屆口口口口口口口口口口口口口口口口口口口口口口口口口口口口一口口口口口口口口口口口口口口口口口口口口口口口口口口口口口口口口口口口口口開口口口寫網開口口開啊網口口口啊口口口口開間口口寫網開口口開口口口口口口口口口口開間口啊寫開開口口開啊啊口開開口口口口口口口 屆口口口口口口口口口口口口口口口口口口織口口口口口口口口口口口口 GRANT NUMBER D7900一BI Financing Agreemellt (Second AdditionalF蜓nancing for Health System SupportProject(&KIRA,,)) bCtween REPUBLIC OF BURUNDI aUd INTERNAT10NAL DEVELOPMENT ASSOCIATION 口口口口口口口口口口口口口口口口 口口口口口口口口口口口口口口口口口口口口口口口口口口口口口口口口口口口口 GRANT NUMBER D7900-BI FINANCING AGREEMENT AGREEMENT dated as of the Signature Date between the REPUBLIC OF BURUNDI ("Recipient") and INTERNATIONAL DEVELOPMENT ASSOCIATION ("Association") for the purpose of assisting in financing the project described in Schedule I to this Agreement ("Project"). The Recipient and the Association hereby agree as follows: ARTICLE I - GENERAL CONDITIONS; DEFINITIONS 1.01. The General Conditions (as defined in the Appendix to this Agreement) apply to and form part of this Agreement. 1.02. Unless the context requires otherwise, the capitalized terms used ill this Agreement have the meanings ascribed to them in the General Conditions or in the Appendix to this Agreement. ARTICLE 11 -FINANCING 2.01. The Association agrees to extend to the Recipient a grant, which is deemed as Concessional Financing for purposes of the General Conditions, in an amount equivalent to thirty four million and eight hundred thousand Special Drawing Rights (SDR 34,800,000) ("Grant"), to assist in financing the project described in Schedule I to this Agreement ("Project"). 2.02. The Recipient may withdraw the proceeds of the Grant in accordance with Section Ill of Schedule 2 to this Agreement. 2.03. The Maximum Comm itinent Charge Rate is one-half or one percent (1 /2 of I%) per annum on the Unwithdrawn Grant Balance. 2.04. The Payment Dates are April 15 and October 15 in each year. 2.05. The Payment Currency is Dollar. ARTICLE III - PROJECT 3.01. The Recipient declares its corninitmeritto the objectives of the Project. To this end the Recipient shall carry out the Project, through the Ministry of Health (MoFf) in accordance with the provisions of Article V of the General Conditions and Schedule 2 to this Agreement. -2- ARTICLE IV - EFFECTIVENESS; TERMINATION 4.01. The Additional Condition of Effectiveness consists of the following, namely that the Recipient has updated and thereafter adopted the Project Implementation Manual, with terms and conditions acceptable to the Association. 4.02. The Effectiveness Deadline is the date ninety (90) days after the Signature Date. 4.03. For purposes of Section 10.05 (b) of the General Conditions, the date on which the obligations of the Recipient under this Agreement (other than those providing for payment obligations) shall terminate is twenty (20) years after the Signature Date. ARTICLE V - REPRESENTATIVE; ADDRESSES 5.01. The Recipient's Representative is its minister responsible for finance. 5.02. For purposes of Section 11.01 of the General Conditions: (a) the Recipient's address is: Ministry of Finance, Budget and Cooperation for Economic Development P.O. Box 1830 Bujumbura, Burundi; and (b) tie Recipient's Electronic Address is: Telex: MINIFINBDI 5.03. For purposes of Section 11.01 of the General Conditions: (a) the Association's address is: International Development Association 1818 H Street, N.W. Washington, D.C. 20433 United States of America; and (b) the Association's Electronic Address is: Telex: Facsimile: 248423 (MCI) 1-202-477-6391 -3- AGREED as of the Signature Date. REPUBLIC OF BURUNDI By .1 Authorized Representative Name:______ __ Title: -( _ Date: L7 A ot _)c INTERNATIONAL DEVELOPMENT ASSOCIATION By Authorized Representative Name: Title: jj p Date: -4- SCHEDULE 1 Project Description The objective of the Project is to increase the use of quality reproductive, maternal, neonatal, child and adolescent health services, and, in the event of an Eligible Crisis or Emergency, to provide immediate and effective response to said Eligible Crisis or Emergency. The Project consists of the Original Project as scaled up below: 1. Performance-based Payments to Support the Recipient's FHC Program Provision of performance-based subsidies (Performance-Based Payments) to support the Recipient's Free Health Care Program through, inter alia: (a) support for the provision of the Package of Health Services through the payment of Performance-Based Payments to selected public and private health facilities and non-profit health providers; (b) suppoil for the provision of a predefined set of activities including health promotion and prevention services, referral services to health centers and community-based distribution of health-related inputs through the payment of Performance-Based Payments to select community health worker associations; (c) Support for the administration and verification of results-based financing claims related to the Package of Health Services through the provision of Performance-Based Payments to applicable Recipient's departments or units tasked with said claims administration and verification activities; and (d) provision of Performance-Based Payments to: (i) strengthen the capacity of strategic programs within the Ministry of Health to manage the public health sector including the enhanced functioning of health facilities; and (ii) improve the quality of nursing training at nursing schools. 