OFFICIAL TheWorld Bank MENTS E-32 Agargaon, Sher-e-Bangla Nagar, Dhaka 1207, BadO C U M ENTS Phone: (880-2) 5566-7777 Facsimile: (880-2) 5566-7778 Qimiao Fan Country Director for Bangladesh, Bhutan & Nepal September 20, 2018 Mr. Kazi Shofiqul Azam Secretary Economic Relations Division Ministry of Finance Dhaka, Bangladesh Dear Secretary Azam: Bangladesh: Health Sector Support Project (Credit No. 6127-BD and GFF Grant No. TF0A4355-BD) Amendments to the Financing Agreement and Grant Agreement We refer to: (i) the Financing Agreement dated August 28, 2017, between the People's Republic of Bangladesh (the Recipient) and the International Development Association (the Association); and (ii) the Grant Agreement dated August 28, 2017, between the Recipient and the Association acting as administrator of the Multi-Donor Trust Fund for the Global Financing Facility in Support of Every Woman Every Child, both related to the Health Sector Support Project. After reaching agreements with the Association, the Recipient, through the Economic Relations Division of Recipient's Ministry of Finance, has requested to restructure the Project in order to process additional financing to the above-mentioned Project. Accordingly, the Association proposes to amend the above-mentioned agreements as follows: I. Financing Agreement 1. Section 2.01 of Article II is amended to read as follows: 'The Association agrees to extend to the Recipient, on the terms and conditions set forth or referred to in this Agreement, a credit in an amount equivalent to three hundred and sixty-one million two hundred thousand Special Drawing Rights (SDR 361,200,000) (variously, "Credit" and "Financing"), to assist in financing Parts 1-3 of the project described in Schedule 1 to this Agreement ("Project").' 2. Section 3.01 of Article III is amended to read as follows: 'The Recipient declares its commitment to the objective of the Project. To this end, the Recipient shall carry out Parts 1-3 of the Project through its Ministry of Health and Family Welfare ("MOHFW") in accordance with the provisions of Article IV of the General Conditions, and Part 4 of the Project in accordance with the provisions of the Additional Financing Agreement.' 3. The description of the Project set forth in Schedule I to the Financing Agreement shall be amended in its entirety to read as set forth in Annex A to this Amendment Letter. 4. The definition number 16 of the Appendix is amended to read as follows: '16. "Eligible Expenditure Program" or "EEP" means the salaries required for the implementation of Parts 1-3 of the Project and included in the Recipient's budget lines, consisting of the following items and corresponding budget codes: (a) Pay of Officers (4500) excluding the following budget codes: 3-2713-0000-4501, 3-274-0000-4501, 3-2715-0000- 2 4501, 3-2716-0000-4501, 3-2742-0000-4501, 3-2744-0000-4501, 3-7421-0047-4501, 3-7424- 0047-4501, 3-7485-0000-4501,3-7487-0000-4501 and 3-7489-0000-4501: 3-2713-0000-4501, 3-2714-0000-4501, 3-2715-0000-4501, 3-2716-0000-4501, 3-2742-0000-4501, 3-2744-0000- 4501, 3-7421-0047-4501, 3-7424-0047-4501, 3-7485-0000-4501, 3-7487-0000-4501 and 3- 7489-0000-4501; and (b) Pay of Establishment (non-gazetted staff) (4600) excluding the following budget codes: (3-2713-0000-4601, 3-2714-0000-4601, 3-2715-0000-4601, 3-2716- 0000-4601, 3-2742-0000-4601, 3-2744-0000-4601, 3-7421-0047-4601, 3-7424-0047-4601, 3- 7485-0000-4601, 3-7487-0000-4601 and 3-7489-0000-4601), as such budget codes may be revised from time to time with the prior written concurrence of the Association.' 5. A new definition number 43 is added to the Appendix stating as follows: '43. "Additional Financing Agreement" means the financing agreement between the Recipient and the Association, dated September 20, 2018 (Credit No 6302 - BD).' 6. A new definition number 44 is added to the Appendix stating as follows: '44. "Original Project" means the project described in Schedule 1 to the financing agreement between the Recipient and the Association, dated August 28, 2017 (Credit No 6127-BD).' II. Grant Agreement 1 . Section 2.01 of Article II is amended to read as follows: 'The Recipient declares its commitment to the objective of the Project. To this end, the Recipient shall carry out Parts 1-3 of the Project through its Ministry of Health and Family Welfare ("MOHFW") in accordance with the provisions of Article II of the Standard Conditions, and Part 4 of the Project in accordance with the provisions of the Additional Financing Agreement.' 2. Section 3.01 of Article III is amended to read as follows: 'The World Bank agrees to extend to the Recipient, on the terms and conditions set forth or referred to in this Agreement, a grant in an amount not to exceed fifteen million United States Dollars ($15,000,000) ("Grant") to assist in financing Parts 1-3 of the Project.' 3. The description of the Project referred in Article II of the Grant Agreement shall be amended in its entirety to read as set forth in Annex A to this Amendment Letter. 4. The definition number 8 of the Appendix is amended to read as follows: '8. "Eligible Expenditure Program" or "EEP" means the salaries required for the implementation of Parts 1-3 of the Project and included in the Recipient's budget lines, consisting of the following items and corresponding budget codes: (a) Pay of Officers (4500) excluding the following budget codes: 3-2713-0000-4501, 3-274-0000-4501, 3-2715-0000- 4501, 3-2716-0000-4501, 3-2742-0000-4501, 3-2744-0000-4501, 3-7421-0047-4501, 3- 7424-0047-4501, 3-7485-0000-4501, 3-7487-0000-4501 and 3-7489-0000-450 1; and (b) Pay of Establishment (non-gazetted staff) (4600), excluding the following budget codes: (3-2713- 0000-4601, 3-2714-0000-4601, 3-2715-0000-4601, 3-2716-0000-4601, 3-2742-0000-4601, 3-2744-0000-4601, 3-7421-0047-4601, 3-7424-0047-4601, 3-7485-0000-4601, 3-7487- 0000-4601 and 3-7489-0000-4601), as such budget codes may be revised from time to time with the prior written concurrence of the Association.' 