World Bank Documentdocuments.worldbank.org/curated/en/...the GOL has prepared a COVID-19 Health Sector Response Plan and is developing a National Multi-Sectoral Plan. Progress has

The World BankLebanon Health Resilience Project (P163476)

REPORT NO.: RES32576

RESTRUCTURING PAPER

ON A

PROPOSED PROJECT RESTRUCTURING

OF

LEBANON HEALTH RESILIENCE PROJECT

APPROVED ON JUNE 26, 2017

TO

THE REPUBLIC OF LEBANON

HEALTH, NUTRITION & POPULATION

MIDDLE EAST AND NORTH AFRICA

Regional Vice President: Ferid Belhaj Country Director: Saroj Kumar Jha

Regional Director: Keiko MiwaPractice Manager/Manager: Rekha Menon

Task Team Leader(s): Nadwa Rafeh

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ABBREVIATIONS AND ACRONYMS

COVID-19 Coronavirus DiseaseESMF Environmental and Social Management FrameworkFM Financial ManagementGCFF Global Concessional Financing FacilityGOL Government of LebanonIA Implementing AgencyIBRD International Bank for Reconstruction and DevelopmentIPC Infection Prevention and ControlMOF Ministry of FinanceMOPH Ministry of Public HealthPCR Polymerase Chain ReactionPDO Project Development ObjectivePHCC Primary Health Care CenterPMU Project Management UnitPOM Project Operational ManualPPE Personal Protective EquipmentPPSD Project Procurement Strategy for DevelopmentRF Results FrameworkTOR Terms of ReferenceTPM Third Party Monitoring


BASIC DATA

Product Information

Project ID Financing Instrument

P163476 Investment Project Financing

Original EA Category Current EA Category

Partial Assessment (B) Partial Assessment (B)

Approval Date Current Closing Date

26-Jun-2017 30-Jun-2023

Organizations

Borrower Responsible Agency

The Republic of Lebanon Ministry of Public Health

Project Development Objective (PDO)

Original PDOThe project development objective (PDO) is to increase access to quality healthcare services to poor Lebanese and displaced Syrians in Lebanon.OPS_TABLE_PDO_CURRENTPDOSummary Status of Financing

Ln/Cr/Tf Approval Signing Effectiveness ClosingNet

Commitment Disbursed Undisbursed

IBRD-87710 26-Jun-2017 09-Mar-2018 14-Nov-2018 30-Jun-2023 95.80 2.64 93.16

TF-A5424 26-Jun-2017 09-Mar-2018 14-Nov-2018 30-Jun-2023 24.20 .60 23.60

Policy Waiver(s)

Does this restructuring trigger the need for any policy waiver(s)?No


I. PROJECT STATUS AND RATIONALE FOR RESTRUCTURING

Project Status. The Lebanon Health Resilience Project (the Project) was approved by the World Bank Board of Executive Directors on June 26, 2017 and became effective after a significant delay on November 14, 2018, with a closing date of June 30, 2023. The Project Development Objective (PDO) is to increase access to quality healthcare services to poor Lebanese and displaced Syrians in Lebanon.

It was financed by a US$120 million loan, consisting of a non-concessional portion of US$95.8 million financed by the International Bank for Reconstruction and Development (IBRD) and a concessional portion of US$24.2 million from the Global Concessional Financing Facility (GCFF). The Project followed condensed emergency procedures as outlined in paragraph 12 of OP 10.00 (Projects in Situations of Urgent Need of Assistance or Capacity Constraints) so that the Government of Lebanon (GOL) could continue to provide critical health services to the target population in the context of the Syrian crisis. The Ministry of Public Health (MOPH) has received US$3.24 million under the Project, consisting of US$2.64 million under the IBRD loan and US$0.6 million GCFF financing, which was approved in May 2019, but has not been disbursed. There are no outstanding audits under the Project.

In the January 8, 2020 Implementation Status Report (ISR), given substantial delays in various areas of project implementation, and failure to meet with legal covenants laid out in the Loan Agreement (i.e., an acceptable finalized Project Operations Manual; the bidding and contracting process for the Third-Party Administrator was not been initiated), the PDO, Implementation Progress, Components, Financial Management (FM), Procurement and Monitoring and Evaluation were rated as Moderately Unsatisfactory (MU).

