The World Bank
Bosnia and Herzegovina Emergency COVID-19 Project (P173809)
Appraisal Environmental and Social Review Summary
Appraisal Stage
(ESRS Appraisal Stage)
Public Disclosure
Date Prepared/Updated: 04/06/2020 | Report No: ESRSA00659
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The World Bank
Bosnia and Herzegovina Emergency COVID-19 Project (P173809)
BASIC INFORMATION
A. Basic Project Data
Country Region Project ID Parent Project ID (if any)
Bosnia and Herzegovina EUROPE AND CENTRAL ASIA P173809
Project Name Bosnia and Herzegovina Emergency COVID-19 Project
Practice Area (Lead) Financing Instrument Estimated Appraisal Date Estimated Board Date
Health, Nutrition & Investment Project 3/31/2020 4/15/2020
Population Financing
Borrower(s) Implementing Agency(ies)
Bosnia and Herzegovina Ministry of Health and Social
Welfare of Republika Srpska,
Ministry of Health of the
Federation of Bosnia and
Herzegovina
Public Disclosure
Proposed Development Objective(s)
The project development objective is to prevent, detect, and respond to the threat posed by the COVID-19 pandemic
in Bosnia and Herzegovina.
Financing (in USD Million) Amount
Total Project Cost 35.72
B. Is the project being prepared in a Situation of Urgent Need of Assistance or Capacity Constraints, as per Bank IPF
Policy, para. 12?
No
C. Summary Description of Proposed Project [including overview of Country, Sectoral & Institutional Contexts and
Relationship to CPF]
This project is in response to the request of the Government of Bosnia and Herzegovina (BiH) for support in preparing
for and responding to the COVID-19 pandemic and sustaining their efforts to prevent future outbreaks of emerging
infectious diseases. The project is prepared under under the COVID-19 Strategic Preparedness and Response Program
(SPRP) using the Multiphase Programmatic Approach (MPA), approved by the World Bank’s Board of Executive
Directors on April 2, 2020 (PCBASIC0219761) with an overall Program financing envelope of up to US $6.00 billion.
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The World Bank
Bosnia and Herzegovina Emergency COVID-19 Project (P173809)
The project will have three components: (1) Responding to the COVID-19 Pandemic in Republika Srpska; (2)
Responding to the COVID-19 pandemic in the Federation of Bosnia and Herzegovina; and (3) Project Management.
Component 1: Responding to the COVID-19 Pandemic in Republika Srpska. This component will provide immediate
support to Republika Srpska to treat existing cases of COVID-19, limit further local transmission, and address
socioeconomic impacts of the pandemic on affected households through social assistance and protection. Activities
are limited to those that require immediate and urgent implementation and to be implemented under two sub-
components: (1.1) health care delivery and health system strengthening and (1.2) Temporary social support and cash
assistance for vulnerable households and individuals.
Component 2: Responding to the COVID-19 pandemic in the Federation of Bosnia and Herzegovina (FBiH). This
component will provide immediate support to the FBiH to prevent additional arrivals of COVID-19 cases and to limit
local transmission through containment strategies and to prevent individuals and household affected by the
pandemic falling into destitution. The project-supported activities include (2.1) health care delivery and health system
strengthening and (2.2) Temporary social support and cash assistance for vulnerable households and individuals.
Component 3. Project Management. This component will support the operation of two Project Implementation Units
(PIUs), in FBiH and in Republika Srpska respectively, which provide overall administration of the project (including
procurement and financial management) and undertakes regular monitoring and reporting of project implementation
(including the required fiduciary assessments). Monitoring and evaluation (M&E) on social assistance will include spot
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checks of cash assistance and social care beneficiaries, at least one beneficiary survey and support for upgrades and
improvements to the existing administrative systems (SOTAC and other) if necessary. Existing structures will be
strengthened by the recruitment of additional staff/consultants responsible for overall administration, safeguards,
communication and outreach, procurement, and financial management.
Through a global waiver, all IPF operations processed under the Fast Track COVID-19 Facility, including projects
prepared under the Global MPA or stand-alone projects, are eligible for the application of the additional flexibility
defined in paragraph 12 of Section III of the IPF Policy due to the urgent need of assistance experienced by all Bank
borrowers in response to the COVID-19 pandemic.
