CREDIT NUMBER 6497-PG Financing Agreement (Improving Access to and Value from Health Services in PNG: Financing the Frontlines Project) between INDEPENDENT STATE OF PAPUA NEW GUINEA and INTERNATIONAL DEVELOPMENT ASSOCIATION 1 CREDIT NUMBER 6497-PG FINANCING AGREEMENT AGREEMENT dated as of the Signature Date between INDEPENDENT STATE OF PAPUA NEW GUINEA (“Recipient”) and INTERNATIONAL DEVELOPMENT ASSOCIATION (“Association”). 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 in this Agreement have the meanings ascribed to them in the General Conditions or in the Appendix to this Agreement. ARTICLE II — FINANCING 2.01. The Association agrees to extend to the Recipient a credit, which is deemed as Concessional Financing for purposes of the General Conditions, in an amount equivalent to twenty-one million eight hundred thousand Special Drawing Rights (SDR 21,800,000) (variously, “Credit” and “Financing”), to assist in financing the project described in Schedule 1 to this Agreement (“Project”). 2.02. The Recipient may withdraw the proceeds of the Financing in accordance with Section III of Schedule 2 to this Agreement. 2.03. The Maximum Commitment Charge Rate is one-half of one percent (1/2 of 1%) per annum on the Unwithdrawn Financing Balance. 2.04. The Service Charge is three-fourths of one percent (3/4 of 1%) per annum on the Withdrawn Credit Balance. 2.05. The Interest Charge is one and a quarter percent (1.25%) per annum on the Withdrawn Credit Balance. 2.06. The Payment Dates are March 15 and September 15 in each year. -2- 2.07. The principal amount of the Credit shall be repaid in accordance with the repayment schedule set forth in Schedule 3 to this Agreement. 2.08. The Payment Currency is Dollar. ARTICLE III — PROJECT 3.01. The Recipient declares its commitment to the objective of the Project. To this end, the Recipient shall carry out the Project through its National Department of Health (“NDOH”) in accordance with the provisions of Article V of the General Conditions and Schedule 2 to this Agreement. ARTICLE IV — EFFECTIVENESS; TERMINATION 4.01. The Effectiveness Deadline is the date ninety (90) days after the Signature Date. 4.02. 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 at the time responsible for treasury. 5.02. For purposes of Section 11.01 of the General Conditions: (a) the Recipient’s address is: Department of Treasury The Treasury Building 10th floor P.O. Box 542 Waigani, 131 NCD Papua New Guinea (b) the Recipient’s Electronic Address is: Facsimile: E-mail: +675 3133671 treasury_enquiries@treasury.gov.pg -3- 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: E-mail: 248423 (MCI) 1-202-477-6391 cdpngpacific@worldbank.org AGREED as of the Signature Date. INDEPENDENT STATE OF PAPUA NEW GUINEA By _____________________________________/s1/ Authorized Representative Name: __________________________/n1/ Title: __________________________/t1/ Date: __________________________/d1/ INTERNATIONAL DEVELOPMENT ASSOCIATION By _____________________________________/s2/ Authorized Representative Michel Kerf Name: __________________________ /n2/ Country Director Title: __________________________/t2/ 4 May 2020 Date: __________________________ /d2/ -4- SCHEDULE 1 Project Description The objective of the Project is to contribute to increasing the utilization of quality essential health services in Project-supported Provinces of the Recipient. The Project consists of the following parts: Part 1: Increase Service Delivery Readiness and Community-Based Service Delivery 1.1 Strengthening service delivery readiness of the Frontline Health Facilities in Selected Provinces, including, inter alia: (a) carrying out training to build health workers’ skills and improve quality of essential health services; (b) improving communications and information technology; (c) providing equipment, supplies and ambulances to ensure availability of health services; (d) upgrading health facilities to meet national standards; and (e) increasing capacity to screen for, and deliver, counseling and support services to address gender-based violence cases. 1.2 Supporting implementation of strategies and digital innovations to improve access to, and usage of, Frontline Health Services in Selected Provinces, including, inter alia: (a) engaging non-state service providers and/or entities to implement digital innovations to supervise and support community health workers and volunteers in remote rural communities, improve citizen engagement and strengthen accountability for service delivery; and (b) carrying out an evaluation of such activities. 1.3 Strengthening capacity of the Selected PHAs on public financial management, service planning, supportive supervision, performance management, monitoring and oversight, and other relevant areas to ensure good quality health service delivery. 1.4 Supporting national oversight of: (a) Provincial Health Authorities’ reforms; and (b) service delivery results of Frontline Health Facilities in Selected Provinces, including, inter alia: (i) appointing an independent verification agent referred to in Section I.F.1 of Schedule 2 to this Agreement; (ii) providing technical support to Provincial Health Authorities to improve the delivery of Frontline Health Services; (iii) finalizing a policy and regulatory framework for the Provincial Health Authorities’ reforms; and (iv) communicating and sharing Project information with Provincial Health Authorities and other key stakeholders. -5- Part 2: Improve Frontline Service Delivery Performance Carrying out a program of results-based financed activities designed to strengthen the Recipient’s health systems at the national and provincial levels, in order to improve the delivery of Frontline Health Services in Project-supported Provinces. Part 3: Project Management Providing technical and operational assistance to the Project Coordination Unit on Project management and implementation. Part 4: Contingent Emergency Response Providing immediate response to an Eligible Crisis or Emergency, as needed. -6- SCHEDULE 2 Project Execution Section I. Implementation Arrangements A. Institutional Arrangements NDOH 1. The Recipient shall vest the overall Project management and implementation responsibilities in NDOH. Project Coordination Unit 2. The Recipient shall establish and maintain, throughout the Project implementation period, a Project Coordination Unit within NDOH, with terms of reference, composition and resources satisfactory to the Association, which shall be responsible for carrying out day-to-day management and implementation of the Project, including, inter alia, supporting coordination, monitoring and evaluation and communication of Project activities, and ensuring compliance with fiduciary and safeguard requirements under the Project. 3. Without limitation to the generality of Section I.A.2 above, the Recipient shall: (a) by not later than six (6) months after the Effective Date (or such other date which the Association has confirmed in writing to the Recipient is reasonable and acceptable under the circumstances, as determined by the Association in its sole discretion), recruit or appoint the following positions within the Project Coordination Unit: (i) a Project coordinator; (ii) a procurement specialist; (iii) a financial management specialist; (iv) a monitoring and evaluation specialist; and (v) an administrative assistant, each with terms of reference, qualifications and experience satisfactory to the Association; and (b) thereafter maintain such positions throughout the Project implementation period. B. Memoranda of Understanding 1. The Recipient shall, prior to the carrying out of any activities under Part 2 of the Project in a Province, enter into a memorandum of understanding (“Memorandum of Understanding”) with such Province’s Provincial Health Authority, under terms and conditions set forth in the DLI Operational Manual and satisfactory to the Association, which shall include, inter alia, the following: (a) the relevant DLIs, DLI Targets, DLI Values and DLI Target Achievement Dates, including the relevant Baseline and/or the process for calculating the relevant Baseline; -7- (b) the Province’s obligation to comply with the relevant provisions of the DLI Operational Manual, including the verification protocol containing the technical standards and arrangements and procedures for the monitoring, reporting and verification of DLIs; (c) the details for the transfer of the PHA Performance Funds by the Recipient to the Province upon an achievement of DLI Targets; and (d) the Recipient’s obligation to provide, in a timely manner, all other resources as may be necessary for the respective Province to carry out aforesaid responsibilities, all in accordance with the provisions of this Agreement. 