Republic of Kenya Ministry of Health (MOH) Building Resilient & Responsive Health Systems (BREHS) (P179698) Environmental & Social Commitment Plan (ESCP) November 2023 1|P a g e ENVIRONMENTAL AND SOCIAL COMMITMENT PLAN 1. The Ministry of Health (MOH) is implementing the Building Resilient and Responsive Health Systems (BREHS) Project (the Project), with the involvement of the Kenya Medical Supplies Authority (KEMSA) as set out in the Financing Agreement. The International Development Association (the Association) has agreed to provide the original financing (P179698) 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 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 and the Association agree to update the ESCP to reflect these changes through an exchange of letters signed between the Association and the Recipient’s Principal Secretary. The Recipient shall promptly disclose the updated ESCP. 2|P a g e ENVIRONMENTAL AND SOCIAL COMMITMENT PLAN (ESCP) – BREHS Project MATERIAL MEASURES AND ACTIONS TIMEFRAME RESPONSIBLE ENTITY MONITORING AND REPORTING A REGULAR REPORTING MOH Prepare and submit to the World Bank regular monitoring reports on the environmental, Submit quarterly and annual reports to social, health and safety (ESHS) performance of the Project, including but not limited to the World Bank throughout Project the implementation of the ESCP, status of preparation and implementation of E&S implementation, commencing 90 days instruments required under the ESCP, stakeholder engagement activities, functioning of after the Project Effectiveness Date. the grievance mechanism(s) and the Sexual Exploitation and Abuse and Sexual Submit each report to the World Bank no Harassment (SEA/SH) Prevention and Response Plan. For incidents related to SEA/SH, the later than 30 days after the end of each report should include only non-identifiable information such as the survivor's age, gender, reporting period. type of incident, whether the alleged perpetrator is related to the project according to the survivor's witness, and the care services the survivor accessed, if any. B INCIDENTS AND ACCIDENTS MOH Promptly notify the WB of any incident or accident related to the Project which has, or is Notify the WB no later than 48 hours likely to have, a significant adverse effect on the environment, the affected communities, after learning of the incident or accident the public or workers, including, inter alia, cases of sexual exploitation and abuse (SEA), and no later than 24 hours after any sexual harassment (SH), and accidents that result in death, serious or multiple injury, severe incident/fatal accident, including forced or child labor. Provide sufficient detail regarding the scope, severity, and possible SEA/SH incidents. causes of the incident or accident, indicating immediate measures taken or that are Provide subsequent report within a planned to be taken to address it, and any information provided by any contractor and/or timeframe acceptable to the WB supervising firm, as appropriate. Subsequently, at the World Bank’s request, prepare a report on the incident or accident and propose any measures to address it and prevent its recurrence. C CONTRACTORS’ MONTHLY REPORTS MOH Where civil works are implemented, require contractors and supervising firms to provide Submit the monthly reports to the WB as monthly monitoring reports on ESHS performance in accordance with the metrics annexes to the reports to be submitted specified in the respective bidding documents and contracts and submit such reports to under action A above. the World Bank 3|P a g e ENVIRONMENTAL AND SOCIAL COMMITMENT PLAN (ESCP) – BREHS Project MATERIAL MEASURES AND ACTIONS TIMEFRAME RESPONSIBLE ENTITY D NOTIFICATIONS RELATING TO DAAB COMPLIANCE REVIEW OF CONTRACTOR No later than 7 days after the issuance or MOH COMPLIANCE WITH SEA/SH PREVENTION AND RESPONSE OBLIGATIONS receipt, as applicable, of the relevant Notify the Association of any referral submitted to the Dispute Avoidance and document (i.e., referral to the DAAB, Adjudication Board (DAAB) to initiate a process of compliance review in relation to a issuance of DAAB decision, Notice of contractor’s obligations to prevent and respond to sexual exploitation and abuse (SEA), Dissatisfaction, notice of and/or sexual harassment (SH) specified in the respective works contract with such commencement of emergency/full contractor; and, in the event of any such referral, notify the Association of: (i) the