The World Bank Saint Vincent and the Grenadines Strengthening Health System Resilience Project (P176559) Concept Environmental and Social Review Summary Concept Stage (ESRS Concept Stage) Public Disclosure Date Prepared/Updated: 03/11/2022 | Report No: ESRSC02655 Mar 11, 2022 Page 1 of 12 The World Bank Saint Vincent and the Grenadines Strengthening Health System Resilience Project (P176559) BASIC INFORMATION A. Basic Project Data Country Region Project ID Parent Project ID (if any) St. Vincent and the LATIN AMERICA AND P176559 Grenadines CARIBBEAN Project Name Saint Vincent and the Grenadines Strengthening Health System Resilience Project Practice Area (Lead) Financing Instrument Estimated Appraisal Date Estimated Board Date Health, Nutrition & Investment Project 7/11/2022 7/31/2022 Population Financing Borrower(s) Implementing Agency(ies) Saint Vincent and the Ministry of Health, Wellness Grenadines and Environment (MOHWE) Proposed Development Objective Public Disclosure Strengthen the capacity of hospital services and health system resilience in Saint Vincent and the Grenadines. Financing (in USD Million) Amount Total Project Cost 50.00 B. Is the project being prepared in a Situation of Urgent Need of Assistance or Capacity Constraints, as per Bank IPF Policy, para. 12? No C. Summary Description of Proposed Project [including overview of Country, Sectoral & Institutional Contexts and Relationship to CPF] The project will assist the GOSVG to strengthen hospital services and health system resilience, support project management and provide flexible financing for contingent emergencies through four components. Through the proposed investments, the project is expected to play a transformative role in strengthening the sector’s capacity and adaptability, including its ability to effectively respond to costly disease outbreaks, devastating natural disasters, and the rising burden of chronic NCDs. The project will finance: (a) the development of a modern, safe and “smart” acute care hospital with a service profile that responds to the burden of diseases and manages higher complexity cases; while contributing to (b) strengthening the health system’s capacity to plan and respond to emergencies and maintain Mar 11, 2022 Page 2 of 12 The World Bank Saint Vincent and the Grenadines Strengthening Health System Resilience Project (P176559) core functions when crises hits; and (c) implementation of the NHSSP’s vision of “redevelopment and modernization of the sector” to improve the quality and sustainability of the health system. D. Environmental and Social Overview D.1. Detailed project location(s) and salient physical characteristics relevant to the E&S assessment [geographic, environmental, social] The major infrastructure development of the project (Component 1) is to co-finance the construction of a new hospital (the Arnos Vale Acute Care Hospital, AVACH) and installation of related medical and non-medical equipment. The new hospital will be constructed in the envisioned “Modern City” on the site of the decommissioned ET Joshua Airport in the community of Arnos Vale, about 3 miles from the existing Milton Cato Memorial Hospital (MCMH). The project will also finance activities to strengthen the health system’s resilience against climate change impacts and other crises to reduce disruption to essential health care service provision to the population during emergencies through Component 2, which will encompass the entire country. The proposed hospital site is on the northeast side of the former airport (which covered about 22 hectares) and is surrounded by the Vigie Highway to the northeast, the Windward Highway to the southeast, Richmond Hill Road to the northwest, and the Caribbean Sea to the southwest. The proposed site is underlain by unconsolidated alluvium of the Warrawarrow Riverflood plain, which runs along the Vigie Highway on the southeast side of the old airport. The proposed site has a shallow groundwater table and lies in the Warrawarrow River watershed, which spans around 1,100 hectares and is susceptible to flooding. The former airport terminal building experienced frequent flooding events, which were modeled over a 25-year return interval and mitigated in part by construction of river defense Public Disclosure systems under the Bank funded Disaster Vulnerability Reduction Project (DVRP, P117871). The current hydraulic conditions will be reviewed during detailed design review, and results incorporated into an updated Environmental and Social Impact Assessment (ESIA). Due to the site’s previous use as an airport, there is no native vegetation remaining, with areas covered either by asphalt of the former runway or a mowed grass lawn. The proposed site is considered “brownfield” due to its former use as an airport. According to the preliminary site information, only the abandoned runway needs to be removed at the site preparation stage. On the bank of the Warrowarrow River immediately east of the former airport grounds there is a squatter community called Pole Yard. This community consists of approximately sixty-two (62) dwellings that are outside the area of the project as well as the former airport grounds, separated by the airport perimeter fence. There will be some direct and in-direct impacts to this community, which needs to be investigated during the project preparation. D. 2. Borrower’s Institutional Capacity The project will be implemented by the Ministry of the Finance, Economic Planning, and Information Technology (MoFEP) in