According to bank documents, the original project objective is to increase coverage of key maternal and child health interventions in targeted rural districts consistent with the Recipient's ongoing health initiatives.

The current project objective is to increase coverage and quality of key health interventions with an emphasis on MCH services in targeted rural and urban districts and strengthen capacity for results-based financing contract management, consistent with the Recipients’ ongoing health initiatives.

The proposed fifth Additional Financing to the Health Sector Development Support Project (AF V) will continue to support the three current project components with some adjustments in scope and will introduce a COVID-19 emergency response component. Support will include measures to improve coverage and quality, and strengthen implementation capacity to manage performance-based contracts, building on lessons learnt from implementation and assessments of RBF. Experiences of other countries and available evidence informed the design of the COVID-19 response component.

The following changes are proposed as part of AF V:

1. Expand the PDO to support the COVID-19 emergency response while improving coverage and quality of essential RMNCAH-N interventions and institutional capacity for RBF contract management;
2. Include a new component, “Component 2: COVID-19 Emergency Response,” with a cost of US$5 million;
3. Extend the AF IV grant implementation period from June 30, 2020 to September 30, 2020 and overall project implementation period to April 30, 2023;
4. Revise the Results Framework to reflect changes in the PDO, expanded project scope and implemenation period, as well as improve the measurement of results by rationalizing and reducing the number of outcome and intermediate outcome indicators;
5. Adjust delivery of essential RMNCAH-N services and RBF approach to reduce infection risks from COVID-19;
6. Refocus RBF in provincial hospitals to be quality oriented and pilot (a) quality-focused RBF in central hospitals together with (b) community-mobilization RBF;
7. Scale-up the urban voucher scheme for poor pregnant women to more health facilities, include vitamin A supplementation for their 6-59 months old children and provide post exposure prophylaxis (PEP) for sexual, gender-based violence affected Urban Voucher (UV) program beneficiaries and their children;
8. Allow for simplified procurement procedures in accordance with the Bank Guidance: Procurement in Situations of Urgent need of Assistance or Capacity Constraints, dated March 7, 2019, and include Handson Extended Implementation Support and the option of using Bank Facilitated Procurement;
9. Strengthen Project Implementation Entity (PIE) staffing to reflect increased scope and activities; and
10. Adjust the economic and technical analysis to reflect changes in Project scope and implementation period.

World Bank:
Christine Lao Pena
Senior Human Development Economist

Borrower:
Republic of Zimbabwe
Mr. George T. Guvamatanga
Permanent Secretary, Finance & Economic Development
mmakuwz@gmail.com

Implementing Agency:
Stichting Cordaid
Ms. Inge Barmentlo
Manager for Health Care
Inge.Barmentlo@cordaid.org 

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