2. The Recipient shall exercise its rights and perform its obligations under each Memorandum of Understanding in such manner as to protect the interests of the Recipient and the Association and to accomplish the purposes of the Financing. Except as the Association shall otherwise agree, the Recipient shall not assign, amend, abrogate or waive any of the Memoranda of Understanding or any of their provisions. C. Project Operational Manual 1. By not later than three (3) months after the Effective Date (or such other date which the Association has confirmed in writing to the Recipient is reasonable and acceptable under the circumstances, as determined by the Association in its sole discretion), the Recipient shall: (a) prepare and furnish to the Association, for its review and approval, a Project operational manual (“Project Operational Manual”), which shall: (i) set forth, inter alia, the following detailed arrangements and procedures for the implementation of the Project (except for the detailed arrangements and procedures with respect to the Emergency Response Part and DLIs): (A) institutional arrangements for the day to day execution of the Project; (B) the preparation and successive updates of the Procurement Plan and its implementation arrangements; (C) implementation arrangements for the Safeguard Instruments; (D) the eligibility criteria and process for the selection of the Selected Provinces; (E) budgeting, disbursement, financial management and auditing arrangements; (F) Project monitoring, reporting, evaluation and communication arrangements; and (G) any other administrative, financial, technical and organizational arrangements and -8- procedures as shall be necessary for the implementation of the Project and the achievement of its development objective; and (ii) attach, as its annex, a DLI operational manual (“DLI Operational Manual”), which shall set forth, inter alia: (A) a verification protocol containing the technical standards and arrangements and procedures for the monitoring, reporting and verification of DLIs, as well as mechanisms for calculation and disbursement of funds in case of partially achieved DLIs; (B) details of the Eligible Expenditure Program, including eligible NDOH budget lines; (C) the criteria and administrative process for disbursement of PHA Performance Funds by NDOH to Provinces that have achieved DLI Targets; (D) form and details of the Memoranda of Understanding; and (E) any other detailed arrangements and procedures in relation to the DLIs; (b) afford the Association a reasonable opportunity to review the proposed Project Operational Manual; and (c) adopt the Project Operational Manual as accepted by the Association. 2. The Recipient shall thereafter ensure that the Project is carried out in accordance with the Project Operational Manual, and except as the Association may otherwise agree in writing, the Recipient shall not amend or waive, or permit to be amended or waived, any provision of the Project Operational Manual. 3. In the event of any inconsistency between the provisions of the Project Operational Manual and those of this Agreement and/or the CERC OM, the provisions of this Agreement and the CERC OM shall prevail, in that order of priority. D. Annual Work Plans and Budgets 1. The Recipient shall prepare and furnish to the Association, by not later than two (2) months after the Effective Date and June 1 of each subsequent year during the implementation of the Project (or such later interval or date as the Association may agree), for the Association’s review and no-objection, an Annual Work Plan and Budget, which shall, inter alia: (a) list all activities (including Operating Costs and Training and Workshops) proposed to be included in the Project for the following fiscal year of the Recipient; (b) provide a budget for their financing; and (c) describe the environmental and social safeguard measures taken or planned to be taken in accordance with the provisions of Section I.E of this Schedule 2. 2. The Recipient shall ensure that the Project is implemented in accordance with the Annual Work Plans and Budgets accepted by the Association for the respective -9- fiscal year; provided, however, that in case of any conflict between the Annual Work Plans and Budgets and the provisions of this Agreement, the provisions of this Agreement shall prevail. 3. The Recipient shall not make or allow to be made any change to the Annual Work Plans and Budgets unless the Association has provided its prior no-objection thereof in writing. E. Safeguards 1. The Recipient shall ensure that: (a) the Project is carried out with due regard to appropriate health, safety, social, and environmental standards and practices, and in accordance with the Safeguard Instruments; and (b) for each activity under the Project for which the ESMF provides for the preparation of an ESMP: (i) proceed to have such ESMP: (A) prepared and disclosed in accordance with the ESMF; (B) consulted upon adequately with people affected by the Project as per the ESMF, and submitted to the Association for review and approval; and (C) thereafter adopted, prior to implementation of the activity; and (ii) take such measures as shall be necessary or appropriate to ensure compliance with the requirements of such ESMP in a manner satisfactory to the Association. 2. The Recipient shall ensure that all bidding documents and contracts for civil works under the Project include the obligation of contractors, and subcontractors to: (a) comply with the relevant aspects of Safeguard Instruments; (b) adopt and implement measures to assess and manage the risks and impacts of labor influx; (c) adopt and enforce codes of conduct that should be provided to and signed by all workers, detailing measures on environmental, social, health and safety, gender-based violence and violence against children; all as applicable to such civil works commissioned or carried out pursuant to said contracts. 3. The Recipient shall ensure that: (a) all consultancies related to technical assistance, design and capacity building under the Project, the application of whose results could have environmental, social and health and safety implications, shall only be undertaken pursuant to terms of reference reviewed and found satisfactory by the Association; and (b) such terms of reference shall require the technical assistance, design and capacity building activities to take into account the requirements of the applicable Safeguard Policies and EHS Guidelines. -10- 4. Except as the Association shall otherwise agree in writing, the Recipient shall ensure that none of the provisions of the Safeguard Instruments is abrogated, amended, repealed, suspended or waived. In case of any inconsistencies between the provisions of any of the Safeguard Instruments and the provisions of this Agreement, the provisions of this Agreement shall prevail. 5. Without limitation upon its other reporting obligations under this Agreement, the Recipient shall: (a) take all measures necessary on its part to regularly collect, compile, and submit to the Association, as part of the Project Reports, and promptly in a separate report whenever the Association may require, information on the status of compliance with the Safeguard Instruments, all such reports in form and substance acceptable to the Association, setting out, inter alia: (i) the status of implementation of the Safeguard Instruments; (ii) conditions, if any, which interfere or threaten to interfere with the implementation of the Safeguard Instruments; and (iii) corrective and preventive measures taken or required to be taken to address such conditions; (b) promptly furnish to the Association a copy of each progress report prepared and submitted by any entity (including any engineer) supervising the Project’s civil works, the Project’s contractors and/or subcontractors; and (c) promptly notify the Association of any incident or accident related to or having an impact on the Project which has, or is likely to have, a significant adverse effect on the environment, the affected communities, the public or workers, including, any case of gender-based violence. 