REPORT NO.: RES47581 RESTRUCTURING PAPER ON A PROPOSED PROJECT RESTRUCTURING OF IMPROVING EARLY CHILDHOOD DEVELOPMENT IN THE WEST BANK AND GAZA APPROVED ON DECEMBER 18, 2019 TO PALESTINE LIBERATION ORGANIZATION EDUCATION MIDDLE EAST AND NORTH AFRICA Regional Vice President: Ferid Belhaj Country Director: Kanthan Shankar Regional Director: Keiko Miwa Practice Manager/Manager: Andreas Blom Task Team Leader(s): Samira Nikaein Towfighian, Samira Ahmed Hillis The World Bank Improving Early Childhood Development in the West Bank and Gaza (P168295) ABBREVIATIONS AND ACRONYMS E&S Environmental and Social ECD Early Childhood Development EHSO Environmental, Health and Social Officer ESC Environmental and Social Consultant ESCP Environmental and Social Commitment Plan ESMF Environmental and Social Management Framework ESMP Environmental and Social Management Plan ESO Environmental and Social Officer EU European Union GBV Gender- Based Violence GM Grievance Mechanism GRM Grievance Redress Service Mechanism IFR Interim Financial Report KG Kindergarten LMP Labor Management Procedures MHPSS Mental Health and Psychosocial Support Services MOE Ministry of Education MOH Ministry of Health MOSD Ministry of Social Development NGO Non-governmental Organization OHS Occupational Health and Safety PCU Project Coordination Unit PDO Project Development Objective PPP Public Private Partnership RDNA Rapid Damage Needs Assessment SEA Sexual Exploitation and Abuse SEF Stakeholder Engagement Framework SEP Stakeholder Engagement Plan SH Sexual Harassment TOR Terms of Reference UNICEF United Nations Children’s Fund UNMAS United Nations Mine Action Service UNRWA United Nations Relief and Works Agency for Palestinian Refugees in the Near East UXO Unexploded Ordinances 2 The World Bank Improving Early Childhood Development in the West Bank and Gaza (P168295) BASIC DATA Product Information Project ID Financing Instrument P168295 Investment Project Financing Environmental and Social Risk Classification (ESRC) Moderate Approval Date Current Closing Date 18-Dec-2019 31-Jan-2025 Organizations Borrower Responsible Agency Palestine Liberation Organization Ministry of Education,Ministry of Health Project Development Objective (PDO) Original PDO Improve the coverage and quality of targeted early childhood development services for children from gestation until age 5 in West Bank and Gaza. OPS_TABLE_PDO_CURRENTPDO Summary Status of Financing (US$, Millions) Net Ln/Cr/Tf Approval Signing Effectiveness Closing Commitment Disbursed Undisbursed TF-B1614 18-Dec-2019 16-Jan-2020 02-Mar-2020 31-Jan-2025 9.00 1.25 7.75 Policy Waiver(s) Does this restructuring trigger the need for any policy waiver(s)? No 3 The World Bank Improving Early Childhood Development in the West Bank and Gaza (P168295) I. PROJECT STATUS AND RATIONALE FOR RESTRUCTURING A. Project Status 1. The project development objective of the Improving Early Childhood Development in the West Bank and Gaza Project is to improve the coverage and quality of targeted early childhood development services for children from gestation until age 5 in West Bank and Gaza. The project was approved by the World Bank Board of Executive Directors on December 18, 2019 and became effective on March 2, 2020. The project consists of three main components jointly implemented by the Ministries of Education and Health: Component 1 Promoting early healthy development, Component 2 Improving access to high-quality KG services and Component 3 Improving availability of ECD data. 2. While the COVID-19 pandemic continues to pose significant challenges, the project has achieved tangible progress in implementation since the last ISR (April 5, 2021). Under component 1 ("Promoting early healthy development"), the procurement process of medical equipment for improved maternal and child health services delivery at the Ministry of Health (MOH) hospitals in both West Bank and Gaza has been initiated. The equipment includes otoacoustic emission, ultrasound machines, incubators, echo-cardiography and others. Furthermore, the MOH and the World Bank team have been proactively advancing preparatory work for the launch of the parenting intervention and adapting it to the new COVID-19 context. A technical review of the existing ECD services and their corresponding protocols is underway to identify gaps and inform the design of the parenting intervention. Under subcomponent 2.1 ("Expanding access to kindergarten (KG) services"), the Ministry of Education (MOE) has launched the procurement process for a firm to design and supervise construction and refurbishment activities to create new KG2 classrooms. The schools for the KG extensions/refurbishments have been identified and validated through on- site visits by the Ministry's Directorate General of Educational Buildings. Activities for the launch of the Public Private Partnership (PPP) pilot have commenced, particularly the technical design of the PPP is being developed through extensive consultations with MOE departments, private providers and relevant stakeholders. Under subcomponent 2.2 (“Enhancing the quality of KG services”), the procurement process for an international university to support the design of an in-service KG Teacher Professional Diploma has been successfully launched. The MOE has already completed the shortlisting process and expects to finalize the selection process by early September 2021. In addition, significant progress has been achieved under the KG Quality Assurance System, where KG quality standards have been developed, and a consolidated monitoring tool to assess the quality of KG service delivery is being field-tested through KG classroom visits. 