The World Bank Bosnia and Herzegovina Emergency COVID-19 Project (P173809) REPORT NO.: RES50141 RESTRUCTURING PAPER ON A PROPOSED PROJECT RESTRUCTURING OF BOSNIA AND HERZEGOVINA EMERGENCY COVID-19 PROJECT APPROVED ON APRIL 23, 2020 TO BOSNIA AND HERZEGOVINA HEALTH, NUTRITION & POPULATION EUROPE AND CENTRAL ASIA Regional Vice President: Anna M. Bjerde Country Director: Linda Van Gelder Regional Director: Fadia M. Saadah Practice Manager/Manager: Tania Dmytraczenko Task Team Leader(s): Adanna Deborah Ugochi Chukwuma, Stefanie Koettl-Brodmann The World Bank Bosnia and Herzegovina Emergency COVID-19 Project (P173809) ABBREVIATIONS AND ACRONYMS PIU Project Implementation Unit IRI Intermediate Results Indicator ISR Implementation Status and Results Report RS Republika Srpska FBIH Federation of Bosnia and Herzegovina PDO Project Development Objective PSA Permanent Social Assistance UNDP United Nations Development Programme The World Bank Bosnia and Herzegovina Emergency COVID-19 Project (P173809) BASIC DATA Product Information Project ID Financing Instrument P173809 Investment Project Financing Environmental and Social Risk Classification (ESRC) Substantial Approval Date Current Closing Date 23-Apr-2020 30-Jun-2022 Organizations Borrower Responsible Agency Ministry of Health and Social Welfare of Republika Srpska,Ministry of Health of the Federation of Bosnia Bosnia and Herzegovina and Herzegovina,Ministry of Labor and Social Policy of the Federation of Bosnia and Herzegovina 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) As of February 15, 2022, 87 MPA-projects had been approved with a total commitment of US$4.2 billion. One operation (Guatemala) was cancelled in mid-September 2021, at the request of the Government. Therefore, there are 86 MPA active operations. Sixty-one (61) country projects or 71% of projects approved have reached 70-100% disbursement (reasons for >100% disbursements relate to fluctuations between the Euro and the SDR against the US$). Out of the 61 operations, 39 operations or 64% have disbursed over 90% of commitments. The projects are benefitting around 3.7 billion people or 50% of the global population. Of the 86 active projects: (i) 33 are in Africa – 12 in AFE and 21 in AFW; (ii) 12 in East Asia; (iii) 14 in Europe and Central Asia; (iv) 11 in Latin America and the Caribbean; (v) 7 in Middle East and North Africa; and (vi) 9 in South Asia. Eighty-five (85) or 99% of projects approved are disbursing. Total disbursements as of February 15, 2022, amount to US$3.33 billion or 79% of overall commitments. Two The World Bank Bosnia and Herzegovina Emergency COVID-19 Project (P173809) operations closed last CY and twenty-eight (28) operations have closing dates by the end of FY22. Six parent projects have been restructured to include vaccine-related procurement. Streamlined procedures, delegated approvals, coupled with flexible project design and intensified efforts across the Bank have contributed to the progress. Implementation is being guided by Bank teams working in parallel with other health-related projects, including Additional Financing operations supporting vaccine procurement and deployment efforts. Implementation continues to face challenges as several countries are still under different levels of lockdown or mobility restrictions, and counterparts and Bank teams are operating from home or partially from home. Also, countries are dealing with new waves of infections as the Omicron variant is spreading rapidly among populations. Many Bank teams continue to conduct implementation support missions virtually, which is challenging for both Bank teams and counterparts. This “virtual” world poses connectivity challenges as the internet is not reliable in many countries, especially IDA countries. Notwithstanding the challenges, the MPA is on track to achieve its PrDO, which is to prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness. The significant level of disbursements attests to the strong implementation of the Bank response thanks to the commitment of counterparts supported by Bank country teams. OPS_TABLE_PDO_CURRENTPDO Project Development Objective (PDO) Original PDO The project development objective is to prevent, detect, and respond to the threat posed by the COVID-19 pandemic in Bosnia and Herzegovina. OPS_TABLE_PDO_CURRENTPDO Summary Status of Financing (US$, Millions) Net Ln/Cr/Tf Approval Signing Effectiveness Closing Commitment Disbursed Undisbursed IBRD-90970 23-Apr-2020 13-May-2020 01-Sep-2020 30-Jun-2022 36.20 38.10 1.21 Policy Waiver(s) Does this restructuring trigger the need for any policy waiver(s)? No I. PROJECT STATUS AND RATIONALE FOR RESTRUCTURING A. Project Status: 1. The Loan was approved on April 23, 2020, in the amount of EUR 33.1 million (US$36.2 million equivalent) and became effective on September 1, 2020. The Project Development Objective (PDO), which remains relevant, is to The World Bank Bosnia and Herzegovina Emergency COVID-19 Project (P173809) prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness in Bosnia and Herzegovina. 