Page 1 INTEGRATED SAFEGUARDS DATASHEET APPRAISAL STAGE I. Basic Information Date prepared/updated: 04/01/2011 Report No.: AC6205 1. Basic Project Data Original Project ID: P093987 Original Project Name: Health Sector Support & Multisectoral AIDS Project Country: Burkina Faso Project ID: P125285 Project Name: Health Sector Support and Multi-Sectoral Aids Project - Additional Financing Task Team Leader: Haidara Ousmane Diadie Estimated Appraisal Date: March 21, 2011 Estimated Board Date: July 5, 2011 Managing Unit: AFTHE Lending Instrument: Sector Investment and Maintenance Loan Sector: Health (70%);Other social services (30%) Theme: HIV/AIDS (40%);Nutrition and food security (40%);Child health (10%);Health system performance (10%) IBRD Amount (US$m.): 0.00 IDA Amount (US$m.): 30.00 GEF Amount (US$m.): 0.00 PCF Amount (US$m.): 0.00 Other financing amounts by source: BORROWER/RECIPIENT 0.00 Plan Africa 3.02 3.02 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 project development objective is reformulated to improve access and quality of priority health, nutrition and HIV/AIDS services. The change is deemed necessary to clarify the intent of the original project development objective. The proposed additional financing will support the subcomponent IV under Component A, i.e., the implementation by the MOH of the National Nutrition Strategic Plan; and Component B, the implementation of the National HIV/AIDS Strategy by the SP/CNLS-IST. 3. Project Description Project Support to the National Nutrition Strategic Plan ($15 million): The nutrition subcomponent, introduced to the project through Additional Financing when the project was half way into its implementation, is progressing well following rigorous preparation of the contracting out approach of community health and nutrition services. With the proposed Additional Financing there will be scope to scale up the coverage, consolidate Page 2 the strategy and improve quality of services. This component will support the following subcomponents: (i) the scaling up of essential direct health and nutrition actions at family and community level to all 13 regions; and (ii) policy and program coordination and monitoring and evaluation of direct nutrition action. Direct nutrition action at community level includes community-based child growth promotion with emphasis on behavior change communication, including care of pregnant women, and case management of severe acute malnutrition. Community-based management of severe acute malnutrition for non-complicated cases is used to complement in-patient care for cases with complications. Community-based activities will be implemented in all 13 regions with emphasis on the worst affected districts. They will be implemented over three years (2012-2014), reaching 65% of the total population of rural children under five years old. This will be achieved by strengthening the capacity at district level, contracting out implementation to NGOs and CBOs, and strengthening their link with the decentralized system. Project Support to the National HIV/AIDS Strategy ($18 million): This component will complement the activities currently funded and proposed by the government for funding by the Global Fund # if approved (approximately US$24 million for 2011-2016) # and provide continuity to the activities funded under the initial project, particularly the strategic priorities and objectives focused on prevention and promotion activities. It aims to reduce new infections and control the risk of epidemic rebound among high-risk groups and its effects on vulnerable populations. It will support the following subcomponents: (i) the strengthening of community-based approaches for the prevention of risky behaviors by target populations and increasing the use of voluntary counseling and testing (VCT) and prevention of mother-to-child transmission (PMTCT) services (ii) enhancing the quality of early diagnosis and case management of HIV, sexually transmitted infections (STI) and opportunistic infections; (iii) laboratory improvements (to be funded by the Spanish Cooperation Africa Plan); (iv) improving the care of and support to PLWHA and in particular to orphans and vulnerable children (OVC); and (v) improving the capacity to coordinate and monitor the HIV/AIDS strategic plan. The case management of HIV patients with ARV treatment are covered by Global Fund. Moreover, the team is working with the government to introduce a line item in the national budget for ARV treatment. Project activities will include behavioural change communication (BCC) promoting healthier sexual behaviours through condom use and reduction of partners, decentralized VCT for HIV, training of health personnel for better PMTCT management and BCC interventions to increase use of prenatal services, early testing and treatment of STIs, improvement of blood safety, universal precaution measures and management of accidental exposure to HIV, and prevention of sexual violence against women. Implementation will continue to draw on the experience of