The World Bank Implementation Status & Results Report B. Faso - Education Access and Quality Improvement Project (EAQIP) (P148062) B. Faso - Education Access and Quality Improvement Project (EAQIP) (P148062) AFRICA WEST | Burkina Faso | Education Global Practice | IBRD/IDA | Investment Project Financing | FY 2015 | Seq No: 12 | ARCHIVED on 25-Nov-2020 | ISR44039 | Implementing Agencies: Ministere de l'Economie, des Finances et du Developpement, Ministere de l’Education Nationale, de l’Alphabetisation et de la Promotion des Langues Nationales Key Dates Key Project Dates Bank Approval Date: 02-Apr-2015 Effectiveness Date: 30-Oct-2015 Planned Mid Term Review Date: 15-Feb-2018 Actual Mid-Term Review Date: 05-Feb-2018 Original Closing Date: 31-Jul-2019 Revised Closing Date: 31-Jul-2024 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The project development objective is to support the Government of Burkina Faso to increase access to pre-school education in the two poorest regions, secondary education in the five poorest regions and to improve teaching and learning. The components in supportof these objectives have been designed to complement other activities financed by the Government and other development partners. Has the Project Development Objective been changed since Board Approval of the Project Objective? Yes Board Approved Revised Project Development Objective (If project is formally restructured) The project development objective is to support the Government of Burkina Faso to: (a) increase access to preschool education in the two poorest regions, secondary education in the five poorest regions, and (b) improve teaching and learning. Components Table Name Component 1: Expanding equitable access to pre-school education in the two poorest regions and secondary education in the five poorest regions:(Cost $30.00 M) Component 2: Improving the quality of teaching and learning:(Cost $13.00 M) Component 3: Contributing to strengthening education institutional capacity at central and decentralized entities:(Cost $8.00 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Moderately Satisfactory Overall Implementation Progress (IP) Satisfactory Moderately Satisfactory Overall Risk Rating High Substantial Implementation Status and Key Decisions Overview. The Education Access and Quality Improvement Project (EAQIP) was approved by the World Bank Board of Directors on April 2, 2015 and declared effective on October 30, 2015. The original closing date was July 31, 2019. However, the closing date was subsequently 11/25/2020 Page 1 of 11 The World Bank Implementation Status & Results Report B. Faso - Education Access and Quality Improvement Project (EAQIP) (P148062) extended to January 31, 2021. The March 6 – 13, 2020 supervision mission conducted by the Government of Burkina Faso (GoBF) and the World Bank’s, as well as the ongoing technical support the task team has been providing the Government over the last several months to support the implementation of the Project, determined that a larger number of project-supported activities have been successfully implemented and that the overall disbursement rate for the Project has significantly improved. .Despite these significant achievements, exogenous shocks—which have been further exacerbated by the ongoing COVID-19 pandemic—have recently posed some challenges to the effective implementation of the Project and to the achievement of the operation’s year-on-year indicator targets. The following provides an overview of progress made by component to date as well as agreed next steps. Progress by Component: Component 1: Expanding Equitable Access to Preschool Education in the two Poorest Regions and Secondary Education in the five Poorest Regions. This component aims to provide early childhood education (ECE) to 3-4-year-old children living in the East and Central East regions and to contribute to increased and equitable access to secondary education. Secondary Education. To date, all the schools’ construction program is completed and has provided access to secondary education (lower and higher level) to approximately 20,595 students, including 10,010 girls (49%). (1) 327 classrooms were built and distributed as follows: 10 new secondary schools, including 5 lower secondary education schools (a lower secondary school comprises 4 classes) and 5 higher secondary education schools (a higher secondary school comprises 3 classes), creating spaces for a total of 5,600 students; 5 lower secondary education schools were constructed within high schools, welcoming 600 additional pupils; and 20 higher