Public Disclosure Copy The World Bank Implementation Status & Results Report GN PRIMARY HEALTH SERVICES IMPROVEMENT PROJECT (P147758) GN PRIMARY HEALTH SERVICES IMPROVEMENT PROJECT (P147758) AFRICA | Guinea | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2015 | Seq No: 5 | ARCHIVED on 17-Oct-2017 | ISR29296 | Implementing Agencies: Ministry of Finance, Ministry of Health Key Dates Key Project Dates Bank Approval Date:20-May-2015 Effectiveness Date:30-Dec-2015 Planned Mid Term Review Date:19-Jun-2018 Actual Mid-Term Review Date:-- Original Closing Date:30-Sep-2020 Revised Closing Date:30-Sep-2020 Project Development Objectives Project Development Objective (from Project Appraisal Document) The development objective of the proposed project is to: Improve the utilization of maternal, child health and nutrition services at the primary level of care in target regions. Has the Project Development Objective been changed since Board Approval of the Project Objective? No PHRPDODEL Components Name Component 1: Commodities and trained human resources for MCHN services at primary level:(Cost $6.00 M) Component 2: Strengthen community-level demand for MCHN services:(Cost $4.00 M) Component 3: Strengthen government capacity to plan, implement, monitor and supervise activities:(Cost $5.00 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO  Moderately Satisfactory  Moderately Satisfactory Overall Implementation Progress (IP)  Moderately Satisfactory  Moderately Satisfactory Overall Risk Rating  Substantial  Substantial 10/17/2017 Page 1 of 14 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report GN PRIMARY HEALTH SERVICES IMPROVEMENT PROJECT (P147758) Implementation Status and Key Decisions Implementation is progressing well. Since the Project launch in Conakry on June 21, 2016, the project has started key activities linked to the implementation of its components, strengthening supplies and human resources for health, governance structures and indigent coverage at the primary level of the health system. Key achievement to date include local recruitment and training of frontline health workers, establishing the architecture and support structure for regular supportive supervision, commencing with indigent identification and coverage, and progressing with evidence generation including the results based financing experiment. These achievements will be reflected in the intermediary indicators soon. 10/17/2017 Page 2 of 14 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report GN PRIMARY HEALTH SERVICES IMPROVEMENT PROJECT (P147758) 10/17/2017 Page 3 of 14 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report GN PRIMARY HEALTH SERVICES IMPROVEMENT PROJECT (P147758) 10/17/2017 Page 4 of 14 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report GN PRIMARY HEALTH SERVICES IMPROVEMENT PROJECT (P147758) 10/17/2017 Page 5 of 14 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report GN PRIMARY HEALTH SERVICES IMPROVEMENT PROJECT (P147758) Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance  Substantial  Substantial  Substantial Macroeconomic  High  High  High Sector Strategies and Policies  Substantial  Substantial  Substantial Technical Design of Project or Program  Substantial  Substantial  Substantial Institutional Capacity for Implementation and Sustainability  Substantial  Substantial  Substantial Fiduciary  Substantial  Substantial  Substantial Environment and Social  Low  Low  Low Stakeholders  Low  Low  Low Other  High  High  High Overall  Substantial  Substantial  Substantial Results Project Development Objective Indicators PHINDPDOTBL  Births (deliveries) attended by skilled health personnel (number) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 27,227.00 -- 14,660.00 43,420.00 Date 30-Dec-2016 -- 30-Jun-2017 30-Sep-2020 Comments This is a new baseline indicator, that replaces the 2012 pre-Ebola period data (only one available at the time). The new baseline data was collected through the M&E efforts of the Project, to obtain this directly from the facility level registers (collected twice)-post Ebola. The current baseline figure spans 12 months, from December 2015-December 2016. The actuals data reflects 6 months of data (December 2016-June 30), which shows that the project is well on its way to achieve beyond the baseline, by December 2017 (when the data will be next updated), i.e. after 6 months, 14,660 is more than half of the baseline of 27,227 assisted deliveries. Following extensive discussions with the government and the project/M&E manager, the target was changed (reduced slightly) taking into account the new baselines. 