D. Environmental and Social Overview
D.1. Project location(s) and salient characteristics relevant to the ES assessment [geographic, environmental, social]
The project will support the preparedness, monitoring, surveillance and response to the global COVID-19 outbreak in
Bosnia and Herzegovina (BiH). Bosnia and Herzegovina is split into two entities, Republika Srpska and Federation BiH
(FBH) along with a District Brcko, each with their own governments and administration and therefore Ministries
responsible for health. There is no central body at the level of BiH that would conduct activities related to health
protection of the population. The project activities will be carried out in healthcare facilities and centers for social
work located in urban areas/settlements, while the delivery of care packages and services at home and specialized
institutions will also include rural areas.
No major civil works are expected in this project; works involved will focus on rehabilitation of existing health care
structures within existing footprints and potential establishment of mobile and modular facilities. Refurbishment of
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The World Bank
Bosnia and Herzegovina Emergency COVID-19 Project (P173809)
existing and establishment of new structures will be conducted in line with site-specific Environmental and Social
Management Plans (ESMPs), prepared based on the provisions of the Environmental and Social Management
Framework (ESMF). The ESMF for this project will be prepared prior to disbursements. There may also be a need to
establish temporary health care facilities in areas experiencing temporary surge needs, including in border areas and
sites of infection concentration. This too will be subject to provisions of the ESMF.
Social differences in BiH are marked by the rural and urban divide, education levels (which influence income) and
demographic characteristics, such as gender and age. 16.9% of the population lives below the national poverty
threshold (32.9% of the rural population is at-risk-of-poverty, compared to 17.3% of the urban population). Social
assistance coverage among the poorest quintile remains low compared to countries of similar per capita income
levels. BiH has an aging population. About one third of the population is above the age of 55 and 15% is above the age
of 65 (2018 estimates). The older population, which is a high-risk group for COVID-19 infection, is highly vulnerable in
BiH. In RS specifically, according to the 2011 Household Budget Survey, 1 in 5 households whose head was over 65
years of age and older were below the relative poverty line. There are geographic inequities in access to health care
due to concentration of hospital services in urban areas and difficulties in staffing rural facilities (70 percent of urban
residents live within 15 minutes of a health facility versus 25 percent of rural residents).
BiH, as all other countries in the world are exposed to the COVID-19 pandemic. As of March 30, 2020, 354 cases have
been registered in Bosnia and Herzegovina (BiH) with ten COVID-19 associated deaths. Most cases are in Republika
Sprska (RS), with the greatest concentration of cases is in Banja Luka, although most people affected have mild
symptoms. In the Federation of BiH (FBiH), there are currently less than 100 cases, with clusters in Bihac, Mostar and
Public Disclosure
Sarajevo. Around 35 000 people are under public health surveillance in FBiH and around 17 000 in RS. . A number of
cases registered are linked with contacts with infected persons from the other countries in the region, but also from
the large number of persons that were employed abroad and which are now returning home. Containment measures
include establishment of tents at border crossings for quarantine and mandatory self-isolation of those entering the
country. However, non-compliance with the isolation measures is a common occurrence. In both RS and FBH, there is
a ban on public gatherings; schools and most shops have been closed with the exception of markets and pharmacies.
In RS specifically, a Coordination Body for Planning, Implementation and Monitoring activities related to the outbreak
was established in early March 2020. As part of the RS Government’s COVID-19 prevention and crisis response, access
to free testing and treatment is temporarily available to all RS citizens regardless of insurance status (costs covered by
the RS Health Insurance Fund).
D. 2. Borrower’s Institutional Capacity
In RS the Ministry of Health and Social Welfare (MoHSW), as an overarching authority in the health sector, will be
responsible for implementation and oversight of the proposed Project. The Planning, Analysis, Financing and Project
Implementation Department (PAFPID) of the Ministry will be the project implementation unit (PIU) headed by the
Deputy Minister of the MoHSW, and will include staff on procurement, financial management, monitoring and
evaluation, communication and technical staff responsible for social protection and health. The PIU will support
relevant technical units in the Ministry, and directly implement certain technical activities, including procurement of
medical supplies, equipment, other good identified for basic care packages, communication and monitoring, facility
repurposing works for activities under Component 1.1 as well as selected activities under Component 1.2. For
Component 1.2, the PIU will work with Centers for Social Work and relevant care institutions for the implementation
of cash transfers and delivery of social care services and packages.
