According to bank documents, the project objective is is to increase the utilization and the quality of health care services in target provinces and municipalities.

US$80.0 million of the total AF financing of US$145.0 million will return to Component 1 and 2 to finance original activities as outlined in the HSPSP Project Appraisal Document.

1. Component 1 provides financing for the delivery of health services which includes: (i) inputs such as equipment, supplies, and mobile health team visits, and (ii) capacity building for provincial and municipal health workers to better manage, supervise, and provide quality control of maternal and child health services provided at different levels of health care, based on norms and guidelines. To complement service delivery, this component also supports key actions to strengthen local governance of the health system by: (i) incentivizing managers to maintain and implement health system maps (mapas sanitários) in the targeted provinces and municipalities, (ii) developing an enabling environment for the implementation of hospital waste management system in additional target provinces of the project, duplicating the national plans for management of environmental and hospital waste for the Province of Luanda, and (iii) review of existing citizen engagement mechanisms to define an approach that helps clients provide feedback which in turn can be used to improve services.

2. Component 2 supports institutional strengthening across the national health system including the strengthening of the national School of Public Health. The US$30 million financing made available under CERC2 was the original allocation for the school of public health. This school of public health activity is advancing and on track for disbursement in year 3-4 of the project, but the amount allocated to the school of public health was made available for an immediate CERC2. Component 2 will also be amended to allow financing to support large endemic disease programs, such as, HIV, malaria, and tuberculosis. This will be extremely important in light of the dual impact of COVID19 pandemic on both the morbimortality of these three health priorities as well as in the inevitable decrease of public health financing that was highlighted above. GoA, through the Minister of Health, formally requested financial support to procure HIV drugs (anti-retroviral drugs (ARVs)). Considering the economic crisis experienced both globally and in Angola due to the COVID19 pandemic, such requests are likely to continue in the near future and therefore the public health directorate will need continued financial support to ensure effective program implementation. Through this additional funding the vertical programs will receive support to develop and implement Annual Action plans, including but not limited to: procurement of drugs and other related health commodities, development of integrated supply chain plans at CECOMA, technical assistance in terms of program management and trainings.

3. The new AF resources of US$65 million will be allocated to a new component 5 (US$50 million) to provide high-impact nutrition services and to component 4 (US$15 million) in support of institutional capacity building and project management. Of the US$65 million, a total of US$50 million will be allocated to a new component 5 to address the national chronic malnutrition crisis in Angola and will be focused in three areas. The first being for scaling up the performance-based financing scheme being piloted under HSPSP to performance-focused nutrition services in the provinces with the highest rates of chronic malnutrition. The second area would focus on preventing chronic malnutrition at the community and household level. The third area would support multisectoral coordination for food security and nutrition programs and activities. The balance of the US$65 million, US$15.0 million, will be allocated to component 4 in support of institutional capacity building and project management. Under the parent project, which began with a total financing of US$110 million, a total of US$10 million was allocated to support institutional capacity building and project management following the World Bank recommendations to maintain a 10% allocation of the total financing envelope for project management. The two AFs, shown in Table 1, require enhancing the government
   institutional capacity to address a multi-sectoral national challenge of chronic malnutrition, and on the other hand, increased project management to maintain a strong pace of implementation of an increased work program. The specific activities to address chronic malnutrition to be supported with the new resources of US$50.0 million are described below.

World Bank:
Carmen Carpio
Senior Health Specialist

Borrower:
Republic of Angola
Nicola Lemos de Mvuayi
Director
nicola.mvuayi@minfin.gov.ao

Implementing Agency:
Ministry of Health
Antonio Zacarias Costa
Director Gabinete de Estudos, Planeamento e Estatística (GEP
ngaveia.felix@gmail.com 

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