The World Bank Reducing Health Risk Factors (P160512) REPORT NO.: RES34533 RESTRUCTURING PAPER ON A PROPOSED PROJECT RESTRUCTURING OF REDUCING HEALTH RISK FACTORS APPROVED ON APRIL 11, 2017 TO BOSNIA AND HERZEGOVINA HEALTH, NUTRITION & POPULATION EUROPE AND CENTRAL ASIA Regional Vice President: Cyril E Muller Country Director: Linda Van Gelder Senior Global Practice Director: Timothy Grant Evans Practice Manager/Manager: Tania Dmytraczenko Task Team Leader: Lorena Kostallari The World Bank Reducing Health Risk Factors (P160512) ABBREVIATIONS AND ACRONYMS BiH Bosnia and Herzegovina FBiH Federation of Bosnia and Herzegovina FMoH Ministry of Health of FBiH GMs Grants manuals LAGs Local action groups NCD Non-communicable disease RS Republika Srpska RSMoHSW Ministry of Health and Social Welfare of RS SDC Swiss Agency for Development and Cooperation The World Bank Reducing Health Risk Factors (P160512) BASIC DATA Product Information Project ID Financing Instrument P160512 Investment Project Financing Original EA Category Current EA Category Not Required (C) Not Required (C) Approval Date Current Closing Date 11-Apr-2017 31-Dec-2018 Organizations Borrower Responsible Agency Bosnia & Herzegovina RS PCU,FBiH PCU Financing (in USD Million) FIN_SUMM_PUB_TBL SUMMARY Total Project Cost 1.41 Total Financing 0.00 Financing Gap 0.00 DETAILS -NewFin3 Project Development Objective (PDO) Original PDO The Project Development Objective (PDO) of this Recipient Executed Trust Fund (RETF) is to assist the Republika Srpska and the Federation of Bosnia and Herzegovina in reducing selected non-communicable disease (NCD) risk factors by promoting tobacco and alcohol control, and diet and physical activity in selected beneficiaries (pre-school children, school children, teachers, health workers and local government employees) in four selected local communities (two in RS and two in FBiH) OPS_TABLE_PDO_CURRENTPDO The World Bank Reducing Health Risk Factors (P160512) Summary Status of Financing Net TF Approval Signing Effectiveness Closing Commitment Disbursed Undisbursed TF-A4795 11-Apr-2017 24-Oct-2017 20-Feb-2018 31-Dec-2018 1.41 .78 .63 Policy Waiver(s) Does this restructuring trigger the need for any policy waiver(s)? No I. PROJECT STATUS AND RATIONALE FOR RESTRUCTURING 1. The Reducing Health Risk Factors Project is a small recipient-executed grant (the Grant), which is a part of the Trustee Trust Fund (TF) for Reducing Health Risk Factors in Bosnia and Herzegovina (BiH) received from the Swiss Agency for Development and Cooperation (SDC). The Grant assists the Republika Srpska (RS) and the Federation of Bosnia and Herzegovina (FBiH) in reducing selected non-communicable disease (NCD) risk factors by promoting tobacco and alcohol control, and diet and physical activity in selected beneficiaries (pre-school children, school children, teachers, health workers and local government employees) in four selected local communities (two in RS and two in FBiH). FBiH Ministry of Health (FMoH) and RS Ministry of Health and Social Welfare (RSMoHSW) have been implementing the Grant in Mostar and Zenica in FBiH and Doboj and Zvornik in RS. 2. The current closing date of the Grant is December 31, 2018. The Grant became effective on February 20, 2018, due to delayed approval by the client; implementation activities commenced in March 2018. The recruitment of consultants in FBiH and RS has been completed, and implementation of relevant activities is underway in all target communities. 3. A project baseline study was conducted to provideinsight into status and practices of addressing NCD risk factors in the four target communities, as well as to help key stakeholders in tailoring programs and strategies aimed at improving health of the population in those communities. The baseline study examined knowledge, attitudes and behaviors on all four key risk factors (use of tobacco, use of alcohol, physical inactivity and improper diet) in the target beneficiaries. The data collection approach used in this study involved (self)completion of standardized questionnaire with pre-coded responses. 