Page 1 INTEGRATED SAFEGUARDS DATASHEET APPRAISAL STAGE I. Basic Information Date prepared/updated: 03/10/2011 Report No.: AC6101 1. Basic Project Data Country: Niger Project ID: P116167 Project Name: HIV/AIDS Support Project 2 Task Team Leader: Djibrilla Karamoko Estimated Appraisal Date: March 11, 2011 Estimated Board Date: April 26, 2011 Managing Unit: AFTHE Lending Instrument: Specific Investment Loan Sector: Other social services (45%);Health (40%);Central government administration (10%);Sub-national government administration (5%) Theme: HIV/AIDS (100%) IBRD Amount (US$m.): 0.00 IDA Amount (US$m.): 20.00 GEF Amount (US$m.): 0.00 PCF Amount (US$m.): 0.00 Other financing amounts by source: BORROWER/RECIPIENT 0.00 0.00 Environmental Category: B - Partial Assessment Repeater [] Is this project processed under OP 8.50 (Emergency Recovery) or OP 8.00 (Rapid Response to Crises and Emergencies) Yes [ ] No [X] 2. Project Objectives The development Objective of the project is to increase access to HV/AIDS/STI related services by high-risk groups. 3. Project Description The project will help the Republic of Niger implement its Strategic Plan for HIV/AIDS. It will have three components: (i) Strengthening of health services delivery for HIV/AIDS/STI; (ii) Prevention of HIV/AIDS/STI for high-risk groups; and (iii) Management, monitoring and evaluation. Component 1: Strengthening health services delivery for HIV/AIDS/STI (US$ 10.0 million). This component will aim to: (i) increase the quality of services for HIV/AIDS/STI; (ii) improve supply chain management; (iii) strengthen the prevention of mother-to-child transmission (PMTCT) program; (iv) integrate HIV/TB services; (v) develop second-generation surveillance; and (vi) improve biosafety. The component will be implemented through two sub-components as follows: Page 2 Sub-component 1.1: Strengthening health service delivery. This sub-component will support improved access to voluntary counseling and testing (VCT), care and treatment centers. It will support the capacity building and provision of critical inputs for HVI/AIDS services. The sector's HIV/AIDS unit (ULSS) will have a designated account to support activities for improving services in the public health sector and in the military's health facilities: training, procurement, and supervision conducted by the sector. Public sector military hospitals, or garnisons, will also be reinforced, as in some regions, notably Agadez, the garnison is the only hospital that provides higher-level care and is frequented by civilians as well. Sub-component 1.2: Piloting of Results-Based Financing for HIV/AIDS services. The sub-component will conduct, through selected health facilities, a pilot RBF during the first two years of the project implementation. Health Results Innovations Trust Fund (HRITF) will support a feasibility study for this project and the Bank's sector-wide approach project to determine which RBF mechanisms, if any, will be most appropriate in Niger's health sector. In the RBF, funds will be transferred to health facilities using the mechanism with aims to strengthen health services, improve quality, and motivate staff. The government will prepare an Operational Manual for Piloting RBF for HIV/AIDS Services in the health sector including (i) guidelines and procedures; (ii) monitoring and evaluation arrangements, and disbursement methodology, having regard to agreed performance targets and third party verification arrangements; and (iii) model forms of output-based financing agreements. This will be a condition of disbursement for subcomponent 1.2. Component 2: Prevention of HIV/AIDS/STI for high-risk groups (US$7.0 million).The objective of the component is to improve the prevention activities for high-risk groups through the proposals implemented by non-profit organizations (NGOs) and CSOs. This component will support a selected number of key interventions that are part of the Government's Strategic Plan for HIV/AIDS and targeted directly to specific high-risk groups as follows: (i) prevention activities for sex workers and their clients; and (ii) support to AIDS orphans and children of sex workers. Interventions for these groups will be targeted using the results of the social mapping exercise that has been conducted by the University of Quebec. In order to ensure that the activities proposed contribute towards the results desired, the project will introduce a competitive "call for proposals" (CFP) mechanism in order to hire qualified NGO/CSOs to target high risk groups and their clients and provide HIV prevention services. NGO/CSOs have the comparative advantage to provide a comprehensive package of evidence-based prevention activities: peer education, condom access, STI control, empowerment and community-based groups. As some of Niger's high-risk groups clients are represented within some sectors (Defense, Mining, Transport, Education) the component will include coordination by the CISLS/CRLS between the contracted NGO/CSOs and the AIDS Committees of these key sectors. In the provision of support to orphans and AIDS-affected children, links will be made with the Bank's Page 3 ongoing social protection project in Niger to ensure that the families identified by the NGOs/CSOs are integrated into the social protection activities of the safety net project. The government will prepare an Output-Based Financing Procedures Manual, giving details of all operational guidelines and procedures for the implementation, monitoring and supervision of Output-based financing, including: (i) guidelines and procedures for preparation, appraisal and environmental screening, and approval of, Output-based Financing proposals, and review of accompanying proposed service packages, along with criteria for the selection of beneficiaries; (ii) monitoring and evaluation arrangements, and disbursement methodology, having regard to agreed performance targets and third party verification arrangements; and (iii) model forms of output-based financing agreements. This will be a condition of effectiveness. Component 3: Management, monitoring and evaluation (US$3.0 million): Under the second project, the Bank will continue to provide support to CISLS, but the role of CISLS will be reoriented towards overall coordination rather than involvement in day-to- day operations. The project will help CISLS strengthen its capacity