The World Bank AFCC2/RI- Great Lakes Emergency Sexual and Gender Based Violence & Women's Health Project (P147489) REPORT NO.: RES30352 RESTRUCTURING PAPER ON A PROPOSED PROJECT RESTRUCTURING OF AFCC2/RI- GREAT LAKES EMERGENCY SEXUAL AND GENDER BASED VIOLENCE & WOMEN'S HEALTH PROJECT APPROVED ON JUNE 26, 2014 TO MINISTRY OF FINANCE, BUDGET AND PRIVATIZATION,MINISTERE DES FINANCES,MINISTRY OF FINANCE AND ECONOMIC PLANNING HEALTH, NUTRITION & POPULATION AFRICA Regional Vice President: Makhtar Diop Country Director: Franck Bousquet Senior Global Practice Director: Timothy Grant Evans Practice Manager/Manager: Trina S. Haque Task Team Leader: Hadia Nazem Samaha, Alain-Desire Karibwami, Patricia Maria Fernandes The World Bank AFCC2/RI- Great Lakes Emergency Sexual and Gender Based Violence & Women's Health Project (P147489) ABBREVIATIONS AND ACRONYMS AWPB Annual Work-Plans and Budget CoE Center of Excellence DA Designated Account DFID Department for International Development DHS Demographic and Health Survey DNA Deoxyribonucleic Acid DRC Democratic Republic of Congo FY Fiscal Year GBV Gender Based Violence GBVIMS Gender Based Violence Information and Monitoring System GoR Government of Rwanda ICGLR International Conference of the Great Lakes Region IOSC Insange One Stop Center ISR Implementation Status and Results Report MIGEPROF Ministry of Gender and Family Promotion MINIJUST Ministry of Justice MoH Ministry of Health NET Narrative Exposure Therapy OSC One Stop Center PEP Post Exposure Prophylaxis RBC Rwanda Bio-Medical Center RNP Rwanda National Police SPIU Single Project Implementation Unit VSLA Village Savings and Loans Associations SGBV Sexual and Gender Based Violence ToT Training of Trainers The World Bank AFCC2/RI- Great Lakes Emergency Sexual and Gender Based Violence & Women's Health Project (P147489) BASIC DATA Product Information Project ID Financing Instrument P147489 Investment Project Financing Original EA Category Current EA Category Partial Assessment (B) Partial Assessment (B) Approval Date Current Closing Date 26-Jun-2014 30-Jun-2018 Organizations Borrower Responsible Agency CFEF Ministere des Finances,MOPH,FSRDC,Ministry of Ministry of Finance, Budget and Privatization,Ministere Human Right, Social Affairs and Gender,Ministry of des Finances,Ministry of Finance and Economic Planning Public Health and Fight against AIDS Project Development Objective (PDO) Original PDO The objectives of this project are to: (i) expand the provision of services to mitigate the short and medium term impact of sexual and gender based violence; and (ii) expand utilization of a package of health interventions targeted to poor and vulnerable females. OPS_TABLE_PDO_CURRENTPDO Summary Status of Financing Net Ln/Cr/Tf Approval Signing Effectiveness Closing Commitment Disbursed Undisbursed IDA-55250 26-Jun-2014 06-Aug-2014 15-Dec-2014 30-Jun-2018 14.95 5.07 8.80 IDA-H9780 26-Jun-2014 29-Jul-2014 27-Oct-2014 30-Jun-2018 15.15 5.05 9.05 IDA-H9790 26-Jun-2014 06-Aug-2014 22-Sep-2014 30-Jun-2018 3.00 1.15 1.64 IDA-H9800 26-Jun-2014 25-Jul-2014 23-Jan-2015 30-Jun-2018 73.86 33.17 35.10 The World Bank AFCC2/RI- Great Lakes Emergency Sexual and Gender Based Violence & Women's Health Project (P147489) Policy Waiver(s) Does this restructuring trigger the need for any policy waiver(s)? No I. PROJECT STATUS AND RATIONALE FOR RESTRUCTURING A. Project Status 1. The Great Lakes Emergency Sexual and Gender Based Violence and Women’s Health Project was approved on June 26, 2014. The regional project includes Burundi (US$15.15 million), DRC (US$73.86 million), Rwanda (US$14.95 million) and the International Conference on the Great Lakes Region (ICGLR, US$3 million). The project is a multi-sectoral intervention focused on offering integrated services to survivors of Gender Based Violence (GBV). Specifically, the project components are (1) holistic support for survivors of sexual and gender based violence and violence prevention, (2) high impact health services; and (3) regional and national knowledge sharing, research and capacity building. The objectives of the project are to: (i) expand the provision of services to mitigate the short and medium- term impact of sexual and gender based violence; and (ii) expand utilization of a package of health interventions targeted to poor and vulnerable females. 2. This restructuring paper focuses on the Rwanda credit of the project (IDA 55250) and proposes the modifications further outlined below. The Rwanda project became effective on December 15, 2014, with a current closing date on June 30, 2018. It focuses exclusively on holistic support for survivors (Component 1 of the regional project) and research, networking and regional knowledge (Component 3 of the regional project). Component 1 includes two Sub- Components: (1a) Integrated support for Survivors of SGBV and Prevention of Violence at Community Levels, and (1b) Integrated Support for Survivors of SGBV at Health Facility Level. Overall coordination of the project in Rwanda is the responsibility of the Ministry of Gender and Family Promotion (MIGEPROF), with relevant activities being implemented by Ministry of Health (MoH)/Rwanda Bio-Medical Center (RBC), Rwanda National Police (RNP) and Ministry of Justice (MINIJUST). 