Public Disclosure Copy The World Bank Implementation Status & Results Report Uganda Reproductive, Maternal and Child Health Services Improvement Project (P155186) Uganda Reproductive, Maternal and Child Health Services Improvement Project (P155186) AFRICA | Uganda | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2017 | Seq No: 6 | ARCHIVED on 23-Jun-2019 | ISR36074 | Implementing Agencies: Ministry of Finance, Planning and Economic Development, Ministry of Health Key Dates Key Project Dates Bank Approval Date: 04-Aug-2016 Effectiveness Date: 26-May-2017 Planned Mid Term Review Date: 14-Oct-2019 Actual Mid-Term Review Date: -- Original Closing Date: 30-Jun-2021 Revised Closing Date: 30-Jun-2021 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The Project Development Objectives (PDOs) are to: (a) improve utilization of essential health services with a focus on reproductive, maternal, newborn, child and adolescent health services in target districts; and (b) scale up birth and death registration services Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Component 1: Results-Based Financing for Primary Health Care Services:(Cost $85.50 M) Component 2: Strengthen Health Systems to Deliver RMNCAH Services:(Cost $62.00 M) Component Three: Strengthen Capacity to Scale-up Delivery of Births and Deaths Registration Services:(Cost $10.00 M) Component Four: Enhance Institutional Capacity to Manage Project Supported Activities:(Cost $7.50 M) Contingent Emergency Response Component Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Moderately Satisfactory Moderately Satisfactory Overall Implementation Progress (IP) Moderately Unsatisfactory Moderately Satisfactory Overall Risk Rating Substantial Substantial Implementation Status and Key Decisions Technical and an Implementation Support missions in January and April 2019, respectively were conducted. The mission found that implementation is picking up pace rapidly, and between January and June 2019, the disbursement rate has more than doubled since the last ISR (from 10.2% to 6/23/2019 Page 1 of 7 Public Disclosure Copy The World Bank Implementation Status & Results Report Uganda Reproductive, Maternal and Child Health Services Improvement Project (P155186) 24%), signaling enhanced proactivity by the client. The project’s Mid-Term Review is planned for October 2019, which will provide an opportunity to evaluate progress, and agree on measures to sustain the achievements and address challenges. 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 Substantial Substantial Substantial Institutional Capacity for Implementation and Sustainability High High High Fiduciary Substantial Substantial Substantial Environment and Social Moderate Substantial Substantial Stakeholders Substantial Substantial Substantial Other -- -- -- Overall Substantial Substantial Substantial Results PDO Indicators by Objectives / Outcomes Improve utilization of essential health services with a focus on reproductive, maternal, newborn, ch IN00671924 ►Children under one year immunized with 3rd dose of pneumococcal conjugate vaccine (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 79.00 92.60 92.60 90.00 Date 30-Jun-2015 06-Dec-2018 06-Dec-2018 30-Jun-2021 IN00671931 ►Pregnant women who received IPT2 (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 53.00 63.20 63.20 80.00 Date 30-Jun-2015 06-Dec-2018 06-Dec-2018 30-Jun-2021 IN00671933 ►Couple Years of Protection (Number, Custom) 6/23/2019 Page 2 of 7 Public Disclosure Copy The World Bank Implementation Status & Results Report Uganda Reproductive, Maternal and Child Health Services Improvement Project (P155186) Baseline Actual (Previous) Actual (Current) End Target Value 3,308,142.00 2,540,251.00 2,540,251.00 3,500,000.00 Date 30-Jun-2015 06-Dec-2018 06-Dec-2018 30-Jun-2021 IN00671820 ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 2,550,000.00 3,200,000.00 Date 30-Jun-2015 -- 06-Dec-2018 30-Jun-2021 IN00671962 Number of children immunized (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 1,535,000.00 1,800,000.00 Date 30-Jun-2015 -- 06-Dec-2018 30-Jun-2021 IN00671963 Number of deliveries attended by skilled health personnel (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 1,020,000.00 1,400,000.00 Date 30-Jun-2015 -- 06-Dec-2018 30-Jun-2021 Scale up birth and death registration services IN00671925 ►Children under five years with birth registration (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 54,127.00 23,667.00 23,667.00 500,000.00 Date 30-Jun-2015 06-Dec-2018 06-Dec-2018 30-Jun-2021 IN00671932 ►Total number of deaths registered (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 3,340.00 3,411.00 3,411.00 50,000.00 Date 30-Jun-2015 06-Dec-2018 06-Dec-2018 30-Jun-2021 Intermediate Results Indicators by Components Component 1: Results-Based Financing for Primary Health Care Services IN00671939 6/23/2019 Page 3 of 7 Public Disclosure Copy The World Bank Implementation Status & Results Report Uganda Reproductive, Maternal and Child