Republic of Guinea / Ministry of Health and Public Hygiene Guinea Enhancing Health System Transformation (GUEST) Project (P506072) Negotiated ENVIRONMENTAL AND SOCIAL COMMITMENT PLAN (ESCP) August 19th, 2024 1|Page ENVIRONMENTAL AND SOCIAL COMMITMENT PLAN 1. The Republic of Guinea (the Recipient) will implement the Guinea Enhancing Health System Transformation (GUEST) Project (the Project), with the involvement of the Ministry of Health and Public Hygiene, as set out in the Financing Agreement. The International Development Association (Association) has agreed to provide financing for the Project, as set out in the referred agreement. 2. The Recipient shall ensure that the Project is carried out in accordance with the Environmental and Social Standards (ESSs) and this Environmental and Social Commitment Plan (ESCP), in a manner acceptable to the Association. The ESCP is a part of the Financing Agreement. Unless otherwise defined in this ESCP, capitalized terms used in this ESCP have the meanings ascribed to them in the referred agreement. 3. Without limitation to the foregoing, this ESCP sets out material measures and actions that the Recipient shall carry out or cause to be carried out, including, as applicable, the timeframes of the actions and measures, institutional, staffing, training, monitoring and reporting arrangements, and grievance management. The ESCP also sets out the environmental and social (E&S) instruments that shall be adopted and implemented under the Project, all of which shall be subject to prior consultation and disclosure, consistent with the ESS, and in form and substance, and in a manner acceptable to the Association. Once adopted, said E&S instruments may be revised from time to time with prior written agreement by the Association. 4. As agreed upon by the Association and the Recipient this ESCP will be revised from time to time if necessary, during Project implementation, to reflect adaptive management of Project changes and unforeseen circumstances or in response to Project performance. In such circumstances, the Recipient through the Ministry of Health and Public Hygiene and the Association agree to update the ESCP to reflect these changes through an exchange of letters signed between the Association and the Minister of Finances. The Recipient shall promptly disclose the updated ESCP. 2|Page ENVIRONMENTAL AND SOCIAL COMMITMENT PLAN (ESCP) of Guinea Enhancing Health System Transformation (GUEST) Project MATERIAL MEASURES AND ACTIONS TIMEFRAME RESPONSIBLE ENTITY MONITORING AND REPORTING A REGULAR REPORTING - Submit quarterly reports to the Project Coordination Unit Prepare and submit regular monitoring reports to the Association on the Association throughout Project (PCU) environmental, social, health, and safety (ESHS) performance of the Project. implementation, commencing These reports should include, but are not limited to, updates on the after the effective Date. implementation of the ESCP, the status of preparation and implementation of E&S instruments required under the ESCP, stakeholder engagement activities, and functioning of the grievance mechanism(s) - Submit each report to the Association no later than 15 days after the end of each reporting period. B INCIDENTS AND ACCIDENTS Promptly notify the Association of any incident or accident related to the Project - Notify the Association no later than PCU that has, or is likely to have, a significant adverse effect on the environment, the 48 hours after learning of the affected communities, the public or workers. This includes, inter alia, cases of incident or accident. Notify the sexual exploitation and abuse (SEA), sexual harassment (SH), and accidents that Association no later than 24 hours result in death, serious or multiple injuries, or contamination by medical waste. of SEA/SH incidents. Provide sufficient details regarding the scope, severity, and possible causes of the incident or accident, indicating immediate measures taken or planned to address it. Include any information from contractors and/or supervising firm, as appropriate. - Provide subsequent report to the Subsequently, at the Association’s request, prepare a report on the incident or Association within an acceptable accident and propose measures to address it and prevent its recurrence. timeframe. C CONTRACTORS’ MONTHLY REPORTS PCU contractors 3|Page ENVIRONMENTAL AND SOCIAL COMMITMENT PLAN (ESCP) of Guinea Enhancing Health System Transformation (GUEST) Project MATERIAL MEASURES AND ACTIONS TIMEFRAME RESPONSIBLE ENTITY Require contractors and supervising firms to provide monthly monitoring reports Submit monthly reports to the