The World Bank Rwanda COVID-19 Emergency Response Project (P173855) REPORT NO.: RES55576 RESTRUCTURING PAPER ON A PROPOSED PROJECT RESTRUCTURING OF RWANDA COVID-19 EMERGENCY RESPONSE PROJECT APPROVED ON APRIL 7, 2020 TO REPUBLIC OF RWANDA HEALTH, NUTRITION & POPULATION EASTERN AND SOUTHERN AFRICA Regional Vice President: Victoria Kwakwa Country Director: Keith E. Hansen Regional Director: Daniel Dulizky Practice Manager/Manager: Francisca Ayodeji Akala Task Team Leader(s): Amparo Elena Gordillo-Tobar The World Bank Rwanda COVID-19 Emergency Response Project (P173855) ABBREVIATIONS AND ACRONYMS AF Additional Financing CERC Contingency Emergency Respond Component COVID-19 Coronavirus Disease IDA International Development Association MoH Ministry of Health PDO Project Development Objective RBC Rwanda Biomedical Center TF Trust Fund The World Bank Rwanda COVID-19 Emergency Response Project (P173855) BASIC DATA Product Information Project ID Financing Instrument P173855 Investment Project Financing Environmental and Social Risk Classification (ESRC) Substantial Approval Date Current Closing Date 07-Apr-2020 30-Jun-2025 Organizations Borrower Responsible Agency Republic of Rwanda Multiphase Programmatic Approach (MPA) Program Development Objective The Program Development Objective is to prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness Multiphase Programmatic Approach (MPA) Status (Public Disclosure) Status and Key Decisions (Public Disclosure) COVID-19 MPA: Sustained efforts continue to be made to advance the implementation of the 87 MPA operations. As reported in the past months, the overall level of disbursements is being affected by three main reasons: (i) low disbursements in six countries (Bangladesh, Kiribati, Nigeria, Samoa, Solomon Islands, and Zambia); (ii) pausing of disbursements in two countries – Afghanistan, and Myanmar; and (iii) processing of refunds to the project accounts, which in the past weeks have increased at this late stage of project implementation. In addition, (i) a large refund from the UN to the project account of the Myanmar operation was processed in March 2023 due to the inability to implement the project, and (ii) the amounts of Loans and Credits denominated in SDRs, and Euros have been affected because of fluctuations between the SDRs and Euros The World Bank Rwanda COVID-19 Emergency Response Project (P173855) against the US dollar. During the past week, a second large refund was processed under the Trinidad and Tobago operation because of savings realized for medical supplies and medicines procured through PAHO. As of March 18, 2024, 88 MPA-projects had been approved with a total commitment of US$4.25 billion. One operation (Guatemala) was cancelled in mid-September 2021. Total disbursements as of March 18, 2024, amount to US$3.98 billion or 94% of overall commitments. This amount does not include disbursements under MPA-V operations which are reported together with AF-V operations or disbursements under PEF grants as commitments do not include PEF Grants. Closing dates for MPA operations have been as follows: (i) ten operations closed by the end of CY22, (ii) nine operations closed on June 30, 2023, (iii) thirteen operations closed on December 31, 2023. Twenty-eight operations are scheduled to close by June 30, 2024. However, this number is likely to change as extension of closing dates are being processed under some operations. As with the Mid Term Review (MTR) issued on March 25, 2023, no individual ICR will be required for COVID-19 MPA operations. Only one ICR will be prepared upon completion of the SPRP COVID-19 MPA Program, which closes on December 31, 2025. The Global ICR will be based on final ISRs packages prepared by country operations’ teams. A template for the final ISR was issued by OPCS on March 21, 2023. So far, seventeen operations have finalized final ISR packages, and some others are under preparation. The overall conclusion of the MPA MTR was that: (i) the COVID-19 MPA Program embodied a rapid, innovative approach to new lending for human health response; (ii) the COVID-19 MPA has been successful, notwithstanding considerable uncertainty and multiple constraints in the early stages of the pandemic; (iii) the Bank’s emergency response was remarkably swift in the most vulnerable countries facing human capital losses and development setbacks; and (iv) notwithstanding the challenges, the MPA is on track to achieve its PrDO, “prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness.“ Seventy-five (75) country projects or 86 percent of projects approved have reached 70-100+ percent disbursement (reasons for >100% disbursements relate to fluctuations between the Euro and the SDR against the US$). Out of the 75 operations, 66 operations or 87 percent have disbursed 90%+ of commitments. Out of the 75 operations, 52 operations or 69 percent are fully disbursed, and 8 operations have disbursed 95-99 percent of commitments. There are six operations with disbursements of 65 percent or less. Out of these four operations, one operation has disbursed 35 percent (AFW), two operations in EAP have disbursed 48-62 percent and one operation in SAR has disbursed 53 percent. The operation in AFW has been restructured in the past two weeks to: (i) extend the closing date by four months, (ii) cancel a large amount under the parent project, (iii) reallocate funds under components and activities, and (iv) revise the Results Framework. The projects are benefitting about 3.7 billion people or 50% of the global population. When countries with AF-V operations are counted, the projects are benefitting about 4.1 billion of 51 percent of the global population. This is because some countries that do not have a parent project have AF-V operations. All projects approved are disbursing. Operations in ECA and MNA are fully disbursed. In other regions, disbursements have reached: (i) SAR 96 percent, (ii) LAC 94 percent, (iii) EAP 88 percent, (iv) AFW 85 percent, and (v) AFE 82 percent. Disbursements for EAP operations are being affected by low disbursements in three The World Bank Rwanda COVID-19 Emergency Response Project (P173855) country projects that have disbursed between 48 and 62 percent. AFE lower disbursements compared to other regions are a result of low disbursements under one operation, which has disbursed 63 percent. In the case of AFW low overall disbursements are a result of low disbursements under one operation (35 percent). Retroactive Financing (RF) represents 20 percent of commitments. SAR has the highest percentage of RF at 37 percent, followed by ECA at 18 percent. Direct Payment (DP) disbursements represent 22 percent of commitments. EAP has the highest level of disbursements using DP – 80 percent, followed by AFW at 38 percent. IDA continues to represent 40 percent while IBRD represents 60 percent of disbursements. Streamlined procedures, delegated approvals, coupled with flexible project design and intensified efforts by counterparts and Bank teams have contributed to the progress. Implementation is being guided by Bank teams working in parallel with other health related projects, including Additional Financing operations which have supported vaccine procurement and deployment efforts. COVID-19 MPA AF: Considerable progress is being made in the implementation of AF-V operations. As of March 18, 2024, the Bank has approved 117 operations (including MPA-V operations) to support vaccine procurement and rollout in 78 countries amounting to $8.54 billion. Four operations have been approved in the past months including: (i) Senegal AF2 operation for $15 million financed by a Grant from The Global Finance Facility (GFF) approved on June 30, 2023; (ii) a Second AF (IDA Grant of $2.50 million) approved on August 31, 2023 for Sao Tome and Principe, (iii) a Grant of $3.94 approved for Chad on July 23, 2023; and (iv) Zimbabwe AF2 operation for $15 million financed by a Grant from the GFF approved on December 7, 2023. One hundred and twenty-one (121) operations had been approved amounting to $10 billion, but with cancellation of four operations and partial cancellations processed in the past months under several operations, commitments today amount to $8.54 billion. The four operations cancelled