6. The Recipient shall maintain, throughout the Project implementation period, and publicize the availability of, a grievance mechanism, in form and substance satisfactory to the Association, to hear and determine fairly and in good faith all complaints raised in relation to the Project, and take all measures necessary to implement the determinations made by such mechanism in a manner satisfactory to the Association. F. DLI Monitoring and Reporting 1. The Recipient shall, by not later than three (3) months after the Effective Date (or such other date which the Association has confirmed in writing to the Recipient is reasonable and acceptable under the circumstances, as determined by the Association in its sole discretion), appoint, and thereafter maintain throughout the Project implementation period, an independent verification agent, with terms of reference and qualifications satisfactory to the Association, for the purpose of -11- carrying out independent verifications of the status of achievement of DLI Targets in accordance with the verification protocol and procedures set out in the DLI Operational Manual. 2. Without limiting its other reporting obligations under this Agreement, the Recipient shall, by not later than five (5) months after the end of each Year (or such other date which the Association has confirmed in writing to the Recipient is reasonable and acceptable under the circumstances, as determined by the Association in its sole discretion), furnish to the Association reports on the status of achievement of the relevant DLI Targets, including the reports of the independent verification agent referred to in Section I.F.1 above, all in accordance with the verification protocol and procedures set out in the DLI Operational Manual. G. Contingent Emergency Response 1. Prior to the implementation of contingent emergency response activities under Part 4 of the Project (“Emergency Response Part”), the Recipient shall: (a) prepare and furnish to the Association for its review and approval, a Contingent Emergency Response Component Operations Manual (“CERC OM”) which shall set forth detailed implementation arrangements for the Emergency Response Part, including: (i) any special institutional arrangements for coordinating and implementing the Emergency Response Part; (ii) specific activities which may be included in the Emergency Response Part, Eligible Expenditures required for those activities (“Emergency Expenditures”), and any procedures for such inclusion; (iii) financial management arrangements for the Emergency Response Part; (iv) procurement methods and procedures for the Emergency Response Part; (v) documentation required for withdrawals of Emergency Expenditures; (vi) application of the Safeguard Instruments and any other relevant safeguard instruments to the Emergency Response Part; and (vii) any other arrangements necessary to ensure proper coordination and implementation of the Emergency Response Part; (b) afford the Association a reasonable opportunity to review the proposed CERC OM; (c) promptly adopt the CERC OM for the Emergency Response Part as shall have been accepted by the Association; (d) ensure that the Emergency Response Part is carried out in accordance with the CERC OM; provided, however, that in the event of any inconsistency between the provisions of the CERC OM and this Agreement, the provisions of this Agreement shall prevail; and -12- (e) not amend, suspend, abrogate, repeal or waive any provision of the CERC OM without the prior written approval by the Association. 2. The Recipient shall undertake no activities under the Emergency Response Part unless and until the following conditions have been met in respect of said activities: (a) the Recipient has determined that an Eligible Crisis or Emergency has occurred, has furnished to the Association a request to include said activities in the Emergency Response Part in order to respond to said Eligible Crisis or Emergency, and the Association has agreed with such determination, accepted said request and notified the Recipient thereof; (b) the Recipient has ensured the preparation and disclosure of all Safeguard Instruments as may be required for said activities in accordance with the provisions of Section I.E of this Schedule 2 and the CERC OM, the Association has approved all said instruments, and the Recipient has ensured the implementation of any actions which are required to be taken under said instruments; (c) the Recipient has ensured that the entities in charge of coordinating and implementing the Emergency Response Part have adequate staff and resources, in accordance with the provisions of the CERC OM, for the purposes of said activities; and (d) the Recipient has adopted the CERC OM, in form and substance acceptable to the Association, and the provisions of the CERC OM remain up to date, or have been updated in accordance with the provisions of this Section I.G so as to provide detailed arrangement and procedures needed for the implementation of the Emergency Response Part. Section II. Project Monitoring, Reporting and Evaluation Project Reports 1. The Recipient shall furnish to the Association each Project Report not later than forty-five (45) days after the end of each calendar semester, covering the calendar semester. Mid-Term Review 2. The Recipient shall carry out, jointly with the Association, not later than three (3) years after the Effective Date, or such other period as may be agreed with the Association, a mid-term review of the Project (“Mid-Term Review”) to assess the status of Project implementation, as measured against the indicators acceptable to the Association, and compliance with the legal covenants included or referred to -13- in this Agreement. Such review shall include an assessment of the following: (i) overall progress in implementation; (ii) results of monitoring and evaluation activities; (iii) progress on procurement and disbursement; (iv) progress on implementation of safeguard measures; (v) implementation arrangements and Project staffing; and (vi) the need to make any adjustments to the Project to improve performance. To this end, the Recipient shall: (a) prepare and furnish to the Association, at least one (1) month before the date of the Mid-Term Review, a report, in scope and detail satisfactory to the Association and integrating the results of the monitoring and evaluation activities performed pursuant to Section II.1 of this Schedule 2, on the progress achieved in the carrying out of the Project during the period preceding the date of such report and setting out the measures recommended to ensure the efficient carrying out of the Project and the achievement of the objective thereof during the period following such date; and (b) review jointly with the Association the report referred to in the preceding paragraph, and thereafter take all measures required to ensure the efficient completion of the Project and the achievement of the objective thereof, based on the conclusions and recommendations of such report and the Association’s views on the matter. Section III. Withdrawal of the Proceeds of the Financing A. General 1. Without limitation upon the provisions of Article II of the General Conditions and in accordance with the Disbursement and Financial Information Letter, the Recipient may withdraw the proceeds of the Financing to finance Eligible Expenditures in the amount allocated and, if applicable, up to the percentage set forth against each Category of the following table: Category Amount of the Percentage of Expenditures Credit Allocated to be Financed (expressed in (inclusive of Taxes) SDR) (1) Goods, works, non- 11,200,000 100% consulting services, consulting services, Operating Costs, and Training and Workshops -14- under Parts 1 and 3 of the Project (2) Eligible Expenditure 10,600,000 100% Program under Part 2 of the Project (3) Emergency 0 100% Expenditures under Part 4 of the Project TOTAL AMOUNT 21,800,000 B. Withdrawal Conditions; Withdrawal Period 1. Notwithstanding the provisions of Part A above, no withdrawal shall be made: (a) for payments made prior to the Signature