1-eng.pdf?sequence=1&isAllowed=y 59 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF S.N. Subproject/Activity ES Risk and Impacts Mitigation Measures poor on planning and decision making  Identification of how such works might interfere with the normal operation  Health facilities are inaccessible to of the HCF; vulnerable groups such as the elderly or  Reference shall also be made to the WBG EHS guideline29. The healthcare people with disabilities. waste produced during the care of COVID-19 patients should be collected  Social unrest/tension due to the establishment safely in designated containers and bags, labeled, treated, and then safely of a health facility by the community in the disposed of using steam-based technology (autoclave) Reference shall be vicinity. made to WHO Safe management of wastes from health-care activities30. Needle cutters will be used in all location where needles are used to ensure that these sharps are destroyed at the source of generation and then autoclaved and disposed of in designated sharp pits  Preparation of a site-specific ESMP based on the Generic ESMP presented and template for Planning & Designing Stage, Template for Construction Stage, Template for Operation Stage, and Template for Decommissioning Stage are presented in Annex 03.  Ensure representatives from vulnerable groups in the planning and decision-making process.  Consideration of universal access in the design of the health care facilities including isolation and quarantine facilities for vulnerable groups particularly people with disability and elderly.  The project will ensure that precautionary measures are taken as recommended by the WHO Interim Guideline for the quarantine of individuals.  Establish an effective Grievance Redress Mechanism for the public to prevent social unrest and mismanagement.  Leaders, Civil society and community groups should be engaged early in the process to facilitate the process and dispel any misinformation  Regular communication with the community in the vicinity about the procedures put in place to address the risks of COVID-19. Communication materials and approaches should be clear and designed to ensure that the vulnerable and marginalized groups such as people with disabilities easily understand. A communication strategy will be guided by the WHO Risks Communication and Community Engagement (RCCE) Protocol, Serbia's 29 https://www.ifc.org/wps/wcm/connect/topics_ext_content/ifc_external_corporate_site/sustainability-at-ifc/policies-standards/ehs-guidelines 30 https://www.who.int/water_sanitation_health/publications/wastemanag/en/ 60 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF S.N. Subproject/Activity ES Risk and Impacts Mitigation Measures National Health Communication Policy 2012, and the SEP prepared for the project. B. Construction-related Activities Construction (including  Resource efficiency and material supply;  Install bins for waste segregation expansion, upgrading, and  solid wastes and wastewater generated from  Collect, treat and dispose-off of waste at designated facilities, rehabilitation) of healthcare construction activities,  Plan and carry out construction working hours to minimize noise, dust, facilities  pollution-related to noise, dust, emission, and emission and waste impact on nearby population hazardous waste.  Provide appropriate PPE to workers including earplugs during working  Occupational Health and Safety (OHS) hours Establishment/rehabilitation related issues;  The PCU will ensure that all rehabilitation work done under the project of laboratories  Possible impacts on patients and health care will be carried out in compliance with a site-specific ESMPs prepared workers; based on the template in in Annex 03. The PCU will also ensure that the  Community health and safety issues site-specific ESMPs will be included in any works or supervision contracts including pollution and road safety; entered into for a specific HCF.  Disruption of community and local  Provide signage for safety at critical locations for warning and informing facilities/services the community with images and text in local language  Influx of labor  Consultation with the local community to identify issues and ways to minimize the disturbance of local facilities  Increased exposure for workers and community in the vicinity  Identify and develop an ESHS plan that includes adequate precautions in place to prevent or minimize the spread of COVID-19 and inclusion as  The potential risk of SEA/SH due to part of civil works contracts. increased workers for construction activities particularly in the rural areas  Regular communication with the community in the vicinity about the procedures put in place to address the risks of COVID-19. Different  Possible use of child labor or forced labor communication approach and materials should be developed which is clear  Discrimination at employment, non-payment and designed to be easily understood, particularly by the vulnerable groups of wages including people with disability.  Establish a functioning GRM. Information dissemination and awareness of the existing project grievance redress mechanism and encourage its use to report concerns relating to COVID-19  Develop Labor and SEA/SH code of conduct and include in civil works contracts. Orientation to the labor force, contractor, and the project.  Laboratories to be supported by the Project will apply international best practices in COVID-19 diagnostic testing and other COVID-19 response activities. 61 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF S.N. Subproject/Activity ES Risk and Impacts Mitigation Measures  Laboratory testing will not be undertaken at the labs unless the appropriate capacity and infrastructure is in place  ESMPs will be prepared as it involves small scale civil works  Waste management facilities will be established and each HCF will prepare and implement an ICMWMP for the same. (Reference shall also be made to the WBG EHS guideline and the World Bank Interim Note on COVID-19 Considerations in Construction/Civil Works Projects –Annex 08). C. Operation Phase Operation of healthcare  Delivery and storage of goods, including  Classify and quantify the HCW (infectious waste, pathological waste, facility and its quality; samples, pharmaceuticals, reagents, and other sharps, liquid, and general waste) following WBG EHS Guidelines for Assets, and management hazardous materials; Healthcare Facilities systems.  Healthcare treatment practices, including the  Assess the adequacy of the healthcare waste management system of the provision and use of PPE, appropriate HCF material delivery, waste generation, handling, disinfection and Procedures implemented to cleaning procedures, testing for COVID-19, sterilization, collection, storage, transport, and disposal and treatment work manage infection control and and transportation of samples to testing and recommend proper measures as necessary waste management to reduce facilities;  Describe applicable performance levels and/or standards and monitor the or avoid cross-infection  Waste processes that align with WHO compliance of the existing management system. guidance on Safe Management of Wastes  Onsite waste management and disposal will be reviewed regularly and from Healthcare Activities, including to: training on protocols contained in the ICMWMP conducted weekly. o Waste generation, minimization, reuse,  The PCU will audit any off-site waste disposal required monthly and and recycling; institute any remedial measures required to ensure compliance; and o Waste segregation at the point of care,  Waste generation, minimization, reuse, and recycling are practiced packaging, collection, storage, and wherever practical in the COVID-19 context. transport; o Suitability and capacity of onsite For further detailed information refer to the ―Infection Control and Medical disinfection and waste handling Waste Management Plan (ICMWMP) Template‖ provided in Annex 04 equipment such as an autoclave. Onsite treatment facilities may include small-  The project will take all measures to ensure proper disposal of medical scale autoclaves and wastewater waste that will be generated during the operation of health facilities to treatment works. avoid community health and safety issues as per the provisions made in o Suitability and capacity of off-site ESMP. Also, the project makes sure the implementation of WHO‘s Safe disposal facilities, where healthcare Management of Wastes from Health-care Facilities and the government wastes will be transported and disposed standard on Hospital Waste Water. of off-site.  The project will take all necessary measures to ensure the safety of health 62 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF S.N. Subproject/Activity ES Risk and Impacts Mitigation Measures  Increased risk for vulnerable groups such as workers as prescribed by WHO and several directives issued by the children, people with disability in accessing government such as Pandemic Health Services and Use of PPE. health services, isolation and quarantine  The project as envisaged in the ESMF and ESMP will classify and services and related information quantify the HCW (infectious waste, pathological waste, sharps, liquid,  Possible discrimination against individuals of and non-hazardous) following WBG EHS Guidelines for Healthcare ethnic groups or religious groups. Facilities and pertaining GIIP  Rise in tensions inside the isolation and  Strengthen the Grievance Redress Mechanism for the public to prevent quarantine centers due to lack of basic social unrest and mismanagement facilities, such as food, water and lodging,  Leaders, Civil society, and community groups should be engaged early in and infection prevention and control the process to facilitate the process and dispel any misinformation. measures  Regular communication with the community in the vicinity about the  Rise in social tensions due to the procedures put in place to address the risks of COVID-19. Communication establishment of mandatory isolation and materials should be clear and designed to be easily understood by them. quarantine centers proximity to a residential Different channels should be opted. Reference should be made to WHO area, school, public spaces, and park. RCCE protocols.  Community health and safety issues due to improper handling and disposal of medical waste Emergency COVID-19  potential for exclusion of issues which are  Ensure communication, messaging is inclusive and accessible to all response to a containment relevant to vulnerable groups such as including people with disabilities, strategy children, people with disability in accessing  Provision of a sufficient supply of tests, medical supplies, food supplies, health services, isolation and quarantine water, and sanitation facilities. services Ensure continued caregiver services for persons who are elderly, children,  Possible discrimination against individuals of or persons with disabilities. ethnic groups or religious groups. Ensure universal access in isolation and quarantine services  Rise in tensions inside the isolation and Provision of accessible quarantine facilities including for persons with quarantine centers due to lack of basic disabilities facilities, such as food, water and lodging, and infection prevention and control Provide separate quarantine facilities for women and children when measures possible. Develop clear protocols to protect women and children against harassment/violence.  Free testing and treatment for COVID-19 among vulnerable populations  Training and sensitization of health workers and others  Possible increase in incidents of  Use of inclusive language and less stigmatizing terminology in 63 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF S.N. Subproject/Activity ES Risk and Impacts Mitigation Measures violence/harassment due to stigmatization information and communication materials related to COVID-19 of health workers,  Prioritize collection and dissemination of accurate information on affected, corona patients treatment options, access to health services.  Social stigma against certain ethnic groups  Engage social influencers such as religious leaders or local women leaders, and religious groups. women's groups. Increased risk of exclusion for people located  The targeted community engagement program in remote areas and low capacity of health  Mobilization of health workers and programs to provide services.  Discomfort concerning the rules that are  Culturally and socially appropriate messaging and awareness-raising imposed for COVID-19 and conflict with the should be carried out. spiritual and cultural practices  Religious leaders and civil society/ community groups should be engaged  Social unrest due to disruption of cultural and early in the process to facilitate adherence and dispel rumors and communal activities due to distancing and misinformation. other restrictions  Strengthen Grievance Redress Mechanism and public information dissemination activities to prevent mismanagement and social unrest Increased risk of VAWG and child due to  Ensure SEA/SH support services are included in COVID-19 response and mandatory confinement, restrictions ensure funding to SEA/SH service providers  Community messaging and awareness-raising campaigns should embed messages on healthy conflict resolutions, stress and anger management, etc.  Encourage informal and (virtual) social support networks and platforms.  Ensure that public health emergency mitigation plans are a gender inclusive and accounting for the needs of vulnerable populations. Impact on residential care for people with  Consider reassignment of caregivers at home as needed to support in day disabilities, elderly due to social distancing to day activities. policies, restricted mobility Community engagement and  Possible risk of exclusion of vulnerable  Mapping of different social groups including vulnerable groups and risk communication groups from access to information due to barriers and challenges. language barrier, cultural barriers, literacy,  Identify key media and other channels and influencers to reach the target remoteness, etc. groups/audience.  Develop culturally and socially relevant messaging and awareness-raising  Social unrest, mistrust due to misinformation for people with disabilities, poor urban communities, children. and misunderstanding  Information dissemination in local languages and in various formats 64 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF S.N. Subproject/Activity ES Risk and Impacts Mitigation Measures through formal and informal channels.  Involve local social mobilizers/ leaders/community influencers who can speak the local language and understand the cultural practices of the vulnerable groups.  Consider providing information through individuals they trust and understand their concerns and language barriers.  Identify vulnerable group networks and mobilize to reach the remote, marginalized, and vulnerable populations who cannot read and do not have access to phone or TV, Radio.  Ensure that community engagement teams are gender-balanced.  Establishment of strong community and citizen engagement platforms taking into consideration the social networks available and operating within poor, disadvantaged, and vulnerable communities…  Establishment of emergency support hotline that is free and known to all, including vulnerable groups  Training modules developed takes into account gender and inclusive requirements.  Regular and proactive communication and engagement with the public to alleviate confusion and avoid misunderstanding.  Establish a regular feedback mechanism and capture common questions, misunderstandings through health hotlines, health care workers, and communities. D. Decommissioning Phase Decommissioning of  Construction-related solid wastes,  Suitability and capacity of off-site disposal facilities, where demolished temporary care facilities in wastewater, noise, dust & emission, wastes will be transported and disposed of off-site. The adequacy and response to the surge of hazardous materials waste, etc. compliance with transport and disposal regulations and licensing for the COVID-19 testing and  Occupational Health and Safety (OHS) transport vehicles and the offsite disposal facilities should be assessed; treatment. related issues;  Appropriate mitigation measures shall be developed preparing site-specific  Community health and safety issues ESMPs following WBG ESF ESS 2,3 and 4; including pollution and road safety;  Reference shall also be made to WHO medical device technical series  Temporary Stockpiling of demolished ―Decommissioning Medical Devices‖ materials; 65 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF ES Risks and Impacts and adequate mitigation measures for Civil Works (refurbishment and construction of medical facilities including isolation facilities) are presented in table 5.2: Table 5.2 ES Risks and Impacts and adequate mitigation measures for Civil Works Activity Risks and Impacts Mitigation Measures Construction Injury during the Apply ESHGs to the implementation of projects. activity – construction of new hospitals, buildings or clinics, refurbishment of mortuary existing buildings. Design and The design of the For patients with possible or confirmed COVID-19, isolation rooms operation of facility and the should be provided and used at medical facilities. Isolation rooms facilities, operating procedures should: including triage, will help prevent the • be single rooms with attached bathrooms (or with a dedicated isolation (or spread of infection commode); quarantine) • ideally be under negative pressure (neutral pressure may be used, facilities but positive pressure rooms should be avoided); • be sited away from busy areas (areas used by many people) or close to vulnerable or high-risk patients, to minimize chances of infection spread; • have dedicated equipment (for example blood pressure machine, peak flow meter, and stethoscope), but should avoid excess equipment or soft furnishings; • have signs on doors to control entry to the room, with the door kept closed; • have an ante-room for staff to put on and take off PPE and to wash/decontaminate before and after providing treatment. An operation manual should be prepared before the opening of isolation rooms to describe the working procedures to be taken by healthcare workers to protect themselves and prevent infection escape while providing treatment. The operational procedures should be of a standard to meet guidance from WHO and/or CDC on infection control: • WHO interim guidance on infection prevention and control during health care when novel coronavirus (nCoV) infection is suspected; • WHO technical brief water, sanitation, hygiene and waste management for COVID-19; • WHO guidance on infection prevention and control at health care facilities (with a focus on settings with limited resources); • WHO interim practical manual for improving infection prevention and control at the health facility; • CDC Guidelines for isolation precautions: preventing transmissions of infectious agents in healthcare settings; and • CDC guidelines for environmental infection control in healthcare facilities. Improve access Some vulnerable The project will carry out targeted consultations with vulnerable to support and groups (especially the groups to understand concerns/needs in terms of accessing treatment for the elderly or those with information, medical facilities and services and other challenges disadvantaged pre-existing medical they face at home, at work places and in their communities vulnerable conditions) may be 66 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF Activity Risks and Impacts Mitigation Measures groups severely affected by COVID-19 and may need additional support to access treatment. Transient and Workers that are Expats or transient workers should adhere to national requirements ex-pat mobilized from and guidelines to COVID-19. workforce abroad or returning Expats or transient workers coming from countries/regions with from abroad become cases of the virus: vectors for  Should not return if displaying symptoms transmission of  Should self-isolate for 14 days following their return disease to construction projects. For self-isolation, workers should be provided with a single room Workers that travel that is well-ventilated (i.e., with open windows and an open door). from other regions If a single room is not available for each worker, adequate space may also provide a should be provided to maintain a distance of at least 1 m between vector for passing the workers sharing a room. Workers in isolation should limit their infection onto work movements in shared space, for example through timed use of sites. shared spaces (such as kitchens and bathrooms) with cleaning before and after use of the facilities. Visitors should not be allowed until the worker has shown no signs and symptoms for 14 days, and the number of staff involved in caring for those in isolation should be kept to a minimum. Healthcare professionals and cleaners should visit each day (wearing the appropriate PPE and observing hygiene requirements and make appropriate arrangements for supplying food and water to the kitchens for the workers in isolation. Further information is provided by WHO in Home care for patients with the suspected novel coronavirus (COVID-19). 67 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF 6. ENVIRONMENTAL AND SOCIAL RISK MANAGEMENT This Section sets out a detailed procedure for the environment and social risk management process to be followed during the implementation of the project activities. The ES procedures ensure effective integration of the environment and social aspects into subproject to strengthen social and environmental risk management and determine the appropriate instrument for addressing the risks. 6.1. Categorization of subprojects In determining activities for support, each activity will be screened and categorized to inform its eligibility for support. The activities will be screened both for National and WB requirements. Activity categorization is essential for an early understanding of the type, nature, and scale of impacts. Based on the sensitivity of the environmental and social risks and impacts subprojects fall in one of the following risk categories: a. HIGH RISK activities are those that will not eligible for support through Project b. SUBSTANTIAL and MODERATE RISK activities are those that will have adverse environmental and/or social impacts that are limited to the actual site of the activity and its immediate surrounding and addressed through mitigation measures that are readily known and available. Depending on scale of its environmental and social impacts, associated risks and sensitivity this activities may require ESIA as per the National requirement and mandatory require ESMP/ESMP Checklist and ICMWMP as adequate ES instruments. c. LOW RISK activities are those that are likely to have minimal or no adverse environmental and social impacts. 6.2. Environmental and Social Screening When subproject locations/ design will be known, each subproject will be screened for ES risks and impacts. Annex 02 provides a screening form which sets out a list of questions on the screening of ES risks and impacts, identifies the relevant ESSs and the type of assessments and management tools that can be developed. Each individual HCF undertaking activities financed by the project will assign one staff member who will be responsible for liaising with the PCU on ESMF implementation throughout the life of the project at that specific HCF. The process of screening of ES risks and impacts begins at the subproject planning stage to allow early identification of potential impacts and mitigation measures. The screening process will: o Screen the eligibility of the activities o Identify potential environmental and social risks and impacts of the proposed subproject activity o Determine the subproject category (High, Substantial, Moderate or Low); and o Determine the level of environment and social assessment and management required to address the potential risks and impacts. Each of the activities will be screened for national EIA requirements as well as WB's ESSs. An Environmental and social checklist has been developed and will be used during the screening. (see Annex 02). Copies of each of these screening forms will be kept at the PCU and individual HCFs. The PCU‘s periodic report to the Bank will include copies of each screening undertaken during the subject quarter Project will also include retroactive financing of eligible expenditures related to COVID-19 that have already been incurred. For such subprojects E-S audit is required in order to review the status and record of measures that were undertaken, identify any outstanding issues and propose gap filling measures, if needed. 6.3. Environment and Social Assessment and ES Instruments Upon screening, proposed activities will be categorized based on the scope of risks and the sensitivity of the receptive environment as below. The screening will also determine the extent of assessment and management plans to be developed. 68 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF o HIGH RISK activities will not be included in the project. o SUBSTANTIAL and MODERATE RISK activities may require the preparation of ESIAs and corresponding ESMP. Support measures to address the issues related to vulnerable groups will be integrated into the ESMPs. ESMPs will be included as an integral part of any works or supervision contract for the activity. Each healthcare facility will prepare and ICMWMP. (See Annex 04 for the templates on ICMWMP and Annex 03 ESMP). The management plans (final draft version) will be submitted to the World Bank for review and/ clearance. ES risk as well as the level of assessments required will be agreed with the World Bank. o LOW RISK activities will not require assessment beyond screening. The screening report will recommend mitigation measures for minor issues/impacts identified by the screening exercise. In some situations, a brief abbreviated and site-specific Environmental and Social Management Plan (ESMP) may be needed. The World Bank will review management plans on a sample basis and/or on case by case based on the perceived risks The PCU and individual HCFs will ensure that all subprojects/activities with civil works will prepare necessary ES instruments (ESMP and ICMWMP) that will describe and prioritize mitigation measures, corrective actions and monitoring measures necessary to manage the impacts and risks identified in the screening assessments or ESIAs. Rehabilitation work at existing HCFs. The PCU will screen each HCF for potential environmental and social risks per World Bank Group EHS Guidelines, WHO COVID-19 Guidelines, and the screening form contained in Annex 02. If the HCF is to be supported under the project, the site-specific ESMP will include mitigation measures to address issues identified during screening. Screening will include: o Determination of any needed design changes in the facility or its operation such as ICUs, isolation facilities, structural and equipment safety, universal access, nosocomial infection control, medical waste disposal, etc.; o Identification of the scope of works expected (i.e. wards rehabilitated into ICUs, installation of box chambers, installation/augmentation of water supply and installation of sanitary stations, rehabilitation or installation of medical waste incinerators, etc.); o Determination that utilities (power, water, heat, etc.) are adequate for planned works; o Identification of how such works might interfere with normal operation of the HCF; o Determination if works are eligible for financing - for example, activities excluded from financing under the project include those requiring the acquisition of land or works conducted in wards or areas where patients are being treated where asbestos insulation or pipe lagging was used in original construction (a list of excluded activities is found in Annex 01); o Determination as to whether external or additional security personnel are needed; and o Preparation of a site-specific ESMP based on. o After the screening, ESMPs, based on the template found in the Annex 03A and 03C the ESMP checklist found in Annex 03B, will be prepared for any small-scale works to be conducted at any HCF including the creation or rehabilitation of ICUs and the laboratories, the rehabilitation of laboratories, the rehabilitation or installation of sanitary stations and hand washing facilities, and the rehabilitation or installation of medical waste incinerators. Once approved, the ESMP will be included as an integral part of any works or supervision contract for the activity. If the HCF undertakes the works on its own, the ESMP will remain applicable for the activities being undertaken. o Each HCF will prepare and implement an ICMWMP, based on the sample found in the Annex 04. 6.4. Preparation of Environmental and Social Management Plans (ESMPs) for all expansion, rehabilitation and upgrading subprojects in HCF Where risks and impacts cannot be avoided or prevented, mitigation measures and actions will be identified so that the activities operate in compliance with applicable national laws and regulations etc. and meets the requirements of relevant World Bank standards. Measures and actions that address identified impacts and risks will favor the avoidance and prevention of impacts over minimization, mitigation wherever technically and financially feasible. The template for ESMPs is provided in Annex 03 and the templates on ICMWMP in Annex 04. The PCU and HCF will ensure that all works contracts will include 69 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF the ESMPs and ICMWMP, and the cost of implementing the ESMPs will be identified as an item in the Bill of Quantities for the respective contracts of physical interventions for implementing the ESMP. All subprojects/activities will prepare ESMPs that will describe and prioritize the actions needed to implement mitigation measures, corrective actions and monitoring measures necessary to manage the impacts and risks identified in the ESIAs. Where risks and impacts cannot be avoided or prevented, mitigation measures and actions will be identified so that the activities operate in compliance with applicable national laws and regulations etc. and meets the requirements of relevant World Bank standards. Measures and actions that address identified impacts and risks will favor the avoidance and prevention of impacts over minimization, mitigation wherever technically and financially feasible. The template for ESMPs is provided in Annex 03. The project will ensure that all works contracts will include the ESMPs, and the cost of implementing the ESMPs will be identified as an item in the Bill of Quantities for the respective contracts of physical interventions. An ESMP will be kept as simple as possible, clearly describing adverse impacts and mitigation actions that are easy to implement. The basic elements of an ESMP are: o A description of all possible significant adverse impacts that are likely to arise due to the project that the ESMP is intending to deal with; o A description of planned mitigation measures, and how and when they will be implemented; o A program for monitoring with measurable indicators that will allow to determine the effectiveness of the mitigation actions o A description of who will be responsible for implementing the ESMP o A cost estimate and source of funds (Refer Annexes 03 for guidelines for developing ESMPs) A standalone ESMP is only considered appropriate in situations where a detailed environmental analysis is not required as per the findings of the Environmental and Social Screening. As per the nature of the proposed physical interventions under the project and resulting operation, it will be mandatory that all proposals/ physical interventions implemented will require an ESMP to mitigate subproject specific impacts identified during the screening exercise at minimum. ESMPs are to be prepared at the stage of project design and included in bidding documents, to be costed for accordingly, and will be part and parcel of contract documents. Activities outlines in the ESMPs will be implemented by the respective investors/contractors implementing the subproject and monitored accordingly by the project management unit during the construction phase. If the HCF undertakes the works on its own, the ESMP will remain applicable for the activities being undertaken. Chapter 5 of this ESMF document presents guidance on possible impacts to be addressed in ESMPs and a template ESMP for the typology of project interventions that provide guidance to facilitate sound ESMP preparation during the project implementation stage are presented in Annex 03. This template ESMP covered all project stages, from design to construction to operation of HCFs to potential decommissioning or demolition of HCFs build as part of COVID-19 response activities. HCFs will be responsible for the implementation of processes outlined in the Operational ESMPs which will be also developed for the facility as per the guidance provided in Annex 03 and the template presented in Annex 12. This guidance has will be laid out in the ESMP in line with the operation of the HCF to ensure sound Infection Control and management of activities in the long term. The World Bank Group General EHS Guidelines contain information on cross-cutting environmental, social, health, and safety issues potentially applicable to construction and is available via the following link https://www.ifc.org/wps/wcm/connect/topics_ext_content/ifc_external_corporate_site/sustainabilit y-at- ifc/policies-standards/ehs-guidelines The World Bank Group ESH Guidelines for Construction Materials Extraction is also applicable to the project and used as key guidance provided to contractors on the management of environmental health and safety during construction material extraction in addition to specific guidance provided in the ESMF. This document includes information relevant to construction materials extraction activities such as aggregates, limestone, slates, sand, gravel, clay, gypsum, feldspar, silica sands, and quartzite, as well as to the extraction of dimension stone. It addresses stand-alone projects and extraction activities supporting construction, civil works, and cement projects. Although the construction materials extraction guidelines 70 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF emphasize major and complex extraction schemes, the concepts are also applicable to small operations and should be used for guidance. These guidelines can also be downloaded via the link provided above. If the Environmental and Social Screening identifies that the project to be financed would require further assessment in line with national regulations- guidance on the EIA process is presented within the Chapter 3.5 of this ESMF document. Finally, all ESMPs will include a Protection and Chance Find Procedures. If any person discovers a physical cultural resource during excavation or construction/rehabilitation/refurbishment works, Protection and Chance Find Procedure provided in Annex 14 will be followed. 6.5. Environmental and Social Management via Bid Documents ESMPs will be prepared at the stage of project design and included in bidding documents, to be costed for accordingly, and will be part and parcel of contract documents. Activities outlined in the ESMPs will be implemented by the respective investors/contractors implementing the subproject and monitored accordingly by the PCU during the construction phase. If the HCF undertakes the works on its own, the ESMP will remain applicable for the activities being undertaken. It is important to ensure the environmental and social specifications and ESMP are included in the bid documents prior to commencement of the bidding process for subprojects where the World Bank‘s Standard Bidding Documents will be used. This applies to all subprojects or activities directly implemented by the PCU or Implementing Agencies. It will be necessary to include a provisional sum for the ESMP as part of the Bill of Quantities for those mitigations measure that are not part of the engineering costing. The environmental and social specifications should also include penalty clauses for non-compliance, specifically for complex and large contracts. The procurement staff of the relevant implementing agency and PCU together with environmental and social officer(s) will be responsible for this step. 6.6. Consultation and Disclosure Given the need for social distancing during the COVID-19 pandemic, stakeholder consultations for the ES instruments, will be conducted compliant to Technical Note: Public Consultations and Stakeholder Engagement in WB-supported operations when there are constraints on conducting public meetings, issued on March 20, 2020 but taking into account the requirements for outreach to vulnerable groups. 6.7. Review and Approval The individual instruments will be prepared by PCU and will be reviewed by WB ES teams before they are implemented. Updates on the instruments will also be sent to WB for review, guidance, and comments. Upon project commencement the Environmental and Social Specialists of the PCU will be required to prepare a table, tracking all requisite ESF instruments for subprojects as outlined in the generic template Environmental and Social Instrument Preparatory Tasks Tracking Sheet presented in Annex 18. This sheet should be continuously updated and managed by the project PCU and shared with the World Banks Environmental and Social specialist every quarter or when requested. 6.8. Implementation The PCU as well as the individual HCF will be responsible for the implementation of the instruments. For ESMPs, this responsibility will be shared with contractors and supervising consultants when applicable. The PCU will also provide implementation support and supervision. During implementation, the project will review the COVID-19 risk level in the project area and the restrictions put in place by the government to contain the disease spread and set-out plan for continued consultation and stakeholder engagement. Appropriate adjustments will be made in the approach, methods, and forms of engagement to take into account the need to prevent the spread of the disease. As described in the SEP, the PCU will publicly disclose this ESMF and all the environmental and social assessments and plans at appropriate locations including the MOH's website (both in English and Serbian). An overview of the project's consultation and stakeholder engagement strategy is provided in Section 7. 71 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF 6.9. Monitoring and Reporting 6.9.1. Monitoring Supervision of final ESMPs and implementation of ICHCWMPs for subprojects, along with other aspects of the project, will cover monitoring, evaluative review and reporting in order to achieve, among others, the following objectives: o Determine whether the project is being carried out in conformity with environmental and social and o legal agreements o Identify issues as they arise during implementation and recommend means to resolve in time o Recommend changes to the proposed concept and the project design, as appropriate, as the project evolves, or circumstances change; and identify the key risks to project sustainability and recommend appropriate risk management strategies. An appropriate environmental and social supervision plan will be developed aiming to ensure the successful implementation of an ESMF across the project and will be shared with the World Bank. The environment and social team based in the PCU will be responsible for overall monitoring of the ESMF implementation up to the project closure and transfer for management to the designated authority. Compliance monitoring comprises of on-site inspection of the construction activities to verify that measures identified in the ESMPs are included in the clauses for contractors are being implemented. This type of monitoring is similar to the normal technical supervision tasks ensuring that the Contractor is achieving the required standards and quality of work. Photographic documentation of non-compliance as well as best practices will be used as a means of recording implementation conditions efficiently, in addition to written evidence. 6.9.2. Reporting For ICMWMPs, the specific plans will include procedures and criteria for monitoring of implementation the MOH will be responsible for overall monitoring of compliance of all plans prepared and present via the PCU a quarterly update of the status of plan implementation. This report will be prepared as a summary report covering all HCFs associated with the project. A standard Environmental and Social Compliance Monitoring Checklist for Project Activities is presented in Annex 19. In addition, the Special Monitoring Checklist for Ensuring Safe Conditions for Workers and Public, presented in Annex 20 should be attached to the main monitoring update presented in Annex 19. For all project ESMPs in implementation Annex 19 and Annex 20 must be combined and maintained through intervention commencement in the field to implementation completion. Compliance monitoring reports will be submitted to the World Bank on a quarterly basis from the commencement of the contract. Regular World Bank missions will include specialists to monitor the project‘s compliance with World Bank safeguard policies. The progress of environmental monitoring will be formally communicated to World Bank through regular progress reports and updates as per the compliance monitoring agreement made during project implementation. There will be two types of reports, Monthly from the HCFs to the PCU and periodic reports from the PCU to the Bank as per ESCP: Monthly Reports. Individual HCFs will prepare and provide monthly reports to the PCU on each activity being undertaken. These reports will include progress on any on-going small works, statistics related to the implementation of the ICMWMP, any grievances received via the GRM and information on their resolution, and any other relevant information. Quarterly Reports. the PCU will submit an overall report of project implementation to the Bank every quarter the project is active. . These reports will include statistics on national project implementation; a summary of grievances received and their resolution, a summary of activities for each individual HCF, and copies of screenings and individual HCF instruments prepared during the subject quarter. 