Health Services Improvement Project (P155186) ►Pregnant women receiving antenatal care during a visit to a health provider (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 1,500,000.00 4,791,351.00 4,791,351.00 1,650,000.00 Date 30-Jun-2015 06-Dec-2018 06-Dec-2018 30-Jun-2021 IN00671942 ►RBF health facilities with functional HUMCs with citizen representation (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 45.00 0.00 0.00 100.00 Date 30-Jun-2015 06-Dec-2018 06-Dec-2018 30-Jun-2021 Since the RBF component of the Project has not started, there is no current data for this indicator. Comments: IN00671944 ►HC IVs offering caesarian section (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 50.00 71.70 71.70 75.00 Date 30-Jun-2015 06-Dec-2018 06-Dec-2018 30-Jun-2021 IN00671946 ►Districts with functional ambulance and referral system (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 25.00 25.00 75.00 Date 30-Jun-2015 06-Dec-2018 06-Dec-2018 30-Jun-2021 Component 2: Strengthen Health Systems to Deliver RMNCAH Services IN00671940 ►Health facilities constructed, renovated, and/or equipped (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 150.00 Date 30-Jun-2015 06-Dec-2018 06-Dec-2018 30-Jun-2021 Civil works has not started so there is no current data. Comments: IN00671943 ►Health personnel receiving training (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 766.00 766.00 400.00 Date 30-Jun-2015 06-Dec-2018 06-Dec-2018 30-Jun-2021 IN00671945 6/23/2019 Page 4 of 7 Public Disclosure Copy The World Bank Implementation Status & Results Report Uganda Reproductive, Maternal and Child Health Services Improvement Project (P155186) ►Health facilities with placed orders that are fully filled by National Medical Stores (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 65.00 77.00 77.00 80.00 Date 30-Jun-2015 06-Dec-2018 06-Dec-2018 30-Jun-2021 IN00671947 ►Approved posts in public facilities filled by qualified health workers (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 65.00 74.00 74.00 75.00 Date 30-Jun-2015 06-Dec-2018 06-Dec-2018 30-Jun-2021 IN00671948 ►Health facilities attaining at least 2 star rating under the QA Program (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 50.00 Date 30-Jun-2015 06-Dec-2018 06-Dec-2018 30-Jun-2021 Data on this is also mot available since activities on the QA program are delayed. Comments: IN00671949 ►Health facilities without stock-outs of any of the six tracer drugs in the previous three months (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 64.00 85.00 85.00 80.00 Date 30-Jun-2015 06-Dec-2018 06-Dec-2018 30-Jun-2021 IN00671950 ►Clients expressing satisfaction with health (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 70.00 0.00 0.00 80.00 Date 30-Jun-2015 14-Dec-2018 14-Dec-2018 30-Jun-2021 The actual data for this indicator is blank. The Client Satisfaction Index was not assessed this year however, there was an assessment of the community perspectives on an array of healthcare related services undertaken in the Uganda National Household Survey 2016/17 by UBOS. According to the UNHS 2016/17, the major concerns of the communities in accessing health services at the public health Comments: facilities were; unavailability of medicines/supplies (23%), long waiting time (13%), long distance (12%), limited range of services (14%) and understaffing (10%). Whereas, in private facilities, it was found that the services being expensive (39%) ranked top followed by limited range of services (23%) and long istance (9%). Component Three: Strengthen Capacity to Scale-up Delivery of Births and Deaths Registration Services IN00671941 ►Reported maternal deaths that are audited (Percentage, Custom) 6/23/2019 Page 5 of 7 Public Disclosure Copy The World Bank Implementation Status & Results Report Uganda Reproductive, Maternal and Child Health Services Improvement Project (P155186) Baseline Actual (Previous) Actual (Current) End Target Value 33.00 49.50 49.50 65.00 Date 06-Dec-2018 06-Dec-2018 06-Dec-2018 30-Jun-2021 Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P155186 IDA-58970 Effective USD 110.00 110.00 0.00 23.86 85.23 22% P155186 TF-A2977 Effective USD 30.00 30.00 0.00 6.73 23.27 22% P163691 TF-A6713 Effective USD 9.44 9.44 0.00 4.50 4.94 48% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P155186 IDA-58970 Effective 04-Aug-2016 19-Jan-2017 26-May-2017 30-Jun-2021 30-Jun-2021 P155186 TF-A2977 Effective 19-Jan-2017 19-Jan-2017 26-May-2017 30-Jun-2021 30-Jun-2021 P163691 TF-A6713 Effective 12-Sep-2018 16-Oct-2018 16-Oct-2018 30-Jun-2021 30-Jun-2021 Cumulative Disbursements 6/23/2019 Page 6 of 7 Public Disclosure Copy The World Bank Implementation Status & Results Report Uganda Reproductive, Maternal and Child Health Services Improvement Project (P155186) Restructuring History There has been no restructuring to date. Related Project(s) P163691-Additional Financing Uganda Reproductive Maternal and Child Health Services Improvement Project 6/23/2019 Page 7 of 7