The World Bank RESTRUCTURING ISDS Nigeria Improved Child Survival Program for Human Capital MPA (P167156) Integrated Safeguards Data Sheet Restructuring Stage Restructuring Stage | Date ISDS Prepared/Updated: 05-May-2021| Report No: ISDSR32071 Regional Vice President: Ousmane Diagana Country Director: Shubham Chaudhuri Regional Director: Dena Ringold Practice Manager/Manager: Magnus Lindelow Task Team Leader(s): Onoriode Ezire, Elina Pradhan The World Bank RESTRUCTURING ISDS Nigeria Improved Child Survival Program for Human Capital MPA (P167156) . I. BASIC INFORMATION 1. BASIC PROJECT DATA Project ID Project Name Nigeria Improved Child Survival Program for Human P167156 Capital MPA Task Team Leader(s) Country Onoriode Ezire, Elina Pradhan Nigeria Approval Date Environmental Category 18-Feb-2020 Partial Assessment (B) Managing Unit HAWH2 PROJECT FINANCING DATA (US$, Millions) SUMMARY -NewFin1 Total Project Cost 650.00 Total Financing 650.00 Financing Gap 0.00 DETAILS -NewFinEnh1 World Bank Group Financing International Development Association (IDA) 650.00 IDA Credit 650.00 2. PROJECT INFORMATION PROG_INF O Current Program Development Objective The project development objective (PDO) of the first phase (IMPACT) is to improve the utilization and quality of immunization plus and malaria services in selected states. . The World Bank RESTRUCTURING ISDS Nigeria Improved Child Survival Program for Human Capital MPA (P167156) 3. PROJECT DESCRIPTION 1. IMPACT is designed to achieve a balance between the need to achieve rapid results through priority programs affecting under-five health and the requirement of strengthening PHC for long-term sustainability. As the first phase of a 10-year engagement, the project invests, among others, in launching and evaluating bold innovations in service delivery, improving demand for health services, improving facility performance and health systems management and accountability more broadly, and increasing data-driven decision making. IMPACT comprises of four components: (1) malaria control; (2) immunization plus; (3) knowledge for change; and (4) Contingent Emergency Response Component. 2. As originally designed, sub-component 2.3 of the IMPACT project has provisions for equipping the Lagos Hub with cold chain commodities. Under this plan, an ongoing project (Polio Eradication Support Project--P130865) was supposed to construct and rehabilitate the Lagos hub building, and IMPACT would finance the equipment. However, because of a change in the scope of this activity which would take more time, the Government was not able to commence the construction and rehabilitation of the Lagos hub under the Polio Project. The scope changed from rehabilitation/expansion of existing structures to demolition/new construction. Parallel to this, because of delays in effectiveness and disbursement of IMPACT project, the Government was also not able to access financing for vaccines provisioned under this project. 3. Hence, the Polio Project was restructured in December 2020 to use the US$ 8M for urgent vaccine procurement for Q1 and Q2 of 2021, with the understanding that the Lagos hub construction will be undertaken by the IMPACT project. To that order, we have received a request from the Government to accommodate Lagos hub construction and rehabilitation under this Project. The project activities are adjusted as below. 4. Construction of Lagos hub: This restructuring will accommodate the demolition of existing dilapidated structures to construct a modern cold and dry storage facility at the Federal Medical Store Complex at Oshodi, Lagos also referred to as the Lagos hub. Initially, the IMPACT project envisaged only minor rehabilitation and repairs such as painting, plastering, and replacing doors/windows and leaking roofs of existing buildings. 5. Within component reallocation of financing for vaccine procurement: This restructuring would also accommodate the reallocation of US$8 million equivalent previously earmarked for vaccines procurement to the construction of the Lagos hub within IMPACT. Note that this reallocation occurs within the same sub-component (2.3). 6. There will be no changes to the PDO, the project costs, results framework, project covenants or risk rating. The World Bank RESTRUCTURING ISDS Nigeria Improved Child Survival Program for Human Capital MPA (P167156) . 