DAAB’s arbitration, emergency/full arbitration decision on such referral; (ii) the consultant’s Notice of Dissatisfaction, if any , with such order, as applicable). DAAB decision; (iii) any notification received on the commencement of an emergency arbitration proceeding or full arbitration proceeding in relation to the DAAB’s decision; and (iv) the resulting emergency arbitration order and/or full arbitration order, if any. ESS 1: ASSESSMENT AND MANAGEMENT OF ENVIRONMENTAL AND SOCIAL RISKS AND IMPACTS 1.1 ORGANIZATIONAL STRUCTURE a) Establish and maintain a PMT as set a) MOH a) Establish and maintain a Project Management Team (PMT) with qualified, out in the Financing Agreement. b) KEMSA experienced, full-time staff and resources to support management of ESHS risks and Ensure both environmental and impacts of the Project including: one environmental safeguards officer with health social appointed prior to the Project and safety expertise and one social safeguards officer with social sciences and health Effectiveness Date. Thereafter, expertise, each with more than five (5) years of experience in carrying out maintained throughout Project environmental and social assessments of Project activities. The PMT staff should have implementation. qualifications and experience acceptable to the World Bank. b) Appoint Environmental & Social b) KEMSA shall assign Environmental & Social focal persons to maintain coordination safeguards focal persons before and support E&S implementation of the Project. disbursement for KEMSA. 1.2 ENVIRONMENTAL AND SOCIAL INSTRUMENTS a, b and c) Adopt the ESMF, VGPF and MOH a) Prepare, consult upon, adopt, disclose and implement an Environmental and Social SEP prior to Project Effectiveness Date Management Framework (ESMF) for the Project, consistent with the relevant ESSs, and thereafter implement throughout World Bank Group Environmental, Health and Safety (EHS) General Guidelines, and Project implementation. Guidelines for Health Care Facilities and relevant national laws. The following E&S d) Prepare and adopt the ESIA/ESMP instruments shall also be prepared as annexes to the ESMF: Environmental and Social where applicable before launching the Codes of Practice (ESCOP); and Sexual Exploitation, Abuse and Harassment (SEAH) bidding process for the respective Prevention and Response Plan; subproject that requires the adoption of b) Prepare, consult upon, adopt, disclose and implement a Stakeholder Engagement such ESIA/ ESMP. Once adopted, Plan (SEP) implement the respective ESIA/ ESMP throughout Project implementation. 4|P a g e ENVIRONMENTAL AND SOCIAL COMMITMENT PLAN (ESCP) – BREHS Project MATERIAL MEASURES AND ACTIONS TIMEFRAME RESPONSIBLE ENTITY c) Prepare, consult upon, adopt, disclose and implement a Vulnerable Groups Planning Framework (VGPF). d) Prepare, consult on, disclose, adopt, and implement the subproject specific environmental and Social Impact Assessment (ESIA) and/or Environmental and Social Management Plan (ESMP)/ Summary Project report (SPR) as set out in the ESMF. Any subprojects/activities described in the exclusion list set out in the ESMF shall be ineligible to receive financing under the Project 1.3 MANAGEMENT OF CONTRACTORS AND SUPPLIERS a) As part of the preparation of a) MOH and KEMSA a) Incorporate the relevant aspects of the ESCP, including, inter alia, the relevant procurement documents and b) MOH subproject E&S instruments, the LMP, and code of conduct, into the ESHS respective contracts. Supervise c) MOH and KEMSA specifications of the procurement documents and contracts with contractors, contractors, suppliers, and other service providers throughout d) MOH supervising firms and suppliers. Thereafter ensure that the contractors, supervising firms and suppliers comply and cause subcontractors to comply with the ESHS Project implementation. specifications of their respective contracts. b) Throughout Project b) Ensure all operators including from participating government entities of the various implementation. facilities and buildings that will be part of the Project incorporate the relevant aspects c) Prior to finalization and signing of of the ESCP, including, inter alia, the relevant subproject E&S instruments, the LMP, contract. Supervise contractors, and code of conduct, into their ESHS systems. suppliers, and other service c) Contractors and suppliers involved in the Project shall be required to adopt and providers throughout Project implement ESHS