72 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF 7. STAKEHOLDER ENGAGEMENT AND DISCLOSURE Stakeholder engagement throughout the project life cycle is critical to the success of the project. In the context of infectious disease, broad, culturally appropriate, and adapted awareness-raising activities are particularly important to sensitize the communities about the risks related to the infectious disease. This section provides an overview of the Stakeholder Engagement Plan (SEP), which has been prepared as a separate instrument in compliance with the World Bank ESS10. The SEP will be updated, adopted and consulted on by January 2021.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. Specific and targeted approaches has been adopted and will be expanded to ensure that the vulnerable and marginalized groups have meaningful participation in the decision making and implementation of the activities. The project will implement and continuously update the SEP as the project evolves to account for the emerging needs of stakeholders. 7.1. Existing Stakeholder Engagement Process The project will build on the existing stakeholder engagement process established by the MOH to combat the spread of COVID-19. WB‘s ESS10 and the relevant national policy or strategy for health communication & WHO‘s ―COVID-19 Strategic Preparedness and Response Plan - Operational Planning Guidelines to Support Country Preparedness and Response‖ (2020) will be the basis for the project‘s stakeholder engagement. In particular, Pillar 2 on Risk Communication and Community Engagement outlines the following approach: ―It is critical to communicate to the public what is known about COVID‑19, what is unknown, what is being done, and actions to be taken on a regular basis. Preparedness and response activities should be conducted in a participatory, community-based way that are informed and continually optimized according to community feedback to detect and respond to concerns, rumours and misinformation. Changes in preparedness and response interventions should be announced and explained ahead of time and be developed based on community perspectives. Responsive, empathic, transparent and consistent messaging in local languages through trusted channels of communication, using community-based networks and key influencers and building capacity of local entities, is essential to establish authority and trust.‖ Different engagement methods are proposed, however until NPIs become more flexible or entirely lifted the Project will adapt virtual communication and consultation methods taking into account social distancing requirements. Hence, alternative ways will be adopted in accordance with the local laws, policies and new social norms in effect to mitigate the virus transmission. The alternative approaches to be practiced for stakeholder engagement will include: (i) small groups consultations if smaller meetings are permitted, or making reasonable efforts to conduct meetings through online channels (e.g. Webex, Zoom, Skype etc.); where possible and appropriate, create dedicated online platforms and chatgroups appropriate for the purpose, based on the type and category of stakeholders; (ii) official Government‘s COVID-19 website, (iii) diversifying means of communication and relying more on social media, chat groups, dedicated online platforms (E-mail, project weblinks/websites etc.); (iv) employing traditional channels of communications such regular mail, TV, radiowhen stakeholders do not have access to online channels or do not use them frequently. Traditional channels can also be highly effective in conveying relevant information to stakeholders, and allow them to provide their feedback and suggestions; (v) Chose venues carefully based on hygiene and sanitation standards that can be achieved during the meetings; (vi) Where direct engagement with project affected people or beneficiaries is necessary, identify channels for direct communication with each affected household via a context specific combination of email messages, mail, online platforms; 73 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF (vii) Each of the proposed channels of engagement should clearly specify how feedback and suggestions can be provided by stakeholders. Further down the implementation, and as the situation with the disease changes accustomed traditional methods shall be gradually deployed, respecting restrictions and governmental decisions in force at the time. These shall have the following format: (i) Formal Meetings, (ii) Focus Group Meetings/ Discussions; (iii) One-on-one interviews; and (iv) Site visits. In terms of consultations with stakeholders on the project design, activities and implementation arrangements, etc., the revised SEP, expected to be updated within month 1 after the Effective date, and continuously updated throughout the project implementation period when required, will clearly lay out: o Type of Stakeholder to be consulted o Anticipated Issues and Interests o Stages of Involvement o Methods of Involvement o Proposed Communications Methods o Information Disclosure o Responsible authority/institution The updated SEP shall identify the needs of the stakeholders and different engagement methods for each group and shall provide a more detailed matrix of notification means as relevant. A tentative matrix is provided in Annex 1 of SEP document. The strategy for stakeholder engagement takes into consideration the limitation posed by the COVID-19 crisis and relies more extensively on online and distant tools (TV, radio, websites) to accommodate the need for social distancing. 7.2. Strategic engagement with the Vulnerable Groups The project will carry out targeted consultations with vulnerable groups to understand concerns/needs in terms of accessing information, medical facilities and services and other challenges they face at home, at work places and in their communities. Some of the strategies that will be adopted to effectively engage and communicate with vulnerable groups will include: o Women: ensure that community engagement teams are gender-balanced and promote women‘s leadership within these, design online and in-person surveys and other engagement activities so that women in unpaid care work can participate; consider provisions for childcare, transport, safety for any in-person community engagement activities, and ensure that targeted messaging reaches elderly women. o Pregnant women: develop education materials for pregnant women on basic hygiene practices, infection precautions, and how and where to seek care based on their questions and concerns. o Elderly and people with existing medical conditions: develop information on specific needs and explain why they are at more risk & what measures to take to care for them; tailor messages and make them actionable for particular living conditions (including assisted living facilities), and health status; target family members, health care providers and caregivers. o People with disabilities: provide information in accessible formats, like braille, large print; offer multiple forms of communication, such as text captioning or signed videos, text captioning for hearing impaired, online materials for people who use assistive technology. o Migrant workers: provide information about the residency, insurance, visas etc. through their employers and the Ministry of Labor, Employment, Veteran and Social affairs. Make sure workers in camps receive the COVID-19 prevention awareness raising information in line with WHO guidelines and national protocols in place. o Roma population: have a higher infection risk due to their living environment which is crowded and often lacks amenities like running water and waste disposal, thereby compromising hygiene. Their common engagement in activities in the green economy such as collection of secondary raw materials (waste picking) also may expose them to the infection risks This will be mitigated by 74 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF providing active outreach and targeted information sessions for these groups on COVID-19 to inform them about the virus, the disease it causes and how to protect themselves from infection including access to PPE; increase emphasis on hand hygiene and respiratory etiquette, and promotion of enhanced hygiene. Ensure the engagement is guided by the Roma mediation specialist from the PCU, and that contact and engagement strategies are planned together with empowered group leaders. Ensure that children within the community receive age friendly information especially on personal hygiene and handwashing importance. Use picturesque didactic brochures to present the risk of infection and Do`s & Don‘ts o Residents of Long and short-term shelter/ care facilities: Make sure that COVID infection prevention and control trainings are provided to all employees. Provide information sessions for residents on COVID-19 to inform them about the virus, the disease it causes and how to protect themselves from infection; Increase emphasis on hand hygiene and respiratory etiquette, Post reminders, posters, flyers around the facility, targeting employees, residents, and visitors to regularly wash hands (if disinfection stations are not available or in addition to them. Issue instructions to visits, group activities, meal distributions, o Correctional and prison residents: Make sure that COVID infection prevention and control trainings are provided to all employees. Engage with prison administration for targeted messages and provide information sessions for residents on COVID-19 to inform them about the virus, the disease it causes and how to protect themselves from infection; Increase emphasis on hand hygiene and respiratory etiquette, Post reminders, posters, flyers around the facility, targeting employees, residents, and visitors to regularly wash hands (if disinfection stations are not available or in addition to them. Issue instructions on visits, group activities, meal distributions in the COVID era that protect inmates and visitors, workers alike. 7.3. Stakeholder Engagement Strategy during COVID-19 crisis The SEP for the project will be guided by the WHO Risks Communication and Community Engagement (RCCE) Protocol; the World Bank‘s ESS 10; Technical note on Public Consultations; and Serbia‘s National Health Communication Policy 2012. Specific and targeted approaches will be adopted to ensure that the vulnerable and marginalized groups have meaningful participation in the decision making and implementation of the activities. The different engagement methods that are proposed will likely have to be modified taking into account the increasing need for social distancing, but in the first instance, these include briefings with health experts, site visits, focus group discussions and radio, television, and print broadcasting. Given the extraordinary situation due to the COVID -19 pandemic, which has greatly limited the prospects of people‘s movements and mass gatherings, the application of the standard consultation procedures is difficult to implement. The project will adopt the following approach in planning engagement activities: o Review the infectious disease situation in the project area and the restrictions put in place by the government to contain the disease spread. o Review the existing approach and methodology for engagement activities and make appropriate adjustments to consider the need to prevent the spread of infectious diseases. o Identify vulnerable or disadvantaged individuals such as people with disabilities and the limitations they may have in participating and/or in understanding the project information or participating in the consultation process amidst the restrictions (for example, language differences, cultural barriers, lack of safe transportation to events, accessibility of venues, disability, lack of understanding of a consultation process). o Where direct engagement with project-affected people or beneficiaries is necessary, and cannot be postponed, identify channels for direct communication with each affected household via a context- specific combination of online platforms (wherever feasible only). o If physical meetings are not permitted, diversify means of communication and consider which communication channels are applicable in the local context. Rely on local engagement partners to understand which channels are used by local community members in this non-normal situation to determine which mechanisms can be used to reach the right audience. List out both ICT-based mechanisms and non-ICT approaches that suit local conditions. 75 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF o Ensure that all the PCU members and project associated staff understand a new set of social behavior and good hygiene practices as prescribed by COVID-19 guidelines and all consultations is preceded with the procedures of articulating hygiene practices o Avoid all gatherings that include direct interactions between project officials and beneficiaries/affected people. However, depending upon the government's permissions, smaller meetings, such as focus group discussions can be organized by taking all precautionary measures prescribed by the government and WHO guidelines. 7.4. Grievance Redressed Mechanism (GRM) MOH has established a Project sensitive GRM by building upon the functioning GRM developed under the SSHP. Along with the possibility to submit grievances via MOH/project website (by filling in an online form), mail (by sending a filled-in form in hard copy to PCU) or e-mail (by sending a filled in form in electronic form to PCU), project stakeholders and citizens can also submit complaints regarding the violation of project policies, guidelines, or procedures, including those related to procurement, labor procedures, child labor, health and safety of community/contract workers and gender violence to the World Bank Grievance Redress Service (GRS), which is accessible on http://www.worldbank.org/en/projects-operations/products-and-services/grievance-redress- service. For information on how to submit complaints to the World Bank Inspection Panel, please visit www.inspectionpanel.org.. The project will offer the grievance redressed services at no cost to communities and without retribution, and grievance mechanism will not impede access to judicial and administrative remedies. The SEP explains in detail the mechanism in place, including the structure of the GRM, intake channels for grievance, procedure for resolution, appeal process, etc. The GRM includes the following steps: STEP 1: Submission of grievances: via MOH/project website, mail or e-mail. The GRM will also allow anonymous grievances to be raised and addressed. The updated SEP shall include details of nationwide Grievance entry points and focal points while the existing avenues are available and provided below. STEP 2: Recording of grievance, classifying the grievances based on the typology of complaints and the complainants in order to provide more efficient response, and providing the initial response immediately if possible. The typology will be based on the characteristics of the complainant (e.g., vulnerable groups, persons with disabilities, people with language barriers, etc.) and also the nature of the complaint (e.g. disruptions in the vicinity of quarantine facilities and isolation units, inability to access the information provided on COVID 19 transmission; inability to receive adequate medical care/attention, etc.). STEP 3: Investigating the grievance and communication of the response within 10 days. The validity of the query, feedback or complaint will be assessed by the PCU GRM team comprising PCU and staff assigned by the Ministry of Health. Details will be determined in the updated SEP. Step 4: Complainant Response: either grievance closure or taking further steps if the grievance remains open. Before any closure of complaints/grievances, the PCU GRM team shall: o Confirm that the required GRM actions have been enforced, that the complaint/grievance handling or dispute resolution process has been followed and that a fair decision has been made; o Organize meeting(s) within 10 days of being contacted by the concerned parties to discuss how to resolve the issue, if not previously conducted; o Recommend the final decision on the mitigation measure to the complainant/aggrieved party; o Implement the agreed mitigation measure; o Update the Grievance Report Form and have it signed by the complainant/aggrieved party; o Sign the Grievance Report Form and log the updated information of the grievance into the Grievance Registry; and o Send copies of relevant documents (e.g. completed Grievance Report Form, mitigation measure, minutes of the meetings, if appropriate) to the concerned parties. The updated SEP shall have details on each Grievance entry point, grievance administration processes, timelines, investigation activities, the 2nd tier appeal process for unresolved grievances before referring to legal recourse and closure conditions. 76 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF 7.5. Handling of GRM related to SEA/SH Even though risk stemming from SEA/SH associated with Project activities and in Serbia is assessed as low, the GRM shall be strengthened with procedures to handle allegations of SEA/SH/Sexual Exploitation and Abuse and Sexual Harassment violation risks. 7.6. World Bank Grievance Redress System Communities and individuals who believe that they are adversely affected by a World Bank (WB) supported project may submit complaints to existing project-level grievance redress mechanisms or the WB‘s Grievance Redress Service (GRS). The GRS ensures that complaints received are promptly reviewed in order to address project-related concerns. Project affected communities and individuals may submit their complaint to the WB‘s independent Inspection Panel which determines whether harm occurred, or could occur, as a result of WB non-compliance with its policies and procedures. Complaints may be submitted at any time after concerns have been brought directly to the World Bank‘s attention, and Bank Management has been given an opportunity to respond. For information on how to submit complaints to the World Bank‘s corporate Grievance Redress Service (GRS), please visit http://www.worldbank.org/en/projects-operations/products-and-services/grievance-redress- service. For information on how to submit complaints to the World Bank Inspection Panel, please visit www.inspectionpanel.org. 77 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF 8. LABOR MANAGEMENT PROCEDURES These Labor Management Procedures (LMP), lay out the approach to meeting the objectives of World Bank ESS 2: Labor and Working Conditions (ESS2) on the Project. It identifies categories of Project workers likely to be hired under the Project, sets out the terms and conditions for employment or engagement of workers on the Project, specifies the requirements and standards to be met and the policies and procedures to be followed, assesses risks and proposes the mechanisms for compliance measures implementation. The LMP is developed to help avoid, mitigate and manage risks and impacts in relation to project workers and set out the way in which project workers will be managed, in accordance with the requirements of the national law and the ESS2. This LMP applies to all Project workers hired under the Project as defined by ESS2. The term ―project worker‖ in the context of the Project, refers to: (a) people employed or engaged directly by the Borrower (including the project proponent and the project implementing agencies) to work specifically in relation to the project (direct workers); people employed or engaged through third parties 31 to perform work related to core functions4 of the project, regardless of location (contracted workers) The focus of the LMP is on workers engaged directly by the Ministry of Health ( MOH), the Project Coordination Unit (PCU) to specifically perform project related tasks. These workers are defined as Direct workers. The LMP also addresses labor risks of Workers engaged or employed by third parties i.e. contractors, sub-contractors and service and good providers are defined as Contracted workers to which these procedures apply. Community workers will not be engaged as the nature of the project excludes engagement of the community labor. The Serbian legal framework guiding Labor and Working Conditions, including OHS, is, except for a few minor gaps, fully aligned with the standards set out in ESS2 as Serbia is signatory to the International Labor Organization (ILO) and United Nations (UN) Conventions informing the ESS2.32 Serbia has ratified more than 70 ILO Conventions including the 8 Core Conventions. Where the national legal framework falls short in compliance, measures to bridging the gaps will be implemented as outlined below. 8.1. Overview of labor use on the project It is expected that the Project supporting COVID-19 response activities will require the following categories of project workers as defined by ESS2 to be engaged:  Direct workers o Personell hired by the Project Coordination Unit (PCU) i.e. External consultants in the area of monitoring, evaluation, Roma outreach specialist, implementation of environmental and social standards.  Contracted workers o Medical workers in health care facilities (HCF) and laboratories (i.e. doctors, nurses, , laboratory workers, clinical trainees). o Non-medical workers in health care facilities (e.g. facility and maintenance staff engaged in food preparation, delivery, technical maintenance, waste management). o Workers engaged by firms (contractors) to: a) carry out small interior refurbishments and rehabilitation works within existing HCFs and establish mobile facilities to respond to the increasing demand for hospital beds created by COVID-19 (construction workers) and b) 31 ‗Third parties‘ may include contractors, subcontractors, brokers, agents or intermediaries. 32 These include: ILO Convention 87 on Freedom of Association and Protection of the Right to Organize, ILO Convention 98 on the Right to Organize and Collective Bargaining , ILO Convention 29 on Forced Labor ,ILO Convention 105 on the Abolition of Forced Labor 2 Guidance Note – ESS2: Labor and Working Conditions • ILO Convention 138 on Minimum Age (of Employment) • ILO Convention 182 on the Worst Forms of Child Labor • ILO Convention 100 on Equal Remuneration • ILO Convention 111 on Discrimination (Employment and Occupation 78 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF of expertise for development and training of front-line responders, capacity building and training (including for mass-media), development of communication strategies, community outreach and support to the project implementation and monitoring provide trainings, develop communication and education materials on COVID-19 (specialized consultants). Health care facility workers: Health workers are at the front line of the COVID-19 outbreak response and as such are exposed to hazards that put them at risk of infection. Hazards include pathogen exposure, long working hours, psychological distress, fatigue, occupational burnout, stigma, and physical and psychological violence. These are persons serving in healthcare settings, both medical and non-medical staff, who have the potential for direct or indirect exposure to patients or their infectious secretions and materials. Health care workers carry out a range of activities, for example: assessing, triaging and treating COVID-19 patients; establishing public health reporting procedures of suspected and confirmed cases; and providing or reinforcing accurate infection prevention and control. This refers to medical staff working regularly in HCFs and on temporary basis in potential mobile facilities. The non-medical staff in HCF is involved in activities such as food supply, medical and non-medical waste treatment, equipment and facility maintenance. While HCF workers employed in hospitals and laboratories do not strictly fall under the ESS2 definition of project workers, due to occupational health and safety risks to which they can be exposed during the COVID-19 pandemic, they have been included in this LMP to ensure that they are provided with adequate health and safety measures in the workplace. In addition to the LMP the WHO Interim Guidance dated March 19, 2020 Coronavirus disease (COVID-19) outbreak: rights, roles and responsibilities of health workers, including key considerations for occupational safety and health, shall be observed. Where civil servants are working in connection with the project, they remain subject to the national legislation regulating the status, rights and duties of employees in the public sector and their employment relationship will remain subject to the terms and conditions of their existing public sector employment agreements or arrangements with the exception of requirements in the area of protecting the workforce and Occupational Health and Safety (OHS) and prohibition of child and forced labor shall apply to civil servants engaged in the project. Until and unless a legal transfer (conducted in accordance with all legal requirements) of their employment or engagement is made such that they are direct project workers, during the life of the Project, their status remains unchanged as civil servants. Such transfer will be conducted in accordance with all legal requirements and transferred workers will be subject to all requirements of this LMP. In absence of a legal transfer to Civil Servants provisions of chapters 8.11 (Protecting the Work Force) and (Occupational Health and Safety) will apply. 8.2. Timing of labor requirements: Direct workers will be continuously engaged i.e. from the beginning of the project implementation and their engagement is expected to last until project closure (24 months in total). With regard to consultants/technical service providers it is anticipated that they will be engaged during the first 6 to 12 months of implementation for approximately 6 months. Contracted workers: o Health care facility workers: All healthcare facility workers are existing workers and the project will neither fund the hiring of additional HCF workers nor cover overtime work of existing workers. o Construction workers: Since minor refurbishment of healthcare facilities and establishment of mobile medical facilities is a priority for treatment of COVID-19 patients, it can be estimated that this category of workers will be engaged during the first year of the project implementation once the procurement activities are completed. 8.3. Number of Project Workers and civil servants Provided that the majority of project workers are existing healthcare facility workers, the extent of mobilization of additional workforce for the project will be limited to consultants and construction workers. The total labor use on the project when taking into account existing civil servants (Ministry staff) and existing HCF workers will be about moderately high. The table below provides data on project 79 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF workers on the basis of preliminary assessment at the time of LMP preparation. The numbers will be updated by the Borrower (PCU) once more precise data becomes known (3-6 months into project implementation). Table 8.1: Overview of indicative labor use Number of Type of workers Type of tasks Necessary skills Location project workers Civil servants Civil servants 6 -10 Office and Essential managerial Belgrade administrative tasks skills Direct workers External consultants 3 Environmental, Social Knowledge in the area Belgrade for PCU and Roma outreach of EHSS and Specialist Communication skills Contracted workers Health care N/A General medicine and Medical expertise, Belgrade, Novi facility/laboratory (to be updated) wide variety of healthcare system Sad, Nis, workers in health specialism knowledge, time Kragujevac and care facilities Diagnosis, patient management and several other (medical staff) care and treatment & organization, cities in Serbia laboratory work communication Health care N/A Belgrade, Novi facility/laboratory (to be updated) Sad, Nis, (non-medical staff) Kragujevac and several other cities in Serbia Construction workers 30 Installing new Plumbing, painting, Countrywide flooring, wall renovation, electrical, construction or refurbishment and reallocation, rehabilitation skills installation of door closures, door and frame installation, electrical and lighting work, plumbing work, painting 8.4. Characteristics of Project Workers Direct workers: will have managerial, coordination and administrative roles and be located at the Ministry‘s head office in Belgrade. These are highly skilled and specialized technical workers. It is expected that these workers will be almost exclusively be from Serbia and over the age of 18. Health care facility workers: Skills levels and expertise will vary and depend on their respective tasks and scope of responsibilities. Majority of medical staff are female. Therefore, it is expected that the number of female workers will be at least 50 percent. The non-medical staff are skilled and semi-skilled workers who will be local workers. Taking into consideration the nature of their work it is expected that the majority of these workers are females (in the region of 60 percent). HCF workers with COVID-19 exposure work in major hospitals located in towns/cities in Serbia. Construction workers: Given the nature of anticipated work of this category of workers (small refurbishments and rehabilitation) it is expected that these are mostly local unskilled and semiskilled male workers. 80 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF 8.5. Assessment of key potential labor risks Project activities The project will support health care delivery and health system strengthening as part of COVID-19 pandemic response, more specifically:  Assessment and triage of patients;  Treatment of COVID-19 patients;  Collection and testing of appropriate specimens (upper and/or lower respiratory specimens) from patients;  Collection of additional clinical specimens;  Improvement of public health reporting procedures of suspect and confirmed cases;  Treatment of medical waste and non-medical waste (items used by COVID-19 patients that are not medical waste);  Facility maintenance;  Procurement of PPE according to WHO guidelines;  Performance of laboratory tests and preparation specimens;  Assembly, disassembly and maintenance of laboratory equipment;  Development and implementation of trainings for health care workers on identifying and treating COVID-19;  Development of communication materials on COVID-19, guidelines and training modules of healthcare professionals, conducting of workshops and symposia on COVID-19  Minor refurbishment works, on existing facilities, with prevalently indoors activities It is assessed that key labor risks under the project would be associated with OHS, labor and working conditions in healthcare facilities, including the probable risk of exposure to the COVID-19 virus. This section summarizes key labor and occupational health and safety (OHS) risks expected during project implementation for each category of workers. Direct workers It is anticipated that direct workers would primarily perform office tasks, in addition to occasional attendance at public events and field visits to health care facilities. Therefore, risks upon the health and safety of these workers are generally estimated to be small with potential minor exposure to COVID-19 during public events and field visits. Their knowledge about COVID-19 risk-reducing practices (social distancing, use of PPE and hygiene) is expected to be higher than among the general public. Risks such as irregular wage payment, withholding rights to leave, informal work or labor of minors is not expected. Contracted workers Health care facility workers (medical staff): The expected risks are: exposure to the to the coronavirus (SARS-CoV2) and disease caused by coronavirus infection with potential for grave outcomes including severe illness and death, physical and mental exhaustion, long shifts with little or no break and deprivation of sleep, occupational burnout, passing on infection to families and local communities and stigma, and exposure to infectious waste. As of November 28, 2020, in a total of 2.434 health worker have contracted the virus. The Project is assessed as having low risk of sexual exploitation and abuse (SEA)/sexual harassment (SH) towards based on records of such incidents, media reports and perceptions among female healthcare workers interviewed during LMP preparation. Due to issues of SEA/SH underreporting, mitigation measures appropriate for a low risk SEA/SH scenario have been proposed in the section 8.8 (Responsible staff). The project will mitigate the risk of SEA by applying the WHO Code of Ethics and Professional Conduct at all beneficiary healthcare and quarantine facilities The GRM will be strengthened as defined in section 7.5. Healthcare facility workers (non-medical staff): It is expected that this category of workers will be exposed to labor and OHS hazards due to COVID-19 exposure, but not all non-medical staff will be exposed to the same risk levels. 81 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF LMP will be reviewed and updated throughout development and implementation of the Project, data about the number of healthcare worker causalities shall be entered subsequently by the Borrower. Contracted workers – for performing minor civil works: It is expected that this category of workers might experience exposure to COVID-19 infected persons at the hospital where they will be conducting rehabilitation works in addition to typical OHS risks for construction workers. These include:  exposure to chemicals (such as paints, solvents, refrigerant oil for transformers and switches, lubricants and fuels);  electrocutions and arc fault burns;  exposure to construction airborne agents (dust, silica and asbestos);  ergonomic hazards during construction;  use of ladder, incorrectly erected equipment, slip, trips and falls;  breach of labor rights (informal labor, irregular pay, etc.);  suitable PPE not provided by employer;  non usage of PPE by construction workers. 8.6. Brief Overview of Labor Legislation: Terms and Conditions This section sets out the key aspects of national labor legislation with regards to terms and conditions of work, and how national legislation applies to different categories of workers identified in Section 8.1. The overview focuses on legislation which relates to the items set out in ESS2, paragraph 11 (i.e. wages, deductions and benefits). Various laws, policies and code of practices are applicable to the implementation of this LMP. These laws and policies are aligned with the international standards, namely ILO Conventions and EU Directives, as the terms, conditions and instruments proposed in the international conventions and directives are incorporated into the national labor legislation. The Constitution of the Republic of Serbia (2006) guarantees the right to work, free choice of occupation, availability of work positions under equal conditions, respect of person‘s dignity at work, safe and healthy working conditions, necessary protection at work, limited working hours, daily and weekly interval for rest, paid annual holiday, fair remuneration for work done and legal protection in case of termination of working relations. The Labor Law (LL) (passed in 2005 as amended in 2018)33 is the main legislation that guides labor practices in Serbia. The terms and conditions provided by this Law includes ban to direct or indirect discrimination regarding employment conditions and choice of candidates for performing a specific job, conditions of labor and all the rights deriving from the employment relationship, education, vocational training and specialization, job promotion and cancelling an employment contract for reasons of sex, birth, language, race, color of the skin, age, pregnancy, health condition, and/or disability, ethnic origin, religion, marital status, family obligations, sexual orientation, political or other belief, social background, financial status, membership in political organizations, trade unions, or any other personal characteristic. The above legislation applies to all who work or provide services in Serbia, patriates or expatriates34 workers or employers. Although it is mostly congruent with the ESS 2 requirements, certain gaps do exist. Wherever such gaps appear, the LMP provide guidelines to be followed in order to ensure compliance with the ESS2 on the condition that such guidelines do not infringe any local regulations. 33 https://www.paragraf.rs/propisi/zakon_o_radu.html (Serbian version) https://www.paragraf.rs/propisi/employment-act-republic-serbiahtml (English version) 34 The term used in this context refers to professionals, skilled workers, or artists taking positions outside their home country, independently or being sent abroad by their employers, i.e. companies, universities, governments, or non-governmental organization. 