OFFICIAL          W~oI
DOCUMENTS
The World Bank
INTERNATIONAL BANK FOR RECONSTRUCTION AND DEVELOPMENT  Independence Ave.   Tel: (233-302) 229681 220837
INTERNATIONAL DEVELOPMENT ASSOCIATION          Ridge, Accra, Ghana         Fax: (233-302) 227887
1-7 +h  L         , 2015
Honorable Seth Terkper
Minister of Finance and Economic Planning
Ministry of Finance and Economic Planning
PO Box MB40
Accra, Ghana
Honorable Minister:
GHANA: Maternal and Child Health and Nutrition Improvement Project
Amendment to the HRITF Grant Agreement (Grant Number TF016617)
We refer to the Grant Agreement ("Agreement") for the above-mentioned Project, dated
January 5, 2015, between the Republic of Ghana ("Recipient") and the International Development
Association ("World Bank"), acting as administrator of the Health Results Innovation Trust Fund
(HRITF). We also refer to your letter dated April 28, 2015, requesting specific amendments to the
Agreement.
Therefore, we propose to amend the Agreement as set forth in this letter (Amendment).
I.     Schedule I to the Agreement shall be amended by inserting Part C as follows:
"Part C:      Epidemic Preparedness and Control
"1 ."  "Preparing and implementing a national epidemic and preparedness plan, and carrying
out a program of specific activities to strengthen the community-based health human and
institutional capacity, including; (a) provision of training on infection prevention and
control for relevant medical staff and volunteers at the community-based health planning
services level, and ambulance staff; (b)renovating a treatment center; (c) strengthening
ambulance services, and renovation of approximately eleven (11) ambulance stations;
and (d) provision of technical advisory services for the establishment of a national
infectious diseases control center, all through the provision of works, technical advisory
services, training, and acquisition of goods and equipment."
2.     Section l.A. I of Schedule 2 to the Agreement shall be amended as follows:
"11."  "MOH and GHS"
"(a)"  "The Recipient shall maintain, at all times during the implementation of the
Project, the MOH and GHS with functions, staffing and resources satisfactory to
the World Bank."


-2-
"(b)"  "Without limitation upon the provisions of paragraph 1(a) immediately above: (i)
the MOH shall be responsible for the implementation of Parts B. 1 and C of the
Project, and for formulation of policies related to the Project, and overall
coordination and stewardship of the Project activities; and (ii) the GHS shall be
responsible for the implementation of Parts A and B.2 of the Project, and for the
delivery of services supported through the Project, as set forth in the Project
Implementation Manual."
3.     Section 1.C.1 of Schedule 2 to the Agreement shall be amended as follows:
"C."   "Subprojects Implementation Manual and Community Performance-based
Financing Implementation Manual"
"l."  "The Recipient shall carry out Parts A. 1 and C of the Project in accordance with the
arrangements and procedures set out in Subprojects Implementation Manual containing,
inter alia, detailed arrangements and procedures for: (a) institutional coordination and day-
to-day execution of the Subprojects; (b) fiduciary arrangements(i.e., financial management
and procurement); (c) environmental and social safeguard guidelines; (d) defined eligibility
criteria and approval, disbursement, administration, communication, monitoring and
evaluation arrangements including key output indicators for Sub-projects; and (e) such
other administrative, financial, technical and organizational arrangements and procedures
as shall be required for the respective Subprojects.  "
All other provisions of the Agreement, except as herein amended, shall remain in full
force and effect.
Please indicate agreement to the foregoing, on behalf of the Recipient, by countersigning
and dating the form of confirmation on the two original copies of this letter and returning one
original, as countersigned, to us. Upon receipt by the World Bank of the copy of this letter
countersigned by the Recipient, this amendment shall become effective as of the date of its
countersignature.
Sincerely,
INTERNATIONAL DEVELOPMENT ASSOCIATION
(acting as administaor of the Health Results Innovation Trust Fund)
Henry G. R. Kerali
Country Director for Ghana
Africa Region


CONFIRMED:
REPUBLIC OF GHANA
By:
Authorized Representati
Name: ZEn4. E. TQvEeP
Title:      kA ( j T-i
Date: 2:I'*" cy . 20 15