are: (i) Costa Rica loan ($120 million), (ii) Peru loan ($500 million), (iii) Gabon loan ($12 million), which loan agreement lapsed, and (iv) Philippines AF2 loan of $300 million. The Afghanistan operation commitment of $113 million was reduced to $60 million. Of the 117 approved operations: (i) 67 are in Africa – 32 in AFE and 35 in AFW; (ii) 10 in East Asia and the Pacific; (iii) 11 in Europe and Central Asia; (iv) 11 in Latin America and the Caribbean; (v) 9 in Middle East and North Africa; and (vi) 9 in South Asia. The 117 operations approved, include 6 operations that involved restructuring of parent projects (Bhutan, Cameroon, North Macedonia, Philippines, and Pakistan) and in the case of Lebanon, restructuring of the Health Resilience Project. Partial cancellations have been/are being processed under several operations -- Afghanistan, Bangladesh, Belarus, Benin, Cabo Verde, Cameroon, Ethiopia, Gabon, Georgia, Lao, Madagascar, Mali, Mozambique, Nepal, Nigeria, Pakistan, Philippines, Papua New Guinea, Sierra Leone, South Africa, Sudan, Republic of Congo AF2, and Togo. Thirty-two (32) operations are being implemented in Fragile and Conflict-affected situations. IDA represents 45 percent and IBRD 55 percent of disbursements. Total disbursements under these projects as of March 18, 2024, amount to US$6.60 billion or 77 percent of overall commitments. Disbursements under MPA-V operations are included in this total while disbursements under the six restructured projects are counted under parent projects. With less than planned demand for IDA/IBRD funds for vaccine procurement because, inter alia, over supply of vaccines from donations from various sources, several projects have The World Bank Rwanda COVID-19 Emergency Response Project (P173855) been/are being restructured and more will need to be restructured to reallocate funds or partially cancel funds allocated to procurement of COVID-19 vaccines and deployment. Guidance was issued under an Email from Juan Pablo Uribe of July 7, 2023, which provided direction for the use of undisbursed funds under COVID-19 operations. HNP is monitoring implementation of the guidelines. Six (6) operations are fully disbursed (Argentina, El Salvador AF1, Indonesia, Iraq, Sri Lanka AF-V 1, and Ukraine AF-V 3). Sixty-four (64) operations or 55 percent of operations approved have disbursed over 70 percent of their commitments. Out of the 64, twenty-nine (29) operations have disbursed 90+ percent. One hundred and seven (107) operations or 91 percent of total operations approved are disbursing. EAP has the highest percentage of disbursements at 96 percent, followed by ECA at 89 percent, LAC at 88 percent, SAR at 81 percent, MNA at 81 percent, AFE at 67 percent, and AFW at 63 percent. Retroactive Financing (RF) represents 36 percent of overall commitments. ECA has the highest level of RF at 74 percent, followed by SAR at 68 percent, LAC at 59 percent, MNA and AFE at 29 percent and AFW at 13 percent. Disbursements to UN agencies represent 23 percent of overall disbursements, while Direct Payment represents 17 percent of disbursements. As with the COVID-19 MPA operations, streamlined procedures, delegated approval, wide use of Bank Facilitated Procurement (BFP), coupled with flexible project design, and intensified efforts from counterparts and Bank staff have contributed to the rapid design, processing, and implementation of the AF-V operations. OPS_TABLE_PDO_CURRENTPDO Project Development Objective (PDO) Original PDO The objective of the Project is to prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness in the Republic of Rwanda. OPS_TABLE_PDO_CURRENTPDO Summary Status of Financing (US$, Millions) Net Ln/Cr/Tf Approval Signing Effectiveness Closing Commitment Disbursed Undisbursed IDA-70920 31-Mar-2022 07-Apr-2022 06-Jun-2022 30-Jun-2025 16.00 10.79 4.52 IDA-E0220 31-Mar-2022 07-Apr-2022 06-Jun-2022 30-Jun-2025 16.00 12.69 2.54 IDA-68710 16-Apr-2021 22-Apr-2021 21-Jun-2021 30-Jun-2025 15.00 14.84 .05 IDA-D8050 16-Apr-2021 22-Apr-2021 21-Jun-2021 30-Jun-2025 15.00 14.92 .03 IDA-66150 07-Apr-2020 09-Apr-2020 20-Apr-2020 30-Jun-2022 