82 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF Provision of information and forms of employment contracts The employment relationship is established by an employment contract concluded between an employee and an employer. The contract is executed in at least three copies, one of which is handed to the employee (LL - Article 30). An employment contract may be concluded either for an indefinite (open-ended) or definite (fixed-term) period of time (LL - Article 31). The contract is concluded in writing before the employee starts to work. Should an employer fail to conclude the employment contract with an employee, it is deemed that the employee has established the employment relationship for an indefinite period, as of the day he started working (LL - Article 32). An employment contracts constituting elements are: the name and address of the employer, name and address of the employee, employee‘s qualifications, position and job description, place of work, type of employment relationship (open-ended or fixed term), duration of the fixed term contract and grounds for establishing employment relation for a definite period of time, date of commencement of work, working hours (full time, part time, reduced time in case of extremely physically demanding or health hazard work), the base salary on the date of contract signing, elements for determining the base salary and work performance, salary compensation, allowances to salary and other earnings of the employee, deadlines for payment of salaries and other earnings to which the employee is entitled, and duration of daily and weekly working hours. (LL- Article 33). If employment contracts are agreed for a fixed -term one or more consecutive employment contracts may be concluded for a period that with or without interruptions must not exceed 24 months. There are exceptions however to this rule e.g. replacement of a temporarily absent employee - until his/her return; employment of a foreign citizen – up to the expiry of the work permit; work with a newly established employer – up to 36 months, employment of an unemployed person who lacks up to five years to fulfill of one of the preconditions for retirement. (LL- Article 37). Temporary and seasonal work, service supply contract and supplementary work are forms of work without established employment relationship. The persons hired in this manner do not enjoy the rights of employees. However, a contract or agreement between the two parties may provide for some rights typically arising from the employment relationship. Temporary and seasonal work have a maximum limitation to 120 days per year. The contract is made in writing, with an unemployed person, a part time employee to the prescribed full time or a pensioner. (LL Article 197). Wages and deductions An employee is entitled to an appropriate salary determined in conformity with the law, bylaw and employment contract. Employees are guaranteed an equal salary for the same work or the work of the equal value. The work of the equal value is the work which requires the same level of qualifications, i.e. education, knowledge and skill, and which implies the same responsibilities and results in an equal contribution to the employer‘s business success. (LL Article 104). The timing of payment of wages and remunerations is stipulated in the employment contract. The law prohibits any deductions apart from those imposed by court or consented by the employee and specifies insurance contributions paid from the gross salary. The employer calculates and pays the contributions together with salaries/wages. An employee is entitled to a minimum salary for standard performance and the time spent at work. The minimum salary is determined on the basis of the minimum wage rate, the time spent at work and the taxes and contributions paid from the salary. A bylaw or the employment contract stipulates the reasons for rendering a decision on paying the minimum salary. (LL Article 111) The minimum wage rate is determined by a decision of the Social and Economic Council of the Republic of Serbia and is determined per a working hour without taxes and contributions, for the calendar year, not later than 15 September of the current year, and is applicable from 1 January next year. (LL Article 112) Working hours 83 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF Full-time working hours amount to 40 hours a week. A bylaw may institute shorter full-time working hours than 40 hours a week, but not shorter than 36 hours a week. (LL - Article 51) The Employer may reschedule working hours in order to support business activities, ensure the effective use of working time and the execution of specific work within the deadlines. Nevertheless, the total working hours of an employee in the period of six months during the course of a calendar year must not exceed in average the contracted working hours of the employee. In any case of rescheduling of the working hours, the employee must not work longer than 60 hours a week. The rescheduling of working hours is not considered overtime work (LL Article 57 and 58). Overtime Overtime is limited to eight hours a week. Employees are not to work longer than 12 hours a day, including the overtime. (LL Article 53) Rest period Any employee is entitled to: (i) rest in the course of a working day with a minimum duration of 30 minutes. The rest period is calculated into working hours. (LL Article 64) (ii) rest between two working days of minimum of 12 consecutive hours within 24 hours. In the rescheduled working hour‘s scheme, the rest cannot be shorter than 11 consecutive hours within 24 hours. (LL Article 66); (iii) weekly rest for a minimum of 24 consecutive hours plus 12 hours (within 24 hours). The weekly rest is normally on Sunday. However, an employer may determine another day for using the weekly rest, should the nature or organization of work so require. The weekly rest of an employee who, because of working in different shifts or in rescheduled working hours, is unable to use the rest as specified above, cannot last less than 24 consecutive hours. If it is indispensable that an employee works on the day of his weekly rest, the employer must allow him/her to take a rest of at least 24 consecutive hours in course of the subsequent week. (LL Article 67). Annual leave Employees are entitled to annual leave. The right to annual leave in a calendar year is granted after a month of continuous employment from the day the employment relationship with the employer has become effective. Continuous employment‘ also includes periods of temporary inability for work, pursuant to health-care regulations, and any absence from work with compensation of salary. Neither waiver by the employee nor denial of this right by the employer is allowed even against substitution with pecuniary compensation, except in case of termination of the employment relationship. (LL Article 68). For each calendar year a minimum of 20 work days is set, which can be increased based on performance results, working conditions, work experience, qualifications and other criteria defined in the employment contractor bylaws (LL Article 69). The employer decides about the time of use of annual leave, with prior consultation with the employee. (LL Article 75). In the termination events unused days of annual leave are pecuniary compensated, in the amount of the average salary in the previous 12 months, proportionate to the number of unused annual leave days. (LL Article 76). Employees are entitled to paid leave in an aggregate duration of five workdays in course of a calendar year, in events such as conceiving marriage, spouse's childbirth, serious illness of a member of immediate family, and in other cases determined by a bylaw or employment contract. Additional five workdays are allowed due to death of an immediate family member and two consecutive days for every instance of voluntary blood donation, counting also the day of donating blood. Members of the immediate family include a spouse, children, brothers, sisters, parents, adoptive parent, adoptee and a legal guardian. The bylaw and the employment contract may provide for longer paid leaves and a wider circle of persons. (LL Article 77). Maternity leave Any employed woman is entitled to absence from work due to pregnancy and child birth ( maternity leave), as well as to a leave for nursing a child, in the total duration of 365 days. The maternity leave commences, on the ground of the opinion of a competent health agency, 45 days at the earliest, but imperatively 28 days prior to the time set for childbirth. The maternity expires with the third month after the childbirth. After the expiry of maternity leave, child nurse leave commences, which expires after 365 days from the commencement day of the maternity leave. The father of a child may as well exercise the right to parental leave lasting three months in cases the mother abandons the child, dies, or is prevented 84 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF due to other justified reasons to exercise that right (serving a prison term, serious illness and the like) and child nursing leave. During maternity leave and leave for nursing a child, compensation of salary is paid in conformity with the law. (LL Article 94) Written Notice and payments on termination Prior to termination of an employment contract in the case of violation of work duties or non-compliance with work discipline, the Employer must warn the employee in writing of the existence of a cause for cancelling the employment contract and to leave him a period of not less than eight days from the day of serving the warning to take a stand on the allegations stated in the warning. An employment contract is cancelled by a decree in writing and is served on the employee in person, in employer's premises, or employee's permanent or temporary residence. Employment relationship of the employee ceases as of the day of serving of the decree, unless another time limit is determined by the decree. (LL Article 185). In cases of termination, other than in retrenchment cases, the employer pays to the employee all unpaid salary, compensation of salary and other earnings due on the day of termination of the employment relationship on or before 30 days, after termination of employment relationship. (LL Article 186). In cases of retrenchment all payment due are to be paid prior to termination date. The employer may terminate the employment contract of an underperforming employee or an employee who does not have the necessary knowledge and skills to perform his duties, or impose some of the measures foreseen for violation of work duties or non-compliance with work discipline, if he has previously given a written notice regarding the deficiencies in employee‘s work, provided guidance and stated appropriate deadline for the employee to enhance work performance, but the employee fails to improve his/her performance within the given deadline. (LL Article 180a) The employee may terminate the employment contract with a prior written notice of 15 calendar days (notice period). A bylaw or employment contract may determine a longer notice period, but not longer than 30 days. (LL Article 178) Labor disputes The Law on Peaceful Settlement of Labor Disputes (2014 as amended in 2018) regulates the method and procedures of settlement of collective and individual labor disputes. A dispute can be initiated on a voluntary basis in relation to the collective agreement, strike, termination of employment contract, working hours, annual leave, disbursement of salary, compensation of costs, discrimination and abuse at work, etc. The labor and employment legislation does not foresee grievance mechanisms as mandatory practice, but provides for judicial protection of employees in case of unfair or unlawful employment relationship practices instead. However, the legislation relating to prevention of discrimination, sexual harassment and abuse at work and combating corruption is much more specific, laying out clear procedures to be followed in any case of discriminatory actions, unjust treatment or concerns over non- compliance with the law. Minimum age of employment The minimum employment age is 15 years. Persons under the age of 18 can enter into an employment agreement with the consent of their legal representative or custodian, given it does not harm them in any way and does not hold minors from acquisition of education. Full working hours of an employee younger than 18 years of age may neither be determined in duration longer than 35 hours a week, nor longer than eight hours a day. (LL Article 87). Overtime work and rescheduling of working hours of an employee under the age of 18 is prohibited. Forced labor The Constitution prohibits forced labor. In addition, Serbia ratified the ILO Forced Labor Convention and the Abolition of Forced Labor Convention both of them currently in force. The Criminal Code of Serbia lists different categories of trafficking as criminal offences and sets punishment ranging from a minimum of 10 years of imprisonment depending on specifics and circumstances of the offence in particular if it involves underaged persons. In summary, there are only a few areas where national legislation is either partially aligned with ESS2, or the implementation modality is not well defined. There are no clear requirements regarding consultation 85 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF with employees on OHS matters and the legislation fails to institute OHS review and evaluation mechanisms and limits to keeping records instead. Covid-19 considerations: In order to minimize exposure to COVID-19, employers of both direct and contracted workers may use the instruments provided for in the LL. The LL foresees performing activities outside the employer's premises (i.e. remote work and work from home) while guaranteeing the employee the same terms and conditions of employment (namely base salary, working hours, rests and leaves). The employment contract has to specify the manner of supervision, work equipment to be used and possible compensation if the employee uses their own equipment. In exceptional circumstances (such as pandemic), the authorities suggest issuing a decision allowing employees to work from home as well as rescheduling working hours and working in shifts. The following issues are identified as a gap with ESS2: Labor and Working Conditions requirements The labor legislation pertinent to categories of project workers is directly applicable. Employers are not required to prepare labor management procedures but key elements can be found in collective bargaining agreements (norm) and employer specific employment rulebooks (in absence of bargaining agreements). The law allows that termination payments and other statutory benefits are paid to the workers within 30 days for termination, while the ESS2 requires these payments to be made before the termination of employment. 8.7. Brief Overview of Labor Legislation: Occupational Health and Safety (OHS) This section sets out the key aspects of the national labor legislation with regards to occupational health and safety, and how national legislation applies to the different categories of workers identified in Section 8.1. The overview focuses on legislation which relates to the items set out in ESS2, paragraphs 24 to 30. The Constitution of Serbia establishes a fundamental right to safe working conditions (2006). The Law on Safety and Health at Work (LSHW, 2005, 2015, 2017)35 is the key legislative act in this area defines general principles of basic requirements and preventive measures that are related to occupational health and safety (OHS) at the workplace, the existing and anticipated risks, prevention of accidents and occupational diseases, training, informing, and consulting of the employees, and their equal engagement in the occupational health and safety protection issues. The LSHW is applicable to all domestic and foreign employers regardless of their size and to all domestic and foreign employees regardless of their employment status36. The law has been harmonized with the ratified ILO Conventions and the EU Directives and complies with WB ESS2 to a large extent. Wherever certain gaps between the Serbian legislation and ESS2 appear, the gap filling measures provided in this LMP will apply. Responsibilities of the Employer The Law stipulates the obligations and responsibilities of the employer in relation to ensuring safety and health at work (general obligations, special obligations and training for employees) and assessing and mitigating labor-related risks and hazards, provides for appointment of persons (licensed OHS officers or legal entities) responsible for ensuring labor compliance and creating a safe working environment, and determines preventive measures for ensuring occupational safety and health. It also regulates the rights and obligations of employees, the way of organizing the task of occupational safety and health, provision of the first aid at the workplace, the possibility of selecting representatives among the employees for occupational safety and health, obligations of the employer related to keeping records, information exchange and cooperation with relevant institutions, the issue of the professional exam and licensing, the competence of the Occupational Safety and Health Administration. The provisions of the LSHW are 35 https://www.paragraf.rs/propisi/zakon_o_bezbednosti_i_zdravlju_na_radu.html 36 The term „employee “is defined as any domestic or foreign natural person who is employed by an employer, works on any basis for an employer or trains for work for an employer. 86 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF further elaborated in numerous by-laws37, for the purpose of regulating the specific implementation procedures. Reporting on accidents, fatalities, injuries The employer is responsible to record accidents, instances of professional diseases and dangerous accidents and provides the report to the employee and the social security service. During the first 24 hours from the accident, the employer should notify the relevant authorities law enforcement bodies (police) and Labor Inspectorate in case of fatal, mass or individual serious injury, due to which the employee is unable to work for three consecutive working days, as well as any dangerous event that may put health and safety of the employees at risk. The employer also has the responsibility to keep a log of accidents and occupational diseases at workplaces. Provision of workers’ insurance in instances of injuries, fatalities disability and disease Insurance. An employee is entitled to compensation of salary for the time of absence from work due to temporary inability to work lasting up to 30 days in the amount of 100% of the average salary in the 12 preceding months before the month in which temporary inability occurred, on condition that it may not be lower than the minimum salary, if the temporary inability was caused by an injury sustained at work or by occupational disease. (LL Article 115). Remedies take into account wage level while the court may consider other socio-economic features. An employer is obliged to pay to an employee compensation for damage sustained due to an injury at work or occupational disease as determined by the court or the insurance company. Preventive and protective measures The Rulebook on identification and assessment of workplace and working environment risks RIAWWER (article 8 and 9) distinguishes between identification and assessment of threats and hazards. It classifies threats into: mechanical, electrical and workplace related. Hazards are classified into: (a) occurring during work processes ( e.g. chemical, physical, biological, indoor and outdoor climate, illumination, radiation, hazardous materials, etc.), (b) physical and psychological stress and strain attributable to work performed, (c) work schedule and organization of work processes (e.g. long working hours, shifts, night work etc.) and (d) other hazards such as third party workplace violence, work with animals, high or low atmosphere pressure work in or under water surface etc. the framework for modification, substitution, or elimination of hazardous conditions or substances based on workplace risk assessment and results thereof. OHS risks which may be specific to female workers A female employee in course of pregnancy and a female employee who is breastfeeding a child may not work at jobs that may be harmful to her health or her child‘s health. She may not work overtime or night shift. (LL Article 89 and 90) Right and responsibility to report unsafe situation, right to leave the workplace and prohibition of retaliation for reporting An employee is obliged to notify the employer of every kind of potential danger that could affect the safety and health at work. (LL Article 80) and has the right to refuse to perform task of instruction in contradiction with the law, or which due to breach of occupational safety and health regulations may trigger risk for employees. Employees are entitled to leave the workplace in the event of danger. Collaboration and consultations with project workers on OHS OHS representatives and OHS boards and provides for employees and their representative to give suggestions and information, initiate measures and demand inspection, there is no clear requirements regarding consultation with employees on OHS matters. In the event that employees of several workplaces work together, each employer involved in this work process is to cooperate with other employers with regards to compliance with occupational health and safety regulations as well as hygiene 37 There are 8 legal acts and 55 rulebooks related to the area of occupational health and safety. 87 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF norms. The employers should also ensure the coordination of their activities according to the specifics of the work, with regards to the occupational health and safety risk prevention. Employers should also exchange and share relevant information regarding health and safety and professional risks. And finally, it should be ensured that employees and representatives of employees are duly informed of relevant issues. Facilities for workers The law is silent on accommodation requirements. The provision of accommodation for employees is seen to be outside the scope of OHS legislation. However, some elements can be found in collective agreements and the Rulebook on Preventive Measures for Healthy and Safe Work at Workplace to prevent the occurrence and spread of the infectious disease epidemic (―Official Gazette of RoS‖ no. 94/20) and Rulebook on preventive measures for safe and healthy work on workplace (―Official Gazette of RoS‖ no. 21/09 and 1/19) – List of health and safety measures at the workplace. System for regular OHS review Under a general requirement set out by Labor Safety Law, the employer has an obligation to ensure health and safety at workplace. As part of this obligation, employer needs to abide by the requirements set out by the law, make sure that employees‘ health and safety is not exposed to risks of negative impact. The law requires the employer to regularly carry out control of safety condition of technical equipment as well as maintenance and cleaning of the individual protection gear, proper use and if needed timely replacement of it. In addition, the employer should be carrying out measurement and evaluation of such factors in the work environment. The law requires employers to document occupational hazards and report on accidents. While the LHSW addresses the main ESS2 requirements related to occupational health and safety, the coverage of certain requirements is partial. The law is applicable to all economic sectors, although specific needs of specific workplaces, activities and industries are addressed separately. The law does not require employers to engage in consultation concerning OHS. Provision of appropriate facilities and accommodation is considered outside the scope of OHS and is only partially addressed in OHS related legislation. COVID-19 considerations: The Ministry of Labor, Employment, Veterans and Social Affairs (MLEVSA) has recently issued the Rulebook on Preventive Measures for Safe and Healthy Work and Control and Prevention of Epidemic38. The Rulebook specifies the obligations of both employers and employees and lists the activities that must be carried out to prevent epidemic from spreading and ensure safe and healthy work environment. In addition, employers must prepare the plan for implementation of measures for prevention and control of epidemic, which has to be part of the act of assessment of the risks at workplaces. An example of this plan can be downloaded from the site of the MLEVSA.39 This LMP, as well as labor provisions of other Environmental and Social Assessment (ESIA, ESMP or ESMP Checklist) reinforce the commitment of all the participants in the Project to comply with prescribed obligations and implement all the required measures. 8.8. Responsible staff The MOH shall rely on its existing structure and the Project Coordination Unit (PCU) established to implement the World Bank supported Second Serbia Health Project SSHP (P129539) which shall assume the responsibility for project implementation. The Health Insurance Fund (HIF) and the national and regional Institutes of Public Health will contribute to planning, executing, and monitoring activities that are within their scope of work. The Project Coordination Unit housed under the MOH, already established to manage the Second Serbia Health Project (SSHP), with support of the Social Specialist to be hired, shall be responsible for overall supervision and coordination for project implementation, as well as for monitoring and reporting on the project‘s labor issues in line with these Labor Management Procedures. 38 https://www.minrzs.gov.rs/sites/default/files/2020-07/94-20%20PRAVILNIK%20ZARAZNE%20BOLESTI-converted.pdf 39 https://www.minrzs.gov.rs/sites/default/files/2020-07/plan%20primene%20mera%20%281%29.pdf 88 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF The PCU will be responsible for the following tasks relevant to labor and working conditions of project workers:  Implement this LMP and apply its‘ policies and procedures to project workers;  Ensure that HCFs and contractors responsible for construction workers and technical consultants are compliant with this LMP;  Monitor that the contractors are meeting obligations towards contracted and sub-contracted workers as included in the General Conditions of the World Bank Standard Bidding Documents, and in line with ESS2 and labor laws;  Maintain records of recruitment and employment process of direct workers;  Monitor that occupational health and safety standards are met at workplaces in line with national occupational health and safety legislation, ESS2 OHS requirements and WHO and WB guidelines on COVID-19 prevention (e.g. disinfection, providing PPE and hand sanitizing products, etc.);  Monitor training of the project workers on OHS, SEA/SH prevention, and any other required trainings, as well as required qualifications of trainers;  Ensure that the grievance mechanism for project workers is established, monitor and report on its implementation;  Monitor implementation of the workers Code of Conduct;  Establish and implement a procedure for documenting specific incidents such as project-related occupational injuries, illnesses, and lost time accidents. Maintains such records and requires all third parties to maintain them. Such records will form an input into the regular review of OHS performance and working conditions;  In instances of medium, severe, fatal and mass accidents, inform the law enforcement bodies and Labor Inspectorates, and the World Bank;  Update these Procedures when necessary in the course of preparation, development and implementation of the project, as well as in case the domestic legislation changes in any aspects of importance for the LMP. The contractors including health care facility management will be responsible for:  Ensure compliance of their policies and procedures with legislation on labor and OHS;  Communicate job description and employment conditions to contracted workers;  Provide appropriate forms of personal protective equipment (PPE) for medical and non-medical staff in line with WHO recommendations and WB EHS Guidelines for Healthcare Facilities;  Provide appropriate PPE to contractors and ensure use of it;  Controlling entry and exit from construction site or workplace;  Carry out health checks of workers to prevent COVID-19, including pre-employment health checks;  Managing work shifts according to legally defined maximum shift duration and rest times, including between shifts;  Deliver regular training to medical and non-medical HCF staff on the latest WHO recommendations on the specifics of COVID-19, including medical waste management;  Raise awareness and ensure that all workers (medical and non-medical staff) participate in trainings in mitigating the spread of COVID-19;  Deliver regular work induction trainings including but not limited to OHS, HSE, SEA/SH prevention training to employees;  Monitoring the implementation of workers code of conduct;  Introduce posters which describe respectful behavior and Code of Ethics at healthcare facilities addressing both patients and HCF staff. Posters shall include address, or E-mail address or adequate Project web site link for reporting SH/SEA incidents in line with the guidance provided in the World Bank ―Technical Note on SEA/H for HNP COVID Response Operations‖ (March, 2020);  Reduce medical staff exposure to COVID-19 by putting in place, as appropriate, tele-medicine appointments and live stream of instructions; 89 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF  Establish and implement a procedure for documenting specific incidents such as project-related occupational injuries, illnesses, and lost time accidents.  In instances of medium, severe, fatal and mass accidents, inform the law enforcement bodies and Labor Inspectorate;  Monitor, supervise, and report on health and safety issues relating to COVID-19 (COVID-19 focal point);  Establish and maintain an easily accessible worker GRM in line with the obligations of this LMP (if a worker GRM is not in placed, contractors shall establish it by the time of contract signing). Contractor and HCF management are responsible for all labor conditions. However, as required by the OHS law, contractors including HCFs shall appoint OHS focal point to perform tasks related to OHS protection at work. 8.9. Policies and Procedure This section outlines main policies and procedures to be followed during project implementation to minimize and prevent labor and OHS risks to project workers. The section provides specific mitigation measures to address labor risks identified in section 8.5 (Assessment of key potential labor risks per type of project worker). For civil servants direct (consultants for PCU) and contracted workers (including HCF workers) the following procedures and measures will be in place to address the identified risks:  workers should have contracts on labor in writing that contain a description of conditions of employment;  workers must be registered for pension and disability insurance, health insurance and insurance in case of unemployment;  workers are entitled to a regular salary, as well as to compensation of salary for periods of absence from work or specific conditions of work (overtime work, work during holidays, etc.)  workers are entitled to rest during working hours, paid sick leave and annual holidays as prescribed under the law;  discrimination must not be present in any aspects of the labor law relationship (employment, compensation, conditions of work and rights resulting from labor relation, education, training and development, notice on termination of labor contract) on the basis of sex, sexual orientation, marital condition, age, disability, pregnancy, language, religion, etc.  compliance with working hours of 40 hours per week, and in case of necessity of overtime work increase of worker‘s salary;  before entering into a labor relation, workers shall be acquainted with the description of tasks, required skills and regulations on safety and health at work;  implementation of measures of protection at work and organization of training for workers in accordance with the guidelines of the Institute of Public Health according to WHO recommendations;  placing posters on hand and respiratory hygiene at the entrance to the workplace and other areas (such as canteens, meeting rooms, etc.);  communicate and promote the message that workers need to stay at home even if they have mild symptoms of COVID-19 (OHS training, messages per e-mail);  provide workers and visitors with easily accessible places where they can wash or disinfect their hands;  provide workers with task-appropriate PPE without costs for workers;  provide beforehand the information on the existing health and safety measures that should be respected during visits to project locations;  consider not to assign senior workers and workers with serious chronic medical conditions (diabetes, heart and lung disease, etc.) to front-line work or as the essential workers; 90 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF  ensure that workers during field visits and events follow procedures on obligatory use of PPE and that they have received training in accordance with WHO guidelines;  organize work in a way to allow for physical distancing of at least 2 m from other people, if possible;  prefer organizing virtual meetings/trainings instead of face-to-face meetings/trainings;  in case of face-to-face meetings/trainings develop a plan: o check the advice from the authorities whether to set up face-to-face meetings/trainings; o beforehand identify a room where a sick person can be isolated in case someone suddenly get sick; o contact cleaners to clean the training and isolation room informing them that rooms have been used for suspected/infected COVID-19 persons; o prepare and provide sufficient disinfectants/hand sanitizer and PPE for participants; o arrange seats are at least two meters apart; o retain the names and contact details of all participant for at least one month, o if someone was during or after the meetings/trainings isolated let other participants know; o if someone has mild symptoms of COVID-19 encourage these workers to stay at home and ensure their participation virtually;  develop a plan if any of workers becomes ill with suspected COVID-19 at workplaces: o identify a room where a sick person with suspected COVID-19 can be isolated until health authority is informed; o without causing stigma and discrimination establish contact tracing (by telephone) at workplaces; o ensure workers who have been in contact with the sick person are informed about it; o in case of an outbreak of COVID-19 at workplaces develop a contingency plan for teleworking;  PCU will inform the Bank within 48 hours about any incident or accident related to the project which has, or is likely to have a significant adverse effect on the environment, the affected communities, the public or workers (labor, health and safety), but no later than three calendar days after the occurrence of the event. Such events can include strikes or other labor protests, serious worker injuries or fatalities, project-caused injuries to community members or property damage. PCU will prepare a report on the event and the corrective action and submit to the Bank within 30 calendar days of the event.  The contractors (including HCFs) will be required to provide the periodic information on the performance in terms of labor, occupational health and safety issues.  HCF will follow the Guideline issued by the Public Health Institute D. Milan Batut40  The contractors (including HCFs) shall report to PCU about any inspection carried out by the labor inspection. The findings will be presented to PCU. 8.10. COVID-19 Prevention Measures To address COVID19 risks at project sites, PIUs and contractors should refer to guidance issued by relevant authorities and international organizations (e.g. WHO). Below are a number of workplace management issues that are especially pertinent in preparing the project response to COVID-19 as outlined in the World Bank ESF/Safeguards Interim Note: COVID-19 Considerations in Construction/Civil Works Projects. Please refer to this note for additional guidance on COVID-19 site prevention procedures relevant to PIUs, HCFs and contractors. Assessing Workforce Characteristics  The contractor should prepare a detailed profile of the project workforce, key work activities, schedule for carrying out such activities, different durations of contracts and rotations (e.g. 4 weeks on, 4 weeks off). 40 http://www.batut.org.rs/download/aktuelno/MerePrevencijeUZdravstvenimUstanovama.pdf 91 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF  Where possible, it should also identify workers that may be more at risk from COVID-19, those with underlying health issues or who may otherwise at risk.  Consideration should be given to ways in which to minimize movement in and out of site. This could include lengthening the term of existing contracts, to avoid workers returning home to affected areas, or returning to site from affected areas.  Workers accommodated on site should be required to minimize contact with people near the site, and in certain cases be prohibited from leaving the site for the duration of their contract, so that contact with local communities is avoided.  Workers from local communities, who return home daily, weekly or monthly, will be more difficult to manage. They should be subject to health checks at entry to the site (as set out above) and at some point, circumstances may make it necessary to require them to either use accommodation on site or not to come to work. a) Entry/Exit to the Worksite and Checks on Commencement of Work Entry/exit to the work site should be controlled and documented for both workers and other parties, including support staff and suppliers. Possible measures may include:  Establishing a system for controlling entry/exit to the site, securing the boundaries of the site, and establishing designating entry/exit points (if they do not already exist). Entry/exit to the site should be documented.  Training security staff on the (enhanced) system that has been put in place for securing the site and controlling entry and exit, the behaviors required of them in enforcing such system and any COVID- 19 specific considerations.  Training staff who will be monitoring entry to the site, providing them with the resources they need to document entry of workers, conducting temperature checks and recording details of any worker that is denied entry.  Confirming that workers are fit for work before they enter the site or start work. While procedures should already be in place for this, special attention should be paid to workers with underlying health issues or who may be otherwise at risk. Consideration should be given to demobilization of staff with underlying health issues.  Checking and recording temperatures of workers and other people entering the site or requiring self- reporting prior to or on entering the site.  Providing daily briefings to workers prior to commencing work, focusing on COVID-19 specific considerations including cough etiquette, hand hygiene and distancing measures, using demonstrations and participatory methods.  During the daily briefings, reminding workers to self-monitor for possible symptoms (fever, cough) and to report to their supervisor or the COVID-19 focal point if they have symptoms or are feeling unwell.  Preventing a worker from an affected area or who has been in contact with an infected person from returning to the site for 14 days or (if that is not possible) isolating such worker for 14 days. Preventing a sick worker from entering the site, referring them to local health facilities if necessary or requiring them to isolate at home for 14 days. b) General Hygiene  Requirements on general hygiene should be communicated and monitored, to include: o Training workers and staff on site on the signs and symptoms of COVID-19, how it is spread, how to protect themselves (including regular handwashing and social distancing) and what to do if they or other people have symptoms (for further information see WHO COVID-19 advice for the public41). o Placing posters and signs around the site, with images and text in local languages. 41 Available: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public 92 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF o Ensuring handwashing facilities supplied with soap, disposable paper towels and closed waste bins exist at key places throughout site, including at entrances/exits to work areas; where there is a toilet, canteen or food distribution, or provision of drinking water; in worker accommodation; at waste stations; at stores; and in common spaces. Where handwashing facilities do not exist or are not adequate, arrangements should be made to set them up. Alcohol based sanitizer (if available, 60-95% alcohol) can also be used. o Review worker accommodations and assess them in light of the requirements set out in IFC/EBRD guidance on Workers‘ Accommodation: processes and standards42, which provides valuable guidance as to good practice for accommodation. o Setting aside part of worker accommodation for precautionary self-quarantine as well as more formal isolation of staff who may be infected (see paragraph (f)). c) Cleaning and Waste Disposal Conduct regular and thorough cleaning of all site facilities, including offices, accommodation, canteens, common spaces. Review cleaning protocols for key construction equipment (particularly if it is being operated by different workers). This should include:  Providing cleaning staff with adequate cleaning equipment, materials and disinfectant.  Review general cleaning systems, training cleaning staff on appropriate cleaning procedures and appropriate frequency in high use or high-risk areas.  Where it is anticipated that cleaners will be required to clean areas that have been or are suspected to have been contaminated with COVID-19, providing them with appropriate PPE: gowns or aprons, gloves, eye protection (masks, goggles or face screens) and boots or closed work shoes. If appropriate PPE is not available, cleaners should be provided with best available alternatives.  Training cleaners in proper hygiene (including handwashing) prior to, during and after conducting cleaning activities; how to safely use PPE (where required); in waste control (including for used PPE and cleaning materials).  Any medical waste produced during the care of ill workers should be collected safely in designated containers or bags and treated and disposed of following relevant requirements (e.g., national, WHO). If incineration of medical wastes is necessary, this should be for as limited a duration as possible. Waste should be reduced and segregated, so that only the smallest amount of waste is incinerated (for further information see WHO interim guidance on water, sanitation and waste management for COVID-1943). d) Adjusting Work Practices Consider changes to work processes and timings to reduce or minimize contact between workers, recognizing that this is likely to impact the project schedule. Such measures could include:  Decreasing the size of work teams.  Limiting the number of workers on site at any one time.  Changing to a 24-hour work rotation.  Adapting or redesigning work processes for specific work activities and tasks to enable social distancing, and training workers on these processes.  Continuing with the usual safety trainings, adding COVID-19 specific considerations. Training should  include proper use of normal PPE. While as of the date of this note, general advice is that construction workers do not require COVID-19 specific PPE, this should be kept under review (for 42 Available: https://www.ifc.org/wps/wcm/connect/60593977-91c6-4140-84d3- 737d0e203475/workers_accomodation.pdf?MOD=AJPERES&CACHEID=ROOTWORKSPACE-60593977-91c6-4140-84d3- 737d0e203475-jqetNIh 43 Available: https://www.who.int/publications/i/item/water-sanitation-hygiene-and-waste-management-for-covid-19 93 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF further information see WHO interim guidance on rational use of personal protective equipment (PPE) for COVID-1944).  Reviewing work methods to reduce use of construction PPE, in case supplies become scarce or the PPE is needed for medical workers or cleaners. This could include, e.g. trying to reduce the need for dust masks by checking that water sprinkling systems are in good working order and are maintained or reducing the speed limit for haul trucks.  Arranging (where possible) for work breaks to be taken in outdoor areas within the site.  Consider changing canteen layouts and phasing mealtimes to allow for social distancing and phasing access to and/or temporarily restricting access to leisure facilities that may exist on site. e) Project Medical Services Consider whether existing project medical services are adequate, taking into account existing infrastructure (size of clinic/medical post, number of beds, isolation facilities), medical staff, equipment and supplies, procedures and training. Where these are not adequate, consider upgrading services where possible, including:  Expanding medical infrastructure and preparing areas where patients can be isolated. Guidance on setting up isolation facilities is set out in WHO interim guidance on considerations for quarantine of individuals in the context of containment for COVID-1945). Isolation facilities should be located away from worker accommodation and ongoing work activities. Where possible, workers should be provided with a single well-ventilated room (open windows and door). Where this is not possible, isolation facilities should allow at least 1 meter between workers in the same room, separating workers with curtains if possible. Sick workers should limit their movements, avoiding common areas and facilities and not be allowed visitors until they have been clear of symptoms for 14 days.  Training medical staff, which should include current WHO advice on COVID-19 and recommendations on the specifics of COVID-19. Where COVID-19 infection is suspected, medical providers on site should follow WHO interim guidance on infection prevention and control during health care when novel Coronavirus46 infection is suspected.  Assessing the current stock of equipment, supplies and medicines on site, and obtaining additional stock, where required and possible. This shall include medical PPE, such as gowns, aprons, medical masks, gloves and eye protection. For further information see WHO interim guidance on rational use of personal protective equipment for COVID-1947).  If PPE items are unavailable due to world-wide shortages, medical staff on the project should agree on alternatives and try to procure them. Alternatives that may commonly be found on constructions sites include dust masks, construction gloves and eye goggles. While these items are not recommended, they should be used as a last resort if no medical PPE is available.  Review existing methods for dealing with medical waste, including systems for storage and disposal (for further information see WHO interim guidance on water, sanitation and waste management for COVID-19 and WHO guidance on safe management of wastes from health-care activities48). f) Instances of Spread of the Virus WHO provides detailed advice on what should be done to treat a person who becomes sick or displays symptoms that could be associated with the COVID-19 virus (for further information see WHO interim guidance on infection prevention and control during health care when novel coronavirus (nCoV) infection is suspected49). The project should set out risk-based procedures to be followed, with differentiated 44 Available: https://apps.who.int/iris/bitstream/handle/10665/331498/WHO-2019-nCoV-IPCPPE_use-2020.2-eng.pdf 45 Available: https://www.who.int/publications/i/item/considerations-for-quarantine-of-individuals-in-the-context-of-containment-for- coronavirus-disease-(covid-19) 46 Available: https://www.who.int/publications/i/item/infection-prevention-and-control-during-health-care-when-novel-coronavirus- (ncov)-infection-is-suspected-20200125 47 Available: https://apps.who.int/iris/bitstream/handle/10665/331498/WHO-2019-nCoV-IPCPPE_use-2020.2-eng.pdf 48 Available: https://www.who.int/water_sanitation_health/publications/wastemanag/en/ 49 Available: https://www.who.int/publications/i/item/infection-prevention-and-control-during-health-care-when-novel-coronavirus- (ncov)-infection-is-suspected-20200125 94 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF approaches based on case severity (mild, moderate, severe, and critical) and risk factors (such as age, hypertension, diabetes) (for further information see WHO interim guidance on operational considerations for case management of COVID-19 in health facility and community50). These may include the following:  If a worker has symptoms of COVID-19 (e.g. fever, dry cough, fatigue) the worker should be removed immediately from work activities and isolated on site.  If testing is available on site, the worker should be tested on site. If a test is not available at site, the worker should be transported to the local health facilities to be tested (if testing is available).  If the test is positive for COVID-19 or no testing is available, the worker should continue to be isolated.  Extensive cleaning procedures with high-alcohol content disinfectant should be undertaken in the area where the worker was present, prior to any further work being undertaken in that area. Tools used by  the worker should be cleaned using disinfectant and PPE disposed of.  Co-workers (i.e. workers with whom the sick worker was in close contact) should be required to stop work, and be required to quarantine themselves for 14 days, even if they have no symptoms.  Family and other close contacts of the worker should be required to quarantine themselves for 14 days, even if they have no symptoms.  If a case of COVID-19 is confirmed in a worker on the site, visitors should be restricted from entering the site and worker groups should be isolated from each other as much as possible.  If worker live at home a has a family member who has a confirmed or suspected case of COVID-19, the worker should quarantine themselves and not be allowed on the project site for 14 days, even if they have no symptoms.  Workers should continue to be paid throughout periods of illness, isolation or quarantine, or if they are required to stop work, in accordance with national law.  Medical care (whether on site or in a local hospital or clinic) required by a worker should be paid for by the employer. g) Continuity of Supplies and Project Activities Where COVID-19 occurs, either in the project site or the community, access to the project site may be restricted, and movement of supplies may be affected.  Identify back-up individuals, in case key people within the project management team (PCU, contractors, sub-contractors) become ill, and communicate who these are so that people are aware of the arrangements that have been put in place.  Document procedures, so that people know what they are, and are not reliant on one person‘s knowledge.  Understand the supply chain for necessary supplies of energy, water, food, medical supplies and cleaning equipment, consider how it could be impacted, and what alternatives are available. Early pro- active review of international, regional and national supply chains, especially for those supplies that are critical for the project, is important (e.g. fuel, food, medical, cleaning and other essential supplies). Planning for a 1-2 month interruption of critical goods may be appropriate for projects in more remote areas.  Place orders for/procure critical supplies. If not available, consider alternatives (where feasible).  Consider existing security arrangements, and whether these will be adequate in the event of interruption to normal project operations.  Consider at what point it may become necessary for the project to significantly reduce activities or to stop work completely, and what should be done to prepare for this, and to re-start work when it becomes possible or feasible. 50 Available: https://apps.who.int/iris/bitstream/handle/10665/331492/WHO-2019-nCoV-HCF_operations-2020.1-eng.pdf 95 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF h) Training and Communication with Workers Workers need to be provided with regular opportunities to understand their situation, and how they can best protect themselves, their families and the community. They should be made aware of the procedures that have been put in place by the project, and their own responsibilities in implementing them.  It is important to be aware that in communities close to the site and amongst workers without access to project management, social media is likely to be a major source of information. This raises the importance of regular information and engagement with workers (e.g. through training, town halls, toolboxes) that emphasizes what management is doing to deal with the risks of COVID-19. Allaying fear is an important aspect of work force peace of mind and business continuity. Workers should be given an opportunity to ask questions, express their concerns, and make suggestions.  Training of workers should be conducted regularly, as discussed in the sections above, providing workers with a clear understanding of how they are expected to behave and carry out their work duties.  Trainings should address issues of discrimination or prejudice if a worker becomes ill and provide an understanding of the trajectory of the virus, where workers return to work.  Training should cover all issues that would normally be required on the work site, including use of safety procedures, use of construction PPE, occupational health and safety issues, and code of conduct, taking into account that work practices may have been adjusted.  Communication should be clear, based on fact and designed to be easily understood by workers, for example by displaying posters on handwashing and social distancing, and what to do if a worker displays symptoms. i) Communication with Workers Relations with the community should be carefully managed, with a focus on measures that are being implemented to safeguard both workers and the community. The community may be concerned about the presence of non-local workers, or the risks posed to the community by local workers presence on the project site. The project should set out risk-based procedures to be followed, which may reflect WHO guidance (for further information see WHO Risk Communication and Community Engagement (RCCE) Action Plan Guidance COVID-19 Preparedness and Response51). The following good practice should be considered:  Communications should be clear, regular, based on fact and designed to be easily understood by community members.  Communications should utilize available means. In most cases, face-to-face meetings with the community or community representatives will not be possible. Other forms of communication should be used; posters, pamphlets, radio, text message, electronic meetings. The means used should take into account the ability of different members of the community to access them, to make sure that communication reaches these groups.  The community should be made aware of procedures put in place at site to address issues related to COVID-19. This should include all measures being implemented to limit or prohibit contact between workers and the community. These need to be communicated clearly, as some measures will have financial implications for the community (e.g. if workers are paying for lodging or using local facilities). The community should be made aware of the procedure for entry/exit to the site, the training being given to workers and the procedure that will be followed by the project if a worker becomes sick. If project representatives, contractors or workers are interacting with the community, they should practice social distancing and follow other COVID-19 guidance issued by relevant authorities, both national and international (e.g. WHO). 8.11. Age of employment 51 Available: https://www.who.int/publications/i/item/risk-communication-and-community-engagement-(rcce)-action-plan-guidance 96 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF Serbia has adopted ILO conventions on child labor and incorporated them in the legal system. The minimum age of employment is 15. An employment relationship may be established with a person under 18 years of age with the consent, in writing, of a parent, adopting parent or guardian, provided that such work does not put at risk his/her health, morality and education, i.e. provided that such work is not prohibited by law. The contractors will be required to verify the identify the age of all workers. This will require workers to provide official documentation to verify age such as a national identification card, passport, driver‘s license, birth certificate, valid medical or school records. A person under 18 years of age must present a medical certificate attesting that he/she is capable of performing the activities related to the specific job, and that such activities do not harm his/her health. If a child under the minimum age is discovered working on the project, measures will be taken to immediately terminate the employment or engagement of the child in a responsible manner, taking into account the best interest of the child. As contractors are expected to employ or engage highly qualified, experienced and competent project workers, it is understood that no one under the age of 18 will be employed or engaged. If any contractor employs or engages a person under the age of 18 years, this will be reported to the authorities (Labor Inspectorate) and measures taken against the contractor in accordance with the Contract for construction works. No other restrictions regarding the age of employment will be imposed. The age of workers will not be used as a criterion in deciding on hiring and promoting project workers or terminating their contracts. The contractors will be required to verify their workers identify and age. This will require workers to provide official documentation, which could include a birth certificate, national identification card, passport, or medical or school record. 8.12. Terms and Conditions The terms and conditions of employment in Serbia are governed by the provisions of the LL, while occupational health and safety is guided by the Law on Health and Safety at Work (LHSW). A project worker may be employed or engaged for work on the project only after negotiating, signing, and receiving a copy of an employment contract or engagement agreement that contains information required by the provisions of the LL. The project worker can be employed on a permanent (open-ended contract) or temporary (fixed-term contract) basis, or can be engaged without establishing the employment relationship on the basis of an agreement.52 In either case, the project worker will be registered in the Central Registry of Compulsory Social Insurance, in accordance with the national legislation of the Republic of Serbia. If the project worker is employed / engaged in his/her domicile country other than Serbia, he/she will be registered in accordance with the national legislation of that country. In case of self-employed project workers, the evidence of registration in the Central Registry of Compulsory Social Insurance or a corresponding foreign body has to be presented. The terms and conditions of employment or engagement of the project worker must meet the inter alia the following standards: The project worker should in advance be clear about the job he/she is going to do and the wage/salary/fee he/she is going to receive. The project worker will be paid on a regular basis, at least once a month, or, if so agreed, upon the completion of specific activities, in accordance with the employment contract or engagement agreement. The project worker will work eight or fewer hours a day, with payment of overtime. Any work longer than eight hours is considered overtime work and the project worker should receive extra payment for the hours of overtime work. In any case, the project worker cannot work more than 12 hours a day. 52 The Serbian Labor Law recognizes two categories of workers: Employees with established employment relations (fixed term and open-ended employment contract) and persons engaged outside employment relations (seasonal works, service contracts, additional work engagement). 97 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF The project worker is entitled to a daily rest of at least 11 hours within 24 hours. The project worker is entitled to a weekly rest of at least 24 consecutive hours. Average weekly hours of work in a six-month period cannot exceed 40 hours. The project worker is entitled to annual, sick, maternity and family leave, as required by the national legislation. Where the national legislation does not stipulate entitlement to leaves on any ground (i.e. temporary or seasonal work), the contracted party will provide the project worker, at his/her request, with a reasonable period of leave taking into consideration all the circumstances. An employment contract or engagement agreement, except in case of permanent employment, ends on the date of its expiry, unless both parties have agreed otherwise. In case of an early termination, a written notice will be submitted at least 15 days in advance. The termination of employment contract and payment of any related entitlements will be done in compliance with the national legislation. risk related to specific jobs will be assessed. In conformity with the national legislation (LHSW), any third party engaging or employing contracted workers will be responsible for taking preventive and protective measures to ensure a safe and healthy work environment and informing the project worker on all the relevant issues and conditions affecting his/her health and safety at work. The project worker will respect regulations relating to safety and protection of life and health at work in order not to put in danger his life and health or life and health of others. COVID-19 Considerations: The project will overall follow relevant national guidance, WHO guidelines and the Banks‘ ESF/SAFEGUARDS INTERIM NOTE: COVID-19 CONSIDERATIONS IN CONSTRUCTION/CIVIL WORKS PROJECTS to address risks of COVID-19 exposure for project workers. All employers of project workers have the overall responsibility of ensuring that all practicable preventive and protective measures are taken to minimize occupational risks. Employers are responsible for providing, where necessary and so far, as is reasonably practicable, adequate protective clothing and protective equipment, at no cost to the worker. Employers are responsible for providing adequate information and appropriate training on occupational safety and health, consulting workers on OSH aspects associated with their work and providing measures to deal with emergencies. Workers have a right to remove themselves from danger when they have good reason to believe that there is an imminent and serious danger to their safety or health, and the duty to inform their supervisors immediately. efforts will be made to establish mechanisms that will prevent discrimination, harassment, sexual harassment and abuse at work and ensure equal treatment, equal payment for equal work and equal opportunity for all. The service providers working in Serbia should follow the procedure laid out by the national legislation regulating the area of discrimination, harassment and equal opportunity. Project workers have the right to form or join union or other organizations of their choosing and to bargain collectively, in accordance with the national legislation. The employer (third party) will not interfere with the worker‘s right to choose the organization or opt for an alternative mechanism to protect their rights regarding working conditions and terms of employment. The project worker will be able to raise his/her grievances using the grievance mechanism defined in section 8.13. The contractors‘ labor management procedure will set out terms and conditions for the contracted workers. These terms and conditions will be in line, at minimum, with this labor management procedure, national Labor Law and General Conditions of the World Bank Standard bidding documents and comparable industry standards. 8.13. Grievance Redress Mechanisms A grievance redress mechanism (GRM) will be established for all project workers where such mechanism is not already in place. The main objective of a worker GRM is to ensure timely, effective and efficient resolution of complaints and grievances related to labor and working conditions. 98 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF For civil servants the law on civil servants addresses the grievance mechanism in such a way to provide for employment relations and workplace dispute resolution through the Appeals Commission housed within the institution providing employment. The above stated mechanisms provided by the Serbian legislation are considered as minimum standard to be achieved in addressing labor dissatisfaction and perceived maltreatment. Any third party employing and engaging contracted workers are expected to design and implement grievance mechanisms that will be aligned or surpass this standard ensuring an easy access to protective measures and effective remedial actions in work situations that may give rise to grievances and disputes. For direct workers (external consultants) engaged by PCU, a GRM shall be conceived and housed by the MOH. This GRM shall address workplace concerns, specifying procedures as to whom a direct worker should lodge the grievance, a reasonable time frame for receiving a response or feedback and steps to refer to a more senior level, while allowing for transparency, confidentiality and non-retribution practices. Consultants shall be informed about the availability of the GRM upon their engagement. For contracted workers (HCF workers, construction workers and technical consultants) a GRM shall be established in compliance with requirements of this LMP, ESS2 and the national law unless such a mechanism already exists in their facilities. The establishment of a GRM involves informing (for example during training, etc.) all contracted workers about the existence of the mechanism to address the current gap in the labor laws and establishment of the new GRM will involve the following elements:  procedure to receive grievances such as comment/complaint form, suggestion boxes, email;  stipulated timeframes to respond to grievances and address cases;  a grievance log to register and track timely resolution of grievances;  appointment of a GRM focal point (HR manager), who will inform the health care worker union about filed complaints and outcomes (for HCF workers)  possibility of submitting a second-instance grievance in case the worker is not satisfied with the solution offered. The mechanism will be based on the following principles:  The process will be transparent and allow workers to express their concerns and file grievances.  There will be no discrimination or sanctions against those who express grievances and any grievances will be treated confidentially.  Anonymous grievances will be treated equally as other grievances, whose origin is known.  Management will treat grievances seriously and take timely and appropriate action in response. The GRM Focal Point will monitor the contractors‘ recording and resolution of grievances, and report these to PCU in their monthly progress reports. The process will be monitored by the GRM Focal Point, and Social Specialist of PCU will be responsible for the project GRM management. Information about the workers‘ GRM will be provided at induction trainings. 8.14. Contractor’s Management The PCU will use the Bank‘s 2017 Standard Procurement Documents for solicitations and contracts, and these include labor and occupational, health and safety requirements. As part of the process to select contractors who will engage contracted workers, PCU through its OHS and Public communications, social and citizen engagement specialist together with the Supervision Consultant should carry out due diligence procedures to identify if there are significant risks related to prospective contractors‘ compliance with labor and OHS requirements. This may include the review of the following information/documents:  Information in public records, for example, corporate registers and public documents relating to violations of applicable labor law, including reports from labor inspectorates and other law enforcement bodies;  Business licenses, registrations, permits, and approvals;  Documents relating to a labor management system, including OHS issues, for example, labor management procedures; 99 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF  Identification of labor management, safety, and health personnel, their qualifications and certifications;  Workers‘ certifications/permits/training to perform required work;  Records of safety and health violations, and responses;  Accident and fatality records and notifications to authorities;  Code of Conduct and SEA/SH Code of Conduct Prior to contracting, the bidders will be required to submit a statement confirming their awareness of WB ESS, their firm compliance with the national labor and employment and occupational health and safety laws and labor management procedures in accordance with WB ESS2, and their willingness to refrain from any practice that can be interpreted or perceived as discriminatory or unfair to their employees. The form of the statement is presented in Annex 16. In addition, the contracts with selected contractors will include provisions related to labor and occupational health and safety, as required by the WB and Serbian law. After the contract award, the contractors are required to provide their own procedures to manage labor risks in line with this LMP in the Contractor‘s ESMP. Contractors are expected to ensure that their subcontractors, suppliers and business partners involved in implementation of the Project are compliant with law and have no records on violating labor or OHS regulations. Contractors should carry out due diligence procedure before entering into any kind of contractual or business relations with subcontractors, suppliers and business partners in order to make sure that they are reliable and law-abiding entities. It is strongly recommended that provisions related to labor and OHS that guarantee adherence to the standards be laid down by the Contractor‘s ESMP and embedded in their contracts and agreements. Contractors will be made aware of these requirements in the bidding stage. The Supervision Consultant will manage and monitor the performance of Contractors in relation to employment relationship and OHS matters regarding contracted workers, focusing on contractors‘ compliance with their contractual agreements (obligations, representations, and warranties). This may include periodic audits, inspections, and/or spot checks of project locations or work sites and/or of labor management records and reports compiled by contractors. Contractors‘ labor management records and reports may include: (a) a representative sample of employment contracts or arrangements between third parties and contracted workers; (b) records relating to grievances received and their resolution; (c) reports relating to safety inspections, including fatalities and incidents and implementation of corrective actions; (d) records relating to incidents of non-compliance with national law; and (e) records of training provided for contracted workers to explain labor and working conditions and OHS for the project . The Template for Labor and Working Conditions Compliance Report is provided Annex 15. 8.15. Budget The tentative budget for the implementation of this LMP, including the hiring of Supervision consultant and third party will be approximately 1% of the total value of civil works. 100 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF 9. IMPLEMENTATION ARRANGEMENTS 9.1. Overall project management and coordination The project will be implemented by the MOH as the key implementing agency, with support from the existing PCU of the Second Serbia Health Project - SSHP (P129539). The project will be implemented over a period of two years. The MOH, which has the overarching responsibility for Serbia‘s health sector and related policy oversight, will have fiduciary responsibility for the project through its PCU and will ensure the technical implementation of all components. The HIF and the national and regional Institutes of Public Health will contribute to planning, executing, and monitoring activities that are in their scope of work. The HIF will support in the planning and monitoring of centralized procurement of goods and supplies for the Project in terms of preparation of technical specifications for procurement of tests, personal protective equipment for medical staff and other sanitation and medical supplies. The national and regional public health institutes will support in the health promotion, disease prevention and environmental protection activities of the Project, including guidance to health care institutions on how to implement such activities. The PCU that is already established for the implementation of the SSHP includes core staff who are responsible for administrative and fiduciary management, as well as several technical staff who will coordinate activities under the Serbia Emergency COVID-19 Response Project. Additional technical staff will be hired to assist with project activities related to the COVID-19 outbreak as needed. All procurement under the project will be undertaken by the PCU/MOH. The existing operations manual will be updated to include project activities and procedures related to COVID-19, covering the project implementation and monitoring arrangements, institutional roles, and the geographic scope of the project. PCU will coordinate and oversight overall activities related to environmental and social activities envisaged by the ESMF until the project closure and transfer for management to the designated authority. The PCU will be responsible for the implementation of ESCP, ESMF, IHCWMP, LMP, and SEP of the project. PCU in coordination with other relevant Divisions will be responsible for due diligence, screening of activities, and monitoring. The project will require clear and strong implementation oversight, regular consultation among key stakeholders, and decision-making mechanisms to prevent and address bottlenecks. The GoS will establish an oversight mechanism to ensure that project activities are aligned with the GoS‘s overall response to the COVID- 19 outbreak. The Project will set up a Project Coordination Unit (PCU) in the MOH that will be headed by a Project Director (PD). A Project Steering Committee (PSC) will be established to provide guidance to the PCU. PCU will recruit an Environmental and a Social Specialist in the PCU, who will be responsible for: o Preparation and consultation for required ES instruments o Addressing ES risks and impacts including monitoring of the implementation of all ES instruments, community health and safety measures, the functioning of the grievance redress mechanism (GRM) etc. o Screening of subprojects (Form at Annex 02) for ES issues, disclosure, review and clearance of subprojects to monitoring the implementation of the ESMP. o Prepare ICMWMP (Template at Annex 04) in coordination with the Head of HCFs and ensure implementation and monitoring In the Operation stage, the PCU will ensure the following aspects are followed in the HCFs: o Define roles and responsibilities along each link of the chain along the cradle-to-crave infection control and waste management process; o Ensure adequate and qualified staff are in place in all HCFs, including those in charge of infection control and biosafety and waste management facility operation. o Stress that the Head of an HCF takes overall responsibility for infection control and waste management; 101 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF o The management involves all relevant departments in a healthcare facility, and build an intra- departmental team to manage, coordinate and regularly review the issues and performance; o Establish an information management system to track and record the waste streams in HCF; and o Capacity building and training should involve medical workers, waste management workers and cleaners. Third-party waste management service providers should be provided with relevant training as well. The training topics will include (for health workers, administrative and operational personnel, construction workers and community in general): o Use and disposal of PPE (for all) o Working in COVID-19 environment (construction workers) o COVID-19 Infection Prevention and Control Recommendations (Health care workers) o Laboratory biosafety guidance related to the COVID-19 (Laboratory personnel) o Specimen collection and shipment (Laboratory personnel) o Standard precautions for COVID-19 patients (Health care workers) o Risk communication, prevention and community engagement (Administrative and operational personnel) o WHO and CDC guidelines on quarantine including case management o Waste disposal and management (Waste disposal staffs and healthcare personnel) 9.2. Monitoring, Evaluation and Reporting Monitoring and evaluation. The M&E activities will be the responsibility of the MOH. The MOH‘s HMIS will be the primary monitoring and reporting mechanism for project results, supplemented by project monitoring by the M&E specialist in the PCU, who will facilitate the regular collection, analysis, and reporting of progress in implementing project activities and of results achieved. Regular monitoring, preparation of ESMPs, and compliance of ESMPs will be responsibility of HCF for construction/rehabilitation works. The preparation of the IHCWM plan will also the responsibility of HCF. All HCFs, as implementing partners, will coordinate with the PCU throughout the preparation and implementation of the procurement process, including conducting supervision during works and will assign from each HCF a focal point for ESMF implementation. HCFs are responsible to ensure that all guidelines in line with managing COVID-19 response and WHO guidance is adequately implemented. PCU will be responsible for reporting of all project activities to the WB. An Environmental and Social Compliance Monitoring template for reporting of Project Activities is presented in Annex 10. Regular World Bank missions will include specialists to monitor the project‘s compliance with World Bank safeguard standards. The World Bank‘s environmental and social specialists will provide close supervision and necessary implementation support and will review the documents ESMPs, screening reports, LMPs, etc. prepared by the project. Review meetings. Through the MOH, the borrower will hold quarterly project review meetings attended by relevant officials of the MOH, Institute of Public Health, Regional Institutes of Public Health, HIF, and any other project stakeholders as relevant. Reporting. The MOH will produce semi-annual progress reports based on agreed targets and the progress made on implementing critical project activities. Supervision and implementation support. An experienced World Bank team of health, operational, fiduciary, and safeguards specialists will provide implementation support to the MOH through regular implementation support visits that will include the participation of relevant partners. In addition, World Bank team members based in Serbia will provide regular operational support. Implementation will also be supported virtually, especially in the early phases of the project, when travel restrictions may still be in place. Sustainability 102 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF The sustainability of the project-supported interventions will largely depend on the capacity of the implementing agency and the specific activities. Some project activities are not intended to be sustained if the response is adequate and timely (e.g., continued testing). However, laboratory capacities will be improved at the national and regional levels so that the system for testing and diagnostics is strengthened and sustained beyond the epidemic period. In addition, the focus of some of the project activities on training and capacity building of health workers and improved biomedical waste management will enhance the sustainability of the project-supported activities and results. Furthermore, there is a low level and quality of medical imaging equipment in Serbia, and the repurposing of medical equipment in the medium- to long-term will add to the sustainability of the investment. 103 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF 10. ANNEXES 104 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF ANNEX 01: EXCLUSION LIST OF PROJECT / ACTIVITIES IFC does not finance the following projects: Production or trade in any product or activity deemed illegal under host country laws or regulations or international conventions and agreements, or subject to international bans, such as pharmaceuticals, pesticides/herbicides, ozone depleting substances, PCB's, wildlife or products regulated under CITES. Production or trade in weapons and munitions. Production or trade in alcoholic beverages (excluding beer and wine).1 Production or trade in tobacco.1 Gambling, casinos and equivalent enterprises.1 Production or trade in radioactive materials. This does not apply to the purchase of medical equipment, quality control (measurement) equipment and any equipment where IFC considers the radioactive source to be trivial and/or adequately shielded. Production or trade in unbounded asbestos fibers. This does not apply to purchase and use of bonded asbestos cement sheeting where the asbestos content is less than 20%. Drift net fishing in the marine environment using nets in excess of 2.5 km. in length. A reasonableness test will be applied when the activities of the project company would have a significant development impact but circumstances of the country require adjustment to the Exclusion List. All financial intermediaries (FIs), except those engaged in activities specified below*, must apply the following exclusions, in addition to IFC's Exclusion List: Production or activities involving harmful or exploitative forms of forced labor/harmful child labor. 3 Commercial logging operations for use in primary tropical moist forest. Production or trade in wood or other forestry products other than from sustainably managed forests. * When investing in microfinance activities, FIs will apply the following items in addition to the IFC Exclusion List: Production or activities involving harmful or exploitative forms of forced labor2/harmful child labor.3 Production, trade, storage, or transport of significant volumes of hazardous chemicals, or commercial scale usage of hazardous chemicals. Hazardous chemicals include gasoline, kerosene, and other petroleum products. Production or activities that impinge on the lands owned, or claimed under adjudication, by Indigenous Peoples, without full documented consent of such peoples. * Trade finance projects, given the nature of the transactions, FIs will apply the following items in addition to the IFC Exclusion List. 105 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF ANNEX 02: SCREENING FORM FOR POTENTIAL ENVIRONMENTAL AND SOCIAL ISSUES This form is to be used by the Project Coordination Unit (PCU) to screen for the potential environmental and social risks and impacts of a proposed subproject. It will help the PCU in identifying the relevant Environmental and Social Standards (ESS), establishing the ES category for these subprojects, and specifying the type of environmental and social assessment required, including specific instruments/plans. The use of this form will allow the PCU to form an initial view of the potential risks and impacts of a subproject. It is not a substitute for project-specific ES assessments or specific mitigation plans. A note on Considerations and Tools for ES Screening and Risk Rating is included in this Annex to assist the process. Subproject Name Subproject Location Subproject Proponent Estimated Investment Start/Completion Date Questions Answer ESS Due diligence / relevance Actions Yes No Does the subproject involve civil works including ESS1 ESIA/ESMP, small refurbishment, expansion, upgrading or SEP rehabilitation of healthcare facilities and/or waste management facilities? Does the subproject involve land acquisition and/or ESS5 Exclude from restrictions on land use? financing Does the subproject involve relocation of ESS5 Exclude from encroachers or squatters? financing Does the subproject involve acquisition of assets ESS5 for quarantine, isolation or medical treatment purposes? Is the subproject associated with any external waste ESS3 ESIA/ESMP, management facilities such as a sanitary landfill, SEP incinerator, or wastewater treatment plant for healthcare waste disposal? Is there a sound regulatory framework and ESS1 ESIA/ESMP, institutional capacity in place for healthcare facility SEP infection control and healthcare waste management? Does the subproject have an adequate system in place (capacity, processes and management) to address waste? Does the subproject involve recruitment of workers ESS2 HORMP, SEP including direct, contracted, primary supply, and/or community workers? Does the subproject have appropriate OHS procedures in place, and an adequate supply of PPE (where necessary)? 106 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF Questions Answer ESS Due diligence / relevance Actions Yes No Does the subproject have a GRM in place, to which all workers have access, designed to respond quickly and effectively? Does the subproject involve use of security or ESS4 ESIA/ESMP, military personnel during refurbishment works SEP and/or operation of healthcare facilities and related activities? Is the subproject located within or in the vicinity of ESS6 ESIA/ESMP, any ecologically sensitive areas? SEP Are there any indigenous groups (meeting specified ESS7 Indigenous ESS7 criteria) present in the subproject area and are Peoples they likely to be affected by the proposed Plan/other plan subproject negatively or positively? reflecting agreed terminology Is the subproject located within or in the vicinity of ESS8 ESIA/ESMP, any known cultural heritage sites? SEP Does the project area present considerable and ESS1 ESIA/ESMP, Sexual Exploitation and Abuse (SEA) / Sexual SEP Harassment (SH) risk? Conclusions: 1. Proposed Environmental and Social Risk Ratings (High, Substantial, Moderate or Low). Provide Justifications. 2. Proposed ES Management Plans/ Instruments. 107 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF INFECTION CONTROL: CONSIDERATIONS AND TOOLS TO ASSIST IN ES SCREENING AND RISK RATING: In the context of global COVID-19 outbreak, many countries have adopted a containment strategy that includes extensive testing, quarantine, isolation and treatment either in a medical facility or at home. A COVID-19 response project may include the following activities:  Small refurbishment of and/or operational support to medical laboratories, quarantine and isolation centers at multiple locations and in different forms, and infection treatment centers in existing healthcare facilities  procurement and delivery of medical supplies, equipment and materials, such as reagents, chemicals, and Personal Protective Equipment (PPEs)  transportation of potentially infected specimens from healthcare facilities to testing laboratories  Expansion or enhancing healthcare waste and wastewater facilities  training of medical workers and volunteers  community engagement and communication 1. Screening ES Risks of Medical laboratories Many COVID-19 projects include capacity building and operational support to existing medical laboratories. It is important that such laboratories have in place procedures relevant to appropriate biosafety practices. WHO advises that non-propagative diagnostic work can be conducted in a Biosafety Level 2 (BSL-2) laboratory, while propagative work should be conducted at a BSL-3 laboratory. Patient specimens should be transported as Category B infectious substance (UN3373), while viral cultures or isolates should be transported as Category A ―Infectious substance, affecting humans‖ (UN2814).The process for assessing the biosafety level of a medical laboratory (including management of the laboratory operations and the transportation of specimens) should consider both biosafety and general safety risks. OHS of workers in the laboratory and potential community exposure to the virus should be considered. The following documents provide further guidance on screening of the ES risks associated with a medical laboratory. They also provide information for assessing and managing the risks.  WHO; Prioritized Laboratory Testing Strategy According to 4Cs Transmission Scenarios  WHO Covid-19 Technical Guidance: Laboratory testing for 2019-nCoV in humans:  WHO Laboratory Biosafety Manual, 3rd edition  USCDC, EPA, DOT, et al; Managing Solid Waste Contaminated with a Category A Infectious Substance (August 2019) 2. Screening ES Risks of Quarantine and Isolation Centers According to WHO:  Quarantine is the restriction of activities of or the separation of persons who are not ill but who may have been exposed to an infectious agent or disease, with the objective of monitoring their symptoms and ensuring the early detection of cases  Isolation is the separation of ill or infected persons from others to prevent the spread of infection or contamination. Many COVID-19 projects include refurbishment, renovation and equipping of quarantine and isolation centers at Point of Entry (POE), in urban and in remote areas. There may also be circumstances where tents are used for quarantine or isolation. Public or private facilities such as a stadium or hotel may also be acquired for this purpose. 108 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF In screening for ES risks associated with quarantine and isolation, the following may be considered:  contextual risks such as conflicts and presence or influx of refugees  refurbishing works and decommissioning related risks  land or asset acquisition  use of security personnel or military forces  availability of minimum requirements of food, fuel, water, hygiene  whether infection prevention and control, and monitoring of quarantined persons can be carried out effectively  whether adequate systems are in place for waste and wastewater management The following documents provide further guidance regarding quarantine of persons.  WHO; Considerations for quarantine of individuals in the context of containment for coronavirus disease (COVID-19)  WHO; Key considerations for repatriation and quarantine of travelers in relation to the outbreak of novel coronavirus 2019-nCoV  WHO; Preparedness, prevention and control of coronavirus disease (COVID-19) for refugees and migrants in non-camp settings 3. SCREENING ES RISKS OF TREATMENT CENTERS WHO has published a manual that provides recommendations, technical guidance, standards and minimum requirements for setting up and operating severe acute respiratory infection (SARI) treatment centers in low- and middle-income countries and limited-resource settings, including the standards needed to repurpose an existing building into a SARI treatment center, and specifically for acute respiratory infections that have the potential for rapid spread and may cause epidemics or pandemics.  WHO Severe Acute Respiratory Infections Treatment Centre  WHO Covid-19 Technical Guidance: Infection prevention and control / WASH  WBG EHS Guidelines for Healthcare Facilities 4. SCREENING ES RISKS RELATING TO LABOR AND WORKING CONDITIONS A COVID-19 project may include different types of workers. In addition to regular medical workers and laboratory workers who would normally be classified as direct workers, the project may include contracted workers to carry out refurbishing works and community workers (such as community health volunteers) to provide clinical support, contact tracing, and data collection, etc. The size of the workforce engaged could be considerable. Risks for such a workforce will range from occupational health and safety to types of contracts and terms and conditions of employment. Further details relevant to labor and working conditions for COVID-19 projects are discussed in the attached Human and Occupational Resource Management Procedure (HORMP, or in ESF term an LMP) 109 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF ANNEX 03A: ENVIRONMENTAL AND SOCIAL MANAGEMENT PLAN (ESMP) TEMPLATE Introduction The Borrower will ensure that site specific Environmental and Social Management Plans (ESMP) are developed by the PCU, setting out how the environmental and social risks and impacts will be managed through the project lifecycle. This ESMP template includes several matrices identifying key risks and setting out suggested ES mitigation measures. The Borrower can use the matrices to assist in identifying risks and possible mitigations. The ESMP should also include other key elements relevant to delivery of the project, such as institutional arrangements, plans for capacity building and training plan, and background information. The Borrower may incorporate relevant sections of the ESMF into the ESMP, with necessary updates. The matrices illustrate the importance of considering lifecycle management of ES risks, including during the different phases of the project identified in the ESMF: planning and design, refurbishing/rehabilitation, operations and decommissioning. The issues and risks identified in the matrix are based on current COVID-19 responses and experience of other Bank financed healthcare sector projects. The Borrower should review and add to them during the environmental and social assessment of a subproject. The WBG EHS Guidelines, WHO technical guidance documents and other GIIPs set out in detail many mitigation measures and good practices, and can be used by the Borrower to develop the ESMP. Proper stakeholder engagement should be conducted in determining the mitigation measures, including close involvement of medical and healthcare waste management professionals. The Infection Control and Medical Waste Management Plan forms part of the ESMP. The ESMP should identify other specific ES management tools/instruments, such as Human and Occupational Resource Management Procedure (HORMP), and/or Medical Waste Management Plan etc. Environmental and Social Management Plan (ESMP) An Environmental and Social Management Plan (ESMP) outlines the mitigation, monitoring and institutional strengthening measures to be taken during project implementation and project operation phases to avoid or eliminate negative environmental/social impacts. For projects of intermediate environmental risk (Substantial and Moderate Risk) an ESMP may be an effective way of summarizing the activities needed to achieve effective mitigation of negative environmental/social impacts. The format in this annex provides a model for development such an ESMP. The model divides the project cycle into two phases: construction, and operation. For each phase, the preparation team identifies any significant environmental and social impacts that are anticipated based on the analysis done in the context of conducting an environmental and social review or preparing an environmental assessment, including social aspects (if required). For each impact, mitigation measures are identified and listed. Estimates are made of the cost of mitigation actions broken down by estimates for implementation (investment cost) and operation (recurrent cost). The ESMP format also provides for the identification of institutional responsibilities for implementation and operation of mitigation devices and methods. To keep track of the requirements, responsibilities and costs for monitoring the implementation of environmental/social mitigation identified in the analysis included in an environmental review or assessment for Substantial and Moderate Risk projects, a monitoring plan may be useful. A format is provided in this annex. Like the ESMP, the project cycle is broken down into two phases (construction and operation). The format also includes a row for baseline information that is needed to achieve reliable and credible monitoring. The key elements of the matrix are: o What is being monitored? o Where is monitoring done? 110 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF o How is the parameter to be monitored to ensure meaningful comparisons? o When or how frequently is monitoring necessary or most effective? o Why is the parameter being monitored (what does it tell us about environmental impact)? In addition to these questions, it is useful to identify the costs associated with monitoring (both investment and recurrent) and the institutional responsibilities. When a monitoring plan is developed and put in place in the context of project implementation, PCU will request reports from the local implementation actors (supervising engineers, contractors etc.) at appropriate intervals, and include the findings in its periodic reporting to the World Bank; in addition, PCU will make the findings available to Bank staff in the course of implementation support missions. 111 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF ESMP Template 01 - Environmental and Social Risks and Mitigation Measures during Planning and Designing Stage Potential ES Risks and Responsibe Key Activities Proposed Mitigation Measures Timeline Budget Impacts Entity Planning and Designing Stage Identify the type, location, and MOH - PCU scale of healthcare facilities (HCF) Identify the need for refurbishment, MOH - PCU expansion, upgrading and/or rehabilitation Identify the needs for ancillary MOH - PCU works and associated facilities, such as access roads, construction materials, supplies of water and power, sewage system Identify the needs for acquisition of MOH - PCU land and assets (e.g. acquiring existing assets such as a hostel, stadium to hold potential patients) Identify onsite and offsite waste Inadequate facilities, Formation of Health care waste management committee in HCF management facilities, and waste expertise and processes the health care facilities transportation routes and service for the treatment of waste  Estimate potential waste streams providers Consider the capacity of existing facilities, and plan to increase capacity, if necessary, through small refurbishment, expansion, etc.  Specify that the design of the facility considers the collection, segregation, transport, and treatment of the anticipated volumes and types of healthcare wastes  Require that receptacles for waste should be sized appropriately for the waste volumes generated and color- coded and labeled according to the types of waste to be segregated.  Develop appropriate protocols for the collection of waste and transportation to storage/disposal areas following WHO guidance. Design training for staff in the segregation of wastes at the source of generation. Identify needs for transboundary MOH - PCU 112 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF Potential ES Risks and Responsibe Key Activities Proposed Mitigation Measures Timeline Budget Impacts Entity movement of samples, specimen, reagent, and other hazardous materials Identify needs for workforce and  Identify numbers and types of workers MOH - PCU type of project workers  Consider accommodation and measures to minimize cross- infection, nosocomial infection, and its controlling measures  Use the COVID-19 LMP template to identify possible mitigation measures Identify needs for using security MOH - PCU personnel during refurbishment and/or operation of HCF HCF design – general  Structural safety risk; MOH – PCU  Functional layout and HCF engineering control for nosocomial infection HCF design - considerations for Some groups may have MOH – PCU differentiated treatment for groups difficulty accessing health HCF of higher sensitivity or vulnerable facilities (the elderly, those with preexisting conditions, or the very young) and those with disabilities Design of the facility should reflect  The design, set up, and management will take into account MOH – PCU specific treatment requirements, the advice provided by WHO guidance for Severe Acute HCF including triage, isolation or Respiratory Infections Treatment Center. quarantine  Hand washing facilities should be provided at the entrances to health care facilities in line with WHO recommendations to Member States to Improve Hygiene Practices.  Isolation rooms should be provided and used at medical facilities for patients with possible or confirmed COVID-19.  Isolation rooms should:  be single rooms with attached bathrooms (or with a dedicated commode);  ideally be under negative pressure (neutral pressure may be used, but positive pressure rooms should be avoided) 113 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF Potential ES Risks and Responsibe Key Activities Proposed Mitigation Measures Timeline Budget Impacts Entity  be sited away from busy areas or close to vulnerable or high- risk patients, to minimize chances of infection spread;  have dedicated equipment (for example blood pressure machine, peak flow meter and stethoscope  have signs on doors to control entry to the room, with the door kept closed;  have an ante-room for staff to put on and take off PPE and to wash/decontaminate before and after providing treatment. Design to consider mortuary Insufficient capacity  Include adequate mortuary arrangements in the design HCF arrangements Spread of infection  Refer to WHO Infection Prevention and Control for the safe management of a dead body in the context of COVID-19) 114 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF ESMP Template 02 - Environmental and Social Risks and Mitigation Measures during Construction53 Stage Activities Potential ES Risks and Impacts Proposed Mitigation Measures Responsibilities Timeline Budget Construction Stage Clearing of vegetation and trees;  Impacts on natural habitats, The Contractor Construction activities near ecological resources, and ecologically sensitive areas/spots biodiversity General construction activities  Impacts on soils and groundwater; The Contractor Foundation excavation; borehole  Geological risks digging General construction activities  Resource efficiency issues, including The Contractor raw materials, water, and energy use;  Materials supply General construction activities –  Construction solid waste; The Contractor general pollution management  Construction wastewater;  Noise;  Vibration;  Dust;  Air emissions from construction equipment General construction activities –  Fuel, oils, lubricant The Contractor hazardous waste management General construction activities –  Workers coming from infected areas  Refer to COVID-19 LMP The Contractor Labor issues  Co-workers becoming infected  Consider ways to minimize/control movement in  Workers introducing infection into and out of construction areas/sites. community/general public  If workers are accommodated on-site require them to minimize contact with people outside the construction area/site or prohibit them from leaving the area/site for the duration of their contract  Implement procedures to confirm workers are fit for work before they start work, paying special to workers with underlying health issues or who may be otherwise at risk 53 there are no significant construction activities anticipated and any physical works will be limited to rehabilitation or upgrading of existing facilities, entirely within their existing footprint 115 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF Activities Potential ES Risks and Impacts Proposed Mitigation Measures Responsibilities Timeline Budget  Check and record temperatures of workers and other people entering the construction area/site or require self-reporting before or on entering  Provide daily briefings to workers before commencing work, focusing on COVID-19 specific considerations including cough etiquette, hand hygiene, and distance measures.  Require workers to self-monitor for possible symptoms (fever, cough) and to report to their supervisor if they have symptoms or are feeling unwell  Prevent a worker from an affected area or who has been in contact with an infected person from entering the construction area/site for 14 days  Preventing a sick worker from entering the construction area/site, referring them to local health facilities if necessary or requiring them to isolate at home for 14 days General construction activities – The Contractor Occupational Health and Safety (OHS) General construction activities – The Contractor traffic and road safety General construction activities – The Contractor security personnel General construction activities – Acquisition of land and assets N/A land and asset General construction activities SEA/SH issues MOH - PCU General construction activities – Cultural heritage  Chance-finds procedure The Contractor cultural heritage General construction activities – The Contractor emergency preparedness and response Construction activities related to Lack of space and expertise Identification of areas for the constructions The Contractor 116 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF Activities Potential ES Risks and Impacts Proposed Mitigation Measures Responsibilities Timeline Budget onsite waste management facilities,  Designated storage areas with adequate lighting, including temporary storage, ventilation, and provision for the containment of autoclaves, sewerage system, and spills within the area wastewater treatment works  Waste should be stored as per the types of waste.  Enough space to ensure maximum storage time before treatment or disposal of the infectious waste is no longer than 48 hours in cold seasons and 24 hours in the warm season  Ensure enough supply of water for cleaning purposes.  Ensure the storage is secure and restricted for access of unauthorized persons  Easy access for the waste collection vehicle  Protected from the sun, rain strong winds and floods. Floors and wall are designed such that routine cleaning and other are easy to undertake. Construction activities related to The Contractor the demolition of existing structures or facilities (if needed) 117 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF ESMP Template 03 - Environmental and Social Risks and Mitigation Measures during Operational Stage Activities Potential ES Risks and Impacts Proposed Mitigation Measures Responsibilities Timeline Budget Operational Stage General HCF operation – General wastes, wastewater, and air HCF Environment emissions General HCF operation – OHS  Physical hazards; HCF issues  Electrical and explosive hazards;  Fire;  Chemical use;  Ergonomic hazard;  Radioactive hazard HCF operation – Labor issue HCF HCF operation - considerations for HCF differentiated treatment for groups with different needs (e.g. the elderly, those with preexisting conditions, the very young, people with disabilities) HCF operation – cleaning  Provide cleaning staff with adequate cleaning HCF equipment, materials, and disinfectant.  Review general cleaning systems, training cleaning staff on appropriate cleaning procedures, and appropriate frequency in high use or high-risk areas.  Where cleaners will be required to clean areas that have been or are suspected to have been contaminated with COVID-19, provide appropriate PPE: gowns or aprons, gloves, eye protection (masks, goggles, or face screens) and boots or closed work shoes. If appropriate PPE is not available, provide the best available alternatives.  Train cleaners in proper hygiene (including handwashing) before, during, and after conducting cleaning activities; how to safely use PPE (where required); in waste control 118 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF Activities Potential ES Risks and Impacts Proposed Mitigation Measures Responsibilities Timeline Budget (including for used PPE and cleaning materials). HCF operation - Infection control HCF and waste management plan Waste minimization, reuse, and Use of non-burn technologies for the  Avoid the use of incinerators HCF recycling sterilization of the infected waste.  If small-scale incineration is the only option, this should be done using best practices, and plans should be in place to transition to alternative treatment as soon as practicable (such as steam treatment before disposal with sterile/non- infectious mutilated waste and disposed of in suitable waste facilities)  Do not use single-chamber, drum and brick incinerators  Always use non-burn technologies such as autoclaves and microwaves. Delivery and storage of specimen, HCF samples, reagents, pharmaceuticals and medical supplies Storage and handling of specimen, HCF samples, reagents, and infectious materials Waste segregation, packaging, Waste should be categorized and segregated into HCF color coding, and labeling the following categories as per their properties:  Hazardous health care waste • o Infectious waste • o Pathological waste • o Sharp waste o Pharmaceutical and Cytotoxic waste • o Chemical waste • o Radioactive waste • Non-hazardous general health care waste Proper labeling should be placed in all the bins used for waste segregation and collection 119 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF Activities Potential ES Risks and Impacts Proposed Mitigation Measures Responsibilities Timeline Budget Onsite collection and transport Lack of designated staffs and time for • Ensure proper color-coded bins are used for HCF collection collection. • Waste is collected away from the patient‘s area every day. Waste storage Establish a dirty utility room/area for temporary HCF waste storage wherever required Onsite waste treatment and HCF disposal Waste transportation to and  Hospitals should have separate trollies for HCF disposal in on-site treatment and transportation of hazardous and general waste. disposal facilities  Waste should be transported via a designated route and time with less movement of patients and visitors.  If trollies are not possible the waste should be transported in bins but never in polythene bags. Transportation and disposal at A separate vehicle should be used for waste HCF offsite waste management facilities transportation for off-site. The specification of the vehicles should be as per the WHO standard HCF operation – transboundary HCF movement of a specimen, samples, reagents, medical equipment, and infectious materials Operation of acquired assets for HCF holding potential COVID-19 patients Emergency events  Spillage; • Emergency Response Plan HCF  Occupational exposure to infectious • Post Exposure Prophylaxis Project disease; • Incident recording system Supervision  Exposure to radiation; Consultant  Accidental releases of infectious or PCU hazardous substances to the environment;  Medical equipment failure;  Failure of solid waste and wastewater treatment facilities 120 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF Activities Potential ES Risks and Impacts Proposed Mitigation Measures Responsibilities Timeline Budget  Fire;  Other emergent events Mortuary arrangements  Arrangements are insufficient • Implement good infection control practices (see HCF  Processes are insufficient WHO Infection Prevention and Control for the safe management of a dead body in the context of COVID-19) • Use mortuaries and body bags, together with appropriate safeguards during funerals (see WHO Practical considerations and recommendations for religious leaders and faith- based communities in the context of COVID-19) ESMP Template 04 - Environmental and Social Risks and Mitigation Measures during Decommissioning Key Activities Potential ES Risks and Impacts Proposed Mitigation Measures Responsibilities Timeline Budget Decommissioning Stage Decommissioning of interim HCF HCF Decommissioning of medical HCF equipment Regular decommissioning HCF 121 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF ANNEX 03B: ESMP CHECKLIST PART A: GENERAL PROJECT AND SITE INFORMATION INSTITUTIONAL & ADMINISTRATIVE Country Serbia Project title Serbia Emergency COVID-19 Response Project Subproject title Scope of site-specific activity Institutional arrangements Task Team Leader: (insert) Safeguards Specialists: (insert) (WB) Implementation arrangements Implementing entity: Works supervisor: Works contractor: (tbd) (Borrower) (insert) (tbd) SITE DESCRIPTION Name of institution whose premises are to be rehabilitated Address and site location of institution whose premises are to be rehabilitated Who owns the land? Who uses the land (formal/informal)? Description of physical and natural environment, and of the socio-economic context around the site Locations and distance for material sourcing, especially aggregates, water, stones? LEGISLATION National & local legislation & permits that apply to project activity PUBLIC CONSULTATION When / where the public consultation process will take /took place ATTACHMENTS Attachment 1: Site plan / photo Attachment 2: Construction permit (as required) Attachment 3: Agreement for construction waste disposal Other permits/agreements – as required 122 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF PART B: ESMP SCOPING ENVIRONMENTAL /SOCIAL SCREENING Activity/Issue Status Triggered Actions 1. Building rehabilitation [ ] Yes [ ] No If ―Yes‖, see Sections A and E below Will the site 2. Small-scale construction at existing facilities [ ] Yes [ ] No If ―Yes‖, see Section A and E below activity 3. Individual wastewater treatment system [ ] Yes [ ] No If ―Yes‖, see Section B below include/involve any of the 4. Acquisition of land [ ] Yes [ ] No If ―Yes‖, activity is excluded following? 5. Hazardous or toxic materials34 [ ] Yes [ ] No If ―Yes‖, see Section C below 6. Traffic and Pedestrian Safety [ ] Yes [ ] No If ―Yes‖, see Section D below 7. Social Risks [ ] Yes [ ] No If ―Yes‖, see Section E below PART C: MITIGATION MEASURES ACTIVITY PARAMETER MITIGATION MEASURES CHECKLIST RESPONSIBILITY BUDGET Section A. Air Quality (a) Use debris-chutes during interior demolition above the first floor Contractors (b) Keep demolition debris in controlled area and sprayed with water mist to reduce General debris dust Rehabilitation and (c) Suppress dust during pneumatic drilling/wall destruction by ongoing water /or Construction spraying and/or installing dust screen enclosures at site Activities (d) Keep the surrounding environment (sidewalks, roads) free of debris to minimize dust (e) Disallow open burning of construction / waste material at the site (f) Disallow excessive idling of construction vehicles at sites Noise (a) Limit construction noise to daytime unless extreme urgency. Notify health workers on the works schedule if it deviates from standard working hours (b) Ensure that during operation, engine covers of generators, air compressors and other powered mechanical equipment are closed, and equipment placed as far away from residential areas as possible Water Quality (a) Establish appropriate erosion and sediment control measures such as e.g. hay bales and / or silt fences to prevent sediment from moving off site and causing excessive turbidity in nearby streams and rivers. Waste management (a) Identify waste collection and disposal pathways for all major waste types Contractors expected from demolition and construction activities 123 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF ACTIVITY PARAMETER MITIGATION MEASURES CHECKLIST RESPONSIBILITY BUDGET (b) Separate mineral construction and demolition wastes from general refuse, organic, lI2Quid and chemical wastes by on-site sorting and stored in (c) appropriate containers. (d) Collect construction waste and dispose properly to the designated locations Whenever feasible, reuse and recycle appropriate and viable materials (except asbestos) Section B. Water Quality (a) Ensure that the approach of handling sanitary wastes and wastewater and the design of the treatment system is approved by relevant authorities Individual Wastewater (b) Ensure that before discharging into receiving waters, effluents from individual wastewater systems are treated in order to meet the minimal quality criteria set out by national guidelines on effluent quality and wastewater treatment treatment system (c) Undertake monitoring of newly established wastewater treatment systems and report to Employer on the monitoring outcome (d) Wash construction vehicles and machinery only in designated areas where runoff will not pollute natural surface water bodies. Section C. Asbestos management (a) If asbestos is located on the subproject site, mark it clearly as hazardous (b) material When possible, appropriately contain and seal asbestos to minimize Toxic Materials (c) exposure Treat asbestos prior to removal (if removal is necessary) with a wetting agent to minimize asbestos dust (d) Handle and disposed asbestos using skilled & experienced professionals (e) If asbestos material is being stored temporarily, securely enclosed it inside closed containments and mark appropriately. Take security measures against unauthorized removal from the site (f) Do not reuse the removed asbestos Toxic / hazardous waste (a) Temporarily store all hazardous or toxic substances on site in safe containers management labeled with details of composition, properties and handling information (b) Place containers of hazardous substances in leak-proof containers to prevent spillage and leaching 124 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF ACTIVITY PARAMETER MITIGATION MEASURES CHECKLIST RESPONSIBILITY BUDGET (c) Transport waste to official landfills and dispose excess excavated material at sites agreed with the local authorities. (d) No not use paints with toxic ingredients or solvents, or lead-based paints Section D. Direct or indirect hazards (a) Signpost, place warning signs, arrange barriers and traffic diversions so that the to public traffic and work site is clearly visible, and the public is warned of all potential hazards Traffic and pedestrians by (b) Establish traffic management system and conduct staff training, especially for Pedestrian Safety construction activities site access and near-site heavy traffic. Provide safe passages and crossings for pedestrians where construction traffic interferes. (c) Adjust working hours to local traffic patterns, e.g. avoid major transport activities during rush hours or times of livestock movement (d) Actively manage traffic if required for safe and convenient passage for the public. (e) Ensure safe and continuous access to office facilities, shops and residences during renovation activities, if the buildings stay open for the public. Section E. Public relationship (a) Implement and update as needed the project-based Stakeholder Engagement Plan PCU management (b) Assign local focal points who is in charge of communication with and receiving Social and Labor requests/complaints from local population at the district and regional level Contractors Risk Management (c) Consult local communities to identify and proactively manage potential conflicts between an external workforce and local people. (d) Raise local community awareness about sexually transmitted disease risks associated with the presence of an external workforce and include local communities in awareness activities. (e) Scheduled works beyond irrigation season to the extent possible in order to avoid/minimize service disruption. Inform local population about construction and work schedules, interruption of services, traffic detour routes and provisional bus routes, blasting and demolition, as appropriate. (f) Limit construction activities at night. When necessary, carefully schedule night work and inform affected community beforehand. (g) Properly mark and fence work site (h) No temporary storage of construction materials and waste occurs within cultivated land plots or any type of private property (i) Allocate areas for temporary storage of construction materials and waste so that free movement of traffic and pedestrians is not hindered. 125 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF ACTIVITY PARAMETER MITIGATION MEASURES CHECKLIST RESPONSIBILITY BUDGET Public Safety (a) Ensure quarantine procedures for COVID-19 patients are maintained; PCU, HCFs (b) Share information on project activities and construction schedule prior to the start of works; Contractors (c) Notify local construction and environment inspectorates and communities on the upcoming activities (d) Notify public on the works through appropriate notification in the media and/or at publicly accessible sites (including the site of the works) (e) Acquire all legally required permits for construction and/or rehabilitation (f) Formally agree with Employer that all work will be carried out in a safe and disciplined manner designed to minimize impacts on neighboring residents and environment. (g) Appropriately signpost construction site to inform workers on key rules and regulations. (h) Inform the community about the established grievance redress mechanisms and share contact numbers of focal points Labor issues management (a) Include the ESMP Checklist into the bidding documents; PCU (b) Ensure contractors and subcontractors comply with labor laws and standards and implement fair work practices; Contractors (c) Inform the contractors about the established grievance redress mechanisms and share contact numbers of focal points; (d) Instruct and train contractor assigned staff on SEA/SH monitoring, GRM, no child/forced labor use, code of conduct and other labor requirements as per ESS2 and Serbian Labor Code; (e) To the extent possible, do not locate work camps in close proximity to local communities. (f) Locate and operate workers‘ camps in consultation with neighboring communities. (g) Recruit unskilled or semi-skilled workers from local communities to the extent possible. Where and when feasible, worker skills training, should be provided to enhance participation of local people. (h) Ensure all workers have written contracts describing terms and conditions of work; (i) Raise awareness of workers on overall relationship management with local population, establish the code of conduct in line with international practice and strictly enforce them, including the dismissal of workers and financial penalties of adequate scale. (j) Ensure neither child (up 18 years old) labor nor forced labor applied; and 126 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF ACTIVITY PARAMETER MITIGATION MEASURES CHECKLIST RESPONSIBILITY BUDGET (k) Inform the workers about the established labor grievance redress mechanism and share contact numbers of focal points. Worker health and safety (a) Ensure contractors and subcontractors comply with occupational safety local PCU requirements laws and requirements as per ESS 2; (b) Provide detailed information to the personnel about the activities foreseen in the Contractors project; (c) Conduct safety trainings carried out by specialists in different fields; HCFs (d) Ensure that workers‘ PPE complies with international good practice (masks, gloves and safety glasses, for civil works also hardhats, harnesses and safety boots); (e) Provide adequate sanitary conditions (lavatories and washing areas) in the work site with adequate supplies of running water, soap, antiseptics and hand drying devices; (f) Secure working conditions meeting health and safety standards required by the Serbian legislation; (g) Ensure regular delivery and proper storage of goods, including samples, pharmaceuticals, disinfectant, reagents, other hazardous materials, PPEs, etc.; (h) Ensure protocols for regular disinfection of public rooms, wards, ICUs, equipment, tools, and waste are in place and followed; (i) Ensure handwashing and other sanitary stations are always supplied with clean water, soap, and disinfectant; (j) Ensure equipment such as autoclaves are in working order; and (k) Provide regular testing to healthcare workers routinely in contact with COVID-19 patients 127 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF PART D: MONITORING PLAN Where How When Why What (Is the Who (Is the parameter (Define the (Is the parameter (Is the parameter to be parameter to (Is responsible for Activity to be frequency / or being monitored?) be monitoring?) monitored?) continuous?) monitored?) monitored?) CONSTRUCTION PHASE Provision of Purchase of In the Verification During Provide technical PCU, construction construction materials provider‘s of conclusion of order of facility materials from the licensed office or documents supply contracts and its safety for Authorized civil provider. warehouse human health works technical supervision company Transportation - Technical - Construction Inspection of roads Undeclared - Limit pollution PCU, of construction condition of site; adjacent to the inspections of soil and air materials and vehicles and - Routs of construction object during work hours from emissions; Traffic Police, waste machinery; transportation in the direction of and beyond - Limit nuisance to - Confinement and of construction the movement rout local Authorized civil works Movement of protection of truck loads materials and communities technical supervision construction with lining; wastes from noise and company machinery - Respect of the vibration; established hours and - Minimize routes of traffic transportation. disruption. Maintenance of - Washing of cars and Construction Inspection During - Avoid pollution of PCU, construction construction equipment site and of operation of water and soil equipment outside the construction construction activities equipment with oil products Authorized civil site or on maximum base adjacent to due to operation works technical distance from natural it (if any) of equipment; supervision company streams; - Timely localize - Refueling or lubrication and decrease of construction expected damage equipment and outside in case of fire the construction site or at the predetermined arranged point; - Technical order of the 128 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF Where How When Why What (Is the Who (Is the parameter (Define the (Is the parameter (Is the parameter to be parameter to (Is responsible for Activity to be frequency / or being monitored?) be monitoring?) monitored?) continuous?) monitored?) monitored?) construction equipment maintenance point: solid impenetrable floor or adsorbent (sand fine gravel, membrane) cover; enough area and impenetrable barriers around fuel containers; basic fire extinguishing means. Generation - Temporary storage of Construction Inspectio Periodically - Prevent PCU of construction waste in site; Waste n of during pollution of Authorized civil construction especially allocated disposal site activities construction and soil, surface works technical waste areas; upon its water and supervision company - Timely disposal of completion ground water, wastes to the formally - Avoid accidents Municipality designated locations. at the construction site due to scattered fragments of construction materials and debris, - Retain esthetic appearance of the construction site and its surroundings Production of - Placement of waste Construction site Visual observation Total Prevent pollution PCU domestic wastes collection containers at and construction period of of soil and water Authorized civil the construction site and base (if any) constructio with domestic works technical construction base (if n waste supervision company any). Agreement with 129 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF Where How When Why What (Is the Who (Is the parameter (Define the (Is the parameter (Is the parameter to be parameter to (Is responsible for Activity to be frequency / or being monitored?) be monitoring?) monitored?) continuous?) monitored?) monitored?) the relevant Municipality Municipality on regular disposal of domestic wastes. Construction Final cleaning of the Construction site Inspectio Final Reduce loss of PCU, site re- construction site. n of period of aesthetical value of cultivation and activities constructi the landscape due Authorized civil landscaping on to construction works technical activities supervision company Municipality Workers‘ - Provision of constructors Construction site Inspectio Total period of Reduce probability PCU, health and with working clothes and n of works of traumas and safety, labor PPE; activities accidents to Authorized civil issues - Strict compliance with the constructors works technical rules of construction supervision company equipment operation and usage of PPE; - Strict compliance with the national regulations for construction works; - Presence of basic fire extinguishing means; - Availability of labor safety training and instruction records. - Compliance with labor laws and requirements as per ESS2. OPERATION PHASE Medical - Separation of medical Premises of HCF - Inspection of Total period of - Maintenance of Administration of the waste waste from other types HCF premises; operation of the good sanitary HCF management of waste generated at - Checking facility conditions at HCF; presence and HCF; 130 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF Where How When Why What (Is the Who (Is the parameter (Define the (Is the parameter (Is the parameter to be parameter to (Is responsible for Activity to be frequency / or being monitored?) be monitoring?) monitored?) continuous?) monitored?) monitored?) - Arrangements in place validity of - Avoid spread of with especially licensed waste removal infection from entity for regular out- and disposal HCF area; transporting and disposal agreement with - Limitation of soil, of medical waste in a licensed entity surface and compliance with the ground water national legislation and pollution the best national practice. Household - Presence of adequate Premises of HCF - Inspection of Total period of - Maintenance of Administration of the waste type and number of HCF premises; operation of the good sanitary HCF management household waste bins; - Checking facility conditions at - Timely removal of presence and HCF; Municipality household waste from validity of - Limitation of soil, the HCF territory on the waste removal surface and basis of out- and disposal ground water transporting and agreement with pollution disposal arrangements. a licensed entity Operation and Regular servicing of the Premises of HCF Site inspection Total period Maintenance of Administration of the maintenance of waste incinerator being of operation the healthcare HCF the healthcare undertaken/ of boiler waste incinerator waste house in safe and incinerator operable condition Emergency Presence of fire alarm and Premises of HCF Periodic check-ups Total period of - Reduce risks Administration of the preparednes fire localization system, operation of the for the staff HCF s and emergency back-up facility and patients of systems for power and HCF; water supply. - Avoid disruption in the provision of utility services to the HCF 131 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF ANNEX 03C: FORMAT FOR ENVIRONMENTAL AND SOCIAL MANAGEMENT AND MONITORING PLAN Objective and Scope of Preparation of Environmental and Social Management and Monitoring Plan In order to ensure short and long term environmental impacts that would arise due to improvement and rehabilitation work (to be described in the first section based on the subproject/activity), an ESMP will need to be developed as per the scope presented below and in accordance with the EAMF of the Project. The project should be reviewed and used as the basis for baseline information. Field level verification should be conducted prior to the preparation of the ESMP:  Identification of impacts and description of mitigation measures: Firstly, Impacts arising out of the project activities need to be clearly identified. Secondly, feasible and cost-effective measures to minimize impacts to acceptable levels should be specified with reference to each impact identified. Further, it should provide details on the conditions under which the mitigation measure should be implemented (ex; routine or in the event of contingencies) The ESMP also should distinguish between type of solution proposed (structural & non- structural) and the phase in which it should become operable (design, construction and/or operational).  Enhancement plans: Positive impacts or opportunities arising out of the project need to be identified during the preparation of the check list and Environmental Assessment process where applicable. Some of these opportunities can be further developed to draw environmental and social benefits to the local area. The ESMP should identify such opportunities and develop a plan to systematically harness any such benefit.  Monitoring programme: In order to ensure that the proposed mitigation measures have the intended results and complies with national standards and donor requirements, an environmental performance monitoring programme should be included in the ESMP. The monitoring programme should give details of the following; o Monitoring indicators to be measured for evaluating the performance of each mitigation measure (for example national standards, engineering structures, extent of area replanted, etc.). o Monitoring mechanisms and methodologies o Monitoring frequency o Monitoring locations  Institutional arrangements: Institutions/parties responsible for implementing mitigation measures and for monitoring their performance should be clearly identified. Where necessary, mechanisms for institutional co-ordination should be identified as often monitoring tends to involve more than one institution.  Implementing schedules: Timing, frequency and duration of mitigation measures with links to overall implementation schedule of the project should be specified.  Reporting procedures: Feedback mechanisms to inform the relevant parties on the progress and effectiveness of the mitigation measures and monitoring itself should be specified. Guidelines on the type of information wanted and the presentation of feedback information should also be highlighted.  Cost estimates and sources of funds: Implementation of mitigation measures mentioned in the ESMP/ESMP will involve an initial investment cost as well as recurrent costs. The ESMP/ESMP should include costs estimates for each measure and also identify sources of funding.  Contract clauses: This is an important section of the ESMP that would ensure recommendations carried in the ESMP will be translated into action on the ground. Contract documents will need to be incorporated with clauses directly linked to the implementation of mitigation measures. Mechanisms such as linking the payment schedules to implementation of the said clauses could be explored and implemented, as appropriate. 132 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF The format to present the ESMP in a matrix is provided below: _____________________________________________________________________________ _____________________________________________________________________________ (subproject, location, description) parameter be carried out? parameter be carried out- or expenses of contractor Date of commencement What cost of equipment implementation stage out/type of monitoring parameter is subject to parameter be carried Date of completion Monitoring cost54 required to conduct will monitoring of will monitoring of will monitoring of responsibility for Institutional monitoring? monitoring? monitoring Subproject equipment frequency Where When What How Construction Operation Important to note the following when using this ESMP template: The ESMP/ESMP that will be prepared should have all sections in place, except the last column on Implementation Progress What go in as the ESMP to the bid and contract documents of construction contractor is the sections highlighted in blue, as Implementation Progress is not relevant at the time of bidding and Operational responsibilities would lie with the council. Any activity that may be identified as the responsibility of design engineers should not be part of the ESMP that goes into the bid and contract documents of construction contractors Important to note: The consultant is responsible to ensure the ESMF requirements are taken into consideration in the designing of infrastructure. The ESMP Presentation The ESMP should follow the same sequence as the tasks described above including the ESMP matrix provided above. Consultant Qualifications if ESMPs are to be prepared by external Consultants The design consultant team should include an expert with at least 5 years of experience preparing environmental management and monitoring plans for infrastructure construction, improvement and rehabilitation, costing of mitigation measures and preparing contractor clauses necessary to capture ESMP implementation needs. Reporting and feedback schedule All submissions related to the assignment should be submitted to the Project Management Unit, as hard copies and electronically. The duration of the consultancy will be determined by the PCU. During the final submission of the ESMP report, if changes requested during the draft report stage have not been incorporated in a satisfactory manner to the client and the World Bank, the consultant will be required to work further on the document until it is considered satisfactory. 133 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF ANNEX 04: INFECTION CONTROL AND MEDICAL WASTE MANAGEMENT PLAN (ICMWMP) TEMPLATE 1. Introduction 1.1 Describe the project context and components; 1.2 Describe the targeted healthcare facility (HCF): - Type: E.g. general hospital, clinics, inpatient/outpatient facility, medical laboratory; - Special type of HCF in response to COVID-19: E.g. existing assets may be acquired to hold yet- to-confirm cases for medical observation or isolation; - Functions and requirement for the level infection control, e.g. biosafety levels; - Location and associated facilities, including access, water supply, power supply; - Capacity: beds 1.3 Describe the design requirements of the HCF, which may include specifications for general design and safety, separation of wards, heating, ventilation and air conditioning (HVAC), autoclave, and waste management facilities. 2. Infection Control and Waste Management 2.1 Overview of infection control and waste management in the HCF - Type, source and volume of healthcare waste (HCW) generated in the HCF, including solid, liquid and air emissions (if significant); - Classify and quantify the HCW (infectious waste, pathological waste, sharps, liquid and non- hazardous) following National Guideline on Infection Control And Medical Waste Management of the Department of Medical Services, MOH. - Given the infectious nature of the novel coronavirus, some wastes that are traditionally classified as non-hazardous may be considered hazardous. It‘s likely the volume of waste will increase considerably given the number of admitted patients during COVID-19 outbreak. Special attention should be given to the identification, classification and quantification of the healthcare wastes. - Describe the healthcare waste management system in the HCF, including material delivery, waste generation, handling, disinfection and sterilization, collection, storage, transport, and disposal and treatment works; - Provide a flow chart of waste streams in the HCF if available; - Describe applicable performance levels and/or standards; - Describe institutional arrangement, roles and responsibilities in the HCF for infection control and waste management. 2.2 Management Measures - Applicable Guidelines: Medical waste management should follow National Guideline on Infection Control and Medical Waste Management of the Department of Medical Services, MOH and applicable WHO guidelines55. - Waste minimization, reuse and recycling: HCF should consider practices and procedures to minimize waste generation, without sacrificing patient hygiene and safety consideration. - Delivery and storage of specimen, samples, reagents, pharmaceuticals and medical supplies: HCF should adopt practice and procedures to minimize risks associated with delivering, receiving and storage of the hazardous medical goods. 55 http://www.euro.who.int/__data/assets/pdf_file/0012/268779/Safe-management-of-wastes-from-health-care-activities-Eng.pdf 134 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF - Waste segregation, packaging, color coding and labeling: HCF should strictly conduct waste segregation at the point of generation. Internationally adopted method for packaging, color coding and labeling the wastes should be followed. - Onsite collection and transport: HCF should adopt practices and procedures to timely remove properly packaged and labeled wastes using designated trolleys/carts and routes. Disinfection of pertaining tools and spaces should be routinely conducted. Hygiene and safety of involved supporting medical workers such as cleaners should be ensured. - Waste storage: A HCF should have multiple waste storage areas designed for different types of wastes. Their functions and sizes are determined at design stage. Proper maintenance and disinfection of the storage areas should be carried out. Existing reports suggest that during the COVID-19 outbreak, infectious wastes should be removed from HCF‘s storage area for disposal within 24 hours. - Onsite waste treatment and disposal (e.g. an incinerator): Many HCFs have autoclave and their own waste incineration facilities installed onsite. Due diligence of an existing incinerator should be conducted to examine its technical adequacy, process capacity, performance record, and operator‘s capacity. In case any gaps are discovered, corrective measures should be recommended. For new HCF financed by the project, waste disposal facilities should be integrated into the overall design and ESIA developed. Good design, operational practices and internationally adopted emission standards for healthcare waste incinerator can be found in pertaining EHS Guidelines and GIIP. - Transportation and disposal at offsite waste management facilities: Not all HCF has adequate or well-performed incinerator onsite. Not all healthcare wastes are suitable for incineration. An onsite incinerator produces residuals after incineration. Hence offsite waste disposal facilities provided by local government or private sector are probably needed. These offsite waste management facilities may include incinerators, hazardous wastes landfill. In the same vein, due diligence of such external waste management facilities should be conducted to examine its technical adequacy, process capacity, performance record, and operator‘s capacity. In case any gaps are discovered, corrective measures should be recommended and agreed with the government or the private sector operators. - Disposal of Personal Protective Equipment (PPE): If PPE is exposed to infectious materials during use (e.g., body fluids from an infected person) the PPE is considered contaminated and the wearer should remove it promptly, using proper removal procedures. It is essential that used PPE is stored securely within disposable rubbish bags. These bags should be placed into another bag, tied securely, marked (with date) and kept separate from other waste within the room. This should be put aside for at least 72 hours before being disposed of as normal. - Wastewater treatment: HCF wastewater is related to the hazardous waste management practices. Proper waste segregation and handling as discussed above should be conducted to minimize entry of solid waste into the wastewater stream. In case wastewater is discharged into municipal sewer sewerage system, the HCF should ensure that wastewater effluent comply with all applicable permits and standards, and the municipal wastewater treatment plant (WWTP) is capable of handling the type of effluent discharged. In cases where municipal sewage system is not in place, HCF should build and proper operate onsite primary and secondary wastewater treatment works, including disinfection. Residuals of the onsite wastewater treatment works, such as sludge, should be properly disposed of as well. There‘re also cases HCF wastewater is transported by trucks to a municipal wastewater treatment plant for treatment. Requirements on safe transportation, due diligence of WWTP in terms of its capacity and performance should be conducted. - Sanitation and Hygiene facilities and practices at existing healthcare facilities are important because coronavirus can find alternate pathways of infection (e.g. faeces and clothing of patients, PPE). A standard protocol for adoption is provided in Annex 06 (water, sanitation and hygiene (WASH) protocols for healthcare facilities treating COVID-19 patients) 135 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF 3. Emergency Preparedness and Response Emergency incidents occurred in an HCF may include spillage, occupational exposure to infectious materials or radiation, accidental releases of infectious or hazardous substances to the environment, medical equipment failure, failure of solid waste and wastewater treatment facilities, and fire. These emergency events are likely to seriously affect medical workers, community, HCF‘s operation and the environment. Thus, an Emergency Response Plan (ERP) that is commensurate with the risk levels is recommended to be developed. The key elements of an ERP are defined in ESS 4 Community Health and Safety (para. 21). 4. Institutional Arrangement and Capacity Building A clearly defined institutional arrangement, roles and responsibilities should be included. A training plan with recurring training programs should be developed. The following aspects are recommended: - Define roles and responsibilities along each link of the chain along the cradle-to-crave infection control and waste management process; - Ensure adequate and qualified staff is in place, including those in charge of infection control and biosafety and waste management facility operation. - Stress the chief of an HCF takes overall responsibility for infection control and waste management; - Involve all relevant departments in a healthcare facility, and build an intra-departmental team to manage, coordinate and regularly review the issues and performance; - Establish an information management system to track and record the waste streams in HCF; and - Capacity building and training should involve medical workers, waste management workers and cleaners. Third-party waste management service providers should be provided with relevant training as well. 5. Monitoring and Reporting Many HCFs in developing countries face the challenge of inadequate monitoring and records of healthcare waste streams. HCF should establish an information management system to track and record the waste streams from the point of generation, segregation, packaging, temporary storage, transport carts/vehicles, to treatment facilities. HCF is encouraged to develop an IT based information management system should their technical and financial capacity allow. As discussed above, the HCF chief takes overall responsibility, leads an intra-departmental team and regularly reviews issues and performance of the infection control and waste management practices in the HCF. Internal reporting and filing system should be in place. Externally, reporting should be conducted per government and World Bank requirements. 136 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF Infection Control and Medical Waste Management Plan (ICMWMP) Template Activities Potential ES Issues and Risks Proposed Mitigation Measures Responsibilities Timeline Budget General HCF operation – General wastes, wastewater, and Environment air emissions General HCF operation –  Physical hazards; OHS issues  Electrical and explosive hazards;  Fire;  Chemical use;  Ergonomic hazard;  Radioactive hazard. HCF operation - Infection control and waste management plan Waste minimization, reuse and recycling Delivery and storage of specimen, samples, reagents, pharmaceuticals and medical supplies Storage and handling of specimen, samples, reagents, and infectious materials Waste segregation, packaging, color coding and labeling Onsite collection and transport Waste storage Onsite waste treatment and disposal Waste transportation to and disposal in offsite treatment and disposal facilities HCF operation – 137 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF Activities Potential ES Issues and Risks Proposed Mitigation Measures Responsibilities Timeline Budget transboundary movement of a specimen, samples, reagents, medical equipment, and infectious materials Emergency events  Spillage; Emergency response plan  Occupational exposure to infectious;  Exposure to radiation;  Accidental releases of infectious or hazardous substances to the environment;  Medical equipment failure;  Failure of solid waste and wastewater treatment facilities;  Fire;  Other emergent events Operation of acquired assets for holding potential COVID-19 patients To be expanded…. 138 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF ANNEX 05: INFECTION AND PREVENTION CONTROL PROTOCOL HEALTH CARE SETTINGS 1. Minimize Chance of Exposure (to staff, other patients and visitors)  Upon arrival, make sure patients with symptoms of any respiratory infection to a separate, isolated and well-ventilated section of the HCF to wait, and issue a facemask  During the visit, make sure all patients adhere to respiratory hygiene, cough etiquette, hand hygiene and isolation procedures. Provide oral instructions on registration and ongoing reminders with the use of simple signs with images in local languages  Provide alcohol-based hand sanitizer (60-95% alcohol), tissues and facemasks in waiting rooms and patient rooms  Isolate patients as much as possible. If separate rooms are not available, separate all patients by curtains. Only place together in the same room patients who are all definitively infected with COVID-19. No other patients can be placed in the same room. 2. Adhere to Standard Precautions  Train all staff and volunteers to undertake standard precautions - assume everyone is potentially infected and behave accordingly  Minimize contact between patients and other persons in the facility: health care professionals should be the only persons having contact with patients and this should be restricted to essential personnel only  A decision to stop isolation precautions should be made on a case-by-case basis, in conjunction with local health authorities. 3. Training of Personnel  Train all staff and volunteers in the symptoms of COVID-19, how it is spread and how to protect themselves. Train on correct use and disposal of personal protective equipment (PPE), including gloves, gowns, facemasks, eye protection and respirators (if available) and check that they understand  Train cleaning staff on most effective process for cleaning the facility: use a high-alcohol based cleaner to wipe down all surfaces; wash instruments with soap and water and then wipe down with high-alcohol based cleaner; dispose of rubbish by burning etc. 4. Manage Visitor Access and Movement  Establish procedures for managing, monitoring, and training visitors  All visitors must follow respiratory hygiene precautions while in the common areas of the facility, otherwise they should be removed  Restrict visitors from entering rooms of known or suspected cases of COVID-19 patients Alternative communications should be encouraged, for example by use of mobile phones. Exceptions only for end-of-life situation and children requiring emotional care. At these times, PPE should be used by visitors.  All visitors should be scheduled and controlled, and once inside the facility, instructed to limit their movement.  Visitors should be asked to watch out for symptoms and report signs of acute illness for at least 14 days. 139 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF Construction site Settings in Areas of Confirmed Cases of COVID-19 1. Minimize Chance of Exposure  Any worker showing symptoms of respiratory illness (fever + cold or cough) and has potentially been exposed to COVID-19 should be immediately removed from the site and tested for the virus at the nearest local hospital  Close co-workers and those sharing accommodations with such a worker should also be removed from the site and tested  Project management must identify the closest hospital that has testing facilities in place, refer workers, and pay for the test if it is not free  Persons under investigation for COVID-19 should not return to work at the project site until cleared by test results. During this time, they should continue to be paid daily wages  If a worker is found to have COVID-19, wages should continue to be paid during the worker‘s convalescence (whether at home or in a hospital)  If project workers live at home, any worker with a family member who has a confirmed or suspected case of COVID-19 should be quarantined from the project site for 14 days, and continued to be paid daily wages, even if they have no symptoms. 2. Training of Staff and Precautions  Train all staff in the signs and symptoms of COVID-19, how it is spread, how to protect themselves and the need to be tested if they have symptoms. Allow Q&A and dispel any myths.  Use existing grievance procedures to encourage reporting of co-workers if they show outward symptoms, such as ongoing and severe coughing with fever, and do not voluntarily submit to testing  Supply face masks and other relevant PPE to all project workers at the entrance to the project site. Any persons with signs of respiratory illness that is not accompanied by fever should be mandated to wear a face mask  Provide handwash facilities, hand soap, alcohol-based hand sanitizer and mandate their use on entry and exit of the project site and during breaks, via the use of simple signs with images in local languages  Train all workers in respiratory hygiene, cough etiquette and hand hygiene using demonstrations and participatory methods  Train cleaning staff in effective cleaning procedures and disposal of rubbish 3. Managing Access and Spread  Should a case of COVID-19 be confirmed in a worker on the project site, visitors should be restricted from the site and worker groups should be isolated from each other as much as possible; Extensive cleaning procedures with high-alcohol content cleaners should be undertaken in the area of the site where the worker was present, prior to any further work being undertaken in that area. 140 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF ANNEX 06: WATER, SANITATION AND HYGIENE (WASH) PROTOCOLS FOR HEALTHCARE FACILITIES TREATING COVID-19 PATIENTS (Adapted from WHO/UNICEF Water, sanitation, hygiene, and waste management for the COVID-19 virus (Interim guidance) 2019) The following actions are particularly important: (i) managing excreta (faeces and urine) safely, including ensuring that no one comes into contact with it and that it is treated and disposed of correctly; (ii) engaging in frequent hand hygiene using appropriate techniques; (iii) implementing regular cleaning and disinfection practices; and (iv) safely managing health care waste. Other important measures include providing sufficient safe drinking-water to staff, caregivers, and patients; ensuring that personal hygiene can be maintained, including hand hygiene, for patients, staff and caregivers; regularly laundering bed sheets and patients‘ clothing; providing adequate and accessible toilets (including separate facilities for confirmed and suspected cases of COVID-19 infection); and segregating and safely disposing of health care waste. 1. Hand hygiene practices: If hands are not visibly dirty, the preferred method is to perform hand hygiene with an alcohol-based hand rub for 20−30 seconds using the appropriate technique. When hands are visibly dirty, they should be washed with soap and water for 40−60 seconds using the appropriate technique. Hand hygi ene should be performed at all five moments, including before putting on PPE and after removing it, when changing gloves, after any contact with a patient with suspected or confirmed COVID-19 infection or their waste, after contact with any respiratory secretions, before eating, and after using the toilet. If an alcohol-based hand rub and soap are not available, then using chlorinated water (0.05%) for hand washing is an option, but it is not ideal because frequent use may lead to dermatitis, which could increase the risk of infection and asthma and because prepared dilutions might be inaccurate. However, if other options are not available or feasible, using chlorinated water for hand washing is an option. Functional hand hygiene facilities should be present for all health care workers at all points of care and in areas where PPE is put on or taken off. In addition, functional hand hygiene facilities should be available for all patients, family members, and visitors, and should be available within 5 m of toilets, as well as in waiting and dining rooms and other public areas. 2. Sanitation and plumbing People with suspected or confirmed COVID-19 disease should be provided with their own flush toilet or latrine that has a door that closes to separate it from the patient‘s room. Flush toilets should operate properly and have functioning drain traps. When possible, the toilet should be flushed with the lid down to prevent droplet splatter and aerosol clouds. If it is not possible to provide separate toilets, the toilet should be cleaned and disinfected at least twice daily by a trained cleaner wearing PPE (gown, gloves, boots, mask, and a face shield or goggles). Further, and consistent with existing guidance, staff and health care workers should have toilet facilities that are separate from those used by all patients. WHO recommends the use of standard, well-maintained plumbing, such as sealed bathroom drains, and backflow valves on sprayers and faucets to prevent aerosolized faecal matter from entering the plumbing or ventilation system, together with standard wastewater treatment. If HCF are connected to sewers, a risk assessment should be conducted to confirm that wastewater is contained within the system (that is, the system does not leak) before its arrival at a functioning treatment or disposal site, or both. For smaller HCF in low-resource settings, if space and local conditions allow, pit latrines may be the preferred option. Standard precautions should be taken to prevent contamination of the environment by excreta. These precautions include ensuring that at least 1.5 m exists between the bottom of the pit and the groundwater table (more space should be allowed in coarse sands, gravels, and fissured formations) and that the latrines are located at least 30 m horizontally from any groundwater source (including both shallow wells and boreholes). If there is a high groundwater table or a lack of space to dig pits, excreta should be retained in impermeable storage containers and left for as long as feasible to allow for a reduction in virus levels before moving it off-site for additional treatment or safe disposal, or both. A two-tank system with parallel tanks would help facilitate inactivation by maximizing retention times, as one tank could be used 141 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF until full, then allowed to sit while the next tank is being filled. Particular care should be taken to avoid splashing and the release of droplets while cleaning or emptying tanks. 3. Toilets and the handling of faeces It is critical to conduct hand hygiene when there is suspected or direct contact with faeces (if hands are dirty, then soap and water are preferred to the use of an alcohol-based hand rub). If the patient is unable to use a latrine, excreta should be collected in either a diaper or a clean bedpan and immediately and carefully disposed of into a separate toilet or latrine used only by suspected or confirmed cases of COVID-19. In all health care settings, including those with suspected or confirmed COVID-19 cases, faeces must be treated as a biohazard and handled as little as possible. Anyone handling faeces should follow WHO contact and droplet precautions and use PPE to prevent exposure, including long-sleeved gowns, gloves, boots, masks, and goggles or a face shield. If diapers are used, they should be disposed of as infectious waste as they would be in all situations. Workers should be properly trained in how to put on, use, and remove PPE so that these protective barriers are not breached. If PPE is not available or the supply is limited, hand hygiene should be regularly practiced, and workers should keep at least 1 m distance from any suspected or confirmed cases. If a bedpan is used, after disposing of excreta from it, the bedpan should be cleaned with a neutral detergent and water, disinfected with a 0.5% chlorine solution, and then rinsed with clean water; the rinse water should be disposed of in a drain or a toilet or latrine. Other effective disinfectants include commercially available quaternary ammonium compounds, such as cetylpyridinium chloride, used according to manufacturer‘s instructions, and peracetic or peroxyacetic acid at concentrations of 500−2000 mg/L. Chlorine is ineffective for disinfecting media containing large amounts of solid and dissolved organic matter. Therefore, there is limited benefit to adding chlorine solution to fresh excreta and it is possible that this may introduce risks associated with splashing. 4. Emptying latrines and holding tanks, and transporting excreta off-site. There is no reason to empty latrines and holding tanks of excreta from suspected or confirmed COVID-19 cases unless they are at capacity. Latrines or holding tanks should be designed to meet patient demand, considering potential sudden increases in cases, and there should be a regular schedule for emptying them based on the wastewater volumes generated. PPE (long-sleeved gown, gloves, boots, masks, and goggles or a face shield) should be worn at all times when handling or transporting excreta offsite, and great care should be taken to avoid splashing. For crews, this includes pumping out tanks or unloading pumper trucks. After handling the waste and once there is no risk of further exposure, individuals should safely remove their PPE and perform hand hygiene before entering the transport vehicle. Soiled PPE should be put in a sealed bag for later safe laundering (see Cleaning practices). Where there is no off-site treatment, in-situ treatment can be done using lime. Such treatment involves using a 10% lime slurry added at 1-part lime slurry per 10 parts of waste. 5. Cleaning practices Laundry should be done and surfaces in all environments in which COVID-19 patients receive care (treatment units, community care centres) should be cleaned at least once a day and when a patient is discharged. Many disinfectants are active against enveloped viruses, such as the COVID-19 virus, including commonly used hospital disinfectants. Currently, WHO recommends using:  70% ethyl alcohol to disinfect small areas between uses, such as reusable dedicated equipment (for example, thermometers);  sodium hypochlorite at 0.5% (equivalent to 5000 ppm) for disinfecting surfaces. All individuals dealing with soiled bedding, towels, and clothes from patients with COVID-19 infection should wear appropriate PPE before touching soiled items, including heavy duty gloves, a mask, eye protection (goggles or a face shield), a long-sleeved gown, an apron if the gown is not fluid resistant, and boots or closed shoes. They should perform hand hygiene after exposure to blood or body fluids and after removing PPE. Soiled linen should be placed in clearly labeled, leak-proof bags or containers, after carefully removing any solid excrement and putting it in a covered bucket to be disposed of in a toilet or latrine. Machine washing with warm water at 60−90°C (140−194°F) with laundry detergent is 142 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF recommended. The laundry can then be dried according to routine procedures. If machine washing is not possible, linens can be soaked in hot water and soap in a large drum using a stick to stir and being careful to avoid splashing. The drum should then be emptied, and the linens soaked in 0.05% chlorine for approximately 30 minutes. Finally, the laundry should be rinsed with clean water and the linens allowed to dry fully in sunlight. If excreta are on surfaces (such as linens or the floor), the excreta should be carefully removed with towels and immediately safely disposed of in a toilet or latrine. If the towels are single use, they should be treated as infectious waste; if they are reusable, they should be treated as soiled linens. The area should then be cleaned and disinfected (with, for example, 0.5% free chlorine solution), following published guidance on cleaning and disinfection procedures for spilled body fluids. 6. Safely disposing of greywater or water from washing PPE, surfaces and floors. Current WHO recommendations are to clean utility gloves or heavy duty, reusable plastic aprons with soap and water and then decontaminate them with 0.5% sodium hypochlorite solution after each use. Single-use gloves (nitrile or latex) and gowns should be discarded after each use and not reused; hand hygiene should be performed after PPE is removed. If greywater includes disinfectant used in prior cleaning, it does not need to be chlorinated or treated again. However, it is important that such water is disposed of in drains connected to a septic system or sewer or in a soakaway pit. If greywater is disposed of in a soakaway pit, the pit should be fenced off within the health facility grounds to prevent tampering and to avoid possible exposure in the case of overflow. 7. Safe management of health care waste Best practices for safely managing health care waste should be followed, including assigning responsibility and sufficient human and material resources to dispose of such waste safely. All health care waste produced during the care of COVID-19 patients should be collected safely in designated containers and bags, treated, and then safely disposed of or treated, or both, preferably onsite. If waste is moved off- site, it is critical to understand where and how it will be treated and destroyed. All who handle health care waste should wear appropriate PPE (boots, apron, long-sleeved gown, thick gloves, mask, and goggles or a face shield) and perform hand hygiene after removing it. 143 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF ANNEX 07: RESOURCE LIST: COVID-19 GUIDANCE WHO Guidance Advice for the public  WHO advice for the public, including on social distancing, respiratory hygiene, self-quarantine, and seeking medical advice, can be consulted on this WHO website: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public Technical guidance  Infection prevention and control during health care when novel coronavirus (nCoV) infection is suspected, issued on March 19, 2020  Recommendations to Member States to Improve Hygiene Practices, issued on April 1, 2020  Severe Acute Respiratory Infections Treatment Center, issued on March 28, 2020  Infection prevention and control at health care facilities (with a focus on settings with limited resources), issued in 2018  Laboratory biosafety guidance related to coronavirus disease 2019 (COVID-19), issued on March 18, 2020  Laboratory Biosafety Manual, 3rd edition, issued in 2014  Laboratory testing for COVID-19, including specimen collection and shipment, issued on March 19, 2020  Prioritized Laboratory Testing Strategy According to 4Cs Transmission Scenarios, issued on March 21, 2020  Infection Prevention and Control for the safe management of a dead body in the context of COVID- 19, issued on March 24, 2020  Key considerations for repatriation and quarantine of travelers in relation to the outbreak COVID-19, issued on February 11, 2020  Preparedness, prevention and control of COVID-19 for refugees and migrants in non-camp settings, issued on April 17, 2020  Coronavirus disease (COVID-19) outbreak: rights, roles and responsibilities of health workers, including key considerations for occupational safety and health, issued on March 18, 2020  Oxygen sources and distribution for COVID-19 treatment centers, issued on April 4, 2020  Risk Communication and Community Engagement (RCCE) Action Plan Guidance COVID-19 Preparedness and Response, issued on March 16, 2020  Considerations for quarantine of individuals in the context of containment for coronavirus disease (COVID-19), issued on March 19, 2020  Operational considerations for case management of COVID-19 in health facility and community, issued on March 19, 2020  Rational use of personal protective equipment for coronavirus disease 2019 (COVID-19), issued on February 27, 2020  Getting your workplace ready for COVID-19, issued on March 19, 2020  Water, sanitation, hygiene and waste management for COVID-19, issued on March 19, 2020  Safe management of wastes from health-care activities, issued in 2014  Advice on the use of masks in the community, during home care and in healthcare settings in the context of the novel coronavirus (COVID-19) outbreak, issued on March 19, 2020  Disability Considerations during the COVID-19 outbreak, issued on March 26, 2020 144 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF WORLD BANK GROUP GUIDANCE  Technical Note: Public Consultations and Stakeholder Engagement in WB-supported operations when there are constraints on conducting public meetings, issued on March 20, 2020  Technical Note: Use of Military Forces to Assist in COVID-19 Operations, issued on March 25, 2020  ESF/Safeguards Interim Note: COVID-19 Considerations in Construction/Civil Works Projects, issued on April 7, 2020  Technical Note on SEA/H for HNP COVID Response Operations, issued in March 2020  Interim Advice for IFC Clients on Preventing and Managing Health Risks of COVID-19 in the Workplace, issued on April 6, 2020  Interim Advice for IFC Clients on Supporting Workers in the Context of COVID-19, issued on April 6, 2020  IFC Tip Sheet for Company Leadership on Crisis Response: Facing the COVID-19 Pandemic, issued on April 6, 2020  WBG EHS Guidelines for Healthcare Facilities, issued on April 30, 2007 ILO GUIDANCE  ILO Standards and COVID-19 FAQ, issued on March 23, 2020 (provides a compilation of answers to most frequently asked questions related to international labor standards and COVID-19) IFI GUIDANCE  ADB Managing Infectious Medical Waste during the COVID-19 Pandemic  IDB Invest Guidance for Infrastructure Projects on COVID-19: A Rapid Risk Profile and Decision Framework  KfW DEG COVID-19 Guidance for employers, issued on March 31, 2020  CDC Group COVID-19 Guidance for Employers, issued on March 23, 2020 145 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF ANNEX 08: WB INTERIM NOTE: COVID-19 CONSIDERATIONS IN CIVIL WORKS PROJECTS This note was issued on April 7, 2020 and includes links to the latest guidance as of this date (e.g. from WHO). Given the COVID-19 situation is rapidly evolving, when using this note it is important to check whether any updates to these external resources have been issued. 1. Introduction The COVID-19 pandemic presents Governments with unprecedented challenges. Addressing COVID-19 related issues in both existing and new operations starts with recognizing that this is not business as usual and that circumstances require a highly adaptive responsive management design to avoid, minimize and manage what may be a rapidly evolving situation. In many cases, we will ask Borrowers to use reasonable efforts in the circumstances, recognizing that what may be possible today may be different next week (both positively, because more supplies and guidance may be available, and negatively, because the spread of the virus may have accelerated). This interim note is intended to guide teams on how to support Borrowers in addressing key issues associated with COVID-19 and consolidates the advice that has already been provided over the past month. As such, it should be used in place of other guidance that has been provided to date. This note will be developed as the global situation and the Bank‘s learning (and that of others) develops. This is not a time when ‗one size fits all‘. More than ever, teams will need to work with Borrow ers and projects to understand the activities being carried out and the risks that these activities may entail. Support will be needed in designing mitigation measures that are implementable in the context of the project. These measures will need to take into account the capacity of the Government agencies, availability of supplies, and the practical challenges of operations on-the-ground, including stakeholder engagement, supervision, and monitoring. In many circumstances, communication itself may be challenging, where face-to-face meetings are restricted or prohibited, and where IT solutions are limited or unreliable. This note emphasizes the importance of careful scenario planning, clear procedures and protocols, management systems, effective communication and coordination, and the need for high levels of responsiveness in a changing environment. It recommends assessing the current situation of the project, putting in place mitigation measures to avoid or minimize the chance of infection, and planning what to do if either project workers become infected or the workforce includes workers from proximate communities affected by COVID-19. In many projects, measures to avoid or minimize will need to be implemented at the same time as dealing with sick workers and relations with the community, some of whom may also be ill or concerned about infection. Borrowers should understand the obligations that contractors have under their existing contracts (see Section 3), require contractors to put in place appropriate organizational structures (see Section 4) and develop procedures to address different aspects of COVID-19 (see Section 5). 