The World Bank Report No: ISR8166 Implementation Status & Results Mozambique Health Service Delivery (P099930) Public Disclosure Copy Operation Name: Health Service Delivery (P099930) Project Stage: Implementation Seq.No: 8 Status: ARCHIVED Archive Date: 17-Oct-2012 Country: Mozambique Approval FY: 2009 Product Line: IBRD/IDA Region: AFRICA Lending Instrument: Specific Investment Loan Implementing Agency(ies): Ministry of Health, Moz Key Dates Board Approval Date 16-Apr-2009 Original Closing Date 28-Feb-2014 Planned Mid Term Review Date 15-Sep-2011 Last Archived ISR Date 04-Sep-2012 Effectiveness Date 11-Jun-2010 Revised Closing Date 28-Feb-2014 Actual Mid Term Review Date 22-Jun-2012 Project Development Objectives Project Development Objective (from Project Appraisal Document) The project#s development objectives are to: (a) reduce child mortality; (b) reduce maternal mortality; (c) reduce the burden of malaria; (d) reduce the prevalence of tuberculosis; and (e) reduce inequity in the access to health services in Mozambique. Has the Project Development Objective been changed since Board Approval of the Project? Yes No Component(s) Component Name Component Cost - Improvement in service delivery. 42.60 Boosting of national malaria control program 13.50 Preparation of health sector investment plan 0.50 Capacity building and Operating Costs 15.80 Overall Ratings Public Disclosure Copy Previous Rating Current Rating Progress towards achievement of PDO Moderately Unsatisfactory Moderately Satisfactory Overall Implementation Progress (IP) Moderately Unsatisfactory Moderately Satisfactory Overall Risk Rating Implementation Status Overview After the Mid-Term Review (MTR) of the project carried out in June 2012, the Government implemented a set of agreed measures to improve the performance of the project. To date, the Ministry of Health (MISAU) completed the recruitment of key specialists to strengthen the project management team; agreed to modify the project development objectives and results framework, and requested an amendment of the Financing Agreement of the project. These measures represent a step forward to address the main bottlenecks to project implementation progress. Page 1 of 6 The World Bank Report No: ISR8166 Locations Country First Administrative Division Location Planned Actual Mozambique Provincia de Niassa Provincia de Niassa Public Disclosure Copy Mozambique Provincia de Nampula Provincia de Nampula Mozambique Provincia de Cabo Delgado Provincia de Cabo Delgado Results Project Development Objective Indicators Indicator Name Core Unit of Measure Baseline Current End Target Direct project beneficiaries Number Value 0.00 0.00 2151445.00 Date 31-Dec-2009 30-Jun-2012 28-Feb-2014 Comments This indicator will be maintained. Female beneficiaries Percentage Value 0.00 0.00 80.00 Sub Type Supplemental Children Immunized (number) Number Value 0.00 0.00 793800.00 Date 14-Dec-2009 30-Jun-2012 28-Feb-2014 Comments Project financing of this activity has just started. The indicator will be maintained but it will no longer be a PDO indicator. It will be an intermediate indicator. Percentage of children vaccinated with BCG; Percentage Value 45.00 76.00 69.00 DPT3; Polio and measles vaccines in the first Date 31-Dec-2009 30-Jun-2012 28-Feb-2014 year of life Public Disclosure Copy Comments This indicator will be modified to align it to the national indicators, in which two more vaccines have been added: Hepatitis B, and Haemophilus influenza B. In addition it will be disaggregated to reflect the situation in each province. Percentage of institutional deliveries Percentage Value 50.80 52.00 58.00 Date 31-Dec-2009 30-Jun-2012 28-Feb-2014 Page 2 of 6 The World Bank Report No: ISR8166 Comments This indicator reflects a national average. It will be disaggregated to reflect the situation in each province. Public Disclosure Copy Accordingly both the baselines and end targets for each province will be revised. Intermediate Results Indicators Indicator Name Core Unit of Measure Baseline Current End Target Percentage of pregnant women who received Percentage Value 0.00 34.00 at least one dose of IPT Date 31-Dec-2009 30-Jun-2012 28-Feb-2014 Comments This indicator will be dropped. The