sDOCUMENTS The World Bank 1818 H Street N.W. (202) 477-1234 INTERNATIONAL BANK FOR RECONSTRUCTION AND DEVELOPMENT Washington, D.C. 20433 Cable Address: INTBAFRAD INTERNATIONAL DEVELOPMENT ASSOCIATION U.S.A. Cable Address: INDEVAS , 2016 H.E. Amadou Ba Minister of Economy, Finance and Planning Ministry of Economy, Finance and Planning Dakar Republic of Senegal Republic of Senegal: Health and Nutrition Financing (Grant No. 15872) Amendment to the Trust Fund Grant Agreement Excellency: We refer to the Trust Fund Grant Agreement dated March 28, 2014 ("Trust Fund Grant Agreement"), between the Republic of Senegal ("Recipient") and the International Development Association and the International Bank for Reconstruction and Development, acting as administrator for the Multi-donor Trust Fund for Health Results Innovation ("Association") for the Health and Nutrition Financing Project ("Project"), and the letter dated September 15, 2015 from the Recipient requesting certain amendments to the Project. Accordingly, we propose to amend the Trust Fund Grant Agreement in respect of the provisions below: 1. Part A.1 of Schedule I to the Trust Fund Grant Agreement is deleted in its entirety and replaced with the following: "1. Provision of a Package of Health Services, comprising preventive and curative services, including, inter alia, maternal, neonatal and child health care, preventive services for pregnant women, delivery care, care for children under the age of five, and family planning, through the provision of RBF Grants to the regions of: (a) Kolda and Kaffrine; and (b) Kedougou, Tambacounda, Sehdiou and Zinguinchor." 2. Part A.2 of Schedule I to the Trust Fund Grant Agreement is deleted in its entirety and replaced with the following: "2. Carrying out a program of activities aimed at: (a) building the MoHSA's capacity at central, regional and district levels to facilitate the implementation of Part A.1 of the Project, said program to include inter alia, technical assistance, development and implementation of Training programs, and provision of goods required for the purpose; (b) providing for the monitoring and verification of activities financed under RBF Grants under Part A.1.(a) of the Project, through the engagement of community-based and independent third party verifiers; and (c) providing for the monitoring and verification of activities financed under RBF Grants under Part A.1.(b) of the Project, through the engagement of community-based and independent third party verifiers. 3. Adding the below Paragraph 4 to Part C of Schedule I to the Financing Agreement as follows: "Carrying out a program of activities aimed at strengthening the Recipient's capacity for preparedness in case of Ebola, including, inter alia, disease surveillance, Training and advocacy." 4. The table in paragraph 2 of Section IV.A of Schedule 2 to the Trust Fund Grant Agreement is deleted in its entirety and is replaced by the table provided in Attachment I to this letter. 5. Definitions numbered 31, 32 and 41 in Section I of the Appendix are amended to read as follows: "Section I. Definitions 31. "RBF Grant" means a grant made or proposed to be made out of the proceeds of the Financing to finance the management and provision of the Package of Health Services-Related Activities, and "RBF Grants" means more than one RBF Grant. 32. "RBF Beneficiary" means: (a) the public or private not-for-profit health facility; (b) a regional or district health management unit and (c) the Central National Unit, with the organization, management and resources necessary to carry out the proposed Package of Health-Related Services Activities; and "RBF Beneficiaries" means more than one RBF Beneficiary. 41. "Targeted Areas" mean the Recipients regions of Kolda, Kaffrine, Kedougou, Tambacounda, Sehdiou, Zinguinchor and the district of Gossas in the region of Fatick" All the terms and conditions of the Trust Fund Grant Agreement that have not been amended hereby shall remain unchanged and in full force and effect. Please indicate your agreement with the foregoing amendments on behalf of the Recipient by countersigning and dating two (2) original copies of this letter and returning one countersigned original to us. Upon receipt by the Association of the countersigned copy, these amendments shall become effective as of the date of this letter. Sincerely, INTERNATIONAL DEVELOPMENT ASSOCIATION C e,a udes, Country irector aULe n ved AFRICA Region adh3nie.leeSnU -2- AGREED: REPUBLIC OF Le 'nistre de I'Ec nomie d s Finiances et Pla Name: Title: Date: .2 A 2016 -3- ATTACHMENT 1 Amount of the Amount of the Percentage of Category Financing Allocated Financing Disbursed Expenditures to be (expressed in US$) (expressed in US$) Financed (inclusive of Taxes) (1) RBF Grants 0 125955 86% under Part A.1 of the Project (2) Maternal Health 2 000 000 0 100% Vouchers under Part B.3 of the Project (3) Goods, non- 0 381 152 27% consulting services, and consultants' services Training, and Operating Costs for Parts A.2, B.1 and C of the Project (4) RBF Grants under 12 274 045 0 100% Part A.1 (b) of the Project (5) Goods, non- 5 218 848 0 27% consulting services, and consultants' services Training, and Operating Costs for Parts A.2.(a), A.2 (c), B.1 and C of the Project TOTAL AMOUNT 20000000 -4-