The World Bank Implementation Status & Results Report Senegal Health & Nutrition Financing (P129472) Senegal Health & Nutrition Financing (P129472) AFRICA | Senegal | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2014 | Seq No: 9 | ARCHIVED on 06-Sep-2018 | ISR33714 | Implementing Agencies: Ministry of Health and Prevention, Government of Senegal Key Dates Key Project Dates Bank Approval Date: 11-Dec-2013 Effectiveness Date: 14-May-2014 Planned Mid Term Review Date: 09-Jan-2017 Actual Mid-Term Review Date: 01-Jun-2017 Original Closing Date: 29-Jun-2018 Revised Closing Date: 30-Jun-2019 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The objective of the project is to increase utilization and quality of maternal, neonatal and child health and nutritional services, especially among the poorest households in Targeted Areas in the Recipient's territory. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name 1. Result-Based Financing for health and nutrition services and capacity building:(Cost $15.70 M) 2. Improvement of accessibility to maternal, nutrition, and children health services:(Cost $15.60 M) 3. Institutional strengthening and project implementation:(Cost $9.50 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Moderately Unsatisfactory Moderately Satisfactory Overall Implementation Progress (IP) Moderately Unsatisfactory Moderately Satisfactory Overall Risk Rating Substantial Substantial Implementation Status and Key Decisions Significant progress has been made on Project progress towards achievement of the PDO and overall implementation progress, justifying an upgrade from previous Moderately Unsatisfactorily to Moderately Satisfactorily. Performance of the project has been further strengthened over the last 6 months, confirming the positive trend since July 2017. On overall implementation progress, disbursements have increased from 35% in December 2017 (32% IDA; 17% TF) to 51%(68% IDA; 41% TF) in August 2018. And implementation of interventions under the different components of the Project has speed up. Under Component 1 (Supply Side Results Based Financing), the revised approach initiated in July 2017 is now being implemented (training of beneficiaries on the new approach, contracts signed with health facilities of the six targeted regions of the project, functionality of the RBF web- based portal, etc..) with a close monitoring by the Ministry of Health. However, it is still necessary to accelerate the verification of the results of 2nd 9/6/2018 Page 1 of 7 The World Bank Implementation Status & Results Report Senegal Health & Nutrition Financing (P129472) semester 2017 (revised contracts with Independent Verification Agencies and Community Based Organizations to be finalized by end of August) and assess the results of the new approach. Some delays have been encountered and the reason why this sub-component is rated Moderately Unsatisfactorily. Interventions under Component 2 (Increased financial accessibility) are implemented as planned with an acceleration following the recent restructuring (for universal health insurance and nutrition activities). The pilot to integrate free health care initiative into health insurance still needs to be implemented (planned in October). Interventions under Component 3 (Institutional strengthening and project coordination) have been implemented satisfactorily. On progress towards achievement of the PDO, with the one-year extension of the Project and restructuring of the Results Framework, two out of the six PDO indicators have already been achieved (severely malnourished detected children and index of quality of care) and the four others are progressing and targets should be achieved by June 2019. Additionally, one intermediary indicator already achieved its target, one surpassed it. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance -- Substantial Substantial Macroeconomic -- Substantial Substantial Sector Strategies and Policies -- Substantial Substantial Technical Design of Project or Program -- Moderate Moderate Institutional Capacity for Implementation and Sustainability -- Moderate Moderate Fiduciary -- Substantial Substantial Environment and Social -- Moderate Moderate Stakeholders -- Moderate Moderate Other -- Low Low Overall -- Substantial Substantial Results PDO Indicators by Objectives / Outcomes Increase utilization of maternal, neonatal and child health services IN00629140 ►Number of poor people reached by the project (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1,990,565.00 2,200,773.00 2,800,000.00 Date 01-Feb-2011 22-Dec-2017 30-Jun-2018 30-Jun-2019 IN00629141 9/6/2018 Page 2 of 7 The World Bank Implementation Status & Results Report Senegal Health & Nutrition Financing (P129472) ►New acceptors of modern contraceptive method (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 84,936.00 85,712.00 107,041.00 Date 05-Jun-2013 22-Dec-2017 30-Jun-2018 30-Jun-2019 IN00629147 ►Severly malnourished detected children who are referred and received at the health center for all necessary visits (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 4,945.00 7,136.00 6,745.00 Date 01-Feb-2011 22-Dec-2017 30-Jun-2018 30-Jun-2019 Increase quality of RMNACH services IN00629145 ►Percentage of pregnant women having 4 antenatal care visits (at standard quality) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 22.00 22.00 35.00 Date 01-Feb-2011 22-Dec-2017 22-Dec-2017 30-Jun-2019 Due to the ongoing strike of health workers in Senegal, there is a retention of health information which Comments: prevents to update this indicator with comprehensive data. IN00629143 ►Births (deliveries) attended by skilled health