3. Financial management and Procurement performance continue to be Satisfactory. The latest Interim Financial Report (IFR) was submitted on time (10 August 2021) covering the period from 1 January 2021 to 30 June 2021 and the audited financial statements of the Project for the year ended 31 December 2020 were submitted, reviewed and accepted on time as well (on 3 June 2021). The management letter accompanying the audited financial statements did not list any material weaknesses in the internal controls implemented in the Project. Similarly, the procurement activities under the project components carried out by the MOH and MOE continue to be implemented in accordance with the applicable World Bank Procurement Regulations and the last procurement plans updated on 24 February 2021 for the MOH and on 30 July 30 2021 for the MOE. The Financial Management risk of the project remains at Substantial and the procurement risk remains at Moderate. B. Rationale for Restructuring 4 The World Bank Improving Early Childhood Development in the West Bank and Gaza (P168295) 4. Eleven days of war, conflict and hostilities afflicted Gaza in May 2021. The human toll in the strip amounted to almost 2,000 Palestinians physically injured, including over 600 children; and 260 Palestinians killed, including 66 children and 41 women. Core physical infrastructure was also damaged, including schools, hospitals and health centers, water and sanitation facilities, and transport, energy and communications networks.1 5. Children in the 0-5 age bracket were particularly vulnerable to the shocks and devastation caused by the war in Gaza. First and foremost, the war had a dramatic impact on children’s physical and psychological health. Studies have shown that exposure to sustained high levels of stress, also known as toxic stress, can disrupt young children's physical development and lead to chronic diseases and cognitive impairment.2 Exposed to high levels of hostilities and toxic stress, children in Gaza are in dire need of mental health and psychosocial support services (MHPSS).3 Specifically, a mass scale-up of MHPSS is required to prevent the development of mental health disorders: from psychological first aid and structured psychosocial support, to case management and clinical mental health services. 6. However, Gaza’s healthcare system is struggling to respond to the large number of vulnerable populations with MHPSS needs due to chronic shortages of qualified healthcare workers. Prior to the May 2021 escalations, an estimated 210,000 people in Gaza were already suffering from a severe or moderate form of mental health illness.4 In 2019, more than 321,000 children were estimated to be in need of MHPSS services.5 The May 2021 war exacerbated this, with more children and their caregivers in need of MHPSS services to address psychosocial trauma. Yet, disrupted by the ongoing COVID-19 outbreak, and further weakened by extensive damages to key healthcare facilities and providers6, Gaza’s already-strained healthcare system is unable to meet this increased demand for MHPSS services. 7. Beyond the direct impact on children’s wellbeing, the war also destroyed or impaired the delivery of key services for children. Specifically, damages to educational infrastructure risk reducing access to KG services, which are key to ensure children’s readiness for primary school. It is estimated that more than 66,000 children enrolled in KGs in Gaza were affected by the war, further exacerbating the substantial learning losses due to the COVID-19 pandemic. According to an assessment report received from MOE, 116 out of 685 private KGs in Gaza have been damaged. Among these, 114 KGs have suffered minor damages, while 2 KGs have been moderately damaged. The damaged KGs enroll more than 6,600 children. Table 1 shows the geographical distribution of damaged KG facilities. Table 1. Overview of Infrastructure Damages to Kindergartens in Gaza 1 World Bank (2021). Gaza Rapid Damage and Needs Assessment. June 2021. Washington, D.C. https://documents1.worldbank.org/curated/en/178021624889455367/pdf/Gaza-Rapid-Damage-and-Needs-Assessment.pdf 2 Norwegian Refugee Council (2020). Stressed: A special report on the psychological impact of Covid-19 on refugee and displaced children in the Middle East. Norwegian Refugee Council: NRC, Amman. https://www.nrc.no/shorthand/stories/stressed/index.html 3 In Gaza, four levels of MHPSS services (basic services and security; community and family support; focused, non-specialized supports; and specialized services, in accordance with the Inter-Agency Standing Committees MHPSS Guidelines (2007)) are provided by 14 service providers, including the Ministry of Health, UN agencies (such as WHO) and NGO partners. Psychosocial support services are provided in all five governorates, while mental health services are provided by a limited number of service providers. (Source: UNICEF. A review of the humanitarian mental health and psychosocial needs and gaps in West Bank and Gaza. September 2019.) 4 United States Agency for International Development. Fact Sheet: West Bank and Gaza – Complex Emergency. June 4, 2021. Available at https://reliefweb.int/sites/reliefweb.int/files/resources/2021_06_04%20USG%20West%20Bank%20and%20Gaza%20Complex%20Emergency%20 Fact%20Sheet%20%231.pdf 5 UNICEF. A review of the humanitarian mental health and psychosocial needs and gaps in West Bank and Gaza. September 2019. 