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Document of
 
The World Bank 
 
Report No: 58370-RO 
 
RESTRUCTURING PAPER 
 
ON A 
 
PROPOSED PROJECT RESTRUCTURING  
OF THE 
HEALTH SECTOR REFORM PROJECT - PHASE II (APL2) 
 
LOAN NO. 4760-RO 
BOARD APPROVAL DATE 
December 16, 2004 
 
TO  
 
ROMANIA 
 
December 17, 2010 
 
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ABBREVIATIONS AND ACRONYMS 
 
APL Adaptable 
Program 
Lending 
EIB European 
Investment 
Bank 
PDO 
Project Development Objective 
WB World 
Bank 
 
Regional Vice President:
Philippe Le Houérou 
Country Director:
Peter C. Harrold 
Sector Manager / Director:
Abdo Yazbeck  
Task Team Leader:
Richard Florescu 
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ROMANIA
 
HEALTH SECTOR REFORM PROJECT 
–
APL 2 
P093096 
CONTENTS 
 
Page 
ANNEX 3: EXTENSION OF CLOSING DATE............................................................4
 
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ANNEX 3: 
Extension of Closing Date 
_______________________________________________________________________ 
 
HEALTH SECTOR REFORM PROJECT - PHASE II (APL2) 
P078971 
 
LOAN NO. 4760-RO
 
Restructuring Paper 
 
1.  The closing date for 
Romania, Health Sector Reform Project (Loan 4760-RO) 
will be 
extended
 
from December 31, 2010 until February 28, 2011.  
2.  As of today, almost EUR 40 million have been disbursed (56% of the WB funds); 
together with commitments, that amount is above 80%. The Project’s overall 
performance is rated as 
Satisfactory
.
Many of the technical assistance activities 
initially included in the Project for neo-natal care (quality assurance, referral system, 
training of medical staff) as well as the development of the National Health Accounts 
have been completed, and most of the medical equipment was purchased and 
delivered to the beneficiary hospitals. The tenders for civil works were launched, and 
the works for 11 out of the 22 maternities included in the Project have commenced. 
However, the civil works process was hampered by the initial inadequacy of the 
technical designs for some of the maternities, requiring their revision. The revisions 
have now been completed.  Most of the PDO indicators have been achieved or 
exceeded, and by the proposed revised closing date, the PDOs are expected to be fully 
met.   
 
3. This two month extension of the Closing Date will be followed by a Project 
Restructuring, to be operated before February 28, 2011. The said restructuring will 
include also an additional 10 month extension of the Closing Date. The aggregate 
proposed extension of 12 months is necessary to enable the completion of the 
remaining rehabilitation of the above mentioned maternities, including finalizing the 
ongoing procurement of medical equipment for neonatal care and emergency health 
services.  Additionally, the additional twelve months will allow for the completion of 
the technical assistance activities related to the development of the primary Health 
Care Strategy and the implementation of the Public Awareness Campaign on co-
payments. A thorough analysis and planning of the implementation of the remaining 
activities has been conducted and agreed with the Borrower, and all the prerequisites 
for their proper completion by the revised closing date have been secured.  
 
4.  There are currently no outstanding audits for this Project.  The audit for the year 
closing in 2009 did not identify any serious issues (i.e. it was unqualified). 
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5.  This will be the second extension of the Project.  The first extension of 12 months 
was granted in 2009, from December 31, 2009 to December 31, 2010.