On January 23, 2020, the Bank issued a notice of threat of suspension to the GOL and requested that the GOL send the Bank satisfactory evidence that the GOL has made satisfactory progress on meeting the Project’s legal covenants by no later than February 24, 2020, in order to lift the threat of suspension. On February 27, 2020, the GOL provided its response to the notice of threat of suspension and in light of the satisfactory meeting of the conditions specified by the Bank, the threat of suspension was lifted on March 10, 2020.

Country Context. An outbreak of COVID-19 caused by the 2019 novel coronavirus (SARS-CoV-2) has been spreading rapidly globally since December 2019, from Wuhan, Hubei Province, China to 115 countries and territories. As of March 10, 2020, the outbreak has resulted in over 114,000 cases and over 4,250 deaths world-wide. The outbreak is taking place at a time when global economic activity is facing uncertainty and governments have limited policy space to act.

Like its neighbors, Lebanon is also affected by the COVID-19 outbreak, which poses a threat to its heath system and beyond. The first case of COVID-19 was reported in Lebanon on February 21, 2020. As of March 10, 2020, there have been 61 confirmed cases and 2 deaths. Although a majority of confirmed cases have resulted from international travel, local transmission is highly likely to be taking place, given the disease dynamics and the current testing and containment strategies, which only focus on people with a travel history. The outbreak is expected to grow exponentially, affecting not just the health system but also the economy and security. In response, the GOL has prepared a COVID-19 Health Sector Response Plan and is developing a National Multi-Sectoral Plan. Progress has been made in risk communication to the population, port of entry screening, setting up one testing center and one treatment center. However, the unmet needs are immense. With only one hospital (the Rafik Hariri University Hospital) prepared to treat cases, Lebanon is under-equipped to respond to such a public health emergency.

The outbreak is coming at a time when Lebanon’s economy is already going through the worst economic crisis in recent history and the GOL has limited resources to respond. The outbreak further clouds an already strained health sector and will further set back


Lebanon’s efforts in its fight against poverty. There are concerns that the outbreak will particularly hit the poor and the refugee population. Lebanon hosts a large number of refugees. Overcrowding and poor living conditions in camps and settlements could further exacerbate the problem and make these camps a breeding ground for the disease.

Rationale for restructuring. The purpose of the proposed restructuring is to support the GOL to mitigate the impact of the COVID-19 outbreak. The restructuring responds to a request from the GOL dated March 4, 2020 to add a component to the Project on COVID-19 preparedness and response that will allow for immediate support to assess country preparedness, multi-sectoral response capabilities, and to finance the procurement of medical goods and equipment, and capacity-building and training of health workers and front-line responders.

II. DESCRIPTION OF PROPOSED CHANGES

Summary of proposed changes:

(a) The PDO will be revised as “ to increase access to quality healthcare services to poor Lebanese and displaced Syrians in Lebanon and to strengthen the Government’s capacity to respond to COVID-19”;

(b) A new component will be added “Component 4: Strengthen capacity to respond to COVID-19”;(c) Project funds will be reallocated from Components 1, 2 and 3 to Component 4; and, (d) The Results Framework (RF) will be amended to include new indicators for Component 4 and to adjust the targets for

the other three components.

While there will be no changes to activities to be delivered under Components 1, 2, and 3, the total cost of each component will be reduced due to the change in the period of coverage from 5 years to 3 years due to delays in project implementation. Changes in Components 1,2, and 3 will be as follows:

Original Budget Allocation

(Million USD)

Budget Allocation after the Restructuring

(Million USD)

Original Number of Target Groups

Revised Number of Target Groups after Restructuring (%

of the original)Component 1 76.5 51.24Component 2 36.4 23.52Component 3 6.86 5Component 4 0 40

Front-end Fee

0.24 0.24

-Contracted PHCCs: 204-Lebanese Beneficiaries: 340,000-Syrian Beneficiaries: 375,000

-Contracted PHCCs: 170 (83.3%)-Lebanese Beneficiaries: 250,000 (73.5%)-Syrian Beneficiaries: 250,000 (66.6%)