close collaboration with the Ministry of Health, Wellness, and the Environment (MoHWE). MoHWE has experience with the World Bank and is currently implementing the OECS Regional Health Project and related Additional Financing I and II (P168539; P174096; 175385) projects in SVG. MoFEP is familiar with the Bank requirements, including the requirements under the Environmental and Social Framework (ESF). The Public Sector Investment Project Management Unit (PSIPMU) within MoEFP is responsible to provide environmental and social risk management support in all bank funded projects. The relevant officers of the PSIPMU participated the ESF Mar 11, 2022 Page 3 of 12 The World Bank Saint Vincent and the Grenadines Strengthening Health System Resilience Project (P176559) training/workshop organized by the Bank. In addition, the officers were also involved in other ESF projects preparation in recent times. It is expected that PSIPMU will also provide E&S support to this project. The detailed institutional arrangement for E&S risk management will be discussed and agreed with the borrower during the project preparation and reflected in the environmental and social commitment plan (ESCP). II. SCREENING OF POTENTIAL ENVIRONMENTAL AND SOCIAL (ES) RISKS AND IMPACTS A. Environmental and Social Risk Classification (ESRC) Substantial Environmental Risk Rating Substantial The environmental risk classification is Substantial under the World Bank Environmental and Social Framework based on the location, type, sensitivity and scale of project intervention, nature and magnitude of potential E&S risks and impacts and client capacity and ownership. The project involves turn-key construction of the Arnos Vale Acute Care Hospital through the brownfield development of the former airport grounds. It will be considered a large construction in the country considering its limited experience with this scale of construction. An initial Environmental and Social Impact Assessment (ESIA) was conducted under the DVRP project in 2018, when the MoFEP hired a consultant for the technical studies and design of the hospital construction. The ESIA was updated in 2021 and, while it provides good background information, still contains some gaps and therefore requires an update. Therefore, the ESIA will be updated at the detailed design review that builds on the initial one, to address the risks and gaps that are identified during project preparation. The main environmental risks and impacts during the construction phase are associated with traffic, dust, air, and noise emissions from the construction, including Public Disclosure runoff into the Warrowarrow River and the Caribbean Sea. Community health and safety issues related to traffic and site access also pose risks during construction. As the site is a brownfield development there may be concerns for soil and groundwater contamination from former aviation land use, that pose an additional risk of hazardous waste management, unless it is fully evaluated. Groundwater monitoring wells were installed and sampled and did not reveal any signs of gross contamination (e.g. stained soils, odors, etc.) but targeted confirmation sampling will be done as part of the ESIA updating. Flooding issues have been addressed in part through the DRVP’s river defense system; however, confirmation of its effectiveness is needed through hydraulic modeling . During the operations phase the main environmental risks are from waste management of biomedical and hazardous wastes associated with the hospital; and, health and safety of health care workers and nearby residents. Most importantly, the project needs to establish proper infection control and waste management plan including lab and bio-medical waste segregation, collection, storage, transportation, treatment, and disposal facility for its operational phase. The updated ESIA will consider the requirement of the safe handling, storage, transportation, treatment and disposal of biomedical waste management of the hospital during its operational phase and recommend appropriate infrastructure and management practices. There are additional risks related to institutional capacity, that will be addressed through the assignment of PSIPMU staff, and ensuring adequate environmental management provisions are included in the turnkey and supervision firm contracts. Social Risk Rating Substantial The Social Risk Rating is currently considered Substantial under the World Bank Environmental and Social Framework due to the proximity of a vulnerable community to the proposed project site and potential direct and in- direct impacts on them. According to the preliminary ESIA, the footprint of the Project will not intersect with surrounding communities. However, a thorough screening of the area would need to confirm that as well as more Mar 11, 2022 Page 4 of 12 The World Bank Saint Vincent and the Grenadines Strengthening Health System Resilience Project (P176559) accurate information on the footprint to be provided in the final design. The screening should pay particular attention to the Pole Yard community since it is an informal vulnerable community adjacent to the proposed project site. No land acquisition is expected as the new medical facility is planned to be built at the site of the decommissioned airport at Arnos Vale. B. Environment and Social Standards (ESSs) that Apply to the Activities Being Considered B.1. General Assessment ESS1 Assessment and Management of Environmental and Social Risks and Impacts Overview of the