OFFICIAL DOCUMENTS The World Bank E-32, Agargaon, Sher-e-Bangla Nagar, Dhaka 1207, Bangladesh Phone: (880-2) 5566-7777, Facsimile: (880-2) 5566-7778 Sereen Juma Acting Country Director for Bangladesh, Bhutan and Nepal October 14, 2018 Senior Secretary Kazi Shofiqul Azam Economic Relations Division Ministry of Finance Government of the People's Republic of Bangladesh Sher-E-Bangla Nagar Dhaka 1207 Bangladesh Re: People's Republic of Bangladesh: Health Sector Support Project (GFF Grant Number TF0A4355-BD) Amendment to the Grant Agreement We refer to the Grant Agreement dated August 28, 2017, between the People's Republic of Bangladesh (the "Recipient") and the International Development Association (the "World Bank"), acting as administrator of the Multi-Donor Trust Fund for the Global Financing Facility in Support of Every Woman Every Child, for the above-mentioned Project (the "Grant Agreement"). We also refer to our exchange with officials from the Ministry of Health and Family Welfare regarding the proposal to restructure the Project. We are pleased to inform you that the World Bank accedes to the restructuring proposal and proposes to amend the Grant Agreement as set out below: 1. The table containing the Disbursement-Linked Indicators, Disbursement-Linked Results and Allocated Amounts Applicable to the Project set forth in the Annex to Schedule 2 is deleted in its entirety and replaced by the table in the Attachment to this letter of amendment. 2. Section III.B. I of Schedule 2 is amended to read as follows: 1. Notwithstanding the provisions of Part A of this Section, no withdrawal shall be made: (a) for payments made prior to the date of this Agreement, except that withdrawals up to an aggregate amount not to exceed US$3,000,000 may be made for payments made prior to this date but on or after January 1, 2017, for Eligible Expenditure Program; and (b) unless and until the Recipient has: Mr. Kazi Shofiqul Azam -2- October 14, 2018 (i) furnished evidence in accordance with the Verification Protocols and acceptable to the World Bank of the Recipient's satisfactory achievement of each DLR for which payment is requested in the amount of the price for each such DLR as set forth in the Annex to this Schedule 2; and (ii) complied with the additional instructions referred to in Section III.A.1 of this Schedule 2, including furnishing to the World Bank the applicable interim unaudited financial reports documenting the incurrence of expenditures under the Eligible Expenditure Program during the respective DLR Period up to the date against which withdrawal is requested. Except as specifically amended by this letter of amendment, all other provisions of the Grant Agreement shall remain unchanged and in full force and effect. The World Bank will disclose this letter of amendment and related information in accordance with the World Bank's policy on Access to Information. By entering into this letter of amendment, the Recipient consents to such disclosure. Please confirm your agreement to the foregoing on behalf of the Recipient by countersigning and dating the corresponding form of confirmation set forth below, and returning one fully signed original of this letter to us. Upon receipt by the World Bank of the copy of this letter of amendment duly countersigned by the authorized representative of the Recipient, the above amendments to the Grant Agreement shall become effective as of the date of countersignature. Sincerely, INTERNATIONAL DEVELOPMENT ASSOCIATION acting as administrator of the Multi-Donor Trust Fund for the Global Financing Facility in Support of Every Woman Every Child By. Sereen Juma CONFIRMED: PEOPLE'S REPUBLIC OF BANGLADESH By: Name: phmurda RAUnUM Additonal SecrtaY Economic Relations DIVISon Title: Minita of Finance