The World Bank 1818 H Street N.W. (202) 473-1000 INTERNATIONAL BANK FOR RECONSTRUCTION AND DEVELOPMENT Washington. D.C. 20433 Cable Address: INTBAFRAD INTERNATIONAL DEVELOPMENT ASSOCIATION U.SA Cable Address: INDEVAS Fkrurm2L ,2020 OFFICIAL H.E. Jos& Sele Yalaghuli DOCUMENTS Minister of Finance Ministry of Finance Kinshasa-Gombe Democratic Republic of Congo Re: DRC: Health System Strengthening for Better Maternal and Child Health Results Project IDA Credit Number No. 5572-ZR; Grant Number D021-ZR IHRITF Grant Number TF018375 Fourth Amendment to the Financing Agrement Second Amendment to the Grant Agreement Excellency: We refer to the Original Financing Agreement (the "Financing Agreement") between the Democratic Republic of Congo (the "Recipient") and the International Development Association (the "Association"), and the Grant Agreement (the "Grant Agreement") between the Recipient and the Association, acting as administrator of the Multi-Donor Trust Fund for Health Results Innovation Grant (collectively, the "Agreements"), both dated January 20, 2015, as amended, for the abovementioned Project. Please note that the capitalized terms used in this letter ("Amendment Letter") and not defined herein have the meanings ascribed to them in the Financing Agreement and/or the Grant Agreement. Pursuant to your letters dated December 16, 2019 and January 11, 2020, requesting the Association for specific amendments to the Project, we are pleased to inform you that the Association hereby agrees to amend the Agreements in respect to the provisions below: Financing Areement (5572-ZR and D021-ZR) and Grant Agreement (TF018375) I. All references to "DEP" are hereby amended throughout the Agreements and replaced with "General Secretariat". 2. Part I of Schedule I to the Agreements is hereby amended to read as follows: -2- "Part 1: Improve Utilization and Quality of Health Services at Health Facilities through Performance-Based Financin2 Support the Recipient to use PBF for the provision of a Package of Priority Health Services with emphasis on child, adolescent and maternal health services and family planning." 3. Section LA.4 of Schedule 2 to the Agreements is hereby amended to read as follows: "4. maintain throughout the period of Project implementation, the General Secretariat to run the day-to-day management and coordination of the Project, with staffing, terms of reference, composition and powers acceptable to the Association as further described in the Project Implementation Manual;" 4. Section I.A.5 of Schedule 2 to the Agreements is hereby amended to read as follows: "5. maintain throughout the period of Project implementation the CT-FBR to provide the technical assistance to the General Secretariat needed to implement the PBF activities as well as other policy guidance related to PBF approaches under the Project, with staffing, terms of reference, composition and powers acceptable to the Association as further described in the Project Implementation Manual;" 5. The definition pertaining to "DEP" in the Appendix to the Agreements is hereby removed in its entirety. 6. The following definition is added and placed in alphabetical order in the Definition Section of the Appendix to the Agreements to read as follows and the rest of the definitions are renumbered accordingly in alphabetical order: "General Secretariat" means the unit within MOPH vested with the responsibility of overseeing the Recipient's health administration and the smooth running of all the reforms affecting it. 7. The Expenditures table as set forth in Section IV.A.2 of Schedule 2 to the Financing Agreement is hereby amended and replaced with the table shown in Annex I of this Amendment Letter. Grant Aerement (TFO183 75) 8. The,Expenditures table as set forth in Section IV.A.2 of Schedule 2 to the Grant Agreement is hereby amended and replaced with the table shown in Annex 2 of this Amendment Letter. -3- All other provisions of the Agreements that have not been amended hereby, shall remain in full force and effect. Please confirm your agreement to the foregoing by signing, dating and returning to us one fully executed original of this Amendment Letter and retaining one original of the letter for your records. This Amendment Letter shall become effective as of the date of countersignature. Very truly yours, INTERNATIONAL DEVELOPMENT ASSOCIATION By: Jean-Christophe Carret Country Director for the Democratic Republic of the Congo Africa Region AGREED: DEMOCRATIC REP IC OF By Authonized Repre tative Name:til Title: J Date: __V -4- Annex I Expenditures Table for Credit Number No. 5572-ZR; Grant Number D021-ZR "Category Amount of the Percentage of Amount of the Percentage of Credit Allocated Expenditures to Grant Allocated Expenditures to (expressed in be Financed by (expressed in be Financed by SDR) the Credit SDR) the Grant (inclusive of (inclusive of Taxes) Taxes) Effective September 1, 2019 (1) PBF Grants for 47,328,000 100% 26,781,000 100% Parts I and 2 of the Project (2) Goods non- 18,249,000 100% 0 0% consulting services, consultants' services, Operational Costs, Training and Workshops for the Project (except for Part 3(a)(iv) of the Project) (3) Goods non- 0 0% 13,500,000 100% consulting services, consultants' services, Operational Costs, Training and Workshops for the Recipient's Ebola preparedness plan under Part 3(a)(iv) of the Project (4) Refund of 4,305,000 Amount payable 2,501,000 Amount payable Preparation pursuant to pursuant to Advance Section 2.07 of Section 2.07 of the General the General Conditions Conditions (5) Emergency 18,118,000 100% 18,118,000 100% Expenditure under Part 4(b) of the Project TOTAL AMOUNT 88,000,000 60,900,000" -5- Annex 2 Expenditures Table for HRITF Grant No. TF018375 "Category Amount of the Grant Percentage of Allocated (expressed in Expenditures to be Dollars) Financed (inclusive of Taxes) Effective September 1, 2019 (1) PBF Grants for Parts 1 6,500,000 100% and 2 of the Project TOTAL AMOUNT 6,500,000"