6 Frontline healthcare workers are also directly affected by the incident and may be unable to resume work or at risk of being overloaded due to the immense needs on the ground. (Source: United Nations Office for the Coordination of Humanitarian Affairs. Escalation of Hostilities and Unrest in the oPt – Flash Appeal. May 27, 2021. Available at https://reliefweb.int/report/occupied-palestinian-territory/escalation-hostilities-and-unrest- opt-flash-appeal-27-may-2021) 5 The World Bank Improving Early Childhood Development in the West Bank and Gaza (P168295) # Education District Office Mild Damages Moderate # Estimated Cost Damages Kindergartens US$ 1. North Gaza Directorate 33 1 34 35,137 Office 2. West Gaza Directorate 15 0 15 29,471 Office 3. East Gaza Directorate 17 1 18 37,390 Office 4. West Khan Younes 14 0 14 10,420 Directorate Office 5. East Khan Younes 14 0 14 6,320 Directorate Office 6. Wusta Directorate 15 0 15 12,430 Office 7. Rafah Directorate office 6 0 6 4,078 TOTAL 114 2 116 135,246 8. Furthermore, children who have been forcibly displaced or whose housing units were damaged remain at particular risk of being cut off from key services and learning materials. As of July 8, about 8,200 people in Gaza remain internally displaced7, including an estimated 500 children of kindergarten age8 who have lost their homes and possessions. With about 1,600 housing units totally destroyed and 2,500 housing units partially damaged9, it is estimated that about 4,100 children aged 4-5 live in temporary housing or dwellings that have been damaged during the war. These children are likely to lack access to educational materials, stationary, games, and toys. These materials are not only conducive to their early learning, but also have the potential to support their psychosocial wellbeing. II. DESCRIPTION OF PROPOSED CHANGES A. Proposed Changes 9. To help address the urgent mental health and psychosocial needs of children in Gaza, the MOH has requested the redistribution of funds under subcomponent 1.2. US$600,000 from sub-component 1.2 (Strengthening nutrition and early stimulation during the critical first 1,000 days of life) will be reallocated to support MHPSS services for children and their caregivers to address short-term needs resulting from the war, while at the same time strengthening capacity for improved MHPSS service delivery in the medium- to long-term. Specifically, new activities will include capacity building to improve the availability and quality of MHPSS services provided by the MOH and MOE. 10. Through the MOH, the project will support the establishing and strengthening of MHPSS services in Gaza through a multi-layered approach: (1) identification, referral and immediate care, (2) focused non-specialized care, and (3) specialized services. Healthcare providers in primary health care centers will receive training and guidance on how to screen children under five for potential mental health issues (e.g., post-traumatic stress disorders). Healthcare workers would then provide treatment when appropriate or refer patients to more specialized MHPSS services as 7 UN OCHA 2021. “Response to the escalation in the oPt | Situation Report No. 7 (2-7 July 2021)”. https://www.ochaopt.org/sites/default/files/SITREP-7.pdf 8 World Bank estimate based on UN World Population Prospects data for 2021 by age. 9 World Bank, European Union, and United Nations (2021). “Gaza Rapid Damage and Needs Assessment - June 2021.” Washington, D.C.: World Bank. 6 The World Bank Improving Early Childhood Development in the West Bank and Gaza (P168295) needed. The support will also include development or adaptation of materials for identification and referral. The MOH may also organize capacity building activities and develop protocols targeting nursery and KG teachers and school principals on screening for mental health disorders in schools and providing caregivers information on available services. As they interact with children for multiple hours in a day and observe their social interactions, teachers play an important role in detecting mental health conditions that could impede normal child development. They will thus benefit from clear and consistent guidance on what behaviors to look out for, how to emotionally support their students more generally, and how they should communicate with parents so that children get the health services they need. To the extent that nurseries and schools employ medical professionals such as nurses, such staff may also attend the more medically-focused capacity building activities targeting healthcare providers in primary health centers. 11. Health care workers will be trained to provide focused individual, family or group MHPSS interventions. The project will support centers that are underserved, under-equipped and lacking trained staff to treat children under 5 with training. At the level of specialized mental health centers, health care workers will be trained to enhance the quality of the existing services as well as to expand the range of services provided to cover interventions such as applied behavioral analysis for children, speech and language therapy, and sensory integration therapy. The services provided by these centers would be strengthened by setting up the needed equipment for diagnosis and treatment especially for children with developmental delays, and by hiring and/or supporting specialized professionals such as speech therapists, occupational therapists, clinical psychologists, social workers, and physicians trained in mental health care, as needed. Given the important role of parents in child development and the association between parental mental health and child development, these services will also target caregivers where appropriate and as needed. 