The World Bank Implementation Status & Results Report Jordan Emergency Health Project (P163387) Jordan Emergency Health Project (P163387) MIDDLE EAST AND NORTH AFRICA | Jordan | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2017 | Seq No: 5 | ARCHIVED on 29-Jul-2019 | ISR37895 | Implementing Agencies: Ministry of Planning and International Cooperation, Ministry of Planning and International Cooperation Key Dates Key Project Dates Bank Approval Date: 13-Jun-2017 Effectiveness Date: 26-Jul-2017 Planned Mid Term Review Date: 30-Oct-2018 Actual Mid-Term Review Date: 27-Sep-2018 Original Closing Date: 29-Jun-2019 Revised Closing Date: 31-Oct-2023 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The Project development objective (PDO) is to support the Government of Jordan in maintaining the delivery of primary and secondary health services to poor uninsured Jordanians and Syrian refugees at Ministry of Health facilities. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Results-based financing to deliver health care services at primary and secondary care facilities of MOH for the target population:(Cost $238.00 M) Improving coverage and quality of the primary health care services:(Cost $11.64 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Moderately Satisfactory Moderately Satisfactory Overall Implementation Progress (IP) Moderately Satisfactory Moderately Satisfactory Overall Risk Rating Substantial Substantial Implementation Status and Key Decisions The parent project was approved by the Board of Executive Directors on June 13, 2017, and declared effective on July 26, 2017, financed by a US$50 million loan, consisting of a non-concessional portion of US$36.1 million and a concessional portion of US$13.9 million from the GCFF. In addition, the Islamic Development Bank (IsDB) provided US$100 million through a parallel co-financing arrangement, of which US$21 million is financed by the GCFF. The Additional Financing (AF) of US$200 million will be implemented over 4 years. Project Rating: The disbursement rate under the Parent project is 96.7% (with full disbursement under Component 1), and the overall PDO and Implementation Progress ratings are rated as Moderately Satisfactory. Component 1: The project has supported financing of human resources needed to deliver primary and secondary health care at MOH facilities, despite tight fiscal constraints. In addition, the project introduced a more detailed monitoring system for delivery of services, independent verification 7/29/2019 Page 1 of 8 The World Bank Implementation Status & Results Report Jordan Emergency Health Project (P163387) tracks and records actual services delivered, disaggregated by gender and target populations. The most recent annual data from this monitoring system covers November 2017 to October 2018 and shows that the overall number of services delivered to the target population was on target (2.1 million primary health services and 2.9 million secondary services). When disaggregated by population group, data for the above period suggest that the targets for Syrian refugees were not met. This was largely due to the decreased demand by Syrian refugees due to the financial barriers resulting from the change in their co-payment rate, which was rolled back in March 2019. Component 2: Although implementation of TA activities under Component 2 has incurred delays, significant progress has been made and preparations are underway to conduct planned activities (i.e. capacity building TA in health financing and health economics, and a costing study). The procurement process for capacity building activities, including selection of a firm to undertake a costing study on NCD prevention and planned trainings on health financing and economics, research methodology and scientific writing and data collection, is underway. AF: Although Effectiveness has not been achieved at the time of submitting this ISR, start-up of activities under the AF is expected to be implemented swiftly. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance Moderate Moderate Moderate Macroeconomic Substantial Substantial Substantial Sector Strategies and Policies Moderate Moderate Moderate Technical Design of Project or Program Moderate Moderate Moderate Institutional Capacity for Implementation and Sustainability Moderate Moderate Moderate Fiduciary Substantial Moderate Moderate Environment and Social Low Low Low Stakeholders Substantial Moderate Moderate Other High Substantial Substantial Overall Substantial Substantial Substantial Results PDO Indicators by Objectives / Outcomes PDO Indicators IN00724051 ►Maintaining number of health services delivered at MOH secondary health care facilities to target populations (Number (Thousand), Custom) Baseline Actual (Previous) Actual (Current) End Target Value 1,905.00 1,905.00 2,984.02 1,905.00 Date 31-Dec-2016 07-Jun-2019 26-Jun-2019 31-Oct-2023 Verified Data from November 2017 - October 2018 Comments: IN00724052 7/29/2019 Page 2 of 8 The World Bank Implementation Status & Results Report Jordan Emergency Health Project (P163387) Number of health services delivered at MOH secondary health care facilities to poor uninsured Jordanians, male (Number (Thousand), Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 792.00 792.00 1,240.05 792.00 Date 31-Dec-2016 07-Jun-2019 26-Jun-2019 31-Oct-2023 IN00724053 Number of health services delivered at MOH secondary health care facilities to poor uninsured Jordanians, female (Number (Thousand), Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 1,009.00 1,009.00 1,660.84 1,009.00 Date 31-Dec-2016 07-Jun-2019 26-Jun-2019 31-Oct-2023 IN00724054 Number of health services delivered at MOH secondary health care facilities to registered Syrian refugees, male (Number (Thousand), Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 46.00 46.00 38.69 46.00 Date 31-Dec-2016 07-Jun-2019 26-Jun-2019 31-Oct-2023 IN00724055 Number of health services delivered at MOH secondary health care facilities to registered Syrian refugees, female (Number (Thousand), Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 58.00 58.00 44.43 58.00 Date 31-Dec-2016 07-Jun-2019 26-Jun-2019 07-Jun-2019 IN00724056 ►Maintaining number of health services delivered at MOH primary health care facilities to target populations (Number (Thousand), Custom) Baseline Actual (Previous) Actual (Current) End Target Value 2,670.00 2,670.00 2,159.72 2,670.00 Date 07-Jun-2019 07-Jun-2019 26-Jun-2019 31-Oct-2023 Verified Data from November 2017 - October 2018 Comments: IN00724057 Number of health services delivered at MOH primary health care facilities to poor uninsured Jordanians, male (Number (Thousand), Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 1,115.00 1,115.00 1,208.12 1,115.00 Date 31-Dec-2016 07-Jun-2019 26-Jun-2019 31-Oct-2023 IN00724058 Number of health services delivered at MOH primary health care facilities to poor uninsured Jordanians, female (Number (Thousand), Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target 7/29/2019 Page 3 of 8 The World Bank Implementation Status & Results Report Jordan Emergency Health Project (P163387) Value 1,420.00 1,009.00 893.08 1,420.00 Date 31-Dec-2016 07-Jun-2019 26-Jun-2019 31-Oct-2023 IN00724059 Number of health services delivered at MOH primary health care facilities to registered Syrian refugees, male (Number (Thousand), Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 59.00 59.00 21.95 59.00 Date 31-Dec-2016 07-Jun-2019 26-Jun-2019 31-Oct-2023 IN00724060 Number of health services delivered at MOH primary health care facilities to registered Syrian refugees, female (Number (Thousand), Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 76.00 76.00 36.56 76.00 Date 31-Dec-2016 07-Jun-2019 26-Jun-2019 31-Oct-2023 Overall Comments PDO Data Source: Verified Data from November 2017 - October 2018 Intermediate Results Indicators by Components Results based financing to deliver health care services at primary and secondary care facilities of MOH for the target population IN00724061 ►Grievances registered related to delivery of project benefits that are actually addressed (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 100.00 0.00 0.00 100.00 Date 30-Dec-2016 31-Oct-2018 26-Jun-2019 23-Oct-2023 IN00724062 ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 220,358.00 220,358.00 1,101,290.00 Date 27-Jul-2017 14-Dec-2018 26-Jun-2019 30-Oct-2023 IN00724063 Number of children immunized (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 220,258.00 220,258.00 1,101,290.00 7/29/2019 Page 4 of 8 The World Bank Implementation Status & Results Report Jordan Emergency Health Project (P163387) Date 27-Jul-2017 14-Dec-2018 26-Jun-2019 30-Oct-2023 IN00724064 ►Review of the existing GRM mechanism (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target No review conducted Review conducted of No review conducted of No review conducted of Value of the existing GRM the existing GRM the existing GRM system the existing GRM system system system Date 29-Mar-2019 29-Mar-2019 26-Jun-2019 15-Jun-2023 IN00724065 ►Percentage increase in proportion of pregnant Syrian women accessing their first antenatal care visits during the first trimester (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 83.2% 