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Public Disclosure Authorized AFRICA Burundi Health, Nutrition & Population Global Practice IBRD/IDA Investment Project Financing FY 2017 Seq No: 2 ARCHIVED on 20-Dec-2017 ISR29199 Implementing Agencies: Ministry of Health, Ministry of Health, Ministry of Health, Ministry of Health, MINISTRY OF FINANCE Public Disclosure Authorized Key Dates Key Project Dates Bank Approval Date:24-Feb-2017 Planned Mid Term Review Date:-- Original Closing Date:30-Jun-2021 Project Development Objectives Effectiveness Date:20-Jun-2017 Actual Mid-Term Review Date:-- Revised Closing Date:30-Jun-2021 Public Disclosure Authorized Project Development Objective (from Project Appraisal Document) To increase the use of quality Reproductive, Maternal, Neonatal, Child and Adolescent Health services, and, in the event of an Eligible Crisis or Emergency, to provide immediate and effective response to said Eligible Crisis or Emergency. Has the Project Development Objective been changed since Board Approval of the Project Objective? No PHRPDODEL Components Name Use of Performance-based Payments to Support the Recipient's Free Health Care (FHC) Program:(Cost $40.60 M) Public Disclosure Authorized Implementation Support for the FHC program-related activities:(cost $8.40 M) Strengthening of Newly Integrated FHC Program Service Providers through financing of minor investments/renovations works for CHWs and nursing training schools:(cost $1.00 M) Contingency Emergency Response Component (CERC) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Satisfactory Satisfactory Overall Risk Rating Substantial Substantial 12/20/2017 Page 1 of 8

Implementation Status and Key Decisions The KIRA project was approved on February 24, 2017 and became effective June 20, 2017. After creating the Designated Accounts, disbursement started on September 4th, 2017 and allowed PBF transfers for the payment of health facilities (for July 2017 performance) along with salary payments for project staff and operational costs. An official launch of the KIRA project was organized on September 13th, 2017 in presence of the Minister of Health. The launch was the occasion to report on achievements of the previous project (Health Sector Development Support-HSDSP) that ended in June 2017, on preliminary results of DHS and SARA surveys that were supported by HSDSP as well as to present the main components of the KIRA project to a large audience of stakeholders. The following activities have already been carried out: (i) Finalization of the Community PBF implementation manual;(ii) Development of a draft implementation schedule for the community PBF; (iii) Elaboration of a draft timetable for implementing contracting of key health programs and services at MOH central level. Moreover, refresher trainings related to changes in the PBF manual and associated tools are underway along with prerequisite activities related to community PBF. This includes legal process of CHW groupings (GASC); training of CHW and purchasing process of their work kits Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance High High High Macroeconomic Substantial Substantial Substantial Sector Strategies and Policies Moderate Moderate Moderate Technical Design of Project or Program Substantial Substantial Substantial Institutional Capacity for Implementation and Sustainability Substantial Substantial Substantial Fiduciary Substantial Substantial Substantial Environment and Social Moderate Moderate Moderate Stakeholders Moderate Moderate Moderate Other High High High Overall Substantial Substantial Substantial Results Project Development Objective Indicators People who have received essential Health, Nutrition, and Population (HNP) services (Children immunized; Women and children who have received basic nutrition services; Deliveries attended by skilled h (Number, Custom) Value 772,087.00 -- 806,168.00 4,259,006.00 12/20/2017 Page 2 of 8

Percentage of pregnant women who received four antenatal care visits within the first 28 gestational weeks (Percentage, Custom) Value 32.35 -- 38.00 51.00 National quality average score of district hospital (Percentage, Custom) Value 80.00 -- 82.50 85.00 Contraceptive prevalence rate for modern methods (Percentage, Custom) Value 38.00 -- 42.50 45.00 Contraceptive prevalence rate among adolescents (Percentage, Custom) 12/20/2017 Page 3 of 8

Value 1.50 -- 3.40 12.00 Overall Comments Intermediate Results Indicators Number visits to a health facility for Children under five years of age (Number, Custom) Value 2.20 -- 2.20 2.50 Date 01-Dec-2016 -- 30-Oct-2017 30-Jun-2021 Pregnant women receiving antenatal care during a visit to a health provider (number) (Number, Custom) Value 165,504.00 -- 163,619.00 903,254.00 Number of years-protection couples for modern methods (Number, Custom) Value 553,679.00 -- 550,865.00 3,066,611.00 12/20/2017 Page 4 of 8

Coverage of births attended by qualified personnel (Percentage, Custom) Value 77.30 -- 86.70 85.00 Number of pregnant women on ARV protocol for the prevention of mother-child transmission (Number, Custom) Value 3,885.00 -- 5,026.00 22,430.00 Percentage of Health Centers with Heads at level A2 (Percentage, Custom) Value 62.00 -- 63.00 83.00 Satisfaction rate of beneficiaries on health care delivered by health centers (Percentage, Custom) Value 99.00 -- 99.00 100.00 12/20/2017 Page 5 of 8

Percentage of public health facilities that offer FHC and use RBF (Percentage, Custom) Value 97.00 -- 97.50 99.00 Number of new Family Planning acceptors referred by Community Health Workers and who arrived at the health center (Number, Custom) Value 0.00 -- 0.00 499,137.00 Number of pregnant women referred for early antenatal care ANC1 (TRIM1) (Number, Custom) Value 0.00 -- 0.00 210,745.00 Total number of children aged 6-59 months tested and referred by community health workers for malnutrition (Number, Custom) Value 0.00 -- 0.00 1,352,334.00 Date 30-Dec-2016 -- 30-Oct-2017 30-Jun-2021 Overall Comments 12/20/2017 Page 6 of 8

Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed Disbursed P156012 IDA-D1660 Effective USD 50.00 50.00 0.00 3.37 49.17 7% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P156012 IDA-D1660 Effective 24-Feb-2017 23-Mar-2017 20-Jun-2017 30-Jun-2021 30-Jun-2021 Cumulative Disbursements Restructuring History There has been no restructuring to date. Related Project(s) 12/20/2017 Page 7 of 8

There are no related projects. 12/20/2017 Page 8 of 8