2. Implementation Support for FHC Program-related Activities Supporting the Free Health Care Program-Related Activities through. iner alia: -5- (a) implementation of Project-related counter verifications and third-party verification activities under Part I of the Project and provision of relevant supplies for verification activities under Part 1(c) of the Project; (b) Project management and coordination for the Project through support to Ministry of Health and the RBF National Technical Unit, including monitoring and evaluation, procurement, financial management, social and environmental safeguards, audits and ad hoc surveys, and (c) (i) design and implementation of a program of activities, including inter alia, capacity building of community-based organizations, training of health workers, and outreach and awareness-raising campaigns for the purpose of increasing demand, including access by vulnerable groups, to the health care services referred to under Parts 1(a) and (b) of the Project and stimulating positive health-related behavioral change; and (ii) construction of Montfort-type incinerators on the grounds of pre- identified hospitals within the Recipient's territory to improve biomedical waste management. 3. Strengthening the Newly Integrated FHC Program Service Providers Strengthening of newly integrated Free Health Care Program service providers consisting of, inler alia: (a) provision of support to nursing training schools through the provision of technical equipment, computers, training software, library supplies, and implementation of minor works; (b) provision of relevant supplies to community health workers, including bicycles, umbrellas, boots, medicines boxes, gears, hats and white coats. (c) carrying out renovations in selected nursing schools to improve the quality of nurses' Training: (d) strengthening the quality, efficiency, diagnostic and surveillance capacity for diseases and other endemo-epidemics, through the purchase of equipment, reagents, and support to accreditation, quality with a gradual process for improving laboratories towards accreditation-SLIPTA; and (e) Supporting Gender Based Violence (GBV) activities, through inter alia: screening and managing GBV survivors at facility level, provision of PEP kits, waiving transport fees for said survivors, provision of capacity building for health staff and CHW in screening and managing GBV survivors, provision of basic equipment to manage GBV cases, carrying -6- out communication and GBV awareness at community level, as well as survivors reintegration activities. 4. Contingent Emergency Response Support Providing immediate response to an Eligible Crisis or Emergency, as needed. -7- SCHEDULE 2 Project Execution Section L Implementation Arrangements A. Institutional Arrangements Ministry qf Health I The Ministry of Health shall be responsible for overall Project implementation and management in accordance with the following institutional arrangements: Department of Health Services 2. The Department of Health Services shall be responsible for coordinating the day- to-day implementation of the Project, with the Department of Resources Management as the deputy coordinating unit. Department qf Resources Management 3. (a) The Department of Resources Management shall be responsible for the administrative and financial management, procurement, and disbursement of the Project, and, to this end, the Recipient shall maintain in said Department of Resources Management, throughout Project implementation, competent personnel in adequate numbers, particularly in the areas of financial management and procurement, all as satisfactory to the Association. (b) Without limitation upon the provisions of the preceding paragraph 3(a) and in furtherance of the obligations thereof, the Recipient shall no later than three (3) months after the Effective Date, recruit and thereafter maintain throughout Project implementation, a Laboratories expert, a GBV expert and a Health Economist; all with qualifications, experience and terms of reference satisfactory to the Association. The Department qf'Planning 4. The Department of Planning shall be responsible for: (a) monitoring and evaluation under the Project; and (b) co-implementation with the RBF National Technical Unit of all activities pertaining to RBF payments to the National Health Information System and, to this end, the Recipient shall maintain in said Department of Planning, throughout Project implementation, competent personnel in adequate numbers, all as satisfactory to the Association. B. Project Implementation Manual I. The Recipient shall update and adopt the Project Implementation Manual in a manner acceptable to the Association ("Project Implementation Manual" or "PIM"), which shall contain detailed (i) technical, administrative, procurement, disbursement, accounting, financial management matters, environmental and social standards, and monitoring and evaluation arrangements; (ii) sample formats for annual reports; (iii) detailed coordination mechanisms on cross-sectoral collaboration with ministries in charge of health and education; (iv) mechanisms for the Recipient to ensure that any Project activities, including any construction activities, involving irrigation will be limited to the rehabilitation and/or renovation of existing irrigation schemes or installations and that no new irrigation investments or other investments in new infrastructure/works involving the use or potential pollution of international waterways will be financed under the Project, and satisfactory to the Association. 