and lower secondary schools, which now host 7,200 students and 30 boreholes in secondary schools that did not previously have any water points. (2) As part of the public-private partnership, 55 classrooms, accommodating 3,575 pupils, have been built in secondary schools offering quality education in order to expand their capacity. In addition to expanding the course offering, these complementary classes provided educational opportunities to at least 179 students from disadvantaged backgrounds. (3) 10 new secondary schools, including 5 lower secondary education schools and 5 higher secondary schools, were built and put up for hire-purchase (These schools are rented out to private education operators.) and this made it possible to accommodate an additional; 3,200 students. (4) One thousand (1,000) selected students, predominantly girls from poor households, received their subsidies as planned. In addition, the two national Science, Technology, Engineering and Mathematics (STEM) high schools (Lycées Scientifiques) have now allowed access to secondary education to 274 students (3 cohorts). These two STEM high schools presented a total of 65 candidates for the 2020 baccalaureate session and all were successful. Early Childhood Education (ECE). ECE activities have been piloted in 88 schools in two regions. A total of 15,446 (103% of the target) child benefited from this intervention and 640 early childhood class facilitators (instead of 300 initially planned i.e., 213%) were enrolled in the short-track training and successfully certified by the end of the Project. Component 2: Improving the Quality of Teaching and Learning. This component aims to contribute to improving the quality of teaching and learning with a particular focus on: (i) curriculum improvement; (ii) secondary teacher training; (iii) textbook development; (iv) school-based quality initiatives; and (v) expanding the use and management of assessment and examination systems. School-based quality initiatives. Regarding the promotion of School Management Committees (SMCs) in secondary schools and the preparation of School Improvement Plans (SIPs), all secondary schools in the 5 target regions of the Project have set up SMCs and their members (2,061) were trained around topics like participatory micro-planning; mobilization of resources; advocacy; partnership and the development and implementation of school improvement plans. Each SMC has developed a school improvement plan which has received a grant from the project for its implementation. A total of 766 school improvement plans (SIPs) have been funded in the amount of FCFA 1,332, 617,500 and implemented. The report on SMCs implementation shows that all stakeholders recognize the relevance and usefulness of the SMCs and are willing to participate in the process of setting them up. The main expectations relate to governance, transparency and the participation of all the education actors concerned by the life of the schools, starting with pupils. It should also be noted that there is a concern to guarantee the autonomy of the SMCs and the need for the school administration, in particular the headteacher, to be involved in the management of the SMCs with a support role, in the interests of consistency, complementarity and synergy of the efforts of all the education stakeholders. Assessment of learning outcomes and examination systems. Satisfactory results have been achieved under this sub-component. Three item banks have been set up; these are quality items on mathematics programs, French and Physics (SVT) and an item bank management software and another item analysis software are acquired. The system for organizing examinations and competitions and for the learning outcomes assessment was substantially improved as a result of project interventions, including technical assistance from the “Consortium international de “développement en education” of Québec. The national survey on learning outcomes was carried out and the report finalized. The dissemination of the results which was scheduled for the first quarter of 2020 was disrupted by the closure of establishments linked to the Coronavirus pandemic (COVI-19) crisis. The exam management software (CEP, BEPC, BEP, CAP, Baccalaureate) which allows the management of each of the exams from registration to the issuance of diplomas has been built and tested. In addition, various learning assessments have been carried out in order to identify the causes underlying student performance and support the development of school improvement plans prepared by the SMCs. Textbooks. The 56 disciplinary and pedagogical guides were developed and tested, and the production process of the guides has been completed. A total of 87,188 teachers have been trained in the use of these new guides. 