Public Disclosure Copy The World Bank Implementation Status & Results Report Cambodia Health Equity and Quality Improvement Project (H-EQIP) (P157291) Cambodia Health Equity and Quality Improvement Project (H-EQIP) (P157291) EAST ASIA AND PACIFIC | Cambodia | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2016 | Seq No: 2 | ARCHIVED on 25-May-2017 | ISR27434 | Implementing Agencies: Ministry of Health, Kingdom of Cambodia, Ministry of Health Key Dates Key Project Dates Bank Approval Date:19-May-2016 Effectiveness Date:09-Nov-2016 Planned Mid Term Review Date:28-Sep-2018 Actual Mid-Term Review Date:-- Original Closing Date:30-Jun-2021 Revised Closing Date:30-Jun-2021 Project Development Objectives Project Development Objective (from Project Appraisal Document) To improve access to quality health services for the targeted population groups with protection against impoverishment due to the cost of health services in the Kingdom of Cambodia. Has the Project Development Objective been changed since Board Approval of the Project Objective? No PHRPDODEL Components Name Component 1: Strengthening Health Service Delivery:(Cost $74.20 M) Component 2: Improving Financial Protection and Equity:(Cost $70.00 M) Component 3: Ensuring Sustainable and Responsive Health Systems:(Cost $30.00 M) Component 4: Contingent Emergency Response Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO  Satisfactory  Satisfactory Overall Implementation Progress (IP)  Satisfactory  Satisfactory Overall Risk Rating  Substantial  Substantial 5/25/2017 Page 1 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Cambodia Health Equity and Quality Improvement Project (H-EQIP) (P157291) Implementation Status and Key Decisions Implementation of the project is progressing well since its effectiveness on November 9, 2016. Findings from field visits indicate that lumpsum grants financed by the Royal Government of Cambodia is flowing to the health facilities and innovative ways of its use are introduced for the facilities to improve their performance. Training on the quality assessment tools is ongoing to prepare for the launch of the performance-based grants. Payment of Health Equity Fund (HEF) is on track and transition of HEF implementer and HEF promoters is well underway. Status of achievement of Disbursement- linked indicators Year 0 targets has been validated and the this is expected to be paid in June 2017. 5/25/2017 Page 2 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Cambodia Health Equity and Quality Improvement Project (H-EQIP) (P157291) 5/25/2017 Page 3 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Cambodia Health Equity and Quality Improvement Project (H-EQIP) (P157291) 5/25/2017 Page 4 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Cambodia Health Equity and Quality Improvement Project (H-EQIP) (P157291) Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance  Substantial  Substantial  Substantial Macroeconomic  Moderate  Moderate  Substantial Sector Strategies and Policies  Moderate  Moderate  Substantial Technical Design of Project or Program  Substantial  Substantial  Substantial Institutional Capacity for Implementation and Sustainability  Substantial  Substantial  Substantial Fiduciary  High  High  High Environment and Social  Moderate  Moderate  Substantial Stakeholders  Moderate  Moderate  Substantial Other  --  --  -- Overall  Substantial  Substantial  Substantial 5/25/2017 Page 5 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Cambodia Health Equity and Quality Improvement Project (H-EQIP) (P157291) Results Project Development Objective Indicators PHINDPDOTBL  Increase in the number of health centers exceeding 60% score on the quality assessment of health facilities. (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 49.00 -- -- 73.50 Date 30-Apr-2016 -- 24-Mar-2017 30-Jun-2021 Comments Data not yet available as training of quality assessment tools is not yet completed. Cascade training is completed for the first phase and assessments have commenced in May 2017 for about one-third of the country, and full rollout is early next year. PHINDPDOTBL  Reduction in the share of households that experienced impoverishing health spending during the year. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.90 -- 0.90 0.70 Date 30-Oct-2015 -- 24-Mar-2017 30-Jun-2021 Comments Baseline from Cambodia Socioeconomic Survey (CSES) 2014. Since this indicator is only available once in a few years, the next update will only be when the next round of CSES is available. PHINDPDOTBL  Reduction in out of pocket health expenditure as percentage of the total health expenditure. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 62.30 -- 62.30 55.00 Date 30-Oct-2015 -- 24-Mar-2017 30-Jun-2021 Comments 5/25/2017 Page 6 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Cambodia Health Equity and Quality Improvement Project (H-EQIP) (P157291) Baseline from National Health Account (NHA) 2013, and the current number is the latest available (for 2014) from the NHA report released in 2016. PHINDPDOTBL  Increase in the utilization of health services by HEF beneficiaries. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 51.00 -- 84.90 81.00 Date 30-Oct-2015 -- 24-Mar-2017 30-Jun-2021 Comments Baseline data is from MOH Health Financing database, 2014. However, current data is from National Health Congress report with data for 2016. This is based on 2.24 million OPD visits and 2.6 million HEF beneficiaries in 2016. Overall Comments Intermediate Results Indicators PHINDIRITBL  Percentage of health centers having stock-outs of 14 essential medicines. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 4.73 4.01 4.01 5.00 Date 30-Oct-2015 30-Jul-2016 30-Jul-2016 30-Jun-2021 Comments This has not been updated as the NHC report did not report this indicator in March 2017. 5/25/2017 Page 7 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Cambodia Health Equity and Quality Improvement Project (H-EQIP) (P157291) PHINDIRITBL  Proportion of health centers with functioning health center management committees. (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 64% -- 64% Baseline + 25% Date 24-Mar-2017 10-Aug-2016 24-Mar-2017 30-Jun-2021 Comments Baseline and actual from National Health Congress report 2017 (p.139) PHINDIRITBL  Percentage of health center, CPA-1, CPA-2, and CPA-3 facilities that receive payments based on performance that includes quality scores within 90 days of the end of the quarter. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 70.00 Date 30-Oct-2015 10-Aug-2016 24-Mar-2017 30-Jun-2021 Comments Quality assessment has not yet commenced, so this number is currently 0. PHINDIRITBL  Reduction in the variance in score on Health Center quality assessment. (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target 43 percentage Not available Value 53 percentage points -- points Date 30-Oct-2015 10-Aug-2016 24-Mar-2017 30-Jun-2021 Comments Baseline from L2 assessment. Updated data not available as SDG quality assessment has not yet started. 5/25/2017 Page 8 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Cambodia Health Equity and Quality Improvement Project (H-EQIP) (P157291) PHINDIRITBL  Percentage of CPA-1, CPA-2 and CPA-3 facilities having a 60% quality score in the previous quality assessments. (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Not yet available Value -- -- Baseline +50% Date 30-Oct-2015 -- 24-Mar-2017 30-Jun-2021 Comments Data not available as quality assessment has not yet started. PHINDIRITBL  Outpatient Department (OPD) consultations (new cases only) per person per year. (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.59 -- 0.63 0.95 Date 30-Oct-2015 -- 30-Jul-2016 30-Jun-2021 Comments Updated data from National Health Congress report 2017. PHINDIRITBL  Number of University of Health Sciences courses that adopt competency-based curricula with trained faculty and use of skills laboratory (DLI 1). (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 2.00 2.00 25.00 Date 30-Jul-2016 10-Aug-2016 24-Mar-2017 30-Jun-2021 Comments Based on DLI report (July 2016) and will be updated with the next DLI report. 5/25/2017 Page 9 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Cambodia Health Equity and Quality Improvement Project (H-EQIP) (P157291) PHINDIRITBL  Percentage of health centers, hospitals and OD/PHD receiving HEF and SDG payments within specified timelines (DLI 7). (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 80.00 Date 30-Oct-2015 -- 24-Mar-2017 30-Jun-2021 Comments This DLI only reported on FM capacity building for year 0. More details on timely payment will flow from the next DLI report. PHINDIRITBL  Percentage of HMIS reports submitted on time. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 95.00 -- 95.00 95.00 Date 30-Oct-2015 -- 24-Mar-2017 30-Jun-2021 Comments Updated data from National Health Congress report 2017. Overall Comments Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed Disbursed P157291 IDA-58130 Effective USD 30.00 30.00 0.00 3.71 26.03 12% P157291 TF-A2562 Effective USD 1.00 1.00 0.00 0.00 1.00 0% P157291 TF-A3114 Effective USD 3.50 3.50 0.00 3.34 0.16 95% 5/25/2017 Page 10 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Cambodia Health Equity and Quality Improvement Project (H-EQIP) (P157291) Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P157291 IDA-58130 Effective 19-May-2016 26-Aug-2016 09-Nov-2016 30-Jun-2021 30-Jun-2021 P157291 TF-A2562 Effective 19-May-2016 15-Sep-2016 15-Sep-2016 30-Jun-2020 30-Jun-2020 P157291 TF-A3114 Effective 19-May-2016 26-Aug-2016 09-Nov-2016 30-Jun-2021 30-Jun-2021 Cumulative Disbursements Restructuring History There has been no restructuring to date. Related Project(s) There are no related projects. 5/25/2017 Page 11 of 11 Public Disclosure Copy