The World Bank Implementation Status & Results Report Supporting Effective Universal Health Coverage in Argentina (P163345) Supporting Effective Universal Health Coverage in Argentina (P163345) LATIN AMERICA AND CARIBBEAN | Argentina | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2018 | Seq No: 1 | ARCHIVED on 31-Aug-2018 | ISR33762 | Implementing Agencies: Ministry of Health, Argentine Republic Key Dates Key Project Dates Bank Approval Date: 18-May-2018 Effectiveness Date: -- Planned Mid Term Review Date: 10-May-2021 Actual Mid-Term Review Date: -- Original Closing Date: 31-Dec-2022 Revised Closing Date: 31-Dec-2022 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The Development Objective of the proposed Project would be to: (i) increase effective and equitable coverage of key health services provided to the eligible population; and (ii) increase the institutional capacity of the MSN and MSPs to implement mechanisms for an integrated delivery system. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Support the Strengthening of Effective Public Health Coverage:(Cost $479.81 M) Strengthening the Institutional Capacity of the National and Provincial Ministries of Health:(Cost $110.96 M) Supporting Management, Monitoring and Evaluation:(Cost $66.53 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO -- Satisfactory Overall Implementation Progress (IP) -- Satisfactory Overall Risk Rating -- Substantial Implementation Status and Key Decisions A Project to support the Government of Argentina to increase effective and equitable coverage of key health services provided to the eligible population; and increase the institutional capacity of the MSN and MSPs to implement mechanisms for an integrated delivery system, was approved by the Board of Directors on May 18th, 2018. 8/31/2018 Page 1 of 6 The World Bank Implementation Status & Results Report Supporting Effective Universal Health Coverage in Argentina (P163345) Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance Moderate -- Moderate Macroeconomic Moderate -- Moderate Sector Strategies and Policies Low -- Low Technical Design of Project or Program Substantial -- Substantial Institutional Capacity for Implementation and Sustainability Substantial -- Substantial Fiduciary Substantial -- Substantial Environment and Social Moderate -- Moderate Stakeholders Moderate -- Moderate Other -- -- -- Overall Substantial -- Substantial Results PDO Indicators by Objectives / Outcomes Increase effective and equitable coverage of key health services provided to the eligible population IN00530121 ►Percentage of eligible population with effective health coverage. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 26.70 -- 0.00 40.00 Date 29-Sep-2017 -- 13-Aug-2018 31-Dec-2022 Numerator: Eligible population with effective health coverage. Denominator: Total eligible population. This indicator will also be monitored on a gender-disaggregated basis, with baseline and target values provided for men and women separately in the Operational Manual. The baseline value for men for this indicator Comments: (21.3%) is lower than that for women (32.1%), because men tend to place much less importance on visiting health providers regularly, even for basic checkups. The Project aims to substantially close the effective coverage gap between men and women. IN00532014 ►Percentage of eligible adults with hypertension that are diagnosed, in regions with poorest health outcomes (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 30.00 Date 31-Oct-2017 -- 13-Aug-2018 31-Dec-2022 Numerator: Number of eligible adults with hypertension that are diagnosed, in regions with poorest health Comments: outcomes. Denominator: Estimated number of eligible adults with hypertension, in regions with poorest health outcomes. The rationale for selecting this indicator was based on the fact that the poorer Northern 8/31/2018 Page 2 of 6 The World Bank Implementation Status & Results Report Supporting Effective Universal Health Coverage in Argentina (P163345) and the Northwest regions generally have the poorest health outcomes, including for NCDs. Thus, an NCD coverage indicator was selected to measure interprovincial equity. This indicator will also be monitored on a gender-disaggregated basis, with baseline and target values provided for men and women separately in the Operational Manual. Increase institutional capacity to implement mechanisms for an integrated delivery system IN00532036 ►Percentage of eligible population enrolled and assigned to a health facility, for continuous care (“empaneled”). (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 12.00 Date 31-Oct-2017 -- 13-Aug-2018 31-Dec-2022 Numerator: Eligible population enrolled in the Program and assigned to a specific health facility, for continuous care (empaneled) according to the provincial definition of empanelment as agreed with the MSN. Denominator: Total eligible population. Empanelment refers to the assignment of the eligible population to a regular primary health care provider for provider continuity. This strategy implies that the Comments: primary health care provider should seek, identify and formally register these people as “patients” and ensure comprehensive and continuous care. This indicator will also be monitored on a gender- disaggregated basis, with baseline and target values provided for men and women separately in the Operational Manual. Intermediate Results Indicators by Components Support the Strengthening of Effective Public Health Coverage IN00530125 ►Percentage of eligible pregnant women with early antenatal care. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 14.70 -- 0.00 25.00 Date 29-Sep-2017 -- 13-Aug-2018 31-Dec-2022 Numerator: Number of eligible pregnant women receiving at least one antenatal care service before the Comments: 13th week of pregancy. Denominator: Number of eligible pregnant women. IN00530127 ►Percentage of eligible women 25 - 64 years of age with at least one cervical cancer screening according to defined protocols. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 19.60 -- 0.00 25.00 Date 28-Apr-2017 -- 13-Aug-2018 31-Dec-2022 Numerator: Eligible women aged 25-64 years with PAP or Human Papillovirus (HPV) sample and / or PAP Comments: or HPV test result following defined protocols. Denominator: All eligible women aged 25 - 64 years. IN00546400 ►Percentage of eligible population with hypertension under treatment. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 25.00 8/31/2018 Page 3 of 6 The World Bank Implementation Status & Results Report Supporting Effective Universal Health Coverage in Argentina (P163345) Date 30-Nov-2017 -- 13-Aug-2018 31-Dec-2022 Numerator: Number of people in eligible population with hypertension receiving drug treatment for this condition. Denominator: Number of people in eligible population with hypertension. This indicator will also Comments: be monitored on a gender-disaggregated basis, with baseline and target values provided for men and women separately in the Operational Manual. IN00547307 ►Percentage of participating provinces with reported health services for selected key lines of care. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 29.00 Date 06-Dec-2017 -- 13-Aug-2018 31-Dec-2022 Numerator: Number of participating provinces with reported key health services for selected key lines of Comments: care. Denominator: Total number of participating provinces. Selected key lines of care include: Cervical cancer; Type 2 Diabetes and Prenatal care for low-risk pregnancy IN00534978 ►Percentage of primary health care providers georreferenced and with a catchment area defined. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 80.00 Date 31-Oct-2017 -- 13-Aug-2018 31-Dec-2022 Numerator: Number of primary health care providers participating in the Program georeferenced and with Comments: a catchment area defined. Denominator: Total number of primary health care providers participating in the Program Strengthening the Institutional Capacity of the National and Provincial Ministries of Health IN00532042 ►Percentage of participating provinces implementing the agreed Interoperability Plan for Information Systems. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 50.00 Date 31-Oct-2017 -- 13-Aug-2018 31-Dec-2022 Numerator: Number of participating provinces adhering to the agreed Interoperability Plan for Health Comments: Information Systems, with presentation of provincial Action Plans and agreed targets. Denominator: Total number of participating provinces. IN00532041 ►Percentage of health facilities with service delivery capacity strengthened for key lines of care, through medical equipment provision. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 40.00 Date 31-Oct-2017 -- 13-Aug-2018 31-Dec-2022 The percentage of all health facilities under the program that: (i) have received medical equipment for key “lines of care” under Sub-Component 2.2 and: (ii) have seen an increase of at least 10% in the number of Comments: relevant services that are billed under the program. “Relevant services” refers to health services in the “lines of care” for which medical equipment was provided. IN00532043 ►Percentage of participating public health facilities billing to the social security institutions. (Percentage, Custom) 8/31/2018 Page 4 of 6 The World Bank Implementation Status & Results Report Supporting Effective Universal Health Coverage in Argentina (P163345) Baseline Actual (Previous) Actual (Current) End Target Value 25.00 -- 0.00 30.00 Date 31-Oct-2017 -- 13-Aug-2018 31-Dec-2022 Numerator: Number of public health facilities participating in the Program that are billing to OSs for use by Comments: OS members of services provided. Denominator: Total number of public health facilities participating in the Program. Supporting Management, Monitoring and Evaluation IN00531984 ►Percentage of participating provinces successfully meeting their annual IPP goals. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 61.00 -- 0.00 83.00 Date 30-Dec-2016 -- 13-Aug-2018 31-Dec-2022 Numerator: Number of participating provinces with IPPs meeting at least 60% of the annual IPP goals. Comments: Denominator: Total number of participating provinces that trigger OP 4.10. IN00531985 ►Percentage of participating provinces implementing actions to disseminate information on the Project’s grievance redress mechanism. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 54.00 -- 0.00 83.00 Date 30-Dec-2016 -- 13-Aug-2018 31-Dec-2022 Numerator: Number of participating provinces that: (i) disclose online information on the Project’s Comments: grievance redress mechanism, and (ii) display visual material on this at 40% or more of contracted health facilities. . Denominator: Total number of participating provinces. Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed Not P163345 IBRD-88530 USD 300.00 300.00 0.00 0.00 300.00 0% Effective Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date Not P163345 IBRD-88530 18-May-2018 -- -- 31-Dec-2022 31-Dec-2022 Effective Cumulative Disbursements 8/31/2018 Page 5 of 6 The World Bank Implementation Status & Results Report Supporting Effective Universal Health Coverage in Argentina (P163345) Restructuring History There has been no restructuring to date. Related Project(s) There are no related projects. 8/31/2018 Page 6 of 6