12. Given MOH’s limited provision of specialized MHPSS services in Gaza and the immediate need for psychosocial support among children, MOH will leverage existing MHPSS service providers, such as those supported by United Nations (UN) agencies and/or non-governmental organization (NGO) partners. Capable and suitable service providers will be selected based on agreed criteria, including available current services provided (preferably covering all levels of MHPSS services), geographical coverage, and service delivery capacity to respond to needs in the next six months or so. In addition to the capacity building targeting healthcare workers in primary health centers and community mental health centers, the activities will include capacity building to improve availability and quality of specialized MHPSS services, as well as technical assistance to identify population needs and service delivery gaps and to design suitable MHPSS interventions/programs. Progress of restructured activities under subcomponent 1.2 will be monitored through PDO indicator #1 (“Share of caregivers reporting improvement in parenting practices in response to a parenting or psychosocial support intervention”) and intermediate results indicator #2 (“Number of service providers trained to administer a parenting or psychosocial support intervention”). 13. Given the substantial needs of KG age children in Gaza, MOE has requested reallocating the financing under Component 3 of the project, to repair infrastructure damages to KGs and provide learning materials. While activities under Component 3 (“Improving availability of ECD data”) of the project are important for strengthening the ECD system, given limited funding, MOE considers that they are not a priority in the current context of humanitarian crisis. As such, financing under this component (US$600,000) will be reallocated to Component 2 of the project as described below. 14. Approximately US$140,000 will be reallocated to subcomponent 2.1 to finance repairs of infrastructure damages to KGs in Gaza. Damages to KG infrastructure in Gaza range from minor to moderate. Upon restructuring of the project, funds will be used to rehabilitate approximately 80 private KGs that have been damaged during the 7 The World Bank Improving Early Childhood Development in the West Bank and Gaza (P168295) war. According to the assessment report received from the MOE, the needed rehabilitation works mainly include the following:  Aluminum works – windows  Wooden works – doors  Sanitary works – toilets, water tanks  Metal works  Painting and finishing works  Cement and plaster works  Electrical works  Outdoor works – playgrounds pavement, gates, boundary walls  Furniture10 15. These proposed activities will follow the same implementation arrangements as those originally envisioned under subcomponent 2.1. The MOE Directorate General of Educational Buildings in full coordination with the Project Coordination Unit (PCU) and its staff in Gaza will prepare the bidding documents as per World Bank procurement guidelines, include the new activities in the project procurement plan, and hire the needed contractors to rehabilitate the damaged KGs as quickly as possible. The PCU will also work closely with the Directorate General of Construction at MOE to ensure timely completion of the rehabilitation works and procurement of needed indoor and outdoor furniture. Progress of restructured activities under subcomponent 2.1 will be monitored through PDO indicator #2 (“Number of children enrolled in KG2 as a result of the project, disaggregated by public provision, PPP provision, and rehabilitation in Gaza”). 16. Roughly US$460,000 will be reallocated to subcomponent 2.2 to finance relevant teaching and learning materials to KG age children in Gaza. Reallocated funds will support the provision of approximately 7,500 child kits to the most vulnerable children aged 4-5 who have been forcibly displaced during the war, those living in temporary or damaged housing, and those attending KGs that are in need of repairs. The child kits will include stationary, handicraft materials, educational games, and toys, leveraging existing resources that have been deployed in West Bank and Gaza during the COVID-19 pandemic. The materials may be provided in an age-appropriate school bag. A preliminary list of items to be included in the child kit at the request of MOE and building on the existing child kits developed and locally adapted to the Palestinian context by other partners is provided in Table 2. In addition, the child kit will be accompanied by an informational leaflet to parents on local psychosocial support services available to them and their children, in close coordination with activities to be supported under Area 3 of the proposed restructuring. Table 2. Potential items for the child kit Category A: Stationary & Handicraft Materials 1. A4 paper (white & colored) 2. Notebooks 3. Crayons 4. Gouache colors 5. Painting brushes 6. Colored beads 7. Child-sized scissors 10 Further information on the type (indoor/outdoor KG furniture) and quantities to be provided by MOE. 8 The World Bank Improving Early Childhood Development in the West Bank and Gaza (P168295) 8. Tape/Glue Category B: Games and Toys 9. Plastic/sponge