2. The Recipient shall carry out the Project in accordance with the Project Implementation Manual, and shall not assign, amend, abrogate, or waive, or permit to be assigned, amended, abrogated, or waived, the aforementioned manual, or any provision thereof, without the prior written agreement of the Association. 3. Notwithstanding the foregoing, in the event of any inconsistency between the provisions of the Project Implementation Manual and those of this Agreement, the provisions of this Agreement shall prevail. C. Results-Based Payments 1 . General Without prejudice to the provisions of Section L.A of this Schedule, the Department of Health Resources, within MOH, shall review and approve, on behalf of the Recipient, applications for Results-Based Payments, in accordance with the provisions of this Part C and the Results-Based Financing Procedures Manual. 2. Results-Based Payments Eligibility and Free Health Care Program-Related Activities Implementation Guidelines and Procedures No proposed Beneficiary shall be eligible for financing under Part I of the Project unless, on the basis of a review conducted in accordance with this Part C and the Results-Based Financing Procedures Manual, the proposed Beneficiary is deemed to satisfy the eligibility criteria specified below and in further detail in the Results- Based Financing Procedures Manual, which shall include the following: -9- (a) the proposed Beneficiary is a service provider carrying out Free Health Care Program-Related Activities or a unit within the Ministry of Health involved in Package of Health Services-related claims administration or verification, all under Part I of the Project; (b) the proposed activities satisfy the requirements of Part I of the Project as described in further detail in the Results-Based Financing Procedures Manual; (c) the proposed activities comply with the Safeguard Instruments; (d) the proposed Beneficiary has put in place all necessary arrangements, including financial and human resources, for the management of the proposed activities. 3. Terms and Conditions of Results-Based Payments Agreements (a) The activities referred to in paragraph LC.2 above shall be carried out pursuant to a results-based payments agreement ("Results- Based Payments Agreement"), to be concluded between the Department of Health Services on behalf of the Recipient and the respective Beneficiary, under terms and conditions, satisfactory to the Association, as further described in the Results-Based Financing Procedures Manual, which shall include the following: (i) a description of the activities, the applicable rates, and applicable performance indicators; (ii) the obligation of the Beneficiary to: (A) carry out said activities with due diligence and efficiency and in accordance with sound technical, financial, administrative, and environmental and social standards and practices satisfactory to the Association; (B) ensure that the resources required for the activities are, provided promptly as needed; (C) maintain adequate records to reflect, in accordance with sound accounting practices, the resources, operations, and expenditures relating to said activities; and (D) at the request of the Association or the Recipient, have such records audited by independent auditors acceptable to the Association, in accordance with consistently applied auditing standards acceptable to the Association, and promptly furnish the records as so audited to the Recipient and the Association; -10- (iii) the obligation of the Beneficiary to carry out said activities in accordance with the provisions of the Anti-Corruption Guidelines applicable to recipients of Grant proceeds other than the Recipient- (iv) the obligation of the Beneficiary to carry out said activities in accordance with the provisions of the Project Implementation Manual and the Results-Based Financing Procedures Manual; (v) the obligation of the Beneficiary to carry out said activities in accordance with the provisions of the Safeguard Instruments; (vi) the requirement that the minor works, goods and consultants' services to be financed from the proceeds of the Results-Based Payment shall be procured in accordance with procedures ensuring efficiency and economy as further detailed in Section III of this Schedule, and shall be used exclusively in the carrying out of said activities; and (vii) the right of the