The World Bank Implementation Status & Results Report Uttarakhand Health Systems Development Project (P148531) Uttarakhand Health Systems Development Project (P148531) SOUTH ASIA | India | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2017 | Seq No: 4 | ARCHIVED on 04-Dec-2018 | ISR34053 | Implementing Agencies: Government of India, Department of Medical Health and Family Welfare, Government of Uttarakhand Key Dates Key Project Dates Bank Approval Date: 26-Jan-2017 Effectiveness Date: 23-May-2017 Planned Mid Term Review Date: 06-Apr-2020 Actual Mid-Term Review Date: -- Original Closing Date: 30-Sep-2023 Revised Closing Date: 30-Sep-2023 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The Project Development Objective (PDO) is to improve access to quality health services, particularly in the hilly districts of thestate, and to expand health financial risk protection for the residents of Uttarakhand Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Innovations in engaging the private sector:(Cost $80.00 M) Stewardship and system improvement component:(Cost $45.00 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Moderately Satisfactory Moderately Unsatisfactory Overall Implementation Progress (IP) Moderately Satisfactory Moderately Unsatisfactory Overall Risk Rating Substantial Substantial Implementation Status and Key Decisions Although though some actions have been taken (first Project Governing Board meeting, better staffed Project Implementation Team, initiation of some activities), progress towards achieving the Project Development Objective (PDO) has been marginal and implementation progress very slow. The rating for the PDO has thus been downgraded as result of the delays. The World Bank is working closely with the Government of Uttarakhand (GoUK) to ensure that all pending actions are taken. Another project review is scheduled for December 2018/January 2019 to assess progress. Over the next few months, concerted efforts are required to quicken the pace of implementation and disbursements. Key activities that need to be completed include: (1) completion of the hiring of PIT consultants; (2) development of Tehri handover roadmap; (3) handover of Tehri facilities to the private provider; (4) data entry well underway for the Family Health Card; (5) NABH gap assessments completed; (6) RFP for NABH turn-key agency drafted; and (7) contracts signed with independent verification agency and training needs assessment agency. 12/4/2018 Page 1 of 6 The World Bank Implementation Status & Results Report Uttarakhand Health Systems Development Project (P148531) 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 -- Moderate Moderate 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 -- Substantial Substantial Other -- -- -- Overall -- Substantial Substantial Results PDO Indicators by Objectives / Outcomes Innovations in engaging the private sector IN00576428 ►Number of outpatient visits to Primary Health Centers (PHCs), CHCs, and mobile vans per year, disaggregated by districts (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 774,926.00 -- 774,926.00 1,150,000.00 Date 31-Mar-2016 -- 31-Mar-2016 31-Mar-2023 IN00576427 ►Number of hospital admissions and outpatient consultations covered by any form of health insurance supported by the project (RSBY and MSBY), disaggregated by gender (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 46,040.00 -- 46,040.00 100,000.00 Date 29-Jul-2016 -- 29-Jul-2016 31-Mar-2023 Stewardship and system improvement component IN00576424 12/4/2018 Page 2 of 6 The World Bank Implementation Status & Results Report Uttarakhand Health Systems Development Project (P148531) ►Number of persons who used the Health Helpline to receive information or lodge grievances, disaggregated by gender (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 81,192.00 -- 81,192.00 160,000.00 Date 25-Nov-2016 -- 25-Nov-2016 31-Mar-2023 IN00576426 ►Patients contacted by the Health Helpline that are satisfied with the health services provided to them (per year, disaggregated by gender) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 70.00 Date 25-Nov-2016 -- 25-Nov-2016 31-Mar-2023 IN00576425 ►Number of government and non-government healthcare facilities in the state issued with an entry (or higher) level certification by the National Accreditation