The World Bank Health System Improvement Project (P113349) REPORT NO.: RES39948 RESTRUCTURING PAPER ON A PROPOSED PROJECT RESTRUCTURING OF HEALTH SYSTEM IMPROVEMENT PROJECT APPROVED ON APRIL 7, 2011 TO REPUBLIC OF UZBEKISTAN December 13, 2019 HEALTH, NUTRITION & POPULATION EUROPE AND CENTRAL ASIA Regional Vice President: Cyril E Muller Country Director: Lilia Burunciuc Regional Director Fadia Saadah Practice Manager/Manager: Tania Dmytraczenko Task Team Leader(s): Elvira Anadolu The World Bank Health System Improvement Project (P113349) BASIC DATA Product Information Project ID Financing Instrument P113349 Investment Project Financing Original EA Category Current EA Category Partial Assessment (B) Partial Assessment (B) Approval Date Current Closing Date 07-Apr-2011 31-Dec-2019 Organizations Borrower Responsible Agency Ministry of Finance Ministry of Health Project Development Objective (PDO) Original PDO The overall Project Development Objectives (PDOs) are to (1) improve access to quality health care at the primary level and atRayonMedical Unions (RMUs); and (2) strengthen the Government’s public health response to the rise in non- communicable diseases(NCDs). Current PDO The revised PDO is to (a) improve access to quality health care at the primary level and at Rayon Medical Unions; and selectedCityMedical Unions (CMUs); and (b) strengthen the Government's public health response to the rise in non- communicable diseases(NCDs). OPS_TABLE_PDO_CURRENTPDO Summary Status of Financing Net Ln/Cr/Tf Approval Signing Effectiveness Closing Commitment Disbursed Undisbursed IDA-52310 07-Mar-2013 18-Jul-2013 19-Sep-2013 31-Dec-2019 48.00 26.76 14.60 IDA-48960 07-Apr-2011 16-Sep-2011 02-Nov-2011 31-Dec-2018 93.00 85.25 .11 The World Bank Health System Improvement Project (P113349) Policy Waiver(s) Does this restructuring trigger the need for any policy waiver(s)? No I. PROJECT STATUS AND RATIONALE FOR RESTRUCTURING The Project closing date is December 31, 2019. All activities have been completed, and all end of project targets for the Intermediate Results Indicators (IR) are assessed as achieved. All four Project Development Indicators (PDO) indicators have been achieved. All legal covenants are met, and there is no outstanding financial audit report. The Project has accumulated about US$ 52 million savings from the procurement of medical equipment through international competitive bidding which will not be used by the current closing date. Therefore, the Ministry of Finance, in its letter dated November 22, 2019, requested to cancel US$7 million (equivalent to SDR5,090,094.68) from the credit undisbursed balance. This is a second restructuring. The first restructuring was made in February 2018, which included the partial cancellation of US$45 million and 12-month extension. Out of total project financing US$141million, as of today US$14.85 million is undisbursed. The remaining US$7.85 million after the cancellation will be used for the committed contracts during the grace period. II. DESCRIPTION OF PROPOSED CHANGES The proposed restructuring is for partial cancelation of US$7 million (equivalent to SDR5,090,094.68) savings from the undisbursed balance of the Credit, as requested by the Ministry of Finance/Borrower. This will allow recommitting the cancelled funds to Uzbekistan IDA pool (FY20 is the last year of IDA 18). The remaining balance of about US$14 million is planned to be used for the contracted activities by the closing dates (December 31, 2019) and the payment for the completed contracts during the grace period. III. SUMMARY OF CHANGES Changed Not Changed Cancellations Proposed ✔ Reallocation between Disbursement Categories ✔ Implementing Agency ✔ DDO Status ✔ The World Bank Health System Improvement Project (P113349) Project's Development Objectives ✔ Results Framework ✔ Components and Cost ✔ Loan Closing Date(s) ✔ Disbursements Arrangements ✔ Disbursement Estimates ✔ Overall Risk Rating ✔ Safeguard Policies Triggered ✔ EA category ✔ Legal Covenants ✔ Institutional Arrangements ✔ Financial Management ✔ Procurement ✔ Implementation Schedule ✔ Other Change(s) ✔ Economic and Financial Analysis ✔ Technical Analysis ✔ Social Analysis ✔ Environmental Analysis ✔ IV. DETAILED CHANGE(S) OPS_DETAILEDCHANGES_CANCELLATIONS_TABLE CANCELLATIONS Value Reason Current Cancellation New Ln/Cr/Tf Status Currency Date of for Amount Amount Amount Cancellation Cancellation BORROWER' S REQUEST IDA-48960- Disburs XDR 59,600,000.00 0.00 22-Nov-2019 59,600,000.00 FOR 001 ing COUNTRY REASONS The World Bank Health System Improvement Project (P113349) BORROWER' Disburs S REQUEST IDA-52310- ing&Re XDR 29,665,999.41 5,090,094.68 22-Nov-2019 24,575,904.73 FOR 001 paying COUNTRY REASONS OPS_DETAILEDCHANGES_REALLOCATION _TABLE REALLOCATION BETWEEN DISBURSEMENT CATEGORIES Financing % Current Allocation Actuals + Committed Proposed Allocation (Type Total) Current Proposed IDA-52310-001 | Currency: XDR iLap Category Sequence No: 1 Current Expenditure Category: G,CS,TR,IOC 29,665,999.41 18,832,091.69 24,575,904.73 100.00 100.00 Total 29,665,999.41 18,832,091.69 24,575,904.73 .