Date: t()___Q-D __Z Mr. Kazi Shofiqul Azam -3- October 14, 2018 Attachment Disbursement-Linked Indicators, Disbursement-Linked Results and Allocated Amounts Applicable to the Project DLR eriod FY2017 FY2018 FY2019 Component 1. Governance and Stewardship DLI 1. Citizen feedback system is strengthened - US$750,000 DLRs DLR 1.1 Assessment of DLR 1.2 GRS guidelines current GRS is completed are approved (1) (1) Allocated Amounts US$375,000 US$375,000 DLI 2. Budget planning and allocation are improved - US$1,680,000 DLRs DLR 2.1 OPs approved DLR 2.2 Increase in the percentage (%) from FY2016 including activities and baseline in repair and maintenance expenditure at the budgets for achievement levels of Upazila and below (2) of DLIs (1) Targets 13 OPs 20% increase 40% increase Allocated Amounts DLR 2.1 US$780,000 DLR 2.2 US$900,000 (US$15,000 per 1% increase from (US$60,000 per OP) FY 2016 baseline) Component 2. Health, Nutrition and Population Systems Strengthening DLI 3. Financial management system is strengthened - US$1,530,000 DLRs DLR 3.1 MOHFW submits DLR 3.2 MOPA endorses DLR 3.3 MOF concurs to FMAU recruitment rules FMAU recruitment rules FMAU recruitment rules to MOPA (1) (1) (1) Allocated Amounts DLR 3.1 US$286,875 DLR 3.2 US$286,875 DLR 3.3 US$956,250 DLI 4. Asset management is improved - US$546,000 DLRs DLR 4.1 Assessment and plan are approved for AMS scale-up (1) DLR 4.2 Number of District Hospitals in which AMS is implemented (2) Targets 1 District Hospitals 3 District Hospitals 6 District Hospitals Allocated Amounts DLR 4.1 US$141,000 I DLR 4.2 US$405,000 (US$40,500 per District Hospital) DLI 5. Procurement process is improved using information technology - US$594,0000 DLRs DLR 5.1 e-GP is initiated DLR 5.2 NCTs using e-GP for procurement by as percentage (%) of all MOHFW (1) specified NCTs issued by MOHFW (2) Target 25% of NCTs Allocated Amounts DLR 5.1 US$150,000 DLR 5.2 US$444,000 (US$11,100 per 1% of NCTs) DLI 6. Institutional capacity is developed for procurement and supply management - US$480,000 DLRs DLR 6.1 CMSD DLR 6.2 MOF concurs to restructuring proposal is CMSD restructuring endorsed by MOPA and proposal (1) submitted to MOF (1) Allocated Amounts DLR 6.1 US$240,000 DLR 6.2 US$240,000 Mr. Kazi Shofiqul Azam -4- October 14, 2018 DLI 7. Availability of midwives for maternal care is increased - US$1,365,000 DLRs DLR 7.1 At least 2,500 DLR 7.2 Number of Upazila Health Complexes with at midwife posts are created least 2 accredited diploma midwives (2) by MOHFW and recruitment of midwives is underway (1) Targets 150 Upazila Health Maintain 150 Upazila ._Complexes Health Complexes Allocated Amounts DLR 7.1 US$607,000 DLR 7.2 US$758,000 (US$2,526.67 per Upazila Health I I_ Complex) DLI 8. Information system is strengthened, including gender-disaggregated data - US$600,000 DLRs DLR 8.1 Number of Community Clinics providing complete essential data to DHIS2, including gender- disaggregated, reported for the previous CY (2) Targets 1,000 Community Clinics 2,000 Community Clinics Allocated Amounts DLR 8.1 US$600,000 (US$20,000 per 100 Community Clinics) Component 3. Provision of Quality Health, Nutrition and Population Services DLI 9. Post-partum family planning services are improved - US$981,750 DLRs DLR 9.1 Facility readiness DLR 9.2 Reporting and DLR 9.3 Assessment and criteria and assessment training guidelines for action plan are completed instrument for PPFP PPFP services are for expansion of PPFP services are approved (1) approved (1) services in targeted health facilities in Sylhet and Chittagong divisions (1) DLR 9.4 Percentage (%) of targeted Public Health Facilities meeting readiness criteria for delivery of PPFP services in Sylhet and Chittagong divisions, reported for the previous CY (2) Target 