The World Bank KOSOVO EMERGENCY COVID-19 PROJECT (P173819) REPORT NO.: RES58819 RESTRUCTURING PAPER ON A PROPOSED PROJECT RESTRUCTURING OF KOSOVO EMERGENCY COVID-19 PROJECT APPROVED ON MAY 20, 2020 TO THE REPUBLIC OF KOSOVO HEALTH, NUTRITION & POPULATION EUROPE AND CENTRAL ASIA Regional Vice President: Antonella Bassani Country Director: Xiaoqing Yu Regional Director: Michal J. Rutkowski Practice Manager/Manager: Rekha Menon Task Team Leader(s): Mrike Aliu, Ha Thi Hong Nguyen, Sarah Coll- Black The World Bank KOSOVO EMERGENCY COVID-19 PROJECT (P173819) ABBREVIATIONS AND ACRONYMS AF Additional Financing E&S Environmental and Social MoH Ministry of Health MRI Magnetic Resonance Imagining NIPH National Institute of Public Health PCU Project Coordination Unit PDO Project Development Objective PHC Primary Health Center UNOPS United Nations Office for Project Services The World Bank KOSOVO EMERGENCY COVID-19 PROJECT (P173819) BASIC DATA Product Information Project ID Financing Instrument P173819 Investment Project Financing Environmental and Social Risk Classification (ESRC) Substantial Approval Date Current Closing Date 20-May-2020 31-Dec-2023 Organizations Borrower Responsible Agency Republic of Kosovo Multiphase Programmatic Approach (MPA) Program Development Objective The Program Development Objective is to prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness Multiphase Programmatic Approach (MPA) Status (Public Disclosure) Status and Key Decisions (Public Disclosure) COVID-19 MPA - ISR Write-up as of November 16, 2023 Sustained efforts continue to be made to advance the implementation of the 87 MPA operations. After a great deal of activity (restructurings and disbursements) processed at the end of FY23 when several operations were restructured just before or on June 30, 2023, the past three months have seen a slower period of disbursements. The overall level of disbursements is being affected by three main reasons: (i) low disbursements in six countries, (ii) pausing of disbursements in two other countries – Afghanistan, and Myanmar, and (iii) processing of refunds to the project accounts at this late stage of project implementation. In addition, (i) a large refund from the UN to the project account of the Myanmar operation was processed in late March due to the inability to implement the project, and (ii) the amounts of Loans and Credits denominated in SDRs and Euros have been affected because of fluctuations between the SDRs and Euros against the US dollar. As of November 16, 2023, 88 MPA-projects had been approved with a total commitment of US$4.27 billion. One operation (Guatemala) was cancelled in mid-September 2021, at the request of the Government. Total The World Bank KOSOVO EMERGENCY COVID-19 PROJECT (P173819) disbursements as of November 16, 2023, amount to US$3.97 billion or 93% of overall commitments. This amount does not include disbursements under MPA-V operations which are reported together with AF-V operations. Ten operations closed by the end of CY22 and nine operations closed on June 30, 2023. While there are thirteen (13) operations with closing dates by the end of CY23, there are plans for some projects to process extensions so this number will change. As with the Mid Term Review (MTR) issued on March 25, 2023, no individual COVID-19 MPA operation will need an ICR. Only one ICR will be prepared upon completion of the SPRP COVID-19 MPA Program, which closes on December 31, 2025. The Global ICR will be based on final ISRs packages prepared by country operations’ teams. A template for the final ISR was issued by OPCS on March 21, 2023. Several operations have/are preparing final ISR packages. The overall conclusion of the MTR was that: (i) the COVID-19 MPA Program embodied a rapid, innovative approach to new lending for human health response; (ii) the COVID- 19 MPA has been successful, notwithstanding considerable uncertainty and multiple constraints in the early stages of the pandemic; (iii) the Bank’s emergency response was remarkably swift in the most vulnerable countries facing human capital losses and development setbacks; and (iv) notwithstanding the challenges, the MPA is on track to achieve its PrDO, “prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness.“ Seventy-three (73) country projects or 86 percent of projects approved have reached 70-100+ percent disbursement (reasons for >100% disbursements relate to fluctuations between the Euro and the SDR against the US$). Out of the 73 operations, 63 operations or 86 percent have disbursed 90+ percent of commitments. Out of the 73 operations, 49 operations or 67 percent are fully disbursed and ten (10) operations have disbursed 95-99 percent of commitments. There are four operations with disbursements of 50 percent or less. Out of these four operations, one operation has disbursed 35 percent (AFW), two operations in EAP have disbursed 46-48 percent and one operation in SAR has disbursed 49 percent. The projects are benefitting about 3.7 billion people or 50% of the global population. When countries with AF-V operations are counted, the projects are benefitting about 4.1 billion of 51 percent of the global population. This is because some countries that do not have a parent project have AF-V operations. All projects approved are disbursing. Operations in ECA and MNA are fully disbursed. In other regions, disbursements have reached: (i) LAC 97 percent, (ii) SAR 95 percent, (iii) EAP 87 percent, (iv) AFW 85 percent, and (v) AFE 79 percent. Disbursements for EAP operations are being affected by low disbursements in three country projects that have disbursed between 46 and 56 percent. AFE lower disbursements compared to other regions are a result of low disbursements under two operations, which have disbursed 55-66 percent respectively. In the case of AFW low overall disbursements are a result of low disbursements under one operation (35 percent). Retroactive Financing (RF) represents 20 percent of commitments. SAR has the highest percentage of RF at 37 percent, followed by ECA at 18 percent. Direct Payment (DP) disbursements represent 22 percent of commitments. EAP has the highest level of disbursements using DP – 80 percent, followed by AFW at 38 percent. IDA continues to represent 40 percent while IBRD represents 60 percent of disbursements. Streamlined procedures, delegated approvals, coupled with flexible project design and intensified efforts by counterparts and Bank teams have contributed to the progress. Implementation is being guided by Bank The World Bank KOSOVO EMERGENCY COVID-19 PROJECT (P173819) teams working in parallel with other health related projects, including Additional Financing operations which have supported vaccine procurement and deployment efforts. COVID-19 MPA AF-V - ISR Write-up as of November 16, 2023 As of November 16, 2023, the Bank has approved 116 operations (including MPA-V operations) to support vaccine procurement and rollout in 78 countries amounting to $9.25 billion. The Senegal AF2 operation for $15 million financed by a Grant from The Global Finance Facility was approved on June 30, 2023. Also, a Second AF (IDA Grant of $1.50 million) was approved on August 31, 2023, for Sao Tome and Principe. One hundred and nineteen (119) operations had been approved amounting to $10 billion, but the: (i) Costa Rica operation ($120 million), (ii) Peru operation ($500 million), and (iii) Gabon operation ($12 million) were cancelled. The first two at the request of the governments and the third because the date of effectiveness lapsed. Also, the Afghanistan operation commitment of $113 million was reduced to $60 million. Partial cancellations have been processed in the past months under several operations, thereby the overall commitment has decreased in the past months. Of the 116 approved operations: (i) 66 are in Africa – 31 in AFE and 35 in AFW; (ii) 10 in East Asia and the Pacific; (iii) 11 in Europe and Central Asia; (iv) 11 in Latin America and the Caribbean; (v) 9 in Middle East and North Africa; and (vi) 9 in South Asia. The 116 operations approved, include 6 operations that involved restructuring of parent projects (Bhutan, Cameroon, North Macedonia, Philippines, and Pakistan) and in the case of Lebanon, restructuring of the Health Resilience Project. Thirty-two (32) operations are being implemented in Fragile and Conflict-affected situations. IDA represents 45 percent and IBRD 55 percent of disbursements. Total disbursements under these projects as of November 16, 2023, amount to US$6.31 billion or 68 percent of overall commitments. Disbursements under MPA-V operations are included in this total while disbursements under the six restructured projects are counted under parent projects. With less than planned demand for IDA/IBRD funds for vaccine procurement because, inter alia, over supply of vaccines from donations from various