Recipient to: (A) inspect by itself, or jointly with the Association, if the Association shall so request, the applicable goods, and sites financed by the Financing, the operations thereof, and any relevant records and documents; (B) obtain all information as it, or the Association, shall reasonably request regarding the administration, operation, and financial condition of said activities; and (C) suspend or terminate the right of the Beneficiary to use the proceeds of the Results- Based Payment, or obtain a refund of all or any part of the amount of the Results-Based Payment then withdrawn, as the case may be, upon failure by the Beneficiary to perform any of its obligations under the Results-Based Payments Agreement. (b) The Recipient shall exercise its rights and carry out its obligations under the Results-Based Payments Agreement in such manner as to protect its interests and those of the Association and to accomplish the purposes of the Results-Based Payment, and, except as the Association shall otherwise agree, the Recipient shall not assign, amend, abrogate, or waive, or permit to be ass igned, amended, abrogated, or waived, the aforementioned, or any provision thereof. -11- 4. External Controls (a) The Recipient shall maintain, throughout Project implementation, external auditors, with qualifications, experience, and terms of reference satisfactory to the Association, for purposes of the third-party verification of Package of Health Services and all Free Health Care Program-Related Activities to be carried out under Part 2 (a) of the Project. (b) The Recipient shall cause said auditors to carry out, throughout Project implementation, quarterly verification exercises of Package of Health Services and Free Health Care Program-Related Activities, including community and focus group surveys, Beneficiary spot checks, verification of data provided and records kept by Beneficiaries in relation to said activities, and assessments of the quality of health services provided under Part 1(a) and 1(b) and, in accordance with the provisions of the Results- Based Financing Procedures Manual. D. Annual Work Program 1 . The Recipient shall, not later than June 15 in each calendar year during Project implementation. prepare and furnish to the Association, a program of Project activities proposed for implementation in the following calendar year, including: (a) a detailed timetable for the sequencing and implementation of said activities; and (b) the types of expenditures required for such activities, a proposed financing plan and a budget ("Annual Work Program"). 2. The Recipient shall exchange views with and seek approval of the Association on each such proposed annual work program, and shall thereafter ensure that the Recipient carries out such program of activities of the Project for such following year as shall have been agreed between the Recipient and the Association 3. Only those activities which are included in an Annual Work Program shall be implemented. Notwithstanding the foregoing, the Annual Work Program might be amended from time to time to include new activities with the prior and written concurrence of the Association. E. Safeguards 1I The Recipient shall implement the Project in accordance with the relevant Safeguards Instruments, and shall, to that end, if any activity under the Project would require the adoption of an ESMP or IPP in accordance with the ESMF or IPPF respectively: -12- (a) prepare: (A) such ESMP or IPP in accordance with the ESMF or IPPF respectively; (B) furnish such ESMP or IPP to the Association for review and approval; and (C) thereafter adopt and disclose such JPP prior to implementation of the activity: and (b) thereafter take such measures as shall be necessary or appropriate to ensure full compliance with the requirements of such ESMP or IPP; and 2. Without limitation upon its other reporting obligations under this Agreement, the Recipient shall. for each Safeguard Instrument, regularly collect, compile and furnish to the Association reports in form and substance satisfactory to the Association, on the status of compliance with each Safeguard Instrument, as part of the Project Reports, giving details of: (a) measures taken in furtherance of such Safeguard Instrument; (b) conditions, if any, which interfere or threaten to interfere with the smooth implementation of such Safeguard Instrument; and (c) remedial measures taken or required to be taken to address such conditions. 3. In the event that any provision of the Safeguards Instruments shall conflict with any provision under this Agreement, the provisions ofthis Agreement shall prevail. 4. The Department of Health Services shall be responsible for the implementation and monitoring and evaluation of said Safeguard Instruments. 5. To this end, and for purposes of capacity building of said Department of Health Services in this regard, the Recipient shall maintain, throughout Project implementation., in said Department of Health Services an environmental and social specialist, with qualifications, experience, and terms of reference satisfactory to the Association. F. Contingent Emergency Response Arrangements for Part 4 of the Project 1. In order to ensure the proper implementation of Part 4 of the Project ("CERC Part"), the Recipient shall: (a) prepare and adopt in form and substance acceptable to the Association, an operations manual (CERC Operations Manual) which shall set forth detailed implementation arrangements for the CERC Part, including: (i) any additional institutional structures or arrangements for coordinating and implementing the CERC Part; (ii) specific activities which may be included in the CERC Part, Eligible Expenditures required therefor ("Emergency Expenditures"), and any procedures for such inclusion; (iii) -13- financial management arrangements for the CERC Part; (iv) procurement methods and procedures for the CERC Part; (v) documentation required for withdrawals of Grant amounts to finance Emergency Expenditures; (vi) environmental and social safeguard management frameworks for the CERC Part, consistent with the Association's policies on the matter; and (vii)a template Emergency Action Plan; (b) prepare and adopt the Emergency Action Plan in form and substance acceptable to the Association; (c) ensure that the CERC Part is carried out in accordance with the CERC Operations Manual and the Emergency Action Plan; provided, however, that in the event of any inconsistency between the provisions of the CERC Operations Manual or the Emergency Action Plan and this Agreement, the provisions of this Agreement shall prevail; and (d) not amend, suspend, abrogate, repeal or waive any provision of the CERC Operations Manual or the Emergency Action Plan without prior approval by the Association. 2. The Recipient shall ensure that the structures and arrangements referred to in the CERC Manual are maintained throughout the implementation of the CERC Part, with adequate staff and resources satisfactory to the Association. 3. The Recipient shall ensure that: (a) the safeguards instruments required for the CERC Part are prepared, disclosed and adopted in accordance with the CERC Operations Manual, and in form and substance acceptable to the Association; and (b) the CERC Pail is implemented in accordance with the environmental and social instruments in a manner acceptable to the Association. 4. Activities under the CERC Part shall be undertaken only after an Eligible Crisis or Emergency has occurred. Section II. Project Monitoring, Reporting and Evaluation The Recipient shall furnish to the Association each Project Report not later than ninety (90) days after the end of each calendar semester, covering the calendar semester. -14- Section 111. Withdrawal of the Proceeds of the FinancinE A. General Without limitation upon the provisions of Article I of the General Conditions and in accordance with the Disbursement and Financial Information Letter, the Recipient may withdraw the proceeds of the Grant to finance Eligible Expenditures; in the amount allocated and, if applicable, up to the percentage set forth against each Category of the following table: Percentage of Amount of the Expenditures to Grant Allocated be Financed Category (expressed in SDR) Inclusive of taxes (1) Result Based Payments under Part 1 26,100,000 92% of the Project. (2) Goods, works, non-consulting 8,700,000 92% services, Training, consulting services, and Operating Costs under the Project (3) Emergency Expenditures under Part 4 0 100% of the Project. TOTAL AMOUNT 34,800,000 B. Withdrawal Conditions; Withdrawal Period 1. Notwithstanding the provisions of Part A above, no withdrawal shall be made for payments: (a) made prior to the Signature Date, or (b) under Category (3), unless and until the Association is satisfied, and has notified the Recipient of its satisfaction, that all of the following conditions have been met in respect of said activities: (i) (A) the Recipient has determined that an Eligible Crisis or Emergency has occurred, has furnished to the Association a request to withdraw Grant amounts under Category (3); and (B) the Association has agreed with such determination, accepted said request and notified the Recipient thereof; and -15- (ii) the Recipient has adopted the CERC Manual and Emergency Action Plan, in form and substance acceptable to the Association. 2. The Closing Date is June 30, 2023. Section IV. Other Undertaldn2s The Recipient shall, throughout Project implementation, set forth measures to ensure post-Project sutainability of the Package of Health Services in accordance with the guidance provided in the Results-Based Financing Procedures Manual. -16- APPENDIX Section 1. Definitions 1 "Annual Work Program" means an annual work program, including proposed budget, referred to in Section J.D of Schedule 2 to this Agreement, as the same may be amended with the written agreement by the Association. 2. "Anti-Corruption Guidelines" means, for purposes of paragraph 5 of the Appendix to the General Conditions, the "Guidelines on Preventing and Combating Fraud and Corruption in Projects Financed by IBRD Loans and IDA Credits and Grants", dated October 15, 2006 and revised in January 2011 and as of July 1, 2016. 