relevance of the Standard for the Project: The standard is relevant to the project. As mentioned earlier, the implementing agency carried out an initial assessment of the E&S risks of the project through an ESIA (initially prepared in 2018 and updated in 2021). The updating of the ESIA at the detailed design review will include i) review of updated design consideration and facility footprint, ii) incorporation of traffic studies, iii) flood analyses considering the new river defense system, iv) assessment of potential soil and groundwater contamination from any previous activity, v) operations phase impacts, and vi) biomedical waste management including autoclave, incinerator, or other appropriate treatment options as required. This new, updated ESIA will be prepared by the turn-key contractor during the design review phase. Since the contractor will not be hired during the project preparation phase, the TOR for the updating ESIA will be agreed with the borrower by Appraisal. The updating Public Disclosure of the ESIA will be prepared in accordance with the requirements of the Bank ESF and the World Bank Group (WBG) Environmental, Health and Safety (EHS) Guidelines. The updated ESIA will include the provision of the Life & Fire Safety (L&FS) aspects and COVID considerations. Detailed information on the Pole Yard community will be collected during the project preparation stage to understand the potential risk of the project on the community. Although the Pole Yard community is living outside the project footprint, there is a risk for inadequate waste management regarding the Pole Yard community as well as surrounding areas if project does not include the appropriate construction and waste management procedure during the construction phase and bio-medical waste management during hospital operational phase. These risks will be reviewed, and adequate measures will be documented and addressed as part of the ESIA updating. If any, the risk to the Pole Yard community is minimal given that it is located outside of the footprint of proposed project site and furthermore, outside of the perimeter fence of the old, decommissioned airport. An adequate Waste Management Plan will be put in place to mitigate identified risks. It is important to note that the buildings at Pole Yard are located off the airport property and were never related to the airport when it was in operation. Pole Yard structures are therefore unrelated to the present project and will not be used in any way as they are outside the perimeter of the airport. Other vulnerable groups are members of the LGBT community, the elderly and women head of households. LGBT experience barriers to accessing quality healthcare as well as the elderly and women head of households. Consultation with LGBT representatives as well as those of elderly folks and female heads of households will be carried out and included in the SEP. If there are no representatives/associations in SVG, attempt will be made to reach out to the broader OECS and find relevant organizations that represent these groups. Mar 11, 2022 Page 5 of 12 The World Bank Saint Vincent and the Grenadines Strengthening Health System Resilience Project (P176559) The turn-key contractor will carry-out both the detailed design review/updating and ESIA updating. In order to ensure independence in updating the ESIA, it will be emphasized that two separate teams of the turn-key contractor will work independently for detailed deign review and updating the ESIA. In addition, the updated ESIA will be reviewed by an independent consultant. The PSIPMU does not have previous experience in reviewing ESIA of this type of large infrastructure, therefore the project will allocate resources for the independent review consultant, which will be confirmed by the project appraisal. The updated ESIA will include Environmental and Social Management Plans (ESMPs) for construction and operation phases and will be consulted and disclosed in-country and on the Bank’s external web site. In addition, the borrower will prepare a stakeholder engagement plan (SEP) with a project wide GRM and Labor Management procedure (LMP), as well as an Environmental and Social Commitment Plan (ESCP) in agreement with the Bank by appraisal. The project has a Contingency Emergency Response Component (CERC) with currently zero allocation. The CERC is only triggered in the case of a public health emergency and when certain actions, as agreed by the Government and Bank teams, are met. A brief CERC Environmental and Social Management Framework (ESMF) will be prepared as per the Bank’s environmental and social CERC requirements based on the CERC Guidance (Oct. 2017), which will include: a) Identification of potential activities that the CERC could finance (Positive list of goods, services and works), b) Analysis of potential Environmental and Social Risks and Impacts; c) Environmental and Social Management Procedures (including the application of the ES screening form, identification of ES issues and preparation of mitigation plans, Bank clearance and approval, Implementation and M&E, and Completion and Evaluation; and d) Institutional Arrangement for the CERC Implementation. Public Disclosure Areas where “Use of Borrower Framework” is being considered: None. ESS10 Stakeholder Engagement and Information Disclosure The standard is relevant. The main stakeholders of the project include residents of Arnos Vale and nearby communities, including the Pole Yard informal settlement, health care workers, and