The World Bank Implementation Status & Results Report Health System Strengthening for Better Maternal and Child Health Results Project (PDSS) (P147555) Health System Strengthening for Better Maternal and Child Health Results Project (PDSS) (P147555) AFRICA | Congo, Democratic Republic of | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2015 | Seq No: 8 | ARCHIVED on 30-Jan-2019 | ISR34452 | Implementing Agencies: Ministry of Health, Republic Democratic of Congo, Democratic Republic of Congo, Ministry Of Finances Key Dates Key Project Dates Bank Approval Date: 18-Dec-2014 Effectiveness Date: 30-May-2016 Planned Mid Term Review Date: 22-Jul-2019 Actual Mid-Term Review Date: -- Original Closing Date: 31-Dec-2019 Revised Closing Date: 31-Dec-2021 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The proposed project development objective is to improve utilization and quality of maternal and child health services in targeted areas within the Recipient's Territory. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Improve Utilization and Quality of Health Services at Health Facilities through PBF:(Cost $182.00 M) Improve Governance, Purchasing and Coaching and Strengthen Health Administration Directorates and Services through PBF:(Cost $92.70 M) Strengthen Health Sector Performance – Financing and Health Policy Capacities:(Cost $110.30 M) Disease Surveillance System Strengthening and Response:(Cost $15.00 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Satisfactory Moderately Satisfactory Overall Risk Rating Substantial Substantial Implementation Status and Key Decisions The Project continues to be implemented in a satisfactory manner. The project has been able to respond efficiently and swiftly to the funding needs of the 9th and 10th Ebola Outbreaks. 1/30/2019 Page 1 of 8 The World Bank Implementation Status & Results Report Health System Strengthening for Better Maternal and Child Health Results Project (PDSS) (P147555) Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance -- High High Macroeconomic -- Substantial Substantial 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 -- Moderate Moderate Other -- -- -- Overall -- Substantial Substantial Results PDO Indicators by Objectives / Outcomes Improve the utilization and quality of maternal and child health services in targeted areas. IN00598582 ►Percentage of pregnant women having at least 3 antenatal care visits before delivery (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 57.00 50.00 50.00 65.00 Date 31-Jul-2014 30-Mar-2018 30-Mar-2018 31-Dec-2021 It is difficult to provide 4 ANC visits since most women do not come to the health center in the 1st trimester due to many reasons including cultural norms, stigma and lack of awareness of their pregnancy. Comments: This figure will be provided as the sum of all ANC visitsin one year, divided by three, divided by the target population of pregnant women. IN00598590 ►People who have received essential Health, Nutrition, Population services (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 2,835,000.00 2,835,000.00 25,000,000.00 Date 31-Dec-2016 30-Mar-2018 30-Mar-2018 31-Dec-2021 IN00656150 ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) 1/30/2019 Page 2 of 8 The World Bank Implementation Status & Results Report Health System Strengthening for Better Maternal and Child Health Results Project (PDSS) (P147555) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 1,838,329.00 7,150,000.00 Date 30-Jun-2016 -- 30-Mar-2018 31-Dec-2021 We have inserted intermediate results indicators in the Results Framework. CRIs for Fully Vaccinated Children, Nutrition services for children and women, Institutional Deliveries were added, including their sum: Total Beneficiaries. The Results Framework contained an original indicator for ‘total beneficiaries’ which is different from the new CRI for ‘total beneficiaries’, due on the one hand to more services being counted under the original indicator as opposed to the new indicator, and also due to the requirement of having unique beneficiaries for the new CRIs. The latter for instance had an impact on how many unique beneficiaries were estimated for growth monitoring services for children under five years of age, and for Comments: antenatal care services. Services included in the new CRIs are: fully vaccinated children (same as for the original results framework), growth monitoring visits children aged 6 