Date, except that withdrawals up to an aggregate amount not to exceed four million three hundred sixty thousand Special Drawing Rights (SDR 4,360,000) may be made for payments made prior to this date but on or after December 1, 2019, for Eligible Expenditures under Categories (1) and/or (2), subject to the requirements referred to in paragraph (b) below for Eligible Expenditure Program under Category (2); or (b) for Eligible Expenditure Program under Category (2), unless and until the Association is satisfied that the Recipient has: (i) adopted a Project Operational Manual in accordance with the provisions of Section I.C of this Schedule 2; (ii) furnished evidence satisfactory to the Association in accordance with the verification protocol set forth in the DLI Operational Manual that the Recipient has achieved the respective DLI Targets by its DLI Target Achievement Date as set forth in Schedule 4 to this Agreement against which withdrawal is requested; and (iii) complied with the additional instructions referred to in the Disbursement and Financial Information Letter, including furnished to the Association a customized statement of expenditures, in form and substance satisfactory to the Association, documenting the incurrence of Eligible Expenditure Program during the respective Year up to the date against which withdrawal is requested; or -15- (c) for Emergency Expenditures under Category (3), unless and until the Association is satisfied that all of the conditions listed in Section I.G.2 of this Schedule 2 have been met in respect of said expenditures. 2. Notwithstanding the provisions of Sections III.A and III.B.1(b) above, the amount of the Financing to be withdrawn upon the verified achievement of any DLI Target shall correspond to the DLI Value of such DLI Target as set forth in Schedule 4 to this Agreement. 3. Notwithstanding the provisions of Sections III.B.1(b) and III.B.2 above, if any of the DLI Targets has not been fully achieved by its DLI Target Achievement Date, the Association may, by notice to the Recipient: (a) authorize, in the case of a scalable DLI Target, the withdrawal of such lesser amount of the unwithdrawn proceeds of the Association then allocated to such DLI, which, in the opinion of the Association, corresponds to the extent of achievement of said DLI Target, said lesser amount to be calculated in accordance with the formula set out for said DLI Target under Schedule 4 to this Agreement and/or the DLI Operational Manual; (b) (i) withhold in whole or in part the proceeds of the Financing then allocated to the DLI Target until such DLI Target is satisfactorily met in accordance with the DLI Operational Manual; and/or (ii) authorize, at a later date (prior to the Closing Date), the full release of the amounts so withheld, if and when the Association is satisfied that the respective DLI Target has been satisfactorily met as per the DLI Operational Manual; (c) reallocate all or a portion of the proceeds of the Financing allocated to said DLI Target to any other DLI Target(s) and/or to Category (1); and/or (d) cancel in whole or in part any withheld amount of the proceeds of the Financing allocated to said DLI Target. 4. The Closing Date is June 30, 2026. Section IV. Other Undertakings 1. By not later than four (4) months after the Effective Date (or such other date which the Association has confirmed in writing to the Recipient is reasonable and acceptable under the circumstances, as determined by the Association in its sole discretion), the Recipient shall complete the selection of the Early Adopter -16- Provinces in accordance with the provisions of this Agreement and the Project Operational Manual. -17- SCHEDULE 3 Repayment Schedule Principal Amount of the Credit Date Payment Due repayable (expressed as a percentage)* On each March 15 and September 15: commencing September 15, 2025 to and 1.65% including March 15, 2045 commencing September 15, 2045 to and 3.40% including March 15, 2050 * The percentages represent the percentage of the principal amount of the Credit to be repaid, except as the Association may otherwise specify pursuant to Section 3.05 (b) of the General Conditions. 18 SCHEDULE 4 Disbursement Linked Indicator Table No. DLIs Year 1 Year 2 Year 3 Year 4 Year 5 National DLIs 1. National DLI 1: DLI Target: DLI Target: Memoranda of NDOH has signed a NDOH has signed a Understanding signed Memorandum of Memorandum of by NDOH with up to Understanding with at Understanding with at four (4) Selected least one (1) Selected least one (1) additional PHAs. PHA. Selected PHA. Targeted for up to two (2) Targeted for up to two (2) Memoranda of additional Memoranda of Understanding signed. Understanding signed. DLI Target DLI Value: DLI Value: Achievement Date: Up to a maximum of SDR Up to a maximum of SDR DLI Target for Year 217,800. 217,800. 1 shall be achieved by the end of Year 1; Disbursement formula: Disbursement formula: and DLI Target SDR 108,900 per SDR 108,900 per described under Year Memorandum of Memorandum of 3 may be achieved at Understanding signed; up Understanding signed; up any time within Year to a maximum of two (2) to a maximum of two (2) 2 to Year 5 Memoranda of Memoranda of (described under Understanding signed. Understanding signed. Year 3 for indicative purposes only). 2. National DLI 2: DLI Target: DLI Target: Integrated Facility NDOH has adopted an NDOH has: Supervision Checklist Integrated Facility adopted and updated. Supervision Checklist by -19- No. DLIs Year 1 Year 2 Year 3 Year 4 Year 5 issuing an operational (a) reviewed and updated directive. the adopted Integrated Facility Supervision Checklist in accordance with the criteria set forth in the DLI Operational Manual; and (b) adopted the updated Integrated Facility Supervision Checklist by issuing an operational directive. DLI Target DLI Value: DLI Value: Achievement Date: SDR 217,800 SDR 217,800 DLI Targets may be achieved at any time Disbursement formula: Disbursement formula: within Year 1 to Year n/a n/a 5 (described under Year 1 and Year 3 for indicative purposes only). 3. National DLI 3: DLI Target: DLI Target: DLI Target: DLI Target: DLI Target: Timely transfer of NDOH has transferred NDOH has transferred NDOH has transferred NDOH has transferred NDOH has transferred PHA Performance PHA Performance Funds, PHA Performance Funds, PHA Performance Funds, PHA Performance Funds, PHA Performance Funds, Funds. in the amount calculated in in the amount calculated in in the amount calculated in in the amount calculated in in the amount calculated in accordance with the DLI accordance with the DLI accordance with the DLI accordance with the DLI accordance with the DLI Operational Manual, to at Operational Manual, to at Operational Manual, to at Operational Manual, to at Operational Manual, to at least one (1) Selected PHA least one (1) Selected PHA least one (1) Selected PHA least one (1) Selected PHA least one (1) Selected PHA within ten (10) working within ten (10) working within ten (10) working within ten (10) working within ten (10) working days from the date the days from the date the days from the date the days from the date the days from the date the Recipient has received an Recipient has received an Recipient has received an Recipient has received an Recipient has received an equivalent amount of equivalent amount of equivalent amount of equivalent amount of equivalent amount of Financing proceeds from Financing proceeds from Financing proceeds from Financing proceeds from Financing proceeds from the Association for the the Association for the the Association for the the Association for the the Association for the -20- No. DLIs Year 1 Year 2 Year 3 Year 4 Year 5 achievement of the achievement of the achievement of the achievement of the achievement of the relevant DLI Target(s) for relevant DLI Target(s) for relevant DLI Target(s) for relevant DLI Target(s) for relevant DLI Target(s) for Year 1. Year 2. Year 3. Year 4. Year 5. Targeted for transfers Targeted for transfers Targeted for transfers Targeted for transfers Targeted for transfers made to up to two (2) made to up to two (2) made to up to four (4) made to up to four (4) made to up to four (4) Selected PHAs. Selected PHAs. Selected PHAs. Selected PHAs. Selected PHAs. DLI Target DLI Value: DLI Value: DLI Value: DLI Value: DLI Value: Achievement Date: Up to a maximum of SDR Up to a maximum of SDR Up to a maximum of SDR Up to a maximum of SDR Up to a maximum of SDR DLI Targets may be 217,800. 