THE WORLD BANK CA IBRD-*ID()pFMRouP 12/ DOCUMENTS 70 1516 :Fo 30 ,2016 Mohammad Mejbahuddin Senior Secretary Economic Relations Division Ministry of Finance Block 8, Room 3 Sher-e-Bangla Nagar Dhaka Dear Senior Secretary Mejbahuddin: Health Sector Development Program (Credit 4954-BD; BHSDP MDTF Grant TF011556 and USAID Trust Fund Grant TF012281; and Credit 5869-BD) Amendment to the Performance Indicators We refer to: (a) the Financing Agreement between the Republic of Bangladesh (the "Recipient") and the International Development Association (the "Association") dated September 11, 2011 (Credit No. 4954-BD) (the "Financing Agreement") as amended; (b) the BHSDP MDTF Grant Agreement between the Recipient and the International Development Association (the "World Bank") dated March 28, 2012 (BHSDP MDTF Grant No. TF011556 and USAID Trust Fund Grant No. TF012281) (the "Grant Agreement") as amended; and (c) the Financing Agreement between the Recipient and the Association dated 7ute so , 2016 (Credit No. 5869-BD) (the "Additional Financing Agreement"), for the Bangladesh Health Sector Development Program (the "Project"). We also refer to: (i) the Supplemental Letter No. 2 of the Financing Agreement dated September 12, 2011; (ii) Section II.A. 1 of Schedule 2 of the Grant Agreement; and (iii) Section II.A.1 of Schedule 2 of the Additional Financing Agreement, and the discussions on the need to amend the Performance Indicators for the Project. Accordingly, we hereby propose to amend the Performance Indicators as set forth in the Annex to this letter. This Performance Indicators shall apply to the Financing Agreement, the Grant Agreement, and the Additional Financing Agreement. 6 WORLD BANK GROUP -2- Please confirm your agreement on behalf of the Recipient by signing the form of confirmation below. Sincerely, INTERNATIONAL DEVELOPMENT ASSOCIATION Autized Representative CONFIRMED: PEOPLE'S REPUBLIC OF BANGLADESH By: thorized Representative THE WORLD BANK IBRD*IDA I WORLDBANKGROUP Annex Results Framework and Monitoring of the Health Sector Development Program Project Development Objective Indicators Status Indicator Name Core Unit of Measure Baseline Actual(Current) End Target Revised Coverage of modern Percentage Value 35.70 41.00 42.00 contraceptives in low Date 31-Dec-2010 08-Feb-2016 30-Jun-2017 performing areas of Bangladesh -- Sylhet Comment Revised Coverage of modem Percentage Value 46.80 47.00 48.00 contraceptives in low Date 31-Dec-2010 08-Feb-2016 30-Jun-2017 performing areas of Bangladesh -- Chittagong Comment Revised Proportion of delivery by Percentage Value 11.50 23.00 15.00 skilled birth attendant among Date 31-Dec-2010 08-Feb-2016 30-Jun-2017 the lowest two wealth quintile groups Comment Revised Prevalence of underweight Percentage Value 48.30 41.60 43.30 among children under 5 years Date 31 -Dec-2007 08-Feb-2016 30-Jun-2017 of age among the lowest two wealth quintile groups Comment WORLD BANK GROUP -4- Intermediate Results Indicators Status Indicator Name Core Unit of Measure Baseline Actual(Current) End Target New MOHFW's web-based Text Value Web-based Web-based Web-based complaint mechanism complaint complaint complaint mechanism mechanism mechanism established established maintained by DGHS Date 10-Apr-2016 10-Apr-2016 30-Jun-2017 Comment New Tuberculosis case notification Number Value 68.00 68.00 69.00 rate for bacteriologically Date 10-Apr-2016 10-Apr-2016 30-Jun-2017 positive cases Comment 68 cases per 68 cases per 69 cases per 100,000 100,000 100,000 population population population Revised Proportion of physician Percentage Value 45.70 29.90 22.80 positions vacant at upazlaldstrit lvel nd blowDate 31 -Dec-2009 04-Aug-20 15 30-Jun-20 17 upazila/district level and below Comment Revised Proportion of nurse positions Percentage Value 24.70 12.80 15.00 vacant at upazila/district level Date 31 -Dec-2009 04-Aug-201 30-Jun-2017 and below Comment Revised Proportion of births in health Percentage Value 23.70 37.40 40.00 facilities Date 31 -Dec-2010 08-Feb-2016 30-Jun-2017 Comment -5- Revised Number of functional Number Value 10323.00 13194.00 13500.00 Community Clinics Date 31-Jan-201 1 08-Feb-2016 30-Jun-2017 Comment Revised Coverage of Measles Percentage Value 82.40 86.10 86.10 Immunization for children Date 31-Dec-2009 08-Feb-2016 30-Jun-2017 under 12 months of age Comment Source: Bangladesh Demographic Health Survey Revised Proportion of infants Percentage Value 43.00 55.30 50.00 exclusively breastfed up to 6 Date 31 -Dec-2007 08-Feb-2016 30-Jun-2017 months of age Comment Revised Proportion of postnatal care for Percentage Value 20.90 33.90 50.00 women within 48 hours (at Date 31 -Dec-2010 08-Feb-2016 30-Jun-2017 least 1 visit) Comment Revised Proportion of annual work Percentage Value 90.00 100.00 plans with budgets submitted Date 04-Aug-2015 30-Jun-2017 by LDs by defined time period (July/Aug) Comment Revised Proportion of health facilities, Percentage Value 66.10 73.60 75.00 by type, without stock-outs of Date 31 -Dec-2009 04-Aug-2015 30-Jun-2017 essential medicines Comment Revised Proportion of serious audit Percentage Value 7.00 68.00 80.00 objections settled within the Date 31 -Dec-2009 04-Aug-2015 30-Jun-2017 last 12 months Comment -6- ' Revised Proportion of Operational Plans Percentage Value 44.70 69.00 100.00 with expenditure > 80% of Date 31-Jan-201 1 04-Aug-2015 30-Jun-2017 ADP allocation (annually) Comment Revised Health personnel receiving X Number Value 59.00 852215 810000 training (number) Date 04-Aug-2015 30-Jun-2017 Comment No Change Births (deliveries) attended by X Number Value 206458.00 skilled health personnel Date 08-Feb-2016 30-Jun-2017 (number) Comment Revised Number of additional service Number Value 0.00 1487.00 3000.00 providers trained in midwifery Date 01-May-2011 08-Feb-2016 30-Jun-2017 at district and upazila health facilities Comment No Change Children immunized - under 12 X Number Value 3670254.00 months against DPT3 (number) Sub Type Date 08-Feb-2016 Breakdown Comment No Change Children immunized - under 5 X 20488480.00 years against Polio (number) Children Number 08-Feb-2016 immunized (number) Breakdown Comment