Public Disclosure Copy The World Bank Implementation Status & Results Report Health Service Delivery Project (P099930) Health Service Delivery Project (P099930) AFRICA | Mozambique | Health, Nutrition & Population Global Practice | IBRD/IDA | Specific Investment Loan | FY 2009 | Seq No: 18 | ARCHIVED on 16-Mar-2017 | ISR27265 | Implementing Agencies: Key Dates Key Project Dates Bank Approval Date:16-Apr-2009 Effectiveness Date:11-Jun-2010 Planned Mid Term Review Date:15-Sep-2011 Actual Mid-Term Review Date:22-Jun-2012 Original Closing Date:28-Feb-2014 Revised Closing Date:31-Dec-2017 Project Development Objectives Project Development Objective (from Project Appraisal Document) The project's development objectives are to: (a) reduce child mortality; (b) reduce maternal mortality; (c) reduce the burden of malaria; (d) reduce the prevalence of tuberculosis; and (e) reduce inequity in the access to health services in Mozambique. Has the Project Development Objective been changed since Board Approval of the Project Objective? Yes Board Approved Revised Project Development Objective (If project is formally restructured)PHRPDODEL To increase access to, and utilization of, maternal and child health and nutrition services in target areas in the Recipient's territory. Components Name Improvement in service delivery.:(Cost $80.00 M) Boosting of national malaria control program:(Cost $15.50 M) Strategic Planning and Capacity Building:(Cost $7.40 M) Project Management and Operating Costs:(Cost $6.50 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO  Satisfactory  Moderately Satisfactory Overall Implementation Progress (IP)  Moderately Satisfactory  Moderately Satisfactory Overall Risk Rating  Moderate  Moderate 3/16/2017 Page 1 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Health Service Delivery Project (P099930) Implementation Status and Key Decisions Overall key project indicators continue to progress satisfactorily. For example, the three provinces achieved a high rate of institutional delivery, an average of 88.4% during 2015, above the national coverage of 75% and a significant increase from 64.6% at the start of the project in 2009. The construction for fifteen type II health centers has been completed in the Niassa, Nampula and Cabo Delgado provinces. Some construction is ongoing in Cabo Delgado for two more health centers. The project has sustained the progress in implementation of Community Based Nutrition (CBN) interventions in the three provinces of Cabo Delgado, Nampula and Niassa, with the activities rolled out in all 28 target districts. Community engagement in the implementation of CBN activities is high with active involvement of various actors that were mobilized and trained, including mother leader groups, health promoters, activists and community leaders. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance  --  Low  Low Macroeconomic  --  Substantial  Substantial Sector Strategies and Policies  --  Moderate  Moderate Technical Design of Project or Program  --  Low  Low Institutional Capacity for Implementation and Sustainability  --  Substantial  Substantial Fiduciary  --  Moderate  Moderate Environment and Social  --  Moderate  Moderate Stakeholders  --  Low  Low Other  --  --  -- Overall  --  Moderate  Moderate Results Project Development Objective Indicators PHINDPDOTBL  Percentage of institutional deliveries (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 50.80 85.60 88.40 90.00 3/16/2017 Page 2 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Health Service Delivery Project (P099930) Date 31-Dec-2009 31-Dec-2015 30-Dec-2016 31-Dec-2017 PHINDPDOTBL  Cabo Delgado (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 57.00 80.00 80.00 84.00 Date 31-Dec-2009 31-Dec-2015 30-Dec-2016 31-Dec-2017 PHINDPDOTBL  Nampula (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 53.00 89.00 87.60 93.00 Date 31-Dec-2009 31-Dec-2015 30-Dec-2016 31-Dec-2017 