217,800. 217,800. 217,800. 217,800. achieved at any time within Year 1 to Year Disbursement formula: Disbursement formula: Disbursement formula: Disbursement formula: Disbursement formula: 5 (described under SDR 108,900 per transfer SDR 108,900 per transfer SDR 54,450 per transfer SDR 54,450 per transfer SDR 54,450 per transfer each Year for made to a Selected PHA; made to a Selected PHA; made to a Selected PHA; made to a Selected PHA; made to a Selected PHA; indicative purposes up to a maximum of two up to a maximum of two up to a maximum of four up to a maximum of four up to a maximum of four only). (2) transfers made. (2) transfers made. (4) transfers made. (4) transfers made. (4) transfers made. 4. National DLI 4: DLI Target: DLI Target: DLI Target: DLI Target: DLI Target: Number of Selected At least one (1) Selected At least one (1) Selected At least one (1) Selected At least one (1) Selected At least one (1) Selected Provinces that have Province has fully Province has fully Province has fully Province has fully Province has fully achieved all achieved DLI Targets of achieved DLI Targets of achieved DLI Targets of achieved DLI Targets of achieved DLI Targets of Provincial DLIs. all Provincial DLIs for all Provincial DLIs for all Provincial DLIs for all Provincial DLIs for all Provincial DLIs for Year 1. Year 2. Year 3. Year 4. Year 5. Targeted for up to two (2) Targeted for up to two (2) Targeted for up to four (4) Targeted for up to four (4) Targeted for up to four (4) Selected Provinces. Selected Provinces. Selected Provinces. Selected Provinces. Selected Provinces. DLI Target DLI Value: DLI Value: DLI Value: DLI Value: DLI Value: Achievement Date: Up to a maximum of SDR Up to a maximum of SDR Up to a maximum of SDR Up to a maximum of SDR Up to a maximum of SDR Each DLI Target 145,200. 145,200. 145,200. 145,200. 145,200. shall be achieved by the end of the Disbursement formula: Disbursement formula: Disbursement formula: Disbursement formula: Disbursement formula: relevant Year. SDR 72,600 per Selected SDR 72,600 per Selected SDR 36,300 per Selected SDR 36,300 per Selected SDR 36,300 per Selected Province; up to a Province; up to a Province; up to a Province; up to a Province; up to a -21- No. DLIs Year 1 Year 2 Year 3 Year 4 Year 5 maximum of two (2) maximum of two (2) maximum of four (4) maximum of four (4) maximum of four (4) Selected Provinces. Selected Provinces. Selected Provinces. Selected Provinces. Selected Provinces. Provincial DLIs 5. Provincial DLI 1: DLI Target: DLI Target: DLI Target: DLI Target: DLI Target: Number of Selected At least one (1) Selected At least one (1) Selected At least one (1) Selected At least one (1) Selected At least one (1) Selected PHAs with a PHA has prepared and PHA has prepared and PHA has prepared and PHA has prepared and PHA has prepared and complete Annual submitted to NDOH, a submitted to NDOH, a submitted to NDOH, a submitted to NDOH, a submitted to NDOH, a Implementation Plan complete Annual complete Annual complete Annual complete Annual complete Annual submitted in a timely Implementation Plan, Implementation Plan, Implementation Plan, Implementation Plan, Implementation Plan, manner and in before the due date before the due date before the due date before the due date before the due date accordance with identified in the relevant identified in the relevant identified in the relevant identified in the relevant identified in the relevant NDOH NDOH budget circular. NDOH budget circular. NDOH budget circular. NDOH budget circular. NDOH budget circular. specifications. Targeted for up to two (2) Targeted for up to two (2) Targeted for up to four (4) Targeted for up to four (4) Targeted for up to four (4) Selected PHAs. Selected PHAs. Selected PHAs. Selected PHAs. Selected PHAs. DLI Target DLI Value: DLI Value: DLI Value: DLI Value: DLI Value: Achievement Date: Up to a maximum of SDR Up to a maximum of SDR Up to a maximum of SDR Up to a maximum of SDR Up to a maximum of SDR Each DLI Target 145,200. 145,200. 290,400. 290,400 . 290,400. shall be achieved by the end of the Disbursement formula: Disbursement formula: Disbursement formula: Disbursement formula: Disbursement formula: relevant Year. SDR 72,600 per Selected SDR 72,600 per Selected SDR 72,600 per Selected SDR 72,600 per Selected SDR 72,600 per Selected PHA; up to a maximum of PHA; up to a maximum of PHA; up to a maximum of PHA; up to a maximum of PHA; up to a maximum of two (2) Selected PHAs. two (2) Selected PHAs. four (4) Selected PHAs. four (4) Selected PHAs. four (4) Selected PHAs. -22- No. DLIs Year 1 Year 2 Year 3 Year 4 Year 5 6. Provincial DLI 2: n/a DLI Target: DLI Target: DLI Target: DLI Target: Percentage of Eligible Level 2-4 For Early Adopter (a) For Early Adopter (a) For Early Adopter (a) For Early Adopter Health Care Facilities Provinces: Provinces: Provinces: Provinces: in Selected Provinces that have achieved a At least ninety percent Percentage of Eligible Percentage of Eligible Percentage of Eligible Minimum Service (90%) of Eligible Level 2- Level 2-4 Health Care Level 2-4 Health Care Level 2-4 Health Care Quality Score. 4 Health Care Facilities in Facilities in an Early Facilities in an Early Facilities in an Early an Early Adopter Province Adopter Province that Adopter Province that Adopter Province that have service quality have achieved a Minimum have achieved a Minimum have achieved a Minimum measured through the Service Quality Score is at Service Quality Score is at Service Quality Score is at Integrated Facility least ten percent (10%) least twenty percent (20%) least thirty percent (30%) Supervision Checklist. over the Baseline. over the Baseline. over the Baseline. Targeted in up to two (2) Targeted in up to two (2) Targeted in up to two (2) Targeted in up to two (2) Early Adopter Provinces. Early Adopter Provinces. Early Adopter Provinces. Early Adopter Provinces. (b) For Expansion (b) For Expansion (b) For Expansion Provinces: Provinces: Provinces: At least ninety percent Percentage of Eligible Percentage of Eligible (90%) of Eligible Level 2- Level 2-4 Health Care Level 2-4 Health Care 4 Health Care Facilities in Facilities in an Expansion Facilities in an Expansion an Expansion Province Province that have Province that have have service quality achieved a Minimum achieved a Minimum measured through the Service Quality Score is at Service Quality Score is at Integrated Facility least ten percent (10%) least twenty percent (20%) Supervision Checklist. over the Baseline. over the Baseline. Targeted in up to two (2) Targeted in up to two (2) Targeted in up to two (2) Expansion Provinces. Expansion Provinces. Expansion Provinces. -23- No. DLIs Year 1 Year 2 Year 3 Year 4 Year 5 DLI Target DLI Value: DLI Value: DLI Value: DLI Value: Achievement Date: Up to a maximum of SDR Up to a maximum of SDR Up to a maximum of SDR Up to a maximum of SDR Each DLI Target 217,800. 435,700. 435,700. 435,700. shall be achieved by the end of the Disbursement formula: Disbursement formula: Disbursement formula: Disbursement formula: relevant Year. SDR 108,900 per Early SDR 108,925 per Selected SDR 108,925 per Selected SDR 108,925 per Selected Adopter Province; up to a Province; up to a Province; up to a Province; up to a maximum of two (2) Early maximum of four (4) maximum of four (4) maximum of four (4) Adopter Provinces. Selected Provinces. Selected Provinces. Selected Provinces. -24- No. DLIs Year 1 Year 2 Year 3 Year 4 Year 5 7. Provincial DLI 3: DLI Target: DLI Target: DLI Target: DLI Target: DLI Target: Number of PHA For Early Adopter For Early Adopter (a) For Early Adopter (a) Provincial (a) Provincial Boards that have used Provinces: Provinces: Provinces: Performance Dashboard in Performance Dashboard in routine data for at least one (1) Selected at least one (1) Selected decision making. A Provincial Performance (a) Provincial (i) Provincial Performance Province has been updated Province has been updated Dashboard has been Performance Dashboard in Dashboard in at least one every six (6) months in every six (6) months in developed and adopted by at least one (1) Early (1) Early Adopter accordance with the DLI accordance with the DLI the PHA Board in at least Adopter Province has Province has been updated Operational Manual; and Operational Manual; and one (1) Early Adopter been updated every six (6) every six (6) months in Province. months in accordance with accordance with the DLI (b) PHA Board of such (b) PHA Board of such the DLI Operational Operational Manual; and province has adopted a province has adopted a Targeted in up to two (2) Manual; and Supportive Supervision Supportive Supervision Early Adopter Provinces. (ii) PHA Board of such Plan. Plan. (b) PHA Board of such province has adopted a province has adopted a Supportive Supervision Targeted in up to four (4) Targeted in up to four (4) Supportive Supervision Plan. Selected Provinces. Selected Provinces. Plan. Targeted in up to two (2) Targeted in up to two (2) Early Adopter Provinces. Early Adopter Provinces. (b) For Expansion Provinces: A Provincial Performance Dashboard has been developed and adopted by the PHA Board in at least one (1) Expansion Province. Targeted in up to two (2) Expansion Provinces. DLI Target DLI Value: DLI Value: DLI Value: DLI Value: DLI Value: Achievement Date: Up to a maximum of SDR Up to a maximum of SDR Up to a maximum of SDR Up to a maximum of SDR Up to a maximum of SDR 108,950. 