The World Bank Report No: ISR4704 Implementation Status & Results Congo, Democratic Republic of DRC Health Sector Rehabilitation Support Project (P088751) Public Disclosure Copy Operation Name: DRC Health Sector Rehabilitation Support Project (P088751) Project Stage: Implementation Seq.No: 14 Status: ARCHIVED Archive Date: 14-Sep-2011 Country: Congo, Democratic Republic of Approval FY: 2006 Product Line: IBRD/IDA Region: AFRICA Lending Instrument: Specific Investment Loan Implementing Agency(ies): Health Ministry Key Dates Board Approval Date 01-Sep-2005 Original Closing Date 30-Jun-2010 Planned Mid Term Review Date Last Archived ISR Date 14-Sep-2011 Effectiveness Date 13-Apr-2006 Revised Closing Date 30-Jun-2013 Actual Mid Term Review Date Project Development Objectives Project Development Objective (from Project Appraisal Document) The Project Development Objective (PDO) is to ensure that the target population of selected health zones has access to, and use, a well-defined package of quality essential health services. Has the Project Development Objective been changed since Board Approval of the Project? Yes No Component(s) Component Name Component Cost Expand Access and Utilization of a Proven Package of Essential Health Services to Selected Districts 104.00 and Health Zones Boost Malaria Control Intervention 30.00 Strengthen Capacity for Oversight and Evidence-based Management of the Health System 12.00 Project Coordination 4.00 Public Disclosure Copy Overall Ratings Previous Rating Current Rating Progress towards achievement of PDO Moderately Satisfactory Moderately Satisfactory Overall Implementation Progress (IP) Satisfactory Satisfactory Overall Risk Rating Substantial Implementation Status Overview The project has been extended for an additional 18 months from its original closing date of December 31, 2011 until June 30, 2013 to allow sufficient time for implementation of the first Additional Financing (AF) for malaria control (H638) and the second AF for polio control (H717) both of which are currently fully operational. The project has made steady progress since the last ISR and met most of the PDO indicator targets set for December 2011 under the original financing (H182). Based on these achievements of the original Page 1 of 10 The World Bank Report No: ISR4704 project the PDO rating could be upgraded and will be revised once implementation of the activities supported by the second and third additional financing is confirmed as satisfactory and results in the desired outcomes. Public Disclosure Copy Locations Country First Administrative Division Location Planned Actual Congo, Dem Rep Not Entered Yambuku Congo, Dem Rep Not Entered Yamaluka Congo, Dem Rep Not Entered Wema Congo, Dem Rep Not Entered Tunda Congo, Dem Rep Not Entered Sous-Region de la Tshuapa Congo, Dem Rep Not Entered Sandoa Congo, Dem Rep Not Entered Samba Congo, Dem Rep Not Entered Pweto Congo, Dem Rep Not Entered Pimu-Lendo Congo, Dem Rep Province du Sud-Kivu Ntondo Congo, Dem Rep Not Entered Sous-Region de la Mongala Congo, Dem Rep Not Entered Mondombe Congo, Dem Rep Not Entered Mondombe Congo, Dem Rep Not Entered Mompono Congo, Dem Rep Not Entered Mankanza Congo, Dem Rep Province du Maniema Province du Maniema Public Disclosure Copy Congo, Dem Rep Not Entered Lusangi Congo, Dem Rep Not Entered Lukolela Congo, Dem Rep Not Entered Lolo Congo, Dem Rep Not Entered Lisala Congo, Dem Rep Not Entered Lingomo Congo, Dem Rep Not Entered Kilwa Page 2 of 10 The World Bank Report No: ISR4704 Country First Administrative Division Location Planned Actual Congo, Dem Rep Not Entered Kapanga Public Disclosure Copy Congo, Dem Rep Not Entered Kalamba Congo, Dem Rep Not Entered Kafakumba Congo, Dem Rep Not Entered Kabambare Congo, Dem Rep Not Entered Ikela Congo, Dem Rep Not Entered Djombo Congo, Dem Rep Not Entered Djolu