INTEGRATED SAFEGUARDS DATA SHEET RESTRUCTURING STAGE Note: This ISDS will be considered effective only upon approval of the project restructuring Public Disclosure Copy Report No.: ISDSR8248 Date ISDS Prepared/Updated: 15-Aug-2014 Date ISDS Approved/Disclosed: 09-Oct-2014 I. BASIC INFORMATION 1. Basic Project Data Country: Egypt, Arab Republic of Project ID: P080228 Project Name: Health Insurance Systems Development Project (P080228) Task Team Alaa Mahmoud Hamed Abdel- Leader: Estimated 26-Oct-2009 Estimated 21-Dec-2009 Appraisal Date: Board Date: Managing Unit: GHNDR Lending Specific Investment Loan Instrument: Sector: Compulsory health finance (93%), Public administration- Health (7%) Theme: Health system performance (100%) Is this project processed under OP 8.50 (Emergency Recovery) or OP 8.00 (Rapid Response to Crises and No Emergencies)? Financing (in USD Million) Public Disclosure Copy Total Project Cost: 76.00 Total Bank Financing: 75.00 Financing Gap: 0.00 Financing Source Amount Borrower 1.00 International Bank for Reconstruction and Development 75.00 Total 76.00 Environmental C - Not Required Category: Is this a No Repeater project? 2. Current Project Development Objectives The Project Development Objective is to establish a proven business model for health insurance operations and management that will encompass formalized business processes, a functioning operation and management information system; and the c orresponding operational and management skills in three governorates of Egypt. Page 1 of 4 Proposed New PDO (from Restructuring Paper) The Project Development Objective is to establish a proven business model for health insurance operations and management that will encompass formalized business Public Disclosure Copy processes, a functioning operation and management information system; and the c orresponding operational and management skills in three governorates of Egypt. 3. Project Description The Government has requested that the project focus on improvement of the quality of healthcare in publicly operated health facilities as a prerequisite for eligibility for entering into contractual agreement with the soon-to-be-established social health insurance fund. Improving quality of care will entail, first and foremost, independent accreditation of health facilities to meet recognized service quality standards. The latter is also expected to lead to improved patient satisfaction, as well as patient safety, including prevention and control of viral hepatitis, a major public health problem in Egypt as a result of unhygienic and unsafe injection practices. Component One: Family Healthcare Quality Improvement Program (US$70m). This component will fund Quality Improvement and Maintenance Plans (QIMP) that support each participating health center undertake a phased process of instituting quality improvements, and that culminates in independently certified accreditation. Targeting 1,000 family health centers and family healthcare units in ten governorates, the accreditation program is intended to bring the quality of care of these facilities up to appropriate internationally recognized quality standards and to enhance system responsiveness at the family health center/family healthcare unit level. Component Two Implementation Support (US$5m). This component will finance the cost of technical assistance, external financial audits, external independent quality audits and project management. 4. Project location and salient physical characteristics relevant to the safeguard analysis (if known) Public Disclosure Copy The project, as restructured, is now directly pro-poor in its design as it will target the poorest governorates in Egypt: Aswan, Qena, Luxor, Sohag, Assiut, Minia, Beni Suif, Giza, Sharkya, and Beheira comprising the poorest 1000 villages (one health facility per village) as defined by CAPMAS (the national statistical body of Egypt). 5. Environmental and Social Safeguards Specialists Banu Setlur (GENDR) Amal Nabil Faltas Bastorous (GSURR) 6. Safeguard Policies Triggered? Explanation (Optional) Environmental Assessment OP/ No BP 4.01 Natural Habitats OP/BP 4.04 No Forests OP/BP 4.36 No Pest Management OP 4.09 No Page 2 of 4 Physical Cultural Resources OP/ No BP 4.11 Public Disclosure Copy Indigenous Peoples OP/BP 4.10 No Involuntary Resettlement OP/BP No 4.12 Safety of Dams OP/BP 4.37 No Projects on International No Waterways OP/BP 7.50 Projects in Disputed Areas OP/BP No 7.60 II. Key Safeguard Policy Issues and Their Management A. Summary of Key Safeguard Issues 1. Describe any safeguard issues and impacts associated with the Restructured project. Identify and describe any potential large scale, significant and/or irreversible impacts: NA 2. Describe any potential indirect and/or long term impacts due to anticipated future activities in the project area: NA 3. Describe any project alternatives (if relevant) considered to help avoid or minimize adverse impacts. NA 4. Describe measures taken by the borrower to address safeguard policy issues. Provide an Public Disclosure Copy assessment of borrower capacity to plan and implement the measures described. NA 5. Identify the key stakeholders and describe the mechanisms for consultation and disclosure on safeguard policies, with an emphasis on potentially affected people. NA B. Disclosure Requirements If the project triggers the Pest Management and/or Physical Cultural Resources policies, the respective issues are to be addressed and disclosed as part of the Environmental Assessment/ Audit/or EMP. If in-country disclosure of any of the above documents is not expected, please explain why: The project is classified C, and thus no safeguards instruments were prepared. C. Compliance Monitoring Indicators at the Corporate Level The World Bank Policy on Disclosure of Information Have relevant safeguard policies documents been sent to the Yes [ ] No [ ] NA [ ] World Bank's Infoshop? Page 3 of 4 Have relevant documents been disclosed in-country in a public Yes [ ] No [ ] NA [ ] place in a form and language that are understandable and accessible to project-affected groups and local NGOs? Public Disclosure Copy All Safeguard Policies Have satisfactory calendar, budget and clear institutional Yes [ ] No [ ] NA [ ] responsibilities been prepared for the implementation of measures related to safeguard policies? Have costs related to safeguard policy measures been included Yes [ ] No [ ] NA [ ] in the project cost? Does the Monitoring and Evaluation system of the project Yes [ ] No [ ] NA [ ] include the monitoring of safeguard impacts and measures related to safeguard policies? Have satisfactory implementation arrangements been agreed Yes [ ] No [ ] NA [ ] with the borrower and the same been adequately reflected in the project legal documents? III. APPROVALS Task Team Leader: Alaa Mahmoud Hamed Abdel- Approved By Regional Safeguards Name: Nina Chee (RSA) Date: 09-Oct-2014 Coordinator: Practice Manager/ Name: Date: Manager: Public Disclosure Copy Page 4 of 4