14.25 14.67 .37 TF-B6226 02-Sep-2021 02-Sep-2021 02-Sep-2021 30-Jun-2025 15.00 10.64 4.36 TF-B4324 30-Nov-2020 06-Dec-2020 06-Dec-2020 28-Feb-2021 .93 .93 0 The World Bank Rwanda COVID-19 Emergency Response Project (P173855) Policy Waiver(s) Does this restructuring trigger the need for any policy waiver(s)? No I. PROJECT STATUS AND RATIONALE FOR RESTRUCTURING A. Project Status: 1. The objective of this Restructuring Paper is to seek Regional Vice-President approval for the proposed Level 2 restructuring of the Rwanda COVID-19 Emergency Response Project (ERP; IDA-Credit No. 7092-RW and IDA- Grant No. E022-RW). This restructuring proposal follows the activation of the Contingent Emergency Response Component (CERC) under the Project on January 18, 2024, in response to floods and landslides that occurred in Rwanda in 2023. The Parent Rwanda COVID-19 ERP was approved on April 7, 2020, and became effective on April 20, 2020, with a closing date of June 30, 2025. 2. The Project Development Objective (PDO) is “to prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness in the Republic of Rwanda”. The project has five components: (i) Component 1: Case Detection, Confirmation and Contact Tracing (US$6.84 million) (ii) Component 2: Public Health Measures and Clinical Care Capacity (US$69.25 million) (iii) Component 3: Implementation Management and Monitoring and Evaluation (US$1.1 million) (iv) Component 4: Contingent Emergency Response Component (CERC) (0) (v) Component 5: Protecting Essential Health Services (US$15 million) 3. The project has received three Additional Financings (AFs), resulting in the project’s total support to the Rwanda health sector reaching US$92.18 million. The project has provided crucial support to the response to the COVID- 19 pandemic, as well as strengthening the overall systems for preparedness and response to emergencies in Rwanda. The Parent Project received a first AF (P175252) in the amount of US$0.94 million from the Pandemic Emergency Financing Facility (PEF) Trust Fund, which was approved on November 20, 2023. The PEF resources were fully utilized by January 31, 2021. The PEF resources financed key emergency response activities, including COVID-19 materials and equipment. A second AF (P1763047) in the amount of US$45 million was approved on April 16, 2021, and brought the total financing to US$45 million. This second AF had two sources of funding, a US$30 million grant from IDA and a US$15 million grant from the Global Financing Facility (GFF). The second AF has financed the procurement of COVID-19 vaccines and consumables and played a critical role in further strengthening the resiliency of the health system. Component 5 (“Protecting Essential Health Services”) was added when the project processed the Second AF and introduced the opportunity to respond to the loss of balance in the provision of routine health care, especially to women and children fully funded by a GFF grant. The third AF (P178282) in the amount of US$32 million approved on March 31, 2022, included restructuring of the project to The World Bank Rwanda COVID-19 Emergency Response Project (P173855) extend the closing date from June 20, 2023 to June 30, 20251 and increased the overall cost of the Project to US$92.19. Scaled up activities and new activities were included in Component 2, including purchase and deployment of vaccines and health system strengthening. Among the vaccines to be procured, the Government considered vaccines with authorization for use among children, and the Moderna vaccine as the booster for the general population. Vaccine deployment included the payment of salary for short-term vaccinators, travel cost and per diem for national and district level staff, health facility staff, volunteers and decentralized level personnel involved in the vaccination campaign, as well as community mobilization, sensitization, and educational activities for vaccination update. 