balls 10. Picture cards 11. Mathematics game 12. Story books 17. These proposed activities will follow the same implementation arrangements as those originally envisioned under subcomponent 2.2. In addition, the MOE will collaborate with relevant UN agencies and international partners (e.g., Save the Children, United Nations Children’s Fund (UNICEF), and UNRWA) to ensure timely procurement of the learning materials and facilitate fast distribution to children in need. This will include leveraging materials from existing resources as needed, building on previous experience of UN agencies and NGOs in providing educational kits during crises. Progress of restructured activities under subcomponent 2.2 will be monitored through intermediate results indicator #6 (“Number of KG classes supplied with teaching or learning materials”). 18. This is the first restructuring of this project. All proposed restructuring activities remain relevant to achieve the Project Development Objective (PDO) as they directly contribute to improving access and quality of early childhood development services, and particularly enable the healthy development of children in Gaza. Environmental and Social (E&S) Appraisal 19. The activities introduced under the restructuring will have an overall positive impact, and the environmental and social risks remain moderate. The environmental risks and impacts for the rehabilitation activities at KGs and health care centers introduced under the restructuring are similar to those identified in the Environmental and Social Management Framework (ESMF). However, the KG rehabilitation activities may have additional health and safety risks for workers and the community, related to the potential presence of unexploded ordinances (UXO) and non-hazardous and hazardous waste mixed within the rubble. Therefore, the KG sites that were directly shelled or include rubble at the work sites will be initially screened for UXO, and the required clearance and permits will be obtained from the United Nations Mine Action Service (UNMAS) prior to conducting the E&S assessment. The risk of rubble presence would be low, as most of the rubble in Gaza Strip has been removed including in the selected KGs zones. On the other hand, the learning materials and capacity building activities under sub-components 2.2 and the supply of equipment under subcomponent 1.2 are of low environmental risk. 20. The primary social risk of a moderate level is of exclusion. There is a moderate risk that the most vulnerable groups and communities may not be able to access and benefit from project interventions (for example, those living in remote locations and access restricted areas such as the Bedouin village, women headed households, the forcibly displaced including those living with host families and unregistered private KG service providers). Risks to the provision and proper use of child kits and access to mental health and psychosocial support at the community and primary health center levels exist due to challenges related to targeting, outreach, and availability of requisite information. These risks will be addressed at the project design level and through implementation of E&S measures. The design of the restructured activities will take into consideration the needs and concerns of these vulnerable groups and communities to ensure inclusion and equity. The activities under the restructuring aim to provide access to ECD services to those populations who were most affected by the war, mainly the most vulnerable populations. The KG repairments will target those KGs damaged by the war, thus ensuring that populations at risk of being excluded from KG services because of infrastructure damages can quickly return to preschool. For the child learning kits, the project will build on the experience of development partners to include tried and tested instructions that are easily accessible to the most vulnerable and disadvantaged caregivers with local community workers as needed. The learning kits will 9 The World Bank Improving Early Childhood Development in the West Bank and Gaza (P168295) be distributed to children who lost their learning materials because of the war and who are at the greatest risk of being left behind in their educational progress because of the war. In addition, no separate self-registration process will be needed to obtain the child kits; instead, the project will leverage existing information and databases form the Ministry of Social Development and development partners including UNICEF, UNRWA and Save the Children. Moreover, the psychosocial support will be provided to children and caregivers suffering the most because of the war. The targeting for the provision of the child kits and the mental health and psychosocial support services will also be informed by the Rapid Damage Needs Assessment (RDNA), conducted jointly by the World Bank, European Union (EU) and UN. In addition to the project’s design, the Stakeholder Engagement Plan (SEP) – that has been updated in keeping with the project restructuring – includes mechanisms to ensure provision of requisite information, in accessible formats, to enable the meaningful engagement of the most vulnerable and marginalized throughout the lifetime of the project. The SEP also ensures that any new stakeholders (e.g., mental health service providers, civil society organizations, international agencies, caregivers, parents, personnel from KGs being rehabilitated, etc.) are included in the SEP and consulted accordingly. There is no risk of land taking as rehabilitation works will be done in the footprint of existing facilities. 