The World Bank Report No: ISR14587 Implementation Status & Results Swaziland Swaziland Health, HIV/AIDS and TB Project (P110156) Public Disclosure Copy Operation Name: Swaziland Health, HIV/AIDS and TB Project (P110156) Project Stage: Implementation Seq.No: 6 Status: ARCHIVED Archive Date: 22-Jun-2014 Country: Swaziland Approval FY: 2011 Product Line: IBRD/IDA Region: AFRICA Lending Instrument: Specific Investment Loan Implementing Agency(ies): Ministry of Health, Deputy Prime Minister's Office Key Dates Board Approval Date 10-Mar-2011 Original Closing Date 31-May-2016 Planned Mid Term Review Date 30-Apr-2015 Last Archived ISR Date 30-Dec-2013 Effectiveness Date 09-May-2012 Revised Closing Date 31-May-2016 Actual Mid Term Review Date Project Development Objectives Project Development Objective (from Project Appraisal Document) The project development objectives (PDOs) are: (i) to improve access to and quality of health services in Swaziland with a particular focus on primary health care, maternal health and TB, and (ii) to increase social safety net access for OVC. Has the Project Development Objective been changed since Board Approval of the Project? Yes No Component(s) Component Name Component Cost Strengthening the Capacity of the Health Sector 3.90 Facility-level Support to Improve Access, Quality and Efficiency of Services 24.38 Strengthening of the Orphans and Vulnerable Children (OVC) Safety Net 6.71 Overall Ratings Previous Rating Current Rating Public Disclosure Copy Progress towards achievement of PDO Satisfactory Moderately Satisfactory Overall Implementation Progress (IP) Moderately Satisfactory Moderately Satisfactory Overall Risk Rating Implementation Status Overview Highlights of recent progress include: (i) final costing and implementation plan for the essential health care package (EHCP), (ii) final report for the Service Availability Mapping (SAM); (iii) finalization of the list of health facilities for rehabilitation and development of drawings, (iv) capacity building of the MOH Biomedical Engineering Department for health facility maintenance, (v) development of a TB infections, prevention and control (IPC) workplan, (vi) training of TB Screening Officers and training of nurses on MDR-TB, and (vii) finalization of the design features for the orphans and vulnerable children (OVC) cash transfer program. To date, this co-financed World Bank loan and European Union grant has disbursed a combined US$ 4.032 million or 10% of the total project funds. Page 1 of 6 The World Bank Report No: ISR14587 The two project implementing teams in the Ministry of Health (MOH) and the Deputy Prime Minister's Office (DPM's Office) have made significant strides in overcoming capacity constraints and implementation challenges. The AWP for the third year of implementation (2014-15) is currently under finalization. Public Disclosure Copy Locations Country First Administrative Division Location Planned Actual Swaziland Not Entered Sitobela Swaziland Not Entered Siteki Swaziland Not Entered Shiselweni District Swaziland Not Entered Mbabane Swaziland Not Entered Manzini District Swaziland Not Entered Manzini Swaziland Not Entered Lubombo District Swaziland Not Entered Hhohho District Results Project Development Objective Indicators Indicator Name Core Unit of Measure Baseline Current End Target Health facilities that provide at least five public Percentage Value 56.30 70.00 80.00 health services Date 31-Dec-2010 25-Nov-2013 31-May-2016 Comments Source:SAM 2010 Service Availability Mapping (SAM) report 2013 Births delivered by a skilled attendant at a Percentage Value 74.00 82.00 85.00 health facility Date 31-Dec-2010 14-May-2013 31-May-2016 Public Disclosure Copy Comments Source: DHS 2007 Source: MICS 2010. The next survey data will be available in 2015. TB case notification rate Number Value 801.00 716.50 941.00 Date 31-Dec-2010 25-Nov-2013 31-May-2016 Comments Source: NTCP quarterly No new data available Note: This target is the report Ministry's own target for its program, as defined in the TB Page 2 of 6 The World Bank Report No: ISR14587 M&E Performance Framework 2011. OVC beneficiaries that receive cash transfers Percentage Value 0.00 0.00 75.00 regularly (as defined in the Implementation Public Disclosure Copy Date 01-Jan-2011 30-May-2014 Manual) Comments The OVC cash transfer pilot This activity has not yet has not yet been established. started The first phase of component 3 will involve capacity building and system strengthening- this will involve the design of the pilot. The pilot will be gradually scaled-up in four constituencies (regions) in Swaziland. It is not expected that grants will be paid until year 3. Intermediate Results Indicators Indicator Name Core Unit of Measure Baseline Current End Target People Living with HIV who are screened for Percentage Value 55.00 100.00 80.00 TB Date 31-Dec-2010 30-Apr-2014 31-May-2016 Comments Source: HMIS, 