Public Disclosure Copy The World Bank Implementation Status & Results Report Health System Support Project ("KIRA") (P156012) Health System Support Project ("KIRA") (P156012) AFRICA | Burundi | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2017 | Seq No: 2 | ARCHIVED on 20-Dec-2017 | ISR29199 | Implementing Agencies: Ministry of Health, Ministry of Health, Ministry of Health, Ministry of Health, MINISTRY OF FINANCE Key Dates Key Project Dates Bank Approval Date:24-Feb-2017 Effectiveness Date:20-Jun-2017 Planned Mid Term Review Date:-- Actual Mid-Term Review Date:-- Original Closing Date:30-Jun-2021 Revised Closing Date:30-Jun-2021 Project Development Objectives Project Development Objective (from Project Appraisal Document) To increase the use of quality Reproductive, Maternal, Neonatal, Child and Adolescent Health services, and, in the event of an Eligible Crisis or Emergency, to provide immediate and effective response to said Eligible Crisis or Emergency. Has the Project Development Objective been changed since Board Approval of the Project Objective? No PHRPDODEL Components Name Use of Performance-based Payments to Support the Recipient's Free Health Care (FHC) Program:(Cost $40.60 M) Implementation Support for the FHC program-related activities:(Cost $8.40 M) Strengthening of Newly Integrated FHC Program Service Providers through financing of minor investments/renovations works for CHWs and nursing training schools:(Cost $1.00 M) Contingency Emergency Response Component (CERC) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO  Satisfactory  Satisfactory Overall Implementation Progress (IP)  Satisfactory  Satisfactory Overall Risk Rating  Substantial  Substantial 12/20/2017 Page 1 of 8 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Health System Support Project ("KIRA") (P156012) Implementation Status and Key Decisions The KIRA project was approved on February 24, 2017 and became effective June 20, 2017. After creating the Designated Accounts, disbursement started on September 4th, 2017 and allowed PBF transfers for the payment of health facilities (for July 2017 performance) along with salary payments for project staff and operational costs. An official launch of the KIRA project was organized on September 13th, 2017 in presence of the Minister of Health. The launch was the occasion to report on achievements of the previous project (Health Sector Development Support-HSDSP) that ended in June 2017, on preliminary results of DHS and SARA surveys that were supported by HSDSP as well as to present the main components of the KIRA project to a large audience of stakeholders. The following activities have already been carried out: (i) Finalization of the Community PBF implementation manual;(ii) Development of a draft implementation schedule for the community PBF; (iii) Elaboration of a draft timetable for implementing contracting of key health programs and services at MOH central level . Moreover, refresher trainings related to changes in the PBF manual and associated tools are underway along with prerequisite activities related to community PBF. This includes legal process of CHW groupings (GASC); training of CHW and purchasing process of their work kits Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance  High  High  High Macroeconomic  Substantial  Substantial  Substantial Sector Strategies and Policies  Moderate  Moderate  Moderate Technical Design of Project or Program  Substantial  Substantial  Substantial Institutional Capacity for Implementation and Sustainability  Substantial  Substantial  Substantial Fiduciary  Substantial  Substantial  Substantial Environment and Social  Moderate  Moderate  Moderate Stakeholders  Moderate  Moderate  Moderate Other  High  High  High Overall  Substantial  Substantial  Substantial Results Project Development Objective Indicators PHINDPDOTBL  People who have received essential Health, Nutrition, and Population (HNP) services (Children immunized; Women and children who have received basic nutrition services; Deliveries attended by skilled h (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 772,087.00 -- 806,168.00 4,259,006.00 Date 01-Jan-2016 -- 30-Oct-2017 30-Jun-2021 12/20/2017 Page 2 of 8 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Health System