project does not substantively contribute to this activity. It will be replaced by two other indicators that can measure project contribution to malaria activities. Health personnel receiving training (number) Number Value 0.00 180.00 300.00 Date 31-Dec-2009 30-Jun-2012 28-Feb-2014 Comments This indicator is to be maintained. The training of health staff started in 2011. Some course will be completed in December 2012 and other in June 2013. The end target may be revised to take into account the request to increase the numbers of coursed financed Public Disclosure Copy under the project. Health facilities constructed, renovated, and/or Number Value 0.00 0.00 18.00 equipped (number) Date 31-Dec-2009 30-Jun-2012 28-Feb-2014 Comments The starting of the construction of new health facilities is subject to the approval by the Bank of the Environmental and Social Management Plan being Page 3 of 6 The World Bank Report No: ISR8166 developed by the MOH. This indicator will be maintained Long-lasting insecticide-treated malaria nets Number Value 0.00 0.00 0.00 purchased and/or distributed (number) Public Disclosure Copy Date 22-Jun-2010 30-Jun-2012 28-Feb-2014 Comments The pertinence of this indicator to the project is being discussed and a decision will be made at the completion of the restructuring of the project. Pregnant women receiving antenatal care Number Value 0.00 0.00 833000.00 during a visit to a health provider (number) Date 22-Jun-2010 30-Jun-2012 28-Feb-2014 Comments Project activities have only recently started. The target may be revised in the final results framework after restructuring. This indicator will be maintained. Preparation of an Investment Plan Text Value Draft ToR available Final Report available Date 14-Dec-2009 30-Jun-2012 28-Feb-2014 Comments Behind schedule. The contract should have already been issued. In addition the MOH proposed to develop a national strategic plan instead of just an investment plan. This indicator will be dropped. Percentage of health facilities offering first-line Percentage Value 40.00 100.00 90.00 treatment for malaria Date 31-Dec-2009 30-Jun-2012 28-Feb-2014 Comments This indicator is to be dropped since all facilities now offer Public Disclosure Copy first-line treatment for malaria based. Number of community health workers trained Text Value 0 1400 (cumulative) Date 31-Dec-2009 30-Jun-2012 28-Feb-2014 Comments This indicator will be modified to reflect only the training of APEs (Agentes Polivalentes Elementares) in the provinces supported by the Project: Page 4 of 6 The World Bank Report No: ISR8166 Cabo Delgado, Nampula and Niassa. Number of outreach teams fully operational Text Value 0 31 Public Disclosure Copy Date 22-Jun-2010 30-Jun-2012 28-Feb-2014 Comments The definition of "fully operational" will be provided and the indicator will be restricted to the three target provinces. Data on Financial Performance (as of 02-May-2012) Financial Agreement(s) Key Dates Project Ln/Cr/Tf Status Approval Date Signing Date Effectiveness Date Original Closing Date Revised Closing Date P099930 IDA-45820 Effective 16-Apr-2009 15-Jul-2009 11-Jun-2010 28-Feb-2014 28-Feb-2014 P099930 TF-58155 Closed 21-Sep-2007 21-Sep-2007 21-Sep-2007 31-Dec-2009 31-Dec-2009 P099930 TF-96375 Effective 19-Mar-2010 24-Mar-2010 24-Mar-2010 30-Apr-2013 30-Apr-2013 P099930 TF-96399 Effective 19-Mar-2010 24-Mar-2010 24-Mar-2010 28-Feb-2014 28-Feb-2014 P099930 TF-96505 Effective 15-Apr-2010 19-Apr-2010 19-Apr-2010 28-Feb-2014 28-Feb-2014 Disbursements (in Millions) Project Ln/Cr/Tf Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P099930 IDA-45820 Effective USD 44.60 44.60 0.00 11.59 34.79 26.00 P099930 TF-58155 Closed USD 1.15 0.18 0.97 0.18 0.00 100.00 P099930 TF-96375 Effective USD 7.86 7.86 0.00 1.80 6.07 23.00 P099930 TF-96399 Effective USD 3.29 3.29 0.00 1.19 2.09 36.00 P099930 TF-96505 Effective USD 16.41 16.23 0.00 4.03 12.64 25.00 Public Disclosure Copy Disbursement Graph Page 5 of 6 The World Bank Report No: ISR8166 Public Disclosure Copy Key Decisions Regarding Implementation N/A Restructuring History There has been no restructuring to date. Related Projects P125477-Mozambique Nutrition Additional Financing Public Disclosure Copy Page 6 of 6