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The World Bank
Bosnia and Herzegovina Emergency COVID-19 Project (P173809)
In FBIH the Ministry of Health (responsible for components 2.1.) will have a PIU while the FBiH Ministry of Labor and
Social Policy (responsible for components 2.2,) will have a Project Implementation Team (PIT). Although the overall
project management and implementation will rest with the PIU the project implementation will also be coordinated
through a Coordination Body for the project. The units will be staffed adequately and will include a person responsible
for environmental and social issues prior to the start of the project.
All three ministries have experience in implementing World Bank projects, including the Health Sector Enhancement
Project (HSEP: P149920) that included reconstruction of a number of health care facilities (closed in 2014), and the
BiH Health Sector Reform Project (P171150) currently under preparation. The Ministry of Labor and Social Policy in
FBIH has currently active projects of Bosnia and Herzegovina Employment Support Program - (P152347) and Bosnia
and Herzegovina Provision of Private Employment Services - (P171433). Under HSEP all works were carried out
according to World Bank environmental guidelines and safeguards compliance was satisfactory. HSEP did not trigger
OP 4.12 and the PIUs did not handle any other social issues, and therefore did not have this expertise on board. Due
to the mandate and staffing of the ministries, the PIU does not have an environmental and social specialist at present.
The PIU has an architect on board that has previous experience in implementing World Bank projects under
safeguards. As per the Environmental and Social Commitment Plan (ESCP), MoHSW and FBIH PIUs will appoint, no
later than 30 days after the project effectiveness date, an Environmental and Social Specialist. If such a person cannot
be appointed from within the existing staff of the FBIH MOH, an external hire should be considered.
II. SUMMARY OF ENVIRONMENTAL AND SOCIAL (ES) RISKS AND IMPACTS
A. Environmental and Social Risk Classification (ESRC) Substantial
Public Disclosure
Environmental Risk Rating Substantial
The Environmental Risk Rating is "Substantial". The major areas of risks for the project are: (i) risks related to
rehabilitation of existing healthcare facilities; (ii) environmental and community health related risks from inadequate
storage, transportation and disposal of infected medical waste; and (iii) occupational health and safety issues related
to the availability and supply of personal protective equipment (PPE) for healthcare workers. These risks are covered
by ESS 1, ESS 2, ESS 3, ESS 4, and ESS 10.
Minor physical works, under Component 1.1, for adapting health care or other facilities for patient care and for
mobile and modular hospitals is also being considered for project financing by BiH at this stage. The main
environmental impacts associated with minor civil works include dust and noise, construction waste management
(including demolition of any hazardous waste or asbestos containing materials), wastewater management from the
facility and worker safety. These are all temporary and easily mitigable through adherence to the ESMF and the site
specific ESMPs that will be developed once the activities are better defined.
Improper handling of health care waste can cause serious health problems for workers, the community and the
environment. Medical wastes have a high potential of carrying micro-organisms that can infect people who are
exposed to it, as well as the community at large if it is not properly disposed of. The management of medical waste is
one of the main risk factors in the project, but considering that the Borrower has specifically included this item in
their overall request ensures strong commitment and ownership from the Borrower side.
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The World Bank
Bosnia and Herzegovina Emergency COVID-19 Project (P173809)
The PAFPID PIU is staffed with a full time architect knowledgeable of World Bank projects and safeguards and will be
supported when and if needed by consultants or environmental specialists from other PIUs within the RS Ministries,
especially in the light of decreased activity on other WB financed projects. The FBiH PIUs will need to appoint a
person responsible for environmental and social issues, and may also include external hires either as consultants or
from other World Bank financed projects, if available. The specialists will be supported by the Bank team to ensure
adequate knowledge of the ESF and compliance with it. The activities within the project are of a moderate
environmental impact, and the staffing is adequate. However, taking into account the risks associated with the
pandemic and spread of infections, the overall risk is determined as "substantial".
Social Risk Rating Substantial
The social risk rating for this project is considered Substantial. The project will provide urgently needed support to the
BiH COVID-19 healthcare response and temporary social support and cash assistance to vulnerable households and
individuals adversely affected by the pandemic. Needs-based home consultations and care services will be provided
to ensure access to medical care and basic services for vulnerable groups. These activities are generally anticipated to
have positive impacts on BIH citizens through improved healthcare services, better infection prevention, and
expanded social assistance to vulnerable groups during a time of anticipated high unemployment and income loss.