sources, several projects have been/are being restructured and more will need to be restructured to reallocate funds allocated to procurement of COVID-19 vaccines and deployment. Guidance was issued under an Email from Juan Pablo Uribe of July 7, 2023, which provided direction for the use of undisbursed funds under COVID- 19 operations. Four (4) operations are fully disbursed (Argentina, Indonesia, Sri Lanka AF-V 1, and Ukraine AF-V 3). Forty- eight (48) operations or 41 percent of operations approved have disbursed over 70 percent of their commitments. Out of the 48, eleven (11) operations have disbursed 95-99 percent. Ninety-five (95) operations or 82 percent of total operations approved are disbursing. ECA has the highest percentage of disbursements at 86 percent, followed by SAR and MNA at 77 percent, LAC at 76 percent, EAP at 74 percent, AFE at 59 percent and AFW at 57 percent. As of August 1, 2023, the World Bank had purchased 635.4 million doses of the COVID-19 vaccine of which 506.8 million had been delivered to client countries and 500.7 million administered. The World Bank KOSOVO EMERGENCY COVID-19 PROJECT (P173819) Retroactive Financing (RF) continues to represent 36 percent of overall commitments. High levels of RF have been authorized under different operations - Ukraine (100%), Panama and Turkey (90%), Argentina and Guyana (80%), and Belize, and Sri Lanka (70%). All loan/financing agreements approved have been signed. As with the COVID-19 MPA operations, streamlined procedures, delegated approval, wide use of Bank Facilitated Procurement (BFP), coupled with flexible project design, and intensified efforts from counterparts and Bank staff have contributed to the rapid design, processing, and implementation of the AF-V operations. OPS_TABLE_PDO_CURRENTPDO Project Development Objective (PDO) Original PDO The project development objective is to prevent, detect, and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness in Kosovo OPS_TABLE_PDO_CURRENTPDO Summary Status of Financing (US$, Millions) Net Ln/Cr/Tf Approval Signing Effectiveness Closing Commitment Disbursed Undisbursed IDA-69630 24-Jun-2021 23-Jul-2021 09-Nov-2021 31-Dec-2023 18.20 7.32 9.20 IDA-66780 20-May-2020 29-Jun-2020 03-Sep-2020 31-Dec-2023 50.00 53.89 1.15 Policy Waiver(s) Does this restructuring trigger the need for any policy waiver(s)? No I. PROJECT STATUS AND RATIONALE FOR RESTRUCTURING PROJECT STATUS 1. The Kosovo Emergency COVID-19 Project with original financing of Euro 46 million (US$ 50 million equivalent at the time of approval) was approved on May 20, 2020, and became effective on September 3, 2020. An Additional Financing (AF) of Euro 15 million (US$ 18.2 million equivalent) was approved on June 24, 2021, and became effective on November 9, 2021. The Project Development Objective (PDO) is to prevent, detect, and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness in Kosovo. 2. The Project has been restructured four times. The first restructuring was processed concurrently with the AF (June 2021) and introduced new activities to support the procurement of medical supplies and COVID-19 vaccines, among others. It also extended the closing date by 12 months, from June 30, 2022, to June 30, 2023. The second restructuring (November 2021) added new activities under Component 1: Emergency COVID-19 Response to reflect the evolving COVID- 19 situation and the Government’s emerging needs, mainly the installation of the centralized oxygen system and The World Bank KOSOVO EMERGENCY COVID-19 PROJECT (P173819) procurement of additional medical equipment. The third restructuring (September 2022) canceled the procurement of COVID-19 vaccines, PCR testing kits, and procurement of drugs given improvements in the pandemic situation and the use of the Government funds or other donor grant funding and re-allocated funds towards procurement of radiology equipment, ambulances, and additional civil works for selected health facilities. The fourth restructuring (March 2023) extended the closing date of the Project by six months, from June 30, 2023, to December 31, 2023, to allow for the completion of the remaining activities and full absorption of credit proceeds, including closure and reporting of advance payments to the United Nations Office for Project Services (UNOPS). In total, the Project has been extended by 18 months from the original closing date. 3. The Project has three components.  