83.2% 83.2% 84.8% Date 24-May-2019 24-May-2019 26-Jun-2019 30-Oct-2023 Disbursement Linked Indicators IN00724066 ►DLI 1 Assessment of PHC coverage & quality gaps (Text, Output, 2,000,000.00, 0.00%) Baseline Actual (Previous) Actual (Current) Year 4 Value No assessment No assessment No assessment -- Date -- 29-Mar-2019 26-Jun-2019 -- DLI 1.1 Additional MOH budget allocation (Text, Intermediate Outcome, 1,000,000.00, 0.00%) Baseline Actual (Previous) Actual (Current) Year 4 US$776,091,777 (JOD US$776,091,777 (JOD US$776,091,777 (JOD 550,419,700), MOH current 550,419,700), MOH 550,419,700), MOH Value -- and capital expenditures, current and capital current and capital 2017 expenditures, 2017 expenditures, 2017 Date -- 29-Mar-2019 26-Jun-2019 -- DLI 1.2 MOH completes an assessment (Text, Output, 1,000,000.00, 0.00%) Baseline Actual (Previous) Actual (Current) Year 4 Value No assessment No assessment No assessment -- Date -- 29-Mar-2019 26-Jun-2019 -- IN00724069 ►DLI 2 Development of an Implementation Plan to Improve Quality & Coverage of PHC (Text, Output, 3,000,000.00, 0.00%) Baseline Actual (Previous) Actual (Current) Year 4 7/29/2019 Page 5 of 8 The World Bank Implementation Status & Results Report Jordan Emergency Health Project (P163387) Value No implementation plan No implementation plan No implementation plan -- Date -- 29-Mar-2019 26-Jun-2019 -- DLI 2.1 Additional MOH budget allocation (Text, Intermediate Outcome, 1,000,000.00, 0.00%) Baseline Actual (Previous) Actual (Current) Year 4 US$776,091,777 (JOD US$776,091,777 (JOD US$776,091,777 (JOD 550,419,700), MOH current 550,419,700), MOH 550,419,700), MOH Value -- and capital expenditures, current and capital current and capital 2017 expenditures, 2017 expenditures, 2017 Date -- 29-Mar-2019 26-Jun-2019 -- DLI 2.2 MOH develops an implementation plan (Text, Output, 2,000,000.00, 0.00%) Baseline Actual (Previous) Actual (Current) Year 4 Value No implementation plan No implementation plan No implementation plan -- Date -- 29-Mar-2019 26-Jun-2019 -- IN00724072 ►DLI 3 Human resources Capacity Building to Improve Outcomes in PHC (Text, Output, 4,000,000.00, 0.00%) Baseline Actual (Previous) Actual (Current) Year 4 MOH provides report on Year 1 Human resources capacity Human resources Human resources implementation building and training plan capacity building and capacity building and Value results of the human completed, and evaluation training plan completed, training plan completed, resources capacity finalized and evaluation finalized and evaluation finalized building and training activities Date -- 29-Mar-2019 26-Jun-2019 -- DLI 3.1 Additional MOH budget allocation (Text, Intermediate Outcome, 2,000,000.00, 0.00%) Baseline Actual (Previous) Actual (Current) Year 4 MOH receives additional budget of US$776,091,777 (JOD US$776,091,777 (JOD US$776,091,777 (JOD US$2,000,000 in the 550,419,700), MOH current 550,419,700), MOH 550,419,700), MOH third consecutive Value and capital expenditures, current and capital current and capital Jordanian fiscal year 2017 expenditures, 2017 expenditures, 2017 following declaration of effectiveness of the project Date -- 29-Mar-2019 26-Jun-2019 -- DLI 3.2 MOH provides report on results (Text, Output, 2,000,000.00, 0.00%) Baseline Actual (Previous) Actual (Current) Year 4 Value Implementation plan Human resources Human resources MOH provides report activities not yet launched capacity building and capacity building and on Year 1 7/29/2019 Page 6 of 8 The World Bank Implementation Status & Results Report Jordan Emergency Health Project (P163387) training plan completed, training plan completed, implementation and evaluation finalized and evaluation finalized results of the human resources capacity building and training activities Date -- 29-Mar-2019 26-Jun-2019 -- Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P163387 IBRD-87680 Effective USD 36.10 36.10 0.00 34.92 1.18 97% P163387 IBRD-90000 Closed USD 141.10 141.10 0.00 0.00 141.10 0% P163387 TF-A5308 Effective USD 13.90 13.90 0.00 13.41 0.49 96% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P163387 IBRD-87680 Effective 13-Jun-2017 23-Jun-2017 26-Jul-2017 29-Jun-2019 31-Oct-2023 P163387 IBRD-90000 Closed 24-Jun-2019 -- -- 29-Jun-2019 29-Jun-2019 P163387 TF-A5308 Effective 13-Jun-2017 23-Jun-2017 26-Jul-2017 29-Jun-2019 31-Oct-2023 Cumulative Disbursements 7/29/2019 Page 7 of 8 The World Bank Implementation Status & Results Report Jordan Emergency Health Project (P163387) Restructuring History Level 2 Approved on 27-Jun-2019 Related Project(s) P170529-Jordan Emergency Health Project Additional Financing 7/29/2019 Page 8 of 8