OFFICIAL L? DOCUMENTS AMENDMENT TO THE AGREEMENT FOR REIMBURSABLE ADVISORY SERVICES on Support to Develop a Health System Strategy for Priority Disease Areas in Latvia This addendum is made the 0 day of n. L 2015, between the NATIONAL HEALTH SERVICE (the "Recipient") and the INTERNATIONAL BANK FOR RECONSTRUCTION AND DEVELOPMENT (the "Bank") (jointly referred to as "the Parties") to the Reimbursable Advisory Services Agreement on Support to Develop a Health System Strategy for Priority Disease Areas in Latvia between the Parties dated December 30, 2014 (the Agreement). The Parties agree as follows (changes are in italics): 1. Article 6 of the Agreement is hereby amended to read in its entirety as follows: "6. Expiration. This Agreement shall expire on July 30, 2016, unless it shall earlier be renewed with the mutual agreement of the Client and the Bank" 2. Article B of the Schedule is hereby amended to read in its entirety as follows: ,,B. Timetable. Except as the Client and the Bank may otherwise agree, the Bank shall endeavor to perform the Reimbursable Advisory Services in accordance with the following tentative timetable: Deliverables Indicative timetable :. [1] An inception paper laying out key issues, working Within 8 weeks after contract signing hypotheses, and an analytical framework for testing hypotheses2. [2] A framework and recommendations for organizing, Within 6 weeks of receipt of relevant funding, and monitoring future health promotion information from NHS and CDPC activities and programs at the national and local levels [3] A summary report and power-point presentation of the bottleneck analysis using data from both publicly and privately financed health services. March 2016 [4] All survey instruments, manuals, and analysis protocols [5] A summary report and power-point presentation of Within 4 months of receipt of sufficient the human resource analysis, information (with request made prior to Feb 20, 2015) [6] A summary report and power-point presentation of the proposed volume-quality studies among hospitals and other health care institutions. February 2016 [7] All survey instruments, manuals, and analysis ' The Bank shall provide basic translations of deliverables into Latvian. 2 This will include multiple pairs of specific null and alternative hypotheses. protocols [8] An operational manual that provides guidance for March 2016 monitoring system bottlenecks [9] A summary report for key informant interviews and January 2016 focus group discussions, along with transcripts in Latvian Practice, capacity, and policy reviews on the following health system functions: [10] Benefits package design Within 4 months of receipt of sufficient information (with request made prior to March 1, 2015) [11] Organization of service delivery Within 4 months of receipt of sufficient information (with request made prior to March 1,2015) [12] Capital investment planning Within 4 months of receipt of sufficient information (with request made prior to March 1,2015) [13] Human resource planning Within 4 months of receipt of sufficient information (with request made prior to March 1,2015) [14] Quality assurance Within 4 months of receipt of all requested information (with request made prior to March 1, 2015) [15] Provider payments Within 4 months of receipt of sufficient information (with request made prior to June 1,2015) [16] A short policy paper and power-point presentation April 2016 for concrete policy proposals [17] Infrastructure and human resource maps and a February 2016 summary report and power-point presentation of infrastructure and human resource gaps under alternative service delivery scenarios, with an accompanying fiscal impact analysis [18] Workshops among stakeholders to discuss findings September 2015; March 2016 [19] Conference for clients to review and prioritize March 2016 underlying causes and policy entry points and to learn from international experiences [20] Dissemination of key findings through a World Bank May 2016 discussion series -2- 3. All the other articles and provisions of the Agreement shall remain unchanged. IN Witness WHEREOF, the parties hereto, acting through their duly authorized representatives, have caused this Agreement to be signed in their respective names as of the day and year first above written. This amendment will become effective as of the date of countersignature, upon receipt by the Bank of the countersigned copy of this Amendment Letter. NATIONAL HEALTH SERVICE INTERNATIONAL BANK FOR RECONSTRUCTION AND / EVELOPM T By ' By: _________ A horized Representative Authorized Representative Name: Ms. Daina M(irmane-Umbragko Name: Marina Wes Title: Director Title: Country Manager Date: S-. / '. '2 Date: _____________ -3-