Component 1: Emergency COVID-19 Response (EUR 31.04 million, US$ 35.6 million equivalent) o 1.1: Strengthening capacity for early case detection, confirmation, contact tracing, reporting, and monitoring o 1.2: Health capacity strengthening o 1.3: Vaccine Procurement and Deployment  Component 2: Supporting households to comply with public health containment measures (EUR 28.9 million, US$ 31.4 million equivalent) o 2.1: Maintenance of social assistance payments o 2.2: Increase in value of social assistance payments o 2.3: Expansion of social assistance payments  Component 3: Project management, communications, and community engagement (EUR 1.06 million, US$ 1.2 million equivalent) 4. Progress towards achievement of the PDO has been rated Satisfactory since approval, while overall implementation progress has been rated Moderately Satisfactory since approval. All four PDO-level indicators have been achieved. Nine out of the twelve intermediate results indicators have been achieved. Of the remaining three intermediate results indicators, one has been partially achieved and the other two are achievable with the proposed extension, as detailed below. a. Number of volunteer healthcare staff covered with salaries for at least three months: partially achieved. The improvement in the COVID-19 situation shortly after the Project effectiveness resulted in a decrease in surge staffing needs. Specifically, only 338 support staff were hired and paid over three months (out of a total of 400 planned). No additional support needs are foreseen prior to the current closing date. b. Beneficiaries reporting satisfaction with the Government’s response to COVID-19 through its health system and Social Assistance Scheme (SAS): not achieved yet. Implementation of the ‘Assessment of the emergency cash transfer support provided through the SAS in response to COVID-19’ is ongoing and expected to be completed by November 30, 2023. Provided the activity is completed as planned and the target of 70 percent is achieved, this indicator can still be achieved by the current closing date. c. The number of communities engaged in participatory testing of the information products for COVID-19 vaccines: not achieved yet. After canceling the recruitment of a firm to conduct public awareness and communication activities, it was necessary to hire additional communications staff (a communication specialist, a communication assistant, and public relations specialist) for the needs of the division for public communication at the Ministry of Health (MoH). All the three consultants were hired as of October 1, 2023. All developed communications materials will be tested with selected communities prior to their incorporation as final products for information campaigns. However, it is unlikely that the target for this indicator will be reached by the current closing date. 5. Most activities under Component 1 have been completed. UNOPS was contracted (EUR 17.57 million) under this component to facilitate procurement of medical equipment and devices, completion of selected civil works, and procurement of drugs and medical supplies under two contracts. Both contracts have been completed and EUR 16.19 The World Bank KOSOVO EMERGENCY COVID-19 PROJECT (P173819) million has been expended from the UNOPS advance payment. The balance from both contracts (~EUR 1.38 million) has been returned by UNOPS to the MoH per required processes and has been reallocated to finance civil work activities implemented by the MoH. In addition, most activities implemented through the Project Coordination Unit (PCU) have been completed, including the development of the laboratory information system for the Microbiology Unit at the National Institute of Public Health (NIPH), civil works at the Regional Institute of Public Health in Prizren, completion of eHealth feasibility study, procurement of primary health center (PHC) vehicles for home outreach and vaccination, creation of PHC zoning, and training on gender-based violence. 