Board for Hospitals (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 2.00 -- 2.00 8.00 Date 25-Nov-2016 -- 25-Nov-2016 31-Mar-2023 Intermediate Results Indicators by Components Innovations in engaging the private sector IN00576431 ►People with access to any form of health insurance in the state during the year, disaggregated by gender (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 921,584.00 -- 921,584.00 3,000,000.00 Date 31-Dec-2014 -- 31-Dec-2014 31-Mar-2023 IN00576432 ►Number of children covered under the expanded health insurance program who received an annual health assessment during the year, disaggregated by gender (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 200,000.00 Date 25-Nov-2016 -- 25-Nov-2016 31-Mar-2023 IN00576434 ►Number of patients who use the services provided by the mobile health vans, disaggregated by gender (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 104,122.00 -- 104,122.00 300,000.00 Date 25-Nov-2016 -- 25-Nov-2016 31-Mar-2023 IN00576435 12/4/2018 Page 3 of 6 The World Bank Implementation Status & Results Report Uttarakhand Health Systems Development Project (P148531) ►Number of mobile medical units complying with the requirement of having at least one female doctor with sonology certification (>90% compliance on a day-to-day basis) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 9.00 Date 25-Nov-2016 -- 25-Nov-2016 31-Mar-2023 IN00576436 ►Number of outsourced CHCs with utilization of emergency services reported during each month (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 8.00 Date 25-Nov-2016 -- 25-Nov-2016 31-Mar-2023 IN00576429 ►Number of outsourced CHCs where at least one emergency caesarean section was reported during each quarter (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 6.00 Date 25-Nov-2016 -- 25-Nov-2016 31-Mar-2023 IN00576430 ►Benefit package of child health services finalized and piloted (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 'yes' from year 2 Date 25-Nov-2016 -- 25-Nov-2016 31-Mar-2023 IN00576437 ►Benefit package of NCDs services finalized and piloted (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target "no" for the first three Value 0.00 -- 0.00 years and "yes" from year 4. Date 25-Nov-2016 -- 25-Nov-2016 31-Mar-2023 IN00576438 ►Share of eligible households successfully enrolled under RSBY/MSBY during the year (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 45.70 -- 45.70 50.00 Date 31-Dec-2014 -- 31-Dec-2014 31-Mar-2023 IN00576439 ►Number of specialists working in the outsourced health facilities (and augmenting the positions functionally vacant in the public system) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 25.00 -- 25.00 50.00 12/4/2018 Page 4 of 6 The World Bank Implementation Status & Results Report Uttarakhand Health Systems Development Project (P148531) Date 25-Nov-2016 -- 25-Nov-2016 31-Mar-2023 IN00636306 ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target Value 140,631.00 -- 140,631.00 180,000.00 Date 31-Mar-2016 -- 31-Mar-2016 31-Mar-2023 Number of children immunized Comments: IN00636307 Number of children immunized (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 140,631.00 -- 140,631.00 180,000.00 Date 31-Mar-2016 -- 31-Mar-2016 31-Mar-2023 Stewardship and system improvement component IN00576440 ►Health personnel receiving training financed by the project- cumulative (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 5,000.00 Date 25-Nov-2016 -- 25-Nov-2016 31-Mar-2023 IN00576441 ►Development and periodical update of a comprehensive disaster response plan at the state level (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Done by year 2, Value 0.00 -- 0.00 updated by year revised by year 6. Date 25-Nov-2016 -- 25-Nov-2016 31-Mar-2023 Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P148531 IDA-59480 Effective USD 100.00 100.00 0.00 0.10 99.90 0.1% Key Dates (by loan) 12/4/2018 Page 5 of 6 The World Bank Implementation Status & Results Report Uttarakhand Health Systems Development Project (P148531) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P148531 IDA-59480 Effective 26-Jan-2017 23-Mar-2017 23-May-2017 30-Sep-2023 30-Sep-2023 Cumulative Disbursements Restructuring History There has been no restructuring to date. Related Project(s) There are no related projects. 12/4/2018 Page 6 of 6