The World Bank Implementation Status & Results Report Ethiopia Health MDG Support Operation (P123531) Ethiopia Health MDG Support Operation (P123531) AFRICA | Ethiopia | Health, Nutrition & Population Global Practice | Requesting Unit: AFCE3 | Responsible Unit: GHN07 IBRD/IDA | Program-for-Results Financing | FY 2013 | Team Leader(s): Paul Jacob Robyn, Roman Tesfaye Seq No: 13 | ARCHIVED on 11-Dec-2018 | ISR35171 | Created by: Amy Champion on 30-Nov-2018 | Modified by: Paul Jacob Robyn on 04-Dec-2018 Program Development Objectives Program Development Objective (from Program Appraisal Document) To improve the delivery and use of a comprehensive package of maternal and child health services. Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Moderately Satisfactory Moderately Satisfactory Overall Implementation Progress (IP) Moderately Satisfactory Moderately Satisfactory Implementation Status and Key Decisions The SDG Health PforR Program comprises an original IDA credit equivalent to US$100 million and a grant from the Health Results Innovation Trust Fund of US$20 million. The additional financing, which became fully effective in November 2017, is comprised of an IDA credit of $150 million, a grant of US$60 million from the Global Financing Facility for Every Woman Every Child and a grant of US$20 million from the Power of Nutrition. Since effectiveness of the AF, an advance payment of US$43.9 million was disbursed (US$36.6 million from IDA, US$2.9 million from GFF and US$4.4 million from Power of Nutrition. DLI 14 (1)- Percent of Woredas with functional Community Based Health Insurance (CBHI) schemes has been met /prior result (US$6.8M);); achieved and verified result DLI 1a. Deliveries attended by Skilled Birth Provider(US$17.7 million). Activities to support national civil registration and vital statistics systems are ongoing with support to the operationalization of the Federal Vital Events Registration Agency (FVERA), as well as the National Nutrition Program II. Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P123531 IDA-52090 Effective USD 100.00 100.00 0.00 73.10 21.43 77% P123531 IDA-60900 Effective USD 150.00 150.00 0.00 67.12 90.41 43% P123531 TF-14107 Effective USD 20.00 20.00 0.00 13.80 6.20 69% P123531 TF-A4689 Effective USD 20.00 20.00 0.00 8.12 11.88 41% P123531 TF-A4705 Effective USD 20.00 20.00 0.00 4.38 15.63 22% 12/11/2018 Page 1 of 17 The World Bank Implementation Status & Results Report Ethiopia Health MDG Support Operation (P123531) Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P123531 IDA-52090 Effective 28-Feb-2013 29-Mar-2013 17-Jun-2013 30-Jun-2018 31-Jul-2021 P123531 IDA-60900 Effective 09-May-2017 18-May-2017 27-Jun-2017 30-Jun-2021 30-Jun-2021 P123531 TF-14107 Effective 29-Mar-2013 29-Mar-2013 29-Mar-2013 30-Jun-2018 31-Jul-2021 P123531 TF-A4689 Effective 18-May-2017 18-May-2017 13-Nov-2017 30-Jun-2021 30-Jun-2021 P123531 TF-A4705 Effective 18-May-2017 18-May-2017 13-Nov-2017 30-Jun-2021 30-Jun-2021 Program Action Plan Development of a Postnatal Care Directive/policy, Implementation of the directive/policy and Monitoring of the Action Description policy/directive. Responsibility Recurrent Frequency Due Date DLI# Status Client Yes Yearly In Progress Comments Commodity distribution process - Roll out of APTS and provide progress update to ensure existence of adequate Action Description monitoring mechanism of delivery to ultimate beneficiaries at the branch level Responsibility Recurrent Frequency Due Date DLI# Status Client Yes Yearly In Progress Comments PFSA launches an open call for pre-qualifications bidders as per the Recipient's law at least once and introducing Action Description Framework Contracting Methods for common and repetitive procurement items. Responsibility Recurrent Frequency Due Date DLI# Status Client Yes Yearly In Progress Comments Ensure a system of recording fraud and corruption complaints at all levels including Woredas; Ensure the deployment Action Description of Ethics and Anticorruption Liaison Officer and experts at all levels (PFSA; PFSA regional Hubs; RHBs, offices). Responsibility Recurrent Frequency Due Date DLI# Status