11/25/2020 Page 2 of 11 The World Bank Implementation Status & Results Report B. Faso - Education Access and Quality Improvement Project (EAQIP) (P148062) Component 3: Contribute to strengthening institutional capacity in education in central and decentralized entities. This component aims to contribute to strengthening the ministry’s capacity for data management and planning, reinforce school level management and support the functioning of the project coordination unit (PCU). The strengthening of statistical production has been very efficient under the project support. The education statistical yearbook is available annually. It was agreed to strengthen the integration of the statistical production of the sector by setting up a single management platform. This process will be continued under the additional funding. The March 2020 mission recommends that the Ministry consider using available digital tools for collecting statistical data to replace the usual collection campaigns. To date, the following key achievements have been noted: (1) The budgeted action plan of the DGESS/MENA (Direction Générale des Etudes et des Statistiques Sectorielles – Ministère de l’Education Nationale et de l’Alphabétisation /General Directorate of Studies and Sector Statistics – Ministry of national Education and Literacy) for the production of school statistical data and the educational map has been supported and implemented. (2) The reproduction of the school statistical data collection forms was carried out. The statistical yearbook is available every year. Following the World Bank’s advice, the Government has agreed to strengthen the integration of the statistical production of the sector by setting up a single management platform. This process will be continued as part of the additional funding. (3) The CAMPUSFASO platform is now set up and operational. Registration for new graduates was undertaken online since the 2018-2019 academic year with the signing and payment of agreements between the MESRSI (Ministère de l’Enseignement Supérieur, de la Recherche Scientifique et de l’Innovation) Ministry of Higher Education, Scientific Research and Innovation) and the mobile telephone operators. (4) The project has paid the 2018 FasoREN's membership agreement with WACREN (West and Central African Research and Education Network). (5) The selection of schools for the planned "Circle of Excellence" was carried in October 2018 and has made it possible to reward the twenty (20) best schools in the 2017-2018 school year (10 public and 10 private schools). The communication plan on the circle of excellence (publication through the press and websites, workshops) was completed. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance -- High Substantial Macroeconomic -- High Substantial Sector Strategies and Policies -- Substantial Moderate Technical Design of Project or Program -- Substantial Moderate Institutional Capacity for Implementation and -- Substantial Substantial Sustainability Fiduciary -- Moderate Moderate Environment and Social -- Moderate Substantial Stakeholders -- Moderate Moderate Other -- High Substantial Overall -- High Substantial Results PDO Indicators by Objectives / Outcomes Project Development Objective Indicators 11/25/2020 Page 3 of 11 The World Bank Implementation Status & Results Report B. Faso - Education Access and Quality Improvement Project (EAQIP) (P148062) IN00911064 ►Increase in the grade promotion rate in lower secondary education disaggregated by gender in the 5 targeted regions. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 59.10 68.10 61.80 66.00 Date 15-Oct-2014 28-Feb-2020 11-Nov-2020 31-May-2019 Based on data from the 2018-2019 school year: Grade 7= 61.8 Grade 8=67.9 Grade 9=84.2 Comments: for Girls Grade 7= 64.0 Grade 8=68.2 Grade 9=83.5 IN00911065 Increase in girls' grade promotion rate in lower secondary education in the 5 targeted regions. (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 59.70 64.00 64.00 66.00 Date 15-Oct-2014 28-Feb-2020 11-Nov-2020 31-May-2019 IN00911076 ►Increase in gross intake rate in the first grade of lower secondary education in the 5 targeted regions disaggregated by gender (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 41.10 43.60 43.60 62.00 Date 15-Oct-2014 28-Feb-2020 11-Nov-2020 31-May-2019 Progress of the indicators related to grade promotion rate and gross