The World Bank Health System Support Project ("KIRA") (P156012) REPORT NO.: RES51212 DOCUMENT OF THE WORLD BANK RESTRUCTURING PAPER ON A PROPOSED PROJECT RESTRUCTURING OF HEALTH SYSTEM SUPPORT PROJECT ("KIRA") APPROVED ON FEBRUARY 24, 2017 TO MINISTRY OF FINANCE HEALTH, NUTRITION & POPULATION EASTERN AND SOUTHERN AFRICA Regional Vice President: Hafez M. H. Ghanem Country Director: Jean-Christophe Carret Regional Director: Amit Dar Practice Manager/Manager: Francisca Ayodeji Akala Task Team Leader(s): Omer Ramses Zang Sidjou, Olivier Basenya The World Bank Health System Support Project ("KIRA") (P156012) I. BASIC DATA Product Information Project ID Financing Instrument P156012 Investment Project Financing Original EA Category Current EA Category Partial Assessment (B) Partial Assessment (B) Approval Date Current Closing Date 24-Feb-2017 30-Jun-2023 Organizations Borrower Responsible Agency MINISTRY OF FINANCE Ministry of Health Project Development Objective (PDO) Original PDO To increase the use of quality Reproductive, Maternal, Neonatal, Child and Adolescent Health services, and, in the event of an Eligible Crisis or Emergency, to provide immediate and effective response to said Eligible Crisis or Emergency. Summary Status of Financing (US$, Millions) Net Ln/Cr/Tf Approval Signing Effectiveness Closing Commitment Disbursed Undisbursed IDA-D7900 22-Apr-2021 03-May-2021 19-Jul-2021 30-Jun-2023 50.00 14.33 33.04 IDA-D1660 24-Feb-2017 23-Mar-2017 20-Jun-2017 30-Jun-2023 50.00 51.97 0 TF-B5105 31-Mar-2021 03-May-2021 19-Jul-2021 30-Jun-2022 4.60 2.86 1.74 TF-B0539 15-May-2019 17-Jun-2019 17-Jun-2019 30-Jun-2022 8.30 8.30 0 The World Bank Health System Support Project ("KIRA") (P156012) Policy Waiver(s) Does this restructuring trigger the need for any policy waiver(s)? No II. SUMMARY OF PROJECT STATUS AND PROPOSED CHANGES The KIRA Project was approved on February 24, 2017 and followed by two rounds of Additional Financing approved on 15 May 2019 and 21 April 2021, respectively. Its Project Development Objective is to increase the use of quality Reproductive, Maternal, Neonatal, Child and Adolescent Health services, and, in the event of an Eligible Crisis or Emergency, to provide immediate and effective response to said Eligible Crisis or Emergency. The overall project disbursement rate, as of April 26, 2022, is 66.42 percent. Implementation progress, as rated in the last ISR of 26 January 2022 is Moderately Satisfactory. Progress towards the PDO is also Satisfactory. Overall performance has been strong, and the Project is on track to meet its PDO and targets by the closing date. The project is closing on June 30, 2023 while the GAVI trust fund (TF) # TF0B5105-BI closes on June 30, 2022. The team seeks the Country Director's approval to: (i) increase the allocations on category 1 (results based payments) for the TF and reflect these in the financing percentage allocation between IDA and the TF effective April 1, 2022 so that some expenditures can be reported retroactively according to the approved reallocations and as per the borrower request dated April 14, 2022; and (iii) extend the closing date of the TF from 30 June, 2022 to December 31, 2022. The objective of the reallocation is to accelerate the absorption of the TF funds, by proposed closing date of December 31, 2022. The closing date can only be extended for 6 months (up to December 31, 2022) as per the donor's requirements. So far, a total of US$1,726,599.22 out of US$4.6 million has been disbursed on the TF. The disbursement team of the World Bank and the team from GAVI confirmed that the reallocation does not conflict with the original grant agreement between GAVI and the Bank. The minor restructuring will not need an amendment of the Financing Agreement/Grant Agreement. This level II restructuring will (i) reallocate funds across disbursement categories and source of funding as noted above and (illustrated in the table below) and (ii) extend the closing date of the TF from June 30, 2022 to December 31, 2022. As a result of the proposed reallocation, for the period from April 1 to December 31, 2022, the TF disbursement category 1 will increase from US$3.45 million to US$4.15 million, while Category 2 will decrease from US$1.15 million to US$0.45 million. This will result in a change of allocation on the TF from 14 to 18 percent and from 21 to 14 percent for category 1 and 2 (goods, non-consulting services, including trainings, consulting services, and operational costs) respectively. For the remaining period of the project, all expenditure will be reported against IDA at 100 percent. The reallocation will not negatively impact implementation of Project activities or the achievement of the PDO/results. It will maintain all the IDA and TF proceeds of the project to implement all activities as planned. III. DETAILED CHANGES LOAN CLOSING DATE(S) Original Revised Proposed Proposed Deadline Ln/Cr/Tf Status Closing Closing(s) Closing for Withdrawal Applications The World Bank Health System Support Project ("KIRA") (P156012) IDA-D1660 Effective 30-Jun-2021 30-Jun-2023 30-Jun-2022, 30-Jun- IDA-D7900 Effective 30-Jun-2023 2023 TF-B0539 Effective 30-Jun-2021 30-Jun-2022 TF-B5105 Effective 30-Jun-2021 30-Jun-2022 31-Dec-2022 30-Apr-2023 REALLOCATION BETWEEN DISBURSEMENT CATEGORIES Current Current Actuals + Proposed Disbursement % Ln/Cr/TF Expenditure Allocation Committed Allocation (Type Total) Category Current Proposed IDA-D1660- RESULTS-BASED 001 PAYMENTS 29,865,807.00 30,376,766.59 29,865,807.00 100.00 100.00 Currency: PART 1 XDR WK, GD, NCS, CONS, TR, OC 7,000,000.00 6,615,848.23 7,000,000.00 100.00 100.00 PART 2, 3 EMERGENCY EXPENDITURES 334,193.00 177,313.09 334,193.00 100.00 100.00 PART 4 Total 37,200,000.00 37,169,927.91 37,200,000.00 IDA-D7900- RESULTS-BASED 001 PAYMENTS 26,100,000.00 6,146,377.66 26,100,000.00 86.00 82 Currency: PART 1 XDR GD, NCS, INCL 8,700,000.00 695,797.41 8,700,000.00 79.00 86 TR, CS & OC EMERGENCY EXPENDITURES 0.00 0.00 0.00 100.00 100.00 PART 4 Total 34,800,000.00 6,842,175.07 34,800,000.00 TF-B0539- Rslt-based pymt 6,300,000.00 6,522,189.38 6,300,000.00 100.00 100.00 001 Pt1 The World Bank Health System Support Project ("KIRA") (P156012) Currency: W,G,N/CS,TR,OC USD 2,000,000.00 1,777,810.62 2,000,000.00 100.00 100.00 P2&3 Total 8,300,000.00 8,300,000.00 8,300,000.00 TF-B5105- RESULTS-BASED 001 PAYMENTS 3,450,000.00 1,589,559.31 4,150,000.00 14.00 18 Currency: PART 1 USD GD, NCS INCL 1,150,000.00 255,019.21 450,000.00 21.00 14 TR, CS & OC Total 4,600,000.00 1,844,578.52 4,600,000.00