The major areas of social risks are: (i) difficulties in delivering temporary social assistance to vulnerable groups during
COVID-19 constrains on mobility and functioning of public offices; (ii) social conflicts and unrest resulting from the
crisis challenges, including competing pressures on medical services; (iii) exacerbated community and health risk due
to inappropriate behavior resulting from false rumors and misinformation. Potential challenges associated with
providing inclusive (social and financial) assistance for vulnerable people can be partially mitigated through COVID-19
sensitive outreach, flexible registration and in-take options (e-mail, phone, local councils, in-house), and availability of
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a responsive feedback/grievance channel. Risk area (ii) and (iii) will be managed through consistent and
contextualized risk communication and public engagement activities and training for target groups (healthcare staff,
media and businesses) on crisis response. Given the risk of limited access to vulnerable groups of the temporary
social assistance program due to untested alternative registration and in-take methods, and the potential difficulty in
managing the public’s response to an unprecedent medical crisis, the social risk is considered to be substantial.
B. Environment and Social Standards (ESSs) that Apply to the Activities Being Considered
B.1. General Assessment
ESS1 Assessment and Management of Environmental and Social Risks and Impacts
Overview of the relevance of the Standard for the Project:
The project is anticipated to have positive environmental and social impacts through improvements in COVID-19
surveillance, detection and containment; provisions of protective equipment and implementation of COVID-19
specific OHS procedures for health care workers, improvements in medical waste management, and provision of in-
kind care and emergency cash assistance for vulnerable persons and households. However, the project could also
cause environmental, health and safety risks due to the dangerous nature of the pathogen and reagents and other
materials to be used in the project-supported health facilities, laboratories, and mobile hospitals. The social-
distancing restrictions and reduced capacity of public offices could also pose challenges to providing (social and
financial) assistance to vulnerable groups. To manage these risks, the MoHSW will prepare two instruments: (i)
Environmental and Social Management Framework (ESMF) that will include templates for Environmental and Social
Management Plans (ESMP) and Infection Control and Medical Waste Management Plan (ICWMP) so that the health
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Bosnia and Herzegovina Emergency COVID-19 Project (P173809)
facilities laboratories, and quarantine facilities to be supported by the Project will apply international best practices in
COVID-19 diagnostic testing and other COVID-19 response activities. The ESMF will have an exclusion list for COVID-
19 health care facilities and lab activities that may not be undertaken at the labs unless the appropriate capacity and
infrastructure is in place). The ESMF will be prepared to a standard acceptable to the Bank and disclosed no later than
30 days after the project effectiveness date; and (ii) Stakeholder Engagement Plan (SEP) for effective outreach and
citizen participation. The preliminary SEP will be updated and disclosed no later than 30 days after project
effectiveness.
Minor Civil Works. Under component 1, the project anticipates refurbishment of health care facilities and
establishment of mobile facilities to respond to the increasing demand for hospital beds created by COVID-19.
Expected risks are typical for small civil works and include emission of dust, noise, generation of construction waste,
small quantities of hazardous and other wastes, and worker health and safety. The ESMF will provide ESMP templates
for both rehabilitation of facilities and for establishment of mobile facilities in areas with large demand.
Time-bound cash-assistance. Access to time-bound cash assistance and in-kind care services could be constrained by
insufficient coverage (difficult to estimate demand; applications processed on a first come first serve basis) and lack
of timely information and/or required documentation to access temporary benefits. The permanent social assistance
program, which targets unemployed, low-income and disabled persons with high number of dependents, will be
expanded to provide temporary cash assistance to households affected by the adverse economic impacts of COVID-
19. The BIH permanent social assistance programs have an existing targeting mechanism which consists of an
assessment of “means” of potential beneficiaries. This consists of assessment and verification of ability to work,
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having insufficient revenues for subsistence or not, and having family members that are legally obliged and capable
to provide support or not. The most vulnerable (households with high number of dependents) are targeted through
provision of slightly higher benefits (based on a formula) and people with disabilities who already receive a care-giver
allowance are given temporary top-up cash benefits. Selection of beneficiaries is done on a first-come-first-serve
basis with all registration being time-logged and verifiable. Similar eligibility criteria also apply for the cash
allowances for elderly and people with disabilities. The SEP proposes targeted outreach to existing and potential new
social assistance beneficiaries and flexible registration through online/phone applications and in-home application
assistance for immobile groups. Regular registration will take place at local centers for social work as well as local
council offices to make the registration process as accessible as possible. The proposed alternative forms of
registration have not been tested in RS and FBH and their implementability and effects are uncertain.