Component 4: Strengthen the capacity to respond to COVID-19. This component will finance the following activities:

i. Case detection and surveillance. This will include support for: a. procuring essential commodities for case detection and surveillance such as Polymerase Chain Reaction (PCR)

machines, sample collection kits, test kits, and other equipment and supplies for COVID-19 testing and surveillance;

b. capacity building in testing and surveillance; and


c. strengthening IT system for surveillance. ii. Case management and protection of health workers and response personnel. This will support the strengthening of

selected health facilities and establishment and equipping of quarantine and treatment centers, so that they can manage COVID-19 cases, including: a. procuring beds, furniture, ventilators, pulse oximeters, laryngoscopes, oxygen generators, other equipment and

supplies for COVID-19 case management;b. Capacity building and training;c. procuring Personal Protective Equipment (PPE), disinfectants and other commodities for infection prevention and

control (IPC) as well as healthcare waste management;d. contracting supplementary health workers for COVID-19 treatment centers;e. paying for fees related to COVID-19 services according to a fee schedule and eligible criteria to be developed and

agreed with the World Bank; and,f. capacity building in COVID-19 case management and in IPC.

iii. Multisectoral response. This will finance goods, services, training and operational costs to support multisectoral activities such as: (i) the operations of command rooms at the central and regional levels, (ii) implementation of risk commutations and community engagement campaigns, (iii) implementation of containment strategies, including port-of-entry interventions, and (iv) operation of rapid response teams.

Procurement Arrangements. Procurement for Component 4 will be carried out in accordance with the World Bank’s Procurement Regulations for IPF Borrowers for Goods, Works, Non-Consulting and Consulting Services, dated July 1, 2016 (revised in November 2017 and August 2018). The Project will be subject to the World Bank’s Anticorruption Guidelines, dated October 15, 2006, revised in January 2011, and as of July 1, 2016. The Project will use the Systematic Tracking of Exchanges in Procurement (STEP) to plan, record and track procurement transactions.

Planned procurement under Component 4 includes procurement of goods, equipment, hospital furniture, consumables, trainings and consultancies required to combat COVID-19, as well as public hospital fees incurred in the detection and treatment of COVID-19 cases. The Borrower has prepared a project procurement strategy for development (PPSD) for the Project, and PPSD relating to Component 4 will be deferred until project implementation. An initial positive list of items to be procured under Component 4 (see Annex 1) has been agreed with the Borrower and will be updated during implementation, to be procured through methods acceptable to the Bank.

Procurement will be carried out by the MOPH. The proposed procurement approach prioritizes fast track emergency procurement for required emergency goods and services. Key measures to fast track procurement under Component 4 include procurement from UN Agencies.

UN Agencies. Considering the limitations in the supply chain of required medical goods, the global involvement of relevant UN Agencies (i.e. WHO, UNICEF and UNOPS) in the procurement and distribution of these goods, and fit for purpose procurement, the procurement plan will be limited to procurement of relevant UN Agencies that are active in Lebanon. Agreements will be reached between the Borrower and UN Agencies, using the Bank’s standard agreement template for UN Agencies/organizations to procure the required goods following their own procurement arrangements, including the possibility of framework agreements and the gradual supply of goods in lots.

Hands-on Expanded Implementation Support (HEIS); The Bank may, at the request of the Borrower, provide HEIS to help expedite the procurement arrangements. HEIS may assist the GOL with the selection and award of the agreement with the UN agency, including:

i. Assist the implementing agency in initiating the selection process of UN Agencies; ii. Identify strengths and weaknesses of UN Agencies proposals;


iii. Advise on areas to clarify or negotiate with UN Agencies;iv. Attend negotiations (virtually) as observers, including clarifying Procurement Regulations matters for the Borrower’s;

and v. Finalize the agreements with UN Agencies.

Procurement risks and mitigation measures:

Procurement Risks Mitigation MeasuresOutdated Country Procurement Regulations, and high perception of fraud and corruption in Lebanon as it ranks 137 out of 180 countries.

Follow Bank Procurement Regulations and hiring the UN Agencies to carry procurement of the required supplies and services on the basis of an agreed positive list and including storage and distribution to the final destinations. In addition, a technical audit will be conducted to verify the contracting approach, the appropriateness of prices relative to market prices, the adherence to acceptable and agreed procurement procedures the appropriate use of funds for the intended purposes.

Lack of experience of the new PMU at the implementing agency with World Bank Procurement Policy and Procedures, through all stages of the procurement cycle.