3. "Beneficiary" means an entity to which or for whose benefit a Results-Based Payment is made or proposed to be made and which is a party to a Results-Based Payments Agreement and which includes health facilities; community health workers; nursing schools; public health programs; regulatory bodies and implementation departments. 4. "Budget Law" means the Recipient's annual Loi de Finance approved by its legislature and promulgated by the president in accordance with the Recipient's budget approval rules and regulations, 5. "Category" means a category set forth in the table in Section Il1.A of Schedule 2 to this Agreement. 6. "CERC Operations Manual" means the operations manual referred to in Section J.F.I(a) of Schedule 2 to this Agreement, to be adopted by the Recipient for the CERC Part of the Project in accordance with the provisions of said Section, as said manual may be revised from time to time with the prior written agreement of the Association, and such term includes any annexes or schedules to such manual. 7. "CERC Part" mean Part 4 of the Project. 8. "Department of Heallh Services" means the Recipient's entity, under the supervisory authority of the Recipient's Ministry of Health, responsible for health servites. 9. "Department of Planning" means the Recipient's entity. under the supervisory authority of the Recipient's Ministry of Health, responsible for overall planning as well as monitoring and evaluation activities. 10. "Department of Resources Management" means the Recipient's entity. under the supervisory authority of the Recipient's Ministry of Health, responsible for resource management for said Ministry. -17- If. "Eligible Crisis or Emergency" means an event that has caused, or is likely to imminently cause, a major adverse economic and/or social impact to the Recipient, associated with a natural or man-made crisis or disaster. 12. "Emergency Expenditure" means any of the Eligible Expenditures set forth in the CERC Operations Manual in accordance with the provisions of Section .F.1 (a)(ii) of Schedule 2 to this Agreement and required for the activities included in the CERC Part of the Project. 13. "Environmental and Social Management Framework" or "ESMF" means the framework disclosed in the Recipient's territory on December 13, 2016 and at the Association's external website on December 14, 2016, and updated and published on December 22, 2020, in form and substance satisfactory to the Association, outlining environmental and social implementation procedures. mitigation measures and monitoring procedures for the Project, including the management of medical waste, as said framework may be amended from time to time with the Association's prior written approval. 14. "Environmental and Social Management Plan" and "ESMP" mean a plan, approved by the Association for the Project, to be prepared by the Recipient, if as required by the ESMF, outlining specific appropriate mitigation, monitoring and institutional measures designed to mitigate potential adverse environmental and resettlement impacts, offset them, reduce them to acceptable levels or enhance positive impacts, as the same may be amended from time to time with the agreement of the Association. 15. "Fiscal Year" means the Recipient's fiscal year as determined by the Budget Law. 16. "Free Health Care Program" means the Recipient's national free health care program defined in the Presidential Decree on the Free Health Care Policy. 17. "Free Health Care Program-Related Activities" means the activities relating to supporting and promoting the effective provision of the Package of Health Service, including activities detailed in Parts 1(b), 1(c) and 1(d) of the Project and in support of which a Results-Based Payment is made or proposed to be made. 18. "General Conditions" means the "International Development Association General Conditions for IDA Financing, Investment Project Financing", dated December 14, 2018 (revised on August 1, 2020). 19. "Health Centers" means the Recipient's health centers referred in the Presidential Decree on the Free Health Care Policy. -18- 20. "Indigenous Peoples Plan" or "IPP" means the plans to be prepared by the Recipient on the basis of the IPPF (as hereinafter defined), defining specific measures to be implemented for indigenous minorities in order to protect them and to ensure that members of said minorities be granted equal legal. financial and organizational opportunities under the Project, as the said plan may be amended and/or supplemented from time to time with the prior written consent of the Association, and such term includes any schedules to such document. 