21. The original project ESMF will be updated to address the restructuring activities and provide mitigation measures to address site specific risks. The risks include (but are not limited to) safe disposal of different types of waste; occupational health and safety for workers related to potential presence of UXO mixed with the rubble and exposure to COVID-19; and, community health and safety related to Sexual Exploitation and Abuse (SEA), and Sexual Harassment (SH) during rehabilitation works.. The risk for SEA/SH is moderate according to the Bank’s screening tool for SEA/SH. The environmental and social assessment will identify the need for a site-specific Environmental and Social Management Plan (ESMP) or an ESMP checklist, where UXO will be initially screened, and clearance and permit obtained from UNMAS prior to conducting the E&S assessment for the KG sites that were directly shelled or include rubble at the work sites. The updated ESMF will be consulted, reviewed and cleared by the Bank, and disclosed in- country and on the Bank system during the first week of September and in time for restructuring activities to commence. The original project Labor Management Procedures (LMP) will also be updated in line with the project restructuring, reviewed and cleared by the Bank, and disclosed in-country and on the Bank’s system during the first week of September and in time for the restructuring activities to commence. 22. The capacity to manage E&S risks and impacts will continue to be enhanced to address restructuring requirements. The PCU hosts an Environmental and Social Officer (ESO) to follow the project activities in West Bank. As the ESO has limited experience, the Bank team has and will continue providing extensive support to assist and guide the ESO in meeting the E&S requirements. The PCU, however, does not have an ESO in Gaza nor does the ESO have access to Gaza. Therefore, the PCU hired a qualified Environmental and Social Consultant (ESC) for the Gaza Strip on August 18, 2021, who will be responsible for implementation of the project’s E&S requirements according to the Environmental and Social Commitment Plan (ESCP) including supervision of the implementation of the updated ESMF and monitoring the compliance of suppliers/contractors to the provisions of the ESMPs; implementation of the updated Stakeholder Engagement Plan (SEP) and updated LMP for the project activities implemented MOE, MOH and Ministry of Social Development (MOSD); and building the capacity of designated team members to implement the E&S measures. Moreover, the ESC will coordinate and report to both the MOH Environmental, Health and Social Officer (EHSO) and the PCU/MOE for the MOH related activities. The Bank’s E&S team will also provide support to the concerned team in Gaza so that the E&S requirements of the project are met as required. 23. The project SEP was updated in line with the project restructuring. The SEP update includes: the description of new activities introduced in the restructuring and accompanying E&S risks and mitigation measures; identification of additional stakeholders; a summary of the public consultation meetings conducted in Gaza on July 11 and August 08, 2021 to inform stakeholders about the education and health-related activities; and, new needs for stakeholder 10 The World Bank Improving Early Childhood Development in the West Bank and Gaza (P168295) engagement and information disclosure (in line with the restructuring) identified during the stakeholder consultations. Details of the Grievance Mechanism (GM) established for the original project, which will also be used for the restructured project, were also shared with stakeholders. The updated SEP was reviewed and cleared by the Bank and disclosed in-country (August 21, 2021) and on the Bank system (August 23, 2021). 24. The project ESCP was also updated to reflect the changes due to project restructuring. Specifically, the project restructuring includes new activities in Gaza, where the PCU does not have qualified, dedicated E&S capacity in place. In addition, other identified risks include the potential presence of rubble at the sub-project site, and the potential risk of presence of UXO. Clear E&S screening is required and a simplified ESMP checklist for sub-projects of minor rehabilitation activities has been proposed. The updated ESCP will include the following additional tasks: hiring of an E&S Consultant to support the E&S compliance in Gaza; updating the ESMF to address the risks associated with the restructuring activities and simplified E&S requirements; and, updating the LMP to address the risk related to UXO and related Occupational Health and Safety (OHS) risks on labor. The updated ESCP was disclosed in-country (August 24, 2021) and on the Bank’s system on (August 24, 2021). Summary of Performance of E&S Compliance 25. The E&S project progress has been slow, following a year of delays due to the COVID-19 emergency situation. In October 2020, the PCU started the project implementation including the requirements of environmental and social compliance. The PCU has updated the Operational Manual to integrate the E&S requirements. In compliance with the ESCP actions: (i) the OHS Manual was disclosed by the Client and the Bank on August 19, 2021; (ii) the PCU has submitted the first quarterly report that the Bank team extensively commented on. The Bank is expecting to receive a better quality second quarterly report ; (iii) the Stakeholder Engagement Framework (SEF) disclosed at appraisal was updated to include feedback from consultations held in May 2021 with relevant stakeholders across the project components. 