on ESHS performance in accordance with the metrics specified in the respective Association as annexes to the reports bidding documents and contracts and submit such reports to the Association. to be submitted under action A above. ESS 1: ASSESSMENT AND MANAGEMENT OF ENVIRONMENTAL AND SOCIAL RISKS AND IMPACTS 1.1 ORGANIZATIONAL STRUCTURE - Maintain a Project Coordination Unit (PCU) with qualified staff and sufficient - The PCU and the regional MoH resources to manage the ESHS risks and impacts of the Project. This includes an specialists shall be maintained environmental and a social development specialist, a GBV specialist (full-time), throughout Project and a waste management specialist (full-time). implementation. - Retain the E&S team hired under the Health Security Program in Western and Central Africa MPA (P179078), consisting of four E&S specialists (two - Hire a GBV Specialist (full-time) and environmental and two social specialists) based in the Regional Health a medical waste management Directorates who will oversee the environmental and social aspects of the specialist (full-time) within three subprojects on the ground. months of the Project’s effective date and maintain these positions throughout Project - Assess the performance of the E&S team and take necessary measures, including implementation. hiring new qualified specialists. - Assess the performance of the E&S team no later than three (3) months after Project effectiveness, and annually throughout the Project’s life. 1.2 ENVIRONMENTAL AND SOCIAL INSTRUMENTS PCU - Adopt and implement an Environmental and Social Management Framework - The ESMF was adopted and (ESMF), consistent with the relevant ESSs, for the Project. disclosed in the country on August 19, 2024, and on the World bank’s website on August 20, 2024. 4|Page ENVIRONMENTAL AND SOCIAL COMMITMENT PLAN (ESCP) of Guinea Enhancing Health System Transformation (GUEST) Project MATERIAL MEASURES AND ACTIONS TIMEFRAME RESPONSIBLE ENTITY - Subcontractors for construction or rehabilitation activities must adopt and - Implement the ESMF throughout implement the site-specific Environmental and Social Impact Assessment Project implementation. (ESIA) and Environmental and Social Management Plan (ESMP) as outlined in the ESMF. Subprojects in the exclusion list of the ESMF shall be ineligible for - Adopt the site-specific ESMP financing under the Project. before any construction or rehabilitation activity that requires it. Once adopted, implement the ESMP throughout Project implementation. 1.3 MANAGEMENT OF CONTRACTORS Incorporate these measures in the PCU Incorporate relevant aspects of the ESCP, including, inter alia, relevant E&S preparation of procurement instruments, Labor Management Procedures, and the code of conduct, into the documents and contracts. ESHS specifications of procurement documents and contracts with contractors Supervise contractors throughout and supervising firms. Thereafter, ensure that contractors and supervising firms Project implementation. comply with the ESHS specifications. 1.4 TECHNICAL ASSISTANCE Ensure that all consultancies, studies (including feasibility studies, if applicable), Throughout Project implementation PCU capacity building, training, and other technical assistance activities under the Project including, inter alia, the ESMF, ESIAs/ESMPs, assessment of ICWMP, regional Waste Management Plans, and any other technical assistance, are carried out in accordance with terms of reference acceptable to the Association, and consistent with the ESSs. Thereafter, ensure that the outputs of these activities comply with the terms of reference. 1.5 CONTINGENT EMERGENCY RESPONSE FINANCING a) The Adoption of the CERC manual CERC component and, if applicable, other relevant designated Authority a) Ensure that the CERC Manual, as specified in the Financial Agreement, includes instruments in a form and substance a description of the ESHS assessment and management arrangements. This may acceptable to the Association, is a include, if applicable, a CERC-ESMF/ESMF Addendum, which should be withdrawal condition under Section incorporated or referenced in the CERC Manual for the implementation of the III.B(c) of Schedule 2 of the Financing CERC component, in accordance with the ESSs. Agreement for the Project. 