The World Bank Nigeria Improved Child Survival Program for Human Capital MPA (P167156) REPORT NO.: RES46611 RESTRUCTURING PAPER ON A PROPOSED PROJECT RESTRUCTURING OF NIGERIA IMPROVED CHILD SURVIVAL PROGRAM FOR HUMAN CAPITAL MPA APPROVED ON FEBRUARY 18, 2020 TO FEDERAL REPUBLIC OF NIGERIA HEALTH, NUTRITION & POPULATION AFRICA WEST Regional Vice President: Ousmane Diagana Country Director: Shubham Chaudhuri Regional Director: Dena Ringold Practice Manager/Manager: Magnus Lindelow Task Team Leader(s): Onoriode Ezire, Elina Pradhan The World Bank Nigeria Improved Child Survival Program for Human Capital MPA (P167156) ABBREVIATIONS AND ACRONYMS ESMF Environmental and Social Management Framework ESMP Environmental and Social Management Plan Gavi Global Alliance for Vaccines and Immunization IMPACT Immunization Plus and Malaria Progress by Accelerating Coverage and Transforming Services MPA Multiphase Programmatic Approach NPHCDA National Primary Healthcare Development Agency PDO Project Development Objective PIU Project Implementing Unit UNICEF United Nations Children’s Fund The World Bank Nigeria Improved Child Survival Program for Human Capital MPA (P167156) BASIC DATA Product Information Project ID Financing Instrument P167156 Investment Project Financing Original EA Category Current EA Category Partial Assessment (B) Partial Assessment (B) Approval Date Current Closing Date 18-Feb-2020 31-Dec-2025 Organizations Borrower Responsible Agency Federal Ministry of Health,National Primary Health Care Federal Republic of Nigeria Development Agency (NPHCDA) Multiphase Programmatic Approach (MPA) Program Development Objective The objective of the program is to reduce under-five mortality rate in program areas. Multiphase Programmatic Approach (MPA) Status (Public Disclosure) Status and Key Decisions (Public Disclosure) The Immunization Plus and Malaria Progress by Accelerating Coverage and Transforming Services (IMPACT) project, Phase 1 of the Improved Child Survival MPA was approved by the World Bank’s Board on February 18th, 2020, and became effective on February 17th, 2021 after the project implementation manual was approved by the National Steering Committee. However, disbursements under the project can only commence once the Federal Ministry of Finance gives the final clearance. Project management trainings for National and State-level Project Implementing Units have been completed while the review of state annual workplans for malaria and immunization plus states have commenced. As originally designed, sub-component 2.3 of the IMPACT project has provisions for equipping the Lagos cold chain hub with cold chain commodities. Under this plan, an ongoing project (Polio Eradication Support Project--P130865) was supposed to construct and rehabilitate the Lagos hub building, and IMPACT would The World Bank Nigeria Improved Child Survival Program for Human Capital MPA (P167156) finance the equipment. However, the scope of the activity changed from rehabilitation and expansion of the existing structures to demolition and new construction. Hence, the Federal Government of Nigeria and the World Bank further discussed and agreed to transition the construction of the Lagos cold chain hub facility from the Polio Project to the IMPACT project to allow enough time for completion of this expanded scope. As a part of the Polio Project transition activities, (1) the site-specific Environment and Social Management Plan (ESMP) has been updated, and (2) the Environmental and Social Management Framework (ESMF) of the project has also been updated to reflect the construction of the Lagos cold chain hub using funds from the Polio Project. The updated ESMP was disclosed in-country on November 3, 2020, and on the World Bank external website on November 12, 2020. The updated ESMF has been disclosed in-country and on the World Bank external website on June 3, 2021. The IMPACT MPA stakeholders have also been duly consulted on the new additional activity to the Project. OPS_TABLE_PDO_CURRENTPDO Project Development Objective (PDO) Original PDO The project development objective (PDO) of the first phase (IMPACT) is to improve the utilization and quality of immunization plus and malaria services in selected states. OPS_TABLE_PDO_CURRENTPDO Summary Status of Financing (US$, Millions) Net Ln/Cr/Tf Approval Signing Effectiveness Closing Commitment Disbursed Undisbursed IDA-65390 18-Feb-2020 18-Sep-2020 17-Feb-2021 31-Dec-2025 650.00 0 678.11 Policy Waiver(s) Does this restructuring trigger the need for any policy waiver(s)? No The World Bank Nigeria Improved Child Survival Program for Human Capital MPA (P167156) I. PROJECT STATUS AND RATIONALE FOR RESTRUCTURING 1. This restructuring paper seeks the