Hire experienced procurement staff for the Project, as well as training and close hand holding. The Bank may also, at the request of the Borrower, provide HEIS to help expedite the procurement arrangements.

Delay in supply especially because of interruptions in supply chain due to spread of COVID-19 virus throughout the world, governments’ export restrictions and scarcity of the goods in question due to high demand across the globe.

This risk would be mitigated through advance payment to the UN Agencies to allow them to make the goods available in their regional stores such as Dubai and Djibouti prior to onward shipment to Lebanon as well as agreeing up front on their sourcing strategy. In addition, the UN agency(ies) will use Independent Inspection agents to certify that goods comply with the technical specifications at the factory and/or at the port of shipment will be considered.

Delays due to the UN agency(ies) internal processes and approvals.

Advanced planning and delegation of authority at the right levels as well as commitment by UN agency(ies) to comply with agreed timelines.

Government’s capacity to monitor and control receipt, storage and distribution of the procured goods.

Agreement with the best placed UN agency to be responsible for delivery of the supplies to the country’s storage facilities. Smart fiduciary tools, such as Internet of Things (IoT), and block chain that can track goods to their final destination, will be explored.

Financial Management. Component 4 will be implemented by contracting UN agency(ies) through a standard agreement with the MOPH. The terms of the agreement with the UN agency(ies) contracted will spell out the authorization, approvals and procedures as well as the governing relationships between the MOPH and the respective UN agency(ies). The agreement will include the prior approval of the MOPH on payment of COVID-19 cases tested, admitted and hospitalized.


FM risks have been identified as below:

i. Delays of funds to be transferred from the Ministry of Finance (MoF) treasury account to the Project designated account;

ii. Delays from the MOPH in the delivery of key project activities including: (i) the finalization of the Third Party Monitoring (TPA) Terms of Reference (TORs) for the hospital component; (ii) the recruitment/assignment of key staff members within the PMU; (iii) finalization of the POM; (iv) the recruitment of an independent controller for prior review on project expenditures (other than the hospital related component);

iii. Limited effectiveness of FM arrangements adopted by UN agency(ies); iv. Potential misuse of goods (diversion of intended acquisition purpose including inefficiency in inventory storage

management and distribution) due to weak Government institutions and limited accountability.

To mitigate these FM risks, Component 4 will be implemented in its entirety by UN agency(ies) who will be contracted by the MOPH and will carry out fiduciary arrangements including the procurement of goods/equipment and the provisions of services. The UN agency(ies) will submit request for funds withdrawal to the Bank. The request, to be cleared by the MOPH will be IFR-based and will include a forecast of cash needs by the UN agency(ies) for the next period. The Bank will transfer the amounts requested from the UN commitment Fund (dedicated fund for UN component implementation) through direct payments, into the UN agency(ies) bank account/s. Additional enhanced fiduciary arrangements will be introduced into the standard agreement with the UN agency(ies) to include:

i. Quarterly financial reporting arrangements for submission to the Bank by the contracted UN agency(ies); ii. Hire an independent external auditor by the UN agency(ies) to carry out yearly “agreed upon procedures “on the project

sources and use of funds. The related terms of reference will need to be agreed and cleared by the Bank; and,iii. Semi-annual technical audits will be required to provide an independent verification on goods procured (types, quantities,

etc.), stock balances by storage locations, and distribution to the final beneficiaries. The main purpose of the technical audit is to ensure that the goods are being used for the intended purpose and are actually reaching the final intended beneficiary. The TOR will be agreed with and cleared by the Bank.

The reallocation by category will be as follows:


Category Original Amount of the Non-

Concessional Portion of the Loan

Allocated in USD

Original Amount of the

Concessional Portion of the

Loan Allocated in USD

Amount After Reallocation of the Non-Concessional

Portion of the Loan in USD

Amount After Reallocation of the

Concessional Portion of the Loan in USD

Percentage of Expenditures to be

financed (inclusive of Taxes)

1.Good, non-consulting services, consulting services, Training and Workshops, and Operating Costs for Parts 1.2, 2.2, 3, and Component 4 of the Project