4. PROJECT LOCATION AND SALIENT PHYSICAL CHARACTERISTICS RELEVANT TO THE SAFEGUARD ANALYSIS (IF KNOWN) The MPA will be implemented in selected states in Nigeria. 5. ENVIRONMENTAL AND SOCIAL SAFEGUARDS SPECIALISTS ON THE TEAM Joseph Ese Akpokodje, Environmental Specialist Elijah Abiodun Siakpere, Social Specialist Cindy Ijeoma Ikeaka, Social Specialist SAFEGUARD_TABLE 6. SAFEGUARD POLICIES TRIGGERED Safeguard Policies Triggered Explanation The activities funded by the IMPACT Project of the MPA will now include civil work activities to accommodate the demolition of existing structures and construction at the exact location of a modern cold and dry storage facility at the Federal Medical Store Complex at Oshodi, Lagos State (referred to as Lagos Hub). The Program will still fund other minor civil works such as the renovation of health facilities and warehouses, including activities such as painting, plastering, replacing doors/windows, leaking roofs which may occur in existing structures. These activities will lead to environmental and social risks/impacts. Other activities funded by the project (e.g., vaccination, Environmental Assessment (OP) (BP 4.01) Yes skilled birth attendance, curative services for children under-five, LLINs etc.) are potentially significant sources of waste generation, especially through expired vaccines and medications due to poor stock, cold chain management and unhealthy and unsafe disposal of used LLINs. However, in the context of Nigeria, this is of modest environmental concern since the volume of waste from wasted vaccine vials, medications and diagnostics is small and because sterilized vaccines and packaged medications do not present a public health or environmental risk. However, given the potential unhealthy and environmental impact of LLINs that may result from The World Bank RESTRUCTURING ISDS Nigeria Improved Child Survival Program for Human Capital MPA (P167156) unsafe disposal of these nets, NMEP/SMEPs will adopt a safe and environmentally friendly disposal method as part of its broader waste management plan as included in the disclosed ESMF. This method will include adequate stakeholders consultation and awareness on proper after use disposal of the nets. To ensure the sustainability of the process, NMEP/SMEPs will have overall responsibility based on their role in the distribution of the LLINs, using the same process/medium of distribution to collect the expired LLINs from the beneficiaries for onward treatment and final disposal. The parent ESMF and HCWMP were disclosed in- country on 7th October 2019 as well as in two national daily newspaper, as required. The ESMF of the MPA has been updated, consulted upon by relevant stakeholders to incorporate additional consideration related to the construction of the Lagos Hub. The framework also includes measures for implementing civil works and stakeholder engagements considering the COVID-19 pandemic. The updated ESMF will be disclosed in-country and on the World Bank external website. In addition, a Health Care Waste Management Plan (HCWMP), aligned with the National Health Care Waste Management Plan and other existing health projects in Nigeria, has been prepared due to the potential medical waste to be generated through expired vaccines and medications resulting from poor stock and cold chain management. Performance Standards for Private Sector No Activities OP/BP 4.03 Natural Habitats (OP) (BP 4.04) No Forests (OP) (BP 4.36) No Pest Management (OP 4.09) No Physical Cultural Resources (OP) (BP 4.11) No Indigenous Peoples (OP) (BP 4.10) No There are no Indigenous Peoples. The World Bank RESTRUCTURING ISDS Nigeria Improved Child Survival Program for Human Capital MPA (P167156) The Project interventions are expected to have a positive social impact as the program will ultimately contribute towards significantly decreasing the Under Five Mortality Rate (U5MR) and reducing the burden of malaria, particularly among the poor and vulnerable populations. The project is not expected to involve land acquisition that might lead to involuntary resettlement or restriction of access to assets, resources or livelihoods. The first phase of the MPA is now restructured to accommodate the rehabilitation (including demolition of delipidated stores and new construction) of the Lagos Hub. All works will take place in the existing Federal Medical Store Complex at Oshodi, Lagos State. No new land is required. Other activities planned under the Project include minor