108,950. 217,800. 217,800. 217,800. -25- No. DLIs Year 1 Year 2 Year 3 Year 4 Year 5 Each DLI Target shall be achieved by Disbursement formula: Disbursement formula: Disbursement formula: Disbursement formula: Disbursement formula: the end of the SDR 54,475 per Early SDR 54,475 per Early SDR 54,450 per Selected SDR 54,450 per Selected SDR 54,450 per Selected relevant Year. Adopter Province; up to a Adopter Province; up to a Province; up to a Province; up to a Province; up to a maximum of two (2) Early maximum of two (2) Early maximum of four (4) maximum of four (4) maximum of four (4) Adopter Provinces. Adopter Provinces. Selected Provinces. Selected Provinces. Selected Provinces. 8. Provincial DLI 4: n/a DLI Target: DLI Target: DLI Target: DLI Target: Percentage increase For Early Adopter (a) For Early Adopter (a) For Early Adopter (a) For Early Adopter in the number of Provinces: Provinces: Provinces: Provinces: Outreach Visits in Selected Provinces. At least one percent (1%) At least eleven percent At least sixteen percent At least twenty-one and up to ten percent (11%) and up to fifteen (16%) and up to twenty percent (21%) and up to (10%) increase in the percent (15%) increase in percent (20%) increase in twenty-five percent (25%) number of Outreach Visits the number of Outreach the number of Outreach increase in the number of over the Baseline in an Visits over the Baseline in Visits over the Baseline in Outreach Visits over the Early Adopter Province. an Early Adopter an Early Adopter Baseline in an Early Province. Province. Adopter Province. Targeted in up to two (2) Early Adopter Provinces. Targeted in up to two (2) Targeted in up to two (2) Targeted in up to two (2) Early Adopter Provinces. Early Adopter Provinces. Early Adopter Provinces. (b) For Expansion (b) For Expansion (b) For Expansion Provinces: Provinces: Provinces: At least one percent (1%) At least eleven percent At least sixteen percent and up to ten percent (11%) and up to fifteen (16%) and up to twenty (10%) increase in the percent (15%) increase in percent (20%) increase in number of Outreach Visits the number of Outreach the number of Outreach over the Baseline in an Visits over the Baseline in Visits over the Baseline in Expansion Province. an Expansion Province. an Expansion Province. Targeted in up to (2) Targeted in up to (2) Targeted in up to (2) Expansion Provinces. Expansion Provinces. Expansion Provinces. DLI Target DLI Value: DLI Value: DLI Value: DLI Value: Achievement Date: -26- No. DLIs Year 1 Year 2 Year 3 Year 4 Year 5 Each DLI Target Up to a maximum of SDR Up to a maximum of SDR Up to a maximum of SDR Up to a maximum of SDR shall be achieved by 217,800. 435,700. 435,700. 435,700. the end of the relevant Year. Disbursement formula: Disbursement formula: Disbursement formula: Disbursement formula: SDR 10,890 per one (1) (a) For Early Adopter SDR 21,785 per one (1) SDR 21,785 per one (1) percentage increase; up to Provinces: percentage increase; up to percentage increase; up to a maximum of SDR a maximum of SDR a maximum of SDR 108,900 per Early Adopter SDR 21,785 per one (1) 108,925 per Selected 108,925 per Selected Province; and up to a percentage increase; up to Province; and up to a Province; and up to a maximum of two (2) Early a maximum of SDR maximum of four (4) maximum of four (4) Adopter Provinces. 108,925 per Early Adopter Selected Provinces. Selected Provinces. Province; and up to a maximum of two (2) Early Adopter Provinces. (b) For Expansion Provinces: SDR 10,892.50 per one (1) percentage increase; up to a maximum of SDR 108,925 per Expansion Province; and up to a maximum of two (2) Expansion Provinces. -27- No. DLIs Year 1 Year 2 Year 3 Year 4 Year 5 Competitive DLIs 9. Competitive DLI 1: n/a n/a DLI Target: DLI Target: DLI Target: Percentage increase NDOH has furnished to NDOH has furnished to NDOH has furnished to in the number of the Association a report, the Association a report, the Association a report, pregnant women who in form and substance in form and substance in form and substance have received four described in the DLI described in the DLI described in the DLI (4) or more antenatal Operational Manual, Operational Manual, Operational Manual, care check-ups. setting forth the list of setting forth the list of setting forth the list of Competitive DLI Competitive DLI Competitive DLI Provinces with a top two Provinces with a top two Provinces with a top two (2) highest percentage (2) highest percentage (2) highest percentage increase in the number of increase in the number of increase in the number of pregnant women who pregnant women who pregnant women who have received four (4) or have received four (4) or have received four (4) or more antenatal care check- more antenatal care check- more antenatal care check- ups in Year 3, compared ups in Year 4, compared ups in Year 5, compared to their respective results to their respective results to their respective results in Year 2, as determined in Year 3, as determined in Year 4, as determined in accordance with the in accordance with the in accordance with the details set forth in the DLI details set forth in the DLI details set forth in the DLI Operational Manual. Operational Manual. Operational Manual. DLI Target DLI Value: DLI Value: DLI Value: Achievement Date: SDR 290,400. SDR 290,400. SDR 290,400. Each DLI Target shall be achieved by Disbursement formula: Disbursement formula: Disbursement formula: the end of the n/a n/a n/a relevant Year. 10. Competitive DLI 2: n/a n/a DLI Target: DLI Target: DLI Target: Percentage increase NDOH has furnished to NDOH has furnished to NDOH has furnished to in number of children the Association a report, the Association a report, the Association a report, under one (1) year of in form and substance in form and substance in form and substance age who have described in the DLI described in the DLI described in the DLI received DPT-3. Operational Manual, Operational Manual, Operational Manual, setting forth the list of setting forth the list of setting forth the list of Competitive DLI Competitive DLI Competitive DLI -28- No. DLIs Year 1 Year 2 Year 3 Year 4 Year 5 Provinces with a top two Provinces with a top two Provinces with a top two (2) highest percentage (2) highest percentage (2) highest percentage increase in the number of increase in the number of increase in the number of children under one (1) children under one (1) children under one (1) year of age who have year of age who have year of age who have received DPT-3 in Year 3, received DPT-3 in Year 4, received DPT-3 in Year 5, compared to their compared to their compared to their respective results in Year respective results in Year respective results in Year 2, as determined in 3, as determined in 4, as determined in accordance with the accordance with the accordance with the details set forth in the DLI details set forth in the DLI details set forth in the DLI Operational Manual. Operational Manual. Operational Manual. DLI Target DLI Value: DLI Value: DLI Value: Achievement Date: SDR 290,400. SDR 290,400. SDR 290,400. Each DLI Target shall be achieved by Disbursement formula: Disbursement