This operation is being processed as an emergency response using condensed procedures under the Fast Track
COVID-19 Facility.
ESS10 Stakeholder Engagement and Information Disclosure
The project builds on the RS government’s Health Emergency Communication Plan and FBiH COVID-19 Preparedness
and Response plan by supporting awareness raising, development of educational material and timely communication
about the COVID-19 emergency response. The objective of the communication activities is to provide clear,
consistent and simple messages about social distancing, personal hygiene, self-isolation, mandatory quarantine
procedures, and the availability of targeted medical and social services for vulnerable groups during the COVID-19
crisis.
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Bosnia and Herzegovina Emergency COVID-19 Project (P173809)
The preliminary Stakeholder Engagement Plan (SEP) outlines the activity-specific methods for sharing information
about project benefits and engaging with affected parties during implementation, including vulnerable groups.
Communication and consultation activities in SEP have been tailored to the local context with the aim of serving the
specific needs of project beneficiaries during a pandemic by avoiding public gatherings, encouraging virtual and
phone engagement for information sharing and feedback.
The project will use the client’s current grievance mechanisms for healthcare and social assistance services, and
adapt them further to the COVID-19 emergency situation which requires minimal physical contact and mobility and
people gathering. The collection and response will hence be through electronic media, hotlines etc. Local centers for
social work will receive training on management of requests and grievances in a consistent manner, and the PIU will
have a grievance focal point responsible for collecting grievances from different entry points, analyzing the data and
monitoring any outstanding issues.
B.2. Specific Risks and Impacts
A brief description of the potential environmental and social risks and impacts relevant to the Project.
ESS2 Labor and Working Conditions
The project will involve the use of both direct workers and contracted workers. Direct workers could be either
government civil servants (MoHSW staff), workers in health care facilities and centers for social work, or technical
consultants engaged specifically in relation to the project, such as PIU consultants. The civil servants are governed by
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the RS and FBiH civil services code, while public health and social workers, and consultants are subject to the RS and
FBiH labor code. As needed, the project may also cover overtime payments or hazard/ indemnity pay for health care
personnel, which will be paid in line with the entity law and ESS2, and any applicable collective agreements.
Contracted workers could include workers of consultancies/organized engaged to provide services under the project
(e.g. develop and implement trainings, communication and educational materials on COVID-19), private health care
institutions engaged temporarily to assist the crisis response, and contractors hired for small scale refurbishments of
medical facilities. Workers engaged for minor civil works, including refurbishment of existing health care facilities and
establishment of temporary mobile facilities, are expected to be locally hired. Primary supply workers are those that
work for companies involved in the provision of medical supplies, PPE, chemicals, reagents etc.
Workers in health care facilities, including those managing medical waste are particularly vulnerable to contagions
like COVID-19. Healthcare-associated infections due to inadequate adherence to occupational health and safety
standards can lead to illness and death among health and laboratory works as well as the wider spreading of the
disease within communities. The project design incorporates measures to strengthen the protection of health care
workers from risks of COVID-19 infection through training on appropriate use of PPE, improved medical waste
management, surveillance and prevention of the spread of infections within healthcare facilities, and distribution of
PPE according to WHO guidelines. The ICWMP being developed will contain detailed procedures, based on WHO
guidance, for protocols necessary for treating patients and handling medical waste as well as environmental health
and safety guidelines for staff, including the necessary PPE. Proper disposal of sharps (see medical waste above),
disinfectant protocols, and regular testing of healthcare workers will be included. The project will also support
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The World Bank
Bosnia and Herzegovina Emergency COVID-19 Project (P173809)
improvements in medical waste management, which will contribute to minimize the risk of infection for medical
waste collection and disposal workers. The client will also provide COVID-19 specific occupational health and safety
directives to social workers to minimize their risk of infection when in contact with social assistance applicants and
during in-home visits.
The project shall be carried out in accordance with the applicable requirements of ESS 2, including through, inter alia,
implementing adequate occupational health and safety measures (including emergency preparedness and response
measures), setting out grievance arrangements for project workers, and incorporating labor requirements into the
ESHS specifications of the procurement documents. All civil works contracts will include industry standard Codes of
Conduct that include measures to prevent Gender Based Violence/Sexual Exploitation and Abuse (GBN/SEA).
ESS3 Resource Efficiency and Pollution Prevention and Management
Medical wastes and chemical wastes (including water, reagents, infected materials, etc.) from the labs, quarantine,
and screening posts to be supported (drugs, supplies and medical equipment) can have a substantial impact on the
environment and human health. Wastes that may be generated from medical facilities and labs could include liquid
contaminated waste, chemicals, and other hazardous materials, and other waste from labs and quarantine and
isolation centers including sharps, used in diagnosis and treatment. Each beneficiary medical facility/lab, following
the requirements of the ESMF to be prepared for the Project, WHO COVID-19 guidance documents, GIIP and other
best international practices, will prepare and follow an ICWMP to prevent or minimize such adverse impacts. Each
facility will apply infection control and waste management planning following the requirements of the ESMF and
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relevant EHS Guidelines, GIIP, WHO etc. The ICWMP will mandate that any waste associated with COVID-19 testing or
treatment will be incinerated on site whenever possible. It will also contain strict protocols for disinfecting and
packing such waste for transportation to the nearest medical waste incinerator if on site destruction is not possible.
The ESMF will adequately cover environmental and social infections control measures and procedures for the safe
handling, storage, and processing of COVID-19 materials including the techniques for preventing, minimizing, and
controlling environmental and social impacts during the operation of project supported laboratories and medical
facilities. It will also clearly outline the implementation arrangement to be put in place by MOHSP for environmental
and social risk management; training programs focused on COVID-19 laboratory bio-safety, operation of quarantine
and isolation centers and screening posts, as well as compliance monitoring and reporting requirements, including on
waste management based on the existing ICWMP prepared as part of the ESMF. The relevant part of the COVID-19
Quarantine Guideline and WHO COVID-19 bio-safety guidelines will be applied while preparing the ESMF so that all
relevant risks and mitigation measures will be covered.
The ESMF will also include guidance related to transportation and management of samples and medical goods or
expired chemical products, as well as small scale rehabilitation activities.
The SEP provides general guidelines for outreach to different segments of the population a on issues related to
COVID-19 response, including social distancing, hygiene, medical treatment, OHS, and quarantine. A project-specific
Communication Plan will be developed for the proposed media and communication activities, education material and
trainings.
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Bosnia and Herzegovina Emergency COVID-19 Project (P173809)
Registration for the time-bound cash assistance for vulnerable groups will be conducted at local centers for social
centers. To avoid risks of community transmissions, congregations will be avoided by making registration also
available through local councils on a specified schedule, by e-mail and phone.
The project anticipates the establishment of specialized units in selected hospitals for COVID-19 patients and
establishment of mobile health care facilities to address the need to minimize virus transmission. The operation of
quarantine areas and mobile centers needs to be implemented in a way that staff, patients, and the
wider public are treated in line with international guidance provide by WHO for COVID-19 response. In case
quarantine and mobile health care facilities are to be protected by security personnel, it will be ensured that the
security personnel follow strict rules of engagement and avoid any escalation of the situation, taking into
consideration the needs of quarantined persons as well as the potential stress related to being quarantined.
The communication activities supported by the project will ensure widespread awareness of the government’s
pandemic response strategy and the role of communities, individuals and businesses in implementing specific
community health and safety measures, including social distancing, personal/worker hygiene practices, self-isolation
and mandatory quarantine. The activities are outlined in SEP and will be further specified in a project-specific
Communication Plan.
ESS4 Community Health and Safety
Medical wastes and chemical wastes (including water, reagents, infected materials, etc.) from the labs, quarantine,
Public Disclosure
and screening posts to be supported (drugs, supplies and medical equipment) can have a substantial impact on the
environment and human health. Wastes that may be generated from medical facilities and labs could include liquid
contaminated waste, chemicals, and other hazardous materials, and other waste from labs and quarantine and
isolation centers including sharps, used in diagnosis and treatment. Each beneficiary medical facility/lab, following
the requirements of the ESMF to be prepared for the Project, WHO COVID-19 guidance documents, and other best
international practices, will prepare and follow an ICWMP to prevent or minimize such adverse impacts. The ICWMP
will mandate that any waste associated with COVID-19 testing or treatment will be incinerated on site whenever
possible. It will also contain strict protocols for disinfecting and packing such waste for transportation to the nearest
medical waste incinerator if on site destruction is not possible.