the citizens of Saint Vincent and Grenadines who will use the hospital. In addition to the Ministry of Health, other ministries that will be involved may include Ministry of Infrastructure Development, Ministry of Finance, and Ministry of Labor. Organizations of the Civil Society (Universities, NGOs, and others present in the project area of influence), and commercial organizations, are also considered stakeholders, as well as residents of nearby communities and relevant local government authorities. The SEP will provide for adequate consultation and inclusion of the community as well as vulnerable and interested groups in the project area of influence who may experience minor disruptions due to the increased activity in the hospital area. The project SEP will outline the measures that will be used to facilitate participation, and how the views of different affected groups will be captured, and will describe a) who the key stakeholders are; b) how they are to be engaged; c) how often the engagement will occur throughout the project; d) how feedback will be solicited, recorded and monitored over the project; e) who will be uncharged/responsible for this engagement; f) timeline for this engagement. As mentioned previously under ESS1, the Pole Yard community is susceptible to exclusion as vulnerable communities have a history of being excluded. The team will make sure to document and address barriers to inclusion regarding Mar 11, 2022 Page 6 of 12 The World Bank Saint Vincent and the Grenadines Strengthening Health System Resilience Project (P176559) the Pole Yard community in the SEP and consultations will be carried out with this vulnerable group and others such as the LGBT community, the elderly and women head of households, where relevant, in order to mitigate these risks. In addition, the SEP will include a description of the role of the possible private security forces and a GRM for presenting and addressing grievances related to the security personnel. The Bank will review the adequacy of the SEP which, as an ES instrument, must be cleared by appraisal. The Borrower will propose and implement a grievance mechanism to receive and facilitate the resolution of concerns and grievances. If relevant, the project level GRM should build upon existing systems already in place by the Government of Saint Vincent and the Grenadines (GoSVG). The GRM will specify special channels and procedure to address Grievances related to Sexual Exploitation, Abuse and Harassment linked to the project. The Grievance Mechanism will be included in the SEP and be operational throughout project implementation. The SEP will be finalized, consulted and disclosed by Appraisal. B.2. Specific Risks and Impacts A brief description of the potential environmental and social risks and impacts relevant to the Project. ESS2 Labor and Working Conditions This standard is relevant given the project’s focus on a large civil work. The type of workers covered under the Labor Management Plan will be Direct workers and Contracted Workers. There will be no Community Workers. Some Public Disclosure unskilled workers may be hired for construction work and to perform small, repetitive, and unskilled tasks. Specialized personnel may be hired for the construction of the hospital building and the installation of medical and other equipment. The project may also engage contracted workers through third parties for different aspects of project implementation. The number of workers will be estimated during the detailed design review. Government civil servants (e.g., MOH) who are expected to work in connection with the project, whether full-time or part-time, will remain subject to the terms and conditions of their existing public-sector employment agreement or arrangement, unless there has been an effective legal transfer of their employment or engagement to the project. ESS2 will not apply to such government civil servants, except for the provisions of Protecting the Work Force Occupational Health and Safety. The project does not intend to engage with primary supply workers nor to include the use of community workers. The Bank team will review the specific HR processes and practices for the project in line with due requirements, as reflected in a Labor Management Procedure (LMP) with a Worker Grievance Redress Mechanism (separate from that described under the ESS10 section, and in line with an existing system in place for MOH employees), as well as Occupational Health and Safety practices. The LMP will include the current information on existing EHS practices and capacity to implement in line with GIIP. The LMP will be finalized, consulted, and disclosed as a standalone document at the national level and in the Bank’s external website by the Project Appraisal. The Borrower will require the turn-key contractor and supervision consultant to prepare and implement a specific Code of Conduct for workers and staff, and that will include at minimum: maintain a safe working environment, report work situation that he/she believes are not safe or healthy and remove himself/herself from a work situation which he/she reasonable believes presents an imminent and serious danger to his/her life or health; treat other people with respect, and not discriminate against specific groups such as women, people with disabilities, migrant Mar 11, 2022 Page 7 of 12 The World Bank Saint Vincent and the Grenadines Strengthening Health System Resilience Project (P176559) workers (if any) or children; not engage in