The World Bank Implementation Status & Results Report Health System Improvement Project (P113349) Health System Improvement Project (P113349) EUROPE AND CENTRAL ASIA | Uzbekistan | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2011 | Seq No: 17 | ARCHIVED on 17-Sep-2019 | ISR38487 | Implementing Agencies: Ministry of Health, Ministry of Health Key Dates Key Project Dates Bank Approval Date: 07-Apr-2011 Effectiveness Date: 02-Nov-2011 Planned Mid Term Review Date: 16-Nov-2015 Actual Mid-Term Review Date: 16-Nov-2015 Original Closing Date: 31-Dec-2016 Revised Closing Date: 31-Dec-2019 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The overall Project Development Objectives (PDOs) are to (1) improve access to quality health care at the primary level and atRayonMedical Unions (RMUs); and (2) strengthen the Government’s public health response to the rise in non-communicable diseases(NCDs). Has the Project Development Objective been changed since Board Approval of the Project Objective? Yes Board Approved Revised Project Development Objective (If project is formally restructured) The revised PDO is to (a) improve access to quality health care at the primary level and at Rayon Medical Unions; and selectedCityMedical Unions (CMUs); and (b) strengthen the Government's public health response to the rise in non-communicable diseases(NCDs). Components Table Name Improving Health Service Delivery:(Cost $133.27 M) Strengthening Health Financing and Management Reforms:(Cost $1.48 M) Institutional Strengthening for NCD Prevention and Control:(Cost $1.88 M) Project Management:(Cost $4.37 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Satisfactory Satisfactory Overall Risk Rating Moderate Moderate Implementation Status and Key Decisions 9/17/2019 Page 1 of 7 The World Bank Implementation Status & Results Report Health System Improvement Project (P113349) The PDO level indicators assessed as partially achieved: two achieved and two are in the progress. Results of survey that would provide final data are expected in December 2019. Most of the project activities are completed. The project has procured, delivered and installed a large quantity of equipment, furniture and instruments over the past years. Most of the training activities under the Project have been completed. The draft Project Implementation Completion Report will be prepared in December 2019. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance -- Moderate Moderate Macroeconomic -- Moderate Moderate Sector Strategies and Policies -- Moderate Moderate Technical Design of Project or Program -- Moderate Moderate Institutional Capacity for Implementation and Sustainability -- Moderate Moderate Fiduciary -- Moderate Moderate Environment and Social -- Moderate Moderate Stakeholders -- Moderate Moderate Other -- Moderate Moderate Overall -- Moderate Moderate Results PDO Indicators by Objectives / Outcomes Improve access to quality health care at the primary level and at Rayon Medical Unions (RMUs) IN00741964 ►Increased proportion of diabetic and hypertension patients referred from PHC facilities to RMUs, in accordance with treatment standards (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 72.20 72.20 80.00 Date 28-Oct-2011 28-Feb-2019 28-Jun-2019 31-Dec-2019 Collection of the data for final target is underway Comments: IN00741965 ►Improved perceived quality of PHC and secondary health care services in intervention areas (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target 9/17/2019 Page 2 of 7 The World Bank Implementation Status & Results Report Health System Improvement Project (P113349) Value 70.00 82.70 82.70 90.00 Date 02-Oct-2012 28-Feb-2019 28-Jun-2019 31-Dec-2019 Collection of the data for final indicator is underway Comments: Strengthen the Government's public health response to the rise in non-communicable diseases(NCDs) IN00741962 ►Increased proportion (number) of hospitals following NCD clinical guidelines developed under the project (at least 20 clinical guidelines) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 172.00 172.00 172.00 Date 28-Oct-2011 28-Feb-2019 28-Jun-2019 31-Dec-2019 Target achieved Comments: IN00741963 ►Issuance of a profile of NCD risk factors and burden of disease (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target The report is published The report is published At least 1 report Value 0.00 on the MOH site on the MOH site published December 2018. December 2018. Date 10-Mar-2011 28-Feb-2019 28-Feb-2019 31-Dec-2019 Indicator achieved Comments: Intermediate Results Indicators by Components Improving Health Service Delivery IN00741976 ►New clinical guidelines developed and adopted by the MOH (CVD, diabetes, etc.) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 22.00 22.00 20.00 Date 10-Mar-2011 28-Feb-2019 28-Jun-2019 31-Dec-2019 Achieved Comments: IN00741979 ►Doctors of urban and rural PHC facilities receiving the training under the 10-month GP training program (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 670.00 3,067.00 3,067.00 3,000.00 Date 10-Mar-2011 28-Feb-2019 28-Jun-2019 31-Dec-2019 Comments: Achieved 9/17/2019 Page 3 of 7 The World Bank Implementation Status & Results Report Health System Improvement Project (P113349) IN00741981 ►Health personnel at PHCs (doctors and nurses) receiving training under continuous professional education (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target 13563 doctors, 44485 13563 doctors, 44485 9400 doctors, 35000 Value 0 doctors, 0 nurses nurses nurses nurses Date 10-Mar-2011 28-Feb-2019 28-Jun-2019 31-Dec-2019 Overachieved Comments: IN00741983 ►Health personnel receiving training (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 43,714.00 43,714.00 22,518.00 Date 01-Mar-2011 28-Feb-2019 28-Jun-2019 31-Dec-2019 Achieved Comments: IN00741985 ►Hospitals equipped with medical and waste management equipment (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 592.00 592.00 516.00 Date 10-Mar-2011 28-Feb-2019 28-Jun-2019 31-Dec-2019 overachieved Comments: IN00741987 ►Hospital core staff receiving training on waste management (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 933.00 933.00 516.00 Date 10-Mar-2011 28-Feb-2019 28-Jun-2019 31-Dec-2019 achieved Comments: IN00741988 ►Health personnel receiving training on clinical case management (NCDs and pediatrics) (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target 3833 doctors/6158 3833 doctors/6158 nurses have been nurses have been trained 1002 doctors and Value 0.00 trained 2064 nurses Date 10-Mar-2011 28-Feb-2019 28-Jun-2019 31-Dec-2019 Overachieved Comments: 9/17/2019 Page 4 of 7 The World Bank Implementation Status & Results Report Health System Improvement Project (P113349) Strengthening Health Financing and Management Reforms IN00741977 ►National Health Accounts developed and published (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target 2 reports are Value 0.00 1 report is published. 2 reports published. Date 10-Mar-2011 28-Feb-2019 09-Sep-2019 31-Dec-2019 achieved. Second report was published in mid August 2019 on the MOH website. Comments: IN00741980 ►Staff of reformed PHC and hospitals receiving training in financial management (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 255.00 255.00 255.00 Date 10-Mar-2011 28-Feb-2019 28-Feb-2019 31-Dec-2019 Achieved Comments: IN00741982 ►Public Expenditure Review developed (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1.00 1.00 2 reports Date 10-Mar-2011 28-Feb-2019 28-Feb-2019 31-Dec-2019 partly achieved. Second report is in progress and will be ready by May 2019. Comments: IN00741984 ►Volume and Cost contract introduced in 3 hospitals in Fergana oblast (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target All 3 hospitals paid Value 0.00 3 in virtual mode 3 in virtual mode according to contract Date 10-Mar-2011 28-Feb-2019 28-Feb-2019 31-Dec-2019 partially achieved Comments: IN00741986 ►Number of urban PHC facilities (urban family policlinics) converted to per capita financing system (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 25.00 155.00 155.00 155.00 Date 05-Feb-2013 28-Feb-2019 28-Feb-2019 31-Dec-2019 achieved Comments: Institutional Strengthening for NCD Prevention and Control IN00741978 9/17/2019 Page 5 of 7 The World Bank Implementation Status & Results Report Health System Improvement Project (P113349) ►Public Health specialists (surveillance staff) and (b) health promotion specialists trained (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 143.00 143.00 140.00 Date 10-Mar-2011 28-Feb-2019 28-Feb-2019 31-Dec-2019 Achieved Comments: Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P113349 IDA-48960 Closed USD 93.00 93.00 0.00 85.25 0.11 100% P113349 IDA-52310 Effective USD 93.00 48.00 45.00 24.41 16.80 59% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P113349 IDA-48960 Closed 07-Apr-2011 16-Sep-2011 02-Nov-2011 31-Dec-2016 31-Dec-2018 P113349 IDA-52310 Effective 07-Mar-2013 18-Jul-2013 19-Sep-2013 31-Dec-2018 31-Dec-2019 Cumulative Disbursements 9/17/2019 Page 6 of 7 The World Bank Implementation Status & Results Report Health System Improvement Project (P113349) Restructuring History Level 2 Approved on 08-Feb-2018 Related Project(s) P133187-Additional Financing to Health System Improvement Project 9/17/2019 Page 7 of 7