intake rate seems to be lagging behind because the definition of the baseline and the end- of-project targets were wrongly based on the available national data instead of considering existing data related to the 5 targeted regions. In 2018-2019, most indicators have decreased compared to 2017-18 at the national level. This situation could be explained in large part by the security situation that has led to the closing of several schools Comments: (2152 classrooms closed affecting most around 358,879 students) in seven regions of our country (Boucle du Mouhoun, Center-Est, Nord, Sahel, North Central, South Central, and Eastern). Three out of five PAAQE regions namely North, East-Central and East are areas of high security challenges. This certainly led to the decline in indicators for all five project target regions. IN00911077 Increase in girls' gross intake rate in the first grade of lower secondary education in the 5 targeted regions. (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target 11/25/2020 Page 4 of 11 The World Bank Implementation Status & Results Report B. Faso - Education Access and Quality Improvement Project (EAQIP) (P148062) Value 39.20 45.10 45.10 61.00 Date 15-Oct-2014 28-Feb-2020 11-Nov-2020 31-May-2019 IN00911078 Increase in gross intake rate in the first grade of upper secondary education in the 5 targeted regions (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 8.70 14.30 22.10 14.00 Date 15-Oct-2014 28-Feb-2020 11-Nov-2020 31-May-2019 IN00911079 Increase in girls' gross intake rate in the first grade of upper secondary education in the 5 targeted regions (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 4.10 11.60 19.80 12.00 Date 15-Oct-2014 28-Feb-2020 11-Nov-2020 31-May-2019 IN00911080 ►Number of additional students enrolled in early childhood education using Interactive Audio Instruction programs in the 2 targeted regions and Ouagadougou (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 15,446.00 15,446.00 15,000.00 Date 15-Oct-2014 28-Feb-2020 11-Nov-2020 31-May-2019 All of the 100 EIA programs (50 in Mooré and 50 in Gulmancema), all 100 guides and 24 scripts out of the 25 of learning program were developed. 320 ECD caregivers have already been trained and 15,446 students Comments: IN00911081 ►Direct project beneficiaries (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 121,575.00 121,575.00 83,494.00 Date 15-Oct-2014 28-Feb-2020 11-Nov-2020 31-May-2019 The number of direct project beneficiaries reached 121,575 persons against as against the end target of Comments: 83,494; and the finalization of the 56 manuals allowed the training of around 87.188 teachers. IN00911082 Female beneficiaries (Percentage, Custom Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 50.00 55.00 50.00 Overall Comments PDO 11/25/2020 Page 5 of 11 The World Bank Implementation Status & Results Report B. Faso - Education Access and Quality Improvement Project (EAQIP) (P148062) The analysis of the level of achievement of the PDO indicators gives the following result: of the four indicators of the project's development objective (and their sub-indicators), two have regressed and are not reached and these are from:  The increase in the grade promotion rate in lower secondary education disaggregated by gender in the 5 targeted regions (G / F) which is 61.8% instead of 66% as expected;  The increase in gross intake rate in the first grade of lower secondary education in the 5 targeted regions disaggregated by gender (43.6% / 62%). The reason for the non-achievement of these indicators is mainly linked to the security challenges in the project intervention regions in which, during the last three years, around 2,600 classrooms have been closed (each year) due to terrorist attacks and which caused the displacement of approximately 300,000 students, sometimes, outside the project intervention zones. The other two PDO indicators are reached and even exceeded. Intermediate Results Indicators by Components Component 1: Expanding equitable access to pre-school education in the two poorest regions and secondary education in the five poorest regions IN00911083 ►Number of pre-school class facilitators enrolled in the short-track training successfully certified by the end of the project. (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 640.00 640.00 300.00 Date 15-Oct-2014 28-Feb-2020 11-Nov-2020 31-May-2019 The planned short-track training is linked with the Interactive Audio Instruction (IAI) pilot which was completed with the production of 100 audio emissions, 100 guides and 25 distance-learning training Comments: modules for IAI program educators. 