2. Challenges with construction/civil works Projects involving construction/civil works frequently involve a large workforce, together with suppliers and supporting functions and services. The workforce may comprise workers from international, national, regional, and local labor markets. They may need to live in on-site accommodation, lodge within communities close to work sites, or return to their homes after work. There may be different contractors permanently present on site, carrying out different activities, each with their dedicated workers. Supply chains may involve international, regional, and national suppliers facilitating the regular flow of goods and services to the project (including supplies essential to the project such as fuel, food, and water). As such there will also be a regular flow of parties entering and exiting the site; support services, such as catering, cleaning services, equipment, material and supply deliveries, and specialist sub-contractors, brought in to deliver specific elements of the works. Given the complexity and the concentrated number of workers, the potential for the spread of infectious disease in projects involving construction is extremely serious, as are the implications of such a spread. Projects may experience large numbers of the workforce becoming ill, which will strain the project‘s health facilities, have implications for local emergency and health services, and may jeopardize the progress of the construction work and the schedule of the project. Such impacts will be exacerbated where a workforce is large and/or the project is in remote or under-serviced areas. In such circumstances, relationships with the community can be strained or difficult and conflict can arise, particularly if people 146 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF feel they are being exposed to disease by the project or are having to compete for scarce resources. The project must also exercise appropriate precautions against introducing the infection to local communities. 3. Does the construction contract cover this situation? Given the unprecedented nature of the COVID-19 pandemic, it is unlikely that the existing construction/civil works contracts will cover all the things that a prudent contractor will need to do. Nevertheless, the first place for a Borrower to start is with the contract, determining what a contractor‘s existing obligations are, and how these relate to the current situation. The obligations on health and safety will depend on what kind of contract exists (between the Borrower and the main contractor; between the main contractors and the sub-contractors). It will differ if the Borrower used the World Bank‘s standard procurement documents (SPDs) or used national bidding documents. If a FIDIC document has been used, there will be general provisions relating to health and safety. For example, the standard FIDIC, Conditions of Contract for Construction (Second Edition 2017), which contains no ‗ESF enhancements‘, states (in the General Conditions, clause 6.7) that the Contractor will be required:  to take all necessary precautions to maintain the health and safety of the Contractor‘s Personnel  to appoint a health and safety officer at site, who will have the authority to issue directives to maintain the health and safety of all personnel authorized to enter and or work on the site and to take protective measures to prevent accidents  to ensure, in collaboration with local health authorities, that medical staff, first aid facilities, sickbay, ambulance services and any other medical services specified are available at all times at the site and any accommodation  to ensure suitable arrangements are made for all necessary welfare and hygiene requirements and the prevention of epidemics These requirements have been enhanced through the introduction of the ESF into the SPDs (edition dated July 2019). The general FIDIC clause referred to above has been strengthened to reflect the requirements of the ESF. Beyond FIDIC‘s general requirements discussed above, the Bank‘s Particular Conditions include some relevant requirements on the Contractor, including:  to provide health and safety training for Contractor‘s Personnel (which include project workers and all personnel that the Contractor uses on-site, including staff and other employees of the Contractor and Sub-contractors and any other personnel assisting the Contractor in carrying out project activities)  to put in place workplace processes for Contractor‘s Personnel to report work situations that are not safe or healthy  gives Contractor‘s Personnel the right to report work situations which they believe are not safe or healthy, and to remove themselves from a work situation which they have a reasonable justification to believe presents an imminent and serious danger to their life or health (with no reprisal for reporting or removing themselves)  requires measures to be in place to avoid or minimize the spread of diseases including measures to avoid or minimize the transmission of communicable diseases that may be associated with the influx of temporary or permanent contract-related labor  to provide an easily accessible grievance mechanism to raise workplace concerns Where the contract form used is FIDIC, the Borrower (as the Employer) will be represented by the Engineer (also referred to in this note as the Supervising Engineer). The Engineer will be authorized to exercise authority specified in or necessarily implied from the construction contract. In such cases, the Engineer (through its staff on-site) will be the interface between the PCU and the Contractor. It is important therefore to understand the scope of the Engineer‘s responsibilities. It is also important to recognize that in the case of infectious diseases such as COVID-19, project management – through the Contractor/sub-contractor hierarchy – is only as effective as the weakest link. A thorough review of management procedures/plans as they will be implemented through the entire contractor hierarchy is important. Existing contracts provide the outline of this structure; they form the basis for the Borrower to 147 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF understand how proposed mitigation measures will be designed and how adaptive management will be implemented and to start a conversation with the Contractor on measures to address COVID-19 in the project. 4. WHAT PLANNING SHOULD THE BORROWER BE DOING? Task teams should work with Borrowers (PCUs) to confirm that projects (i) are taking adequate precautions to prevent or minimize an outbreak of COVID-19, and (ii) have identified what to do in the event of an outbreak. Suggestions on how to do this are set out below:  The PCU, either directly or through the Supervising Engineer, should request details in writing from the Main Contractor of the measures being taken to address the risks. As stated in Section 3, the construction contract should include health and safety requirements, and these can be used as the basis for identification of, and requirements to implement COVID-19 specific measures. The measures may be presented as a contingency plan, as an extension of the existing project emergency and preparedness plan or as standalone procedures. The measures may be reflected in revisions to the project‘s health and safety manual. This request should be made in writing (following any relevant procedure set out in the contract between the Borrower and the contractor).  In making the request, it may be helpful for the PCU to specify the areas that should be covered. This should include the items set out in Section 5 below and take into account current and relevant guidance provided by national authorities, WHO, and other organizations. See the list of references in the Annex to this note.  The PCU should require the Contractor to convene regular meetings with the project health and safety specialists and medical staff (and where appropriate the local health authorities), and to take their advice in designing and implementing the agreed measures.  Where possible, a senior person should be identified as a focal point to deal with COVID-19 issues. This can be a work supervisor or a health and safety specialist. This person can be responsible for coordinating the preparation of the site and making sure that the measures taken are communicated to the workers, those entering the site, and the local community. It is also advisable to designate at least one back-up person; in case the focal point becomes ill; that person should be aware of the arrangements that are in place.  On sites where there are several contractors and therefore (in effect) different workforces, the request should emphasize the importance of coordination and communication between the different parties. Where necessary, the PCU should request the main contractor to put in place a protocol for regular meetings of the different contractors, requiring each to appoint a designated staff member (with back up) to attend such meetings. If meetings cannot be held in person, they should be conducted using whatever IT is available. The effectiveness of mitigation measures will depend on the weakest implementation, and therefore all contractors and sub-contractors must understand the risks and the procedure to be followed.  The PCU, either directly or through the Supervising Engineer, may provide support to projects in identifying appropriate mitigation measures, particularly where these will involve interface with local services, in particular health and emergency services. In many cases, the PCU can play a valuable role in connecting project representatives with local Government agencies and helping coordinate a strategic response, which takes into account the availability of resources. To be most effective, projects should consult and coordinate with relevant Government agencies and other projects in the vicinity.  Workers should be encouraged to use the existing project grievance mechanism to report concerns relating to COVID-19, preparations being made by the project to address COVID-19 related issues, how procedures are being implemented, and concerns about the health of their co- workers and other staff. 5. What should the contractor cover? The Contractor should identify measures to address the COVID-19 situation. What will be possible will depend on the context of the project: the location, existing project resources, availability of supplies, the 148 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF capacity of local emergency/health services, the extent to which the virus already exists in the area. A systematic approach to planning, recognizing the challenges associated with rapidly changing circumstances, will help the project put in place the best measures possible to address the situation. As discussed above, measures to address COVID-19 may be presented in different ways (as a contingency plan, as an extension of the existing project emergency and preparedness plan or as standalone procedures). The PCUs and contractors should refer to guidance issued by relevant authorities, both national and international (e.g. WHO), which is regularly updated (see sample References and links provided in the references). Addressing COVID-19 at a project site goes beyond occupational health and safety and is a broader project issue which will require the involvement of different members of a project management team. In many cases, the most effective approach will be to establish procedures to address the issues and then to ensure that these procedures are implemented systematically. Where appropriate given the project context, a designated team should be established to address COVID-19 issues, including PCU representatives, the Supervising Engineer, management (e.g. the project manager) of the contractor and sub-contractors, security, and medical and OHS professionals. Procedures should be clear and straightforward, improved as necessary, and supervised and monitored by the COVID-19 focal point(s). Procedures should be documented, distributed to all contractors, and discussed at regular meetings to facilitate adaptive management. The issues set out below include a number that represents expected good workplace management but is especially pertinent in preparing the project response to COVID-19. (a) Assessing workforce characteristics Many construction sites will have a mix of workers e.g. workers from the local communities; workers from a different part of the country; workers from another country. Workers will be employed under different terms and conditions and be accommodated in different ways. Assessing these different aspects of the workforce will help in identifying appropriate mitigation measures:  The Contractor should prepare a detailed profile of the project workforce, key work activities, schedule for carrying out such activities, different durations of contract, and rotations (e.g. 4 weeks on, 4 weeks off).  This should include a breakdown of workers who reside at home (i.e. workers from the community), workers who lodge within the local community and workers in on-site accommodation. Where possible, it should also identify workers that may be more at risk from COVID-19, those with underlying health issues, or who may be otherwise at risk.  Consideration should be given to ways in which to minimize movement in and out of the project site. This could include lengthening the term of existing contracts, to avoid workers returning home to affected areas, or returning to site from affected areas.  Workers accommodated on-site should be required to minimize contact with people near the site, and in certain cases be prohibited from leaving the site for the duration of their contract, so that contact with local communities is avoided.  Consideration should be given to requiring workers lodging in the local community to move to site accommodation (subject to availability) where they would be subject to the same restrictions.  Workers from local communities, who return home daily, weekly or monthly, will be more difficult to manage. They should be subject to health checks at the entry to the site (as set out above) and at some point, circumstances may make it necessary to require them to either use accommodation on- site or not to come to work. (b) Entry/exit to the worksite and checks on commencement of work Entry/exit to the work site should be controlled and documented for both workers and other parties, including support staff and suppliers. Possible measures may include:  Establishing a system for controlling entry/exit to the site, securing the boundaries of the site, and establishing designating entry/exit points (if they do not already exist). Entry/exit to the site should be documented. 149 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF  Training security staff on the (enhanced) system that has been put in place for securing the site and controlling entry and exit, the behaviors required of them in enforcing such system, and any COVID - 19 specific considerations.  Training staff who will be monitoring entry to the site, providing them with the resources they need to document entry of workers, conducting temperature checks, and recording details of any workers that are denied entry.  Confirming that workers are fit for work before they enter the site or start work. While procedures should already be in place for this, special attention should be paid to workers with underlying health issues or who may be otherwise at risk. Consideration should be given to the demobilization of staff with underlying health issues.  Checking and recording temperatures of workers and other people entering the site or requiring self- reporting before or on entering the site.  Providing daily briefings to workers before commencing work, focusing on COVID-19 specific considerations including cough etiquette, hand hygiene, and distancing measures, using demonstrations and participatory methods.  During the daily briefings, reminding workers to self-monitor for possible symptoms (fever, cough) and to report to their supervisor or the COVID-19 focal point if they have symptoms or are feeling unwell.  Preventing a worker from an affected area or who has been in contact with an infected person from returning to the site for 14 days or (if that is not possible) isolating such workers for 14 days.  Preventing a sick worker from entering the site, referring them to local health facilities if necessary, or requiring them to isolate at home for 14 days. (c) General hygiene Requirements on general hygiene should be communicated and monitored, to include:  Training workers and staff on-site on the signs and symptoms of COVID-19, how it is spread, how to protect themselves (including regular handwashing and social distancing), and what to do if they or other people have symptoms (for further information see WHO COVID-19 advice for the public).  Placing posters and signs around the site, with images and text in local languages.  Ensuring handwashing facilities supplied with soap, disposable paper towels and closed waste bins exist at key places throughout the site, including at entrances/exits to work areas; where there is a toilet, canteen or food distribution, or provision of drinking water; in worker accommodation; at waste stations; at stores; and in common spaces. Where handwashing facilities do not exist or are not adequate, arrangements should be made to set them up. Alcohol-based sanitizer (if available, 60-95% alcohol) can also be used.  Review worker accommodations, and assess them in light of the requirements set out in IFC/EBRD guidance on Workers‘ Accommodation: processes and standards, which provides valuable guidance as to good practice for accommodation.  Setting aside part of worker accommodation for precautionary self-quarantine as well as more formal isolation of staff who may be infected (see paragraph (f)). (d) Cleaning and waste disposal Conduct regular and thorough cleaning of all site facilities, including offices, accommodation, canteens, common spaces. Review cleaning protocols for key construction equipment (particularly if it is being operated by different workers). This should include:  Providing cleaning staff with adequate cleaning equipment, materials, and disinfectant.  Review general cleaning systems, training cleaning staff on appropriate cleaning procedures, and appropriate frequency in high use or high-risk areas. 150 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF  Where it is anticipated that cleaners will be required to clean areas that have been or are suspected to have been contaminated with COVID-19, providing them with appropriate PPE: gowns or aprons, gloves, eye protection (masks, goggles or face screens) and boots or closed work shoes. If appropriate PPE is not available, cleaners should be provided with the best available alternatives.  Training cleaners in proper hygiene (including handwashing) before, during, and after conducting cleaning activities; how to safely use PPE (where required); in waste control (including for used PPE and cleaning materials).  Any medical waste produced during the care of ill workers should be collected safely in designated containers or bags and treated and disposed of following relevant requirements (e.g., national, WHO). If incineration of medical wastes are necessary, this should be for a limited duration as possible. Waste should be reduced and segregated, so that only the smallest amount of waste is incinerated (for further information see WHO interim guidance on water, sanitation, and waste management for COVID-19). (e) Adjusting work practices Consider changes to work processes and timings to reduce or minimize contact between workers, recognizing that this is likely to impact the project schedule. Such measures could include:  Decreasing the size of the work teams.  Limiting the number of workers on-site at any one time.  Changing to a 24-hour work rotation.  Adapting or redesigning work processes for specific work activities and tasks to enable social distancing, and training workers on these processes.  Continuing with the usual safety training, adding COVID-19 specific considerations. Training should include the proper use of normal PPE. While as of the date of this note, the general advice is that construction workers do not require COVID-19 specific PPE, this should be kept under review (for further information see WHO interim guidance on the rational use of personal protective equipment (PPE) for COVID-19).  Reviewing work methods to reduce the use of construction PPE, in case of supplies become scarce or the PPE is needed for medical workers or cleaners. This could include, e.g. trying to reduce the need for dust masks by checking that water sprinkling systems are in good working order and are maintained or reducing the speed limit for haul trucks.  Arranging (where possible) for work breaks to be taken in outdoor areas within the site.  Consider changing canteen layouts and phasing mealtimes to allow for social distancing and phasing access to and/or temporarily restricting access to leisure facilities that may exist on-site, including gyms.  At some point, it may be necessary to review the overall project schedule, to assess the extent to which it needs to be adjusted (or work stopped completely) to reflect prudent work practices, potential exposure of both workers and the community and availability of supplies, taking into account Government advice and instructions. (b) Project medical services Consider whether existing project medical services are adequate, taking into account existing infrastructure (size of clinic/medical post, number of beds, isolation facilities), medical staff, equipment and supplies, procedures, and training. Where these are not adequate, consider upgrading services where possible, including:  Expanding medical infrastructure and preparing areas where patients can be isolated. Guidance on setting up isolation facilities is set out in WHO interim guidance on considerations for quarantine of individuals in the context of containment for COVID-19). Isolation facilities should be located away from worker accommodation and ongoing work activities. Where possible, workers should be 151 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF provided with a single well-ventilated room (open windows and door). Where this is not possible, isolation facilities should allow at least 1 meter between workers in the same room, separating workers with curtains, if possible. Sick workers should limit their movements, avoiding common areas and facilities, and not be allowed visitors until they have been clear of symptoms for 14 days. If they need to use common areas and facilities (e.g. kitchens or canteens), they should only do so when unaffected workers are not present, and the area/facilities should be cleaned before and after such use.  Training medical staff, which should include current WHO advise on COVID-19 and recommendations on the specifics of COVID-19. Where COVID-19 infection is suspected, medical providers on-site should follow WHO interim guidance on infection prevention and control during health care when novel coronavirus (nCoV) infection is suspected.  Training medical staff in testing, if testing is available.  Assessing the current stock of equipment, supplies, and medicines on-site, and obtaining additional stock, where required and possible. This could include medical PPE, such as gowns, aprons, medical masks, gloves, and eye protection. Refer to WHO guidance as to what is advised (for further information see WHO interim guidance on the rational use of personal protective equipment (PPE) for COVID-19).  If PPE items are unavailable due to worldwide shortages, medical staff on the project should agree on alternatives and try to procure them. Alternatives that may commonly be found on construction sites include dust masks, construction gloves, and eye goggles. While these items are not recommended, they should be used as a last resort if no medical PPE is available.  Ventilators will not normally be available on worksites, and in any event, intubation should only be conducted by experienced medical staff. If a worker is extremely ill and unable to breathe properly on his or her own, they should be referred immediately to the local hospital (see (g) below).  Review existing methods for dealing with medical waste, including systems for storage and disposal (for further information see WHO interim guidance on water, sanitation and waste management for COVID-19, and WHO guidance on the safe management of wastes from health-care activities). (c) Local medical and other services Given the limited scope of project medical services, the project may need to refer sick workers to local medical services. Preparation for this includes:  Obtaining information as to the resources and capacity of local medical services (e.g. number of beds, availability of trained staff, and essential supplies).  Conducting preliminary discussions with specific medical facilities, to agree on what should be done in the event of ill workers needing to be referred to.  Considering ways in which the project may be able to support local medical services in preparing for members of the community becoming ill, recognizing that the elderly or those with pre-existing medical conditions require additional support to access appropriate treatment if they become ill.  Clarifying how an ill worker will be transported to the medical facility and checking the availability of such transportation.  Establishing an agreed protocol for communications with local emergency/medical services.  Agreeing with the local medical services/specific medical facilities the scope of services to be provided, the procedure for in-take of patients, and (where relevant) any costs or payments that may be involved.  A procedure should also be prepared so that project management knows what to do in the unfortunate event that a worker ill with COVID-19 dies. While normal project procedures will continue to apply, COVID-19 may raise other issues because of the infectious nature of the disease. The project should liaise with the relevant local authorities to coordinate what should be done, including any reporting or other requirements under national law. 152 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF (d) Instances or spread of the virus WHO provides detailed advice on what should be done to treat a person who becomes sick or displays symptoms that could be associated with the COVID-19 virus (for further information see WHO interim guidance on infection prevention and control during health care when novel coronavirus (nCoV) infection is suspected). The project should set out risk-based procedures to be followed, with differentiated approaches based on case severity (mild, moderate, severe, critical) and risk factors (such as age, hypertension, diabetes) (for further information see WHO interim guidance on operational considerations for case management of COVID-19 in health facility and community). These may include the following:  If a worker has symptoms of COVID-19 (e.g. fever, dry cough, fatigue) the worker should be removed immediately from work activities and isolated on site.  If testing is available on site, the worker should be tested on-site. If a test is not available at the site, the worker should be transported to the local health facilities to be tested (if testing is available).  If the test is positive for COVID-19 or no testing is available, the worker should continue to be isolated. This will either be at the worksite or home. If at home, the worker should be transported to their home in transportation provided by the project.  Extensive cleaning procedures with high-alcohol content disinfectants should be undertaken in the area where the worker was present, before any further work being undertaken in that area. Tools used by the worker should be cleaned using disinfectant and PPE disposed of.  Co-workers (i.e. workers with whom the sick worker was in close contact) should be required to stop work, and be required to quarantine themselves for 14 days, even if they have no symptoms.  Family and other close contacts of the worker should be required to quarantine themselves for 14 days, even if they have no symptoms.  If a case of COVID-19 is confirmed in a worker on the site, visitors should be restricted from entering the site and working groups should be isolated from each other as much as possible.  If workers live at home and have a family member who has a confirmed or suspected case of COVID-19, the worker should quarantine themselves and not be allowed on the project site for 14 days, even if they have no symptoms.  Workers should continue to be paid throughout periods of illness, isolation, or quarantine, or if they are required to stop work, following national law.  Medical care (whether on-site or in a local hospital or clinic) required by a worker should be paid for by the employer. (e) Continuity of supplies and project activities Where COVID-19 occurs, either in the project site or the community, access to the project site may be restricted, and the movement of supplies may be affected.  Identify back-up individuals, in case key people within the project management team (PCU, Supervising Engineer, Contractor, sub-contractors) become ill, and communicate who these are so that people are aware of the arrangements that have been put in place.  Document procedures, so that people know what they are, and are not reliant on one person‘s knowledge.  Understand the supply chain for necessary supplies of energy, water, food, medical supplies, and cleaning equipment, consider how it could be impacted, and what alternatives are available. Early pro-active review of international, regional, and national supply chains, especially for those supplies that are critical for the project, is important (e.g. fuel, food, medical, cleaning, and other essential supplies). Planning for a 1-2 month interruption of critical goods may be appropriate for projects in more remote areas. 153 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF  Place orders for/procure critical supplies. If not available, consider alternatives (where feasible).  Consider existing security arrangements, and whether these will be adequate in the event of an interruption to normal project operations.  Consider at what point it may become necessary for the project to significantly reduce activities or to stop work completely, and what should be done to prepare for this, and to re-start work when it becomes possible or feasible. (f) Training and communication with workers Workers need to be provided with regular opportunities to understand their situation, and how they can best protect themselves, their families, and the community. They should be made aware of the procedures that have been put in place by the project, and their responsibilities in implementing them.  It is important to be aware that in communities close to the site and amongst workers without access to project management, social media is likely to be a major source of information. This raises the importance of regular information and engagement with workers (e.g. through training, town halls, toolboxes) that emphasize what management is doing to deal with the risks of COVID-19. Allaying fear is an important aspect of workforce peace of mind and business continuity. Workers should be allowed to ask questions, express their concerns, and make suggestions.  Training of workers should be conducted regularly, as discussed in the sections above, providing workers with a clear understanding of how they are expected to behave and carry out their work duties.  Training should address issues of discrimination or prejudice if a worker becomes ill and provide an understanding of the trajectory of the virus, where workers return to work.  Training should cover all issues that would normally be required on the worksite, including the use of safety procedures, use of construction PPE, occupational health and safety issues, and code of conduct, taking into account that work practices may have been adjusted.  Communications should be clear, based on fact, and designed to be easily understood by workers, for example by displaying posters on hand washing and social distancing, and what to do if a worker displays symptoms. (g) Communication and contact with the community Relations with the community should be carefully managed, with a focus on measures that are being implemented to safeguard both workers and the community. The community may be concerned about the presence of non-local workers, or the risks posed to the community by a local worker's presence on the project site. The project should set out risk-based procedures to be followed, which may reflect WHO guidance (for further information see WHO Risk Communication and Community Engagement (RCCE) Action Plan Guidance COVID-19 Preparedness and Response). The following good practice should be considered:  Communications should be clear, regular, based on fact, and designed to be easily understood by community members.  Communications should utilize available means. In most cases, face-to-face meetings with the community or community representatives will not be possible. Other forms of communication should be used; posters, pamphlets, radio, text messages, electronic meetings. The means used should take into account the ability of different members of the community to access them, to make sure that communication reaches these groups.  The community should be made aware of procedures put in place at the site to address issues related to COVID-19. This should include all measures being implemented to limit or prohibit contact between workers and the community. These need to be communicated clearly, as some measures will have financial implications for the community (e.g. if workers are paying for lodging or using local facilities). The community should be made aware of the procedure for entry/exit to the site, the 154 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF training being given to workers, and the procedure that will be followed by the project if a worker becomes sick.  If project representatives, contractors, or workers are interacting with the community, they should practice social distancing and follow other COVID-19 guidance issued by relevant authorities, both national and international (e.g. WHO). 6. Emergency powers and legislation Many Borrowers are enacting emergency legislation. The scope of such legislation, and the way it interacts with other legal requirements, will vary from country to country. Such legislation can cover a range of issues, for example:  Declaring a public health emergency  Authorizing the use of police or military in certain activities (e.g. enforcing curfews or restrictions on movement)  Ordering certain categories of employees to work longer hours, not to take holiday or not to leave their job (e.g. health workers)  Ordering non-essential workers to stay at home, for reduced pay or compulsory holiday Except in exceptional circumstances (after referral to the World Bank‘s Operations Environmental and Social Review Committee (OESRC)), projects will need to follow emergency legislation to the extent that these are mandatory or advisable. The Borrower must understand how mandatory requirements of the legislation will impact the project. Teams should require Borrowers (and in turn, Borrowers should request Contractors) to consider how the emergency legislation will impact the obligations of the Borrower set out in the legal agreement and the obligations set out in the construction contracts. Where the legislation requires a material departure from existing contractual obligations, this should be documented, setting out the relevant provisions. 155 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF ANNEX 09: GENERAL CHECKLIST COVERING OHS, CHS, HYGIENE & SANITATION, DISEASES SAFETY TO SAFEGUARD AGAINST COVID-19 DURING EXECUTION OF WORKS S. N List of Activities Yes No N/A Remarks Ergonomics and Working Environment 1 Completion of a self‑assessment checklist (Self Declaration Form) to ensure workers comply with good ergonomic practices. 2 Appointment or designation of a contact person at the workplace so that workers can talk to about any concerns. 3 Set up ways of communication with workers to connect with them daily (ex. morning meetings, group SMS, etc.). 4 Provide information to workers about the support available to them (ex. through group SMS, meetings, or morning meetings, etc.). 5 Ensure automatic alerts set up on computer systems to remind workers about washing hands and not touching eyes, nose, and face. 6 If possible, accept only cashless transactions. 7 Increase access to closed bins in your workplace. Planning Ahead 8 Pre-approval for the deployment of new workmen from Project Director /Project Manager. 9 Avoiding entry of new workmen from known hotspots of COVID 19. 10 Allocating separate rooms for the new workmen in the workmen habitat. 11 A medical checkup by a doctor and contactless thermal scanning. 12 Ensure the signing of MoU with the COVID -19 designated hospital/Primary Health Care Unit and availability of medical practitioner with COVID-19 know-how in the locality or near vicinity of the workplace. 13 Develop a plan (Emergency Preparedness Plan) to ensure business continuity if there is a suspected or confirmed outbreak of COVID-19 in the workplace. 14 Plan for will done if any worker is suspected or confirmed to have COVID-19, including how to support that workman and what needs to be done to ensure the workplace remains safe for other workers. 15 Ensure appropriate cleaning products and personal protective equipment available to disinfect the workplace following an outbreak. 16 Put a protocol in place for reopening your workplace after an outbreak or quarantine period. 17 Medical Insurance of all workers before resuming a worksite. 18 Detailed profile of the project workforce, key work 156 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF S. N List of Activities Yes No N/A Remarks activities, schedule for carrying out such activities, different durations of contract, and rotations (e.g. 4 weeks on, 4 weeks off, or instructed by the Project Director/Project Manager). Symptoms Monitoring 19 Put up signs about the symptoms of COVID-19 in the workplace. 20 Instruct workers to stay home if they are sick, and if they are displaying symptoms of COVID-19. 21 Instruct workers to inform if they are displaying symptoms of COVID-19 have been in close contact with a person who has COVID-19 or has been tested for COVID-19. 22 Remind and ensure the staff of their leave entitlements if they are sick or required to self‑quarantine. 23 Treat personal information about the individual worker‘s health carefully and confidentially. Physical Distancing at Workplace and Office 24 Put up posters around the workplace on keeping at least 1.5 meters distance between everyone at the workplace. 25 Erect signs at the entrances to meeting rooms to ensure the maximum safe capacity is not exceeded. 26 Move workstations, desks, and tables in staffrooms further apart to comply with social distancing. 27 If possible, bring in shift arrangements so less staff are in the workplace at once. 28 Instruct workers to organize meetings by phone (if required) instead of in person. If not possible, require they meet in a large space and keep meetings short complying with social distancing. Hand Washing and Hygiene 29 Ensure hand sanitizer stations at entry and exit points and around the workplace. 30 Ensure bathrooms are well stocked with hand wash, cleaned frequently, and well ventilated with toilet paper (as applicable). 31 Put up posters with instructions on how to hand wash/hand rub. 32 Instruct workers on other ways to limit the spread of germs, including by not touching their face, sneezing into their elbow, and staying home if feeling sick. 33 Instruct workers to limit contact with others– no shaking hands or touching objects unless necessary. 34 Put up signs to request workers only touch tools & equipment they require and use during execution of works. Cleaning 35 Ensure any areas frequented by workers or others (e.g. visitors to the premises) are cleaned at least daily with detergent or disinfectant. 157 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF S. N List of Activities Yes No N/A Remarks 36 Instruct workers to wear gloves when cleaning; wash their hands thoroughly with soap or use an alcohol-based hand sanitizer before and after wearing gloves. 37 Clean frequently touched areas and surfaces several times a day with a detergent or disinfectant solution or wipe. This includes equipment, switches, levers, handrails, tables, countertops, doorknobs, sinks, and keyboards. 38 Instruct workers to clean personal property that comes to work, such as sunglasses, mobile phones, laptops with disinfectants. Workmen Camp 39 Daily thermal screening and symptom checking of cooks. 40 Cleaning and disinfection daily once the cooking is over. 41 Staggered Timings for dining to be adopted to limit the number of workmen using the hall or dining table to maintain social distance or Increase the Space of dining facility where possible. Quarantine and Isolation Rooms 42 An adequate number of rooms or beds complying with social distancing with cross ventilation shall be identified and reserved to accommodate symptomatic workmen. New Worker Dwelling 43 New workers shall not be accommodated in the same rooms as the existing workmen. 44 Dwelling units/rooms shall be suitably organized to ensure the avoidance of proximity of the worker groups, limiting the number of workmen in dwelling units maintaining social distancing. Resources at the Workplace 45 As far as possible, grocery shops, saloons, and other items shall be made available within the workplace to avoid the movement of workmen outside the camp. Restriction of a worker from Camp 46 Worker exit access shall be restricted to avoid infection from outside the community. 