26. Under subcomponent 2.1, the PCU has selected nine schools in the West Bank governorates. There has been slow progress in conducting environmental and social risk classification and assessment of the project activities. The selected sites are of moderate risk, and the main risks are related to occupational health and safety, community health and safety, low/moderate risk of SEA/SH due to potential presence of labor on school premises during school hours, noise, air quality, and risk of exposure to COVID-19. Site-specific ESMPs will be prepared and submitted for Bank review and clearance. The PCU has also included E&S, and health and safety requirements in the Terms of Reference (TOR) for “design and supervision of schools”. For Component 1, the environmental risk rating is low for the selected activities. MOH issued the tender documents for the equipment, including all the E&S provisions in the bidding documents. 27. For labor related requirements (ESS2), a dedicated grievance redress mechanism for all types of project workers still needs to be established. The Bank team is providing support to the PCU in this regard and a GRM for project workers, in line with the LMP updated to cover project restructuring activities, will be in place by the end of August 2021. Code of Conduct has been prepared and included in the TORs and bidding documents. 28. The GM that was developed for the original project shall remain accessible and functional to receive and facilitate the resolution of concerns and grievances in relation to the restructured project in accordance with ESS10. Information about the GM has been communicated to the project beneficiaries during the consultation meetings conducted with stakeholders and beneficiaries in May, July and August 2021. Complaints will be handled in line with the GM manual that was established for the project and will be registered in the complaints log. Adequate resources shall be provided 11 The World Bank Improving Early Childhood Development in the West Bank and Gaza (P168295) for the continued operation of the GM. For project activities in Gaza, the ESC has been hired at the PCU and will be responsible for receiving and addressing project related complaints in coordination with the ESO, the Directorate General of Educational Buildings at the MOE and the ESO at the MOH. MOE/ESO shall also include in the assessment of potential impacts and risks of the construction activities, an assessment of risks related to SEA/SH. This assessment of impacts and risks will be prepared prior to initiating construction. 29. Due to the capacity constraints at the PCU, the Bank’s ES team has provided extensive hands-on support through periodic meetings to assist and guide the PCU ESO in preparing the E&S assessment, the site-specific ESMPs and the OHS Manual. This extensive support from the Bank will continue to be provided until the PCU is capable to deliver and maintain E&S compliance. III. SUMMARY OF CHANGES Changed Not Changed Results Framework ✔ Components and Cost ✔ Procurement ✔ Implementation Schedule ✔ Technical Analysis ✔ Social Analysis ✔ Environmental Analysis ✔ Implementing Agency ✔ DDO Status ✔ Project's Development Objectives ✔ PBCs ✔ Loan Closing Date(s) ✔ Cancellations Proposed ✔ Reallocation between Disbursement Categories ✔ Disbursements Arrangements ✔ Disbursement Estimates ✔ Overall Risk Rating ✔ Legal Covenants ✔ Institutional Arrangements ✔ Financial Management ✔ 12 The World Bank Improving Early Childhood Development in the West Bank and Gaza (P168295) APA Reliance ✔ Other Change(s) ✔ Economic and Financial Analysis ✔ IV. DETAILED CHANGE(S) OPS_DETAILEDCHANGES_COMPONENTS_TABLE COMPONENTS Current Current Proposed Proposed Cost Action Component Name Component Name Cost (US$M) (US$M) Promoting early healthy Promoting early healthy 3.00 Revised 3.00 development development Improving access to high-quality Improving access to high- 4.35 Revised 4.95 kindergarten services quality kindergarten services Improving availability of ECD Marked for 0.60 0.00 data Deletion Project management and Project management and 1.05 No Change 1.05 implementation support implementation support TOTAL 9.00 9.00 . 13 The World Bank Improving Early Childhood Development in the West Bank and Gaza (P168295) . Results framework COUNTRY: West Bank and Gaza Improving Early Childhood Development in the West Bank and Gaza Project Development Objectives(s) Improve the coverage and quality of targeted early childhood development services for children from gestation until age 5 in West Bank and Gaza. Project Development Objective Indicators by Objectives/ Outcomes RESULT_FRAME_TBL_PDO Indicator Name PBC Baseline Intermediate Targets End Target 1 2 3 4 Improve coverage of targeted ECD services Share of caregivers reporting improvement in parenting practices in response to a parenting or psychosocial 0.00 0.00 0.00 15.00 30.00 30.00 support intervention (disaggregated by gender and type of intervention) (Percentage) Rationale: Action: This indicator has been In light of the humanitarian emergency in Gaza and capacity constraints faced by MOH, the lead implementing agency for this activity, the indicator has Revised been simplified. Instead of gender-specific targets, disaggregation by gender and type of intervention will