4. Community mobilization is underway and local steering groups have been set up, which are meeting regularly in all target communities. These groups are presently highlighting community priorities that should be addressed through ‘small scale projects’, which are to be supported by project grant funds, and are formulating medium-term plans to ensure focused joint actions for reducing the four identified NCD risk factors. Work on action plans enhanced collaboration, resources alignment, and linkages among different sectors to help achieve collective population health impact. ==`. 5. Education activities in relation to development, implementation and evaluation of evidence-based promotion and prevention programs have commenced. Appropriate syllabi and accompanying handbooks have been prepared for training of school, health institutions, and local government offices staff. Training activities targeting preschool, The World Bank Reducing Health Risk Factors (P160512) elementary and secondary education institutions, health organizations and local government staff have been conducted and underway in all target communities. 6. The timeframe available to prepare, distribute and implement ‘small scale projects’ is extremely short. FMoH and RSMoHSW have developed ‘small scale projects’ grants manuals (GM) that provide instructions, guidance and documentation for organizations participating in the process of publishing calls for proposals, selecting winning entities and implementing grants in FBiH and RS. This process might be lengthy as it involves a number of institutions engaged in contractual arrangements. ‘Small scale project’ preparatory work should continue and needs to be completed urgently. The priorities identified by the local action groups (LAGs) in each target community will guide this process. It is important that all four risk factors be covered by the ‘small scale projects’. 7. Consequently, the Government requested an extension of the Grant closing date until June 30, 2019 to allow for the activities to be completed and the resources to be fully disbursed, as initially planned. The request was approved by the Donor (SDC), and the amendment to the administrative agreement for the Trustee TF was countersigned on November 6, 2018, extending the end of disbursement date until December 31, 2019. 8. The Grant has no overdue audits at present time. II. DESCRIPTION OF PROPOSED CHANGES 9. The reason for the requested extension to June 30, 2019 is: (a) to compensate for the initial delays between the Grant approval (April 11, 2017) and declaration of effectiveness (February 20, 2018), resulting in implementation starting only in March 2018; and (b) to allow time for the completion of ‘small scale projects’. The preparatory work is currently proceeding (including preparation of the GMs, guidance and documentation for organizations participating in the process of applying for grants in FBiH and RS). However, this process might take longer than originally envisaged as it involves a number of institutions engaged in contractual arrangements. In addition, the entire process is under guidance of the LAGs in each target community, hence its overall coordination is expected to be time consuming. 10. No other changes are proposed. 11. The list of activities as defined in the initial procurement plan remains relevant. The deadlines will be revised to take into account the extension of the closing date. III. SUMMARY OF CHANGES Changed Not Changed Loan Closing Date(s) ✔ Implementing Agency ✔ Project's Development Objectives ✔ Results Framework ✔ Components and Cost ✔ The World Bank Reducing Health Risk Factors (P160512) Cancellations Proposed ✔ Additional Financing Proposed ✔ Reallocation between Disbursement Categories ✔ Disbursements Arrangements ✔ Disbursement Estimates ✔ Change in Overall Risk Rating ✔ Safeguard Policies Triggered ✔ EA category ✔ Legal Covenants ✔ Institutional Arrangements ✔ Financial Management ✔ Procurement ✔ Implementation Schedule ✔ Other Change(s) ✔ IV. DETAILED CHANGE(S) OPS_DETAILEDCHANGES_LOANCLOSING_TABLE LOAN CLOSING DATE(S) Original Revised Proposed Proposed Deadline TF Status Closing Closing(s) Closing for Withdrawal Applications TF-A4795 Effective 31-Dec-2018 30-Jun-2019 30-Oct-2019 Note to Task Teams: End of system generated content, document is editable from here.