sexual harassment; not engage in sexual exploitation; not engage in sexual abuse; not engage in any form of sexual activity with individuals under the age of 18; report violation of code of conduct, and not retaliate against any person who reports violation of the code of conduct. ESS3 Resource Efficiency and Pollution Prevention and Management The standard is relevant from the perspectives of resource conservation, and waste management. The project will seek to promote the sustainable use of water and energy, and to avoid or minimize project-related wastes emissions, especially biomedical and hazardous wastes. Design of the hospital is expected to include energy conservation measures such as LED lighting, efficient HVAC elements, building orientation and ventilation, and selection of suitable building materials. Water conservation will be promoted with low-flow fixtures, efficient water treatment plant design, and other measures as appropriate. The technical specifications of different equipment will promote energy efficiency and measures to reduce GHG emissions. These requirements will be discussed and agreed with the borrower by appraisal and will reflect in the ESCP. The project will focus on adequate solid waste management practices, which will be reflected in the contract documents (for repairing and installation) to ensure the appropriate management of waste from construction, including end location of the waste removed. During operations, the project will create an increase in use and scope Public Disclosure of services, resulting in additional sources of medical waste which will require proper treatment and disposal. Presently, there is no formalized plan for health care waste management in St. Vincent and the Grenadines, but a National Biomedical Waste Plan (NBWP) was developed in 2002 and describes proposed measures and practices for waste classification/minimization/segregation, labelling, storage, transport, treatment (long term, short term), waste pit design, areas of landfills receiving wastes, and training practices. Procedures are in place including sharps collection in designated containers and the use of bio hazard bags. Biomedical wastes are stored in a designated area and then taken by the Solid Waste Management Unit Personnel of CWSA via manually loaded metal containers to the Diamond Sanitary Landfill for deep burial. Currently an assessment of healthcare waste management system (HWMS) for Saint Vincent and the Grenadines is underway through the OECS Regional Health Project (P168539) . The HWMS is expected to be completed in mid-2022 and will evaluate the adequacy of biomedical waste disposal at the country level. The updated ESIA of the proposed project will evaluate health care waste management issue considering the waste to be generated in new hospital and the existing facilities. If it is concluded that a new incinerator, autoclave, and/or other associated facilities are necessary, then the provision(s) will be funded by the project. ESS4 Community Health and Safety The Standard is relevant. Although most of the work will be confined to the existing and secured areas of the former airport, transportation of construction materials, machinery and equipment may increase the risk of traffic hazard and associated incidents. In addition, there are potential for community health and safety risks if unauthorized Mar 11, 2022 Page 8 of 12 The World Bank Saint Vincent and the Grenadines Strengthening Health System Resilience Project (P176559) people enter work zones. The Contractor will put in place a traffic management plan (TMP) to ensure that trucks unloading equipment do not cause traffic jams and can safely offload equipment and supplies. The ESMPs will outline the measures to reduce the community health and safety related risks, especially through the establishment of a security perimeter around the site to minimize the risks of injury or exposure to hazards. The ESMPs must also include mitigation measures for storage, handling, transportation, and disposal of hazardous materials such as fuels. The project is not expecting to use national security forces in project implementation. However, personnel from private security companies could be involved for protection of project related activities. Deployment in a manner consistent with applicable national law that the relevant ESS4 requirements will be implemented as well as other requirements outlined in the ESIA and ESMPs. The ESMPs will specify appropriate requirements for management of use of security forces, such as: i) screening to confirm that they have not engaged in past unlawful or abusive behavior, including sexual exploitation and abuse (SEA), sexual harassment (SH) or excessive use of force; ii) adequate instruction and training, on a regular basis, on the use of force and appropriate behavior and conduct (including in relation to SEA and SH); and iii) deployment in a manner consistent with applicable national law. These conditions which will be included in any relevant agreements/contracts during bidding which should also include a code of conduct. In addition, the SEP will include a GRM for presenting and addressing grievances related to the security personnel. The SEA/SH Risk category is considered Moderate, preliminarily. There is currently no available data on neighboring facilities or schools. The team will enquire and conduct the pertinent due diligence during the project preparation. Public Disclosure The project will also put into place safety measures