Support Project ("KIRA") (P156012) PHINDPDOTBL  Percentage of pregnant women who received four antenatal care visits within the first 28 gestational weeks (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 32.35 -- 38.00 51.00 Date 01-Jan-2016 -- 30-Oct-2017 30-Jun-2021 PHINDPDOTBL  National quality average score of district hospital (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 80.00 -- 82.50 85.00 Date 01-Jan-2016 -- 30-Oct-2017 30-Jun-2021 PHINDPDOTBL  Contraceptive prevalence rate for modern methods (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 38.00 -- 42.50 45.00 Date 01-Jan-2016 -- 30-Oct-2017 30-Jun-2021 PHINDPDOTBL  Contraceptive prevalence rate among adolescents (Percentage, Custom) 12/20/2017 Page 3 of 8 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Health System Support Project ("KIRA") (P156012) Baseline Actual (Previous) Actual (Current) End Target Value 1.50 -- 3.40 12.00 Date 01-Jan-2016 -- 30-Oct-2017 30-Jun-2021 Overall Comments Intermediate Results Indicators PHINDIRITBL  Number visits to a health facility for Children under five years of age (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 2.20 -- 2.20 2.50 Date 01-Dec-2016 -- 30-Oct-2017 30-Jun-2021 PHINDIRITBL  Pregnant women receiving antenatal care during a visit to a health provider (number) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 165,504.00 -- 163,619.00 903,254.00 Date 01-Jan-2016 -- 30-Oct-2017 30-Jun-2021 PHINDIRITBL  Number of years-protection couples for modern methods (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 553,679.00 -- 550,865.00 3,066,611.00 Date 01-Jan-2016 -- 30-Oct-2017 30-Jun-2021 12/20/2017 Page 4 of 8 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Health System Support Project ("KIRA") (P156012) PHINDIRITBL  Coverage of births attended by qualified personnel (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 77.30 -- 86.70 85.00 Date 01-Jan-2016 -- 30-Oct-2017 30-Jun-2021 PHINDIRITBL  Number of pregnant women on ARV protocol for the prevention of mother-child transmission (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 3,885.00 -- 5,026.00 22,430.00 Date 01-Jan-2016 -- 30-Oct-2017 30-Jun-2021 PHINDIRITBL  Percentage of Health Centers with Heads at level A2 (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 62.00 -- 63.00 83.00 Date 01-Jan-2016 -- 30-Oct-2017 30-Jun-2021 PHINDIRITBL  Satisfaction rate of beneficiaries on health care delivered by health centers (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 99.00 -- 99.00 100.00 Date 01-Jan-2016 -- 30-Oct-2017 30-Jun-2021 12/20/2017 Page 5 of 8 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Health System Support Project ("KIRA") (P156012) PHINDIRITBL  Percentage of public health facilities that offer FHC and use RBF (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 97.00 -- 97.50 99.00 Date 01-Jan-2016 -- 30-Oct-2017 30-Jun-2021 PHINDIRITBL  Number of new Family Planning acceptors referred by Community Health Workers and who arrived at the health center (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 499,137.00 Date 01-Jan-2016 -- 30-Oct-2017 30-Jun-2021 PHINDIRITBL  Number of pregnant women referred for early antenatal care ANC1 (TRIM1) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 210,745.00 Date 01-Jan-2016 -- 30-Oct-2017 30-Jun-2021 PHINDIRITBL  Total number of children aged 6-59 months tested and referred by community health workers for malnutrition (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 1,352,334.00 Date 30-Dec-2016 -- 30-Oct-2017 30-Jun-2021 Overall Comments 12/20/2017 Page 6 of 8 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Health System Support Project ("KIRA") (P156012) Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed Disbursed P156012 IDA-D1660 Effective USD 50.00 50.00 0.00 3.37 49.17 7% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P156012 IDA-D1660 Effective 24-Feb-2017 23-Mar-2017 20-Jun-2017 30-Jun-2021 30-Jun-2021 Cumulative Disbursements Restructuring History There has been no restructuring to date. Related Project(s) 12/20/2017 Page 7 of 8 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Health System Support Project ("KIRA") (P156012) There are no related projects. 12/20/2017 Page 8 of 8 Public Disclosure Copy