Additional Financing- CAR Health Service Delivery and System Strengthening Project

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The project supports the government’s effort to improve the delivery of essential health services and strengthen the country’s health system. The project is fully aligned with the strategic priorities of the National Health Development Plan III and build on the gains made under the predecessor project SENI while ensuring complementarity with other health sector engagements and beyond. The project aims to support the government in its effort to attain Universal Health Coverage by: (i) continuing support to delivery of essential quality health services at health facilities and extending its reach to communities; (ii) providing holistic support to gender based violence (GBV) survivors. The project will further strengthen the various pillars of the health system through: (iii) developing a functional national health supply chain; (iv) supporting targeted investments to improve hospital capacity especially at subnational levels; (v) supporting sectoral reforms in the areas of human resources for health, health management information systems (HMIS) and performance measurement, and public financial management. The project will further help the country prepare for future pandemics and emerging diseases by integrating these activities as part of health system strengthening. Component 1 seeks to: (i) continue the delivery of essential health services and support the government's provision of Targeted Free Health care through use of an adapted performance-based financing delivery model; (ii) support the delivery of community-level interventions by financing a basic package of services delivered by community health workers, and (iii) provide holistic support to GBV survivors in target districts. Component 2 will address critical bottlenecks to a functioning health system in CAR. A first set of investments will directly facilitate the delivery of essential services to women and children by accelerating the development of a functional national health supply chain (2.1) and through targeted investments to equip and conduct rehabilitation in priority hospitals outside of the capital region (2.2). The project will also support selected government reforms that are key to moving towards a stronger and sustainable health system, while ensuring the performance and sustainability of the project’s investment is met. This component will further contribute to building a sustainable and resilient health system (2.3) that is prepared to respond to future pandemics and emerging diseases (2.4). Component 3 will help ensure effective and efficient technical and fiduciary management and implementation of the project. The component will support project implementation through the financing of (i) operating costs, training, and equipment; (ii) paying salaries of international and national consultants; (iii) audits and communications, and (iv) implementation and monitoring of environmental and social standards as well as project results indicators. The Project Implementation Unit responsible for day-to-day management of the project will be the current PIU responsible for managing SENI, REDISSE IV and COVID-19 projects that will also assume the responsibilities of the implementation of the SENI-plus project. Component 4 is a Contingency Emergency Response Component (CERC) which will be included under the project in accordance with World Bank IPF Policy’ paragraphs 12 and 13, for projects in Situations of Urgent Need of Assistance or Capacity Constraints. This will allow for rapid reallocation of project proceeds in the event of a natural or man-made disaster or crisis that has caused, or is likely to imminently cause, a major adverse economic and/or social impact.