3. Under Sub-Component (1a) on Integrated Support for Survivors of SGBV and Prevention of Violence at Community Levels, MIGEPROF has been implementing a wide range of communication and awareness raising activities, including through radio, TV and the annual multi-media campaigns as part of the 16 Days of Activism Against Violence Against Women. There is, however, limited evidence of the effectiveness of these mass media interventions. In addition to these broad communication and awareness raising activities, MIGEPROF implements more intensive behavior change interventions targeting couples already participating in Village Savings and Loans Associations (VSLAs), building on the Agents of Change intervention developed by DFID and implemented in Rwanda. An Impact Evaluation of this intervention is underway. Furthermore, this sub-component has supported the rehabilitation of safe houses in two districts, for which construction has been completed. Service provision in these two safe houses is yet to start. Lastly, the sub-component was to fund referral of survivors of GBV to community-level economic support programs by social workers. This activity, however, has not shown to be effective so far. The World Bank AFCC2/RI- Great Lakes Emergency Sexual and Gender Based Violence & Women's Health Project (P147489) 4. Sub-Component (1b) on Integrated Support for Survivors of SGBV at Health Facility Level has supported the establishment of 17 Isange One Stop Centers (IOSC) at district hospital level, including additional safe rooms where needed and the provision of medical equipment, furniture, IT equipment. Support to the IOSCs also includes the training of staff and support for running and supervision costs. 27 existing IOSC have further been supported since December 2017 as support by the Netherlands for the centers has been phased out. Service provision is ongoing in all 44 Issange One Stop Centers. For both newly established and existing IOSC, the project covers the costs of clinical care, case management and referral as well as the provision of PEP kits and medical consumables, medico-legal support and psychosocial support. Key challenges with IOSC service provision relate to the limited knowledge of services available by local communities; socio-cultural and other barriers to accessing services; limited availability of shelter services in older IOSC locations; limited availability of staff and need for additional training of current staff; and limited fund availability to conduct specific community outreach activities around IOSCs. 5. Component 3 on Research, Networking and Regional Knowledge Exchange has funded the establishment of a Regional Center of Excellence (CoE) on GBV. Construction was completed in November 2016. The RNP is ensuring the overall management of the CoE. The CoE has hosted a number of high level regional events, but a coherent management structure, staffing plan, plan of activities and budget is still being put in place. An Operational Manual on CoE has been drafted, but will require much greater detailing to provide the required guidance on the activation and operation of the center. The originally planned Gender Based Violence Information and Monitoring System (GBVIMS) under this Component has not been commissioned to date. 6. The Mid-Term Review of the Rwanda project carried out between August 28 and September 7, 2017 noted that, given the progress to date, the project was not on track to meet its objectives by the current closing date of June 30, 2018. As of February 10, 2018, the disbursement rate for Rwanda intervention was 37% compared to 43% for the regional project as a whole. 7. There are currently no outstanding audits for the Rwanda project. The audit for the year ending June 2017 was carried out in a timely manner. It’s quality was considered acceptable and in compliance with International Standards of the Supreme Audit Institutions (ISSAIs). The auditor general expressed an unqualified opinion on financial statements and a qualified opinion on compliance based on the following: (i) persistent low disbursement and execution rate; (ii) the Center of Excellence (CoE) on GBV completed in November 2016 is not fully operational; (iii) weaknesses in asset management at the level of the CoE and IOSCs; and (iv) low execution of the previous year’s audit recommendations. The World Bank AFCC2/RI- Great Lakes Emergency Sexual and Gender Based Violence & Women's Health Project (P147489) 8. Current progress for the key performance indicators at the PDO level for Rwanda includes: (i) 6,398 direct beneficiaries (with an original target of 12,600) of which 5,680 female, (ii) 34% of reported cases of SGBV who received emergency kits (PEP) within 72 hours, with an original target of 50%, (iii) 100% of reported cases of SGBV who received at least 2 multidisciplinary services as needed (medical, legal and psycho-social), with an original target of 60%. Progress on the intermediate project indicators includes: (i) 6,398 survivors receiving medical treatment, psychosocial, forensic, and legal services, with an original target of 12,600 (ii) 0 SGBV cases in which referrals to community level economic support services or programs with an original target of a 20% increase, (iii) 8 sensitization and advocacy activities to promote gender equality implemented, with an original target of 30, (iv) 8,249 reported SGBV cases taken to the prosecutor with an original target of 7,524, (v) 17 OSCs set up and/or upgraded and staffed as per guidelines in line with the original target, (vi) 79 staff involved in SGBV services trained in relevant areas with an original target of 230. B. Rationale for Restructuring 9. Given the challenges in implementation, the restructuring proposal focuses on streamlining project activities by focusing them primarily on service delivery through the IOSCs and bringing such services closer to the target population. Key elements of the restructuring towards this purpose will be: (a) Streamlining and rationalizing communication activities, with an increased focus on the Agents of Change intervention and related Impact Evaluation; (b) Supporting the further roll-out of the IOSC network, including increased outreach and prevention interventions through the IOSCs and capacity building of service providers at sector and cell level to ensure the availability of services and adequate referral closer to communities; (c) Opening a separate Designated Account (DA) for MoH to further accelerate implementation by giving RBC more autonomy in the management of resources programmed for the IOSCs; (d) Extending the project closing date by one year given initial delays; and (e) Reviewing and simplifying the Results Framework to adjust indicators and targets accordingly. II. DESCRIPTION OF PROPOSED CHANGES A. Change in Results Framework 10. Considering the current pace of implementation, caseloads and barriers to access, the following changes to indicators and targets are proposed as further detailed in section IV: (a) Increase the final target for direct project beneficiaries from 19,800 to 29,600 of which 88% female (given the proposed roll-out of services for survivors of GBV to cell and sector level). (b) Reduce the final target for the percentage of reported SGBV cases who receive emergency kits (PEP) within 72 hours from 60% to 42%. (c) Increase the final target for the percentage of reported cases of SGBV who receive at least 2 multidisciplinary services as needed from 80% to 100%. (d) Disaggregate the indicator on services received by survivors into one sub-indicator covering medical treatment, psychosocial and forensic services (with a final target of 29,600) and a second sub-indicator covering legal services (with a final target of 610). (e) Drop the indicator capturing SGBV cases in which referrals to community-level economic support services or programs are done as this support is currently not effective at the IOSC level. (f) Reduce the final target for the number of sensitization and advocacy activities to promote gender equality from 39 to 8. The World Bank AFCC2/RI- Great Lakes Emergency Sexual and Gender Based Violence & Women's Health Project (P147489) (g) Increase the final target for reported SGBV cases taken to the prosecutor from 7,866 to 12,866. (h) Increase the final target for the number of OSCs set up and/or upgraded and staffed as per guidelines from 17 to 23, with the additional six IOSCs being Kacyiru, Butaro, Rwamagana, Ruhango, Kabutare and Kigeme. (i) Add a new indicator capturing the successful completion of the Impact Evaluation. (j) Add a new indicator capturing the implementation of the Agents of Change model under the project. The World Bank AFCC2/RI- Great Lakes Emergency Sexual and Gender Based Violence & Women's Health Project (P147489) B. Change in Components and Cost 11. With the overall objective of streamlining project activities by focusing them primarily on service delivery through the IOSCs and bringing such services closer to the target population, the following reorientation in Component activities is being proposed: 12. Sub-Component 1a - Integrated Support for Survivors of SGBV and Prevention of Violence at Community Levels: (a) Agents of Change and Impact Evaluation: Structured GBV prevention activities in the form of the Agents of Change intervention and the related Impact Evaluation will continue as planned. (b) Communication and sensitization activities: The scope of mass media interventions on GBV prevention will be streamlined and reduced given the lack of evidence of the effectiveness of such interventions and the limits of these approaches in terms of behavior change regarding GBV. Remaining behavior change communication will be increasingly targeted at the community level and more closely linked to IOSC, i.e. encouraging service seeking behavior and explicitly providing information on services available at IOSCs. Essential interventions during the 16 Days of Activism will be retained. (c) Referrals of SGBV cases to community-level economic support services or programs: This activity is currently not effective at IOSC level and will therefore be dropped going forward. (d) Safe houses: The construction of two safe houses has been completed under the project pending the start of activities. Two additional safe houses will be constructed and equipped during the remainder of the project. 