6. Some activities are ongoing and are on track to be completed by the end of 2023, as described below. a. Delivery/installation of medical and surgical devices for neurosurgery and vascular clinics (EUR 2.36 million): The equipment is in the country at the supplier’s warehouse, with expected delivery and installation by December 30, 2023. The contract for adaptation of the sites for installation of equipment is ongoing and the civil works are progressing well. The works are expected to be completed by December 10, 2023, which will enable delivery and installation of the procured equipment by the current closing date. b. Installation of magnetic resonance imaging (MRI) equipment in Prizren Regional Hospital (EUR 785,000): The MRI has been procured. However, small works are needed to strengthen the power supply at the installation site, with the related contract signed on November 27, 2023. The works are scheduled to be completed by December 12, 2023, to enable installation of the MRI by the current closing date. c. Development of a surveillance electronic system for infectious diseases (EUR 226,560): This system includes integration with the European Centers for Disease Prevention and Control reporting. Most of the system modules have been developed and tested, with the full development of the system expected to be completed by December 15, 2023. d. Renovation works in the National Institute of Public Health (NIPH), Neurosurgery, and Vascular Surgery Clinics (EUR 452,273): The works are ongoing, with priority given to adaptation of the sites at the neurosurgery and vascular surgery clinics for installation of the equipment specified under point (a) above. Works at the NIPH are ongoing in parallel and are expected to be completed by December 10, 2023. 7. However, two activities are not likely to be completed by the December 2023 closing date, as outlined below. a. Renovation works in Gynecology and Urology Clinics (EUR 3,600,000): The works are expected to start on December 10, 2023, and be completed by mid-March 2024. The MoH had issued a commitment letter that any unfinished work that remains to be completed after the Project closing would be paid from government resources. The MoH has also put in place a strong contract management team and has negotiated with the awarded bidder to ensure the timely completion of works. However, there are a number of factors that hinder the completion of this package by the current closing date: (i) based on the current implementation schedule, works would start during the winter season, which would impede their completion; and (ii) the works would be carried out while the clinics, continue serving the patients which, judging from past experience, is likely to impact the completion timelines. With no extension of the current closing date, due to peculiarities of the country’s public procurement regulations1, the MoH will have to re- tender the works remaining to be completed after the project’s current closing date, which would substantially delay the completion of works. b. Procurement of ambulance for Neonatology Clinic (EUR 200,000): The first tender failed, as no bidders applied through the open bid competition. Two bidders applied under the second tender and the Evaluation Report is expected by December 1, 2023. Following the expected contract signature on December 7, 2023. Given the market 1According to the Public Procurement Law, any use of public funds that comes from a direct government budget must undergo public procurement regulations. It does not recognize World Bank procurement regulations, which can be used only for activities directly funded by a World Bank loan. The World Bank KOSOVO EMERGENCY COVID-19 PROJECT (P173819) supply disruptions in the vehicle manufacturing industry and the need for customization of the vehicle, there is a high risk that this package will not be completed by the current closing date. The delivery timeline for the ambulance is expected not earlier than mid-March 2024. 8. All activities under Component 2 have been completed, with respective funds in the approximate amount of EUR 28,900,000 disbursed through cash transfers to 310,126 beneficiaries. The provision of cash transfers under the Project has allowed the country to ensure financial support for the SAS beneficiaries to assist them in meeting their basic needs in the face of rising healthcare costs and loss of other income sources. The cash transfers have also helped expand coverage of the scheme to additional households that have lost their income as a result of the pandemic. 