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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                                                    _Zj MAI 2016
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. TF0A0565)
Amendment to the Grant Agreement
Excellency:
We refer to the Senegal Health RBF Trust Fund Grant Agreement dated January 28, 2016 ("Grant
Agreement"), between the Republic of Senegal ("Recipient") and the International Development
Association and the International Bank for Reconstruction and Development, acting as trustee for the
Senegal Health RBF Trust Fund ("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 Grant Agreement in respect of the provisions below:
1.     Part A. I of Schedule 1 to the 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 1 to the 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. .(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 Grant 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 Grant Agreement is deleted in its
entirety and is replaced by the table provided in Attachment I to this letter.
5.     Definitions numbered 31, 33 and 38 in Section I of the Appendix are amended to read as follows:
"Section I. Definitions
31.    "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.
33.    "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.
38.    "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 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
MO
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AGREED:--
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REPUBL(C                                                                   SE d  a
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Name:
Title:
Date:


ATTACHMENT 1
Amount of the     Percentage of Expenditures
Category                 Financing             to be Financed
Allocated          (inclusive of Taxes)
(expressed in US$)
(1) RBF Grants under Part A.1 (a)   612000         100%
of the Project.
(2) Goods, non-consulting services,  216 000       100%
and consultants' services
Training, and Operating Costs
for Parts A.2. (b) of the Project.
TOTAL AMOUNT                         828,000