2. Progress toward achieving the PDO has been rated Satisfactory since effectiveness, and the Loan is 97 percent disbursed. Two of the four PDO indicators and 11 out of 24 intermediate results indicators (IRIs) have met or exceeded their end-of-Project target values, as of the last Implementation Status and Results Report (ISR) dated August 25, 2021. 3. Implementation progress is rated Satisfactory and has been rated no less than Moderately Satisfactory since Effectiveness. Under Component 1, “Responding to the COVID-19 Pandemic in Republika Srpska,” the Project Implementation Unit (PIU) has procured goods and non-consultancy services, including personal protective equipment, surgical masks, rapid diagnostic tests, furniture, and cleaning and translation services. The Republika Srpska (RS) Ministry of Health and Social Welfare has also made transfers under the social protection sub- component to 16,862 beneficiaries for permanent social assistance (PSA), one-time cash assistance, and benefits for disabled persons. 4. Under Component 2, “Responding to the COVID-19 Pandemic in the Federation of Bosnia and Herzegovina (FBIH)”, the FBIH PIU has entered, via direct selection, into a contractual agreement with the United Nations Development Programme (UNDP) via direct selection. Also, the PIU has implemented two rounds of beneficiary surveys first- hand. The Federal Ministry of Labor and Social Policy has made significant progress in disbursing funds for social protection. To date, transfers under the social protection sub-component have reached 22,805 beneficiaries for Permanent Social Assistance (PSA) and homecare benefits for disabled persons. Funds that were planned on an emergency one-time cash assistance in FBiH were cancelled and disbursed under the PSA instead due to lack of harmonized criteria for selecting beneficiaries across cantons. 5. Project Management is rated Satisfactory and has been rated no less than Moderately Satisfactory since effectiveness. Both PIUs are adequately staffed. The project has acceptable organization, staffing, systems of accounting, budgeting, reporting, auditing, internal controls, and flow of funds. The quarterly Interim Un-audited Financial Reports have been submitted in a timely manner and found acceptable. There are no overdue auditor’s reports. B. Rationale for Restructuring: 6. The Bosnia and Herzegovina Ministry of Finance and Treasury sent a letter to the World Bank dated January 9, 2022, and received on February 16, 2022, requesting a 9-month extension (from June 30, 2022 to March 31, 2023) of the Loan Closing Date. The justification for the extension was provided in accompanying letters from RS and FBiH, which highlihted the need for additional time to complete the procurement of goods and services included in the Procurement Plan. In FBiH, the urgent procurement of goods was negatively affected by initial global bottlenecks in supply chains. Hence, this extension is also necessitated by the requirement to extend the agreement with UNDP given the institutional financial reporting requirements in the United Nations System. 7. With the proposed restructuring, the (a) project objectives continue to be achievable; (b) performance of the Borrower and PIU remains satisfactory; and (c) the Borrower has prepared a specific action plan acceptable to the World Bank to complete the project within the proposed extension period, including procedures to accelerate the approval of technical specifications of tenders. The World Bank Bosnia and Herzegovina Emergency COVID-19 Project (P173809) II. DESCRIPTION OF PROPOSED CHANGES 8. Extension of the Project Closing Date. The Project closing date will be extended from June 30, 2022 to March 31, 2023. This will allow additional time necessary for completion of the remaining project activities. 9. Revision of the Results Framework. i. All the project indicators will be revised by extending the end-of-project target dates to March 31, 2023 to account for the extension of the Closing Date. ii. The baseline value for the indicator “Pandemic preparedness and response plan as per Ministry of Health/Agriculture guidelines updated and adopted for Republika Srpska” has been revised to “No” to correct an error introduced during implementation monitoring. iii. Given discontinuation of the one-time cash assistance programs in FBiH, the following intermediate results indicator will be deleted, “Number of beneficiaries receiving COVID-19 related one-off cash assistance in Federation of BiH.” iv. The end-of-project target values for the social assistance-related indicators will be changed to reflect the changes in one-time cash assistance and other social protection program scope, as follows:  The target value for the PDO indicator, “Total number of beneficiaries covered by COVID- related social protection benefits” will be reduced from 50,575 to 40,000.  