months to 23 months (volume of services divided by 6 – the target norm for annual visits in this age group), growth monitoring visits children aged 24 months to 59 months (volume of services divided by 4 – the target norm for annual visits in this age group), first antenatal care visits for pregnant women (not counting all follow up visits) and postnatal care visits (assuming unique beneficiaries). IN00656151 People who have received essential health, nutrition, and population (HNP) services - Female (RMS requirement) (Number, Corporate Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 1,494,562.00 5,812,950.00 IN00656152 Number of children immunized (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 319,681.00 1,250,000.00 Date 30-Jun-2016 -- 30-Mar-2018 30-Dec-2021 IN00656153 Number of women and children who have received basic nutrition services (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 717,011.00 4,200,000.00 Date 30-Jun-2016 -- 30-Mar-2018 30-Dec-2021 IN00656154 Number of deliveries attended by skilled health personnel (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 434,307.00 1,700,000.00 Date 30-Jun-2016 -- 30-Mar-2018 30-Dec-2021 IN00598594 ►Average score of the quality checklist at the health centers (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 20.00 58.10 58.10 60.00 Date 31-Jul-2014 30-Mar-2018 30-Mar-2018 31-Dec-2021 1/30/2019 Page 3 of 8 The World Bank Implementation Status & Results Report Health System Strengthening for Better Maternal and Child Health Results Project (PDSS) (P147555) Criterion-based clinical measures and vignettes will also be included in the quality checklist. The quality Comments: check list will be applied at two levels: at the health center and at the first level referral hospital level. IN00598593 ►Percentage of Children Fully Immunized (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 54.00 66.00 66.00 65.00 Date 31-Jul-2014 30-Mar-2018 30-Mar-2018 31-Dec-2021 The project will also measure fully immunized children under 1 which is a more sensitive and complete measure of correct and timely application of all obligatory immunizations done prior to 11 months of age. Comments: This measure is also a proxy of the quality of the EPI program (follow-up on defaulters; quality and effectiveness of outreach and community based programs). IN00598583 ►New curative consultations per capita per year (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.25 0.42 0.42 0.50 Date 31-Jul-2014 30-Mar-2018 30-Mar-2018 31-Dec-2021 Intermediate Results Indicators by Components Improve Utilization and Quality of Health Services at Health Facilities through PBF IN00598581 ►Number of new and existing acceptors of modern contraceptive use (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 194,480.00 311,582.00 311,582.00 500,000.00 Date 31-Jul-2014 30-Jun-2018 30-Jun-2018 31-Dec-2021 Comments: Condom use and the use of traditional methods will not be used here as they are very difficult to verify IN00598588 ►First time adolescent girls acceptant of modern contraceptives (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 17,508.00 17,508.00 50,000.00 Date 31-Dec-2016 30-Jun-2018 30-Jun-2018 31-Dec-2021 IN00598597 ►Average quality of nutritional services (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 20.00 20.00 55.00 Date 31-Dec-2015 30-Jun-2018 30-Jun-2018 31-Dec-2021 IN00598584 1/30/2019 Page 4 of 8 The World Bank Implementation Status & Results Report Health System Strengthening for Better Maternal and Child Health Results Project (PDSS) (P147555) ►Percentage of pregnant women counseled and tested for HIV (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 17.50 60.00 60.00 40.00 Date 31-Jul-2014 30-Jun-2018 30-Jun-2018 31-Dec-2021 IN00598587 ►Number of Direct Beneficiaries, of which female (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 10,624,580.00 10,624,580.00 25,000,000.00 Date 31-Jul-2014 30-Jun-2018 30-Jun-2018 31-Dec-2021 IN00598600 Number of women (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 4,519,786.00 4,519,786.00 15,000,000.00 Date 31-Dec-2014 30-Jun-2018 30-Jun-2018 31-Dec-2021 IN00598598 ►Percentage of children under 24 months participating in the Growth Monitoring and Promotion activities at community level (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 26.90 28.00 28.00 45.00 Date 31-Dec-2015 30-Jun-2018 30-Jun-2018 31-Dec-2021 IN00598592 ►Percentage