9. Procurement and Financial Management. Procurement performance is rated as Satisfactory. Financial management arrangements at the PCU, including planning and budgeting, accounting, financial reporting, internal controls, and disbursement are adequate and acceptable to the Bank. There are no overdue audit reports under the Project. In line with Project spending requirements for the year 2024, the MoH has ensured that the annual budget law for 2024 adequately reflects the allocation for the eligible expenditures2 to be incurred prior to the extended closing date (under both foreign finance and government budget) to ensure a proper and smooth closing process. 10. Environmental and Social (E&S) E&S performance is rated as Satisfactory. The PCU E&S specialist is in place as of March 2021. The Stakeholder Engagement Plan, the E&S Management Framework, and the Labor Management Plan were finalized and disclosed on both the MoH and the World Bank websites timely. In addition, a review of the E&S management of the Project activities under Components 1 and 2 was carried out. The review indicated that no remedial actions were required and no gaps that would require updating of the E&S Management Framework and/or other documents were identified. The E&S Management Plans have been prepared for the renovation works procured and those in the procurement process. All ongoing works are regularly monitored by the PCU. No environmental and social issues of concern have been noted/reported. The tender document for other planned rehabilitation works in Gynecology and Urology clinics have been reviewed, with the E&S issues and mitigation measures being duly considered. The grievance redress mechanism is functional through the MoH’s website and working under PCU’s monitoring. No grievances have been received from the community or the workers. 11. Disbursements/Commitments. As of November 24, 2023, the Project has disbursed 87 percent (EUR 52.55 million) of the total original and AF credits. An additional amount of EUR 2.3 million is currently being processed for reimbursement and will be reflected as a new disbursement in the coming days. An additional EUR 3.8 million is committed for ongoing packages and is expected to be disbursed by the end of December 2023. An amount of EUR 3.6 million is at risk of being absorbed by the current closing date. RATIONALE FOR RESTRUCTURING 12. Select Project activities (financed by the AF) were delayed due to several reasons that are beyond the Project’s control. Firstly, there have been numerous changes in the leadership of the MoH, leading to delays in decision-making and management of the Project from the client’s side. Specifically, since the AF’s effectiveness on November 9, 2021, there have been four rotations of ministers or acting ministers. Secondly, the evolving nature of the COVID-19 pandemic has resulted in shifting priorities which required additional time for planning and implementing the related activities. Thirdly, being a small country, Kosovo is disproportionately challenged by the limited and disrupted supply chain markets, which impacted delivery time, particularly for medical equipment. Lastly, the unexpected recommendation from the MoH’s internal audit office to not sign the third agreement with UNOPS (planned to be signed in early 2023) for the 2For works/goods expected to be delivered close to the closing date and that can be paid out of the IDA credit proceeds during the grace period. The World Bank KOSOVO EMERGENCY COVID-19 PROJECT (P173819) implementation of selected remaining activities, mainly additional civil works, has led to delays and created additional risks to completing all activities by the current closing date. 13. The MoH is committed to speeding up the implementation of the two remaining activities under the Project. To this end, a formal request was sent to the Bank on November 22, 2023 to extend the Project closing date from December 31, 2023 to April 30, 2024. The extension will allow adequate time for completing the remaining activities. Specifically, the completion of renovation works for two gynecology and urology clinics is imperative due to their excessive use during COVID-19. The overwhelming influx of patients took a toll on the physical infrastructure of these two clinics and has left them in a deteriorated state. Renovation is essential to restore these clinics to a safe and functional state, ensuring the well-being of both patients and healthcare providers and building a more resilient service going forward. As noted above, the contract is expected to be signed upon approval of this restructuring, with works expected to start on December 10, 2023 and completed by mid-March 2024. Given the works for