5|Page ENVIRONMENTAL AND SOCIAL COMMITMENT PLAN (ESCP) of Guinea Enhancing Health System Transformation (GUEST) Project MATERIAL MEASURES AND ACTIONS TIMEFRAME RESPONSIBLE ENTITY b) Adopt all environmental and social (E&S) instruments required for activities b) Adopt any required E&S instrument under the CERC component of the Project, as specified in the CERC Manual and, if and include it as part of the respective applicable, the CERC-ESMF or CERC-ESMF Addendum, in alignment with the ESSs. bidding process, if applicable, and in Thereafter, implement the measures outlined in these E&S instruments within the any case, before carrying out the specified timeframes. relevant Project activities for which the E&S instrument is required. Implement the E&S instruments according to their terms throughout Project implementation. ESS 2: LABOR AND WORKING CONDITIONS 2.1 LABOR MANAGEMENT PROCEDURES PCU Adapt, adopt and implement the Labor Management Procedures (LMP) for the - The LMP was adopted and disclosed Project MPA, including, inter alia, provisions on working conditions, management in the country on July 19, 2024 and on of worker relationships, occupational health and safety (including personal the World Bank website on August 08, protective equipment, and emergency preparedness and response), code of 2024. conduct (including policies relating to SEA and SH), and measures against forced - Thereafter implement the LMP labor and child labor. Include grievance arrangements for Project workers, and throughout Project implementation. applicable requirements for contractors, subcontractors, and supervising firms. If needed, the LMP will be updated If Project activities include community workers, update the LMP prior to engaging during the Project implementation. them in accordance with relevant requirements ESS2 and in a manner acceptable to the Association. 2.2 GRIEVANCE MECHANISM FOR PROJECT WORKERS PCU Establish a grievance mechanism prior Contractors/sub- Establish and operate a grievance mechanism for Project workers including engaging Project workers and contractors community’ workers, as described in the LMP and consistent with ESS2. thereafter maintain and operate it throughout Project implementation ESS 3: RESOURCE EFFICIENCY AND POLLUTION PREVENTION AND MANAGEMENT 3.1 WASTE MANAGEMENT PLAN - Adopt the MWMP within six (6) - Prepare a Medical Waste Management Plan (MWMP) for the Boké, Mamou, months of the Project’s effective date PCU Faranah, Nzérékoré, and Labé regions. of the project and thereafter, implement it throughout Project implementation. 6|Page ENVIRONMENTAL AND SOCIAL COMMITMENT PLAN (ESCP) of Guinea Enhancing Health System Transformation (GUEST) Project MATERIAL MEASURES AND ACTIONS TIMEFRAME RESPONSIBLE ENTITY - Review and assess the Infection Control and Waste Management Plan (ICWMP) - Assess the ICWMP three (3) months and fill any gaps with specific measures. after the Project’s effective date. 3.2 RESOURCE EFFICIENCY AND POLLUTION PREVENTION AND MANAGEMENT Same timeframe as for the adoption PCU Incorporate resource efficiency and pollution prevention and management and implementation of the ESMP. measures into the ESMP prepared under actions 1.2 and 1.5 above. ESS 4: COMMUNITY HEALTH AND SAFETY 4.1 TRAFFIC AND ROAD SAFETY Incorporate measures to manage traffic and road safety risks as required into the Same timeframe as for the adoption ESMP prepared under actions 1.2 and 1.5 above. and implementation of the ESMP. 4.2 COMMUNITY HEALTH AND SAFETY Assess and manage specific risks and impacts to the community arising from Same timeframe as for the adoption PCU Project activities, including, inter alia, risk related to construction activities, the and implementation of the ESMPs. handling, transport and use of medical products and waste, behavior of Project workers, labor influx, and emergency response. Include mitigation measures in the ESMPs prepared in accordance with the ESMF. 4.3 SEA AND SH RISKS Adopt the SEA/SH action plan before PCU the start of activities and monitor its Adopt and implement an SEA/SH action plan to assess and manage the risks of execution throughout Project SEA and SH, proportional to the risk level (i.e. Substantial). implementation 4.4 SECURITY MANAGEMENT Assess and implement measures to manage the security risks of the Project, Prior to engaging security personnel including risks associated with engaging security personnel to protect project’s and thereafter implemented workers, sites, assets, and activities, as set out in the ESMP, guided by the throughout Project implementation principles of proportionality and GIIP, and by applicable law, regarding hiring, conduct, training, equipping, and monitoring of these personnel. ESS 5: LAND ACQUISITION, RESTRICTIONS ON LAND USE AND INVOLUNTARY RESETTLEMENT Not relevant ESS 6: BIODIVERSITY CONSERVATION AND SUSTAINABLE MANAGEMENT OF LIVING NATURAL RESOURCES Not relevant ESS 7: INDIGENOUS PEOPLES/SUB-SAHARAN AFRICAN HISTORICALLY