formula: Disbursement formula: the end of the n/a n/a n/a relevant Year. 11. Competitive DLI 3: n/a n/a DLI Target: DLI Target: DLI Target: Increase in number of NDOH has furnished to NDOH has furnished to NDOH has furnished to registered drug the Association a report, the Association a report, the Association a report, susceptible in form and substance in form and substance in form and substance tuberculosis patients described in the DLI described in the DLI described in the DLI on treatment who Operational Manual, Operational Manual, Operational Manual, have been cured. setting forth the list of setting forth the list of setting forth the list of Competitive DLI Competitive DLI Competitive DLI Provinces with a top two Provinces with a top two Provinces with a top two (2) highest increase in the (2) highest increase in the (2) highest increase in the number of registered drug number of registered drug number of registered drug susceptible tuberculosis susceptible tuberculosis susceptible tuberculosis patients on treatment who patients on treatment who patients on treatment who have been cured in Year 3, have been cured in Year 4, have been cured in Year 5, compared to their compared to their compared to their respective results in Year respective results in Year respective results in Year 2, as determined in 3, as determined in 4, as determined in accordance with the accordance with the accordance with the -29- No. DLIs Year 1 Year 2 Year 3 Year 4 Year 5 details set forth in the DLI details set forth in the DLI details set forth in the DLI Operational Manual. Operational Manual. Operational Manual. DLI Target DLI Value: DLI Value: DLI Value: Achievement Date: SDR 362,900. SDR 362,900. SDR 362,900. Each DLI Target shall be achieved by Disbursement formula: Disbursement formula: Disbursement formula: the end of the n/a n/a n/a relevant Year. - 30 - APPENDIX Section I. Definitions 1. “Annual Implementation Plan” means a plan prepared by a Selected PHA in accordance with the guidelines issued by NDOH and details set forth in the DLI Operational Manual, outlining, inter alia, key activities and associated budgets linked to the national health plan and other relevant documents. 2. “Annual Work Plan and Budget” means each annual work plan and budget (including related cash forecasts) for the implementation of the Project accepted by the Association, referred to in Section I.D of Schedule 2 to this Agreement; and “Annual Work Plans and Budgets” means, collectively, all such plans and budgets. 3. “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. 4. “Baseline” means, in relation to a DLI, the baseline data for measuring the achievement of DLI Targets, as set out in, or calculated in accordance with, the DLI Operational Manual. 5. “Category” means a category set forth in the table in Section III.A of Schedule 2 to this Agreement. 6. “Competitive DLI Province” means a Province which has met the selection criteria for participating in Competitive DLIs as set forth in the DLI Operational Manual and agreed with the Association; and “Competitive DLI Provinces” means, collectively, all such provinces. 7. “Competitive DLIs” means, collectively, the DLIs set to be achieved at the provincial level by Competitive DLI Provinces, as set forth in the table in Schedule 4 to this Agreement; and “Competitive DLI” means, individually, any of them. 8. “Contingent Emergency Response Component Operations Manual” or its acronym “CERC OM” means the manual referred to in Section I.G.1 of Schedule 2 to this Agreement, to be adopted by the Recipient for the Emergency Response Part in accordance with the provisions of said Section; as said manual may be modified from time to time with the prior written agreement of the Association, and such term includes any schedules or annexes to the manual. 9. “Disbursement Linked Indicator” or its acronym “DLI” means any one of the indicators set forth in the table in Schedule 4 to this Agreement; and “DLIs” means, collectively, all such DLIs. -- 31 -- 10. “DLI Operational Manual” means the manual referred to in Section I.C.1(a)(ii) of Schedule 2 to this Agreement, in form and substance satisfactory to the Association, which is attached as an annex to the Project Operational Manual and to be adopted by the Recipient in accordance with the provisions of the said section; as said manual may be modified from time to time with prior approval in writing of the Association, and such term includes any schedules or annexes to the DLI Operational Manual. 11. “DLI Target” means the annual target set to be achieved under each DLI, as set forth in the table in Schedule 4 to this Agreement; and “DLI Targets” means, collectively, all such targets. 12. “DLI Target Achievement Date” means, in relation to each DLI Target, the end of the Year during which the relevant DLI Target is set to be achieved, as specified in the table in Schedule 4 to this Agreement. 13. “DLI Value” means the total amount of the Financing allocated to each DLI Target, as set forth in the table in Schedule 4 to this Agreement, as such amount may be reallocated in whole or in part among the DLI Targets or among the Categories by notice by the Association from time to time. 14. “DPT-3” means Diphtheria Pertussis Tetanus 3 vaccination. 15. “Early Adopter Provinces” means the first two Provinces which have met the selection criteria and process for participating in Parts 1.1, 1.2 and 1.3 of the Project as set forth in the Project Operational Manual and agreed with the Association; and “Early Adopter Province” means either of such Provinces. 16. “EHS Guidelines” means the World Bank Group Environmental, Health and Safety Guidelines published on www.ifc.org/ehsguidelines, as said guidelines are updated from time to time. 17. “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. 18. “Eligible Expenditure Program” means certain NDOH budget lines for salaries and allowances, as set forth in the DLI Operational Manual, which are required to support the implementation of Part 2 of the Project. 19. “Eligible Level 2-4 Health Care Facilities” means, collectively, health care facilities managed by the Recipient’s government and/or churches within a Selected Province, which are classified as levels 2, 3 or 4 in accordance with the National Health Service Standards, or other equivalent classification acceptable to -- 32 -- the Association, and set forth in the DLI Operational Manual; and “Eligible Level 2-4 Health Care Facility” means any of such facilities. 20. “Emergency Expenditure” means any eligible expenditures set forth in the CERC OM in accordance with the provisions of Section I.G of Schedule 2 to this Agreement, and included in the Emergency Response Part. 21. “Emergency Response Part” means a specific activity or activities to be carried out in the event of an Eligible Crisis or Emergency under Part 4 of the Project. 22. “Environmental and Social Management Framework” or its acronym “ESMF” means the document titled ‘Environmental and Social Management Framework (ESMF): Papua New Guinea IMPACT Health (P167184)’ prepared and adopted by the Recipient, satisfactory to the Association, dated August 2019, disclosed in- country, and on the Association’s website on October 2, 2019, setting out the principles, rules, guidelines and procedures to screen and assess the potential adverse environmental and social risks and impacts (including health and safety issues) of Project activities, adopt measures to avoid, reduce, mitigate or offset environmental and social adverse risks and impacts, procedural, budget and institutional arrangements and actions needed to implement these measures, and information on the agency or agencies responsible for addressing the Project’s risks and impacts; as well as for the preparation of ESMPs, as said framework may be amended from time to time with the Association’s prior written agreement. 23. “Environmental and Social Management Plan” or its acronym “ESMP” means any environmental and social management plan to be prepared by the Recipient under the Project pursuant to the provisions of Section I.E of Schedule 2 to this Agreement, in accordance with the procedures and requirements under the ESMF, satisfactory to the Association, which details (a) the measures to be taken during the implementation and operation of the Project to avoid, minimize, mitigate or offset adverse environmental and social impacts (including health and safety issues), or to reduce them to acceptable levels, and (b) the actions needed to implement these measures, as said instrument may be amended from time to time with the Association’s prior written agreement; and “ESMPs” means, collectively, all such ESMPs. 