The World Bank E-32, Agargaon, Sher-e-Bangla Nagar, Dhaka 1207, Bangladesh Phone: (880-2) 5566-7777, (880) 96-0440-4000 Facsimile: (880-2) 5566-7778, 5566-7779 Abdoulaye Seck Country Director for Bangladesh and Bhutan 20-Jun-2024 ______________ Secretary Md. Shahriar Kader Siddiky Economic Relations Division Ministry of Finance Block 8, Room 3Sher-e-Bangla Nagar Agargaon, Dhaka Dear Secretary Siddiky: Bangladesh - Health Sector Support Project (Grant No. TF0A6941) Amendment to Grant Agreement We refer to the Grant Agreement between the People’s Republic of Bangladesh (“Recipient”) and the International Bank for Reconstruction and Development/International Development Association (“World Bank”), acting as administrator of Bangladesh Health Sector Support Project Multi-Donor Trust Fund (HSSP-MDTF), dated November 05, 2018, as amended (“Grant Agreement”), for the above-mentioned Project (“Project”). We also refer to your letter dated January 01, 2024, regarding restructuring of the Project. We are pleased to inform you that the Association agrees to your request and proposes to amend the Grant Agreement as set forth below: The Disbursement Linked Results set forth in the Annex to Schedule 2 to the Grant Agreement are revised to read as set forth in the Annex to this Amendment Letter. Except as specifically amended in this Amendment Letter, all other terms and conditions of the Grant Agreement shall remain in full force and effect. The World Bank will disclose this Amendment Letter and related information in accordance with the World Bank’s Policy on Access to Information. By countersigning this Amendment Letter, the Recipient consents to disclosure of this Amendment Letter and related information. Please confirm your agreement to this Amendment Letter on behalf of the Recipient by countersigning and dating the form of confirmation set forth below and returning one fully countersigned original of this Amendment Letter to us and retaining one original for your records. Upon receipt by the World Bank of the countersigned original of this Amendment Letter, this Amendment Letter shall become effective as of July 1, 2023. -2- Sincerely, INTERNATIONAL BANK FOR RECONSTRUCTION AND DEVELOPMENT INTERNATIONAL DEVELOPMENT ASSOCIATION Acting as administrator of Bangladesh Health Sector Support Project Multi-Donor Trust Fund By: ________________________ Abdoulaye Seck Country Director for Bangladesh and Bhutan South Asia Region AGREED: PEOPLE’S REPUBLIC OF BANGLADESH By: ____________________________ Authorized Representative Md. Anwar Hossain Name: ____________________________ Additional Secretary Title: ____________________________ 25-Jun-2024 Date: ____________________________ -3- Annex MDTF DLI Table Disbursement-Linked Indicators, Disbursement-Linked Results and Allocated Amounts Applicable to the Project DLR Period FY2018 FY2019 FY2020 FY2021 FY2022 Component 1. Governance and Stewardship DLI 1. Citizen feedback system is strengthened – US$10,002,940 DLRs DLR 1.1 Assessment of DLR 1.2 GRS guidelines DLR 1.3 An annual GRS performance report current GRS is completed are approved (1) for previous calendar year published (2) (1) Allocated DLR 1.1 US$3,000,000 DLR 1.2 US$4,002,940 DLR 1.3 US$3,000,000 (US$1,500,000 per Amounts annual report) DLI 2. Budget planning and allocation are improved – US$20,745,076 DLRs DLR 2.2 Increase in the percentage (%) from FY2016 baseline in repair and maintenance expenditure at the levels of Upazila and below (2) Allocated DLR 2.2 US$20,745,076 (US$30,418 per 1% increase from FY2016 baseline) Amount Component 2. Health, Nutrition and Population Systems Strengthening DLI 3. Financial management system is strengthened – US$14,199,051 DLRs DLR 3.2 MOPA endorses DLR 3.3 MOF concurs to DLR 3.4 MOPA FMAU recruitment rules FMAU recruitment rules approves FMAU (1) (1) recruitment rules (1) Allocated DLR 3.2 US$10,199,051 DLR 3.3 US$2,000,000 DLR 3.4 Amounts US$2,000,000 DLI 4. Asset management is improved – US$2,208,000 DLR DLR 4.2 Number of District Hospitals in which AMS is implemented (2) Allocated DLR 4.2 US2,208,000 (US$92,000 per District Amount Hospital) DLI 5. Procurement process is improved using information technology – US$8,071,365 -4- Disbursement-Linked Indicators, Disbursement-Linked Results and Allocated Amounts Applicable to the Project DLR Period FY2018 FY2019 FY2020 FY2021 FY2022 DLRs DLR 5.1 e-GP is initiated DLR 5.2 National competitive tenders (NCTs) using e-GP as a percentage for procurement by (%) of all specified NCTs issued by MOHFW (2) MOHFW (1) Targets 34% of NCTs 89% of NCTs 80% of NCTs Allocated DLR 5.1 US$1,200,000 DLR 5.2 US$6,871,365 (US$33,849 per 1% of NCTs) Amounts DLR 6. Institutional capacity is developed for procurement and supply management – US$2,500,000 DLRs DLR 6.1 CMSD restructuring proposal is endorsed by MOPA and submitted to MOF (1) Allocated DLR 6.1 US$2,500,000 Amounts DLI 7. Availability of midwives for maternal care is increased – US$17,551,714 DLRs DLR 7.1 At least 2,500 midwife posts are created by MOHFW and recruitment of midwives is underway (1) DLR 7.2 Number of Upazila Health Complexes with at least 2 accredited diploma midwives (2) Allocated