2010 ART and TB Program database - HMIS. Source: Semi Annual progress report, April 2014. Targeted health facilities with TB infection Percentage Value 0.00 0.00 100.00 control measures in place Date 31-Dec-2010 30-Apr-2014 31-May-2016 Comments Although renovations supported by the project have not yet started, the National TB Control Program database Public Disclosure Copy (1 Jan 2013-31 Dec 2013) reported 63.8% of ALL facilities have at least one of four IC measures in place. Targeted health facilities with health care waste Percentage Value 15.80 0.00 100.00 management facilities in place Date 31-Dec-2010 25-Nov-2013 31-May-2016 Comments The baseline is an estimate HCWM activities are in and will be finalized following progress, and no data yet determination of the target available on targeted facilities. However, 77% of ALL Page 3 of 6 The World Bank Report No: ISR14587 facilities. facilities nationwide reported Source: HMIS, 2010 having at least one of four HCW measures in place. National TB Control Program Public Disclosure Copy database (1 Jan 2013-31 Dec 2013) Service Availability Mapping (SAM) report, 2013. Clinics that have had at least 6 supervision Percentage Value 35.80 81.00 80.00 visits in the last 12 months Date 31-Dec-2010 31-Dec-2013 Comments Source: HMIS, 2010 HMIS database and SAM 2013 OVC directly supported through this cash Number Value 0.00 0.00 8000.00 transfer pilot Date 01-Jan-2011 30-May-2014 Comments Note: The baseline is zero This activity has not yet because the OVC cash started. transfer pilot has not yet been established. The pilot will be gradually scaled-up in four constituencies (regions) in Swaziland. It is not expected that grants will be paid until year 3. Health facilities constructed, renovated, and/or Number Value 0.00 0.00 15.00 equipped (number) Date 01-Jan-2011 30-May-2014 Comments Note: The associated target Renovations have not yet and progress data only refer started. to the number of health facilities to be renovated and equipped. Results are cumulative. Quarterly progress reports produced by the Percentage Value 0.00 0.00 75.00 Management Information System, according to Public Disclosure Copy Date 01-Jan-2011 30-May-2014 agreed reporting standards Comments Note: The MIS system will be The MIS development is built under the project. It is underway. The first phase expected that this will be comprising five modules have operational by year 2 of the been developed, deployed, project- 2012. tested and implemented with the support of an MIS lead Consultant. The necessary trainings have been completed. Currently, Page 4 of 6 The World Bank Report No: ISR14587 arrangements for data entry set up are being made. Health facilities that submit HMIS reports on Percentage Value 77.00 100.00 85.00 time Public Disclosure Copy Date 31-Dec-2010 30-Apr-2014 Comments Source: HMIS, 2010 HMIS has 287 facilities reporting. Of these, 203 are government and mission facilities. The balance of 84 facilities are private & industry/company facilities. They all reported on time for FY2013. Source: Semi Annual report, April 2014. Women who deliver at target health facilities Number Value 5247.00 5400.00 6500.00 Date 01-Jan-2011 30-Apr-2014 Comments Source: HMIS, 2011 Data not yet reported on targeted facilities only recently identified. However, the national figure reported by HMIS, January - December 2013 is 10,252. Health centers that provide Basic EmONC Number Value 0.00 0.00 5.00 services Date 01-Jan-2011 30-Apr-2014 31-May-2016 Comments Renovations and training have not yet started. Students who are trained under the newly Number Value 0.00 0.00 100.00 developed guidelines for mentorship & Date 01-Jan-2011 30-May-2014 preceptorship Comments Pre-service training curriculum has been developed and preceptorship is happening informally, as Public Disclosure Copy the program is being piloted. The project is considering removing this indicator at the MTR stage. Data on Financial Performance (as of 28-May-2014) Financial Agreement(s) Key Dates Project Ln/Cr/Tf Status Approval Date Signing Date Effectiveness Date Original Closing Date Revised Closing Date P110156 IBRD-80190 Effective 10-Mar-2011 14-Dec-2011 09-May-2012 31-May-2016 31-May-2016 Page 5 of 6 The World Bank Report No: ISR14587 Project Ln/Cr/Tf Status Approval Date Signing Date Effectiveness Date Original Closing Date Revised Closing Date P110156 TF-11740 Effective 04-Apr-2012 04-Apr-2012 09-May-2012 31-May-2016 31-May-2016 Disbursements (in Millions) Public Disclosure Copy Project Ln/Cr/Tf Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P110156 IBRD-80190 Effective USD 20.00 20.00 0.00 2.50 17.50 13.00 P110156 TF-11740 Effective USD 8.55 8.55 0.00 1.53 7.03 18.00 Disbursement Graph Key Decisions Regarding Implementation N/A Public Disclosure Copy Restructuring History There has been no restructuring to date. Related Projects There are no related projects. Page 6 of 6