Public Disclosure Copy The World Bank Implementation Status & Results Report Health Sector Support Project (P160846) Health Sector Support Project (P160846) SOUTH ASIA | Bangladesh | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2018 | Seq No: 2 | ARCHIVED on 05-Apr-2018 | ISR31607 | Implementing Agencies: Ministry of Health and Family Welfare, People's Republic of Bangladesh Key Dates Key Project Dates Bank Approval Date:28-Jul-2017 Effectiveness Date:02-Oct-2017 Planned Mid Term Review Date:14-Feb-2020 Actual Mid-Term Review Date:-- Original Closing Date:31-Dec-2022 Revised Closing Date:31-Dec-2022 Project Development Objectives Project Development Objective (from Project Appraisal Document) The Project Development Objective (PDO) is to strengthen the health, nutrition and population (HNP) sector's core management systems and delivery of essential HNP services with a focus on selected geographical areas. Has the Project Development Objective been changed since Board Approval of the Project Objective? No PHRPDODEL Components Name Component 1. Governance and Stewardship:(Cost $175.00 M) Component 2. Health, Nutrition and Population Systems Strengthening:(Cost $369.50 M) Component 3. Provision of Quality Health, Nutrition and Population Services:(Cost $555.50 M) 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 Implementation Status and Key Decisions 4/5/2018 Page 1 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Health Sector Support Project (P160846) The project was approved by the Board of Executive Directors of the World Bank Group on July 28, 2017 and made effective on October 2, 2017. The project supports the Ministry of Health and Family Welfare (MOHFW)'s fourth health, nutrition and population sector program which covers the period 2017-22 and has a planned total budget of US$14.7 billion, most of which will be financed from domestic sources. The project provides a platform for pooled co-financing of the government’s sector program based on the achievement of pre-defined results in the areas of governance and stewardship, health systems strengthening and delivery of quality HNP services particularly in the regions of Sylhet and Chittagong. A first disbursement of US$36 million has been made following verification of results in the areas of planning and budgeting, procurement reform and development of an adolescent health program. Along with support from the International Development Association (IDA), the project includes co-financing from the Global Financing Facility, Sweden and the Netherlands. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance  Substantial  Substantial  Substantial Macroeconomic  Moderate  Moderate  Moderate Sector Strategies and Policies  Moderate  Moderate  Moderate Technical Design of Project or Program  Moderate  Moderate  Moderate Institutional Capacity for Implementation and Sustainability  Moderate  Moderate  Moderate Fiduciary  High  High  High Environment and Social  Moderate  Moderate  Moderate Stakeholders  Substantial  Substantial  Substantial Other  --  --  -- Overall  Substantial  Substantial  Substantial Results Project Development Objective Indicators PHINDPDOTBL  Increase in the number of Community Clinics providing complete essential data on service delivery, including gender- disaggregated (DLI 8) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 7,000.00 Date 30-Jun-2017 -- 19-Feb-2018 31-Dec-2022 Comments This DLR is not due until June 2018. 4/5/2018 Page 2 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Health Sector Support Project (P160846) PHINDPDOTBL  Increase in the number of Upazila Health Complexes with at least 2 accredited diploma midwives (DLI 7) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 150.00 Date 30-Jun-2017 -- 19-Feb-2018 31-Dec-2022 Comments The recruitment process for the first batch of midwives is underway. PHINDPDOTBL  Increase in the number of normal deliveries in public health facilities in Sylhet and Chittagong divisions (DLI 10) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 128,805.00 -- -- 146,000.00 Date 30-Jun-2017 -- 19-Feb-2018 31-Dec-2022 Comments MOHFW has reported 128,960 deliveries in CY2017. This is to be verified by IMED. PHINDPDOTBL  Increase in the number of District Hospitals with improved capacity to provide comprehensive emergency obstetric and neonatal care (CEmONC) services in Sylhet and Chittagong divisions (DLI 11) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- -- 10.00 Date 30-Jun-2017 -- 19-Feb-2018 31-Dec-2022 4/5/2018 Page 3 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Health Sector Support Project (P160846) Comments The project aims to maintain and increase the number of hospitals with a capacity to deliver CEmONC services. MOHFW reports that 5 District Hospitals had CEmONC capacity in the two divisions in FY17. This is to be verified by IMED. PHINDPDOTBL  Increase in the percentage of registered children aged under 2 years receiving specified nutrition services in Sylhet and Chittagong divisions (DLI 14) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- -- 35.00 Date 30-Jun-2017 -- 19-Feb-2018 31-Dec-2022 Comments This indicator has not yet been reported by MOHFW. Overall Comments Intermediate Results Indicators PHINDIRITBL  Annual GRS performance report for previous CY is published (DLI 1) (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value N -- N Y Date 30-Jun-2017 -- 19-Feb-2018 31-Dec-2022 Comments This DLR is not due until June 2020. 