Congo, Dem Rep Not Entered Bumba Congo, Dem Rep Not Entered Bosondjo Congo, Dem Rep Not Entered Bosanga Congo, Dem Rep Not Entered Bongandanga Congo, Dem Rep Not Entered Bokungu Congo, Dem Rep Not Entered Binga Congo, Dem Rep Not Entered Befale Congo, Dem Rep Not Entered Sakania Congo, Dem Rep Not Entered Lukafu Congo, Dem Rep Not Entered Kisenge Congo, Dem Rep Not Entered Kipushi Public Disclosure Copy Congo, Dem Rep Not Entered Kasongo Congo, Dem Rep Province du Katanga Kasenga Congo, Dem Rep Not Entered Kasaji Congo, Dem Rep Not Entered Kafubu Congo, Dem Rep Not Entered Dilolo Congo, Dem Rep Not Entered Yumbi Congo, Dem Rep Not Entered Wangata Page 3 of 10 The World Bank Report No: ISR4704 Congo, Dem Rep Not Entered Pendjwa Congo, Dem Rep Not Entered Oshwe Public Disclosure Copy Congo, Dem Rep Not Entered Nioki Congo, Dem Rep Ville de Kinshasa Ndjili Congo, Dem Rep Not Entered Mushie Congo, Dem Rep Not Entered Monkoto Congo, Dem Rep Not Entered Monieka Congo, Dem Rep Not Entered Mimia Congo, Dem Rep Not Entered Ville de Mbandaka Congo, Dem Rep Province de l' Equateur Mbandaka Congo, Dem Rep Not Entered Mampoko Congo, Dem Rep Not Entered Lotumbe Congo, Dem Rep Not Entered Lilanga Congo, Dem Rep Province de Bandundu Kwamouth Congo, Dem Rep Not Entered Kiri Congo, Dem Rep Ville de Kinshasa Ville de Kinshasa Congo, Dem Rep Not Entered Kikimi Congo, Dem Rep Not Entered Kibombo Congo, Dem Rep Ville de Kinshasa Kibanseke I Public Disclosure Copy Congo, Dem Rep Not Entered Irebu Congo, Dem Rep Not Entered Inongo Congo, Dem Rep Not Entered Ingende Congo, Dem Rep Not Entered Iboko-Bolombi Congo, Dem Rep Not Entered Iboko-Bolombi Congo, Dem Rep Not Entered Sous-Region de l' Equateur Page 4 of 10 The World Bank Report No: ISR4704 Congo, Dem Rep Not Entered Bosobe Congo, Dem Rep Not Entered Bomongo Public Disclosure Copy Congo, Dem Rep Not Entered Bolomba Congo, Dem Rep Not Entered Bolobo Congo, Dem Rep Not Entered Bolenge Congo, Dem Rep Not Entered Bokungu Congo, Dem Rep Not Entered Bokoro Congo, Dem Rep Not Entered Boende Congo, Dem Rep Not Entered Bobangi Congo, Dem Rep Not Entered Bikoro Congo, Dem Rep Not Entered Basankusu Congo, Dem Rep Not Entered Bandjow-Moke Congo, Dem Rep Ville de Kinshasa Masina Congo, Dem Rep Ville de Kinshasa Kimbanseke II Results Project Development Objective Indicators Indicator Name Core Unit of Measure Baseline Current End Target % of under-five children who slept under an Percentage Value 38.00 28.00 70.00 insecticide-treated net (ITN) the night before Date 31-Dec-2010 31-Dec-2011 30-Jun-2013 Comments The baseline does not apply Based on EEA Report Public Disclosure Copy to the PARSS zones but was December 2011, to be collected by UNICEF on a reviewed after LLIN relatively small sample of distribution campaigns households, insufficientto supported under malaria AF is disaggregate by province and completed.11 by health zones. % of pregnant women who slept under ITN the Percentage Value 43.00 28.00 74.00 night before Date 31-Dec-2010 31-Dec-2011 30-Jun-2013 Page 5 of 10 The World Bank Report No: ISR4704 Comments The baseline does not apply Based on EEA Report to the PARSS zones but was December 2011, to be collected by UNICEF on a reviewed after LLIN relatively small sample of distribution campaigns Public Disclosure Copy households, insufficientto supported under malaria AF is disaggregate by province and completed. by health zones. % of pregnant women who received 2 doses of Percentage Value 49.00 61.00 70.00 IPT during last pregnancy (NEW Date 31-Dec-2010 31-Dec-2011 30-Jun-2013 Comments Based on HMIS, based on IP reports Q4 2011 % of children immunized with OPV3 Percentage Value 74.00 74.00 94.00 Date 31-Dec-2010 30-Jun-2013 Comments No updated data available in target zones despite the fact that mass campaigns were carried out in 2011 but without follow up coverage