640 ECD caregivers have been trained and a total of 15,446 students has been enrolled. IN00911085 ►Percent % of Lower secondary schools in the targeted five poorest regions have agreed School Improvement Plans (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 100.00 90.00 Date 22-Oct-2014 28-Feb-2020 11-Nov-2020 31-May-2019 Following the signing of 683 School Improvement Plans (SIPs) in the 2018-2019 school year, an amount of 1,164,237,500 FCFA was transferred to 683 SMCs in the 5 target regions for the implementation of Comments: their school improvement plans. IN00911087 ►Percent % Lower secondary schools in the targeted five poorest regions have functional SBMCs (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target 11/25/2020 Page 6 of 11 The World Bank Implementation Status & Results Report B. Faso - Education Access and Quality Improvement Project (EAQIP) (P148062) Value 0.00 100.00 100.00 90.00 Date 15-Oct-2014 28-Feb-2020 11-Nov-2020 31-May-2019 SMCs were set up in all secondary schools in the 5 targeted regions (687 functional SMCs exist). SIPs have been developed and a refresher training of trainers was organized for around 40 trainers on various Comments: modules who will carry out this training for the benefit of SMCs' members. Component 2: Improving the quality of teaching and learning IN00911084 ►Percent % teachers have been coached in situ by supervisors by the end of the project. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 5.00 76.00 76.00 60.00 Date 15-Oct-2014 28-Feb-2020 11-Nov-2020 31-May-2019 The current progress was achieved through the provision of existing in-service teacher training programs. In-service training for teachers has been conducted in the regional direction of education (DREPS) in the form of pedagogical workshops and class visits, and the design workshop of Comments: Open Distance Learning modules for the benefit of 50 teacher-researchers and pedagogical supervisors. was also held. IN00911086 ►Percent % Lower and upper secondary teachers have participated in in-service training by the end of the project (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 92.00 92.00 60.00 Date 15-Oct-2014 28-Feb-2020 11-Nov-2020 31-May-2019 The selected supervisors involved in the MS4SSA initiative have been trained in Niger node and are expected to expand the approach. In addition, ongoing teacher training is underway and expected to Comments: reach at least 50% of teachers by the end of the school year. IN00911088 ►Number of teachers and staff trained on the using of the new guides. (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 87,148.00 87,148.00 50,000.00 Date 15-Oct-2014 28-Feb-2020 11-Nov-2020 31-May-2019 The 56 disciplinary and pedagogical guides (preschool, primary and post-primary) were developed and Comments: 87,188 teachers were trained on the use of the new guides. IN00911089 ►Number of teaching guides developed and piloted with project support for the three education levels (ECD, primary and secondary education). (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 56.00 56.00 56.00 11/25/2020 Page 7 of 11 The World Bank Implementation Status & Results Report B. Faso - Education Access and Quality Improvement Project (EAQIP) (P148062) Date 15-Oct-2014 28-Feb-2020 11-Nov-2020 31-May-2019 The new guides have been prepared along with the new curriculum and are ready for use. Comments: IN00911090 ►Number of additional classrooms built in lower and upper secondary levels resulting from project interventions. (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 315.00 327.00 339.00 Date 15-Oct-2014 28-Feb-2020 11-Nov-2020 31-May-2019 The construction of 5 lower and 5 higher secondary schools to be awarded to private sector as well as the construction of 55 additional classes for the benefit of well-performing private educational institutions have Comments: been completed. The expected target of 339 classrooms has been achieved. IN00911091 ►Number of Students receiving subsidies to support the costs of their school fees disaggregated by gender in the five targeted regions (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1,000.00 1,000.00 1,000.00 Date 15-Oct-2014 28-Feb-2020 11-Nov-2020 31-May-2019 In the academic year 2016-2017, 566 lower secondary students received support for their schooling. During the 2017-2018 academic year, additional 434 upper secondary students received subsidies. In total, 1,000 secondary students benefited from support, already reaching the end-of-project target. The Comments: support