Client No 31-Dec-2018 Delayed Comments 12/11/2018 Page 2 of 17 The World Bank Implementation Status & Results Report Ethiopia Health MDG Support Operation (P123531) Action Description Automation of PFSA Responsibility Recurrent Frequency Due Date DLI# Status Client Yes Yearly Delayed Comments FPPA undertaking annual procurement audit and FMOH and Bank team to consult OFAG on the feasibility of Action Description undertaking financial and value for money audits for SDGPF. Responsibility Recurrent Frequency Due Date DLI# Status Client Yes Yearly Delayed Comments Review and improve the SBD and agree with FPPA; and review current Bid Evaluation reporting methods and develop Action Description a template that keeps and records all relevant evaluation information Responsibility Recurrent Frequency Due Date DLI# Status Client Yes Yearly In Progress Comments Action Description Improve tracking system of monitoring contracts with UN agencies and disclose award decisions to the public Responsibility Recurrent Frequency Due Date DLI# Status Client Yes Yearly In Progress Comments Action Description Undertake assessment study and develop coding and categorization system of procurable items Responsibility Recurrent Frequency Due Date DLI# Status Client Yes Yearly In Progress Comments Gender based violence strategy for the health sector is prepared and implemented and analytical in gender Action Description disaggregated HMIS data is conducted. 12/11/2018 Page 3 of 17 The World Bank Implementation Status & Results Report Ethiopia Health MDG Support Operation (P123531) Responsibility Recurrent Frequency Due Date DLI# Status Client Yes Yearly Delayed Comments Conduct Training and regular implementation support of health workers at the facility level on cause of death as per Action Description national disease notification codes, registration of births and other VE registration requirements. Responsibility Recurrent Frequency Due Date DLI# Status Client Yes Yearly In Progress Comments MoH Provides and Federal Ethics and Anti- corruption ( FEACC) verify and submit to the Bank quality and timely Action Description biannual report on Fraud and Corruption complaints and priority actions related to the program Responsibility Recurrent Frequency Due Date DLI# Status Client Yes CONTINUOUS In Progress Comments Ensure inclusiveness of Fraud and Corruption and complaint handling processes or priority actions in FMOH and Action Description Regional Health Bureaus joint forum discussions semiannually. Responsibility Recurrent Frequency Due Date DLI# Status Client Yes CONTINUOUS In Progress Comments Availing appropriate temporary storage facilities for collection of hazardous wastes until final disposal, enforce Action Description compliance with MWM and Disposal Directive in HF constructed before issuance of the Directive Responsibility Recurrent Frequency Due Date DLI# Status Client Yes CONTINUOUS In Progress Comments Update relevant documents to incorporate environmental impact and risk criteria in site selection screening for all Action Description health facilities, strengthen the coordination and reporting mechanism on social and environmental safeguard in MOH. Responsibility Recurrent Frequency Due Date DLI# Status 12/11/2018 Page 4 of 17 The World Bank Implementation Status & Results Report Ethiopia Health MDG Support Operation (P123531) Both No 31-Dec-2018 In Progress Comments Documenting consultations and participatory nature of discussions where communal land is used for construction of Action Description health centers and where applicable compensation for land and livelihood paid. Responsibility Recurrent Frequency Due Date DLI# Status Client Yes CONTINUOUS In Progress Comments Action Description Documenting outreach and specific actions focused on providing services to all vulnerable persons Responsibility Recurrent Frequency Due Date DLI# Status Client Yes CONTINUOUS In Progress Comments 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 -- Moderate Moderate Institutional Capacity for Implementation and Sustainability -- Moderate Moderate Fiduciary -- Substantial Substantial Environment and Social -- High High Stakeholders -- High High Other -- -- -- Overall -- High High Results 12/11/2018 Page 5 of 17 The World Bank Implementation Status & Results Report Ethiopia Health MDG Support Operation (P123531) PDO Indicators by Objectives / Outcomes To Improve the delivery and use of comperhensive package of Maternal and Child Health (MCH) Services IN00651515 ►Deliveries attended by skilled birth providers for the bottom 3 performing regions(Afar,Oromia&Somal (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 19.00 19.00 19.00 28.00 Date 31-Oct-2016 31-Oct-2016 31-Oct-2016 30-Jun-2021 Comments IN00651556 ►Pregnant women receiving at least four antenatal care visits (Percentage, Custom) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 32.00 32.00 32.00 38.00 Date 31-Oct-2016 31-Oct-2016 31-Oct-2016 30-Jun-2021 Comments IN00651557 ►Percent of children 6-59 month receiving Vitamin A supplements (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 45.00 45.00 45.00 53.00 Date 31-Oct-2016 31-Oct-2016 31-Oct-2016 30-Jun-2021 Comments IN00651558 ►Deliveries attended by skilled birth providers (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 10.00 26.00 26.00 40.00 Date 31-Mar-2016 22-Jun-2017 22-Jun-2017 30-Jun-2021 Comments IN00651559 ►Children 12-23 months immunized with Pentavalent 3 vaccines (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 65.70 65.70 65.70 76.70 Date 31-Dec-2012 31-Dec-2012 31-Dec-2012 30-Jun-2021 Comments IN00651560 12/11/2018 Page 6 of 17 The World Bank Implementation Status & Results Report Ethiopia Health MDG Support Operation (P123531) ►Pregnant women receiving at least one antenatal care visit (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 43.00 62.40 62.40 56.00 Date 29-Mar-2013 22-Jun-2017 22-Jun-2017 30-Jun-2018 Comments IN00651561 ►Contraceptive prevalence rate (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 27.30 35.00 35.00 35.00 Date 30-Mar-2012 22-Jun-2017 22-Jun-2017 30-Jun-2018 Comments IN00651562 ►Percent of Woredas in non emerging regions delivering vitamin A supplements to children (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 48.00 48.00 48.00 80.00 Date 30-Dec-2016 06-Jun-2018 06-Jun-2018 30-Jun-2021 Comments Intermediate Results Indicators by Results Areas Improve Delivery and use of a comperhensive package of maternal and child health serevices IN00651563 ►Introduction of Procurement Key Performance Indicators developed by Federal Public Procurement Agenc (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No No No Yes Date 27-Jun-2017 06-Jun-2018 06-Jun-2018 30-Jun-2021 Comments IN00651564 ►Automate the PFSA Core Business Fiduciary System using selected software in PFSA HQ and Addis Ababa (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No No No Yes Date 27-Jun-2017 06-Jun-2018 06-Jun-2018 30-Jun-2021 Comments 12/11/2018 Page 7 of 17 The World Bank Implementation Status & Results Report Ethiopia Health MDG Support Operation (P123531) IN00651565 ►PFSA submission of Backlog audit reports and timely quality audit reports thereafter (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No No No No Date 27-Jun-2017 27-Jun-2017 27-Jun-2017 30-Jun-2021 Comments IN00651566 ►Percent of Children 0- 23 month participating in GMP (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 27.00 27.00 27.00 51.00 Date 30-Dec-2016 30-Dec-2016 30-Dec-2016 30-Jun-2021 Comments IN00651567 ►Percent of Woredas in emerging Regions transitioning from EOS to Community Health Days- CHD (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 50.00 Date 30-Dec-2016 30-Dec-2016 30-Dec-2016 30-Jun-2021 Comments IN00651568 ►Percent of PHC Facilities having all drug from the MOH list of drug available (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 42.00 42.00 42.00 47.00 Date 30-Dec-2016 30-Dec-2016 30-Dec-2016 30-Jun-2021 Comments IN00651569 ►Developed and Implement postnatal Care Service directive to improve the quality of Postnatal service (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No No No Yes Date 27-Jun-2017 27-Jun-2017 27-Jun-2017 30-Jun-2021 Comments IN00651570 ► Improve quality of adolescent services (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No No No Yes 12/11/2018 Page 8 of 17 The World Bank Implementation Status & Results Report Ethiopia Health MDG Support Operation (P123531) Date 30-Jun-2017 30-Jun-2017 30-Jun-2017 30-Jun-2021 Comments IN00651571 ►Percent of Woreda with Functional Community Health Insurance Schemes (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 23.00 23.00 23.00 53.00 Date 19-Jun-2017 19-Jun-2017 19-Jun-2017 30-Jun-2021 Comments IN00651572 ►Undertake CBHI review every two Years (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No No No Yes Date 27-Jun-2017 27-Jun-2017 27-Jun-2017 30-Jun-2021 Comments IN00651573 ►Devise and implement a mechanism for documenting consultations (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No No No Yes Date 27-Jun-2017 27-Jun-2017 27-Jun-2017 30-Jun-2021 Comments IN00651574 ►Development and implementation of health sector community score card (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No No No Yes Date 27-Jun-2016 06-Jun-2017 06-Jun-2017 30-Jun-2020 Comments IN00651575 ►Health Centers reporting HMIS data in time (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 50.00 68.00 68.00 86.00 Date 30-Mar-2012 30-Jun-2014 30-Jun-2014 30-Jun-2021 Comments IN00651576 12/11/2018 Page 9 of 17 The World Bank Implementation Status & Results Report Ethiopia Health MDG Support Operation (P123531) ►Development and implementation of Annual Rapid Facility Assessment (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No Yes Yes Yes Date 30-Mar-2012 30-Jun-2016 30-Jun-2016 30-Jun-2018 Comments IN00651577 ►Improved transparency of Pharmaceutical Fund and Supply Agency (PFSA) procurement process (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No Yes Yes Yes Date 29-Mar-2013 30-Jun-2016 30-Jun-2016 30-Jun-2021 Comments IN00651543 ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 2,693,545.00 3,443,602.00 Date 31-Dec-2012 -- 30-Jun-2017 30-Jun-2021 Sum of CRI sub-indicators included. Comments IN00651545 Number of children immunized (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 1,887,467.00 2,203,481.00 Date 31-Dec-2012 -- 31-Dec-2012 30-Jun-2021 IN00651612 Number of deliveries attended by skilled health personnel (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 806,078.00 1,240,121.00 Date 31-Dec-2012 -- 30-Jun-2017 30-Jun-2021 Disbursement Linked Indicators DLI_IND_TABLE ►DLI 1 Deliveries attended by skilled birth providers (Original- DLI 1) (Intermediate Outcome, 20,000,000.00, 0%) Baseline Actual (Previous) Actual (Current) N/A Value 10.00 26.00 26.00 18.00 12/11/2018 Page 10 of 17 The World Bank Implementation Status & Results Report Ethiopia Health MDG Support Operation (P123531) Date 31-Mar-2012 22-Jun-2017 04-Dec-2018 -- Comments ►DLI 2 Children 12-23 months immunized with Pentavalent 3 vaccine (original- DLI 2 ) (Intermediate Outcome, 11,730,000.00, 0%) Baseline Actual (Previous) Actual (Current) N/A Value 59.60 65.70 65.70 75.70 Date 31-Dec-2012 31-Dec-2012 04-Dec-2018 -- Comments Update information is expected from the upcoming cluster survey by the end of 2018 ►DLI 3 Contraceptive prevalence rate (original- DLI 4) (Intermediate Outcome, 20,500,000.00, 0%) Baseline Actual (Previous) Actual (Current) N/A Value 27.30 35.00 35.00 35.00 Date 31-Mar-2012 22-Jun-2017 04-Dec-2018 -- Comments ►DLI 4 Health centers reporting HMIS data in time (Original- DLI 5) (Process, 5,000,000.00, 0%) Baseline Actual (Previous) Actual (Current) N/A Value 50.00 68.00 68.00 80.00 Date 31-Mar-2012 30-Jun-2014 04-Dec-2018 -- HMIS Data Quality Assurance has been integrated with the 2nd round Service Availability and Readiness Assessment (SARA) that is being conducted by EPHI. The data collection is completed and the first draft Comments report is to be released soon. Disbursement (US$1.77M) of this DLI will be made upon the result achieved and verified by SARA. The ISR will be updated upon publication of the report. ►DLI 5 Development and implementation of Annual Rapid Facility Assessment (Original- DLI 7) (Process, 10,950,000.00, 0%) Baseline Actual (Previous) Actual (Current) N/A Value No Yes Yes Yes Date -- 15-Dec-2015 04-Dec-2018 -- Comments The 2013 target was met and total disbursements made under DLI 7a consist of SDR 1.3m and USD 2m and for DLI 7b, a total of SDR 1.6m was also disbursed. The SPA+ 2014 was finalized and served as the basis for the result of this DLI. As a result, SDR 1.2 m was disbursed for SPA+ and action plan. SARA 2016 has also been finalized and action plan to address the weaknesses was developed and submitted to the Bank. A total of SDR1,449,275.00 was disbursed. For FY18, the target for this DLI is to undertake survey and disclose result with proposed actions. Data collection has been completed, and the final report is expected to be 12/11/2018 Page 11 of 17 The World Bank Implementation Status & Results Report Ethiopia Health MDG Support Operation (P123531) disclosed in July 2018. Disbursement (US$4.95M) will be made upon submission of the survey and action plan to address the identified weakness. The ISR will be updated upon the publication of the 2018 report. ►DLI 6 Transparency of PFSA procurement process (scaled - DLI 8c) (Process, 10.86, 0%) Baseline Actual (Previous) Actual (Current) N/A Value No No No No Date 31-Mar-2013 06-Jun-2018 04-Dec-2018 -- The data collection is completed and the first draft report is to be released soon. Disbursement (US$1.77M) of Comments this DLI will be made upon the result achieved and verified by SARA. The ISR will be updated upon publication of the report. ►DLI 7 Deliveries attended by skilled birth providers (Scaled DLI- 1a) (Intermediate Outcome, 45,430,000.00, 0%) Baseline Actual (Previous) Actual (Current) N/A Value 26.00 26.00 26.00 40.00 Date -- 22-Jun-2017 04-Dec-2018 -- Result was fully achieved and exceeded by 8 percentage points for which disbursement was made for and Comments under the AF this DLI is scaled for further results from baseline 26% to 40%. ►DLI 8 Deliveries attended by skilled birth providers for the bottom 3 performing regions -Afar, Oromia & Somali- (New DLI- 1b) (Intermediate Outcome, 20,000,000.00, 0%) Baseline Actual (Previous) Actual (Current) N/A Value 19.00 19.00 19.00 28.00 Date -- 31-Oct-2016 04-Dec-2018 -- Comments ►DLI 9 Pregnant women receiving at least four antenatal care visits (New DLI -3a) (Intermediate Outcome, 20,000,000.00, 0%) Baseline Actual (Previous) Actual (Current) N/A Value 32.00 32.00 32.00 38.00 Date -- 31-Oct-2016 04-Dec-2018 -- Comments Updated information is expected from next round of a Mini-DHS for the FY2018 target. ►DLI 10 Contraceptive prevalence rate for rural women only (New DLI -4a) (Intermediate Outcome, 17,000,000.00, 0%) Baseline Actual (Previous) Actual (Current) N/A 12/11/2018 Page 12 of 17 The World Bank Implementation Status & Results Report Ethiopia Health MDG Support Operation (P123531) Value 32.00 32.00 32.00 38.00 Date -- 31-Oct-2016 04-Dec-2018 -- Comments ►DLI 11 Introduction of Procurement Key Performance Indicators developed by Federal Public Procurement Agency at PFSA (New DLI- 9(1)) (Process, 2,000,000.00, 0%) Baseline Actual (Previous) Actual (Current) N/A Value No No No Yes Date -- 06-Jun-2018 04-Dec-2018 -- Per the MOH’s implementation support mission report, the KPI is developed and included in HCMIS KPI Comments dashboard. Disbursement will be made upon the verification report of independent consultant in FY2018. ►DLI 12 Automate the PFSA Core Business Fiduciary System using selected software in PFSA HQ and Addis Ababa City (New_ DLI- 9(2) ) (Process, 7,000,000.00, 0%) Baseline Actual (Previous) Actual (Current) N/A Value No No No Yes Date -- 06-Jun-2018 04-Dec-2018 -- The target for this DLI signing a contract with vendor for automation of core business fiduciary system software Comments installation has been delayed. ►DLI 13 PFSA submission of Backlog audit reports and timely quality audit reports thereafter (New - DLI 9(3) ) (Process, 6,000,000.00, 0%) Baseline Actual (Previous) Actual (Current) N/A Value No Yes Yes Yes Date -- 06-Jun-2018 04-Dec-2018 -- The target for this DLI 9(3) was to submit audit reports backlog from EFY2005 and 2006 by December 2017 is Comments not met. Thought the EFY 2005 audit was submitted on December 31, 2017, disbursement for the first year(US$2M) will not be made as the target is not fully achieved. ►DLI 14 Percent of children 6-59 months receiving Vitamin A supplements (New- DLI -10a) (Intermediate Outcome, 5,000,000.00, 0%) Baseline Actual (Previous) Actual (Current) N/A Value 45.00 45.00 45.00 53.00 Date -- 31-Oct-2016 04-Dec-2018 -- Comments 12/11/2018 Page 13 of 17 The World Bank Implementation Status & Results Report Ethiopia Health MDG Support Operation (P123531) ►DLI 15 Percent of Wordas in non-emerging Regions delivering Vitamin A Supplements to children through routine system – Health Facilities (New- DLI-10b) (Process, 5,000,000.00, 0%) Baseline Actual (Previous) Actual (Current) N/A Value 48.00 48.00 48.00 80.00 Date -- 30-Dec-2016 04-Dec-2018 -- Per the MOH’s implementation support mission report, the target for this DLI 10(b) is fully achieved. Hence Comments disbursement (US$4M) will be made in FY18 once result is verified by joint review mission with nutrition partners. ISR will be updated upon the verification of the result by the technical partners. ►DLI 16 Percent of Pregnant women taking Iron Folic Acid (IFA) tablets (New- DLI- 11) (Intermediate Outcome, 5,000,000.00, 0%) Baseline Actual (Previous) Actual (Current) N/A Value 17.00 17.00 17.00 25.00 Date -- 31-Oct-2016 04-Dec-2018 -- Updated information is expected from next round of a Mini-DHS for the FY2018 target. According to the MOH mission report, two round of IFA procurements has been secured from the SDG pool fund. In addition, the IFA Comments 90+ supplementation is included in the revised HMIS indicator. Training is provided, recording and reporting formats has been printed and distributed to regions and down to facilities. ►DLI 17 Percent of Children 0- 23 month participating in GMP (New DLI-12a) (Process, 15,000,000.00, 0%) Baseline Actual (Previous) Actual (Current) N/A Value 27.00 27.00 27.00 51.00 Date -- 30-Dec-2016 04-Dec-2018 -- According to the HMIS report, the result for this DLI 12(a) has exceeded the FY17 target by 6 percentage points. Disbursement (US$10M) will be made in FY18 once result is verified by joint review mission with Comments technical partners. The actual result will be update in the next ISR upon the outcome of the joint review mission. ►DLI 18 Percent of Woredas in emerging Regions transitioning from EOS to Community Health Days- CHD (NewDLI- 12b) (Process, 5,000,000.00, 0%) Baseline Actual (Previous) Actual (Current) N/A Value 0.00 0.00 0.00 50.00 Date -- 30-Dec-2016 04-Dec-2018 -- According to the HMIS report, the result for this DLI12(b) has exceeded the target (10 percentage point increase) by 9 percentage points which is 168 (19%) woredas transitioned from EoS to CHD from baseline 0. Comments Disbursement (US$3M) will be made in FY18 once result is verified by joint review mission with technical partners. Result will be update in the next ISR upon the outcome of the joint review mission. ►DLI 19 Percent of PHC Facilities having all drug from the MOH list of drug available(New- DLI DLI-13(1)) (Process, 7,000,000.00, 0%) 12/11/2018 Page 14 of 17 The World Bank Implementation Status & Results Report Ethiopia Health MDG Support Operation (P123531) Baseline Actual (Previous) Actual (Current) N/A Value 42.00 42.00 42.00 47.00 Date -- 30-Sep-2016 04-Dec-2018 -- Comments ►DLI 20 Developed and Implement postnatal Care Service directive to improve the quality of Postnatal services (New- DLI- 13(2)) (Process, 5,000,000.00, 0%) Baseline Actual (Previous) Actual (Current) N/A Value No Yes No Yes Date -- 06-Jun-2018 04-Dec-2018 -- The target for DLI 13(1) for 2017 is to develop Postnatal Care Directive by December 31st, 2017. The Comments Postnatal Care Directive guideline is developed and submitted. Disbursement (UD$1M) will be made once the achieved result is reviewed and verified by the technical partners. ►DLI 21 Improve quality of adolescent services (New- DLI 13(3)) (Process, 6,000,000.00, 0%) Baseline Actual (Previous) Actual (Current) N/A Value No No No Yes Date -- 06-Sep-2017 04-Dec-2018 -- The strategy is endorsed by the government in October 2017 and submitted to the Bank. Disbursement Comments (UD$1M) will be made once the dissemination process is verified by the technical partners. ►DLI 22 Percent of Woreda with Functional Community Health Insurance Schemes (New- DLI-14 (1)) (Process, 19,500,000.00, 0%) Baseline Actual (Previous) Actual (Current) N/A Value 0.00 23.00 23.00 53.00 Date -- 19-Jun-2017 04-Dec-2018 -- The target for FY17 establishing a baseline of functional community based health insurance schemes was met and US$9.50 was disbursed. The target for FY18- 20 percentage points increase from the baseline of 205 Comments functional CBHI is exceeded by 46 percentage points which is 271 functional Woredas. Disbursement (UD$ 7.5 M) will be made once the achieved result is verified by the technical partners. ►DLI 23 Undertake CBHI review every two Years (New- 14- (2)) (Process, 5,000,000.00, 0%) Baseline Actual (Previous) Actual (Current) N/A Value Yes Yes Yes Yes Date -- 31-Dec-2017 04-Dec-2018 -- 12/11/2018 Page 15 of 17 The World Bank Implementation Status & Results Report Ethiopia Health MDG Support Operation (P123531) The target for FY17 reviewing the implementation of CBHI schemes is met. Disbursement (UD$ 3 M) will be Comments made once the achieved result is verified by the technical partners. ►DLI 24 Devise and implement a mechanism for documenting consultations when communal Private land is used for construction of health facilities (New- DLI-15(1)) (Process, 4,500,000.00, 0%) Baseline Actual (Previous) Actual (Current) N/A Value No No No Yes Date -- 06-Jun-2018 04-Dec-2018 -- According to the MOH’s mission report, a mechanism for a systematically documenting the consultations when the communal/private land is used for construction of health facilities. Hence, disbursement will be made once Comments the document is submitted and verified by the technical partners. ISR will be updated upon the verification report of technical partners. ►DLI 25 Development and implementation of health sector community score card(New- DLI- 15(2)) (Process, 5,000,000.00, 0%) Baseline Actual (Previous) Actual (Current) N/A Value No No No Yes Date -- 06-Jun-2018 04-Dec-2018 -- Comments ►DLI 26 Children 12-23 months immunized with Pentavalent 3 vaccine (Scaled- DLI- 2c) (Intermediate Outcome, 8,130,000.00, 0%) Baseline Actual (Previous) Actual (Current) N/A Value 65.70 65.70 65.70 75.70 Date -- 31-Dec-2012 04-Dec-2018 -- Comments ►DLI 27 Health Centers reporting HMIS data in time (restructured -DLI- 5a) (Process, 7,770,000.00, 0%) Baseline Actual (Previous) Actual (Current) N/A Value 68.00 68.00 68.00 86.00 Date -- 06-Jun-2018 04-Dec-2018 -- Comments ►DLI 28 Development and implementation of Annual Rapid Facility Assessment (restructured-DLI- 7c) (Process, 10,950,000.00, 0%) 12/11/2018 Page 16 of 17 The World Bank Implementation Status & Results Report Ethiopia Health MDG Support Operation (P123531) Baseline Actual (Previous) Actual (Current) N/A Value No Yes No Yes Date -- 19-Jun-2017 04-Dec-2018 -- The 2013 target was met and total disbursements made under DLI 7a consist of SDR 1.3m and USD 2m and Comments for DLI 7b, a total of SDR 1.6m was also disbursed. The SPA+ 2014 was finalized and served as the basis for the result of this DLI. As a result, SDR 1.2 m was disbursed for SPA+ and action plan. ►DLI 29 Development and implementation of Balanced Score Card Approach to assess performance and related institutional incentives (Original- DLI- 6) (Process, 20,200,000.00, 0%) Baseline Actual (Previous) Actual (Current) N/A Value Yes Yes No Yes Date -- 01-Oct-2014 04-Dec-2018 -- DLI dropped: No disbursement against results for this DLI and the disbursements made to date have been advances (6a: SDR 325k, US$250k; 6b: SDR 1.95m, US$500k). Progress was delayed due to the Government decision to change the roll out modality for the BSC; the Bank and Government have agreed to Comments drop the DLI as part of restructuring and AF and replace it with a new DLI on service quality. Accordingly, DLI 13, Percent of Primary Health Care facilities having all drugs from the MOH list of essential drugs, has been added to improve the quality of health care services. 12/11/2018 Page 17 of 17