4/5/2018 Page 4 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Health Sector Support Project (P160846) PHINDIRITBL  Increase in percentage from FY16 baseline in repair and maintenance expenditure at the levels of Upazila and below (DLI 2) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 100.00 Date 30-Jun-2017 -- 19-Feb-2018 31-Dec-2022 Comments This DLR is not due until June 2018. PHINDIRITBL  MOHFW FMAU completes internal audit for the previous fiscal year (DLI 3) (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value N -- N Y Date 30-Jun-2017 -- 19-Feb-2018 31-Dec-2022 Comments This DLR is not due until June 2021. PHINDIRITBL  Increase in the number of district-level referral facilities in which AMS is implemented (DLI 4) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 1.00 -- -- 15.00 Date 30-Jun-2017 -- 19-Feb-2018 31-Dec-2022 Comments MOHFW reports that AMS was implemented in 1 District Hospital in FY17. This is to be verified by IMED. 4/5/2018 Page 5 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Health Sector Support Project (P160846) PHINDIRITBL  Increase in percentage of NCTs using e-GP issued by MOHFW (DLI 5) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 75.00 Date 30-Jun-2017 -- 19-Feb-2018 31-Dec-2022 Comments This DLR is not due until June 2020, and is under process with the MOHFW having initiated e-GP (at least one tender notice has been published using the e-GP system). PHINDIRITBL  MOPA approves CMSD restructuring proposal (DLI 6) (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value N -- N Y Date 30-Jun-2017 -- 19-Feb-2018 31-Dec-2022 Comments This DLR is not due until June 2020. PHINDIRITBL  Increase in percentage of targeted public health facilities meeting readiness criteria for delivery of PPFP services in Sylhet and Chittagong divisions, reported for the previous CY (DLI 9) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 35.00 Date 30-Jun-2017 -- 19-Feb-2018 31-Dec-2022 Comments This DLR is not due until June 2019. 4/5/2018 Page 6 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Health Sector Support Project (P160846) PHINDIRITBL  Increase in the number of districts reaching at least 85% coverage of measles-rubella vaccination among children aged 0-12 months in Sylhet and Chittagong divisions (DLI 12) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 14.00 -- -- 15.00 Date 30-Jun-2017 -- 19-Feb-2018 31-Dec-2022 Comments The project aims to support consistently high and equitable routine immunization coverage in the two Divisions, where coverage at the district levels has been variable. MOHFW reports that 15 districts achieved at least 85% coverage in CY17. This is to be verified by IMED. PHINDIRITBL  Increase in the percentage of registered pregnant women receiving specified maternal nutrition services in Sylhet and Chittagong divisions, reported for the previous CY (DLI 13) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 25.00 Date 30-Jun-2017 -- 19-Feb-2018 31-Dec-2022 Comments This DLR is due in June 2018. PHINDIRITBL  Increase in percentage of registered infants and children aged under 2 years receiving specified nutrition services in Sylhet and Chittagong divisions, reported for the previous CY (DLI 14) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 35.00 Date 30-Jun-2017 -- 19-Feb-2018 31-Dec-2021 Comments Data not yet available. 4/5/2018 Page 7 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Health Sector Support Project (P160846) PHINDIRITBL  Orientation of teachers and peer girl students is completed in at least 30% of public secondary schools in each targeted district in Sylhet and Chittagong divisions (DLI 15) (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value N -- N Y Date 30-Jun-2017 -- 19-Feb-2018 31-Dec-2022 Comments This DLR is not due until June 2021. PHINDIRITBL  Assessment is completed of hypertension diagnosis and referral services at the primary level in at least 2 Upazilas (DLI 16) (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value N -- N Y Date 30-Jun-2017 -- 19-Feb-2018 31-Dec-2022 Comments This DLR is not due until June 2022. PHINDIRITBL  People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 1,652,603.00 7,805,455.00 Date 31-Dec-2016 -- 31-Dec-2017 31-Dec-2021 Comments Actual (Current) and End Target are cumulative figures for the period CY17-CY21. End Targets have been revised, correcting errors in the PAD. The Actual (Current) figures provided in this ISR are for CY17. People who have received essential health, nutrition, and population (HNP) services = number of women receiving Vitamin A + number of children immunized (measles) (in Sylhet and Chittagong Divisions) People who have received essential health, nutrition, and population (HNP) services - Female = number of women receiving vitamin A + 50.5% of the number of children immunized (measles) (in Sylhet and Chittagong Divisions) Number of children immunized = number of children under 5 years who received measles immunization (in Sylhet and Chittagong Divisions) 4/5/2018 Page 8 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Health Sector Support Project (P160846) Number of women and children who have received basic nutrition services = Number of women who received Vitamin A dose + number of women who reported complementary feeding of their children (in Sylhet and Chittagong Divisions) Number of deliveries attended by skilled health personnel = Number of deliveries at public health facilities (in Sylhet and Chittagong Divisions) PHINDIRITBL  People who have received essential health, nutrition, and population (HNP) services - Female (RMS requirement) (Number, Corporate Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 1,079,073.00 5,029,254.00 PHINDIRITBL  Number of children immunized (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 1,147,060.00 5,608,505.00 Date 30-Jun-2017 -- 31-Dec-2017 31-Dec-2021 PHINDIRITBL  Number of women and children who have received basic nutrition services (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 562,865.00 3,314,070.00 Date 30-Jun-2017 -- 31-Dec-2017 31-Dec-2021 4/5/2018 Page 9 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Health Sector Support Project (P160846) PHINDIRITBL  Number of deliveries attended by skilled health personnel (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 128,960.00 385,580.00 Date 30-Jun-2017 -- 31-Dec-2017 31-Dec-2021 Overall Comments Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed Disbursed P160846 IDA-61270 Effective USD 500.00 500.00 0.00 35.83 488.18 6.8% P160846 TF-A4355 Effective USD 15.00 15.00 0.00 0.00 15.00 0% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P160846 IDA-61270 Effective 28-Jul-2017 28-Aug-2017 02-Oct-2017 31-Dec-2022 31-Dec-2022 P160846 TF-A4355 Effective 28-Jul-2017 28-Aug-2017 02-Oct-2017 31-Dec-2021 31-Dec-2021 Cumulative Disbursements 4/5/2018 Page 10 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Health Sector Support Project (P160846) Restructuring History There has been no restructuring to date. Related Project(s) There are no related projects. 4/5/2018 Page 11 of 11 Public Disclosure Copy