of families participating in parental education sessions at community level (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 50.00 Date 31-Dec-2016 30-Jun-2018 30-Jun-2018 31-Dec-2021 IN00598599 ►Exclusive breastfeeding for children under 6 months (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 54.00 54.00 66.00 Date 31-Dec-2015 30-Jun-2018 30-Jun-2018 31-Dec-2021 Improve Governance, Purchasing and Coaching and Strengthen Health Administration Directorates and Services through PBF IN00598595 ►Average number of days with stock out of tracer drugs in targeted health facilities on the day of the visit (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target 1/30/2019 Page 5 of 8 The World Bank Implementation Status & Results Report Health System Strengthening for Better Maternal and Child Health Results Project (PDSS) (P147555) Value >30 days >30 days >30 days >15 days Date 31-Dec-2016 30-Jun-2018 30-Jun-2018 31-Dec-2021 IN00598586 ►Health personnel receiving training (number) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 4,946.00 4,946.00 10,000.00 Date 31-Jul-2014 30-Jun-2018 30-Jun-2018 31-Dec-2021 This indicator measures the cumulative number of health personnel receiving training through a Bank- Comments: financed project. IN00598589 ►Health facilities receiving Client Tracer and Satisfaction Survey feedback (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 64.00 64.00 70.00 Date 31-Dec-2016 30-Jun-2018 30-Jun-2018 31-Dec-2021 Strengthen Health Sector Performance – Financing and Health Policy Capacities IN00598596 ►Civil servants eligible for retirement in the Ministry of Health that have received their retirement indemnities/packages and retired from active service (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 4,000.00 Date 31-Dec-2016 30-Jun-2018 30-Jun-2018 31-Dec-2021 IN00598585 ►Number of poor people benefiting from fee exemption mechanisms (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 5,248.00 34,085.00 34,085.00 6,500.00 Date 31-Jul-2014 30-Jun-2018 30-Jun-2018 31-Dec-2021 Disease Surveillance System Strengthening and Response IN00598591 ►Single contract signed and implemented at province level (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 2.00 6.00 6.00 11.00 Date 31-Dec-2016 30-Jun-2018 30-Jun-2018 31-Dec-2021 1/30/2019 Page 6 of 8 The World Bank Implementation Status & Results Report Health System Strengthening for Better Maternal and Child Health Results Project (PDSS) (P147555) Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P147555 IDA-55720 Effective USD 130.00 130.00 0.00 51.59 71.02 42% P147555 IDA-59980 Effective USD 120.00 120.00 0.00 90.03 32.90 73% P147555 IDA-D0210 Effective USD 90.00 90.00 0.00 40.00 44.67 47% P147555 TF-18375 Effective USD 6.50 6.50 0.00 1.94 4.56 30% P147555 TF-A4579 Effective USD 40.00 40.00 0.00 2.27 37.73 5.7% P147555 TF-A5096 Effective USD 3.50 3.50 0.00 3.49 0.01 100% P147555 TF-A6945 Closed USD 10.00 10.00 0.00 4.53 5.47 45% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P147555 IDA-55720 Effective 18-Dec-2014 20-Jan-2015 30-May-2016 31-Dec-2019 31-Dec-2021 P147555 IDA-59980 Effective 31-Mar-2017 19-Apr-2017 13-Feb-2018 31-Dec-2021 31-Dec-2021 P147555 IDA-D0210 Effective 18-Dec-2014 20-Jan-2015 30-May-2016 31-Dec-2019 31-Dec-2021 P147555 TF-18375 Effective 20-Jan-2015 20-Jan-2015 30-May-2016 31-Dec-2019 31-Dec-2021 P147555 TF-A4579 Effective 19-Apr-2017 19-Apr-2017 18-Aug-2017 31-Dec-2021 31-Dec-2021 P147555 TF-A5096 Effective 24-May-2017 24-May-2017 22-Nov-2017 30-Jun-2019 30-Jun-2019 P147555 TF-A6945 Closed 24-Jan-2018 14-Mar-2018 14-Aug-2018 31-Aug-2018 31-Aug-2018 Cumulative Disbursements 1/30/2019 Page 7 of 8 The World Bank Implementation Status & Results Report Health System Strengthening for Better Maternal and Child Health Results Project (PDSS) (P147555) Restructuring History Level 2 Approved on 01-Sep-2015 ,Level 2 Approved on 31-Oct-2018 ,Level 2 Approved on 06-Dec-2018 Related Project(s) P157864-DRC Health System Strengthening Additional Financing ,P165435-DRC - Additional Financing Health System Strengthening Project for Better Maternal and Child Health Results ,P166004-Health System Strengthening for Better Maternal and Child Health Results AF2 ,P167766- Health System Strengthening for Better Maternal and Child Health PEF AF ,P169753-AF III DRC Health System Strengthening for Better Maternal and Child Health Results 1/30/2019 Page 8 of 8