The target value for the IRI, “Number of COVID-19 related beneficiaries of the permanent social assistance program in Republika Srpska” will be reduced from 6,300 to 4,300.  The target value for the IRI, “Number of COVID-19 related beneficiaries of disability benefits in Republika Srpska” will be increased from 5,500 to 9,500.  The target value for the IRI, “Number of beneficiaries covered by COVID-related permanent social assistance program in Federation of BiH” will be reduced from 15,000 to 10,000. v. All other baseline and target values will not be changed. 10. Revision of Disbursement Estimates. The disbursement estimates have been revised to reflect planned disbursements against project activities given the extension of the Closing Date. III. SUMMARY OF CHANGES Changed Not Changed Results Framework ✔ Loan Closing Date(s) ✔ Disbursement Estimates ✔ Implementing Agency ✔ DDO Status ✔ Project's Development Objectives ✔ MPA Program Development Objective ✔ The World Bank Bosnia and Herzegovina Emergency COVID-19 Project (P173809) MPA Expected Results and Indicators ✔ PBCs ✔ Components and Cost ✔ Cancellations Proposed ✔ Reallocation between Disbursement Categories ✔ Disbursements Arrangements ✔ Overall Risk Rating ✔ Legal Covenants ✔ Institutional Arrangements ✔ Financial Management ✔ Procurement ✔ Implementation Schedule ✔ 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: • Country has activated their public health Emergency Operations Centre or a coordination mechanism for COVID-19; The World Bank Bosnia and Herzegovina Emergency COVID-19 Project (P173809) • 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 IBRD-90970 Effective 30-Jun-2022 31-Mar-2023 31-Jul-2023 OPS_DETAILEDCHANGES_DISBURSEMENT_TABLE DISBURSEMENT ESTIMATES Change in Disbursement Estimates Yes Year Current Proposed 2020 17,500,000.00 17,500,000.00 2021 17,500,000.00 17,000,000.00 The World Bank Bosnia and Herzegovina Emergency COVID-19 Project (P173809) 2022 1,200,000.00 1,000,000.00 2023 0.00 700,000.00 2024 0.00 0.00 2025 0.00 0.00 . The World Bank Bosnia and Herzegovina Emergency COVID-19 Project (P173809) . Results framework COUNTRY: Bosnia and Herzegovina Bosnia and Herzegovina Emergency COVID-19 Project Project Development Objectives(s) The project development objective is to prevent, detect, and respond to the threat posed by the COVID-19 pandemic in Bosnia and Herzegovina. Project Development Objective Indicators by Objectives/ Outcomes RESULT_FRAME_TBL_PDO Indicator Name PBC Baseline End Target Respond to the COVID-19 pandemic by strengthening BiH health systems Number of acute healthcare facilities with isolation capacity in 12.00 28.00 BiH (Number) Action: This indicator has been Revised Number of acute healthcare facilities with isolation capacity in 2.00 10.00 Republika Srpska (Number) Action: This indicator has been Revised Number of acute healthcare facilities with isolation capacity in 10.00 18.00 Federation of BiH (Number) Action: This indicator has been Revised Number of intensive care beds fully equipped (with ventilators) 282.00 490.00 (Number) Action: This indicator has been Revised Number of intensive care beds fully equipped (with 82.00 140.00 ventilators) in Republika Srpska (Number) The World Bank Bosnia and Herzegovina Emergency COVID-19 Project (P173809) RESULT_FRAME_TBL_PDO Indicator Name PBC Baseline End Target Action: This indicator has been Revised Number of intensive care beds fully equipped (with 200.00 350.00 ventilators) in Federation of BiH (Number) Action: This indicator has been Revised Number of suspected COVID-19 cases reported and investigated 1,642.00 160,000.00 based on guidelines (Number) Action: This indicator has been Revised Number of suspected COVID-19 cases reported and investigated based on guidelines in Republika Srpska 586.00 50,000.00 (Number) Action: This indicator has been Revised Number of suspected COVID-19 cases reported and investigated based on guidelines in Federation of BiH 1,056.00 110,000.00 (Number) Action: This indicator has been Revised Respond to the COVID-19 pandemic by providing social assistance to most vulnerable groups Total number of beneficiaries covered by COVID-related social 0.00 40,000.00 protection benefits (Number) Action: This indicator has been Revised Total number of beneficiaries covered by COVID-related social 0.00 14,600.00 protection benefits in Republika Srpska (Number) Action: This indicator has been Revised Total number of beneficiaries covered by COVID-related social 0.00 25,400.00 protection benefits in Federation of BiH (Number) Action: This indicator has been Revised The World Bank Bosnia and Herzegovina Emergency COVID-19 Project (P173809) PDO Table SPACE Intermediate Results Indicators by Components