mitigation actions as well as enhance their capacity in accordance implementation. with the requirements set out in the respective contractual documents which shall be d) Throughout Project implementation prepared by PMT according to the requirements of applicable ESSs. of component 1 and 2activities. d) Ensure that relevant environmental and social monitoring requirements are considered in conducting component 1 and 2 activities in a manner acceptable to the Association, that are consistent with the ESF and relevant ESS. 1.4 TECHNICAL ASSISTANCE Throughout Project implementation. MOH Ensure that the consultancies, studies (including feasibility studies, if applicable), capacity building, training, and any other technical assistance activities under the Project are carried out in accordance with terms of reference acceptable to the World Bank, that are consistent with the ESSs. Thereafter ensure that the outputs of such activities comply with the terms of reference. ESS 2: LABOR AND WORKING CONDITIONS 5|P a g e ENVIRONMENTAL AND SOCIAL COMMITMENT PLAN (ESCP) – BREHS Project MATERIAL MEASURES AND ACTIONS TIMEFRAME RESPONSIBLE ENTITY 2.1 LABOR MANAGEMENT PROCEDURES Adopt the LMP prior to the Project MOH Adopt and implement the Labor Management Procedures (LMP) for the Project, including, Effectiveness Date, and thereafter inter alia, provisions on working conditions, management of workers relationships, implement the LMP throughout Project occupational health and safety (including personal protective equipment, and emergency implementation. preparedness and response), code of conduct (including relating to SEA and SH), forced labor, child labor, grievance arrangements for Project workers, and applicable requirements for contractors, subcontractors, supervising firms, service providers and suppliers. 2.2 GRIEVANCE MECHANISM FOR PROJECT WORKERS a) Establish grievance mechanism MOH a) Establish and operate a grievance mechanism for Project workers, as described in the prior engaging Project workers and LMP and consistent with ESS2. The Grievance Redress Mechanism (GRM) will be thereafter maintain and operate it sensitive to SEA/SH, through a transparent and easy-to-understand process that throughout Project provides feedback to affected parties in a language they understand, without implementation. retaliation, and will operate in an independent and objective manner. This GRM will b) As part of the preparation of be available to all direct and contract workers (and their organizations, if any) to procurement documents and express their work-related concerns. These workers will be informed of the existence respective contracts. of the GRM at the time of hiring and of the measures taken to protect them from any retaliation for having used it, as well as the GBV service providers identified by the project in the intervention zones and who guarantee their care if necessary. Care will be taken to ensure that the grievance redress mechanism is easily accessible to all. b) Include in the bidding documents for the recruitment of contractors, the terms of reference for the selection of consultants, service providers and any subcontractors of the Project, as well as in the project implementation manual, clauses relating to the GRM in connection with any labor or employment issue within the framework of the Project and in compliance with the ESS2 and national labor legislation. ESS 3: RESOURCE EFFICIENCY AND POLLUTION PREVENTION AND MANAGEMENT 3.1 WASTE MANAGEMENT PLAN a) Adopt the MWMP prior to Project a) MOH a) Prepare, consult on, disclose, adopt, and implement a Medical Waste Management Effectiveness Date and thereafter b) KEMSA, Primary care Plan (MWMP) for the Project as part of the ESMF, to manage both hazardous and implement the MWMP throughout facilities non-hazardous wastes consistent with ESS3, general and HCF EHSGs, and other Project implementation. relevant GIIP including relevant WHO guidelines. b) Prepare and adopt site-specific MWMPs within six (6) months of Project Effectiveness. 6|P a g e ENVIRONMENTAL AND SOCIAL COMMITMENT PLAN (ESCP) – BREHS Project MATERIAL MEASURES AND ACTIONS TIMEFRAME RESPONSIBLE ENTITY b) Mandate other Project implementing entities, the KEMSA, to prepare site-specific c) Implement the MWMP and site Waste Management Plans for their operations, and in alignment with the Project’s specific WMP throughout Project MWMP. implementation. 