23,045,500 5,882,000 54,977,500 13,950,000 100%

2.Capitation Payments under Part 1.1 of the Project

46,170,000 11,663,000 25,838,895 6,526,105 100%

3.Special Capitation Payments under Part 2.1 of the Project

26,345,000 6,655,000 14,744,105 3,723,895 100%

4. Front-end Fee to be paid pursuant to Section 2.03 of this Agreement in accordance with Section 2.05 (b) of the General Conditions (renumbered as such pursuant to paragraphs 3 and 5 of Section II of the Appendix to this Agreement and relating to Capitalizing Front-end Free and Interest)

239,500 0 239,500 0 Amount payable pursuant to Section 2.03 of this Agreement in accordance with Section 2.07 (b) of the General Conditions

5. Interest Rate Cap or Interest Rate Collar premium to be paid pursuant to Section 2.08 (c) of

0 0 0 0 Amount due pursuant to Section 2.08 (c) of this Agreement


The Borrower will be able to finance acquisition of eligible goods and services for the COVID-19 response under Component 4 under Disbursement Category 1 of the Project. Goods and services acquired for COVID-19 response under Component 4, after the effective date of the Project, will be eligible for financing, including goods and equipment acquired before the restructuring of the Project is made effective by the Parliament's action.

Additional FM arrangements - Component 4. The MOPH/UN agency(ies) agreement will include a description of the services to be provided. This list will include goods to be purchased and services to be provided, the payments mechanism, the reporting schedule, oversight procedures, quarterly financial reports and a special purpose audit.

Through the financial management framework with UN Agencies, the Bank will make the funds available directly to the UN Agencies based on the standard agreement that will be signed between the Government and the UN Agencies. The process of funds transfers will be as follows:

• Implementing Agency (IA) prepares the standard agreement to be signed with UN agency(ies).• Bank clears the agreement and financial provisions.• IA signs agreement with UN agency(ies).• IA prepares a blanket withdrawal application and submit to the Bank with a copy of the agreement.• Bank opens a UN commitment fund (in the amount of agreement).• UN agency(ies) submit payment request to the Bank based on the financial provisions of the agreement (IFR-based and will

include a forecast of cash needs by the UN agency(ies) for the next period). The request will need to be also cleared/signed by the MOPH. The Bank transfers the funds directly to the UN agency(ies) bank account.

• UN agency(ies) uses funds then submits a utilization report (financial reports) to the IA.• IA Submits a withdrawal application along with utilization report to document funds used by the UN agency(ies).

Safeguards. An Environmental and Social Framework (ESMF) was prepared, consulted on and disclosed in 2019. The ESMF identifies the environmental and social risks and impacts associated with the Project and recommends mitigation measures. The key environmental and social risks under Component 4 are largely covered in the ESMF. As per the ESMF, installation of new equipment as needed and scaling up of facilities are acceptable. However, given that COVID-19 is a new disease, additional mitigation measures will need to be included in the ESMF related to health and safety measures related to waste management, fire life safety, wastewater management, occupational health and safety aspects related to exposure to infection and diseases, and emergency preparedness and response plan and exposure control plan and infection control policies and procedures in line with World Health Organization guidelines and WBG Environmental, Health and Safety guidelines. The Grievance Redress Mechanism will also be strengthened to include a designated line for COVID-19 intake and processing. In addition, Component 4 will be implemented by UN Agency(ies) who will follow World Bank Safeguards Policies. The ESMF will be updated, consulted upon and disclosed to reflect these additional mitigation measures and institutional arrangements for the new component. Given the urgent nature of this restructuring, this update will be prepared as soon as possible and before any activities are started.

this Agreement in accordance with Section 4.05 of the General Conditions.Total Amount 95,800,000 24,200,000 95,800,000 24,200,000


III. SUMMARY OF CHANGES

Changed Not Changed

Project's Development Objectives ✔

Results Framework ✔

Components and Cost ✔

Disbursements Arrangements ✔

Disbursement Estimates ✔

Institutional Arrangements ✔

Procurement ✔

Implementation Schedule ✔

Economic and Financial Analysis ✔

Technical Analysis ✔

Social Analysis ✔

Implementing Agency ✔

DDO Status ✔

DLIs ✔

Loan Closing Date(s) ✔

Cancellations Proposed ✔

Reallocation between Disbursement Categories ✔

Overall Risk Rating ✔

Safeguard Policies Triggered ✔

EA category ✔

Legal Covenants ✔

Financial Management ✔

APA Reliance ✔

Other Change(s) ✔

Environmental Analysis ✔


IV. DETAILED CHANGE(S)

OPS_DETAILEDCHANGES_PDO_TABLE

PROJECT DEVELOPMENT OBJECTIVE

Current PDOThe project development objective (PDO) is to increase access to quality healthcare services to poor Lebanese and displaced Syrians in Lebanon.