13. Sub-Component 1b - Integrated Support for Survivors of SGBV at Health Facility Level: (a) Rehabilitation of Kacyiru IOSC: Based on a strategic plan to be developed, the Kacyiru IOSC in Kigali will be upgraded as a referral and coordination center for the remaining IOSCs. (b) Rehabilitation of older IOSCs: Five older IOSCs will be rehabilitated and equipped to meet the current standards for service delivery (Butaro, Rwamagana, Ruhango, Kabutare and Kigeme). (c) Equipping health centers: To bring basic IOSC services closer to the community-level, at least one room each in 495 health centers will be equipped accordingly. (d) Training of IOSC staff: Additional training of IOSC staff on multi-sectoral service delivery and forensic data collection will be conducted to improve service delivery. (e) Training of health center staff and police: Training will be provided to at least two health center staff and one Rwanda National Police staff operating in the same areas at sector level to familiarize them with multi-sectoral service delivery and provision of basic services for survivors and effective referral to district hospitals. (f) Community outreach and awareness raising on available services: Community awareness of IOSC service delivery remains low. Additional community outreach interventions will therefore be undertaken by local service providers to strengthen the knowledge of the availability of services for survivors of GBV at health center and IOSC level. (g) Providing specialized mental health and psychotherapeutic interventions: The scope of the activity will be simplified to reflect current capacity to deliver specialized mental health services at IOSC level. The project will focus on supporting group therapy sessions by trained psychologists at IOSC. (h) Legal aid services: Legal aid services will be maintained as an element of IOSC service provision. Dedicated focal persons will be identified at MINIJUST to ensure a more effective monitoring and quality assurance of the services provided going forward. 14. Component 3 - Regional and National Knowledge Sharing, Research and Capacity Building: (a) Training of Trainers (ToT) on multi-sectoral services for survivors of GBV: Two rounds of regional ToT sessions on the provision of multi-sectoral services for survivors of GBV will be organized and hosted at the CoE. The World Bank AFCC2/RI- Great Lakes Emergency Sexual and Gender Based Violence & Women's Health Project (P147489) (b) CoE detailed Operational Plan: Building on the guiding principles to be laid out in the Operations Manual that is under preparation, a detailed operational plan for the CoE will be supported with project funds in order to provide MIGEPROF, RNP and partners with a step by step road map on the setting up of the CoE structure and funding of this activities using Government of Rwanda (GoR) resources to ensure the sustainability of activities beyond the life-span of the project. The Operational Plan will support GBV programming in Rwanda and will be closely linked to service provision on GBV. (c) Operational study on quality of service delivery of IOSC services: An operational study will be conducted to assess the quality of IOSC service delivery, which can be used by the IOSC coordination to further strengthen service delivery. The study will be complemented by analysis of Knowledge, Attitudes and Practices posing barriers to service-seeking behavior as well as an analysis of risk factors for GBV based on the Demographic and Health Survey (DHS). (d) DNA training: Police officers will be trained on DNA and forensic evidence collection. (e) Gender Based Violence Information and Monitoring System (GBVIMS) and data collection at IOSC level: Given the challenges in the consolidation and timely provision of data on service delivery at the level of the IOSC, funds initially programmed for the development of a centralized Gender-Based Violence Integrated Management System will be re-programmed to support the streamlining of data collection at IOSC level and improve data compilation and reporting from all 44 IOSCs. This will include training of the relevant staff. (f) Conference on Ending Child Marriage in Africa to be hosted in Kigali: Targeting technical staff, the project will support side events at this conference focusing on exchanges about the dissemination of the IOSC model and learning on SGBV prevention at the community level. 15. This reorientation in components and activities would be reflected in changes to component costs. Changes in component costs are further impacted by currency depreciation, due to which the value of the credit to Rwanda decreased from an initial US$14.95 million to currently US$13.83 million. The increased focus on Component 1 – and specifically Sub-Component 1b – activities is reflected in the increased estimated cost of the component (US$9.89) and a reduction in estimated cost of Component 3 (US$3.93). This is reflected in the overall cost of the regional project as detailed in section IV. C. Change in Loan Closing Date 16. The regional project was developed over a short period of time following Emergency Procedures. Start-up activities that would typically take place during the preparatory phase were therefore carried out during the first year of project implementation, leading to subsequent delays. Further considering the current disbursement rate of 37%, it is therefore proposed to extend the closing date of the Rwanda project to June 28, 2019. D. Change in Disbursement Arrangements 17. The implementing agency for the project is MIGEPROF. MIGEPROF holds the DA for the project and is responsible for the consolidation and submission of Annual Work-Plans and Budgets (AWBPs), Quarterly Progress Reports and Interim Financial Reports (IFRs). In addition to the procurement for the activities under its direct responsibility, MIGEPROF is responsible for carrying out the procurement for activities implemented in coordination with the RNP and MINIJUST. The MoH/RBC takes the lead on the implementation of all activities related to the Health Sector and IOSCs. The Single Project Implementation Unit (SPIU) in place at RBC carries out the procurement of IOSC interventions and provides inputs to MIGEPROF for the preparation of AWBPs, Quarterly Progress Reports and IFRs. The World Bank AFCC2/RI- Great Lakes Emergency Sexual and Gender Based Violence & Women's Health Project (P147489) 18. It is proposed to open a separate DA for RBC in order to accelerate implementation by giving RBC more autonomy in the management of the resources programmed for the IOSCs. Delays have been noted in replenishing the MoH project account. A DA for MoH will contribute to adequate funds flow for smooth implementation. E. Change in Overall Risk Rating 19. While the overall risk rating remains Substantial, it is suggested to align the detailed project risk ratings with the latest Implementation Status and Results Report (ISR) to reflect the current realities on the ground and challenges in project implementation so far. F. Change in Implementation Schedule 20. The implementation schedule will be adjusted to reflect the proposed change in closing date and detailed timelines for individual activities have been agreed with the implementing agencies. G. Other Change(s) 21. Disbursement estimates: Disbursement estimates for the regional project as a whole will be adjusted during upcoming restructurings of the interventions in other participating countries. In the meantime, revised disbursement estimates for Rwanda are US$2,958,310 in FY18 and US$5,901,690 in FY19. III. SUMMARY OF CHANGES Changed Not Changed Change in Results Framework ✔ Change in Components and Cost ✔ Change in Loan Closing Date(s) ✔ Change in Disbursements Arrangements ✔ Change in Overall Risk Rating ✔ Change in Implementation Schedule ✔ Other Change(s) ✔ Change in Implementing Agency ✔ Change in DDO Status ✔ Change in Project's Development Objectives ✔ Cancellations Proposed ✔ Reallocation between Disbursement Categories ✔ Change in Disbursement Estimates ✔ The World Bank AFCC2/RI- Great Lakes Emergency Sexual and Gender Based Violence & Women's Health Project (P147489) Change in Safeguard Policies Triggered ✔ Change of EA category ✔ Change in Legal Covenants ✔ Change in Institutional Arrangements ✔ Change in Financial Management ✔ Change in Procurement ✔ Change in Economic and Financial Analysis ✔ Change in Technical Analysis ✔ Change in Social Analysis ✔ Change in Environmental Analysis ✔ IV. DETAILED CHANGE(S) OPS_DETAILEDCHANGES_RESULTS_TABLE RESULTS FRAMEWORK Project Development Objective Indicators PDO_IND_TABLE Direct project beneficiaries Unit of Measure: Number Indicator Type: Custom Baseline Actual (Current) End Target Action Value 0.00 10635.00 641593.00 No Change Date 26-Jun-2014 30-Nov-2016 29-Jun-2018 Direct project beneficiaries, DRC Unit of Measure: Number Indicator Type: Custom Breakdown Baseline Actual (Current) End Target Action Value 0.00 10231.00 540000.00 No Change Date 24-Jun-2014 30-Nov-2016 29-Jun-2018 Direct project beneficiaries, Rwanda Unit of Measure: Number Indicator Type: Custom Breakdown The World Bank AFCC2/RI- Great Lakes Emergency Sexual and Gender Based Violence & Women's Health Project (P147489) Baseline Actual (Current) End Target Action Value 0.00 6398.00 29600.00 Revised Date 24-Jun-2014 05-Jan-2018 28-Jun-2019 Female beneficiaries Unit of Measure: Percentage Indicator Type: Custom Supplement Baseline Actual (Current) End Target Action Value 0.00 9751.00 450000.00 No Change Female beneficiaries, DRC Unit of Measure: Percentage Indicator Type: Custom Breakdown Baseline Actual (Current) End Target Action Value 0.00 9716.00 0.00 No Change Date 24-Jun-2014 30-Nov-2016 29-Jun-2018 Female beneficiaries, Burundi Unit of Measure: Percentage Indicator Type: Custom Breakdown Baseline Actual (Current) End Target Action Value 0.00 49.00 0.00 No Change Date 24-Jun-2014 08-Jun-2017 29-Jun-2018 Female beneficiaries, Rwanda Unit of Measure: Percentage Indicator Type: Custom Breakdown Baseline Actual (Current) End Target Action Value 0.00 88.00 88.00 Revised Date 24-Jun-2014 05-Jan-2018 28-Jun-2019 Percentage of reported cases of SGBV who receive emergency kits (PEP) within 72 hours, DRC Unit of Measure: Percentage The World Bank AFCC2/RI- Great Lakes Emergency Sexual and Gender Based Violence & Women's Health Project (P147489) Indicator Type: Custom Baseline Actual (Current) End Target Action Value 25.00 92.00 50.00 No Change Date 26-Jun-2014 30-Nov-2016 29-Jun-2018 Percentage of reported cases of SGBV who receive emergency kits (PEP) within 72 hours, Burundi Unit of Measure: Percentage Indicator Type: Custom Breakdown Baseline Actual (Current) End Target Action Value 30.00 58.00 60.00 No Change Date 26-Jun-2014 08-Jun-2017 29-Jun-2018 Percentage of reported cases of SGBV who receive emergency kits (PEP) within 72 hours, Rwanda Unit of Measure: Percentage Indicator Type: Custom Breakdown Baseline Actual (Current) End Target Action Value 30.00 34.00 42.00 Revised Date 26-Jun-2014 05-Jan-2018 28-Jun-2019 Percentage of reported cases of SGBV who receive at least 2 multidisciplinary services as needed (medical, legal and psychosocial), DRC Unit of Measure: Percentage Indicator Type: Custom Baseline Actual (Current) End Target Action Value 50.00 90.00 75.00 No Change Date 26-Jun-2014 30-Nov-2016 29-Jun-2018 Percentage of reported cases of SGBV who recieve at least 2 multidisicplinary services as needed (medical, legal and psychosocial), Burundi Unit of Measure: Percentage Indicator Type: Custom Breakdown Baseline Actual (Current) End Target Action Value 0.00 95.00 75.00 No Change The World Bank AFCC2/RI- Great Lakes Emergency Sexual and Gender Based Violence & Women's Health Project (P147489) Date 26-Jun-2014 08-Jun-2017 29-Jun-2018 Percentage of reported cases of SGBV who receive at least 2 multidisciplinary services as needed (medical, legal and pshychosocial), Rwanda Unit of Measure: Percentage Indicator Type: Custom Breakdown Baseline Actual (Current) End Target Action Value 20.00 100.00 100.00 Revised Date 26-Jun-2014 05-Jan-2018 28-Jun-2019 Prevalence of modern contraceptive use (women between 15-49 years old), DRC Unit of Measure: Percentage Indicator Type: Custom Baseline Actual (Current) End Target Action Value 9.00 18.00 No Change Date 26-Jun-2014 31-Mar-2015 29-Jun-2018 Prevalence of modern contraceptive use (women between 15-49 years old), Burundi Unit of Measure: Percentage Indicator Type: Custom Breakdown Baseline Actual (Current) End Target Action Value 22.00 46.93 31.00 No Change Date 24-Jun-2014 08-Jun-2017 29-Jun-2018 Percentage of pregnant women who benefit from 4 antenatal care visits, DRC Unit of Measure: Percentage Indicator Type: Custom Baseline Actual (Current) End Target Action Value 41.00 60.00 No Change Date 26-Jun-2014 31-Mar-2015 29-Jun-2018 Percentage of pregnant women who benefit from 4 antenatal care visits, Burundi Unit of Measure: Percentage Indicator Type: Custom Breakdown Baseline Actual (Current) End Target Action The World Bank AFCC2/RI- Great Lakes Emergency Sexual and Gender Based Violence & Women's Health Project (P147489) Value 49.00 44.38 64.00 No Change Date 24-Jun-2014 08-Jun-2017 29-Jun-2018 Births (deliveries) attended by skilled health personnel, DRC Unit of Measure: Percentage Indicator Type: Custom Baseline Actual (Current) End Target Action Value 74.00 84.00 No Change Date 26-Jun-2014 31-Mar-2015 29-Jun-2018 Births (deliveries attended by skilled health personnel), Burundi Unit of Measure: Percentage Indicator Type: Custom Breakdown Baseline Actual (Current) End Target Action Value 72.90 88.34 85.00 No Change Date 24-Jun-2014 08-Jun-2017 29-Jun-2018 Intermediate Indicators IO_IND_TABLE Number of survivors who present themselves at least once to an SGBV case manager trained by the project, DRC Unit of Measure: Number Indicator Type: Custom Baseline Actual (Current) End Target Action Value 0.00 0.00 27060.00 No Change Date 26-Jun-2014 15-Sep-2014 29-Jun-2018 Number of survivors treated in a health facility, DRC Unit of Measure: Number Indicator Type: Custom Baseline Actual (Current) End Target Action Value 0.00 6377.00 20075.00 No Change Date 26-Jun-2014 30-Nov-2016 29-Jun-2018 Number of beneficiaries receiving specialized mental health care, DRC Unit of Measure: Number The World Bank AFCC2/RI- Great Lakes Emergency Sexual and Gender Based Violence & Women's Health Project (P147489) Indicator Type: Custom Baseline Actual (Current) End Target Action Value 0.00 0.00 6975.00 No Change Date 26-Jun-2014 15-Sep-2014 29-Jun-2018 Survivors receiving psychosocial, legal services, and referral to health services at the community level, DRC Unit of Measure: Number Indicator Type: Custom Baseline Actual (Current) End Target Action Value 0.00 6377.00 29660.00 No Change Date 26-Jun-2014 30-Nov-2016 29-Jun-2018 Survivors receiving medical treatment, psychosocial, forensic, and legal services, Burundi Unit of Measure: Number Indicator Type: Custom Baseline Actual (Current) End Target Action Value 0.00 103.00 550.00 No Change Date 26-Jun-2014 08-Jun-2017 29-Jun-2018 Survivors receiving medical treatment, psychosocial, forensic, and legal services, Rwanda Unit of Measure: Number Indicator Type: Custom Breakdown Baseline Actual (Current) End Target Action Value 0.00 6520.00 30210.00 Revised Date 26-Jun-2014 05-Jan-2018 28-Jun-2019 Survivors receiving medical treatment, psychosocial, and forensic services, Rwanda