PHINDPDOTBL  Percentage of children vaccinated with DPTHepHib3 in the first year of life in each province (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 45.00 106.60 106.00 90.00 Date 31-Dec-2009 30-Jun-2015 30-Dec-2016 31-Dec-2017 PHINDPDOTBL  Cabo Delgado (Percentage, Custom Breakdown) 3/16/2017 Page 3 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Health Service Delivery Project (P099930) Baseline Actual (Previous) Actual (Current) End Target Value 71.00 108.00 109.00 90.00 Date 31-Dec-2009 30-Jun-2015 30-Dec-2016 31-Dec-2017 PHINDPDOTBL  Nampula (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 51.00 107.00 100.00 90.00 Date 31-Dec-2009 30-Jun-2015 30-Dec-2016 31-Dec-2017 PHINDPDOTBL  Percentage of pregnant women who received 2nd dose of IPT at antenatal clinics (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 18.60 77.60 59.10 78.00 Date 31-Dec-2009 31-Dec-2015 30-Dec-2016 31-Dec-2017 Comments Reporting on this indicator in the last ISR was incorrectly reflected. Data has been reviewed by the Bank team, and the available preliminary data confirms this indicator is currently 59.1%. The next mission will carefully discuss and review data reporting with MISAU. PHINDPDOTBL  Cabo Delgado (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 18.60 75.00 53.30 75.00 Date 31-Dec-2009 31-Dec-2015 30-Dec-2016 31-Dec-2017 PHINDPDOTBL  Niassa (Percentage, Custom Breakdown) 3/16/2017 Page 4 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Health Service Delivery Project (P099930) Baseline Actual (Previous) Actual (Current) End Target Value 18.60 78.00 59.90 78.00 Date 31-Dec-2009 31-Dec-2015 30-Dec-2016 31-Dec-2017 PHINDPDOTBL  Nampula (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 18.60 80.00 64.00 80.00 Date 31-Dec-2009 31-Dec-2015 30-Dec-2016 31-Dec-2017 PHINDPDOTBL  Direct project beneficiaries (Number, Core) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 893,396.00 893,396.00 1,030,100.00 Date 31-Dec-2013 31-Dec-2015 31-Dec-2015 31-Dec-2017 PHINDPDOTBL  Female beneficiaries (Percentage, Core Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 83.00 83.00 80.00 PHINDPDOTBL  Percentage of children aged 0-24 months fed in accordance with all 3 IYCF practices (food diversity, feeding frequency, and consumption of breast milk or milk (Percentage, Custom) 3/16/2017 Page 5 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Health Service Delivery Project (P099930) Baseline Actual (Previous) Actual (Current) End Target Value 2.01 -- -- 10.00 Date 31-Dec-2013 30-Jun-2016 30-Jun-2016 31-Dec-2017 Overall Comments Intermediate Results Indicators PHINDIRITBL  Annual outreach visits to facilities in Cabo Delgado, Nampula, and Niassa (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 2,210.00 2,957.00 2,210.00 Date 31-Dec-2009 31-Dec-2015 30-Dec-2016 31-Dec-2017 PHINDIRITBL  Number of Agentes Polivalentes Elementares (APEs) trained (cumulative) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1,732.00 1,732.00 1,732.00 Date 31-Dec-2009 31-Dec-2015 30-Dec-2016 31-Dec-2017 PHINDIRITBL  Health personnel receiving training (number) (Number, Core) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 374.00 374.00 374.00 Date 31-Dec-2009 31-Dec-2015 31-Dec-2015 31-Dec-2017 3/16/2017 Page 6 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Health Service Delivery Project (P099930) PHINDIRITBL  Health facilities constructed, renovated, and/or equipped (number) (Number, Core) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 15.00 18.00 Date 31-Dec-2009 31-Dec-2015 01-Mar-2017 31-Dec-2017 PHINDIRITBL  Pregnant women receiving first ANC visit (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 165,917.00 590,149.00 590,149.00 593,000.00 Date 31-Dec-2009 31-Dec-2015 31-Dec-2015 31-Dec-2017 PHINDIRITBL  Cabo Delgado (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 118,126.00 120,804.00 120,804.00 121,000.00 Date 31-Dec-2009 31-Dec-2015 