infrastructural rehabilitation works on existing health facilities and warehouses under the Involuntary Resettlement (OP) (BP 4.12) No decentralized facility financing to primary health care facilities. During implementation, appropriate site-specific Environmental and Social Management Plans (ESMPs), including mitigation measures associated with prevention of sexual exploitation and abuse/sexual harassment, would be prepared, consulted upon and disclosed prior to commencement of rehabilitation works. In addition, the labour required for these activities would be limited to and sourced from the health care facility immediate community to guide against labour influx and its attendant risk. Furthermore, a stand-alone project Feedback and Grievance Redress Mechanism is being developed to address complaints and grievances regarding project activities. To effectively manage social risk on the project, Social Specialist has been engaged as part of the PIU team at the federal and state levels. Safety of Dams (OP) (BP 4.37) No Projects on International Waterways (OP) No (BP 7.50) Projects in Disputed Areas (OP) (BP 7.60) No KEY_POLICY_TABLE II. KEY SAFEGUARD POLICY ISSUES AND THEIR MANAGEMENT A. SUMMARY OF KEY SAFEGUARD ISSUES The World Bank RESTRUCTURING ISDS Nigeria Improved Child Survival Program for Human Capital MPA (P167156) 1. Describe any safeguard issues and impacts associated with the Restructured project. Identify and describe any potential large scale, significant and/or irreversible impacts. The MPA has been classified as a Category B project. The first phase of the MPA is now restructured to include Component 2.3 that will support financing for the new construction of the NPHCDA Cold and Dry Stores located in the Federal Medical Complex, Oshodi, Lagos State (referred to as Lagos Hub) which was originally envisaged under the Nigeria Polio Eradication Support Project – Additional Financing Three Project (P130865). This construction will include the demolition of existing warehouses and constructing a new facility in the exact location of Lagos Hub. Involuntary resettlement is not triggered since this construction will take place in the existing location. The potential risks and impacts of this sub-project have been assessed in the stand-alone Environmental and Social Management Plan, which has been disclosed in-country on November 3, 2020, under the Nigeria Polio Eradication Support Project – Additional Financing Three Project. The overall environmental and social risks associated with the MPA has been reviewed, and no additional Operational Policies are triggered. Nonetheless, the ESMF has been updated, consulted upon by relevant stakeholders to incorporate additional consideration related to the construction of the Lagos Hub. The framework also includes measures for implementing civil works and stakeholder engagements in light of the COVID-19 pandemic. The updated ESMF was disclosed in-country and on the World Bank external website on June 3, 2021. Other minor works, such as rehabilitation repairs (painting, plastering, replacing doors/windows, leaking roofs, may occur in existing buildings and health facilities are still consistent with potential civil works planned under the MPA. Furthermore, vaccination/immunization, distribution of drugs, and LLINs generate healthcare waste such as expired vaccines, sharps, and unsafe disposal of used LLINs, which pose environmental and health risks. Operational Policy (OP) 4.01 on Environmental Assessment is still relevant given the potential environmental and health concerns around healthcare waste handling (HCW). Furthermore, other activities under the MPA will include vaccination/immunization, distribution of drugs and LLINs that generate healthcare waste such as expired vaccines, sharps and unsafe disposal of used LLINs which pose environmental and health risks. Operational Policy (OP) 4.01 on Environmental Assessment is triggered given the potential environmental and health concerns around the handling of health care waste (HCW). In addressing concerns bordering on HCW, a Healthcare Waste Management Plan was prepared and disclosed in-country on October 7, 2019, and on the World Bank’s External site on November 8, 2019. 