approval of the country director to finance construction of the Lagos vaccine hub under this project. The construction of this hub was originally envisaged under the National Polio Eradication Support Project (Polio Project--P130865). Along with accommodating the Lagos hub construction, the restructuring will also reallocate US$8 million equivalent originally allocated for vaccines procurement towards the construction of the Lagos hub within the same subcomponent. This restructuring was requested by the Government in the letter Ref: F11373/S.34/C.3061/163, and dated April 30th2021, and completes the loop on the last restructuring of the Polio project to transition the construction of the Lagos hub. A. Project Status 2. The Immunization Plus and Malaria Progress by Accelerating Coverage and Transforming Services (IMPACT) project, the Phase 1, of the Improved Child Survival MPA was approved by the World Bank’s Board on February 18th, 2020, and became effective on February 17th, 2021 after the project implementation manual was approved by the National Steering Committee. The MPA Program Objective is to reduce under-five mortality rate in participating states. The project development objective (PDO) of the first phase (IMPACT) is to improve the utilization and quality of immunization plus and malaria services in selected states. The project is currently effective. However, disbursements under the project can only commence once the Federal Ministry of Finance gives the final clearance. Project management training for National and State-level Project Implementing Units (PIUs) have been completed while the review of state annual workplans for the malaria and immunization plus states have commenced. 3. Implementation progress is currently rated as moderately satisfactory because of the delay in effectiveness after the financing agreement was signed. Most project risk rating categories – political and governance, institutional capacity for implementation and sustainability, and fiduciary – are currently rated as moderate. However, macro-economic risks remain substantial as the lingering effects of the COVID-19 pandemic continues which may affect Government’s ability meet its vaccine financing obligations under the Gavi Accountability framework linked to subcomponent 2.3 of the IMPACT project. Finally, no audit reports are currently due or conducted or qualified at this stage of the Project. B. Rationale for Restructuring 4. The proposed restructuring would allow for the incorporation of new civil works (construction) into the IMPACT project to accommodate the demolition of dilapidated existing structures, and construct a modern cold and dry storage facility at the Federal Medical Store Complex at Oshodi, Lagos also referred to as the Lagos hub. The Lagos hub is the country’s main mega- warehouse compound for receiving and storing vaccines and other medical commodities and it is not able to serve its purpose in its current state. The completion of the Lagos hub expansion/rehabilitation is critical to ensure the country continues to have the necessary storage capacity to accommodate essential vaccines, including new vaccines such as for COVID-19. The hub construction is also part of a joint investment with other developing partners towards improving the overall logistics and storage capacity for vaccines and other medical commodities in the country. 5. As originally designed, sub-component 2.3 of the IMPACT project has provisions for equipping the Lagos Hub with cold chain commodities. The execution of the Lagos hub construction itself was originally planned under the Polio project. However, this could not be completed before the Polio project closing date of April 30th, 2021 because of a change in the scope of this activity which would take more time—the scope changed from rehabilitation/expansion of existing structures to demolition/new construction. As a result, the Government and the Bank agreed to transit this activity to IMPACT, as IMPACT aims to consolidate WB’s support to Government of Nigeria for health systems strengthening and primary health care. The Government has therefore requested restructuring of the IMPACT project to accommodate this change to allow sufficient time to implement all the steps necessary to transform the current dilapidated structure into a modern hub. The World Bank Nigeria Improved Child Survival Program for Human Capital MPA (P167156) 6. This restructuring would also allow for the reallocation of US$8 million equivalent previously earmarked under subcomponent 2.3 for vaccines procurement to the construction of the Lagos hub under the same subcomponent. Parallel to the extended timeline of Lagos hub construction under the Polio Project, IMPACT