Proposed New PDOThe project development objective (PDO) is to increase access to quality healthcare services to poor Lebanese and displaced Syrians in Lebanon and to strengthen the Government’s capacity to respond to COVID-19.

OPS_DETAILEDCHANGES_COMPONENTS_TABLE

COMPONENTS

Current Component Name

Current Cost

(US$M)Action Proposed

Component NameProposed

Cost (US$M)

Scaling up the scope and the capacity of the primary health care UHC program

76.50 RevisedScaling up the scope and the capacity of the primary health care UHC program

51.24

Provision of health Care services in public hospitals 36.40 Revised Provision of health care

services in public hospitals 23.52

Strengthening project management and monitoring 6.80 Revised Strengthening project

management and monitoring 5.00

0.00 NewStrengthen the Government’s capacity to respond to COVID-19

40.00

TOTAL 119.70 119.76

OPS_DETAILEDCHANGES_DISBURSEMENT_TABLE

DISBURSEMENT ESTIMATES

Change in Disbursement EstimatesYes

Year Current Proposed

2017 0.00 0.00

2018 5,000,000.00 0.00

2019 7,000,000.00 0.00

2020 20,000,000.00 5,000,000.00


2021 23,000,000.00 35,000,000.00

2022 30,000,000.00 40,000,000.00

2023 35,000,000.00 40,000,000.00

.


.Results framework

COUNTRY: LebanonLebanon Health Resilience Project

Project Development Objectives(s)

The project development objective (PDO) is to increase access to quality healthcare services to poor Lebanese and displaced Syrians in Lebanon.

Project Development Objective Indicators by Objectives/ OutcomesRESULT_FRAME_TBL_PDO

Indicator Name DLI Baseline Intermediate Targets End Target

1 2 3

Increase Access to quality healthcare for poor Lebanese and displaced Syrians

Primary care beneficiaries (Number) 280,000.00 290,000.00 290,000.00 390,000.00 500,000.00

Action: This indicator has been Revised

Poor Lebanese (Number) 150,000.00 150,000.00 150,000.00 200,000.00 250,000.00


Displaced Syrians (Number) 130,000.00 130,000.00 140,000.00 190,000.00 250,000.00


% female of total beneficiaries (Percentage) 50.00 50.00 50.00 50.00 50.00


Health facilities accredited (Number) 30.00 30.00 30.00 50.00 85.00


RESULT_FRAME_TBL_PDO


1 2 3


Pregnant women receiving at least four antenatal care visits (Percentage)

50.00 50.00 50.00 55.00 60.00


Number of patients receiving inpatient and outpatient public hospital care above the MoPH contracted ceiling (Number)

0.00 0.00 5,000.00 12,000.00 19,000.00


Children fully vaccinated under the age of two according to national immunization policy (Percentage)

50.00 50.00 65.00 70.00 75.00


Strengthen the Government’s capacity to respond to the COVID-19 (Action: This Objective is New)

Number of health personnel got infected (COVID-19) (Text) 2.00 <10 <15 <20

Action: This indicator is New

PDO Table SPACE


Intermediate Results Indicators by ComponentsRESULT_FRAME_TBL_IO


1 2 3

Scaling up the scope and the capacity of the primary health care UHC program

Target population 40 years and above who were screened for diabetes mellitus (Percentage)

0.00 0.00 30.00 35.00 45.00


Health personnel receiving training (Number) 0.00 0.00 500.00 750.00 850.00


Health facilities contracted (Number) 75.00 75.00 75.00 130.00 170.00


Maintain Client Satisfaction (PHCCs & Hospitals) (Percentage) 75.00 75.00 75.00 75.00 75.00


People who have received essential health, nutrition, and population (HNP) services (CRI, Number)

0.00 12,000.00


Number of children immunized (CRI, Number) 0.00 0.00 2,000.00 7,000.00 12,000.00


RESULT_FRAME_TBL_IO


1 2 3


Strengthening project management and monitoring

Grievances registered related to delivery of project benefits addressed (Percentage)