to lead the country in the campaign against the HIV/AIDS epidemic, to coordinate the National HIV/AIDS Program and to help in overseeing the implementation of Component 2. The role of the CISLS will become more focused on: overall planning, budgeting and coordination of the National AIDS Program; building a strong coalition across civil society and donors for prevention, care and treatment; strengthening the governance of the National program; monitoring program execution; and evaluating preventive approaches and disseminating best practices. This component will finance: (i) administrative and management costs, including the recruitment of key fiduciary staff at central and regional level; (ii) capacity building in CISLS and decentralized units (regional and local committees); (iii) technical support to enhance the design of policies and strategies including the analyze of ART financing options which will be conduct in the project first year; and (iv) implementation of the monitoring and evaluation (M&E) system throughout the country, including a joint review of the National HIV/AIDS strategic Framework and an impact evaluation. 4. Project Location and salient physical characteristics relevant to the safeguard analysis The project will be located at the central level (CISLS, MOH) and in the regional health facilities. 5. Environmental and Social Safeguards Specialists Mr Africa Eshogba Olojoba (AFTEN) Page 4 6. Safeguard Policies Triggered Yes No Environmental Assessment (OP/BP 4.01) X Natural Habitats (OP/BP 4.04) X Forests (OP/BP 4.36) X Pest Management (OP 4.09) X Physical Cultural Resources (OP/BP 4.11) X Indigenous Peoples (OP/BP 4.10) X Involuntary Resettlement (OP/BP 4.12) X Safety of Dams (OP/BP 4.37) X Projects on International Waterways (OP/BP 7.50) X Projects in Disputed Areas (OP/BP 7.60) X II. Key Safeguard Policy Issues and Their Management A. Summary of Key Safeguard Issues 1. Describe any safeguard issues and impacts associated with the proposed project. Identify and describe any potential large scale, significant and/or irreversible impacts: Increasing utilization of HIV related services will result in additional medical waste, which will need to be safely disposed of at health centers and laboratories. A Waste management plan has been prepared, implemented through the ongoing health project (P083350). It will be updated and disseminated before negotiations. 2. Describe any potential indirect and/or long term impacts due to anticipated future activities in the project area: The project will have a potential negative impact if the work plan finalized for the waste management is not implemented correctly. 3. Describe any project alternatives (if relevant) considered to help avoid or minimize adverse impacts. The ongoing health project will close in June 2011 and the new project will be an opportunity to continue the support for the country. 4. Describe measures taken by the borrower to address safeguard policy issues. Provide an assessment of borrower capacity to plan and implement the measures described. - The country has the experience to implement the Waste management plan - Technical capacity has been developed by the first HIV/AIDS project, and has been strengthened through the ongoing health project. 5. Identify the key stakeholders and describe the mechanisms for consultation and disclosure on safeguard policies, with an emphasis on potentially affected people. The stakeholders will be the National Direction for Hygiene, and the NGO involved in the management of the waste. B. Disclosure Requirements Date Page 5 Environmental Assessment/Audit/Management Plan/Other: Was the document disclosed prior to appraisal? Yes Date of receipt by the Bank 03/07/2011 Date of "in-country" disclosure 03/07/2011 Date of submission to InfoShop 03/10/2011 For category A projects, date of distributing the Executive Summary of the EA to the Executive Directors Resettlement Action Plan/Framework/Policy Process: Was the document disclosed prior to appraisal? Date of receipt by the Bank Date of "in-country" disclosure Date of submission to InfoShop Indigenous Peoples Plan/Planning Framework: Was the document disclosed prior to appraisal? Date of receipt by the Bank Date of "in-country" disclosure Date of submission to InfoShop Pest Management Plan: Was the document disclosed prior to appraisal? Date of receipt by the Bank Date of "in-country" disclosure Date of submission to InfoShop * If the project triggers the Pest Management and/or Physical Cultural Resources, the respective issues are to be addressed and disclosed as part of the Environmental Assessment/Audit/or EMP. If in-country disclosure of any of the above documents is not expected, please explain why: C. Compliance Monitoring Indicators at the Corporate Level (to be filled in when the ISDS is finalized by the project decision meeting) OP/BP/GP 4.01 - Environment Assessment Does the project require a stand-alone EA (including EMP) report? Yes If yes, then did the Regional Environment Unit or Sector Manager (SM) review and approve the EA report? Yes Are the cost and the accountabilities for the EMP incorporated in the credit/loan? Yes The World Bank Policy on Disclosure of Information Have relevant safeguard policies documents been sent to the World Bank's Infoshop? Yes Have relevant documents been disclosed in-country in a public place in a form and language that are understandable and accessible to project-affected groups and local NGOs? Yes All Safeguard Policies Page 6 Have satisfactory calendar, budget and clear institutional responsibilities been prepared for the implementation of measures related to safeguard policies? Yes Have costs related to safeguard policy measures been included in the project cost? Yes Does the Monitoring and Evaluation system of the project include the monitoring of safeguard impacts and measures related to safeguard policies? Yes Have satisfactory implementation arrangements been agreed with the borrower and the same been adequately reflected in the project legal documents? Yes D. Approvals Signed and submitted by: Name Date Task Team Leader: Mr Djibrilla Karamoko 03/07/2011 Environmental Specialist: Mr Africa Eshogba Olojoba 03/08/2011 Social Development Specialist Additional Environmental and/or Social Development Specialist(s): Approved by: Sector Manager: Ms Eva Jarawan 03/08/2011 Comments: