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Liberia-Institutional-Foundations-To Public Disclosure Authorized FOR OFFICIAL USE ONLY Report No: PAD3449 INTERNATIONAL DEVELOPMENT ASSOCIATION PROJECT APPRAISAL DOCUMENT ON A PROPOSED CREDIT IN THE AMOUNT OF US$ 54 MILLION Public Disclosure Authorized FROM THE IDA SCALE-UP FACILITY TO THE REPUBLIC OF LIBERIA FOR THE INSTITUTIONAL FOUNDATIONS TO IMPROVE SERVICES FOR HEALTH PROJECT April 30, 2020 Public Disclosure Authorized Health, Nutrition & Population Global Practice Africa Region This document is being made publicly available prior to Board consideration. This does not imply a presumed outcome. This document may be updated following Board consideration and the updated document will be made publicly available in accordance with the Bank’s policy on Access to Information. Public Disclosure Authorized CURRENCY EQUIVALENTS (Exchange Rate March 31, 2020) Currency Unit = Liberian Dollar 199.58 = US$1 FISCAL YEAR July 1 – June 30 Regional Vice President: Hafez M. H. Ghanem Country Director: Pierre Frank Laporte Regional Director: Amit Dar Practice Manager: Gaston Sorgho Task Team Leaders: Opope Oyaka Tshivuila Matala, Preeti Kudesia ABBREVIATIONS AND ACRONYMS AF Additional Financing ANC Antenatal Care ASRH Adolescent Sexual and Reproductive Health ASRHR Adolescent Sexual and Reproductive Health and Rights AWP&B Annual Work Plan and Budget BEmONC Basic Emergency Obstetric and Neonatal Care BMZ German Federal Ministry for Economic Development and Cooperation C-EHSMP Contractor’s Environmental, Health, and Safety Management Plan CBL Central Bank of Liberia CEmONC Comprehensive Emergency Obstetric and Neonatal Care CHA Community Health Assistant CHT Community Health Team CMS Central Medical Store CMU Country Management Unit CPF Country Partnership Framework CPIA Country Policy and Institutional Assessment CPS Country Partnership Strategy CRVS Civil Registration Vital Statistics CSO Civil Society Organization DA Designated Account DHIS2 District Health Information Software-2 DLI Disbursement-Linked Indicator DLR Disbursement-Linked Result DMA Deputy Minister Administration DPs Development Partners EEP Eligible Expenditure Program EmONC Emergency Obstetric and Neonatal Care ESCP Environmental and Social Commitment Plan ESF Environmental and Social Framework ESMF Environment and Social Management Framework ESRS Environmental and Social Review Summary EVD Ebola Virus Disease FCV Fragile Conflict Violence FHD Family Health Division GA Grant Agent GAC General Audit Commission GAVI Global Alliance for Vaccines and Immunization GBV Gender-Based Violence GDP Gross Domestic Product GFF Global Financing Facility GGHE General Government Health Expenditure GNI Gross National Income GOL Government of Liberia HCI Human Capital Index HIES Household Income and Expenditure Survey HWF Health Workforce HSCC Health Sector Coordinating Committee HRH Human Resources for Health HNP Health, Nutrition and Population HMER Health Information Systems, Monitoring and Evaluation and Research IBRD International Bank for Reconstruction and Development IC Investment Case ICT Information Communications Technology IDA International Development Association IDA-SUF International Development Association – Scale-Up Facility IFISH Institutional Foundation to Improve Services for Health IFR Interim Financial Report IMF International Monetary Fund INTOSSAI International Organization of Supreme Audit Institutions IPF Investment Project Financing IR Implementation Research IVA Independent Verification Agent LCPS Liberia College of Physicians and Surgeons LMIS Logistic Management Information System LMP Labor Management Procedure MFDP Ministry of Finance and Development Planning MNDSR Maternal and Neonatal Death Surveillance and Response MOE Ministry of Education MOH Ministry of Health NDS National Drugs Store NVA National Verification Agency OOP Out of Pocket Spending PBF Performance-Based Financing PFM Public Financial Management PFMRS Public Financial Management Reforms for Institutional Strengthening PFMU Public Financial Management Unit PHC Primary Health Care PHCFs Public primary healthcare facilities PIM Project Implementation Manual PIU Project Implementation Unit PNC Postnatal Care PPP Purchasing-Power-Parity PPSD Project Procurement Strategy for Development RMNCAH Reproductive, Maternal, Neonatal Child, and Adolescent Health SCMU Supply Chain Management Unit SEP Stakeholder Engagement Plan STEP Systematic Tracking of Exchanges in Procurement SUF Scale Up Facility SWEDD Sahel Women’s Empowerment and Demographic Dividend Project UHC Universal Health Coverage UNFPA United Nations Population Fund UNICEF United Nations Children’s Fund USAID United States Agency for International Development WBG World Bank Group WDI World Development Indicator WHO World Health Organization WISN Workload Indicators of Staffing Need The World Bank Institutional Foundations to Improve Services For Health (P169641) TABLE OF CONTENTS DATASHEET.................................................................................................................................1 I. STRATEGIC CONTEXT ...........................................................................................................7 A. Country Context ..................................................................................................................... 7 B. Sectoral and Institutional Context ........................................................................................... 9 C. Building on PFM inputs. ........................................................................................................ 14 D. Relevance to Higher Level Objectives .................................................................................... 15 II. PROJECT DESCRIPTION ......................................................................................................16 A. Project Development Objective ............................................................................................ 16 B. Project Components ............................................................................................................. 18 C. Project Beneficiaries ............................................................................................................. 24 D. Results Chain ........................................................................................................................ 24 E. Rationale for Bank Involvement and Role of Partners............................................................ 25 F. Lessons Learned and Reflected in the Project Design ............................................................ 27 III. IMPLEMENTATION ARRANGEMENTS ................................................................................28 A. Institutional and Implementation Arrangements .................................................................. 28 Figure 2: Overall Project implementation arrangement ................................................................ 29 B. Results Monitoring and Evaluation Arrangements................................................................. 32 C. Sustainability ........................................................................................................................ 32 IV. PROJECT APPRAISAL SUMMARY .......................................................................................33 A. Technical, Economic and Financial Analysis ........................................................................... 33 B. Fiduciary ............................................................................................................................... 39 C. Legal Operational Policies ..................................................................................................... 40 D. Environmental and Social...................................................................................................... 40 V. GRIEVANCE REDRESS SERVICES .........................................................................................44 VI. KEY RISKS ...........................................................................................................................44 VII. RESULTS FRAMEWORK AND MONITORING .......................................................................47 ANNEX 1: Implementation Arrangements and Support Plan.............................................73 ANNEX 2: Disbursement- Linked Indicators .......................................................................81 The World Bank Institutional Foundations to Improve Services For Health (P169641) DATASHEET BASIC INFORMATION BASIC_INFO_TABLE Country(ies) Project Name Liberia Institutional Foundations to Improve Services For Health Project ID Financing Instrument Environmental and Social Risk Classification Investment Project P169641 Moderate Financing Financing & Implementation Modalities [ ] Multiphase Programmatic Approach (MPA) [ ] Contingent Emergency Response Component (CERC) [ ] Series of Projects (SOP) [✓] Fragile State(s) [✓] Disbursement-linked Indicators (DLIs) [ ] Small State(s) [ ] Financial Intermediaries (FI) [ ] Fragile within a non-fragile Country [ ] Project-Based Guarantee [ ] Conflict [ ] Deferred Drawdown [ ] Responding to Natural or Man-made Disaster [ ] Alternate Procurement Arrangements (APA) Expected Approval Date Expected Closing Date 21-May-2020 31-Aug-2026 Bank/IFC Collaboration No Proposed Development Objective(s) To improve health service delivery to women, children and adolescents in Liberia. Components Component Name Cost (US$, millions) Page 1 of 119 The World Bank Institutional
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