3.2 RESOURCE EFFICIENCY AND POLLUTION PREVENTION AND MANAGEMENT Same timeframe as for the adoption MOH Incorporate resource efficiency and pollution prevention and management measures in and implementation of the WMP and Project Beneficiaries the MOH, KEMSA, etc., operations. MWMP. ESS 4: COMMUNITY HEALTH AND SAFETY 4.1 COMMUNITY HEALTH AND SAFETY Same timeframe as for the adoption MOH Assess and manage specific risks and impacts to the community arising from Project and implementation of the ESMPs. KEMSA activities, including, inter alia, transportation and distribution of HPTs, behavior of Project workers, risks of labor influx, response to emergency situations, and include mitigation measures in the ESMPs to be prepared in accordance with the ESMF 4.2 TRAFFIC AND ROAD SAFETY Develop and implement a “driving for MOH Incorporate measures to manage traffic and road safety risks as required in the ESMP to work policy” not later than 90 days be prepared under action 1.2d above. from project effectiveness, and thereafter implement the Policy throughout Project implementation. 4.3 SEA AND SH RISKS Adopt SEA/SH Prevention and Response MOH Develop and implement a SEA/SH Prevention and Response Plan as part of the ESMF, to Plan which is part of the ESMF prior to assess and manage the risks of SEA and SH in the Project, complete with the relevant the Project Effectiveness Date, and referral pathways for survivors. thereafter implement the SEA/SH Action Plan throughout Project implementation. 4.4 Assess and implement measures to manage the security risks of the Project, including the Prior to engaging security personnel and MOH risks of engaging security personnel to safeguard project workers, sites, assets, and disbursement of Component 2 and activities, and include in the Project Operation Manual (POM) measures for Security thereafter implemented throughout Management in the project, guided by the principles of proportionality and GIIP, and by Project implementation. applicable law, in relation to hiring, rules of conduct, training, equipping, and monitoring of such personnel. ESS 5: LAND ACQUISITION, RESTRICTIONS ON LAND USE AND INVOLUNTARY RESETTLEMENT 5.1 Not relevant 7|P a g e ENVIRONMENTAL AND SOCIAL COMMITMENT PLAN (ESCP) – BREHS Project MATERIAL MEASURES AND ACTIONS TIMEFRAME RESPONSIBLE ENTITY ESS 6: BIODIVERSITY CONSERVATION AND SUSTAINABLE MANAGEMENT OF LIVING NATURAL RESOURCES 6.1 BIODIVERSITY RISKS AND IMPACTS ESMF disclosed prior to appraisal to Maximum efforts shall be exerted to ensure that Project activities avoid encroachment include respective screening provisions PMT and/or infringement on any protected areas or other areas with sensitive habitats or and exclusions and guidance for ESMPs. Contractors important biodiversity. Projects with potential impacts on critical habitats as defined in Site specific ESMP to be prepared and ESS6 shall not be eligible for financing. adopted prior to the call for bids of Consistent with ESS6, the Project shall develop and implement and cause to be developed subproject site activities, and thereafter and implemented by contractors and sub-contractors, measures and actions to assess and implemented throughout the Project. manage risks and impacts on biodiversity, including identification of different types of habitats and circumstances. These measures shall be spelled out in the site-specific ESIA/ESMPs in accordance with the ESSs and the ESMF: Sensitive ecosystems such as legally designated protected areas, forests, biodiversity areas or buffer zones shall not be encroached upon; Subprojects which will potentially generate sensitive impact on sensitive habitats, such as protected areas, wetlands, forests, shall not be eligible and shall be identified and screened out according to criteria and mechanisms set out in the ESMF; and The ESMF shall set out the types of impacts on natural habitats that are not excluded. ESS 7: INDIGENOUS PEOPLES/SUB-SAHARAN AFRICAN HISTORICALLY UNDERSERVED TRADITIONAL LOCAL COMMUNITIES 7.1 VULNERABLE GROUPS PLANNING FRAMEWORK (VGPF) Adopt the VGPF prior to the Project MOH Adopt and implement VGPF for the Project, consistent with ESS7. Effectiveness Date, and thereafter implement the VGPF throughout Project implementation. 