24. “Expansion Provinces” means the third and fourth Provinces which have met the selection criteria and process for participating in Parts 1.1, 1.2 and 1.3 of the Project as set forth in the Project Operational Manual and agreed with the Association; and “Expansion Province” mean either of such Provinces. 25. “Frontline Health Facilities” means, collectively, health care facilities managed by the Recipient’s government and/or churches, which are classified as levels 1, 2, 3 or 4 in accordance with the National Health Service Standards, or other -- 33 -- classification acceptable to the Association and described in the Project Operational Manual. 26. “Frontline Health Services” means health services delivered through the Frontline Health Facilities, including services provided through outreach from such facilities. 27. “General Conditions” means the “International Development Association General Conditions for IDA Financing, Investment Project Financing”, dated December 14, 2018. 28. “Integrated Facility Supervision Checklist” means a checklist developed and adopted by NDOH in accordance with the details set forth in the DLI Operational Manual, for Selected PHAs to use in their supervision of service delivery. 29. “Memorandum of Understanding” means, in relation to a Province, a Memorandum of Understanding entered into between the Recipient and its PHA, for the purpose of carrying out activities under Part 2 of the Project in such Province, referred to in Section I.B of Schedule 2 to this Agreement, as such memorandum of understanding may be revised from time to time with the Association’s prior written agreement, and such term includes any annexes or schedules to such memorandum of understanding; and “Memoranda of Understanding” means, collectively, all such Memoranda of Understanding. 30. “Mid-Term Review” shall have the meaning ascribed to it in Section II.2 of Schedule 2 to this Agreement. 31. “Minimum Service Quality Score” means a minimum score which an Eligible Level 2-4 Heath Care Facility is required to achieve to reflect its minimal service delivery quality level, as measured through the Integrated Facility Supervision Checklist and set forth in the DLI Operational Manual. 32. “National Capital District” means the National Capital District referred to in Section 4 of the Constitution of the Independent State of Papua New Guinea. 33. “National Department of Health” or its acronym “NDOH” means the Recipient’s National Department of Health, or any successor thereto. 34. “National DLIs” means, collectively, the DLIs set to be achieved at the national level by NDOH, as set forth in the table in Schedule 4 to this Agreement; and “National DLI” means, individually, any of them. 35. “National Health Service Standards” means the National Health Service Standards for Papua New Guinea 2011-2020, issued by the Recipient’s government on June 2011. -- 34 -- 36. “Operating Costs” means the reasonable incremental expenses incurred by the Recipient on account of the implementation, management and monitoring and evaluation of the Project, based on the Annual Work Plans and Budgets accepted ex-ante by the Association, including rental of office space, bank charges, communications, advertising costs, utilities, stationery, vehicle operation, maintenance, insurance and transportation costs, but excluding salaries, fees, honoraria, bonuses, and any other salary supplements of any of the Recipient’s civil servants. 37. “Outreach Visit” means a visit conducted in accordance with the DLI Operational Manual by a health facility staff to a lower level health facility or a community in a Selected Province, with the objective of delivering health services. 38. “PHA Act” means the Recipient’s Provincial Health Authorities Act 2007, No. 9 of 2007, as such act may be amended from time to time. 39. “PHA Board” means, in relation to a PHA, the board of governance of such PHA, established pursuant to the PHA Act. 40. “PHA Performance Funds” means funds allocated to a Province from NDOH’s budget for the achievement of DLIs, in accordance with the details set forth in the DLI Operational Manual. 41. “Procurement Regulations” means, for purposes of paragraph 87 of the Appendix to the General Conditions, the “World Bank Procurement Regulations for IPF Borrowers”, dated July 2016, revised November 2017 and August 2018. 42. “Project Coordination Unit” means the unit established within NDOH, referred to in Sections I.A.2 and I.A.3 of Schedule 2 to this Agreement. 43. “Project Operational Manual” means the Project’s operational manual referred to in Section I.C.1(a) of Schedule 2 to this Agreement, in form and substance satisfactory to the Association, to be adopted by the Recipient in accordance with the provisions of the said section; as said manual may be modified from time to time with prior approval in writing of the Association, and such term includes the DLI Operational Manual and any other schedules or annexes to the Project Operational Manual. 44. “Provinces” means, for the purpose of this Agreement, collectively: (a) the provinces of the Recipient, declared as such pursuant to Section 5 of the Constitution of the Independent State of Papua New Guinea; and (b) the National Capital District; and “Province” means any of such Provinces. -- 35 -- 45. “Provincial DLIs” means, collectively, the DLIs set to be achieved at the provincial level by Selected Provinces, as set forth in the table in Schedule 4 to this Agreement; and “Provincial DLI” means, individually, any of them. 46. “Provincial Health Authority” or its acronym “PHA” means a provincial health authority established pursuant to the PHA Act; and “Provincial Health Authorities” or “PHAs” means all such PHAs. 47. “Provincial Performance Dashboard” means a dashboard developed and adopted by a Selected PHA in accordance with the details set forth in the DLI Operational Manual, which contains, inter alia, critical health performance data of such Selected PHA. 48. “Safeguard Instruments” means, collectively, the ESMF and ESMPs; and “Safeguard Instrument” means any of such Safeguard Instruments. 49. “Safeguard Policies” means the Operational Policies (OPs) and Bank Procedures (BPs) of the Association, namely OP/BP 4.01 (Environmental Assessment), OP/BP 4.04 (Natural Habitats), OP/BP 4.09 (Pest Management), OP/BP 4.10 (Indigenous Peoples), OP/BP 4.11 (Physical Cultural Resources), OP/BP 4.12 (Involuntary Resettlement), OP/BP 4.36 (Forests), and OP/BP 4.37 (Safety of Dams); they can be found at https://policies.worldbank.org. 50. “Selected PHA” means the PHA of a Selected Province; and “Selected PHAs” means, collectively, all such Selected PHAs. 51. “Selected Province” means an Early Adopter Province or an Expansion Province; and “Selected Provinces” means, collectively, all Early Adopter Provinces and Expansion Provinces. 52. “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. 53. “Supportive Supervision Plan” means a plan adopted by the PHA Board in accordance with the details set forth in the DLI Operational Manual, outlining, inter alia, measures for improving the delivery of Frontline Health Services in a Selected Province and addressing any performance concerns. 54. “Training and Workshops” means the reasonable costs of training and workshop activities under the Project, based on the Annual Work Plans and Budgets accepted ex-ante by the Association, including preparation and reproduction of training materials, rental of facilities, reasonable transportation costs, per diem of trainers and trainees (if applicable), and any other expenses directly related to course preparation and implementation. -- 36 -- 55. “Year 1” means the period from December 1, 2019 to June 30, 2021; “Year 2” means the period from July 1, 2021 to June 30, 2022; “Year 3” means the period from July 1, 2022 to June 30, 2023; “Year 4” means the period from July 1, 2023 to June 30, 2024; “Year 5” means the period from July 1, 2024 to June 30, 2025; and “Year” means any of such Year 1 to Year 5.