the remaining civil works will be utilized from Category 2 of the withdrawal table, a re-allocation of funds from Category 1 to 2 is needed, as requested formally on November 29, 2023. II. DESCRIPTION OF PROPOSED CHANGES 12. Closing Date Extension. The Project’s closing date and the closing date of the AF credit (6963-XK) is proposed to be extended by four months, from December 31, 2023 to April 30, 2024, to allow for the completion of the remaining activities and full absorption of the credit proceeds. The original credit (6678-XK) has been fully disbursed and will be closed by the current closing date. 14. Reallocation Between Disbursement Categories. To allow the disbursement of the remaining activities, a reallocation of EUR 700,000 among disbursement categories is needed for the AF credit (No. 6963-XK.) The reallocation consists in reducing the allocation under Category 1 “Goods, works, consulting services, non-consulting services, Operating Costs, and Training for Part 1.A and Part 1.B(i-vii) of the Project” by EUR 700,000, pertaining to remaining funds following completion of related activities, and increasing Category 2 “Goods, works, consulting services, non-consulting services, Operating Costs, and Training for Part 1.B (viii)-(ix) and 1.C of the Project” by EUR 700,000. 13. Results Framework, Disbursement Estimates, and Implementation Schedule. End target dates for indicators not yet achieved have been revised to reflect the extension of the closing date. Similarly, disbursement estimates and implementation schedule have also been revised to reflect the extension of the closing date. NOTE TABLE III. SUMMARY OF CHANGES Changed Not Changed Results Framework ✔ Loan Closing Date(s) ✔ Reallocation between Disbursement Categories ✔ Disbursements Arrangements ✔ Disbursement Estimates ✔ The World Bank KOSOVO EMERGENCY COVID-19 PROJECT (P173819) Implementation Schedule ✔ Implementing Agency ✔ DDO Status ✔ Project's Development Objectives ✔ MPA Program Development Objective ✔ MPA Expected Results and Indicators ✔ PBCs ✔ Components and Cost ✔ Cancellations Proposed ✔ Overall Risk Rating ✔ Legal Covenants ✔ Institutional Arrangements ✔ Financial Management ✔ Procurement ✔ Other Change(s) ✔ Economic and Financial Analysis ✔ Technical Analysis ✔ Social Analysis ✔ Environmental Analysis ✔ IV. DETAILED CHANGE(S) MPA PROGRAM DEVELOPMENT OBJECTIVE Current MPA Program Development Objective The Program Development Objective is to prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness EXPECTED MPA PROGRAM RESULTS Current Expected MPA Results and their Indicators for the MPA Program Progress towards the achievement of the PDO would be measured by outcome indicators. Individual country-specific projects (or phases) under the MPA Program will identify relevant indicators, including among others: The World Bank KOSOVO EMERGENCY COVID-19 PROJECT (P173819) • Country has activated their public health Emergency Operations Centre or a coordination mechanism for COVID-19; • Number of designated laboratories with COVID-19 diagnostic equipment, test kits, and reagents; • Number of acute healthcare facilities with isolation capacity; • Number of suspected cases of COVID-19 reported and investigated per approved protocol; • Number of diagnosed cases treated per approved protocol; • Personal and community non-pharmaceutical interventions adopted by the country (e.g., installation of handwashing facilities, provision of supplies and behavior change campaigns, continuity of water and sanitation service provision in public facilities and households, schools closures, telework and remote meetings, reduce/cancel mass gatherings); • Policies, regulations, guidelines, or other relevant government strategic documents incorporating a multi- sectoral health approach developed/or revised and adopted; • Multi-sectoral operational mechanism for coordinated response to outbreaks by human, animal and wildlife sectors in place; • Coordinated surveillance systems in place in the animal health and public health sectors for zoonotic diseases/pathogens identified as joint priorities; and • Mechanisms for responding to infectious and potential zoonotic diseases established and functional; and • Outbreak/pandemic emergency risk communication plan and activities developed and tested OPS_DETAILEDCHANGES_LOANCLOSING_TABLE LOAN CLOSING DATE(S) Original Revised Proposed Proposed Deadline Ln/Cr/Tf Status Closing