7.2 VULNERABLE GROUPS PLAN (VGP) Adopt the VGP prior to the carrying out MOH Prepare, consult, disclose, and implement a VGP for the components being implemented of any activity that requires the under the Project for which the VGPF requires such VGP, and consistent with ESF/ESS7. preparation of such VGP. Once adopted, implement the respective VGP throughout Project implementation. ESS 8: CULTURAL HERITAGE 8|P a g e ENVIRONMENTAL AND SOCIAL COMMITMENT PLAN (ESCP) – BREHS Project MATERIAL MEASURES AND ACTIONS TIMEFRAME RESPONSIBLE ENTITY 8.1 CHANCE FINDS Describe the chance find procedures MOH Describe and implement the chance finds procedures as part of the ESMP for subprojects, during preparation of ESMPs for and in alignment with the ESMF of the Project. subprojects, as relevant. Implement the procedures throughout Project implementation. ESS 9: FINANCIAL INTERMEDIARIES 9.1 Not relevant. ESS 10: STAKEHOLDER ENGAGEMENT AND INFORMATION DISCLOSURE 10.1 STAKEHOLDER ENGAGEMENT PLAN PREPARATION AND IMPLEMENTATION Adopt the SEP prior to the Project MOH Adopt and implement a Stakeholder Engagement Plan (SEP) for the Project, consistent Effectiveness Date, and thereafter with ESS10, which shall include measures to, inter alia, provide stakeholders with timely, implement the SEP throughout Project relevant, understandable, and accessible information, and consult with them in a implementation. culturally appropriate manner, which is free of manipulation, interference, coercion, discrimination and intimidation. 10.2 PROJECT GRIEVANCE MECHANISM Establish the grievance mechanism two MOH Establish, publicize, maintain, and operate an accessible grievance mechanism as part of months after Project Effectiveness Date, the SEP, to receive and facilitate resolution of concerns and grievances in relation to the and thereafter maintain and operate Project, promptly and effectively, in a transparent manner that is culturally appropriate the mechanism throughout Project and readily accessible to all Project-affected parties, at no cost and without retribution, implementation. including concerns and grievances filed anonymously, in a manner consistent with ESS10 The grievance mechanism shall be equipped to receive, register, and facilitate the resolution of SEA/SH complaints, including through the referral of survivors to relevant gender-based violence service providers, all in a safe, confidential, and survivor-centered manner. CAPACITY SUPPORT CS1 PIU staff training on: Within 12 months of Project MOH • Stakeholder Engagement Plan (SEP) – stakeholder mapping and engagement Effectiveness. • Specific aspects of environmental and social assessment • Emergency preparedness and response • Community health and safety • Labor Management Procedures (LMP) consisting of Code of Conduct for project workers in relevant languages and Labor Specific GRM 9|P a g e ENVIRONMENTAL AND SOCIAL COMMITMENT PLAN (ESCP) – BREHS Project MATERIAL MEASURES AND ACTIONS TIMEFRAME RESPONSIBLE ENTITY • World Bank ESHS requirements • SEA/SH Prevention and Response Plan • Project-wide GRM • Occupational Health and Safety (OHS) • VGPF, Chance finds procedure, etc. CS2 Project workers training on: Upon signing of contractors’ contract MOH a) Occupational health and safety including on emergency prevention and preparedness and immediately on mobilization of the County Governments and response arrangements to emergency situations, Personal protective equipment, contractor and thereafter throughout Workplace risk management, prevention of work-related accidents, Health and safety Project implementation rules; waste management, Occupational health and safety standards, etc. b) Employment and working conditions – Conditions of employment under national labor laws; Code of conduct for suppliers, service providers and subcontractors; Workers' organizations and trade unions; and Rules on child labor and minimum age for employment of children. c) SEA/SH sensitive GRM – Registration and Processing Procedures; Complaint Resolution Procedures; Operation of the GRM; Documentation and processing of complaints; and Use of the procedure by the different actors. d) GBV/SEA/SH – Awareness, prevention and measures to prevent, mitigate and respond to SEA/SH risks; Content of the project's code of conduct prohibiting behaviors related to SEA/SH, as well as sanctions in case of non-compliance; Themes, activities and target audiences will be defined as part of the prevention measures; Support to survivors, including service providers identified by the project in the intervention areas and the referral and counter-referral process; and SEA/SH complaint management: complaint handling, responsible parties, verification process and complaint resolution 10 | P a g e