surveys. Total number of new polio cases reported Number Value 98.00 98.00 30.00 quarterly Date 31-Dec-2010 31-Dec-2010 30-Jun-2013 Comments No new cases reported nationwide in the last quarter. AFPs reported monthly through surveillance system. Per capita annual curative consultation rate in Number Value 0.19 0.39 0.40 project districts Date 01-Jul-2007 31-Dec-2011 31-Dec-2011 Comments from HMIS, reported by Implementing Partners Q4 2011 % children 0-11 months vaccinated with DPT3 Percentage Value 54.00 83.00 75.00 Public Disclosure Copy in project districts Date 01-Jul-2007 31-Dec-2011 31-Dec-2011 Comments Population-weighted average from HMIS, reported by Trend over project period will from collection of HMIS data Implementing Partners Q4 be verified by comparison of in the project districts 2011 baseline and end-of-project end-2007 by thecontracted householdsurveys. M&E firm is 47%. Estimate from end-2007 household survey in project districts by M&E firm is 60% Page 6 of 10 The World Bank Report No: ISR4704 % deliveries assisted by qualified personnel in Percentage Value 47.00 77.00 65.00 project districts Date 01-Jul-2007 31-Dec-2011 31-Dec-2011 Comments from Implementing Partner from HMIS, reported by Trend over project period will Public Disclosure Copy reports Population-weighed Implementing Partners report be verified by comparison of average from collection of Q4 2011 baseline and end-of-project HMIS data by contracted household surveys M&E firm end-2007 is 50%. Estimate from end-2007 household survey by M&E firm is 65%. % women 15-49 years new users of family Percentage Value 2.00 6.00 4.00 planning in project districts Date 01-Jul-2007 31-Dec-2011 31-Dec-2011 Comments Population-weighted average from HMIS, reported by Trend in current use of of collection of HMIS data by Implementing Partners report modern contraceptives over contracted M&E firm Q4 2011. Third AF with project period will be verified end-2007 is 1.3%. Estimate tentative Board approval on by comparisonof 2007 DHS from household survey March 27 puts a strong estimate with end-of-project end-2007 by M&E firm is not focuson FP with 10% target household survey usable. Estimate of current by end of project. use of modern contraceptives (ie. new users and previous adopters) in rural areas of DRC from 2007 DHS is 3.3%. Intermediate Results Indicators Indicator Name Core Unit of Measure Baseline Current End Target Children immunized Number Value 250000.00 1580000.00 5780000.00 Date 01-Jul-2007 31-May-2011 30-Jun-2013 Comments 2007 estimate Million, cumulative. No cumulative since 2007 updated data available in target zones yet. Public Disclosure Copy % pregnant women who receive intermittent Percentage Value 26.00 59.00 60.00 preventive treatment (IPT) against malaria in Date 01-Jul-2007 31-Dec-2011 31-Dec-2011 project districts Comments Population-weighted estimate HMIS, IP report Q4 2011 Trend over project period will from collection of HMIS data be verified by comparison of by contracted M&E firm baseline and end-of-project end-2007 is 44%. Estimate household surveys. from household survey byM&E firm end-2007 is 44%. Page 7 of 10 The World Bank Report No: ISR4704 percentage of pregnant women who receive Percentage Value 63.00 85.00 75.00 antenatal care Date 31-Dec-2007 31-Dec-2011 31-Dec-2011 Comments HMIS, IP report Q4 2011 Public Disclosure Copy percentage disbursement of NGOs contracts Percentage Value 0.00 87.00 100.00 Date 01-Jul-2007 31-Dec-2011 31-Dec-2011 Comments Still a few payments for large contracts (civil works etc) pending. Expected to reach 100% once these are arrived. Direct project beneficiaries Number Value 0.00 7.11 25.50 Date 01-Jul-2007 31-Dec-2011 30-Jun-2013 Comments millions millions Female beneficiaries Percentage Value 0.00 51.50 51.50 Sub Type Supplemental % of female direct beneficiaries ( over total Percentage Value 0.00 51.50 60.00 number of beneficiaries) Date 01-Jul-2007 31-Dec-2011 31-Dec-2011 Comments DHS data number of health personnel who received Number Value 10269.00 6700.00 training Date 01-Jul-2007 31-Dec-2011 31-Dec-2011 Comments % of children 6-59 months of age having Percentage Value 83.00 83.00 94.00 received Vitamin A Date 31-May-2011 30-Jun-2013 Comments No updated data available in target zones but Vit A capsules have been supplied by UNICEF in most facilities % of provincial and health zones with OPV in Percentage Value 70.00 90.00 98.00 Public Disclosure Copy stock and without stock shortage Date 01-Jul-2007 31-May-2011 30-Jun-2013 Comments No updated data available in target zones. But regular shortages of all antigens during several months affected the whole country % of provincial and health zones with adequate Percentage Value 60.00 60.00 98.00 vaccines storage, cold chain, and capacity Date 31-May-2011 31-May-2011 30-Jun-2013 Page 8 of 10 The World Bank Report No: ISR4704 Comments No updated data available in target zones But regular shortages of all antigens during several Public Disclosure Copy months affected the whole country Households that possess at least one or more Number Value 9.20 50.20 80.00 bed nets Date 01-Jul-2007 30-Jun-2013 Comments No updated data available in target zones. mass distribution will start in April. 2012 DHS will provide accurate information. % of under-five children with fever and treated Percentage Value 60.00 with ACTs Date 30-Jun-2013 Comments No updated data available in target zones Long-lasting insecticide-treated malaria nets Number Value 2900000.00 11800000.00 purchased and/or distributed Date 31-Aug-2011 30-Jun-2013 Comments Distribution planned in To be updated after April2012 completion of distribution under malaria AF % of reports including malaria control activities Percentage Value 70.00 completed at health zone level and transmitted Date 30-Jun-2013 to provincial level. Comments No data available now Health facilities constructed, renovated, and/or Number Value 0.00 810.00 400.00 equipped Date 01-Jul-2007 31-Dec-2011 30-Jun-2013 Comments cumulative, updated based on To be determined. IP reports Q4 2011 Public Disclosure Copy Data on Financial Performance (as of 06-Mar-2012) Financial Agreement(s) Key Dates Project Loan No. Status Approval Date Signing Date Effectiveness Date Closing Date P088751 IDA-H1820 Effective 01-Sep-2005 18-Oct-2005 13-Apr-2006 30-Jun-2013 P088751 IDA-H6380 Effective 20-Dec-2010 02-Feb-2011 02-May-2011 30-Jun-2013 P088751 IDA-H7170 Effective 28-Jun-2011 28-Jul-2011 25-Oct-2011 30-Jun-2013 P088751 TF-95892 Effective 25-Feb-2010 01-Mar-2010 01-Mar-2010 30-Jun-2013 Page 9 of 10 The World Bank Report No: ISR4704 Disbursements (in Millions) Project Loan No. Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P088751 IDA-H1820 Effective USD 150.00 150.00 0.00 149.24 3.81 99.00 P088751 IDA-H6380 Effective USD 80.00 80.00 0.00 61.57 19.23 77.00 Public Disclosure Copy P088751 IDA-H7170 Effective USD 30.00 30.00 0.00 8.88 19.66 30.00 P088751 TF-95892 Effective USD 0.42 0.42 0.00 0.25 0.61 59.00 Disbursement Graph Key Decisions Regarding Implementation The project has been extended for an additional 18 months from its original closing date of December 31, 2011 until June 30, 2013 to allow sufficient time for implementation of the first Additional Financing (AF) for malaria control (H638) and the second AF for polio control (H717) both of which are currently fully operational. Public Disclosure Copy Restructuring History Level two Approved on 15-Jan-2010 Related Projects P122251-DRC Malaria Control Additional Financing to Health Sector Rehab Support, P125677-DRC Polio Control Additional Financing to Health Sector Rehab Support, P126088- DRC Additional Financing Primary Health Care Page 10 of 10