40.00 40.00 50.00 60.00 70.00


Provision of health care services in public hospitals

Hospital Assessment carried out (Text) NA NA NA Completed Assessment completed


Capacity building to respond to the COVID-19 (Action: This Component is New)

Number of COVID-19 treatment centers (cumulative) (Number) 1.00 6.00 6.00 6.00


Number of COVID-19 rapid response teams at the governate level (cumulative) (Number)

1.00 5.00 5.00 5.00


IO Table SPACE


Annex 1: Positive List of Items to be Procured under Component 4

# Positive List

A N95: Particulate respirator compliant with NIOSH N95 or EN 149 FFFP2 and fluid resistant B 3 ply surgical face mask, compliant with EN 14683 type IIR or ASTM F2100 level2 or level 3 C Disposable gown: single use, long sleeves, fiber made non-woven, thumb loop, tape tab for neck closure,

water and liquids proof, compliant with the EN 13795 high performance level, or AAMI level 3 performance D Goggles / eye protection compliant with EU standard directive 86/686/EEC, EN 166/2002 or ANSI/ISEA Z87.1-

2010 E Disposable coverall: compliant with EN 943-1:2002 such TYVEK or equivalent F Nitrile gloves, High risk nitrile gloves

F2 Latex gloves free powderF3 Latex gloves powdered G Trash bags H Hand sanitizer I Disinfectant solution, Pc sprayJ Zipped bags

M Face shield compliant with EU standard directive 86/686/EEC, EN 166/2002 or ANSI/ISEA Z87.1-2010 O Cover shoes for Tyvek coverall Q Duct tapeR Disposable coversS Cadaver bagsT Thermometer: digital infrared

T2 Thermometer batteries fitting the digital infrared thermometer U Tissue paperV ScissorsW Permanent markerX Cover head Y Cover shoes

Z1 Transparent plastic Z3 Autoclavable bags


Z5 Sharp containers Z9 Bacillol

Z10 Alcoholic, Hand Rub-(Sterilium) Z11 Pissette Z12 Gauze Z13 Towel RollZ14 Dosing pumpZ15 Waste bin closed with piddleZ17 Regular Lab. coats for technicians Z20 Clorox , eau de javel Z21 Isopropanol, Alcohol Z22 Baktolin,1LITRE, Wash pure ,colorant free, Mild, perfume-free wash lotion with skin friendly, PH5.5R1 QIAmp Viral RNA minikit (250 Reactions) QIAGENR2 MagNA Pure Compact NA isolation kit I, RocheR3 Rnase Inhibitor 40U/µl, InvitrogenR4 SuperScript III Platinum Pne-Step qRT-PCR kit 100rxns, InvitrogenR5 Microamp 96-well reactions plate, ABI SystemsR6 LightCycler Capillaries 20µl (5*96 capillaries), RocheR7 Sterile pipette tips with aerosol-resistant filtersR9 Ethanol 100% (in glass bottles), Merck

R10 Ethanol 70% R12 Nuclease free water (10*50ml), AmbionR13 Cryovial box & lid R14 Biohazard specimen bag, Mnigrip/labguardZ23 Bed Sheet 305x150Z24 Pillow single use 70x50Z25 Pillow cover 70x55Z26 Blankets 150x80Z27 Hydro solubale bags Z28 Scrub Suits T4 Hepa filtersT5 covid- Naso-pharyngeal swab, pediatric, flocked swabs, copan T6 covid-Viral transport media VTM, for the collection and preservation of virus and other microorganisms


T7 covid- Naso-pharyngeal swab, adult, flocked swabs, copan with VTMsT8 Stationary, toners, papers, ….T9 Portable X-Ray (with cassettes)

T10 ECG machine T11 Suction pumpT13 Infusion pumpT14 IV standT15 Vital signs monitorT16 DefibrillatorT17 Respirator - MobileT19 Stainless trailT22 OtoscopeT24 Negative pressure in isolated roomsT25 Oxygen regulatorT26 Suction regulatorT28 Electric bedsT30 PCR machines


Documents

World Bank Documentdocuments.worldbank.org/curated/en/...the GOL has prepared a COVID-19 Health Sector Response Plan and is developing a National Multi-Sectoral Plan. Progress has