be captured at the main indicator level. Share of mothers that received the parenting 0.00 0.00 0.00 15.00 30.00 50.00 intervention and self- reported improved 14 The World Bank Improving Early Childhood Development in the West Bank and Gaza (P168295) RESULT_FRAME_TBL_PDO Indicator Name PBC Baseline Intermediate Targets End Target 1 2 3 4 parenting practices (Percentage) Action: This indicator has been Marked for Deletion Share of fathers that received the parenting intervention and self- 0.00 0.00 0.00 15.00 30.00 50.00 reported improved parenting practices (Percentage) Action: This indicator has been Marked for Deletion Share of caregiver other than mother or father that received the parenting intervention and self- 0.00 0.00 0.00 15.00 30.00 50.00 reported improved parenting practices (Percentage) Action: This indicator has been Marked for Deletion Number of children enrolled in KG2 as a result of the project, disaggregated by public 0.00 0.00 300.00 1,020.00 1,740.00 3,000.00 provision, PPP provision, and rehabilitation in Gaza (Number) 15 The World Bank Improving Early Childhood Development in the West Bank and Gaza (P168295) RESULT_FRAME_TBL_PDO Indicator Name PBC Baseline Intermediate Targets End Target 1 2 3 4 Rationale: Action: This indicator has been This indicator has been revised to capture the number of children enrolled in KG2 as a result of rehabilitation of KG infrastructure in Gaza. Accordingly, the Revised end target has been revised upwards to reflect the increased number of beneficiaries. Improve quality of targeted ECD services Share of KG2 classes that reach higher quality standards based 0.00 0.00 0.00 0.00 10.00 25.00 on the new QA system (Percentage) Rationale: The targets for this indicator have been revised to account for prolongued KG closures caused by COVID-19, which have substantially reduced the timeframe Action: This indicator has been available for KG supervisors to complete repeated monitoring visits, provide capacity building to KG teachers, and register improvements in KG service Revised delivery according to the standards of the Paletinian KG quality assurance system. PDO Table SPACE Intermediate Results Indicators by Components RESULT_FRAME_TBL_IO Indicator Name PBC Baseline Intermediate Targets End Target 1 2 3 4 Promoting early healthy development Number of children undergoing early screening for auditive 0.00 0.00 0.00 13,000.00 26,000.00 40,000.00 problems (Number) Action: This indicator has been Rationale: Revised 16 The World Bank Improving Early Childhood Development in the West Bank and Gaza (P168295) RESULT_FRAME_TBL_IO Indicator Name PBC Baseline Intermediate Targets End Target 1 2 3 4 The targets for this indicator have been revised to account for capacity constraints in the healthcare sector caused by the COVID-19 pandemic. Number of service providers trained to administer a parenting or psychosocial 0.00 0.00 0.00 100.00 200.00 417.00 support intervention (disaggregated by type of provider) (Number) Rationale: This indicator has been revised to reflect the psychosocial support intervention introduced as part of the restructuring. Resources will be reallocated to Action: This indicator has been prioritize training of service providers on psychosocial support over the rollout of the parenting intervention, and the intermediate targets have been Revised adjusted accordingly. Improving access to high-quality KG services Number of public-private partnerships (PPP) for KG2 0.00 0.00 0.00 28.00 28.00 28.00 created and operational (Number) Number of KG2 teachers who completed the KG professional 0.00 0.00 0.00 300.00 600.00 1,000.00 diploma (Corporate Results Indicator) (Number) Share of KG2 teachers who find that the KG professional 0.00 0.00 0.00 75.00 75.00 75.00 diploma meets their professional development 17 The World Bank Improving Early Childhood Development in the West Bank and Gaza (P168295) RESULT_FRAME_TBL_IO Indicator Name PBC Baseline Intermediate Targets End Target 1 2 3 4 needs (Citizen Engagement Indicator) (Percentage) Number of KG classes supplied with teaching or learning 0.00 0.00 1,000.00 2,000.00 2,000.00 2,100.00 materials (Number) Rationale: Action: This indicator has been The target for this indicator has been revised upward to include child kits provided to KG aged children in Gaza affected by the conflict. Revised Number of KG2 classes where teaching practices and children's learning has been 0.00 0.00 0.00 200.00 400.00 600.00 assessed through the new QA system (Number) Students benefiting from direct interventions to enhance 0.00 30,000.00 learning (CRI, Number) Students benefiting from direct interventions to 0.00 15,000.00 enhance learning - Female (CRI, Number) Improving availability of ECD data (Action: This Component has been Marked for Deletion) Number of KG2 classes where relevant data is digitized and 0.00 0.00 0.00 100.00 200.00 341.00 compiled centrally (Number) Action: This indicator has been Marked for Deletion 18 The World Bank Improving Early Childhood Development in the West Bank and Gaza (P168295) RESULT_FRAME_TBL_IO Indicator Name PBC Baseline Intermediate Targets End Target 1 2 3 4 Number of nurseries where relevant data is digitized and 0.00 0.00 0.00 60.00 120.00 182.00 compiled centrally (Number) Action: This indicator has been Marked for Deletion Number of nurseries and KG2 classes for which data on their 0.00 0.00 0.00 160.00 320.00 523.00 quality has been made publicly available (Number) Action: This indicator has been Marked for Deletion IO Table SPACE 19