DLR 7.1 US$11,370,000 Amounts DLR 7.2 US$6,181,714 (US$10,549 per Upazila Health Complex) DLR 8. Information system is strengthened, including gender-disaggregated data – US$2,204,156 DLR DLR 8.1 Number of Community Clinics providing complete essential data to DHIS2, including gender-disaggregated, reported for the previous CY (2) Allocated DLR 8.1 US$2,204,156 (US$323.19 per 1 Community Clinic) Amount Component 3. Provision of Quality Health, Nutrition and Population Services DLI 9. Post-partum family planning services are improved – US$9,398,660 -5- Disbursement-Linked Indicators, Disbursement-Linked Results and Allocated Amounts Applicable to the Project DLR Period FY2018 FY2019 FY2020 FY2021 FY2022 DLRs DLR 9.2 Reporting and DLR 9.3 Assessment and training guidelines for action plan are completed PPFP services are for expansion of PPFP approved (1) services in targeted health facilities in Sylhet and Chattogram divisions (1) DLR 9.4 Percentage (%) of targeted Public Health Facilities meeting readiness criteria for delivery of PPFP services in Sylhet and Chattogram divisions, reported for the previous CY (2) Allocated DLR 9.2 US$1,500,000 DLR 9.3 US$4,205,885 Amounts DLR 9.4 US$ 3,692,775 (US$47,711 per 1% of targeted facilities) DLI 10. Utilization of maternal health care services is increased – US$4,486,391 DLR DLR 10.1 Number of normal deliveries in Public Health Facilities in Sylhet and DLR 10.2 Number Chattogram divisions (2) of normal deliveries in Public Health Facilities in Sylhet, Chattogram and Barisal divisions (2) Allocated DLR 10.1 US$3,073,428 (US$7.7565 per 1 delivery) DLR 10.2 Amount US$1,412,963 (US$7.7565 per 1 delivery) DLI 11. Emergency obstetric care services are improved – US$6,363,968 DLRs DLR 11.2 Assessment and action plans are approved for development of CEmONC services in targeted District Hospitals in Chattogram and Sylhet (1) DLR 11.3. Number of District Hospitals with capacity to provide CEmONC services in Sylhet and Chattogram divisions, reported for the previous CY (2) -6- Disbursement-Linked Indicators, Disbursement-Linked Results and Allocated Amounts Applicable to the Project DLR Period FY2018 FY2019 FY2020 FY2021 FY2022 Allocated DLR 11.2 US$500,000 Amounts DLR 11.3 US$5,863,968 (US$217,184 per District Hospital) DLI 12. Immunization coverage and equity are enhanced - US$6,264,930 DLR DLR 12.2 Number of districts reaching at least 85% coverage of measles-rubella vaccination among children ages 0-12 months in Sylhet and Chattogram divisions, reported for the previous CY (2) Targets 15 districts 15 districts 12 districts Allocated DLR 12.2 US$6,264,930 (US$149,165 per district) Amount DLI 13. Maternal nutrition services are expanded – US$11,312,488 DLRs DLR 13.2 Reporting and DLR 13.3 Assessment is quality assessment completed of maternal guidelines for maternal nutrition service quality in nutrition services are Sylhet and Chattogram approved (1) divisions (1) DLR 13.4 Percentage (%) of registered pregnant mothers receiving specified maternal nutrition services in Sylhet and Chattogram divisions, reported for the previous CY (2) Allocated DLR 13.2 US$2,400,000 DLR 13.3 US$4,000,000 Amounts DLR 13.4 US$4,912,488 (US$64,638 per 1% of registered pregnant mothers) DLI 14. Infant and child nutrition services are expanded – US$8,426,407 DLRs DLR 14.2 Reporting and DLR 14.3 Assessment is quality assessment completed of child nutrition guidelines for infant and service quality in Sylhet child nutrition services and Chattogram divisions are approved (1) (1) DLR 14.4 Percentage (%) of registered infants and children aged under 2 years receiving specified nutrition services in Sylhet and Chattogram divisions, reported for previous CY (2) DLR 14.2 US$2,400,000 DLR 14.3 US$4,000,000 -7- Disbursement-Linked Indicators, Disbursement-Linked Results and Allocated Amounts Applicable to the Project DLR Period FY2018 FY2019 FY2020 FY2021 FY2022 Allocated DLR 14.4 US$2,026,407 (US$35,551 per 1% of registered infant and children Amounts aged under 2 years) DLR 15. School-based adolescent HNP program is developed and implemented – US$3,040,007 DLRs DLR 15.1 Revised DLR 15.2 Assessment of DLR 15.3 MOHFW teacher training manual is current school-based completes training for approved (1) services in Sylhet and MOHFW’s school- Chattogram divisions is based adolescent HNP jointly completed with the program in at least 50 education sector (1) schools in targeted districts of Sylhet and Chattogram divisions (1) Allocated DLR 15.1 US$1,500,000 DLR 15.2 US$1,000,000 DLR 15.3 US$540,007 Amounts DLR 16. Emerging challenges are addressed – US$4,385,566 DLRs DLR 16.1 Urban Health DLR 16.2 Guidelines for Coordination Committee screening, referral and meets and agrees on treatment of hypertension actions to improve are approved (1) coordination on urban health (1) Allocated DLR 16.1 US$385,566 DLR 16.2 US$4,000,000 Amounts Notes: 1. These are non-scalable DLRs and shall be achieved once only. The timeframe for achievement of these DLR is indicative, but no later than the Closing Date. 2. These are scalable DLRs, and the timeframe for achievement of these DLRs is indicative, but not later than the Closing Date.