2. Describe any potential indirect and/or long term impacts due to anticipated future activities in the project area. There are no potential indirect or cumulative/long-term environmental and social impacts envisaged in the project area. 3. Describe any potential alternatives (if relevant) considered to help avoid or minimize adverse impacts. N/A The World Bank RESTRUCTURING ISDS Nigeria Improved Child Survival Program for Human Capital MPA (P167156) 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. Nigeria has demonstrated its commitment to mitigating adverse social and environmental impacts in the implementation of a range of World Bank projects such as the HIV/AIDS project, NSHIP and Polio Eradication Support project. There are adequate legal and institutional frameworks in the country to ensure compliance with World Bank safeguards policies. On September 4, 2013, the Nigerian Federal Executive Council approved a new National Strategic Healthcare Waste Management Policy, including the National Strategic Healthcare Waste Management Plan and Guideline for the country. The fact that the Ministers of Environment and Health jointly presented the memo seeking Council’s approval for the adoption of the NHWMP, underscores the high level of the commitment of the Government toward improving the situation of the sector. The policy stipulates that waste generated by both public and private medical institutions in Nigeria must be safely handled and disposed of by these institutions, and provides guidelines and a strategic plan for medical waste management activities at medical institutions. 5. Identify the key stakeholders and describe the mechanism for consultation and disclosure on safeguard policies, with an emphasis on potentially affected people. Key stakeholders include: (i) poor and vulnerable groups in the country, and vulnerable groups such as women and children who face a disproportionate risk of mortality and morbidity due to avertable causes; (ii) states, including the State Primary Healthcare Development Agencies (SPHCDAs) and the State Malaria Elimination Programs (SMEPs) and local governments; (iii) the government at the federal level, including the National Primary Healthcare Development Agency (NPHCDA) and the National Malaria Elimination Program (NMEP) within the Federal Ministry of Health; (iv) the development partner community, and (v) the private sector. Public consultation will be an on-going activity taking place throughout the entire program cycle. Public participation and consultation would take place through meetings, radio programs, requests for written proposals/comments, filling in of questionnaires, explanations of project to the locals, making public documents available at the state and local levels. DISCLOSURE_TABLE B. DISCLOSURE REQUIREMENTS ENV_TABLE Environmental Assessment/Audit/Management Plan/Other Date of receipt by the Bank Date of submission for disclosure 24-Jun-2019 20-Sep-2019 For Category ‘A’ projects, date of distributing the Executive Summary of the EA to the Executive Directors “In country� Disclosure Country Date of Disclosure Nigeria 07-Oct-2019 Comments The World Bank RESTRUCTURING ISDS Nigeria Improved Child Survival Program for Human Capital MPA (P167156) COMPLIANCE_TABLE C. COMPLIANCE MONITORING INDICATORS AT THE CORPORATE LEVEL EA_TABLE 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 Practice Manager (PM) review Yes and approve the EA report? Are the cost and the accountabilities for the EMP incorporated in the credit/loan? Yes PDI_TABLE The World Bank Policy on Disclosure of Information Have relevant safeguard policies documents been sent to the World Bank for Yes disclosure? 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 Yes and local NGOs? ALL_TABLE All Safeguard Policies Have satisfactory calendar, budget and clear institutional responsibilities been Yes prepared for the implementation of measures related to safeguard policies? Have costs related to safeguard policy measures been included in the project Yes cost? Does the Monitoring and Evaluation system of the project include the monitoring Yes of safeguard impacts and measures related to safeguard policies? Have satisfactory implementation arrangements been agreed with the borrower Yes and the same been adequately reflected in the project legal documents? III. APPROVALS Onoriode Ezire Task Team Leader(s) Elina Pradhan The World Bank RESTRUCTURING ISDS Nigeria Improved Child Survival Program for Human Capital MPA (P167156) Approved By Safeguards Advisor Nathalie S. Munzberg 25-Jun-2021 Practice Manager/Manager Magnus Lindelow 28-Jun-2021 .