Unit of Measure: Number Indicator Type: Custom Breakdown Baseline Actual (Current) End Target Action Value 0.00 6398.00 29600.00 New Date 26-Jun-2014 05-Jan-2018 28-Jun-2019 Survivors receiving legal services, Rwanda The World Bank AFCC2/RI- Great Lakes Emergency Sexual and Gender Based Violence & Women's Health Project (P147489) Unit of Measure: Number Indicator Type: Custom Breakdown Baseline Actual (Current) End Target Action Value 0.00 122.00 610.00 New Date 26-Jun-2014 05-Jan-2018 28-Jun-2019 SGBV cases in which referrals to community level economic support services or programs are done, Rwanda Unit of Measure: Percentage Indicator Type: Custom Baseline Actual (Current) End Target Action Value 0.00 20.00 Marked for Deletion Date 24-Jun-2014 29-Jun-2018 Number of poor and vulnerable women benefitting from economic empowerment activities,Burundi Unit of Measure: Number Indicator Type: Custom Baseline Actual (Current) End Target Action Value 17000.00 17000.00 31600.00 No Change Date 26-Jun-2014 08-Jun-2017 29-Jun-2018 Number of poor and vulnerable women benefitting from economic empowerment activities, DRC Unit of Measure: Number Indicator Type: Custom Breakdown Baseline Actual (Current) End Target Action Value 0.00 13530.00 No Change Date 24-Jun-2014 29-Jun-2018 Number of persons benefiting from sensitization and advocacy activities to improve awareness and knowledge of SGBV, gender equalityand/or reproductive health, DRC Unit of Measure: Number Indicator Type: Custom Baseline Actual (Current) End Target Action Value 0.00 58627.00 1260000.00 No Change Date 26-Jun-2014 30-Oct-2015 29-Jun-2018 The World Bank AFCC2/RI- Great Lakes Emergency Sexual and Gender Based Violence & Women's Health Project (P147489) Number of persons benefiting from sensitization and advocacy activities to improve awareness and knowledge of SGBV, gender equalityand/or reproductive health,Burundi Unit of Measure: Number Indicator Type: Custom Breakdown Baseline Actual (Current) End Target Action Value 2100.00 2100.00 9400.00 No Change Date 24-Jun-2014 08-Jun-2017 29-Jun-2018 Sensitization and advocacy activities to promote gender equality implemented, Rwanda Unit of Measure: Number Indicator Type: Custom Baseline Actual (Current) End Target Action Value 0.00 8.00 8.00 Revised Date 26-Jun-2014 05-Jan-2018 28-Jun-2019 Reported SGBV cases taken to the prosecutor, Burundi Unit of Measure: Number Indicator Type: Custom Baseline Actual (Current) End Target Action Value 240.00 278.00 1300.00 No Change Date 26-Jun-2014 08-Jun-2017 29-Jun-2018 Reported SGBV cases taken to the prosecutor, Rwanda Unit of Measure: Number Indicator Type: Custom Breakdown Baseline Actual (Current) End Target Action Value 6840.00 8249.00 12866.00 Revised Date 26-Jun-2014 05-Jan-2018 28-Jun-2019 OSCs set up and/or upgraded and staffed as per guidelines, Burundi Unit of Measure: Number Indicator Type: Custom Baseline Actual (Current) End Target Action Value 0.00 3.00 3.00 No Change Date 26-Jun-2014 08-Jun-2017 29-Jun-2018 The World Bank AFCC2/RI- Great Lakes Emergency Sexual and Gender Based Violence & Women's Health Project (P147489) OSCs set up and/or upgraded and staffed as per guidelines, Rwanda Unit of Measure: Number Indicator Type: Custom Breakdown Baseline Actual (Current) End Target Action Value 0.00 17.00 23.00 Revised Date 24-Jun-2014 05-Jan-2018 28-Jun-2019 Health facilities constructed, renovated, and/or equipped (number) Unit of Measure: Number Indicator Type: Custom Baseline Actual (Current) End Target Action Value 0.00 180.00 No Change Date 26-Jun-2014 30-Nov-2016 29-Jun-2018 Staff involved in SGBV services trained in relevant areas, Burundi Unit of Measure: Number Indicator Type: Custom Baseline Actual (Current) End Target Action Value 65.00 270.00 320.00 No Change Date 24-Jun-2014 08-Jun-2017 29-Jun-2018 Staff involved in SGBV services trained in relevant areas, Rwanda Unit of Measure: Number Indicator Type: Custom Breakdown Baseline Actual (Current) End Target Action Value 0.00 79.00 230.00 Revised Date 26-Jun-2014 05-Jan-2018 28-Jun-2019 Number of youth who benefit from reproductive health services, Burundi Unit of Measure: Number Indicator Type: Custom Baseline Actual (Current) End Target Action Value 0.00 0.00 10000.00 No Change Date 27-Jun-2014 08-Jun-2017 29-Jun-2018 The World Bank AFCC2/RI- Great Lakes Emergency Sexual and Gender Based Violence & Women's Health Project (P147489) Pregnant women receiving antenatal care during a visit to a health provider (number) Unit of Measure: Number Indicator Type: Custom Baseline Actual (Current) End Target Action Value 0.00 0.00 280000.00 No Change Date 27-Jun-2014 15-Sep-2014 29-Jun-2018 Births (deliveries) attended by skilled health personnel (number) Unit of Measure: Number Indicator Type: Custom Baseline Actual (Current) End Target Action Value 83834.00 83834.00 366493.00 No Change Date 26-Jun-2014 15-Sep-2014 29-Jun-2018 Births (deliveries) attended by skilled health personnel, DRC Unit of Measure: Number Indicator Type: Custom Breakdown Baseline Actual (Current) End Target Action Value 59700.00 337200.00 No Change Date 24-Jun-2014 29-Jun-2018 Births (deliveries) attended by skilled health