for COVID-19 by an Infection Control and Waste Management Procedure, both for the construction phase and the operation of the hospital, as well as an Occupational Health and Safety Plan that includes infectious diseases. ESS5 Land Acquisition, Restrictions on Land Use and Involuntary Resettlement The standard is not currently relevant. Based on the current information, the Project activities will not require the acquisition of land or any restrictions on land use. Therefore, there is no potential for physical displacement (relocation, loss of residential land or loss of shelter) or economic displacement (loss of land, assets or access to assets, leading to loss of income sources or other means of livelihood). The final footprint of the hospital will be confirmed during the detailed design. In addition, as part of the updated ESIA, a rigorous screening of the area will be conducted to understand the proximity and boundaries of the nearby Pole Yard community and if there are any type of livelihood links between the community and the proposed project site. The relevance of the EES5 will be confirmed/reconsidered during that period. ESS6 Biodiversity Conservation and Sustainable Management of Living Natural Resources The standard is not relevant as the former airport has been cleared of vegetation for some decades. ESS7 Indigenous Peoples/Sub-Saharan African Historically Underserved Traditional Local Communities Mar 11, 2022 Page 9 of 12 The World Bank Saint Vincent and the Grenadines Strengthening Health System Resilience Project (P176559) The standard is not currently relevant. There are no communities who meet the definition of indigenous people present in the project’s area of influence. ESS8 Cultural Heritage The standard is relevant as the construction activities will include excavation and earth moving activity. Accordingly, the updated ESIA will have a chance find procedure in its ESMP which will be included in any construction contracts awarded under the project. The chance find procedure includes: i) setting out how chance finds associated with the project will be managed, ii) including a requirement to notify relevant authorities of found objects or sites by cultural heritage experts; iii) fencing-off the area of finds or sites to avoid further disturbance; iv) conducting an assessment of found objects or sites by cultural heritage experts; v) identifying and implementing actions consistent with the requirements of this ESS and national law; and, vi) training project personnel and project workers on chance find procedures. ESS9 Financial Intermediaries The standard is currently not relevant, as there are no FIs involved in the project. B.3 Other Relevant Project Risks Public Disclosure None C. Legal Operational Policies that Apply OP 7.50 Projects on International Waterways TBD OP 7.60 Projects in Disputed Areas TBD III. WORLD BANK ENVIRONMENTAL AND SOCIAL DUE DILIGENCE A. Is a common approach being considered? No Financing Partners Not known at this stage. B. Proposed Measures, Actions and Timing (Borrower’s commitments) Actions to be completed prior to Bank Board Approval: Preparation and disclosure of Environmental and Social Commitment Plan (ESCP) Mar 11, 2022 Page 10 of 12 The World Bank Saint Vincent and the Grenadines Strengthening Health System Resilience Project (P176559) Preparation, consultation, and disclosure of the Stakeholder Engagement Plan (SEP) with its Grievance Redress Mechanism. Terms of Reference (TOR) for carrying out ESIA including ESMPs Preparation, consultation, and disclosure of a Labor Management Procedure (LMP), with its Grievance Redress Mechanism Contingency Emergency Response Component (CERC) Environmental and Social Management Framework (ESMF) Possible issues to be addressed in the Borrower Environmental and Social Commitment Plan (ESCP): The ESCP will likely address, at a minimum, commitments related to the following: Institutional arrangement for E&S risk management Supervision, monitoring, and reporting requirements Preparation, review, consultation, and disclosure of the ESIA and implementation of ESMPs Preparation and implementation of Labor Management Procedures and a Grievance Redress Mechanism for Project workers. Preparation and implementation of Health and Safety Procedures for both workers and for the affected communities. Establishment of a project Grievance Redress Mechanism Finalization and implementation of Stakeholder Engagement Plan Capacity building of implementing agency on environmental and social risk management Public Disclosure C. Timing Tentative target date for preparing the Appraisal Stage ESRS 20-Apr-2022 IV. CONTACT POINTS World Bank Contact: Edit V. Velenyi Title: Senior Economist Telephone No: +1-202-458-4319 Email: evelenyi@worldbank.org Borrower/Client/Recipient Borrower: Saint Vincent and the Grenadines Implementing Agency(ies) Implementing Agency: Ministry of Health, Wellness and Environment (MOHWE) V. FOR MORE INFORMATION CONTACT Mar 11, 2022 Page 11 of 12 The World Bank Saint Vincent and the Grenadines Strengthening Health System Resilience Project (P176559) The World Bank 1818 H Street, NW Washington, D.C. 20433 Telephone: (202) 473-1000 Web: http://www.worldbank.org/projects VI. APPROVAL Task Team Leader(s): Edit V. Velenyi Practice Manager (ENR/Social) Genevieve Connors Recommended on 09-Mar-2022 at 12:28:44 GMT-05:00 Safeguards Advisor ESSA Angela Nyawira Khaminwa (SAESSA) Cleared on 11-Mar-2022 at 16:07:4 GMT-05:00 Public Disclosure Mar 11, 2022 Page 12 of 12