21. "Indigenous Peoples Planning Framework" or "IPPF" means the Recipient's framework, disclosed in country on December 13, 2016 and at the Association's external website on December 14, 2016 and updated and published on December 22, 2020, outlining measures to ensure culturally appropriate social and economic benefits for very vulnerable peoples, including the Batwa under the Project and avoidance, minimization, or mitigation of or compensation for any potential adverse effects on them associated with activities to be implemented under the Project, as shall have been agreed with the Association for purposes of Project implementation, as the same may be updated from time to time with the prior written agreement of the Association, and such term includes any annexes or schedules to said plan. 22. "Ministry of Health" means the Recipients ministry responsible for health, and any successor thereto. 23. "Medical Waste, Management Plan" or "MWMP" means the Recipient's plan, disclosed in country on December 13, 2016 and at the Association's external website on December 14, 2016, setting out the measures to be taken for the development and implementation of biomedical waste management and safe handling of said waste, as the same may be modified from time to time with the prior written agreement of the Association, and such term includes any annexes or schedules to said plan. 24. "National Health Information System" means the national information program managed by the Ministry of Health, consisting of interrelated procedures organized to generate health information and intelligence that is used to monitor the Recipient's health sector status and services. 25. "Operating Costs" means the incremental'operating costs under the Project, based on the Annual Work Program approved by the Association, and incurred by the Ministry of Health, on account of utilities and supplies, bank charges, communications, vehicle operation, maintenance, and insurance, office space rental, building and equipment maintenance, public awareness-related media expenses, travel and supervision, and salaries of contractual and temporary staff, but excluding salaries, fees, honoraria, and bonuses of members of the Recipient's civil service. -19- 26. "Original Project" means the original financing for the KIRA Project signed on March 23, 2016, (Grant number Dl66-BI), and its first additional financing signed on June 17, 2019, (Grant Number TFOB0539). 27. "Package of Health Services" means the Recipient's free package of health services, referred to under Part I (a) of the Project. procured in accordance with Section IIl of Schedule 2 to this Agreement, packaged as a minimum package of activities (MPA) or complementary package of activities (CPA) and comprising preventive and curative services, including primary health care and preventive services for pregnant women, delivery and post-partum care, care for children under the age of five, adolescents and couples of reproductive age. 28, "Presidential Decree on the Free Health Care Policy" means the Recipient's Decret no. 100/38 du 16 Mars 2010 Poutant Revision de Subvention des Soins aux Enfants de Moins de 5 Ans et des Accouchements dans les Structures de Soins Publiques el Asshnilees, as the same may be updated from time to time. 29. "Procurement Regulations" means, for purposes of paragraph 87 of the Appendix to the General Conditions, the "World Bank Procurement Regulations for IPF Borrowers", dated November 2020. 30. "Project Implementation Manual" means the manual referred to in Section LB of Schedule 2 to this Agreement, as the same may be revised from time to time with the prior written consent of the Association. 31. "RBF" means Results-Based Financing. 32. "RBF National Technical Unit" means a unit within the Department of Health Services responsible for coordinating the RBF program. 33, "Results-Based Financing Procedures Manual" (Manuel des Procidures relatives au Financement Basd sur les Resultats) means the manual, dated September 2011 and as updated as of the date of this Agreement and referred to in Section I.C.] of Schedule 2 to this Agreement, as the same may be further revised from time to time with the prior written agreement of the Association, and such term includes any schedules to said manual. 34. "Results-Based Payment" means a payment made or proposed to be made out of the proceeds of the Grant to finance the activities provided for under Part I of Schedule 1 of this Agreement. 35. "Results-Based Payments Agreement" means an agreement between the Recipient, represented by the Department of Health Services, and a Beneficiary, setting forth the terms and conditions governing Results-Based Payments. -20- 36. "Safeguards Instruments" means the ESMF, IPPF, MWMP, ESMP and any [PP prepared in accordance with the IPPF and Safeguards Instrument means each and any of the Safeguards Instruments. 37. "Signature Date" means the later of the two dates on which the Recipient and the Association signed this Agreement and such definition applies to all references to "the date of the Financing Agreement" in the General Conditions. 38. "Training" means the costs of training under the Project, based on the Annual Work Program approved by the Association, and attributable to seminars, workshops, and study tours, along with travel and subsistence allowances for training participants, services of trainers, rental of training facilities, preparation and reproduction of training materials, and other activities