UNDERSERVED TRADITIONAL LOCAL COMMUNITIES Not relevant ESS 8: CULTURAL HERITAGE 7|Page ENVIRONMENTAL AND SOCIAL COMMITMENT PLAN (ESCP) of Guinea Enhancing Health System Transformation (GUEST) Project MATERIAL MEASURES AND ACTIONS TIMEFRAME RESPONSIBLE ENTITY Not relevant ESS 9: FINANCIAL INTERMEDIARIES Not relevant ESS 10: STAKEHOLDER ENGAGEMENT AND INFORMATION DISCLOSURE 10.1 STAKEHOLDER ENGAGEMENT PLAN PREPARATION AND IMPLEMENTATION 1. Adapt, adopt and implement a Stakeholder Engagement Plan (SEP) for the - The SEP was adopted and disclosed in MPA Project, consistent with ESS10. The SEP shall include measures to, the country on July 19, 2024, and on inter alia, provide stakeholders with timely, relevant, understandable and the World bank’s website on August accessible information, and to consult with them in a culturally 08, 2024. appropriate manner, free from manipulation, interference, coercion, - Implement the SEP throughout discrimination, and intimidation. Project implementation. 2. The Stakeholder Engagement Plan (SEP) will be updated to include - The SEP will be updated no later than detailed information on information sharing methodologies, robust three (3) months after the project’s stakeholder mapping and identification of existing community platforms effective date. to facilitate effective and participatory community engagement, monitoring and evaluation. 3. Recruit a local NGO specialist to support the implementation and monitoring of the SEP (if needed). 10.2 PROJECT GRIEVANCE MECHANISM PCU 1. Establish, publicize, maintain, and operate an accessible grievance mechanism to receive and facilitate the resolution of concerns and grievances related to the Project promptly and effectively. The mechanism should be transparent, culturally appropriate, and readily accessible to all Project-affected parties, at no cost and without retribution, including anonymous concerns and grievances, in a manner consistent with ESS10. 8|Page ENVIRONMENTAL AND SOCIAL COMMITMENT PLAN (ESCP) of Guinea Enhancing Health System Transformation (GUEST) Project MATERIAL MEASURES AND ACTIONS TIMEFRAME RESPONSIBLE ENTITY 2. Prepare and implement a Grievance Mechanism Implementation Action - Establish the grievance mechanism no Plan in coordination with the National Agency for Local Communities later than three (3) months after Financing (ANAFIC in French). Project’s effective date, and thereafter, maintain and operate it throughout 3. The grievance mechanism shall be equipped to receive, register, and Project implementation. In the facilitate the resolution of SEA/SH complaints, including referring meantime, the project will use the GM survivors to relevant gender-based violence service providers, all in a safe, establish under the previous project confidential, and survivor-centered manner. This grievance redressing (the Guinea COVID-19 Emergency Mechanism will be supported by a communication plan to ensure that Response and System Preparedness project stakeholders are aware of its existence, procedures for submitting Strengthening Project (CERSPSP) and and handling complaints, and other avenues of redress. its two additional financing [P174032, P176706 & P178602], and the Health Services and Capacity Strengthening Project [P163140]). CAPACITY SUPPORT CS1 E&S capacity strengthening for regional health inspection staff including: • Environmental and social basic requirements; Regional E&S specialists Training to start six (6) months after the • Environmental and social monitoring, evaluation and reporting; Project effective date and continue PCU • Medical waste management; and throughout the project duration. • Environmental and social incident investigation CS2 Environmental and social standards training: Six (6) months after the Project’s PCU • ESS 1: Assessment and management of environmental and social risks and effective date. impacts • ESS 2: Labor and working conditions and the Labor Management Procedures (LMP) • ESS 3: Resource efficiency and pollution prevention and management • ESS 4: Community Health and Safety, and the SEA/SH prevention and management plan • ESS 10: Stakeholder Engagement and Information Disclosure and the Stakeholder Engagement Plan (SEP) 9|Page ENVIRONMENTAL AND SOCIAL COMMITMENT PLAN (ESCP) of Guinea Enhancing Health System Transformation (GUEST) Project MATERIAL MEASURES AND ACTIONS TIMEFRAME RESPONSIBLE ENTITY The training shall target the following actors: • Project Steering Committee; • PCU (social specialist, environmental specialist, specialist, procurement specialist); • MoH central and health regional directorates; • NGOs working in the environmental and social