10/17/2017 Page 6 of 14 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report GN PRIMARY HEALTH SERVICES IMPROVEMENT PROJECT (P147758) PHINDPDOTBL  Percentage of Children (0-11months) Fully Vaccinated (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 57.00 -- -- 65.00 Date 30-Dec-2016 -- -- 30-Sep-2020 Comments The new baseline reflects the new M&E baseline data collection, which was completed and reflects vaccinations over one year between December 2015-December 2016. Given that these data are collected yearly, no intermediary data is available as of now. The next ISR will include this. Following extensive discussions with the government and the project/M&E manager, the target was changed (increased to 65%) taking into account the new baselines. PHINDPDOTBL  Percentage of pregnant women receiving at least 4 Antenatal care visits from health provider (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 47.00 -- 50.50 55.00 Date 30-Dec-2016 -- 30-Jun-2017 30-Sep-2020 Comments Again, this is the new baseline, which reflects the average percentage of women receiving at least 4 antenatal care visits between Dec 2015-Dec 2016. In June, this percentage is up to 50.6 percent. Following extensive discussions with the government and the project/M&E manager, the target was changed taking into account the new baselines. PHINDPDOTBL  Number of children under 5 with confirmed malaria who received antimalarial treatment (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 50,610.00 -- 21,513.00 70,306.00 Date 30-Dec-2015 -- 30-Jun-2017 30-Sep-2020 Comments This is a new baseline indicator, that replaces the 2012 pre-Ebola period data (only one available at the time). The new baseline data was 10/17/2017 Page 7 of 14 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report GN PRIMARY HEALTH SERVICES IMPROVEMENT PROJECT (P147758) collected through the M&E efforts of the Project, to obtain this directly from the facility level registers (collected twice)- post Ebola. The current baseline figure spans 12 months, from December 2015-December 2016. The actuals data reflects 6 months of data (December 2016-June 30), which shows good project to surpass the baseline by December 30, 2017 (the next time the data will be collected). Following extensive discussions with the government and the project/M&E manager, the target was changed taking into account the new baselines. PHINDPDOTBL  Percentage of Children (0-1year) receiving Vitamin A supplementation every 6 months (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 11.00 50.00 Date 30-Dec-2016 -- 30-Jun-2017 30-Sep-2020 Comments Again, this is the new baseline, which reflects the average percentage of children receiving vitamin A supplementation between Dec 2015- Dec 2016, which was zero. To date, 6 months into the new measurement year, this is now at 11 percent. Following extensive discussions with the government and the project/M&E manager, the target was changed taking into account the new baselines. PHINDPDOTBL  Direct project beneficiaries (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 336,455.00 930,456.00 Date 30-Dec-2016 -- 30-Jun-2017 30-Sep-2020 PHINDPDOTBL  Female beneficiaries (Percentage, Custom Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 75.00 75.00 10/17/2017 Page 8 of 14 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report GN PRIMARY HEALTH SERVICES IMPROVEMENT PROJECT (P147758) Overall Comments Intermediate Results Indicators PHINDIRITBL  percentage stock outs of tracer drugs in health center (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 41.00 -- 46.00 10.00 Date 30-Dec-2016 -- 30-Jun-2017 30-Sep-2020 Comments Again, this is the new baseline, which reflects the average percentage stock-outs between Dec 2015-Dec 2016. Currently, 6 months in- this is at 46 percent, higher than the baseline. This largely reflects the fact that the procurement of drugs and pharmaceuticals has yet to occur PHINDIRITBL  Number of new health workers recruited and in service at health centers and posts (cumulative) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 450.00 Date 13-Aug-2015 13-Aug-2015 30-Jun-2017 30-Sep-2020 Comments deployment is currently ongoing, following the completion of recruitment. This indicator is thus expected to change