also faced delays in effectiveness and continues to face disbursement delays. The Government therefore, was not able to access financing for vaccines provisioned under the IMPACT project, and the Polio Project was restructured in December 2020 to reallocate the US$8 million equivalent originally earmarked for the Lagos hub expansion to procure vaccines urgently needed at the time. 7. Vaccines procured under the Polio Project under the arrangement mentioned above successfully filled a critical vaccine financing gap. This repurposing under the Polio Project resulted in savings of $8 million from the vaccine financing budget under the IMPACT project which the Bank agreed with the client to apply towards the Lagos hub construction. Therefore, the proposed restructuring does not require any additional financing or changes in budget categories, and this reallocation occurs within the same sub-component. II. DESCRIPTION OF PROPOSED CHANGES 8. Components and Costs: The proposed change will restructure subcomponent 2.3 of the project to incorporate civil works to include the construction of the Lagos hub. The change will also reallocate US$8 million originally earmarked for vaccine financing to the construction of the Lagos hub under the same component. Thus, the equivalent of US$118,669,536 originally earmarked for vaccine financing over the life of the IMPACT project, will be adjusted to US$110,669,536 after the reallocation. Given that vaccine procurement is executed through a standard agreement between Govt and UNICEF, the revised sum of US$110,669,536 will be reflected in this standard agreement. 9. There will be no changes in the PDO, the project costs, results framework, project covenants or risk rating. 10. Environmental Analysis: The original Project did not envisage support to the construction of the Lagos Hub, which will include the demolition of existing buildings within the Federal Medical Stores Complex in Oshodi, Lagos State. No additional Safeguard Policy is triggered since the construction would be implemented within the existing Government Complex and the Environmental and Social Framework risk classification for the Project remains B. 11. The Environmental and Social Management Framework (ESMF) prepared and disclosed during the project preparation stage has been updated and consulted upon by relevant stakeholders to incorporate additional considerations related to the construction of the Lagos hub. The updated ESMF has been disclosed in-country and on the World Bank External Website on June 3, 2021. The site-specific Environmental and Social Management Plan (ESMP) for the Lagos hub was updated in November 2020 to incorporate the potential risks/impacts and their corresponding mitigation measures associated with the construction and expansion activities which will require the demolition of the dilapidated structures. The plan also includes measures for implementing civil works in light of COVID-19, more specifically, protection protocols for workers involved in construction during the pandemic. The World Bank Nigeria Improved Child Survival Program for Human Capital MPA (P167156) III. SUMMARY OF CHANGES Changed Not Changed Components and Cost ✔ Environmental Analysis ✔ Implementing Agency ✔ DDO Status ✔ Project's Development Objectives ✔ MPA Program Development Objective ✔ MPA Expected Results and Indicators ✔ Results Framework ✔ Loan Closing Date(s) ✔ Cancellations Proposed ✔ Reallocation between Disbursement Categories ✔ Disbursements Arrangements ✔ Disbursement Estimates ✔ Overall Risk Rating ✔ Safeguard Policies Triggered ✔ EA category ✔ Legal Covenants ✔ Institutional Arrangements ✔ Financial Management ✔ Procurement ✔ Implementation Schedule ✔ Other Change(s) ✔ Economic and Financial Analysis ✔ Technical Analysis ✔ Social Analysis ✔ IV. DETAILED CHANGE(S) The World Bank Nigeria Improved Child Survival Program for Human Capital MPA (P167156) MPA PROGRAM DEVELOPMENT OBJECTIVE Current MPA Program Development Objective The objective of the program is to reduce under-five mortality rate in program areas. EXPECTED MPA PROGRAM RESULTS Current Expected MPA Results and their Indicators for the MPA Program OPS_DETAILEDCHANGES_COMPONENTS_TABLE COMPONENTS Current Current Proposed Proposed Cost Action Component Name Component Name Cost (US$M) (US$M) Component 1:Malaria Control 188.00 No Change Component 1:Malaria Control 188.00 Component 2: Immunization Component 2: Immunization Plus 409.30 Revised 409.30 Plus Component 3: Knowledge for Component 3: Knowledge for 52.70 No Change 52.70 Change Change Component 4: Contingent Component 4: Contingent Emergency Response Component 0.00 No Change Emergency Response 0.00 (CERC) Component (CERC) TOTAL 650.00 650.00 .