RESULT_FRAME_TBL_IO Indicator Name PBC Baseline End Target Component 1: Responding to the COVID-19 Pandemic in Republika Srpska Number of designated laboratories with COVID-19 diagnostic equipment, test kits, and reagents per MOH guidelines in 2.00 4.00 Republika Srpska (Number) Action: This indicator has been Revised Percentage of cases who are healthcare workers in Republika 4.5% Under 2% Srpska (Text) Action: This indicator has been Revised Risk communication and community engagement strategies for No contextualized strategies Strategies are in place and operational documents issued COVID-19 adapted in Republika Srpska (Text) Action: This indicator has been Revised Pandemic preparedness and response plan as per Ministry of Health/ Agriculture guidelines updated and adopted for No Yes Republika Srpska (Text) Action: This indicator has been Revised Republika Srpska has activated their Public Health Emergency Operations Center or a coordination mechanism for COVID-19 Partly established The coordination mechanism established and functional (Text) Action: This indicator has been Revised Number of COVID-19 related beneficiaries of the permanent 4,300.00 4,300.00 social assistance program in Republika Srpska (Number) Action: This indicator has been Revised The World Bank Bosnia and Herzegovina Emergency COVID-19 Project (P173809) RESULT_FRAME_TBL_IO Indicator Name PBC Baseline End Target Number of COVID-19 related beneficiaries of disability benefits in 0.00 9,500.00 Republika Srpska (Number) Action: This indicator has been Revised Number of COVID-19 related beneficiaries who are elderly and 0.00 350.00 PWDs residing in institutions in Republika Srpska (Number) Action: This indicator has been Revised Number of new applications received for COVID-related beneficiaries for social protection benefits (for accommodation 0.00 2,000.00 in social institutions or one-time cash assistance) in Republika Srpska (Number) Action: This indicator has been Revised Percentage of complaints received and resolved related to COVID related social assistance benefits in Republika Srpska 0.00 100.00 (Percentage) Action: This indicator has been Revised Number of in-kind assistance packages delivered to social care 0.00 20.00 institutions in Republika Srpska (Number) Action: This indicator has been Revised Number of communication and dissemination activities undertaken on social protection benefits in Republika Srpska 0.00 15.00 (Number) Component 2: Responding to the COVID-19 pandemic in the Federation of Bosnia and Herzegovina Number of designated laboratories with COVID-19 diagnostic equipment, test kits, and reagents per MOH guidelines in 3.00 6.00 Federation of BiH (Number) Action: This indicator has been Revised The World Bank Bosnia and Herzegovina Emergency COVID-19 Project (P173809) RESULT_FRAME_TBL_IO Indicator Name PBC Baseline End Target Percentage of cases who are healthcare workers in Federation of 4% under 2% BiH (Text) Action: This indicator has been Revised Risk communication and community engagement strategies for COVID-19 and for specific communities adapted in Federation of Yes Yes BiH (Text) Action: This indicator has been Revised Pandemic preparedness and response plans updated and adopted, according to government and international guidelines, Yes Yes in Federation of BiH (Text) Action: This indicator has been Revised Public Health Emergency Operations Center, or other coordination mechanism for COVID-19, activated in Federation Yes Yes of BiH (Text) Action: This indicator has been Revised Number of beneficiaries covered by COVID-related permanent 10,000.00 10,000.00 social assistance program in Federation of BiH (Number) Action: This indicator has been Revised Number of beneficiaries receiving COVID-19 related one-off cash 4,838.00 4,838.00 assistance in Federation of BiH (Number) Action: This indicator has been Marked for Deletion Number of beneficiaries receiving COVID-related home 15,893.00 16,137.00 assistance in Federation of BiH (Number) Action: This indicator has been Revised The World Bank Bosnia and Herzegovina Emergency COVID-19 Project (P173809) RESULT_FRAME_TBL_IO Indicator Name PBC Baseline End Target Number of applications received for COVID-related social 0.00 5,000.00 assistance in Federation of BiH (Number) Action: This indicator has been Revised Number of complaints received relating to COVID-19 related 0.00 500.00 social assistance benefits in Federation of BiH (Number) Action: This indicator has been Revised Number of in-kind assistance packages delivered to social care 0.00 29.00 institutions in Federation of BiH (Number) Action: This indicator has been Revised Number of communication and dissemination activities undertaken on social protection benefits in the Federation of BiH 0.00 85.00 (Number) Action: This indicator has been Revised IO Table SPACE The World Bank Bosnia and Herzegovina Emergency COVID-19 Project (P173809)