Closing(s) Closing for Withdrawal Applications 30-Jun-2023, 31- IDA-66780 Effective 30-Jun-2022 31-Dec-2023 30-Apr-2024 Dec-2023 IDA-69630 Effective 30-Jun-2023 31-Dec-2023 30-Apr-2024 30-Aug-2024 OPS_DETAILEDCHANGES_REALLOCATION _TABLE REALLOCATION BETWEEN DISBURSEMENT CATEGORIES Financing % Current Allocation Actuals + Committed Proposed Allocation (Type Total) Current Proposed The World Bank KOSOVO EMERGENCY COVID-19 PROJECT (P173819) IDA-69630-001 | Currency: EUR iLap Category Sequence No: 1 Current Expenditure Category: G,W,CS,non-CS,OC,TR,P1A,1B i-vii 3,927,793.00 60,920.00 3,227,793.00 100.00 100.00 iLap Category Sequence No: 2 Current Expenditure Category: G,W,CS,non-CS,OC,TR,P1Bviii,1C 10,915,087.00 6,492,076.31 11,615,087.00 100.00 100.00 iLap Category Sequence No: 3 Current Expenditure Category: G,CS,non-CS,OC,TR,P3 157,120.00 0.00 157,120.00 100.00 100.00 Total 15,000,000.00 6,552,996.31 15,000,000.00 OPS_DETAILEDCHANGES_DISBURSEMENT_TABLE DISBURSEMENT ESTIMATES Change in Disbursement Estimates Yes Year Current Proposed 2020 0.00 0.00 2021 43,573,150.00 43,573,150.00 2022 17,146,300.00 17,146,300.00 2023 7,480,550.00 3,680,550.00 2024 0.00 3,800,000.00 2025 0.00 0.00 . The World Bank KOSOVO EMERGENCY COVID-19 PROJECT (P173819) . Results framework COUNTRY: Kosovo KOSOVO EMERGENCY COVID-19 PROJECT Project Development Objectives(s) The project development objective is to prevent, detect, and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness in Kosovo Project Development Objective Indicators by Objectives/ Outcomes RESULT_FRAME_TBL_PDO Indicator Name PBC Baseline End Target To prevent, detect, and respond to the threat posed by COVID-19 and strengthen national systems Number of suspected cases of COVID19 reported and 6,351.00 356,000.00 investigated per approved protocol (Number) Number of diagnosed cases treated per approved protocol 80.00 14,000.00 (Number) Number of beneficiaries receiving financial support to enable 98,096.00 234,192.00 social distancing (Number) Percentage of population vaccinated, which is included in the priority population targets defined in the national plan 0.00 40.00 (disaggregated by gender) (Percentage) PDO Table SPACE Intermediate Results Indicators by Components RESULT_FRAME_TBL_IO Indicator Name PBC Baseline Intermediate Targets End Target 1 Health care delivery and health capacity strengthening The World Bank KOSOVO EMERGENCY COVID-19 PROJECT (P173819) RESULT_FRAME_TBL_IO Indicator Name PBC Baseline Intermediate Targets End Target 1 Number of designated laboratories with COVID-19 diagnostic equipment, consumables, and reagents 0.00 6.00 per MoH guidelines (Number) Number of medical staff in public health laboratories, trained to undertake contact tracing 0.00 28.00 (Number) Number of healthcare workers trained on appropriate use of PPE, disease surveillance and 0.00 800.00 prevention of the spread of respiratory infections within healthcare facilities (Number) Upgraded infrastructure in designated health No Yes facilities completed (Text) Number of ICU beds equipped and functional in 0.00 60.00 the Infectious Disease Clinic (Number) Number of volunteer healthcare staff covered 0.00 400.00 with salaries for at least 3 months (Number) Number of Primary Healthcare Centers (PHCs) 0.00 28.00 equipped with essential drugs (Number) Percentage of trained PHC healthcare workers with the knowledge to recognize and refer GBV 0.00 20.00 victims during the pandemic (Percentage) Action: This indicator has been Revised Number of Primary Healthcare Centers (PHCs) 0.00 15.00 receiving vehicles for outreach (Number) Supporting households to comply with public health containment measures Adoption of Government Decision to waive SAS SAS beneficiaries continue to be paid during Not adopted Adopted exclusion criteria (Text) public health emergency The World Bank KOSOVO EMERGENCY COVID-19 PROJECT (P173819) RESULT_FRAME_TBL_IO Indicator Name PBC Baseline Intermediate Targets End Target 1 Project management, communication and citizen engagement Beneficiaries reporting satisfaction with Government’s response to COVID-19 through its 0.00 70.00 health system and SAS (Percentage) Action: This indicator has been Revised The number of communities engaged in participatory testing of the information products 0.00 50.00 for COVID-19 vaccines (Number) Action: This indicator has been Revised IO Table SPACE The World Bank KOSOVO EMERGENCY COVID-19 PROJECT (P173819)