OFFICIAL DOCUMENTS WORLD BANK GROUP THE WORLD BANK 57, Pyay Road, Hlaing Township IBRD* IDA I WORwwbmOUP Yangon, Myanmar, 11051 Ref: WB-170-AUG/2018 Aug 24, 2018 H.E. U Soe Win Union Minister Ministry of Planning and Finance Building No. 1 Nay Pyi Taw Myanmar Excellency: Re: Essential Health Services Access Project (IDA Credit No. 5542-MM) Second Amendment to the Financing Agreement We refer to the Financing Agreement dated February 5, 2015, as amended on February 20, 2017, between the Republic of the Union of Myanmar (the Recipient) and the International Development Association (the Association) for the Essential Health Services Access Project. In connection with the understandings reflected in the letter from the Ministry of Health and Sports dated May 31, 2018 and subsequent discussions regarding changes to the Disbursement Linked Indicators (DLI) and the fiscal year period for DLI year 4, reallocation of unutilized Immediate Response Mechanism allocations, and extension of the Project closing date as well as the deadline for submission of interim unaudited financial reports, the Association hereby proposes to amend the Financing Agreement as follows: 1. Section II.B.2 of Schedule 2 to the Financing Agreement shall be amended to read as follows: "2. Without limitation on the provisions of Part A of this Section, the Recipient shall prepare and furnish to the Association, not later than sixty (60) days after the end of each semester of the Fiscal Year, interim unaudited financial reports for the Project covering each such period, in form and substance satisfactory to the Association." 2. The withdrawal table in Section IV.A.2 of Schedule 2 to the Financing Agreement shall be amended to read as follows: Category Amount of the Credit Percentage of Expenditures to Allocated (expressed in SDR) be Financed (inclusive of Taxes) (1) Eligible Expenditure 54,880,000 100% Programs under Part I of the Project (2) Goods, non-consulting 10,520,000 100% services, consultants' services (including audits), Training and The World Bank Group: No. 57, Pyay Road, 6%' Mile, Hiaing Township. Yangon, Myanmar Telephone: (95) 1 654824, Facsimile: (95) 1 654825, www woridbank.ora Workshops, and Operating Costs under Part 2 of the Project (3) Emergency Expenditures 0 100% under Part 3 of the Project TOTAL AMOUNT 65,400,000 3. Section IV.B.5 of Schedule 2 to the Financing Agreement shall be amended to read as follows: "5. The Closing Date is March 31, 2021." 4. Schedule 4 to the Financing Agreement shall be amended to read as set forth in the Attachment to this letter. 5. The definition of "Fiscal Year" in paragraph 17 of the Appendix to the Financing Agreement shall be amended to read as follows: "17. "Fiscal Year" and the acronym "FY" mean the Recipient's fiscal year, which commences on April I and closes on March 31 of each year in respect of FYs 2015/2016, 2016/2017 and 2017/2018, and which commences on October 1 and closes on September 30 of each year in respect of FY 2018/2019." Except as specifically amended by this letter, all other provisions of the Financing Agreement shall remain unchanged and in full force and effect. Please confirm your agreement with the amendments set out above countersigning the enclosed copy of this letter. Upon receipt by the Association of the countersigned copy of this letter, the amendments shall become effective as of the date of countersignature. Very truly yours, Ellen A. Goldstein Country Director, Myanmar, Cambodia, Lao PDR East Asia and Pacific Region Tel: +95 (1) 654 825 Fax: +95 (1) 654 825 AGREED: REPUBLIC OF THE UNION OF MYANMAR By: S,_____Wki Authorized Representative Name: (Si SiRYone ) Title: DkQ-crgeni- Date: Treasury Department Ministry of Planning and Finance Tel: +95 (1) 654 825 Fax: +95 (1) 654 825 Attachment REVISED SCHEDULE 4 Disbursement Linked Indicators with DLI Tar,ets and DLI Values DLIs FY 2015/2016 FY 2016/2017 FY 2017/2018 FY 2018/2019 DLI 1: Number of DLI Target: 50 DLI Target: 100 DL Target: 140 DLI Target: 180 Townships in which the Township hospital and at least 60% of the other DLI Value: DLI Value: DLI Value: DLI Value: Health Facilities have SDR 2,610,000 SDR 2,610,000 SDR 2,610,000 SDR 2,610,000 met a minimum Readiness Level of 14 out of 20 to provide essential maternal, neonatal and child health services DLI 2: Number of DLI Target: 50 DLI Target: 100 DLI Target: 140 DLI Target: 180 Townships in which the Township hospital and at least 80% of the other DLI Value: DLI Value: DLI Value: DLI Value: Health Facilities have SDR 2,610,000 SDR 2,610,000 SDR 2,610,000 SDR 2,610,000 received Health Facility Grants in accordance with the Project Operations Manual DLI 3: Number of DLI Target: 50 DLI Target: 100 DLI Target: 140 DLI Target: 180 Townships in which at least 80% of the required number of DLI Value: DLI Value: DLI Value: DLI Value: antenatal and postnatal SDR 1,960,000 SDR 1,960,000 SDR 1,960,000 SDR 1,960,000 visits and deliveries I I_I_I Tel: +95 (1) 654 825 Fax: +95 (1) 654 825 H.E. U Soe Win -5- Disbursement Linked Indicators with DLI Targets and DLI Values DLIs FY 2015/2016 FY 2016/2017 FY 2017/2018 FY 2018/2019 have been carried out by basic health staff in accordance with the Project Operations Manual DLI 4: Number of DLI Target: 50 DLI Target: 100 DLI Target: 140 DLI Target: 180 Townships in which the Township Health Departments have DLI Value: DLI Value: DLI Value: DLI Value: prepared an annual SDR 1,310,000 SDR 1,310,000 SDR 1,310,000 SDR 1,310,000 integrated and inclusive Township Health Plan in accordance with the Project Operations Manual and the CEPF DLI 5: Number of DLI Target: 50 DLI Target: 100 DLI Target: 140 DLI Target: 180 Townships in which all rural health centers and at least 50% of rural DLI Value: DLI Value: DLI Value: DLI Value: health sub-centers have SDR 1,960,000 SDR 1,960,000 SDR 1,960,000 SDR 1,960,000 been supervised at least twice in the Fiscal Year by Township Health Department medical officers using the supervision checklist in Tel: +95 (1) 654 825 Fax: +95 (1) 654 825 H.E. U Soe Win -6- Disbursement Linked Indicators with DLI Tar ets and DLI Values DLIs FY 20152016 FY 2016/2017 FY 20172018 FY 2018/2019 the Project Operations Manual DLI 6: Number of DLI Target: 50 DLI Target: 100 DLI Target: 140 DLI Target: 180 Townships in which the Township Health Departments have been DLI Value: DLI Value: DLI Value: DLI Value: supervised at least twice SDR 1,310,000 SDR 1,310,000 SDR 1,310,000 SDR 1,310,000 in the Fiscal Year by State/Region Health Department officials using the supervision checklist in the Project Operations Manual DLI 7: Number of DLI Target: 50 DLI Target: 100 DLI Target: 140 DLI Target: 180 Townships in which at least 60% of midwives have been trained to DLI Value: DLI Value: DLI Value: DLI Value: deliver basic emergency SDR 1,960,000 SDR 1,960,000 SDR 1,960,000 SDR 1,960,000 obstetric and neonatal care and integrated management of childhood illnesses Tel: +95 (1) 654 825 Fax: +95 (1) 654 825