4. The most recent Implementation Status and Results Report (ISR, March 2024) rated the Project “satisfactory” on its progress towards the PDO. The Rwanda COVID-19 ERP has been under implementation for over three years with steady progress towards the PDO and disbursements on track (roughly 86 percent of the US$92.18 million disbursed). Both progress on implementation and towards achievement of the PDO are rated as “satisfactory”. Major achievements have been documented under both PDO indicators (each has exceeded its respective targets, with this data already verified by WHO/PAHO), as well as across the 12 intermediate outcome indicators in the Project’s Results Framework. Additionally, significant progress has been recently made in improving quality of care (via advances in hospital waste management and electronic health data management) and in training of health care workers (via advances on the preparation of a National Continuing Education strategy). Out of four PDO indicators, one has surpassed the end line Project target, two have met the target and one is on track to achieve the end line Project target. A total of US$24.85 million has been allocated to the payment of vaccines, which will ensure a coverage of up to 14 percent (about 1.8 million people) of the Rwanda population. In addition to the vaccine procurement, the Project has contributed to the roll out of COVID-19 vaccines and to the implementation of important health measures to curb the spread of the virus, such as risk communication, community engagement, contact tracing, enhanced testing, case management, program coordination, and monitoring. The Project has supported health facilities and health workers response to the pandemic through increased capacity of laboratories for the diagnosis of COVID-19 cases in more sites, both in Kigali and outside Kigali, including mass sample collection sites. Currently, 110 laboratory staff have been trained through the Project to conduct COVID-19 diagnostic testing and the country has 11 public laboratories, offering Polymerase Chain Reaction (PCR) tests. All health centers across the country are offering rapid diagnostic tests for COVID-19. A total of 448 health staff in public hospitals and private clinics as well as 2,825 people from different fields (schools, hotels, religious congregations, banks, etc.) were trained on Infection Prevention and Control (IPC). Moreover, the Project is also supporting case management as well as screening for NCDs. The Project continues to be effectively implemented through an experienced implementation unit which has a solid track record working with the World Bank and there are no outstanding audits. 5. CERC Activation. On August 3, 2023, the Government of Rwanda submitted a request to activate the CERC by reallocating US$15 million to respond to the flood and landslide disaster that occurred in different locations of the Southern, Western and Northern Provinces in May 2023. The CERC activation process was completed on January 18, 2024. The process was slightly delayed due to the need to resolve pending land acquisition and re- allocation issues. In the meantime, the verification of the project records indicated that the available balance for reallocation is US$9 million (EUR 6,144,237.71 which equal US$ 5,591,256.32 in IDA-Credit No. 7092-RW as of exchange rate of 08/03/2023 date of Borrower request date and SDR 4,208,689.72 which equal US$ 3,156,517,29 1The extension of the closing date was required to allow for sufficient time to implement the activities related to immunization considering global supply-side constraints resulting in longer procurement and delivery timelines and the complexity of rolling out nationwide vaccination. The World Bank Rwanda COVID-19 Emergency Response Project (P173855) in IDA-Grant No. E022-RW as of exchange rate of 08/03/2023 date of Borrower request date). The implementing agency RBC has confirmed that US$9 million will be used for CERC and shared the CERC Emergency Action Plan reflecting this amount. The resources allocated to CERC (Category 2 for disbursement) are to be reassigned from Category 1 of Component 2 (Public Health Measures and Clinical Care Capacity) of the Project. The World Bank, RBC and MINEMA teams have visited sites in Rubavu, Nyabihu and Gakenke Districts where