to these 1,000 lower and upper secondary students was planned in a way that they all complete their current education cycle before the project close. IN00911092 Percentage of Students receiving subsidies to support the costs of their school fees in the five targeted regions are girls. (Percentage, Custom Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 55.00 55.00 50.00 IN00911093 ►Percentage increase in gross enrollment rate in lower and upper secondary education in the five poorest regions disaggregated by gender (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 40.20 47.80 47.80 63.00 Date 15-Oct-2014 28-Feb-2020 11-Nov-2020 31-May-2019 This indicator is disaggregated by level (Lower and Upper Secondary) and the level is determined by the values of its sub- indicators (listed below). It will not be monitored by itself. The opening of 5 lower and 5 higher secondary schools to be awarded to private sector as well as the construction of 55 additional classes for the benefit of well-performing private educational institutions at the next school year will allow Comments: recruitment of new students and the project will then likely exceed the end-of-project target on the percentage increase in gross enrollment rate in lower and upper secondary education in the five poorest regions disaggregated by gender. IN00911094 Percentage increase in the gross enrollment rate in lower secondary education in the five poorest regions disaggregated by gender (Percentage, Custom Breakdown) 11/25/2020 Page 8 of 11 The World Bank Implementation Status & Results Report B. Faso - Education Access and Quality Improvement Project (EAQIP) (P148062) Baseline Actual (Previous) Actual (Current) End Target Value 37.60 46.40 46.40 63.00 Date 15-Oct-2014 28-Feb-2020 11-Nov-2020 31-May-2019 IN00911095 Percentage increase in girls' gross enrollment rate in lower secondary education in the five poorest regions (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 35.10 49.20 49.20 43.00 Date 15-Oct-2014 28-Feb-2020 11-Nov-2020 31-May-2019 IN00911096 Percentage increase in gross enrollment rate in Upper secondary education in the five poorest regions (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 9.20 18.60 18.60 20.00 Date 15-Oct-2014 28-Feb-2020 11-Nov-2020 31-May-2019 IN00911097 Percentage increase in girls' gross enrollment rate in Upper secondary education in the five poorest regions (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 5.80 15.30 15.30 12.00 Date 15-Oct-2014 28-Feb-2020 11-Nov-2020 31-May-2019 Overall Comments IR With regard to the achievement of the project intermediate results indicators, out of the ten indicators; two are not fully achieved:  Percentage increase in gross enrollment rate in lower and upper secondary education in the five poorest regions disaggregated by gender (47.80% instead of 63%) and the main reason is the closure of classes in areas affected by insecurity.  The indicator on the number of additional classrooms built in lower and upper secondary levels resulting from project interventions (327/339) was not reached due to poor programming at the project start. The two national Science, Technology, Engineering and Mathematics (STEM) high schools which were supposed to receive 12 classrooms each were finally resized to 6 classrooms per school because of the cost of construction; which makes a shortfall of 12 classrooms. All the other intermediate results indicators are reached and even exceeded. Performance-Based Conditions 11/25/2020 Page 9 of 11 The World Bank Implementation Status & Results Report B. Faso - Education Access and Quality Improvement Project (EAQIP) (P148062) Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P148062 IDA-D0330 Effective USD 50.00 50.00 0.00 49.40 0.34 99% Not P148062 IDA-D6840 USD 100.00 100.00 0.00 0.00 103.99 0% Effective Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P148062 IDA-D0330 Effective 02-Apr-2015 13-May-2015 30-Oct-2015 31-Jul-2019 31-Jan-2021 Not P148062 IDA-D6840 25-Aug-2020 28-Sep-2020 -- 31-Jul-2024 31-Jul-2024 Effective Cumulative Disbursements PBC Disbursement Achievement Disbursed amount in Disbursement % PBC ID PBC Type Description Coc PBC Amount Status Coc for PBC 11/25/2020 Page 10 of 11 The World Bank Implementation Status & Results Report B. Faso - Education Access and Quality Improvement Project (EAQIP) (P148062) Restructuring History Level 2 Approved on 07-May-2019 ,Level 2 Approved on 13-Oct-2020 Related Project(s) P170452-Burkina Faso - Education Access and Quality Improvement Project Additional Financing 11/25/2020 Page 11 of 11