The World Bank Implementation Status & Results Report eGabon (P132824) eGabon (P132824) AFRICA | Gabon | Digital Development Global Practice | IBRD/IDA | Investment Project Financing | FY 2016 | Seq No: 5 | ARCHIVED on 03-Mar-2019 | ISR35354 | Implementing Agencies: Gabonese Republic, National Commission for Public Infras. Works and Promotion of Small-Scale Enterprises (CN-TIPPEE) Key Dates Key Project Dates Bank Approval Date: 03-Jun-2016 Effectiveness Date: 19-Apr-2017 Planned Mid Term Review Date: 15-Jan-2019 Actual Mid-Term Review Date: 07-Dec-2018 Original Closing Date: 05-Jan-2022 Revised Closing Date: 05-Jan-2022 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The Project Development Objective (PDO) is to: (i) improve the timeliness and availability of information to support the delivery and management of public health services; and (ii) to foster the development and roll-out of eHealth applications and services, and Information and Communication Technology (ICT) services more generally. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Component 1: Strengthening the National Health Information System:(Cost $40.08 M) Component 2: Advancing the Digital Innovation Ecosystem Development:(Cost $11.00 M) Component 3: Project Management, coordination, monitoring and evaluation of the Project:(Cost $4.78 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Moderately Satisfactory Moderately Satisfactory Overall Implementation Progress (IP) Moderately Satisfactory Moderately Satisfactory Overall Risk Rating Substantial Substantial Implementation Status and Key Decisions This Sequence #5 ISR reflects the findings of the Mid-term Review mission conducted from December 3-7 2081in Gabon as well as prior and subsequent interactions with the project teams. For component 1, important tasks have been completed (stakeholders survey) or are in process or waiting inputs from other activities (legal framework for e-health applications, change management, health map, annual statistical summary) but are not completed yet. The key activity at this point is the preparation of the complex tender documents for the health information system, and the contract for this activity has been signed. One part of this activity (the development of the interoperability framework) had to be tendered separately since none of the firms bidding on the detailed design properly addressed this area. This bidding process has closed and an evaluation report has been submitted to the Bank. As for 3/3/2019 Page 1 of 8 The World Bank Implementation Status & Results Report eGabon (P132824) component 2, the incubator’s company is officially created since November 2018 and includes shareholders from the private sector (Gabon Telecom, Solsi, BICIG, Infracom, GVA), the public sector (SPIN) and a representative of the Ministry in charge of the Digital Economy. The incubator has a full team in place and the site of the Libreville incubator is operational. Some important activities were successfully completed in the past 6 months, with a hackathon in September 2018, an Open Data day, and multiple trainings to enterprises and start-ups provided by the incubator team. The first cohort of start-ups is accompanied by the incubator since January 2019. The next activities will be the opening of the Port- Gentil and Franceville sites, a national hackathon in the first half of 2019, and a business plan competition. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance Moderate Moderate Moderate Macroeconomic Moderate Moderate Moderate Sector Strategies and Policies Moderate Moderate Moderate Technical Design of Project or Program Substantial Substantial Substantial Institutional Capacity for Implementation and Sustainability Moderate Moderate Moderate Fiduciary Moderate Substantial Substantial Environment and Social Moderate Low Low Stakeholders Substantial Substantial Substantial Other -- -- -- Overall Substantial Substantial Substantial Results PDO Indicators by Objectives / Outcomes Improve the timeliness and availability of Health information IN00624680 ►Prescriptions transmitted electronically (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 60.00 Date 31-Dec-2015 31-Dec-2017 31-Dec-2018 31-Dec-2020 End target expected to be achieved (once the system is in place). Comments: IN00624758 ►Health workers reporting that they regularly use and update the patients’ electronic medical record during clinical consultations (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target 3/3/2019 Page 2 of 8 The World Bank Implementation Status & Results Report eGabon (P132824) Value 0.00 0.00 0.00 70.00 Date 31-Dec-2015 31-Dec-2017 31-Dec-2018 31-Dec-2020 End target expected to be achieved (once the system is in place). Comments: IN00624748 ►Direct project beneficiaries (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 450.00 1,820,000.00 Date 31-Dec-2015 31-Dec-2017 31-Dec-2018 31-Dec-2020 End target expected to be achieved (once the system is in place). Comments: IN00624761 Female beneficiaries (Percentage, Custom Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 55.00 0.00 0.00 55.00 Foster the development and roll-out of digital services IN00624746 ►Start-up projects incubated (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 3.00 50.00 Date 31-Dec-2015 31-Dec-2017 31-Dec-2018 31-Dec-2020 End target expected to be achieved progressively, now that the incubator is in place. The trend will Comments: accelerate as the incubator in Libreville matures and the two secondary sites open. IN00624760 percent of start-up projects in eHealth (Percentage, Custom Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 20.00 IN00624747 ►Increase in the level of satisfaction by ICT sector actors regarding government’s promotion of the digital economy (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 80.00 Date 31-Dec-2015 31-Dec-2017 31-Dec-2018 31-Dec-2020 End target expected to be achieved - data to be collected through a survey. Comments: Overall Comments PDO 3/3/2019 Page 3 of 8 The World Bank Implementation Status & Results Report eGabon (P132824) Component 1 of the project is around 18 months behind scheduled due to a number of factors mentioned in this ISR. Planning for 2019 has included a number of initiatives in the area of facility and staff readiness in order to reduce this gap. Intermediate Results Indicators by Components Component 1: Strengthening the National Health Information System IN00624750 ►Health workers level of satisfaction regarding the effectiveness of NHIS (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 35.00 80.00 Date 31-Dec-2015 31-Dec-2017 31-Dec-2018 31-Dec-2020 End target expected to be achieved (once the system is in place). Comments: IN00624749 ►Service providers (CNAM-GS and others) level of satisfaction regarding the effectiveness of the NHIS (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 80.00 Date 31-Dec-2015 31-Dec-2017 31-Dec-2018 31-Dec-2020 End target expected to be achieved (once the system is in place). Comments: IN00624679 ►Patient perception of the quality of electronically supported public health services (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 66.00 75.00 Date 31-Dec-2015 31-Dec-2017 31-Dec-2018 31-Dec-2020 End target expected to be achieved (once the system is in place). Comments: IN00624759 Patient women perception of the quality of electronically supported public health services (Percentage, Custom Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 70.00 IN00624751 ►Health professionals and managers having achieved a sufficient level of knowledge regarding the use of the NHIS (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 80.00 3/3/2019 Page 4 of 8 The World Bank Implementation Status & Results Report eGabon (P132824) Date 31-Dec-2015 31-Dec-2017 31-Dec-2018 31-Dec-2020 End target expected to be achieved (once the system is in place). Comments: IN00624762 Health women professionals and managers having achieved a sufficient level of knowledge regarding the use of the NHIS (Number, Custom Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 80.00 IN00624752 ►Information technology managers and technicians trained (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 25.00 90.00 Date 31-Dec-2015 31-Dec-2017 31-Dec-2018 31-Dec-2020 End target expected to be achieved progressively. Comments: IN00624753 ►Health care providers and administrators at the national level trained with improved skills and ability to use the NHIS (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 400.00 Date 31-Dec-2015 31-Dec-2017 31-Dec-2018 31-Dec-2020 IN00624757 ►Completion of business process re-engineering and change management activities (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 90.00 Date 31-Dec-2015 31-Dec-2017 31-Dec-2018 31-Dec-2020 End target expected to be achieved (once the system is in place). Comments: Component 2: Advancing the Digital Innovation Ecosystem Development IN00624754 ►Number of participants in application competitions (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 50.00 500.00 Date 31-Dec-2015 31-Dec-2017 31-Dec-2018 31-Dec-2020 End target expected to be achieved - the next competitions will be nationwide with more participants. Comments: IN00624763 % of women in Number of participants in application competitions (Percentage, Custom Supplement) Baseline Actual (Previous) Actual (Current) End Target 3/3/2019 Page 5 of 8 The World Bank Implementation Status & Results Report eGabon (P132824) Value 0.00 0.00 20.00 40.00 IN00624764 % of youth in Number of participants in application competitions (Percentage, Custom Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 100.00 60.00 IN00624755 ►Number of participants in business plan competitions (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 90.00 Date 31-Dec-2015 31-Dec-2017 31-Dec-2018 31-Dec-2020 End target expected to be achieved - first competition scheduled for Q3 2019 (calendar year). Comments: IN00624765 % of women in Number of participants in business plan competitions (Percentage, Custom Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 40.00 IN00624766 % of youth in Number of participants in business plan competitions (Percentage, Custom Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 40.00 IN00624756 ►Number of participants in training courses offered by the incubators (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 221.00 750.00 Date 31-Dec-2015 31-Dec-2017 31-Dec-2018 31-Dec-2020 End target expected to be achieved. Comments: IN00624767 % of women in Number of participants in training courses offered by the incubators (Percentage, Custom Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 64.00 50.00 IN00624768 % of youth in Number of participants in training courses offered by the incubators (Percentage, Custom Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 80.00 Overall Comments IR For component 1, no progress yet on most of the indicators. However, according to the baseline survey, at least 71% of respondents think that the NHIS could bring a net benefit in the following areas: increased productivity, ease of information exchange and coordination of activities, management of care and health services, care of 3/3/2019 Page 6 of 8 The World Bank Implementation Status & Results Report eGabon (P132824) the patient (management of information, eviction of investigations and unnecessary examinations, access to the results of additional examinations). About 78% of health professionals believe that the NHIS could avoid unnecessary investigations and examinations for the patient. Only around 35% of respondents think that the current SIS could answer some of the questions raised. This could be used as the current baseline (shown below). Among patients, 92% of respondents say that the future NHIS will allow faster medical appointments, which 86% expect the NHIS to will allow them to access their medical reports more rapidly. In terms of improving patient-care communication, 81% think that the new NHIS would be a solution, and 66% feel it will improve quality of care. In view of these perceived benefits, 78% of respondents say they are ready to use the services offered by the new NHIS, while only around 9% say they need technical assistance to use these services. Among the respondents, 60% are satisfied with the current SIS, although this should not really be taken as a baseline, in view of how different the current system is to what is being proposed. The figure shown for training is for the project team (3 sessions completed to date). Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P132824 IBRD-86240 Effective USD 56.00 56.00 0.00 10.64 45.61 19% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P132824 IBRD-86240 Effective 03-Jun-2016 21-Jul-2016 19-Apr-2017 05-Jan-2022 05-Jan-2022 Cumulative Disbursements 3/3/2019 Page 7 of 8 The World Bank Implementation Status & Results Report eGabon (P132824) Restructuring History There has been no restructuring to date. Related Project(s) P164035-eGabon Additional Financing 3/3/2019 Page 8 of 8