works of rehabilitation and construction of houses for the affected families will be undertaken. The January 2024 implementation support mission for the project observed the sites and assessed no challenges with the proposed plans. B. Rationale for Restructuring: 6. The main rationale for the proposed restructuring is two-fold. First, there is a World Bank requirement for a formal restructuring to be completed after activating CERC. The World Bank Policy guidance provides that this restructuring should be completed within three months of CERC activation. Second, the restructuring responds to the Government’s request to reallocate US$9 million (US$5,591,256.32 from IDA-Credit No. 7092-RW and US$ 3,156,517.29 from IDA-Grant No. E022-RW) from Category 1 of Component 2 (Public Health Measures and Clinical Care Capacity) of the Project to CERC (Category 2 for disbursement) due to the intended funds not being utilized after the Government received the donation of the COVID-19 vaccines. II. DESCRIPTION OF PROPOSED CHANGES 7. Changes in the Project’s Development Objective (PDO)s: With the CERC activation in January 2024, the PDO will be modified as follows: “to (1) to prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness in the Republic of Rwanda, and (2) provide immediate and effective response in the case of an eligible crisis or emergency”. 8. Change in the Project’s Results Framework: CERC activation also requires corresponding updates to the project’s Results Framework (RF). To this end, the end target values for the following PDO level indicators are being revised. These indicators are: (i) “Percentage of the population fully vaccinated which is included in the priority population targets as defined in the national plan disaggregated by sex, age group and location”, and (ii) “Number of doses of COVID-19 vaccine procured with Project funding”. A detailed description of the changes made to the RF is provided in Section IV below. 9. Changes in Components and Costs: While the components remain the same, the following change is being proposed in the allocation of project funds: reallocation of US$9 million from Component 2, funded through the IDA-Credit No. 7092-RW and Grant No. E022-RW, to Component 4 under the same Credit and Grant. Table 1 below summarizes the revised project costs: Table 1: Proposed Reallocation of Funds Across Components Component Original Cost Revised Cost at (US$M) CERC Activation (US$M) The World Bank Rwanda COVID-19 Emergency Response Project (P173855) 1- Case Detection, Confirmation and Contact Tracing 6.84 6.84 2- Public Health Measures and Clinical Care Capacity 69.25 60.25 3- Implementation Management and Monitoring and 1.10 1.10 Evaluation 4-CERC 0.0 9.0 5- Protecting Essential Health Services 15.0 15.0 Total 92.18 92.18 10. Reallocation between Disbursement Categories: US$ 5,591,256.32 IDA-Credit No. 7092-RW and US$ 3,156,517.29 IDA-Grant No. E022-RW are being proposed to be reallocated from Category 1 to Category 2 (CERC). Section IV below (‘Detailed Changes’) summarizes the proposed revised category allocations. 11. Procurement. As part of the restructuring, the Project Procurement Strategy for Development (PPSD) has been updated by the Government and revised by the Bank. Additional procurement activities have been added in the revised procurement plan. A summary of the Procurement Plan and the revised PPSD have been included in the final restructuring package. ES NOTE TABLE III. SUMMARY OF CHANGES Changed Not Changed Project's Development Objectives ✔ Results Framework ✔ Reallocation between Disbursement Categories ✔ Implementing Agency ✔ DDO Status ✔ MPA Program Development Objective ✔ MPA Expected Results and Indicators ✔ PBCs ✔ The World Bank Rwanda COVID-19 Emergency Response Project (P173855) Components and Cost ✔ Loan Closing Date(s) ✔ Cancellations Proposed ✔ Disbursements Arrangements ✔ Disbursement Estimates ✔ Overall Risk Rating ✔ Legal Covenants ✔ Institutional Arrangements ✔ Financial Management ✔ Procurement ✔ Implementation Schedule ✔ Other Change(s) ✔ Economic and Financial Analysis ✔ Technical Analysis ✔ Social Analysis ✔ Environmental Analysis ✔ IV. DETAILED CHANGE(S) OPS_DETAILEDCHANGES_PDO_TABLE PROJECT DEVELOPMENT OBJECTIVE Current PDO The objective of the Project is to prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness in the Republic of Rwanda. Proposed New PDO To prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness in the Republic of Rwanda, and provide immediate and effective response in the case of an eligible crisis or emergency MPA PROGRAM DEVELOPMENT OBJECTIVE Current MPA Program Development Objective The Program Development Objective is to prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness The World Bank Rwanda COVID-19 Emergency Response Project (P173855) EXPECTED MPA PROGRAM RESULTS Current Expected MPA Results and their Indicators for the MPA Program Progress towards the achievement of the PDO would be measured by outcome indicators. Individual country-specific projects (or phases) under the MPA Program will identify relevant indicators, including among others: • Country has activated their public health Emergency Operations Centre or a coordination mechanism for COVID-19; • Number of designated laboratories with COVID-19 diagnostic equipment, test kits, and reagents; • Number of acute healthcare facilities with isolation capacity; • Number of suspected cases of COVID-19 reported and investigated per approved protocol; • Number of diagnosed cases treated per approved protocol; • Personal and community non-pharmaceutical interventions adopted by the country (e.g., installation of handwashing facilities, provision of supplies and behavior change campaigns, continuity of water and sanitation service provision in public facilities and households, schools closures, telework and remote meetings, reduce/cancel mass gatherings); • Policies, regulations, guidelines, or other relevant government strategic documents incorporating a multi- sectoral health approach developed/or revised and adopted; • Multi-sectoral operational mechanism for coordinated response to outbreaks by human, animal and wildlife sectors in place; • Coordinated surveillance systems in place in the animal health and public health sectors for zoonotic diseases/pathogens identified as joint priorities; and • Mechanisms for responding to infectious and potential zoonotic diseases established and functional; and • Outbreak/pandemic emergency risk communication plan and activities developed and tested OPS_DETAILEDCHANGES_REALLOCATION _TABLE REALLOCATION BETWEEN DISBURSEMENT CATEGORIES Financing % Current Allocation Actuals + Committed Proposed Allocation (Type Total) Current Proposed IDA-68710-001 | Currency: XDR iLap Category Sequence No: 1 Current Expenditure Category: GDS,WRKS,NCS & CS EXCEPT PT. 5 The World Bank Rwanda COVID-19 Emergency Response Project (P173855) 10,500,000.00 9,855,717.06 10,500,000.00 100.00 iLap Category Sequence No: 2 Current Expenditure Category: Emergency Expnditures 0.00 0.00 0.00 100.00 Total 10,500,000.00 9,855,717.06 10,500,000.00 IDA-70920-001 | Currency: EUR iLap Category Sequence No: 1 Current Expenditure Category: Gds,Wks,Ncs,Cs for the project 14,300,000.00 8,155,762.29 8,155,762.29 100.00 iLap Category Sequence No: 2 Current Expenditure Category: Emergency Expnditures 0.00 0.00 6,144,237.71 100.00 Total 14,300,000.00 8,155,762.29 14,300,000.00 IDA-E0220-001 | Currency: XDR iLap Category Sequence No: 1 Current Expenditure Category: Gds,Wks,Ncs,Cs for the project 11,500,000.00 7,291,310.28 7,291,310.28 100.00 iLap Category Sequence No: 2 Current Expenditure Category: Emergency Expnditures 0.00 0.00 4,208,689.72 100.00 Total 11,500,000.00 7,291,310.28 11,500,000.00 TF-B6226-001 | Currency: USD iLap Category Sequence No: 1 Current Expenditure Category: G,NCS,OC,PERF-BASED PMTS,TR&CS PT.5 15,000,000.00 9,641,681.78 15,000,000.00 100.00 The World Bank Rwanda COVID-19 Emergency Response Project (P173855) Total 15,000,000.00 9,641,681.78 15,000,000.00 . The World Bank Rwanda COVID-19 Emergency Response Project (P173855) . Results framework COUNTRY: Rwanda Rwanda COVID-19 Emergency Response Project Project Development Objectives(s) The objective of the Project