5. A new definition number 34 is added to the Appendix stating as follows: 3 '34. "Additional Financing Agreement" means the financing agreement between the Recipient and the Association, dated September 20, 2018 (Credit No 6302 - BD).' 6. A new definition number 35 is added to the Appendix stating as follows: '35. "Original Project" means the project described in Schedule I to the grant agreement between the Recipient and the Association, acting as administrator of the Multi-Donor Trust Fund for the Global Financing Facility in Support of Every Woman Every Child, dated August 28, 2017 (TF0A4355-BD).' Except as specifically amended by this Amendment Letter, all other provisions of the Financing Agreement and the Grant Agreement shall remain unchanged and in full force and effect. The Association will disclose this Amendment Letter and related information in accordance with the World Bank's Policy on Access to Information. By entering into this Amendment Letter, the Recipient consents to disclosure of this Amendment Letter and related information. Please confirm your acceptance to the foregoing by signing and dating the two originals, retaining one original for your records and returning the other original to the Association. Upon receipt by the Association of the original Amendment Letter countersigned by you, in a manner satisfactory to the Association, this Amendment Letter will become effective as of the date on which the Association confirms the acceptance of the aforementioned documents. Sincerely, INTERNATIONAL DEVELOPMENT ASSOCIATION Qimiao Fan Country Director AGREED: PEOPLE'S REPUBLIC OF BANGLADES By:___ Authorized Representative Name: Kazi Shofiqul Azam Title: Secretary, Economic Relations Division Date: September 20, 2018 4 Annex A Revised SCHEDULE 1 Project Description The objective of the Project is to strengthen the health, nutrition and population ("HNP") sector's core management systems and delivery of essential HNP services with a focus on Selected Geographical Areas. The Project consists of the following Parts, of which Parts 1-3 formed part of the Original Project and are financed through the Eligible Expenditure Program, while Part 4 is a new Part with additional activities: Part 1: Governance and Stewardship 1. Enhancing the Recipient's citizen feedback system for its health services, including making the performance of the system and the responses to the messages received more transparent to the public. 2. Improving budget efficiency and allocation in the HNP sector through the increase of budget allocation and execution towards repair and maintenance to support basic service delivery. Part 2: HNP Systems Strengthening 1. Improving the Recipient's financial management, procurement, supply chain management and asset management systems in the HNP sector. 2. Improving the quality of the health management information system through the completeness of the reporting and inclusion of gender, for gender-disaggregated report, from the community clinic level. 3. Improving human resource in the HNP sector through the appointment and retention of qualified midwives at Upazila Health Complexes. Part 3: Provision of Quality HNP Services 1. Improving coverage of essential services at the primary and first-referral levels for reproductive (including family planning), maternal, neonatal, child, and adolescent health and nutrition, including reducing geographic inequalities. 2. Supporting the Recipient in addressing emerging areas through the strengthening of the coordination mechanisms with the Ministry of Local Government, Rural Development and Cooperatives and urban local governments and the development and implementation of a pilot to address non-communicable diseases (hypertension), starting from screening and referral services at the community clinic level. Part 4. Develop HNP Services for the Displaced Rohingva Population in Cox's Bazar District 1. Enhancing the Recipient's planning, coordination, monitoring and management capacities for providing scaled up and new HNP services providing care to the displaced Rohingya population in Cox's Bazar District, including for disease surveillance and outbreak response, service management of referral systems, and medical waste management. 5 2. (a) Enhancing delivery of the Essential Service Package (as defined in the Additional Financing Agreement) to the displaced Rohingya population at community clinics and similar facilities in Cox's Bazar District; (b) Enhancing delivery of the Essential Service Package to the displaced Rohingya population at union level and similar facilities in Cox's Bazar District; and (c) Supporting integrated communication and outreach strategies focused on improving HNP- related household knowledge and behaviors in Cox's Bazar District. 3. Enhancing the delivery of the Essential Service Package to the displaced Rohingya population at Upazila Health Complexes, maternal and child welfare centers and the District Hospital (as defined in the Additional Financing Agreement) in Cox's Bazar District.