OFFICIAL
DOCUMENTS
THE WORLD BANK
IBRO - IDA I WORLDBANKGROUP
March 31, 2019
Hon. (Amb.) Lkur Yatani
Cabinet Secretary
The National Treasury
Treasury Building, Harambee Avenue
Nairobi
Dear Hon. Amb Yatani
Re: IDA Credit Financing 5836-KE
(Transforming Health Systems for Universal Care Project)
Fourth Amendment to the Disbursement Letter dated November 13, 2018
Additional Instructions: Disbursement
I refer to the Financing Agreement between the International Development Association
(the "Association") and the Republic of Kenya (the "Recipient") for the above-referenced project,
dated July 4, 2016. The Agreement provides that the Association may issue additional instructions
regarding the withdrawal of the proceeds of financing IDA 5836-KE ("Financing"). This letter
("Disbursement Letter"), as revised from time to time, constitutes the additional instructions. This
Disbursement Letter shall be amended as set forth in this letter (the "Fourth Amendment") to revise
the Designated Account Advances under this financing.
The instructions set forth in Section II (vi) in the Second Revised Disbursement Letter dated
November 13, 2018 shall be modified as follows:
II. Withdrawal of Financing Proceeds
(vi) Advances (sections 5 and 6).
*     Ceiling (subsection 6.1):
DA-C for Category 4 only: Variable - Forecast as cleared by the Task Team
Leader


THE WORLD BANK
IBRD-IDA I WORLD BANKGROUP
All other instructions and attachments of the Disbursement letter (IDA 5836-KE) dated
November 13, 2018 which are not expressly modified in accordance with this letter, shall remain
in force and effect.
If you have any queries in relation to the above, please contact askloans@worldbank.ore
using the above reference.
Very truly yours,
INTERNATIONAL DEVELOPMENT ASSOCIATION
C. Felipe J r  illo
Country ire r
Kenya, Rwanda, Somalia and Uganda
Africa Region