is to prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness in the Republic of Rwanda. Project Development Objective Indicators by Objectives/ Outcomes RESULT_FRAME_TBL_PDO Indicator Name PBC Baseline Intermediate Targets End Target 1 Prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems Proportion of suspected cases of COVID-19 reported and investigated based on national 80.00 50.00 100.00 guidelines (Percentage) Action: This indicator has been Revised Number of designated laboratories with COVID-19 1.00 80.00 151.00 diagnostic capacity (Number) Action: This indicator has been Revised Proportion of designated healthcare facilities with 20.00 60.00 100.00 isolation capacity (Percentage) Action: This indicator has been Revised COVID-19 Vaccine Coverage Percentage of population 18 years and above 0.00 30.00 56.00 receiving a booster, which is included in the The World Bank Rwanda COVID-19 Emergency Response Project (P173855) RESULT_FRAME_TBL_PDO Indicator Name PBC Baseline Intermediate Targets End Target 1 population targets defined in the national plan, disaggregated by sex (Percentage) Action: This indicator has been Revised Percentage of the population fully vaccinated which is included in the priority population targets 0.00 50.00 80.00 as defined in the national plan disaggregated by sex, age group and location. (Percentage) Action: This indicator has been Revised Number of doses of COVID-19 vaccine procured 0.00 3,000,000.00 3,600,000.00 with Project funding (Number) Action: This indicator has been Revised PDO Table SPACE Intermediate Results Indicators by Components RESULT_FRAME_TBL_IO Indicator Name PBC Baseline Intermediate Targets End Target 1 Component 1: Case Detection, Confirmation and Contact Tracing Number of laboratory staff trained to conduct 0.00 40.00 50.00 COVID-19 diagnosis (Number) Action: This indicator has been Revised Percentage of grievances documented, processed 0.00 20.00 100.00 and resolved within 30 days (Percentage) Action: This indicator has been Revised The World Bank Rwanda COVID-19 Emergency Response Project (P173855) RESULT_FRAME_TBL_IO Indicator Name PBC Baseline Intermediate Targets End Target 1 Total tests performed by the Government 0.00 1,000,000.00 0.00 facilities, disaggregated by sex (Number) Action: This indicator has been Revised Time response to COVID-19 Proportion of targeted healthcare facilities with clinical capacity for COVID-19 patients 20.00 50.00 100.00 (Percentage) Action: This indicator has been Revised Number of health staff trained in infection 20.00 1,000.00 2,000.00 prevention and control (Number) Action: This indicator has been Revised COVID-19 Vaccine Knowledge, Acceptance, and Safety Number of mass media campaigns on COVID-19 0.00 45.00 90.00 prevention and vaccination (Number) Action: This indicator has been Revised Proportion of serious Adverse events following immunization (AEFI) reported and investigated, by 0.00 95.00 95.00 sex (Percentage) Action: This indicator has been Revised Health System Strengthening Number of people screened for underlying chronic conditions, disaggregated sex and age group 0.00 1,000,000.00 300,000.00 (Number) Action: This indicator has been Revised The World Bank Rwanda COVID-19 Emergency Response Project (P173855) RESULT_FRAME_TBL_IO Indicator Name PBC Baseline Intermediate Targets End Target 1 Percentage of targeted hospitals with functioning 0.00 50.00 100.00 oxygen therapy system (Percentage) Action: This indicator has been Revised Maintaining Essential Health Services during and beyond COVID-19 Number of outpatient consultations, 18,860,619.00 19,238,800.00 19,622,500.00 disaggregated by age and sex (Number) Number of new acceptors of modern 238,392.00 243,160.00 248,023.00 contraception (Number) Number of deliveries conducted within the facility 315,814.00 322,130.00 328,573.00 (Number) Number of pregnant women receiving four 0.00 186,550.00 190,280.00 antenatal care visits (Number) Number of infants receiving Pentavalent 3 vaccine 345,423.00 347,150.00 352,330.00 (Number) IO Table SPACE . The World Bank Rwanda COVID-19 Emergency Response Project (P173855)