fields in the Project areas; • Technical structures; • National Environment Agency (AGE); and • Relevant territorial authority’s Monitoring and Evaluation Plan. CS3 Occupational health and safety training: Prior to the start of employment of PCU • Contractors and supervising entities shall train all workers involved in newly recruited workers and those Project activities, including security personnel, on occupational health and already working, training would be safety, first aid equipment, prevention of emergencies, preparedness, and provided quarterly to ensure that all response (how to prepare for and react to such situations) ; staff are trained. • Risk management in the workplace; • Management of sanitary waste, D3E and livestock waste; and Throughout the implementation of the Project • Complaint management. Contractors must also ensure that their subcontractors’ workers are trained on the same subjects. The training shall target the following: • Contractors; • Contractors Workers (including subcontractors) ; • Community workers; • Supervising entities; and • PCU Information, Education and Communication (IEC) 10 | P a g e ENVIRONMENTAL AND SOCIAL COMMITMENT PLAN (ESCP) of Guinea Enhancing Health System Transformation (GUEST) Project MATERIAL MEASURES AND ACTIONS TIMEFRAME RESPONSIBLE ENTITY Raise awareness among contractors’ workers, including subcontractors’ workers, and supervising entity mobilized on the sites of environmental and social standards. CS4 Training on labor and working conditions: PCU • Conditions of employment under national labor laws ; Contractors Prior to the start of employment for • Code of conduct for suppliers/ service providers and subcontractors; both newly recruited workers and • Workers’ organizations ; those already working, training would • Rules on child labor and minimum working age; be provided quarterly to ensure that all • Workers’ rights ; staff are trained. • Worker complaints and related SEA/SH complaints; and • Discrimination and harassment, SEA/SH incidence in the workplace. The training shall target the following actors: • Workers of service providers and • NGOs working in the social field of the Project area. CS5 Training on the grievance mechanism Prior to the start of employment for • The training shall cover the following modules: both newly recruited workers and • Registration and processing procedure ; those already working, training would • Complaint’s Resolution Procedure; be provided quarterly to ensure that all • Documentation and handling of complaints; staff are trained. • Use of the procedure by various stakeholders; and • SEA/SH complaints. The training shall target the following stakeholders: • PCU (social specialist, environmental specialist, gender/SEA/SH specialist, and procurement specialist) ; • Local or regional monitoring committees or grievance management committees; 11 | P a g e ENVIRONMENTAL AND SOCIAL COMMITMENT PLAN (ESCP) of Guinea Enhancing Health System Transformation (GUEST) Project MATERIAL MEASURES AND ACTIONS TIMEFRAME RESPONSIBLE ENTITY • Local community representatives; • Relevant technical structures; • Relevant local governments; and • NGOs working in the social field in the Project area. CS6 SEA/SH Risk Training Prior to the start of employment for PCU newly recruited workers and those • Awareness, prevention, and mitigation of SEA/SH risk; already working, training would be • Topics, activities, and target audiences shall be defined in the SEA/SH Action provided quarterly to ensure that all Plan; staff, actors, and stakeholders involved • Dissemination of the SEA/SH Action Plan (activities, target groups); are trained • Addressing SEA/SH complaints; The training shall target the following actors: • PCU (social specialist, environmental specialist, gender/SEA/SH specialist, procurement specialist); • Relevant central and local technical structures; • The Guinean Environmental Assessment Agency (Agence Guinéenne d’Evaluation Environnementale, AGEE in French ) ; • Authorities and local communities concerned; • NGOs working in the social field in the Project area CS7 Before the start of the works (studies PCU • Information on/awareness of potential environmental and social risks and consultations, etc.) and targeting local populations/communities: throughout Project implementation. • Information on/awareness of potential environmental and social risks, including the Project SEA/SH, to demonstrate their commitment and participation in the identification of measures aimed at minimizing and mitigating negative environmental and social risks and impacts related to Project implementation. 12 | P a g e