5% Allocated Amounts DLR 9.1 US$150,000 DLR 9.2 US$90,000 DLR 9.3 US$1561,50 DLR 9.4 US$ 585,600 (US$117,120 per 1% of targeted facilities) DLI 10. Utilization of maternal health care services is increased - US$617,250 DLRs DLR 10.1 Number of normal deliveries in Public Health Facilities in Sylhet and Chittagong divisions (2) Targets 130,000 132,000 135,000 Allocated Amounts DLR 10.1 US$617,250 (US$ 1,554.786 per 1,000 deliveries) Mr. Kazi Shofiqul Azam -5- October 14, 2018 DLI 11. Emergency obstetric care services are improved - US$1,176,000 DLRs DLR 11.1 Facility DLR 11.2 Assessment and assessment instrument for action plans are approved CEmONC is approved (1) for development of CEmONC services in targeted District Hospitals in Sylhet and Chittagong divisions (1) DLR 11.3. Number of District Hospitals with capacity to provide CEmONC services in Sylhet and Chittagong divisions, reported for the previous CY (2) Targets 5 District Hospitals 6 District Hospitals 7 District Hospitals Allocated Amounts DLR 11.1 US$90,000 DLR 11.2 US$141,000 DLR 11.3 US$945,000 (US$52,500 per District Hospital) DLI 12. Immunization coverage and equity are enhanced - US$1,500,000 DLRs DLR 12.1 Immunization micro-plans for CY17 are approved for each district in Sylhet and Chittagong divisions (1) DLR 12.2 Number of districts reaching at least 85% coverage of measles-rubella vaccination among children ages 0-12 months in Sylhet and Chittagong divisions, reported for the previous CY (2) Targets All 15 districts All 15 districts All 15 districts Allocated Amounts DLR 12.1 US$150,000 DLR 12.2 US$1,350,000 (US$30,000 per district) DLI 13. Maternal nutrition services are expanded - US$840,000 DLRs DLR 13.1 Technical DLR 13.2 Reporting and DLR 13.3 Assessment is standards for maternal quality assessment completed of maternal nutrition services are guidelines for maternal nutrition service quality in approved (1) nutrition services are Sylhet and Chittagong approved (1) divisions (1) DLR 13.4 Percentage (%) of registered pregnant mothers receiving specified maternal nutrition services in Sylhet and Chittagong divisions, reported for the previous CY (2) Targets 5% 10% Allocated Amounts DLR 13.1 US$90,000 DLR 13.2 US$90,000 DLR 13.3 US$210,000 DLR 13.4 US$450,000 (US$30,000 per 1% of registered pregnant mothers) Mr. Kazi Shofiqul Azam -6- October 14, 2018 DLI 14. Infant and child nutrition services are expanded - US$840,000 DLRs DLR 14.1 Technical DLR 14.2 Reporting and DLR 14.3 Assessment is standards for infant and quality assessment completed of infant and child nutrition services are guidelines for infant and child nutrition service approved (1) child nutrition services are quality in Sylhet and approved (1) Chittagong divisions (1) DLR 14.4 Percentage (%) of registered infants and children aged under 2 years receiving specified nutrition services in Sylhet and Chittagong divisions, reported for the previous CY (2) Targets 10% 15% 20% Allocated Amounts DLR 14.1 US$90,000 DLR 14.2 US$90,000 DLR 14.3 US$214,500 DLR 14.4 US$445,500 (US$9,900 per 1% of registered infants and children aged under 2 years) DLI 15. School-based adolescent HNP program is developed and implemented - US$750,000 DLRs DLR 15.1 Revised teacher DLR 15.2 Assessment of training manual is current school-based approved (1) services in Sylhet and Chittagong divisions is jointly completed with the education sector (1) Allocated Amounts DLR 15.1 US$281,250 DLR 15.2 US$468,750 DLI 16. Emerging challenges are addressed - US$750,000 DLRs DLR 16.1 Urban Health DLR 16.2 Guidelines for Coordination Committee screening, referral and meets and agrees on treatment of actions to improve hypertension are coordination on urban approved (1) health (1) Allocated Amounts DLR 16.1 US$468,750 DLR 16.2 US$281,250