Additional Financing to Health System Efficiency and Resilience Project

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In response to the humanitarian emergency in Gaza and the continued need to strengthen the resilience of the health system in West Bank, this proposed restructuring and AF mobilizes urgent financing for priority emergency and early recovery activities, while maintaining the principles and the initial component design of the parent project. The parent project was designed at a point where catalytic investments were needed across Gaza and West Bank to improve access to high quality care, efficiency of health services, and resilience of service delivery. Investments within the scope of the parent project were selected to reduce the reliance on costly outside medical referrals (OMR) which posit access and financing barriers, and instead to strengthen integration of services for NCD through a patient-centered approach; to improve technical efficiency of hospital services through provision of effective, lower-cost services at public hospitals; and to improve the capacity of service delivery at all levels given the health system’s vulnerability to shocks. Given the eruption of the conflict four months into the effectiveness of the project, almost none of the initially planned activities have been implemented, with the changes described in section I-B implying most of the funds planned for initially designed activities were allocated to emergency response. Through three recipient-executed trust fund grants, the proposed AF will therefore a) finance the scale up of project activities across the first two components to support emergency and early recovery efforts to ensure the continuity of health service delivery, with required changes to sub-component design based on the context; and b) introduce a new component to strengthen the quality, efficiency, and resiliency of public health and PPR services. Financing gaps are included to provide a platform for scaling project interventions to respond to substantial needs. Original project design is therefore retained at the component level, with the first component continuing to support cost-effective primary health care services, and the second component focusing on public hospital service delivery; as described in the subsequent paragraphs, sub-component design and activities are modified to respond to the current crisis. A third component is added to strengthen public health functions, pandemic preparedness, prevention, and response.