The World Bank Reinforcing SAcc of health services by supporting health committees and the community diagnosis in Bas Congo and South Kivu (P150874) REPORT NO.: RES34020 RESTRUCTURING PAPER ON A PROPOSED PROJECT RESTRUCTURING OF REINFORCING SACC OF HEALTH SERVICES BY SUPPORTING HEALTH COMMITTEES AND THE COMMUNITY DIAGNOSIS IN BAS CONGO AND SOUTH KIVU APPROVED ON NOVEMBER 18, 2014 TO THE CATHOLIC ORGANIZATION FOR RELIEF AND DEVELOPMENT AID CORDAID HEALTH, NUTRITION & POPULATION AFRICA Regional Vice President: Hafez M. H. Ghanem Country Director: Jean-Christophe Carret Senior Global Practice Director: Timothy Grant Evans Practice Manager/Manager: Trina S. Haque Task Team Leader: Hadia Nazem Samaha The World Bank Reinforcing SAcc of health services by supporting health committees and the community diagnosis in Bas Congo and South Kivu (P150874) ABBREVIATIONS AND ACRONYMS CORDAID Catholic Organization for Relief and Development Aid CSO Civil Society Organization DRC Democratic Republic of Congo HFC Health Facility Committee The World Bank Reinforcing SAcc of health services by supporting health committees and the community diagnosis in Bas Congo and South Kivu (P150874) Note to Task Teams: The following sections are system generated and can only be edited online in the Portal. BASIC DATA Product Information Project ID Financing Instrument P150874 Investment Project Financing Original EA Category Current EA Category Not Required (C) Not Required (C) Approval Date Current Closing Date 18-Nov-2014 18-Nov-2018 Organizations Borrower Responsible Agency The Catholic Organization for Relief and Development Aid The Catholic Organization for Relief and Development CORDAID Aid CORDAID Financing (in USD Million) FIN_SUMM_PUB_TBL SUMMARY Total Project Cost 0.80 Total Financing 0.00 Financing Gap 0.00 DETAILS -NewFin3 The World Bank Reinforcing SAcc of health services by supporting health committees and the community diagnosis in Bas Congo and South Kivu (P150874) Project Development Objective (PDO) Original PDO The objective of the Project is to improve access and quality of health care services in Targeted Regions through the strengthening of Health Facility Committees ("HFCs').   OPS_TABLE_PDO_CURRENTPDO Summary Status of Financing Net TF Approval Signing Effectiveness Closing Commitment Disbursed Undisbursed TF-18164 18-Nov-2014 18-Nov-2014 18-Nov-2014 18-Nov-2018 .80 .54 .26 Policy Waiver(s) Does this restructuring trigger the need for any policy waiver(s)? No I. PROJECT STATUS AND RATIONALE FOR RESTRUCTURING A. Status of the Grant. 1. Cordaid DRC has been implementing the project in 185 Health Facility Committees (HFCs) in Congo Central and South Kivu in Collaboration with the Regional Departments of the Health Ministry. The recruitment of CSOs in South Kivu has been completed and micro-projects are being implemented in collaboration with Regional Health Authorities and HFCs, while in Congo Central the process of recruitment of CSOs is progressing. This component of the project has been the last one to be implemented since it needed HFCs to be active and engaged with public institutions and communities, to start jointly designing and implementing micro-projects. 2. In the 185 HFCs reached by the project to date, members have received multiple training sessions and support resulting in an active collaboration with public institutions. In two Health zones located in the East of DRC, the security situation worsened considerably, and the project could not transfer payments to local partners. The project has been increasingly encouraging the emergence The World Bank Reinforcing SAcc of health services by supporting health committees and the community diagnosis in Bas Congo and South Kivu (P150874) of risk-sharing mechanisms by stimulating the implementation of community projects through the granting of community grants since the end of 2017. 3. The project has shown significant progress in terms of social cohesion within community groups, making the Ministry of Health consider its potential in future projects and collaborations. Aiming to build on the existing experience with HFCs , the Project will support efforts of the Ministry in other regions and settings. Given the socio-economic situation in the country, the project doubled efforts through citizen engagement in communities to promote and increase self-help for indigents. An impact study will be launched in June 2018 to measure these efforts and support results with scientific data. 4. The project is ensuring positive dialogue at the community level, thus empowering the communities to hold meetings with Health Center managers and solve problems locally when it’s possible by mobilizing the community towards specific goals. These skills are very important and basic for a community-based social accountability process to be sustained. Given the situation in the country, the Project is perceived as a response to mitigate risks and ensure support to communities and develop their ownership of solutions and self-care. The efforts of the project can eventually bring some relief to communities and increase their resilience. B. Rationale for extension of project Closing Date 5. The reason for the requested extension to February 2019 is: (i) to compensate for initial delays of between 7 to 9 months in project launches due to holdups in the signing of agreements with Regional Government entities; and (ii) to allow time for the completion of Knowledge Management products such as the impact study to show how much success was achieved in improving the access of poor and vulnerable populations to health facilities and its publications by the project. This will also measure the contribution of the project to social cohesion and self-care given the socio- economic situation in the DRC. 6. The project is bringing more emphasis to micro-projects that are encouraged within the communities after succeeding in activating and training 185 HFCs at the regional level. The project started The World Bank Reinforcing SAcc of health services by supporting health committees and the community diagnosis in Bas Congo and South Kivu (P150874) engaging with the Ministry of Health and other actors to plan for the sustainability of its activities and finding creative ways to build-on what the project achieved through HFCs. 7. The project has no overdue audits at present time. II. DESCRIPTION OF PROPOSED CHANGES After receiving a detailed action plan with adjusted activities and implementation timelines, the team proposes extending the Project’s closing date for a period of ninety (90) days to February 18, 2019. Note to Task Teams: The following sections are system generated and can only be edited online in the Portal. III. SUMMARY OF CHANGES Changed Not Changed Loan Closing Date(s) ✔ Implementation Schedule ✔ Implementing Agency ✔ Project's Development Objectives ✔ Results Framework ✔ Components and Cost ✔ Cancellations Proposed ✔ Additional Financing Proposed ✔ Reallocation between Disbursement Categories ✔ Disbursements Arrangements ✔ Disbursement Estimates ✔ Change in Overall Risk Rating ✔ Safeguard Policies Triggered ✔ EA category ✔ The World Bank Reinforcing SAcc of health services by supporting health committees and the community diagnosis in Bas Congo and South Kivu (P150874) Legal Covenants ✔ Institutional Arrangements ✔ Financial Management ✔ Procurement ✔ Other Change(s) ✔ IV. DETAILED CHANGE(S) OPS_DETAILEDCHANGES_LOANCLOSING_TABLE LOAN CLOSING DATE(S) Original Revised Proposed Proposed Deadline TF Status Closing Closing(s) Closing for Withdrawal Applications TF-18164 Effective 18-Nov-2018 18-Feb-2019 18-Jun-2019 Note to Task Teams: End of system generated content, document is editable from here.