31-Dec-2015 31-Dec-2017 PHINDIRITBL  Nampula (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 267,517.00 368,239.00 368,239.00 370,000.00 Date 31-Dec-2009 31-Dec-2015 31-Dec-2015 31-Dec-2017 3/16/2017 Page 7 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Health Service Delivery Project (P099930) PHINDIRITBL  Children receiving a dose of vitamin A (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 194,521.00 1,380,149.00 1,380,149.00 1,385,200.00 Date 31-Dec-2009 31-Dec-2015 31-Dec-2015 31-Dec-2017 PHINDIRITBL  Cabo Delgado (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 178,490.00 312,812.00 312,812.00 314,000.00 Date 31-Dec-2009 31-Dec-2015 31-Dec-2015 31-Dec-2017 PHINDIRITBL  Nampula (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 185,879.00 796,019.00 796,019.00 799,260.00 Date 31-Dec-2009 31-Dec-2015 31-Dec-2015 31-Dec-2017 PHINDIRITBL  Number of children under 1 year of age fully immunized (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 81,848.00 302,187.00 302,187.00 316,645.00 Date 31-Dec-2009 31-Dec-2015 31-Dec-2015 31-Dec-2017 3/16/2017 Page 8 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Health Service Delivery Project (P099930) PHINDIRITBL  Cabo Delgado (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 62,412.00 63,396.00 63,396.00 69,527.00 Date 31-Dec-2012 31-Dec-2015 31-Dec-2015 31-Dec-2017 PHINDIRITBL  Nampula (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 150,427.00 180,523.00 180,523.00 184,320.00 Date 31-Dec-2012 31-Dec-2015 31-Dec-2015 31-Dec-2017 PHINDIRITBL  Number of Volunteers functional (cumulative) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 18,784.00 19,050.00 21,000.00 Date 31-Mar-2013 31-Dec-2015 30-Dec-2016 31-Dec-2017 PHINDIRITBL  Percentage of children aged 0-24 months attended at least 1 Growth Monitoring and Promotion services during the 2 preceding months,% who are female (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 43.00 43.00 80.00 Date 31-Mar-2013 30-Jun-2016 30-Jun-2016 31-Dec-2017 3/16/2017 Page 9 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Health Service Delivery Project (P099930) PHINDIRITBL  Percentage of children aged 6-24 months received at least 60 sachets of micronutrient powder (MNP) during the 2 preceding months, %who are female (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 60.00 60.00 80.00 Date 31-Mar-2013 30-Jun-2016 30-Jun-2016 31-Dec-2017 PHINDIRITBL  Percentage of pregnant women received a complete dose of IFA tablets (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 63.30 63.30 63.00 Date 31-Mar-2013 30-Jun-2016 30-Jun-2016 31-Dec-2017 Overall Comments Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed Disbursed P099930 IDA-45820 Effective USD 44.60 44.60 0.00 40.40 3.25 91% P099930 IDA-51940 Effective USD 37.00 37.00 0.00 30.33 4.48 82% P099930 TF-58155 Closed USD 1.15 0.18 0.97 0.18 0.00 100% P099930 TF-96375 Closed USD 7.86 7.53 0.33 7.53 0.00 100% P099930 TF-96399 Closed USD 4.05 3.84 0.22 3.84 0.00 100% P099930 TF-96505 Closed USD 12.80 12.34 0.46 14.02 0.00 114% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date 3/16/2017 Page 10 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Health Service Delivery Project (P099930) P099930 IDA-45820 Effective 16-Apr-2009 15-Jul-2009 11-Jun-2010 28-Feb-2014 31-Dec-2017 P099930 IDA-51940 Effective 24-Jan-2013 25-Mar-2013 21-Jun-2013 31-Dec-2016 31-Dec-2017 P099930 TF-58155 Closed 21-Sep-2007 21-Sep-2007 21-Sep-2007 31-Dec-2009 31-Dec-2009 P099930 TF-96375 Closed 19-Mar-2010 24-Mar-2010 24-Mar-2010 30-Apr-2013 31-Jul-2013 P099930 TF-96399 Closed 19-Mar-2010 24-Mar-2010 24-Mar-2010 28-Feb-2014 28-Feb-2016 P099930 TF-96505 Closed 15-Apr-2010 19-Apr-2010 19-Apr-2010 28-Feb-2014 31-Jan-2016 Cumulative Disbursements Restructuring History Level 2 Approved on 30-Dec-2016 Related Project(s) P125477-Mozambique Nutrition Additional Financing 3/16/2017 Page 11 of 11 Public Disclosure Copy