by the next ISR. PHINDIRITBL  Health personnel receiving training (number) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 1,350.00 Date 13-Aug-2015 13-Aug-2015 30-Jun-2017 30-Sep-2020 Comments Training has commenced and numbers trained will be reflected in the next ISR. 10/17/2017 Page 9 of 14 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report GN PRIMARY HEALTH SERVICES IMPROVEMENT PROJECT (P147758) PHINDIRITBL  Health Centers offering Integrated Management of Childhood illnesses (percent) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 80.00 Date 13-Aug-2015 13-Aug-2015 30-Jun-2017 30-Sep-2020 PHINDIRITBL  Number of new indigents covered under exemption mechanisms (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 50,000.00 Date 13-Aug-2015 13-Aug-2015 30-Jun-2017 30-Sep-2020 Comments The indigent selection is currently piloted which will allow for a first group of indigents to have card with which to receive free care. Thereafter, this will be scaled up. Indigent coverage will thus be reflected in the near future. PHINDIRITBL  Percentage of indigents satisfied with exemption mechanisms (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 70.00 Date 13-Aug-2015 13-Aug-2015 30-Jun-2017 30-Sep-2020 Comments This will show results once the indigents have been selected and covered. 10/17/2017 Page 10 of 14 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report GN PRIMARY HEALTH SERVICES IMPROVEMENT PROJECT (P147758) PHINDIRITBL  Number of newly trained community health workers engaged in health promotion and basic service delivery (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 530.00 Date 13-Aug-2015 13-Aug-2015 30-Jun-2017 30-Sep-2020 Comments the recruitment of CHWs has just been completed and they are in the process of being deployed. the training programs have been finalized and training will commence soon. Results will thus be reflected in the near future. PHINDIRITBL  Percent of health facilities and posts assessed monthly (by district team) meeting minimum checklist score (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 70.00 Date 13-Aug-2015 13-Aug-2015 30-Jun-2017 30-Sep-2020 Comments The supervision training and documentation is almost finalized. Results should be reflected here in the near future. 10/17/2017 Page 11 of 14 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report GN PRIMARY HEALTH SERVICES IMPROVEMENT PROJECT (P147758) PHINDIRITBL  Percent of community workers and health workers at health center that receive monthly supportive supervision (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 70.00 Date 13-Aug-2015 13-Aug-2015 30-Jun-2017 30-Sep-2020 Comments Supervision manuals and training is almost complete. Results will be reflected in near future PHINDIRITBL  Standardized MNCH District training program developed and implemented (Y/N) (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value N N N Y Date 13-Aug-2015 13-Aug-2015 30-Jun-2017 30-Sep-2020 Comments The MNCH direct training program has now been developed and is currently being implemented. PHINDIRITBL  Work Plan Budget execution Rate (percent) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 14.08 83.00 Date 13-Aug-2015 13-Aug-2015 30-Jun-2017 30-Sep-2020 10/17/2017 Page 12 of 14 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report GN PRIMARY HEALTH SERVICES IMPROVEMENT PROJECT (P147758) PHINDIRITBL  Health facilities reporting health management data on time (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 85.00 80.00 Date 13-Aug-2015 13-Aug-2015 30-Jun-2017 30-Sep-2020 Overall Comments To update the baselines and obtain the actuals, the project has received data from the vast majority of the health facilities. Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed Disbursed P147758 IDA-56570 Effective USD 8.30 8.30 0.00 1.46 7.20 18% P147758 IDA-D0690 Effective USD 6.80 6.80 0.00 1.16 5.93 17% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P147758 IDA-56570 Effective 20-May-2015 26-Jun-2015 30-Dec-2015 30-Sep-2020 30-Sep-2020 P147758 IDA-D0690 Effective 20-May-2015 26-Jun-2015 30-Dec-2015 30-Sep-2020 30-Sep-2020 Cumulative Disbursements 10/17/2017 Page 13 of 14 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report GN PRIMARY HEALTH SERVICES IMPROVEMENT PROJECT (P147758) Restructuring History There has been no restructuring to date. Related Project(s) There are no related projects. 10/17/2017 Page 14 of 14 Public Disclosure Copy