The ESMF will also include guidance related to transportation and management of samples and medical goods or
expired chemical products, as well as small scale rehabilitation activities.
Registration for the time-bound cash assistance for vulnerable groups will be conducted at local centers for social
centers. To avoid risks of community transmissions, congregations will be avoided by making registration also
available through local councils on a specified schedule, by e-mail and phone.
The project anticipates the establishment of specialized units in selected hospitals for COVID-19 patients and
establishment of mobile health care facilities to address the need to minimize virus transmission. The operation of
quarantine areas and mobile centers needs to be implemented in a way that staff, patients, and the
wider public are treated in line with international guidance provide by WHO for COVID-19 response. In case
quarantine and mobile health care facilities are to be protected by security personnel, it will be ensured that the
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Bosnia and Herzegovina Emergency COVID-19 Project (P173809)
security personnel follow strict rules of engagement and avoid any escalation of the situation, taking into
consideration the needs of quarantined persons as well as the potential stress related to being quarantined.
The communication activities supported by the project will ensure widespread awareness of the government’s
pandemic response strategy and the role of communities, individuals and businesses in implementing specific
community health and safety measures, including social distancing, personal/worker hygiene practices, self-isolation
and mandatory quarantine. The activities are outlined in SEP and will be further specified in a project-specific
Communication Plan.
ESS5 Land Acquisition, Restrictions on Land Use and Involuntary Resettlement
Civil works will be restricted to minor rehabilitation of existing health care facilities to accommodate higher number
of hospital beds or establishment of mobile health care facilities (about 500 hospital beds) in areas of temporary
surge needs. All mobile facilities will either be located on vacant public or private land with written voluntary
consent. The project-specific ESMF will outline procedures for obtaining prior consent for temporary use of private
land, and conditions for minimizing impacts on the owners, such as returning the land/property to its original state
after temporary use. Involuntary acquisition or occupation of land is not expected. Based on the assessment of risks
and impacts associated with ESS5, this ESS is currently not considered applicable.
ESS6 Biodiversity Conservation and Sustainable Management of Living Natural Resources
Public Disclosure
All works will be conducted within the existing footprint of facilities; hence, this standard is not considered currently
relevant to the proposed project interventions.
Mobile hospital and any other temporary objects that would be developed within the project will be located away
from protected or otherwise sensitive natural areas, including forests, habitats, waterways or otherwise sensitive
areas.
ESS7 Indigenous Peoples/Sub-Saharan African Historically Underserved Traditional Local Communities
Bosnia and Herzegovina does not have distinct social and cultural groups as covered by ESS7. Thus, this standard is
not applicable.
ESS8 Cultural Heritage
There is a potential for minor repurposing of existing health care facilities to accommodate a higher number of
hospital beds. There are no project implications on cultural heritage.
ESS9 Financial Intermediaries
This standard is not relevant to the proposed project interventions.
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Bosnia and Herzegovina Emergency COVID-19 Project (P173809)
B.3 Other Relevant Project Risks
None noted
C. Legal Operational Policies that Apply
OP 7.50 Projects on International Waterways No
Not relevant. No implications on waterways.
OP 7.60 Projects in Disputed Areas No
Not relevant.
III. BORROWER’S ENVIRONMENTAL AND SOCIAL COMMITMENT PLAN (ESCP)
DELIVERABLES against MEASURES AND ACTIONs IDENTIFIED TIMELINE
ESS 1 Assessment and Management of Environmental and Social Risks and Impacts
ORGANIZATIONAL STRUCTURE:
The RS Ministry of Health and Social Welfare, the Federation of Bosnia and Herzegovina (FBIH)
Ministry of Health and the Ministry of Labor and Social Policy shall establish and maintain
05/2020
units/departments responsible for project implementation, including relevant Project Implementation
Team (PIT) with qualified staff and resources to support the management of ESHS risks and impacts of
Public Disclosure
the Project including environmental and social risk management specialists.
