Public Disclosure Copy The World Bank Implementation Status & Results Report Reducing Health Risk Factors (P160512) Reducing Health Risk Factors (P160512) EUROPE AND CENTRAL ASIA | Bosnia and Herzegovina | Health, Nutrition & Population Global Practice | Recipient Executed Activities | Investment Project Financing | FY 2017 | Seq No: 3 | ARCHIVED on 22-Jan-2019 | ISR35274 | Implementing Agencies: RS PCU, Bosnia & Herzegovina, FBiH PCU Key Dates Key Project Dates Bank Approval Date:11-Apr-2017 Effectiveness Date:20-Feb-2018 Original Closing Date:31-Dec-2018 Revised Closing Date:30-Jun-2019 Project Development Objectives Project Development Objective (from Project Appraisal Document) The Project Development Objective (PDO) of this Recipient Executed Trust Fund (RETF) is to assist the Republika Srpska and the Federation of Bosnia and Herzegovina in reducing selected non-communicable disease (NCD) risk factors by promoting tobacco and alcohol control, and diet and physical activity in selected beneficiaries (pre-school children, school children, teachers, health workers and local government employees) in four selected local communities (two in RS and two in FBiH) Has the Project Development Objective been changed since Board Approval of the Project Objective? No PHRPDODEL Components Name Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO  Moderately Unsatisfactory  Moderately Unsatisfactory Overall Implementation Progress (IP)  Moderately Unsatisfactory  Moderately Satisfactory Implementation Status and Key Decisions Implementation started in March 2018. Despite significant delay in implementation start up in the four pilot communities (Doboj, Zvornik, Mostar, Zenica), extensive groundwork has been carried out over the past six months, which has led to positive results, including: (i) development and approval, in every pilot community, of a locally relevant action plans that include tools for behavior change and actions to address challenges related to cases of multiple behavior risk; (ii) community mobilization and establishment of fully operational steering groups; (iii) establishment of advocacy 1/22/2019 Page 1 of 6 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Reducing Health Risk Factors (P160512) coalitions and ongoing dialog on advocacy arrangements between local stakeholders; (iv) development of educational tools for pre-schools institutions, primary and secondary schools, health institutions and local governments; (v) start-up of education activities with all target groups, including preschool institutions, municipal authorities, school and health organizations (staff and parents). Regular meetings of key stakeholders of the Project have been held on a monthly basis with representatives from the Ministries of Health (Federation of Bosnia and Herzegovina, and Republika Sprska), consultants, municipal administrative staff (of the pilot communities) and the World Bank team during which progress on activities being implemented is presented, implementation challenges are discussed, and the action plans for the following month are agreed upon. Feedback and support on all four pillars (Advocacy; Community Mobilization; Education and Intervention; and Monitoring and Evaluation) have been provided to consultants and to local action groups in target communities on relevant project deliverables (i.e., education materials, action plans, etc.), resulting in improvement of their capacities to develop evidence-based project proposals for all four risk factors covered by the Project (smoking, alcohol use, poor diet, lack of physical activity). Risks Overall Risk Rating Risk Category Rating at Approval Previous Rating Current Rating Overall  --  Substantial  Substantial Results Project Development Objective Indicators PHINDPDOTBL Percentage increase in awareness among primary and secondary school students on tobacco and alcohol use and addiction (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target waiting for the final RS and FBiH: Value a) RS: 0; b) FBiH: 0 -- survey (spring 2019) 50% Date 01-May-2017 -- 21-Dec-2018 28-Jun-2019 Comments Currently, the following steps have been successfully completed: • Education package aimed at strengthening capacity of teachers, parents and families to implement evidence-based healthy life style policies and related health promotion activities has been developed. • In the FBiH, training modules of total duration of seven days have been completed (namely: ToT for elementary school staff, junior students (two days); ToT for elementary school staff, senior students (two days); and ToT for high school staff (three days). • In RS, training modules of a total duration of four days have been completed (namely, workshops for preschool staff (two days) and elementary and secondary schools staff (two days)). • Preschool, elementary and secondary education institution staff trainings have been conducted, involving 80% of education institutions in FBiH and 85% of education institutions in RS. • Education activities aimed at improving skills of parents to support their children not to use tobacco and alcohol were 1/22/2019 Page 2 of 6 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Reducing Health Risk Factors (P160512) implemented in all target communities. PHINDPDOTBL Percentage of public education (kindergartens, primary and secondary schools) and health care institutions that have implemented smoke free policies in line with the Initiative for Tobacco Control (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target % of education institutions FBiH: Zenica 4%; Mostar 7% RS: Zvornik 0; Doboj 0 waiting the final survey RS and FBiH: Value -- % of health institutions (spring 2019) 50% FBiH: Zenica 0%; Mostar 25% RS: Zvornik 0%; Doboj 0% Date 19-May-2017 -- 21-Dec-2018 28-Jun-2019 Comments Currently, working groups with aim to develop and implement smoke free policies in primary and secondary schools established all four targeted communities. Smoke-free policies drafted in all four target communities and being discussed by involved stakeholders, namely local action groups, government agencies and education and health institutions. PHINDPDOTBL Percentage increase in awareness of linkage between habits and behaviors, and NCD risks (such as cardiovascular disease, cancer, diabetes, stroke) among public education and health care employees (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target RS and FBiH: Value a) RS: 0; b) FBiH: 0 -- -- 30% Date 02-Feb-2017 -- 21-Dec-2018 31-Dec-2018 Comments Current achievements include: • Education package, aimed at strengthening capacity of health organizations and municipal government staff to implement evidence-based healthy life style policies and related health promotion activities has been developed. • In the FBiH, training modules of total duration of 2.5 days were completed (namely, 1.5-day workshop for the health 1/22/2019 Page 3 of 6 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Reducing Health Risk Factors (P160512) organizations staff and one day workshop for municipal government staff). • In RS, training modules of total duration of one day were held, namely half-day workshop for health organizations staff and half- day workshop for municipal government staff. • Workshops for employees in education and health institutions with aim to improve their knowledge of health promotion have been conducted in all four target communities, involving 456 health and education professionals (FBiH: 97; RS: 359). • Local government staff trainings have been conducted, involving 399 municipal governments’ staff (FBiH: 114; RS: 285). Overall Comments Intermediate Results Indicators PHINDIRITBL (a)Number of toolkits for tobacco and alcohol control, and diet and physical activity developed according to target group (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target at least two toolkits in each Value RS and FBiH: 0 -- RS and FBH: 11 toolkits entity per target group Date 02-Feb-2017 -- 21-Dec-2018 31-Dec-2018 Comments Total of 11 toolkits aimed at strengthening capacity of teachers, parents and families, and health organizations and municipal government staff to implement evidence-based healthy life style policies and health promotion activities have been developed. Education package in the FBiH includes six training modules targeting key risk factors. Specifically, training modules are as follows: preschool staff (one day workshop), health organizations staff (one day workshop plus additional half a day workshop); municipal government staff (one day workshop); ToT for elementary school staff, junior students (two day workshop); ToT for elementary school staff, senior students (two day workshop); and ToT for high school staff (three day workshop). In RS education package include 5 training modules targeting key risk factors. Namely, training modules are as follows: preschool staff (two-day workshop); elementary and secondary schools staff (two-day workshop); health organizations staff (half-day workshop); and municipal government staff (half-day workshop). 1/22/2019 Page 4 of 6 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Reducing Health Risk Factors (P160512) PHINDIRITBL Number of attendees in Training of Trainers by entity (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target 106 in FBiH and 171 in according to Value RS and FBiH: 0 -- RS progress report Date 02-Feb-2017 -- 21-Dec-2018 31-Dec-2018 Overall Comments Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed Disbursed P160512 TF-A4795 Effective USD 1.41 1.41 0.00 0.85 0.56 60% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P160512 TF-A4795 Effective 11-Apr-2017 24-Oct-2017 20-Feb-2018 31-Dec-2018 30-Jun-2019 Cumulative Disbursements 1/22/2019 Page 5 of 6 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Reducing Health Risk Factors (P160512) Restructuring History Level 2 Approved on 21-Nov-2018 Related Project(s) There are no related projects. 1/22/2019 Page 6 of 6 Public Disclosure Copy