personnel, Burundi Unit of Measure: Number Indicator Type: Custom Breakdown Baseline Actual (Current) End Target Action Value 74537.00 76018.00 29293.00 No Change Date 24-Jun-2014 08-Jun-2017 29-Jun-2018 Health personnel receiving training (number) Unit of Measure: Number Indicator Type: Custom Baseline Actual (Current) End Target Action Value 0.00 0.00 400.00 No Change Date 26-Jun-2014 15-Sep-2014 29-Jun-2018 The World Bank AFCC2/RI- Great Lakes Emergency Sexual and Gender Based Violence & Women's Health Project (P147489) Average availability of essential tracer drugs at health facilities, DRC Unit of Measure: Percentage Indicator Type: Custom Baseline Actual (Current) End Target Action Value 63.00 63.00 80.00 No Change Date 26-Jun-2014 15-Sep-2014 29-Jun-2018 New curative consultations per capita per year, DRC Unit of Measure: Percentage Indicator Type: Custom Baseline Actual (Current) End Target Action Value 54.00 54.00 65.00 No Change Date 26-Jun-2014 15-Sep-2014 29-Jun-2018 Average quality score at health facilities (PBF check list), DRC Unit of Measure: Number Indicator Type: Custom Baseline Actual (Current) End Target Action Value 0.00 85.00 No Change Date 24-Jun-2014 29-Jun-2018 Percentage of identified poor people benefiting of Equity Fund, DRC Unit of Measure: Percentage Indicator Type: Custom Baseline Actual (Current) End Target Action Value 0.00 0.00 30.00 No Change Date 26-Jun-2014 15-Sep-2014 29-Jun-2018 Number of participants from ICGLR Member States benefitting from training on SGBV at the Regional Training Facility, ICGLR Unit of Measure: Number Indicator Type: Custom Baseline Actual (Current) End Target Action Value 0.00 1400.00 No Change Date 24-Jun-2014 29-Jun-2018 The World Bank AFCC2/RI- Great Lakes Emergency Sexual and Gender Based Violence & Women's Health Project (P147489) Percentage of Trainers of Trainers (ToTs) training professionals in respective areas of training received in their respective home country, ICGLR Unit of Measure: Percentage Indicator Type: Custom Baseline Actual (Current) End Target Action Value 0.00 70.00 No Change Date 24-Jun-2014 29-Jun-2018 Number of lessons learned and good practices shared among ICGLR member states, ICGLR Unit of Measure: Number Indicator Type: Custom Baseline Actual (Current) End Target Action Value 0.00 8.00 No Change Date 24-Jun-2014 29-Jun-2018 Number of member states countries using regional SGBV messages developed by the ICGLR, ICGLR Unit of Measure: Number Indicator Type: Custom Baseline Actual (Current) End Target Action Value 0.00 12.00 No Change Date 24-Jun-2014 29-Jun-2018 Number of M&E reports published of the progress of the Kampala Declaration published, ICGLR Unit of Measure: Number Indicator Type: Custom Baseline Actual (Current) End Target Action Value 0.00 4.00 No Change Date 24-Jun-2014 29-Jun-2018 Annual disclosed unqualified external financial audit with the ICGLR annual budget (planned and executed), ICGLR Unit of Measure: Number Indicator Type: Custom Baseline Actual (Current) End Target Action Value 0.00 1.00 3.00 No Change Date 24-Jun-2014 30-Jun-2016 29-Jun-2018 Impact evaluation baseline and endline data collected, Rwanda The World Bank AFCC2/RI- Great Lakes Emergency Sexual and Gender Based Violence & Women's Health Project (P147489) Unit of Measure: Yes/No Indicator Type: Custom Baseline Actual (Current) End Target Action Value No No Yes New Date 26-Jun-2014 05-Jan-2018 28-Jun-2019 Couples trained on GBV prevention using Agents of Change methodology, Rwanda Unit of Measure: Number Indicator Type: Custom Baseline Actual (Current) End Target Action Value 0.00 640.00 640.00 New Date 26-Jun-2014 05-Jan-2018 28-Jun-2019 OPS_DETAILEDCHANGES_COMPONENTS_TABLE COMPONENTS Current Current Proposed Proposed Cost Action Component Name Component Name Cost (US$M) (US$M) Holistic Support for Sexual and Holistic Support for Sexual and Gender Based Violence and 50.51 Revised Gender Based Violence and 50.62 Violence Prevention Violence Prevention High Impact Basic Health High Impact Basic Health Services 34.03 No Change 34.03 Services Regional Networking, Knowledge Regional Networking, Sharing, Capacity Building and 22.42 Revised Knowledge Sharing, Capacity 21.18 Research Building and Research Program Management 0.00 No Change Program Management 0.00 TOTAL 106.96 105.83 OPS_DETAILEDCHANGES_LOANCLOSING_TABLE LOAN CLOSING DATE(S) Original Revised Proposed Proposed Deadline Ln/Cr/Tf Status Closing Closing(s) Closing for Withdrawal Applications IDA-55250 Effective 30-Jun-2018 28-Jun-2019 28-Oct-2019 The World Bank AFCC2/RI- Great Lakes Emergency Sexual and Gender Based Violence & Women's Health Project (P147489) IDA-H9780 Effective 30-Jun-2018 IDA-H9790 Effective 30-Jun-2018 IDA-H9800 Effective 30-Jun-2018 OPS_DETAILEDCHANGES_SORT_TABLE SYSTEMATIC OPERATIONS RISK-RATING TOOL (SORT) Risk Category Rating at Approval Current Rating Political and Governance  High Macroeconomic  Substantial Sector Strategies and Policies  Substantial Technical Design of Project or Program  High Institutional Capacity for Implementation and  Substantial Sustainability Fiduciary  Substantial Environment and Social  Moderate Stakeholders  Moderate Other Overall  Substantial