working with NGO, line ministries and local authorities to develop IEC/BCC and care interventions targeted to miners, sex workers, uniformed personnel, in school and out of school youth, OVC´s, health workers, local story-teller (#griotes#), religious and traditional authorities and other groups. Page 3 4. Project Location and salient physical characteristics relevant to the safeguard analysis The Project will be implemented nationwide with an emphasis at community level activities. Under Component B, the Spanish Program for Africa Grant (US$3,024,957) will finance the renovation of, and equipment and furniture for the: (i) HIV/AIDS and STIs national reference laboratory; (ii) laboratories of two regional hospitals, three district hospitals, and four NGO-run laboratories involved that support PLWHA (those that previously operated under the ARV treatment acceleration program (TAP) funded by World Bank from 2002 to 2007; and (iii) facilities of three Regional Antennas of the SP/CNLS-IST, which were damaged during the floods of September, 2009. The project will not support any construction works. The renovation works are limited to painting and fixing windows, doors, floors and frames/panels. 5. Environmental and Social Safeguards Specialists 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: The Environmental Category for the AF is B, as was the case in the original project. The Medical Waste Management Plan for the original project has been updated and re- disclosed in March 2011. Under Component B, the Spanish Program for Africa Grant (US$3,024,957) will finance the renovation of, and equipment and furniture for various laboratories, hospitals, and facilities. The project will not support any construction works. The renovation works are limited to painting and fixing windows, doors, floors and frames/panels of the existing structures. These works will be carried out in accordance with national and local laws and regulations. Page 4 2. Describe any potential indirect and/or long term impacts due to anticipated future activities in the project area: The Environmental Category for the AF is B, as was the case in the original project. The Medical Waste Management Plan for the original project has been updated and re- disclosed in March 2011. Under Component B, the Spanish Program for Africa Grant (US$3,024,957) will finance the renovation of, and equipment and furniture for various laboratories, hospitals, and facilities. The project will not support any construction works. The renovation works are limited to painting and fixing windows, doors, floors and frames/panels of the existing structures. These works will be carried out in accordance with national and local laws and regulations. The Environmental Category for the AF is B, as was the case in the original project. The Medical Waste Management Plan for the original project has been updated and re- disclosed in March 2011. Under Component B, the Spanish Program for Africa Grant (US$3,024,957) will finance the renovation of, and equipment and furniture for various laboratories, hospitals, and facilities. The project will not support any construction works. The renovation works are limited to painting and fixing windows, doors, floors and frames/panels of the existing structures. These works will be carried out in accordance with national and local laws and regulations. 3. Describe any project alternatives (if relevant) considered to help avoid or minimize adverse impacts. Not Relevant 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 proposed implementing agencies are the Ministry of Health and the National AIDS/STI Council. During HSSMAP preparation, the Government of Burkina Faso developed a Medical Waste Management Plan (MWMP), in compliance with National and World Bank Safeguard Policies. The MWMP has been updated and disclosed in March 2011. The activities of the nutrition component will not trigger any environmental or social safeguard policy issues. 5. Identify the key stakeholders and describe the mechanisms for consultation and disclosure on safeguard policies, with an emphasis on potentially affected people. People have been consulted about the project during supervision as well as monitoring rounds and have expressed general satisfaction with the approach followed by the project. Page 5 B. Disclosure Requirements Date Environmental Assessment/Audit/Management Plan/Other: Was the document disclosed prior to appraisal? Yes Date of receipt by the Bank 02/15/2011 Date of "in-country" disclosure 03/03/2011 Date of submission to InfoShop 03/28/2011 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? N/A 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 Yes Page 6 groups and local NGOs? All Safeguard Policies 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 Haidara Ousmane Diadie 03/18/2011 Environmental Specialist: Mr Amadou Konare 03/17/2011 Social Development Specialist Additional Environmental and/or Social Development Specialist(s): Approved by: Sector Manager: Ms Eva Jarawan 03/17/2011 Comments: