Public Disclosure Copy The World Bank Implementation Status & Results Report Health Sector Reform (P145174) Health Sector Reform (P145174) EUROPE AND CENTRAL ASIA | Romania | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2014 | Seq No: 9 | ARCHIVED on 21-Dec-2017 | ISR30601 | Implementing Agencies: Ministry of Health, ROMANIA Key Dates Key Project Dates Bank Approval Date:28-Mar-2014 Effectiveness Date:22-Jan-2015 Planned Mid Term Review Date:25-Sep-2017 Actual Mid-Term Review Date:25-Sep-2017 Original Closing Date:15-Dec-2020 Revised Closing Date:15-Dec-2020 Project Development Objectives Project Development Objective (from Project Appraisal Document) The Project Development Objective is to improve access to, and quality and efficiency of public health services in Romania Has the Project Development Objective been changed since Board Approval of the Project Objective? No PHRPDODEL Components Name Hospital Network Rationalization:(Cost $249.30 M) Ambulatory Care Strengthening:(Cost $66.40 M) Health Sector Governance and Stewardship Improvement:(Cost $13.60 M) Project Management, and Monitoring and Evaluation:(Cost $9.50 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO  Moderately Unsatisfactory  Moderately Unsatisfactory Overall Implementation Progress (IP)  Moderately Unsatisfactory  Moderately Satisfactory Overall Risk Rating  Substantial  Substantial 12/21/2017 Page 1 of 7 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Health Sector Reform (P145174) Implementation Status and Key Decisions The Implementation has improved significantly since December 2016. The new authorities in the Ministry of Health have taken decisive actions in a number of key areas and a significant number of activities are completed or under implementation. Contracts for installation of new radiotherapy equipment (linear accelerators, CT simulators, etc.) in 5 hospitals (Baia Mare Emergency County Hospital, Oncological Institute Bucharest, Elias Emergency University Hospital, Galati Emergency Hospital and Constanta Emergency County Hospital) were signed and are under implementation. In addition, equipment for emergency units and intensive care units are in the process of installation or are already installed in all county hospitals. Contracts for diagnostic imaging equipment (computed Tomography scans and Magnetic Resonance Imaging scans) are planned to be signed by the end of this calendar year (2017). Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance  --  Substantial  Substantial Macroeconomic  --  Substantial  Substantial Sector Strategies and Policies  --  Substantial  Substantial Technical Design of Project or Program  --  Substantial  Substantial Institutional Capacity for Implementation and Sustainability  --  High  High Fiduciary  --  Substantial  Substantial Environment and Social  --  Moderate  Moderate Stakeholders  --  Moderate  Moderate Other  --  --  -- Overall  --  Substantial  Substantial Results Project Development Objective Indicators PHINDPDOTBL 1. Percentage of eligible women age 25 to 60 with at least one test of cervical cancer in the last three years (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 10.00 13.60 15.00 70.00 Date 19-Dec-2013 30-Dec-2016 06-Oct-2017 15-Dec-2020 12/21/2017 Page 2 of 7 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Health Sector Reform (P145174) PHINDPDOTBL 2. Percentage of hospitals in the rationalized network contracted by the NHIH that have successfully passed a technical/clinical auditing the previous 12 months. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 25.00 Date 19-Dec-2013 30-Dec-2016 06-Oct-2017 15-Dec-2020 PHINDPDOTBL  3. The first phase of the hospital rationalization plan has been implemented and has achieved all of the following milestones (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 0.00 Date 19-Dec-2013 30-Dec-2016 30-Dec-2016 31-Dec-2019 PHINDPDOTBL  3.i. Hospital payment system updated based on the results of standardized cost accounting systems implemented in pilot hospitals. (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 1.00 Date 19-Dec-2013 30-Dec-2016 06-Oct-2017 15-Dec-2020 PHINDPDOTBL 3.ii. Percentage of surgeries paid by the NHIH and included in a list of elective surgeries performed as outpatient and ambulatorysurgeries. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 2.00 2.00 15.00 30.00 Date 19-Dec-2013 30-Dec-2016 06-Oct-2017 15-Dec-2020 PHINDPDOTBL  3.iii. Ratio of public acute beds per 1,000 inhabitants reduced to 4.5. (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 5.50 4.50 4.50 4.50 12/21/2017 Page 3 of 7 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Health Sector Reform (P145174) Date 19-Dec-2013 30-Dec-2016 06-Oct-2017 31-Dec-2019 Overall Comments Intermediate Results Indicators PHINDIRITBL  1. Number of merging services and hospitals reshaping schemes. (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 8.00 Date 19-Dec-2013 13-Jun-2017 13-Jun-2017 31-Dec-2019 PHINDIRITBL 2. Number of regional radiotherapy units updated fully implemented . (including institutional cancer registries) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 4.00 Date 19-Dec-2013 13-Jun-2017 13-Jun-2017 31-Dec-2019 PHINDIRITBL  3. Number of centers for ambulatory diagnostic and treatment fully implemented. (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 12.00 Date 19-Dec-2013 13-Jun-2017 13-Jun-2017 31-Dec-2019 12/21/2017 Page 4 of 7 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Health Sector Reform (P145174) PHINDIRITBL  4. Number of regional pathology and cytology laboratories fully operational. (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 6.00 Date 19-Dec-2013 13-Jun-2017 13-Jun-2017 31-Dec-2019 PHINDIRITBL  5. Number of quality-oriented disease management arrangements designed, including explicit protocols and quality indicators to fight NCDs implemented. (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 5.00 Date 19-Dec-2013 13-Jun-2017 13-Jun-2017 31-Dec-2019 PHINDIRITBL  6. Number of health workers trained in disease management for NCDs and updated protocols. (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 120.00 Date 19-Dec-2013 13-Jun-2017 13-Jun-2017 31-Dec-2019 PHINDIRITBL  8. Number of health workers trained in HTA. (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 18.00 Date 19-Dec-2013 13-Jun-2017 13-Jun-2017 31-Dec-2019 12/21/2017 Page 5 of 7 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Health Sector Reform (P145174) PHINDIRITBL  7. Comprehensive communications campaigns implemented (Number, Custom Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 2.00 PHINDIRITBL  9. Percentage of total spending on prosthesis, orthopedic, and cardiac devices for national hospital contracted through centralizedprocurement. (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 40.00 Date 19-Dec-2013 13-Jun-2017 13-Jun-2017 31-Dec-2019 Overall Comments Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed Disbursed P145174 IBRD-83620 Effective USD 338.80 338.80 0.00 11.89 324.38 4% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P145174 IBRD-83620 Effective 28-Mar-2014 17-Jun-2014 22-Jan-2015 15-Dec-2020 15-Dec-2020 Cumulative Disbursements 12/21/2017 Page 6 of 7 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Health Sector Reform (P145174) Restructuring History Level 2 Approved on 24-Jun-2017 Related Project(s) There are no related projects. 12/21/2017 Page 7 of 7 Public Disclosure Copy