The World Bank Report No: ISR16755 Implementation Status & Results Barbados Barbados Second HIV/AIDS Project (P106623) Public Disclosure Copy Operation Name: Barbados Second HIV/AIDS Project (P106623) Project Stage: Implementation Seq.No: 12 Status: ARCHIVED Archive Date: 17-Nov-2014 Country: Barbados Approval FY: 2009 Product Line: IBRD/IDA Region: LATIN AMERICA AND CARIBBEAN Lending Instrument: Specific Investment Loan Implementing Agency(ies): National HIV/AIDS Commission Key Dates Board Approval Date 07-Aug-2008 Original Closing Date 30-Nov-2013 Planned Mid Term Review Date 05-Dec-2011 Last Archived ISR Date 12-Jul-2014 Effectiveness Date 06-Jan-2009 Revised Closing Date 30-Nov-2014 Actual Mid Term Review Date 05-Dec-2011 Project Development Objectives Project Development Objective (from Project Appraisal Document) The project would support the implementation of the 2008-2013 Barbados National HIV/AIDS Strategic Plan, specifically to increase: - Adoption of safe behaviors, in particular amongst key populations at higher risk. - Access to prevention, treatment and social care, in particular for key populations at higher risk. - Capacity of organizational and institutional structures that govern the NAP. - Use of quality data for problem identification, strategy definition and measuring results. Has the Project Development Objective been changed since Board Approval of the Project? Yes No Component(s) Component Name Component Cost Component 1: Prevention and Care 31.50 Component 2: Institutional Strengthening 3.50 Overall Ratings Previous Rating Current Rating Public Disclosure Copy Progress towards achievement of PDO Moderately Satisfactory Satisfactory Overall Implementation Progress (IP) Moderately Satisfactory Satisfactory Overall Risk Rating Low Implementation Status Overview This Project was approved on August 7, 2008 and has been effective since January 6, 2009. The full loan amount of US$35 million has been disbursed and the Project will close on November 30, 20 The Project supported the Government of Barbados' National HIV/AIDS Program under which significant results have been attained towards the overall achievement of the Project Development Objectives (PDOs). The results achieved under the Project's results framework, which consisted of nine Key Performance Indicators (KPIs), illustrate the progress Page 1 of 5 The World Bank Report No: ISR16755 made towards the PDOs. Specifically, six of the nine KPIs were fully achieved against the four PDOs, as follows: PDO1 - With regard to the adoption of safe behaviors among key populations, two of the three KPIs used to measure progress were achieved which include the 80% of men who have sex with men (MSM) reporting condom use surpassing the target of 70%, and the 71.7 percent of 15-24 year olds reporting condom use surpassing the target of 65%. PDO2 - Of the four KPIs used to measure an increase in access to prevention, treatment, and social care for key populations at higher risk, 2 of the KPIs were achieved which include 99.6% of young women and men aged 15-24 indicating sexual Public Disclosure Copy relations as a way of transmitting HIV, surpassing the target of 90%, and 92.5% of people living with HIV on first line antiretroviral regimen achieving virologic success within the first 6 months of treatment surpassing the target of 70%. PDO3 - The one KPI measuring the increase in the capacity of organizational and institutional structures that govern the National HIV/AIDS Program (NAP) was achieved with US$186,848 spent by Civil Society Organizations under results-based agreements surpassing the target of US$150,000. PDO4 - the KPI measuring the increase in the use of quality data for problem identification, strategy definition, and measuring results was achieved with the country now having an Evidence- based National Strategic Plan in place and disseminated which was developed using data from surveys targeting key populations and provides a strategy and results framework to guide and measure progress on the country's national response to HIV. In sum, overall achievement of the PDO is rated as Satisfactory because 2 PDOs were partially achieved while 2 PDOs were fully achieved. The Implementation Completion Report (ICR) will include additional information (not currently available) on the three KPIs which were not achieved. Locations Country First Administrative Division Location Planned Actual Barbados Christ Church Christ Church ✔ Results Project Development Objective Indicators Indicator Name Core Unit of Measure Baseline Current End Target Percentage of female sex workers reporting the Percentage Value 80.00 0.00 85.00 use of a condom with their most recent client Date 31-Dec-2006 29-Oct-2014 31-Dec-2012 Comments Baseline reported for 2006 Data to be available by November 30, 2014 Percentage of men reporting the use of a Percentage Value 64.00 80.00 70.00 condom the last time they had sex with a male Date 31-Dec-2007 29-Oct-2014 31-Dec-2011 partner Comments Baseline reported for 2007. 80: Adult KABP 2014 56.9: BSS 2014 Percentage of young men and women aged Percentage Value 21.00 71.70 65.00 Public Disclosure Copy 15-24 years reporting the use of a condom the Date 31-Dec-2006 29-Oct-2014 31-Dec-2013 last time they had sex with non marital non Comments Baseline reported for Adult KABP Survey 2014 cohabitating sexual partner. 2005-2006 Percentage of young women and men aged Percentage Value 94.30 99.60 90.00 15-24 indicating sexual relations as a way of Date 31-Dec-2006 29-Oct-2014 31-Dec-2013 transmitting HIV Comments Baseline reported for Adult KABP Survey 2014 Target is to maintain at least a 2005-2006 rate of 90%. Page 2 of 5 The World Bank Report No: ISR16755 Percentage of identified HIV positive pregnant Percentage Value 96.00 90.00 95.00 women who gave birth in the last 12 months Date 31-Dec-2008 29-Oct-2014 31-Dec-2013 receiving a complete course of ARV to reduce Comments Baseline reported for year- 90.9 (20/22) - denominator is Target is to maintain a MTCT Public Disclosure Copy end 2008. number of HIV positive PMTCT rate above 95% over pregnant women accessing the 2008-2013 period. care 83 (20/24) - denominator is number of HIV positive pregnant women. Percentage of people living with HIV on first Percentage Value 60.00 92.50 70.00 line antiretroviral regimen achieving virologic Date 31-Dec-2008 29-Oct-2014 31-Dec-2011 success within the first 6 months of treatment. Comments Baseline reported for year- 92.5% calculated as <1000 Target is to maintain a end 2008. copies/mL within 12 mos. virologic success above 70%. 70.1% calculate as <50 copies /mL within 6 mos. Percent of most at-risk populations (female sex Percentage Value 0.00 54.40 70.00 workers and men who have sex with men) Date 29-Oct-2014 31-Dec-2012 reached with HIV prevention services. Comments No baselines MSM: 54.4, FSW: 44.5 The target for FSW is 70% Caribbean HIV/AIDS Alliance and the target for MSM is (CHAA) data 75%. Amount of funds spent by CSOs under results- Amount(USD) Value 0.00 186848.00 150000.00 based agreements. Date 31-Dec-2008 29-Oct-2014 31-Dec-2013 Comments National HIV/AIDS Commission (NHAC) Desk Review from Grant Monitoring Reports Evidence-based Strategic Plan 2014-2018. Text Value Strategic PLan 2008-2013 2014-2018 NSP finalized and 2014-2018 Plan developed by being disseminated June 2013 Date 31-Dec-2008 29-Oct-2014 30-Jun-2013 Comments Public Disclosure Copy Intermediate Results Indicators Page 3 of 5 The World Bank Report No: ISR16755 Indicator Name Core Unit of Measure Baseline Current End Target Amount spent on HIV/AIDS in the past 12 Amount(USD) Value 6900000.00 7458720.00 6650000.00 months Date 31-Dec-2007 31-Mar-2012 31-Dec-2011 Public Disclosure Copy Comments US$6.9 million baseline Data for this indicator is not Target is to be met every year reported for 2006-2007. being reported on due to this of 70% of Eligible Program indicator not having been Expenditures (EPEs) which is included as a KPI following at least US$6.65 million. the restructuring. Data on Financial Performance (as of 29-Oct-2014) Financial Agreement(s) Key Dates Project Ln/Cr/Tf Status Approval Date Signing Date Effectiveness Date Original Closing Date Revised Closing Date P106623 IBRD-75850 Effective 07-Aug-2008 25-Sep-2008 06-Jan-2009 30-Nov-2013 30-Nov-2014 Disbursements (in Millions) Project Ln/Cr/Tf Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P106623 IBRD-75850 Effective USD 35.00 35.00 0.00 35.00 0.00 100.00 Disbursement Graph Public Disclosure Copy Key Decisions Regarding Implementation Page 4 of 5 The World Bank Report No: ISR16755 The key activities that were completed in the Project's final year of implementation are the Health Information System (HIS), the Behavioral Sero-prevalence Survey (BSS) for Female Sex Workers (FSW) and Men who have Sex with Men (MSM), and the National HIV/AIDS Strategic Plan (NSP). Public Disclosure Copy Restructuring History Level two Approved on 29-Jul-2011, Level two Approved on 07-Mar-2013, Level 2 CD Decision on 26-Nov-2013 Related Projects There are no related projects. Public Disclosure Copy Page 5 of 5