personnel (number) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 155,397.00 176,495.00 271,679.00 Date 01-Feb-2011 22-Dec-2017 29-Jun-2018 30-Jun-2019 Due to the ongoing strike of health workers in Senegal, there is a retention of health information which Comments: prevents to update this indicator with comprehensive data. IN00629148 ►Index of quality of health care (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 72.66 72.66 70.00 Date 01-Feb-2011 22-Dec-2017 22-Dec-2017 30-Jun-2019 Due to the revision of the RBF approach, the index of quality of care should be available in October 2018. Comments: Intermediate Results Indicators by Components 9/6/2018 Page 3 of 7 The World Bank Implementation Status & Results Report Senegal Health & Nutrition Financing (P129472) 1. Result-Based Financing for health and nutrition services and capacity building IN00629142 ►Number of health facilities that have an RBF contract (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 318.00 318.00 318.00 Date 01-Jul-2013 22-Dec-2017 29-Jun-2018 30-Jun-2019 IN00629150 ►Percentage of facilities with verified results and having received their payments (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 63.00 63.00 85.00 Date 01-Jul-2013 22-Dec-2017 22-Dec-2017 30-Jun-2019 IN00629152 ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 2,331,326.00 2,331,326.00 3,016,899.00 Date 01-Jul-2013 22-Dec-2017 22-Dec-2017 30-Jun-2019 IN00629157 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 1,355,728.00 1,355,728.00 1,778,108.00 IN00629158 Number of children immunized (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 244,653.00 266,455.00 445,220.00 Date 31-Dec-2013 22-Dec-2017 29-Jun-2018 30-Jun-2019 IN00629159 Number of women and children who have received basic nutrition services (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1,931,276.00 2,402,774.00 2,300,000.00 Date 31-Dec-2013 22-Dec-2017 29-Jun-2018 30-Jun-2019 IN00629160 Number of deliveries attended by skilled health personnel (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 155,397.00 155,397.00 271,679.00 Date 31-Dec-2013 22-Dec-2017 22-Dec-2017 30-Jun-2019 IN00629151 9/6/2018 Page 4 of 7 The World Bank Implementation Status & Results Report Senegal Health & Nutrition Financing (P129472) ►Pregnant women receiving antenatal care during a visit to a health provider (cumulative number) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 275,605.00 309,413.00 468,884.00 Date 31-Dec-2013 22-Dec-2017 29-Jun-2018 30-Jun-2019 IN00629139 ►Health personnel receiving training (number) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 2,916.00 2,916.00 3,144.00 Date 01-Feb-2011 22-Dec-2017 22-Dec-2017 30-Jun-2019 2. Improvement of accessibility to maternal, nutrition, and children health services IN00629144 ►Children aged 0-23 months who attended at least one growth monitoring and promotion service during the 3 precedent months (cumulative number) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 316,366.00 316,366.00 585,456.00 Date 01-Jul-2013 22-Dec-2017 22-Dec-2017 30-Jun-2019 IN00629149 ►Number of maternal health vouchers distributed (cumulative number) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 15,991.00 21,025.00 50,245.00 Date 01-Jul-2013 22-Dec-2017 29-Jun-2018 30-Jun-2019 IN00629155 ►Percentage of eligible women that have received a maternal health financial incentive (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 17.00 36.00 72.00 Date 01-Jul-2013 22-Dec-2017 29-Jun-2018 30-Jun-2019 IN00629154 ►Number of people effectively targeted by the communication activities of the CMU (cumulative number) (Amount(USD), Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 53,571.00 53,571.00 165,000.00 Date 01-Jul-2013 22-Dec-2017 22-Dec-2017 30-Jun-2019 IN00629156 ►Number of operationnal SIGICMU modules (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target 9/6/2018 Page 5 of 7 The World Bank Implementation Status & Results Report Senegal Health & Nutrition Financing (P129472) Value 0.00 0.00 0.00 5.00 Date 22-Dec-2017 22-Dec-2017 22-Dec-2017 30-Jun-2019 3. Institutional strengthening and project implementation IN00629153 ►Number of hospitals where the cost accounting system has been implemented (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 34.00 Date 01-Jul-2013 22-Dec-2017 22-Dec-2017 30-Jun-2019 IN00629146 ►One continuous Demographic and Health Survey (DHS) report and one health Service Delivery report are produced every year (cumulative number) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 6.00 6.00 10.00 Date 01-Jul-2013 22-Dec-2017 01-Aug-2018 30-Jun-2019 2017 DHS full reports not yet available Comments: Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P129472 IDA-53240 Effective USD 20.00 20.00 0.00 12.56 5.97 68% P129472 TF-15872 Effective USD 20.00 20.00 0.00 7.52 12.48 38% P129472 TF-16618 Closed USD 0.45 0.19 0.26 0.19 0.00 100% P129472 TF-A0565 Closed USD 0.83 0.78 0.04 0.78 0.00 100% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P129472 IDA-53240 Effective 11-Dec-2013 28-Mar-2014 14-May-2014 29-Jun-2018 30-Jun-2019 P129472 TF-15872 Effective 28-Mar-2014 28-Mar-2014 29-May-2014 29-Jun-2018 28-Jun-2019 P129472 TF-16618 Closed 17-Dec-2014 17-Dec-2014 17-Dec-2014 30-Jun-2015 31-Mar-2016 P129472 TF-A0565 Closed 28-Jan-2016 28-Jan-2016 28-Jan-2016 31-Dec-2016 31-Dec-2016 9/6/2018 Page 6 of 7 The World Bank Implementation Status & Results Report Senegal Health & Nutrition Financing (P129472) Cumulative Disbursements Restructuring History Level 2 Approved on 04-May-2016 ,Level 2 Approved on 10-Apr-2018 Related Project(s) There are no related projects. 9/6/2018 Page 7 of 7