47 Any worker going out of the habitat shall get a gate pass from the camp supervisor or authority. Consultation and Grievance Mechanisms 48 Ensure mechanisms for worker‘s consultation designed and in place. 49 Ensure fair conflict resolution mechanisms in place. 50 Ensure an efficient process for dealing with community grievances, 158 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF ANNEX 10: ENVIRONMENTALLY SUSTAINABLE PROCUREMENT GUIDELINES There are a lot of elements for making an environmentally sustainable purchasing decision. The principles listed below provide a range of potential considerations – many may not apply to specific purchases, and some may not be achievable. It is designed to guide what to look for when assessing goods or services. Conserve Resources • Evaluate and reduce the need to purchase goods, materials, and services; • Evaluate the appropriate scale and utilization of a good, material or service; • Purchase goods, materials, and services that use recycled products; • Purchase goods and materials that require less material to manufacture; • Purchase goods and materials that require less packaging; and • Reuse, recycle and recover goods and materials. Conserve Energy • Purchase goods, materials, and services where the consumption of energy (electricity and fossil fuels) during production, transportation, usage, and delivery is minimized; and • Purchase goods, materials, and services that facilitate energy efficiency and resource conservation. Waste Reduction and Pollution Prevention • Purchase goods and materials that are easy to recycle; • Purchase goods and materials with structures that facilitate disassembly for processing, recycling, and waste management; • Purchase goods and materials which are packed with recycled products or materials that are recyclable; • Purchase goods and materials with a manufacturing process that avoids the creation of waste and pollutants at source; • Purchase goods and materials that are used or remanufactured; • Purchase services that minimize adverse environmental impacts; and • Purchase goods and materials that have greater durability and longer lifespan. Evaluate Value and Performance • Purchase goods, materials and services that perform adequately and are available at a reasonable price with careful consideration of life-cycle costing; and • Purchase goods, materials, and services that comply with recognized environmental standards. Example Clauses in Tenders and Contracts Examples of standard environmental clauses for tenders and other documents that have been developed (to be modified to suit each situation): • The MOH is committed to purchasing sustainable products, works, and services wherever possible. The organization will give appropriate weightage to sustainable products, works, and services in the purchasing process; • The Supplier will perform the services in a manner that gives appropriate regard to the protection of the natural environment. The Supplier will comply with all environmentally related legislation and codes of practices relating to the products and services being offered; • The Supplier will ensure any opportunities for improvement in the organization‘s environmental performance, identified by the Supplier‘s employees or sub-contractors are reported; • Tenders are to provide details of any eco-label license or similar initiatives; • Tenders will include details of energy ratings for appliances; • The Supplier shall provide the minimum appropriate level of packaging for the supplied items, consistent with ensuring an adequate level of protection during the storage and delivery phases of those items. • The Supplier shall provide products and services with appropriate considerations to reduced levels of toxicity, end of life disposal, shipping efficiencies, and reducing environmental impact during its operation. 159 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF ANNEX 11: SERBIAN ES REGULATORY FRAMEWORK  Constitution of Serbia Passed in 2006 the Constitution of RoS proclaims the rule of law and social justice, principles of civil democracy, human and minority rights and freedoms, equality and commitment to European principles and values and the right to a healthy natural environment. This Law provides the right to healthy environment and the right to receiving timely and comprehensive information about the state of environment and any changes thereto  Law on Health Care Health care includes the implementation of measures for the preservation and improvement of public health, prevention, early prevention and detection of diseases, injuries and other health problems in timely and their effective treatment and rehabilitation. A citizen of the Republic of Serbia, as well as any other person who has permanent or temporary residence in the Republic has the right to health care, in accordance with the law, and the duty to protect and improve their health, health of other citizens, and environmental conditions and working environment.  Law on Medicines and Medical Devices This Law regulates the conditions and procedures for issuing licenses for the marketing authorization, or entry of drugs into the registers maintained by the Agency for Medicines and Medical Devices Agency of Serbia, production and marketing of drugs and medical devices and monitoring in these areas, the Agency for Medicinal Products and Medical Devices Serbia and other issues relevant to the field of medicines and medical devices.  Law on Ionizing Radiation and on Nuclear Safety This law prescribes measures to protect life, health and the environment from harmful effects of ionizing radiation and nuclear safety, measures in all proceedings related to nuclear activities and defines the conditions for conducting activities with ionizing radiation sources, nuclear materials and radioactive management. It is forbidden to carry out the activities with ionizing radiation sources and nuclear materials without prior approval by the Serbian Radiation Protection and Nuclear Safety Agency. The measuring of radiation level and ensuring safety and security is an integral part of the technical documentation for facilities that use or will use ionizing radiation sources, whose implementation ensures that such facilities meet the prescribed level of protection of exposed persons, and the environment from ionizing radiation. The Institute of Occupational Health of Serbia "Dr. Dragomir Karajovic" is accredited for measuring of ionized radiation.  Law on Environmental Protection Law on Environmental Protection (LEP) is adopted in 2004. The LEP is currently the main legislation relating to environment protection in Serbia. The Law on Environmental Protection is fully harmonized with Council Directive 2003/105/EC, which amends Council Directive 96/82/EC on the control of major-accident hazards involving dangerous substances (Seveso II Directive). The main objectives of LEP are:  Conservation and improvement of the environment; and  Control and mitigation of pollution of the environment. The main focuses of LEP are:  Declaration of ecologically critical areas and restriction on the operations and processes, which can or cannot be carried out/ initiated in the ecologically critical areas;  Regulations in respect of vehicles emitting smoke harmful for the environment;  Environmental Approval; 160 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF  Regulation of industries and other development activities‗ discharge permits;  Promulgation of standards for quality of air, water, noise and soil for different areas for different purposes;  Promulgation of a standard limit for discharging and emitting waste; and  Formulation and declaration of environmental guidelines. To implement the Law on Environmental Impact Assessment, a government Decree determines the list of projects for which an impact assessment is mandatory (2009) or may be required in accordance with the relevant EU directives 97/11/EC and 337/85/EEC. Public participation is also envisaged in all environmental impact assessment stages. All subsidiary regulations were adopted in 2005. Public information and public participation in decision-making have been introduced in line with EU Directive 2003/35/EC on public participation.  Law on Environmental Impact Assessment The Law on EIA (LOEIA) provides categorization of industries and projects and identifies types of environmental assessment required against respective categories of industries or projects. The Law covers, among others:  Declaration of ecologically critical areas;  Classification of industries and projects into 2 categories;  Procedures for issuing the Final Environmental Approval (FEA); and  Determination of environmental standards. LOEIA also contains the procedures for obtaining FEA from the Department of EIA for different types of proposed industries or projects.  The Law on Waste Management56 The Law on Waste Management, which is harmonized with all relevant EU directives, has been adopted in 2009 and contains provisions that relate to electric and electronic waste. The Law on Waste Management (―Official Gazette of RoS‖ No. 36/09, 88/10, 14/16 and 95/18) is harmonized with all relevant EU directives. The Law regulate: types and classification of waste; waste management planning; waste management entities; responsibilities and obligations in waste management; organization of waste management; managing special waste streams; conditions and procedure for permit issuance; transboundary movement of waste; reporting on waste and database; financing of waste management; supervision, and other issues relevant for waste management. The Law on Waste Management has transposed the European Waste Framework Directive (2008/98/EC as last amended by 851/18/EC), the European Directive on Landfills (1999/31/EC, as amended) through transposition in the Serbian Law on Waste Management and/or Regulation on waste landfilling in combination with the Regulation on Categories, Testing and Classification of Waste, the European Directive on Packaging and Packaging Waste (1994/62/EC, as amended transposition in the Serbian Law on Packaging and Packaging Waste. The European Directive on Waste Electric and Electronical Equipment (WEEE) (2012/19/EU, as amended) has experienced transposition though the Serbian Law on Packaging and Packaging Waste in combination with the Rulebook on the List of Electric and Electronic Products, Measures of Prohibition and Restriction of Use of Electric and Electronic Equipment Containing Hazardous Substances, Methods and Procedures of Managing Waste from Electric and Electronic Products. Waste shall be classified according to a waste catalogue. A waste catalogue is a comprehensive list of non-hazardous and hazardous waste classified by its origin and composition. Hazardous waste shall be 56 http://www.pregovarackagrupa27.gov.rs/?wpfb_dl=109 161 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF classified, when necessary, according to the limit values of the hazardous material concentration. The owner and/or other holder of waste, i.e. operator, shall be obliged to classify waste in a prescribed manner, in compliance with this Law. In order to determine the composition and hazardous characteristics of waste, the entity referred to in paragraph 4 of this Article shall be obliged to test hazardous waste, as well as waste which, according to its origin, composition and characteristics, may be hazardous waste. A set of secondary laws of importance for hazardous waste management in Serbia:  Rulebook on categories, testing and classification of waste (―Official Gazette of RoS‖ of the RoS, No. 56/10, 93/19) 57;  Governmental order on conditions, methods and management procedures of waste oils (Official Gazette of RoS of the RoS, No. 71/10);  Rulebook on management of medical waste (―Official Gazette of RoS‖ No. 48/19);  Rulebook on the management of waste containing asbestos ("Official Gazette of RS", No. 75/10)  Rulebook on the list of electric and electronic products, measures of prohibition and restriction of use of electric and electronic equipment containing hazardous substances, methods and procedures of managing waste from electric and electronic products (―Official Gazette of RoS‖ No. 99/10, adopted on 10/01/11),  Governmental order on products which after use become separate waste flows, form of daily record on quantity and type of produced and imported products and annual report, method and deadlines for delivering the annual report, entities required to pay a fee, criteria for billing, amount and method of billing and payment of fee (Official Gazette of RoS of the RoS, No. 548/10).  Draft of Ministerial Order on management of PCB-containing equipment and waste  Draft of Ministerial Order on reporting on waste management ―Improvement of hazardous waste management in the Republic of Serbia - IWHMS ―  Orders regulating transboundary shipment of waste are: - Governmental order on the lists of waste for transboundary shipment of waste and the content and form of the document, which accompanies the transboundary shipment of waste and its filling-in - Governmental order on determination of specific sorts of hazardous waste which can be imported as secondary raw material - Ministerial order on the content of the documentation for transboundary shipment of waste  Orders regulating waste treatment and waste disposal are: Governmental order on authorize conditions, method and procedure of thermal waste treatment (―Official Gazette of RoS of RoS‖ No 102/10) Governmental order on disposal of waste in landfills (―Official Gazette of RoS‖ No, 92/26010, adopted in 2010).  The Law on Occupational Safety and Health The Law on Occupational Safety and Health organized (―Official Gazette of RoS‖ No. 101/05, 91/15 and 113/17 -other law) governs the occupational safety and health system in Serbia. By harmonizing this law with the ratified International Labor Organization conventions and EU Framework Directive 89/391/EEC, as well as special directives derived from the Framework Directive, all guidelines originating from them have been accepted in a form adjusted to national conditions. Apart from this Law, the regulatory framework of the occupational safety and health system is integrated by several sub-acts. The Rulebook on preventive measures for occupational health and safety and prevention and containment of contagious diseases epidemic (―Official Gazette RoS‖ No 94/20) governs preventive measures employers need to introduce at workplaces and applies to all persons at workplaces in cases an epidemic has been declared.  The Law on Planning and Construction 57 http://www.subotica.rs/documents/zivotna_sredina/Propisi/Pokate.pdf 162 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF This law is regulated with the terms and manner of spatial development and use construction land and construction of buildings; supervision over implementation of this legislation and inspection, the second issue of importance for the development of space, editing and use of land for construction.  Regulation on Labor, Working Conditions and Gender equality The below represent the core laws relevant to Labor, working conditions and equality in general and to Project workers. Labor Law (2005 as amended in 2018) Law on Civil Servants (2005 as amended in 2018) The Law on Peaceful Settlement of Labor Disputes (2004 as amended in 2018) Law on Employment and Unemployment Insurance (2009 as amended in 2017) Law on Employment of Foreign Citizens (2014 as amended in 2019) Law on Retirement and Disability Insurance (2003 as amended in 2019) Law on Health Insurance (2019) Law on the Prohibition of Discrimination (2009) Law on the Prevention of Harassment at the Workplace (2010) Rulebook on Conduct of Employers and Employees in Relation to (2009) Prevention and Protection from Harassment at Work Law on Protection of Whistle Blowers (2014) Law on Gender Equality (2009) The Republic of Serbia is a signatory of a number of important and binding international documents, which guarantee the equality of women and men and prohibit gender-based discrimination. Among these documents, the most important are documents of the United Nations (Universal Declaration of Human Rights, the Convention on the Elimination of All Forms of Discrimination against Women — CEDAW), the Council of Europe (European Conventions for the Protection of Human Rights and Fundamental Freedoms, the European Social Charter and the Council of Europe Convention on preventing and combating violence against women and domestic violence) and the European Union (EU Charter of Fundamental Rights). NOTE> Full List of regulations in the field of environmental protection in the Republic of Serbia is placed on following website: https://www.ekologija.gov.rs/wp-content/uploads/inspekcija/List_of_regulations.pdf  National Legal Framework guiding labor and Working Conditions The legal framework of Serbia guiding Labor and Working Conditions is, with a few minor shortcomings, strongly compliant with the ESS2 as Serbia is signatory to the International Labor Organization (ILO) and United Nations (UN) Conventions informing the ESS2.58) The Labor Law (LL) (―Official Gazette of RoS‖ No. 24/05, 61/05, 54/09, 32/13, 75/14, 13/17- CC ruling,113/17 and 95/18 – authentic interpretation), is the main legislation that guides labor practices in Serbia. It provides for the minimum rights of employees such as the right to corresponding salary/wage, safety and health at work, health-care protection, personal integrity protection, personal dignity, and other rights in the event of illness, reduction or loss of work ability and old age, including unemployment financial benefits during temporary unemployment, as well as the right to other forms of protection, in conformity with the law and bylaw, i.e. the employment contract. An employed woman is entitled to special protection during f pregnancy and childbirth. Special protection is also guaranteed to employees under 18 years of age and an employed person with a disability. 58 These include: • ILO Convention 87 on Freedom of Association and Protection of the Right to Organize • ILO Convention 98 on the Right to Organize and Collective Bargaining • ILO Convention 29 on Forced Labor • ILO Convention 105 on the Abolition of Forced Labor 2 Guidance Note – ESS2: Labor and Working Conditions • ILO Convention 138 on Minimum Age (of Employment) • ILO Convention 182 on the Worst Forms of Child Labor • ILO Convention 100 on Equal Remuneration • ILO Convention 111 on Discrimination (Employment and Occupation 163 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF The terms and conditions provided by this Law also includes ban to direct or indirect discrimination regarding employment conditions and choice of candidates for performing a specific job, conditions of labor and all the rights deriving from the employment relationship, education, vocational training and specialization, job promotion and termination of employment contracts on the grounds of differences by virtue of sex, birth, language, race, color of the skin, age, pregnancy, health condition, and/or disablement, ethnic origin, religion, marital status, family obligations, sexual orientation, political or other belief, social background, financial status, membership in political organizations, trade unions, or any other personal characteristic. The LL guarantees the employee‘s right to corresponding earnings, compensations and refund of expanses, entitlement to training and professional development, provision of safety and health at work, health-care protection, personal integrity protection, personal dignity, and other rights in the event of illness, reduction or loss of work ability and old age, including financial benefits of temporary unemployment, as well as the right to other forms of protection. The provisions of the Labor Law apply to all employees who work in the territory of the Republic of Serbia for a national or foreign legal or natural person (i.e. employer), as well as to employees assigned to work abroad by an employer, unless otherwise specified by the law. The LL is also applicable to the employees in the field of transport, employed foreign nationals and stateless persons working for an employer in the territory of the Republic of Serbia (Labor Law - Article 2). 164 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF ANNEX 12: REPORTING TEMPLATE – TRACKING ENVIRONMENTAL AND SOCIAL PERFORMANCE Serbia Emergency COVID-19 Response Project - Reporting template 1. Waste Generation and Management Practices being adopted in Quarantine facilities and hospitals a. Enumerate/describe the type of waste generated (e.g. 100 syringes used at XX facility) b. Describe waste management activities: collection, segregation, transport and disposal waste management of PPEs c. Waste management issues discussed with local communities 2. Risk Communication and Community Engagement (Engagements, communication materials, campaigns) a. Describe IEC materials developed and distributed b. Print and press sessions held during the month (e.g. XX radio discussions held on XX radio stations in Kathmandu) c. Training modules developed and rolled out d. Any differential communication strategies to reach vulnerable communities? For example, people with disabilities, people with low literacy rates, people in remote areas, etc. e. Any challenges? 3. Occupational Health and Safety a. OHS plan developed b. Health issues – site amenities – Drinking water, hand washing facilities, toilets, etc.--- c. Health Worker exposure to general hazards 4. Management Plans and Instruments Developed a. ESMF developed and disclosed? b. ESMF, SEP translated in Serbia and disclosed? c. SEP updated and disclosed? d. Code of Conduct for Health Professionals developed and/or revised to include issues about SEA/SH 5. Grievance Redress Management and SEA a. Number and type of complaints received b. Summary of complaints type (e.g. community health, local employment, community resistance over the location of COVID facilities, etc.) c. No. of complaints resolved d. No. of complaints outstanding e. No. of SEA-related complaints received, escalated, investigated, and addressed? 165 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF 6. Access and Inclusion for vulnerable communities a. Isolation/Quarantine facilities) set up at remote locations and accessible to vulnerable communities. b. Health education targeting remote and vulnerable groups/communities and c. Do quarantine and isolation facilities address issues of gender-sensitive? 7. Construction and civil works (both minor and new construction) a. Works (rehabilitation and new constructions) in support of COVID-19 intervention? b. Work procedure to address key issues of health and safety prepared and applied? c. Supply of PPEs, hand wash facilities? d. Worker characteristics: locals/ migrant workers. 8. Annex and References a. photos b. documents 166 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF ANNEX 13: WHO AND OTHER RELATED GUIDANCE RELATED TO ESS3 Resource Efficiency and Pollution Prevention and Management. A. Transportation and management of samples, medical goods and expired chemical products 1. Laboratory testing for coronavirus disease (COVID-19) in suspected human cases 2. Guidelines for the collection of clinical specimens during field investigation of outbreaks 3. Surface sampling of coronavirus disease (COVID-19): A practical ―how to‖ protocol for health care and public health professionals 4. Coronavirus disease (COVID-19) technical guidance: Essential resource planning 5. Laboratory biosafety guidance related to coronavirus disease 2019 (COVID-19) 6. Guidelines for Safe Disposal of Unwanted Pharmaceuticals in and after Emergencies 7. Health-care waste guidance B. Energy and resource efficiency during refurbishment and operation of health facilities 1. GoS Health Sector Emergency Response Plan 2020 2. Maintaining essential health services: operational guidance for the COVID-19 3. COVID-19 Resources for Health Care Facilities 4. Best Practices for Environmental Cleaning for Prevention and Control of Infections in All Health Care Settings, 3rd Edition C. International Best Practice Guidance for Environment Management in HCFs  Guidelines for Environmental Infection Control in Health-Care Facilities Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC) U.S. Department of Health and Human Services Centers for Disease Control and Prevention (CDC)-Updated: July 2019.  Guidelines for Design and Construction of Hospital and Health Care Facilities- The American Institute of Architects Academy of Architecture for Health the Facility Guidelines Institute With assistance from the U.S. Department of Health and Human Services: 2018 o (Further guidance is available in the form of the Guidelines for Design and Construction of Residential Health, Care, and Support Facilities- 2018 and Guidelines for Design and Construction of Outpatient Facilitie-2018)  Safe management of wastes from health-care activities-Second edition. The World Health Organization: 2014  Safe management of wastes from health-care activities A summary. The World Health Organization: 2017  UNICEF COVID-19 response: Considerations for Children and Adults with Disabilities, 167 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF ANNEX 14: GUIDELINES FOR PROTECTING PHYSICAL CULTURAL RESOURCES Avoiding Impacts on Cultural and Historical Properties Cultural heritage is site, structure, and remains of archaeological, historical, religious, cultural, and aesthetic value. It is important to assess the site to understand the significance of a site and to provide due protection according to its aesthetic, historic, scientific, and social value. Preventive Measures:  Specify in the works contracts all required steps, notifications, and preservative actions in case new/undiscovered archaeological or other culturally interesting items are encountered during excavation works. The clauses will specify whom to inform and how to proceed with works after the respective approval.  Plan the infrastructure development activities such that the acquisition of sites known for cultural heritage is avoided at a good distance (to prevent possible damage by infrastructure-induced activities like air pollutants, vibrations, and noise, etc.). Mitigation Measures:  The contractor is responsible for strictly instructing workers to stay away from and respect local cultural assets, to avoid any direct harm to those items or to hurt the traditional feelings of local people.  Avoid any actions that bear the risk to destroy the sites or alter their scientific or aesthetic character.  In case of accidental damages, the Contractor will be obliged to inform immediately the archaeological department who will then decide further actions.  In case of accidental damages, the Contractor will be obliged to carry out immediate corrective and repair measures to satisfy the local population and, as applicable, the representative of the archaeological department. Chance Find Procedures A chance find is an archaeological material encountered unexpectedly during project construction or operation. A chance find is a project-specific procedure that will be followed if previously unknown cultural heritage is encountered during project activities. The chance find procedure will set out how chance find associated with the project will be managed. The procedure will include a requirement to notify relevant authorities of found objects or sites by cultural heritage experts; to fence off the area of finds or sites to avoid further disturbance; to conduct an assessment of found objects or sites by cultural heritage experts; to identify and implement actions consistent with the requirements of ESS8- Culture Heritage and national law, and to train project personnel and project workers on chance find procedures. The project area comprises entire Serbia hospitals and health centers including privately owned hospitals. Hence, the possibility of encountering cultural sites during construction may not be ruled out. If such physical cultural resources defined as ―movable or immovable objects, sites, structures or groups of structures having archaeological, paleontological, historical, architectural, religious, aesthetic, or other cultural significance is found during construction, this has to be immediately informed to the local authority as per the law of the land. All findings belong to the Government of Serbia. The department of Archeology will determine the final destination of any artifact that is salvaged during the construction process. Construction activity will immediately halt and will not resume until authorized by the competent authority (Chief District Office and Department of Archeology).The Contractor will train all workers, especially those working on earth movements and excavations, on recognition of artifacts most likely to be found in the area. The Department of Archeology or any other recognized Historical or Archaeological Institute can be requested to provide this training. 168 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF ANNEX 15: LABOR AND WORKING CONDITIONS COMPLIANCE REPORT (to be used by third parties engaging contracted workers) Assignment name: Contract ref. No: Contract period: Start date (M/D/Y) End date (M/D/Y) Contractor/Service Supplier: Reported period: Date of report: Signature of authorized person: LABOR AND WORKING CONDITIONS COMPLIANCE REPORT I/ COMPANY EMPLOYEES* STATISTICS: 1. Total number of employee‘s gender disaggregated1: M______F_______ 2. Number of employees with an employment contract 3. Number of persons engaged without established employment relationship 4. Number of employees with access to social security, pension and health insurance 5. Number of employees/engaged persons who receives wages/salaries regularly at least once a month 6. Number of employees who left the company in the reported period 7. Number of employees hired in the reported period 8. Number of hours worked per employee (monthly average) 9. Total overtime (monthly average per employee) 10. Number of injuries at work (in reporting period and cumulative since contract start) 11. Number of fatalities at work (in reporting period and cumulative) 12. Number of reported violence 13. Number of reported harassment/ abuses 14. Availability of an accessible and functioning employee grievance mechanism (Y/N) 15. Number of grievances raised with the GM (in reporting period and cumulative since contract start) 16. Number of grievances resolved by GM (in reporting period and cumulative since contract start) 17. Number of suits filed with regard to labor, employment and OHS issues 18. Number of disputes brought to peaceful settlement/ voluntary arbitration procedure 19. Number of visits by labor/ OHS inspection *The employee is any natural person employed or engaged to work or perform service for the employer 1 The number of employees refers to the actual number/headcount on the date of the report. 169 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF II/ PROJECT WORKERS STATISTICS: 1. Total number of project workers: 2. Number of project workers with an employment contract: 3. Number of project workers with other types of contract: 4. Number of project workers with access to social security, pension and health insurance verified by confirmation from the registry: Working and Labor Conditions Screening Check List Terms and conditions Yes / No Notes 1 All project workers have an employment contract or Yes ¨ If ―No‖ please specify and engagement agreement in writing. explain No ¨ 2 All project workers are paid at least once a month Yes ¨ If ―No‖ please specify and explain No ¨ 3 All project workers worked 8 hours a day, 40 hours a Yes ¨ If ―No‖ please explain and week, or less specify the hours worked No ¨ 4 All project workers had a regular daily and weekly rest Yes ¨ If ―No‖ please specify and explain No ¨ 5 Project workers were terminated from employment Yes ¨ If ―Yes‖ please specify number No ¨ and explain conditions of termination 6 Project workers attended OHS related training program Yes ¨ If ―Yes‖ please specify number and explain No ¨ 7 Project workers were granted leaves they are entitled to Yes ¨ If ―Yes‖ Please specify the type and number of leaves No ¨ 8 Project workers were involved in accidents at work Yes ¨ If ―Yes‖ please specify and resulting in injuries or fatalities explain No ¨ 9 Project workers reported on cases of discrimination, Yes ¨ If ―Yes‖ please specify and harassment, sexual harassment or non-compliance with explain law No ¨ 10 Project workers raised grievances or started voluntary Yes ¨ If ―Yes‖ please specify and arbitration / legal proceedings to settle a dispute explain No ¨ 11 In the reported period there were some incidents on Yes ¨ If ―Yes‖ please specify and noncompliance with the LMP explain No ¨ 170 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF ANNEX 16: THIRD PARTIES STATEMENT (POTENTIAL CONTRACTORS AND SERVICE PROVIDERS) ON COMPLIANCE WITH PROVISIONS OF LABOR LEGISLATION and THE PROJECT`S LMP Date and place of issuance: ________________________ Name and address of the issuer (Bidder): ________________________ STATEMENT OF LEGAL AND REGULATORY COMPLIANCE Hereby we declare that  We are aware of, and comply with, the standards laid down in the WB ESS2;  We conform to all national laws* and applicable regulations concerning employment, labor and employee relations, and labor and working conditions;  We are committed to providing a safe and healthy environment for our employees and to implementing all occupational health and safety requirements as stipulated by national legislation and WB ESS2;  We do not tolerate any form of child, forced or slavery work.  We prohibit any form of harassment, sexual harassment, abuse, violence, including SEA/SH at work and forbid direct or indirect discrimination against any employee or groups of employees on any ground and for whatever reason.  We confirm that a worker Grievance Mechanism will have been available to all our employees and persons hired to work with us by the commencement date of the contract. We hereby state that should we be awarded with the contract; we shall adopt the Labor Management Procedures in line with WB ESS2, applicable to the project, and incorporate them in our practice. We hereby acknowledge our understanding that our company may be subjected to announced and unannounced visits, site checks and labor and working condition audits by authorized Employer‘s representatives or independent third parties with the aim to verify compliance with the above statement. We understand that the failure to respect any of the above stated commitments could lead to termination of the contract and exclusion from the project. Signature: Name: Position: *National Laws refers both to the Laws of Republic of Serbia and the domicile Law of the country in case the Bidder is foreign 171 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF ANNEX 17: GENERIC MONITORING PLAN FOR ENVIRONMENTAL AND SOCIAL PARAMETERS FOR CONSTRUCTION PHASE OF SUBPROJECTS Cost What parameter is to be How is the When is the monitored? Where is the parameter to be parameter to be Why is the Instal Operate Institutional Phase (Actio parameter to be monitored? / monitored? parameter to Monitoring n Steps Should be type of (frequency of be monitored? l Responsibili oversight monitored? ty consistent with the monitoring measurement or (optional) respective ESMPs) equipment continuous) Construction Material Sourcing a) Stone, Construction sand, a) possession of official a) stone, Supervising a) before a) a) gravel and approval or valid gravel and clay a) Inspection a) NA Engineer and work begins NA Contractor clay operating license borrow pit Environmental borrow pit Officer Transport of Construction Material Construction a)-c) safety a) a) Main and a) unannounced Supervising a) truck load covered requirement a) a) a) Crushed local road; a) Inspection inspections Engineer and or wetted s and enable NA minimal Contractor stone job site during work Environmental as Officer Construction little b) Sand, b) Main and b) unannounced Supervising b) truck load covered disruption to b) b) b) gravel, local road; b) Inspection inspections Engineer and or wetted traffic as it NA minimal Contractor clay job site during work Environmental is possible Officer Construction c) routes selected; c) Main and c) unannounced Supervising c) Traffic c) c) c) following a traffic local road; c) Inspection inspections Engineer and management NA minimal Contractor management plan job site during work Environmental Officer During Construction Phase a) sound a) assure monitoring a) At the compliance a) Overall level of noise a) job site; smart beginning of of a) a) Environmental a) Noise that is transmitted in the nearest a) NA phone works, on performance NA Contractor Officer immediate environment homes application complain with / sound environment, 172 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF Cost What parameter is to be How is the When is the monitored? Where is the parameter to be parameter to be Why is the Instal Operate Institutional Phase (Actio parameter to be monitored? / monitored? parameter to Monitoring n Steps Should be type of (frequency of be monitored? l Responsibili oversight monitored? ty consistent with the monitoring measurement or (optional) respective ESMPs) equipment continuous) monitoring device health and b) laboratory safety with b) Emissions, b) air pollution (flying b) during requirement necessary Particulate particles, pollutants in the b) at and material delivery s and enable b) b) Environmental equipment of b) NA matter and air and oxides of C, S, N, near job site and construction; as little NA Contractor Officer the licensed Dust ozone and similar. ) on complain disruption to organization traffic as it is (NBRO) possible c) observation, c) unannounced /Vibration inspections c) c) Environmental c) Vibrations c) limited time of activities c) job site c) NA metering during work and NA Contractor Officer device on complain d) Traffic Construction d) unannounced disruption d) existence of traffic d) main and Supervising inspections d) d) during management plan; local road; d) traffic police d) NA Engineer and during work and NA Contractor construction traffic patterns job site Environmental on complain activity Officer Construction a) Reduced a) During Supervising access due a) a) a) a) Provided alternative access c) Job site b) Observation constructio Engineer and to project NA minimal Contractor n Environmental activities Officer b) Construction b) Visibility Vehicle b) During Supervising and d) At and b) b) b) and c) Observation constructio Engineer and appropriatenes near job site NA minimal Contractor pedestrian n Environmental s safety Officer c) Water c) water and soil quality e) runoff from d) a) Twice and soil (suspended solids, oils, site, material observation; depending on the pollution organic solids, heavy storage areas; laboratory construction c) c) Environmental c) NA from metals, pH value, wash down with necessary lifetime NA Contractor Inspector improper conductivity, constant areas of equipment of material physical and chemical equipment the licensed b) On complain 173 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF Cost What parameter is to be How is the When is the monitored? Where is the parameter to be parameter to be Why is the Instal Operate Institutional Phase (Actio parameter to be monitored? / monitored? parameter to Monitoring n Steps Should be type of (frequency of be monitored? l Responsibili oversight monitored? ty consistent with the monitoring measurement or (optional) respective ESMPs) equipment continuous) storage, parameters) organization or in case of management accident and usage situation building and auxiliary materials a) Twice a) Potential b) depending on the contaminatio a) Water and soil quality Observation; construction n of soil and (suspended solids, oils, fuel, h) Job site; laboratory with lifetime water from lubricants, organic equipment a) a) Environmental necessary a) NA improper compounds, heavy metals, maintenance NA Contractor Inspector equipment of b) On complain maintenance pH value, conductivity); facilities the licensed or in case of and fuelling of procedures of work organization accident equipment situation PHI, i) protective equipment Construction h) Labor i) Job a) Unannounced (glasses, masks, helmets, a) a) a) Supervising Health site/Worke b) Observation inspections boots, etc.); ii) Condition NA minimal Contractor Engineer and and Safety r camps during work of worker camps Environmental Officer 174 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF ANNEX 18: ENVIRONMENTAL SAFEGUARDS PREPARATORY TASKS TRACKING SHEET ENVIRONMENT AND SOCIAL PREPRATORY TASKS FOR SUBPROJECTS STATUS TRACKING SHEET Date safeguards instrument sent Clearance/conditional clearance Safeguards Tentative Date for Tender Date received by WB Instrument ESHS Clauses in Contract IMPLEMENTATION (Indicate via use of tick mark) Date SCHEDULE Name (Indicate via use Status CLEARANCES and of tick mark) as at RECEIVED Status Screening Report i Descripti BOQ (Date Environmental ESMP/ESIA E&S Related ICMWMP # on of ESHS Includes sheet is Docume Comments Subproje Clauses adequate updated nt ct in costing for ) INST DATE Included Contra ESMP in Bid ct implementati Docs on Phase I Component 1 Comp 1.1 Component 2 Comp 2.1 Phase 2 175 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF ANNEX 19: ENVIRONMENTAL AND SOCIAL COMPLIANCE MONOTORING CHECKLIST FOR SUBPROJETS IN IMPLEMENTATION Title of project Project Proponent Contractor‘s Name Monitoring Date Monitor‘s Name Designation Proposed mitigation measures Implementing Reason for non- Issue Compliance Yes/No Follow up Action (from the ESMP/ICHWMP) Responsibility compliance Photo-documentation of Issue Identified Above Issue # (from Date of Photograph depicting issue description above) photograph 176 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF ANNEX 20: SPECIAL MONITORING CHECKLIST FOR ENSURING SAFE CONDITIONS FOR WORKERS AND PUBLIC DURING CONSTRUCTION PROJECTS 177 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF 178 SERBIA EMERGENCY COVID-19 RESPONSE PROJECT ENVIRONMENTAL AND SOCIAL MANAGEMENT FRAMEWORK - ESMF ANNEX 21: REPORT ON PUBLIC CONSULTATIONS This annex will be completed after the Public Consultations. 179