ENVIRONMENT AND SOCIAL MANAGEMENT FRAMEWORK (ESMF)
Prepare an ESMF acceptable to the Association and disclose the ESMF on the Project website. The 05/2020
ESMF will include templates for site specific Environmental and Social Management Plans (ESMP) and
Infection Control and Medical Waste Management Plan (ICWMP).
ESIA/ESMP/OTHER INSTRUMENTS/CONTRACTORS
a. Assess the environmental and social risks and impacts of Project activities in accordance the ESMF.
b. Prepare, disclose, adopt, and implement any ESMPs or other instruments required for Project
03/2025
activities in a manner acceptable to the Bank.
c. Incorporate the relevant aspects of this ESCP into the procurement documents and contracts with
contractors and supervising firms.
EXCLUSIONS: The following activities are ineligible:
• Those that may cause permanent and/or irreversible adverse impacts on the environment
• Those that may have significant adverse social impacts and may give rise to significant social conflict
• Those that may affect lands or rights of indigenous people or other vulnerable minorities, 03/2025
• Those that may involve permanent resettlement or land acquisition or adverse impacts on cultural
heritage
• Excluded activities included in the ESMF.
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The World Bank
Bosnia and Herzegovina Emergency COVID-19 Project (P173809)
ESS 10 Stakeholder Engagement and Information Disclosure
STAKEHOLDER ENGAGEMENT PLAN: Prepare, disclose, adopt, and implement a Stakeholder
05/2020
Engagement Plan (SEP) consistent with ESS10, in a manner acceptable to the Bank.
ESS 2 Labor and Working Conditions
LABOR MANAGEMENT: ESS 2 will be adhered to through adequate occupational health and safety
measures (including emergency preparedness and response), grievance arrangements for workers, 03/2025
and incorporating labor requirements into procurement documents.
ESS 3 Resource Efficiency and Pollution Prevention and Management
Relevant aspects of this standard shall be considered, as needed, under action 1.2 above, including,
inter alia, measures to: manage health care wastes, and other types of hazardous and non-hazardous 03/2025
wastes.
ESS 4 Community Health and Safety
ESS 4 falls under action 1.2, including: minimizing exposure to disease; ensuring vulnerable parties
access to benefits; managing risks of security personnel and labor influx; and preventing/responding 03/2025
to sexual exploitation, abuse, or harassment.
ESS 5 Land Acquisition, Restrictions on Land Use and Involuntary Resettlement
Public Disclosure
Not considered currently relevant. All mobile health care facilities will either be located on vacant
public or private land with written voluntary consent in accordance with principles of voluntary 03/2025
consent specified in ESS5.
ESS 6 Biodiversity Conservation and Sustainable Management of Living Natural Resources
Not relevant. 03/2025
ESS 7 Indigenous Peoples/Sub-Saharan African Historically Underserved Traditional Local Communities
ESS 8 Cultural Heritage
ESS 9 Financial Intermediaries
B.3. Reliance on Borrower’s policy, legal and institutional framework, relevant to the Project risks and impacts
Is this project being prepared for use of Borrower Framework? No
Areas where “Use of Borrower Framework” is being considered:
The Borrower framework is not considered for any part of this project, or the project in whole.
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The World Bank
Bosnia and Herzegovina Emergency COVID-19 Project (P173809)
IV. CONTACT POINTS
World Bank
Contact: Mirey Ovadiya Title: Sr Social Protection Specialist
Telephone No: 473-2960 Email: movadiya@worldbank.org
Contact: Ian Forde Title: Senior Health Specialist
Telephone No: 5220+36905 / Email: iforde@worldbank.org
Borrower/Client/Recipient
Borrower: Bosnia and Herzegovina
Implementing Agency(ies)
Implementing Agency: Ministry of Health and Social Welfare of Republika Srpska
Implementing Agency: Ministry of Health of the Federation of Bosnia and Herzegovina
V. FOR MORE INFORMATION CONTACT
Public Disclosure
The World Bank
1818 H Street, NW
Washington, D.C. 20433
Telephone: (202) 473-1000
Web: http://www.worldbank.org/projects
VI. APPROVAL
Task Team Leader(s): Mirey Ovadiya, Ian Forde
Safeguards Advisor ESSA Nina Chee (SAESSA) Concurred on 07-Apr-2020 at 15:37:47 EDT
Apr 07, 2020 Page 14 of 14