The World Bank Implementation Status & Results Report South Sudan Provision of Essential Health Services Project (P168926) South Sudan Provision of Essential Health Services Project (P168926) AFRICA | South Sudan | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2019 | Seq No: 2 | ARCHIVED on 27-Nov-2019 | ISR38997 | Implementing Agencies: International Committee of the Red Cross, International Committee of the Red Cross, UNICEF, UNICEF Key Dates Key Project Dates Bank Approval Date: 27-Feb-2019 Effectiveness Date: 11-Mar-2019 Planned Mid Term Review Date: 31-Mar-2020 Actual Mid-Term Review Date: Original Closing Date: 31-Dec-2021 Revised Closing Date: 31-Dec-2021 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The Project Development Objective is to increase access to an essential package of health services in the Republic of South Sudan, with a particular focus on the former states of Upper Nile and Jonglei. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Delivery of Essential Health Services:(Cost $93.00 M) Monitoring, Evaluation and Learning:(Cost $4.00 M) Emergency Preparedness and Response:(Cost $3.00 M) Repayment of Project Preparation Advances:(Cost $5.40 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Moderately Satisfactory Satisfactory Overall Risk Rating High High Implementation Status and Key Decisions The first Implementation Support Mission for the project took place October 14-18, 2019. Activities implemented through IDA grants to UNICEF and ICRC to support health service delivery in areas targeted by the project are being carried out according to project design and schedule, despite logistical challenges generated by an unusually severe rainy season. An all nine PDO indicators are on track to be achieved, indicating that the PDO is likely to be achieved. For example, number of deliveries attended by skilled health personnel” is 5,483 as of August 31, 2019 or 22% of the end-project target of 25,000, compared to 19% expected achievement by August 31, 2019. Seventy-three percent (8/11) of intermediate results indicators are on track to be achieved. For example, “Number of pregnant women receiving ANC four visits” is 15,617 women or 39% of the end- project target of 40,000 compared to expected 19% achievement through August 31, 2019. 11/27/2019 Page 1 of 8 The World Bank Implementation Status & Results Report South Sudan Provision of Essential Health Services Project (P168926) Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance High High High Macroeconomic High High High Sector Strategies and Policies High High High Technical Design of Project or Program High High High Institutional Capacity for Implementation and Sustainability High High High Fiduciary High High High Environment and Social High High High Stakeholders High High High Other -- -- -- Overall High High High Results PDO Indicators by Objectives / Outcomes Increase the utilization of an essential package of health services IN00757403 ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 514,323.00 1,400,000.00 Date 31-Dec-2018 07-May-2019 31-Aug-2019 31-Jan-2021 People who have received essential health, nutrition, and population (HNP) services ICRC: 158,524 UNICEF: 355,781 People who have received essential health, nutrition, and population (HNP) services - Female ICRC: 46,920 UNICEF: 177,891 Comments: Number of children immunized ICRC: 45,597 UNICEF: 18,953 Number of women and children who have received basic nutrition services ICRC: 31,329 UNICEF: 54,576 Number of deliveries attended by skilled health personnel 11/27/2019 Page 2 of 8 The World Bank Implementation Status & Results Report South Sudan Provision of Essential Health Services Project (P168926) ICRC: 2,050 UNICEF: 3,433 IN00757406 People who have received essential health, nutrition, and population (HNP) services - Female (RMS requirement) (Number, Corporate Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 224,811.00 800,000.00 IN00757408 Number of children immunized (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 64,550.00 75,000.00 Date 31-Dec-2018 07-May-2019 31-Aug-2019 31-Jan-2021 IN00757409 Number of women and children who have received basic nutrition services (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 85,905.00 200,000.00 Date 31-Dec-2018 07-May-2019 31-Aug-2019 31-Jan-2021 IN00757410 Number of deliveries attended by skilled health personnel (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 5,483.00 25,000.00 Date 31-Dec-2018 07-May-2019 31-Aug-2019 31-Jan-2021 IN00757411 ►Number of curative consultations provided for under 5 children (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 377,500.00 1,000,000.00 Date 31-Dec-2018 07-May-2019 31-Aug-2019 31-Jan-2021 ICRC: 44,105 UNICEF: 333,395 Comments: Total number of consultations provided to children less than 5 years of age Increase the quality of an essential package of health services IN00757404 ►Number of health facilities with essential medicines available (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 176.00 200.00 Date 31-Dec-2018 07-May-2019 31-Aug-2019 31-Jan-2021 Comments: Total 176 (82%) 11/27/2019 Page 3 of 8 The World Bank Implementation Status & Results Report South Sudan Provision of Essential Health Services Project (P168926) ICRC: 19 (100%) UNICEF: 157 on Average (80%) Availability of 5 tracer drugs during supervision visits (oral paracetamol, oral amoxicillin, oral rehydration solution, oral artesunate-amodiaquine) IN00757405 ►Number of health facilities providing at least 75 percent of the essential package of health services (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 169.00 200.00 Date 01-Jan-2019 07-May-2019 31-Aug-2019 31-Jan-2021 Total 169 (78%) ICRC: 11 (55%) UNICEF: 158 (81% on average) Comments: Essential package of services is defined in Annex 6 of the PAD IN00757407 ►Proportion of disease outbreaks detected and responded to within 72 hours of confirmation (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 15.00 0.00 100.00 50.00 Date 31-Dec-2018 07-May-2019 31-Aug-2019 31-Jan-2021 ICRC: 100% UNICEF: 100% Comments: Proportion of disease outbreaks detected and responded to within 72 hours of confirmation Intermediate Results Indicators by Components Delivery of a package of essential health services IN00757412 ►Number of children aged 6-59 months who received vitamin A supplementation (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 54,576.00 250,000.00 Date 31-Dec-2018 07-May-2019 31-Aug-2019 31-Jan-2021 Number of children aged 6-59 months who received vitamin A supplementation Comments: IN00757414 ►Number of children less than 1 year who received measles vaccination (first dose) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 26,756.00 75,000.00 Date 31-Dec-2018 07-May-2019 31-Aug-2019 31-Jan-2021 11/27/2019 Page 4 of 8 The World Bank Implementation Status & Results Report South Sudan Provision of Essential Health Services Project (P168926) ICRC: 3,836 UNICEF: 22,290 Comments: Number of children less than 1 year who received measles vaccination (first dose) IN00757417 ►Number of pregnant women receiving ANC four visits (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 15,617.00 40,000.00 Date 31-Dec-2018 07-May-2019 31-Aug-2019 31-Jan-2021 ICRC: 4,068 UNICEF: 11,549 Comments: Number of pregnant women receiving ANC four visits IN00757419 ►Number of newborns receiving postnatal visit within two days of childbirth (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 2,357.00 17,000.00 Date 31-Dec-2018 07-May-2019 31-Aug-2019 31-Jan-2021 Comments: Number of newborns receiving postnatal visit within two days of childbirth IN00757420 ►Proportion of gender-based survivors presenting at health facilities provided with clinical management of rape services (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 96.00 100.00 Date 31-Dec-2018 07-May-2019 31-Aug-2019 31-Jan-2021 ICRC: 92% UNICEF: 100% Comments: Number of gender-based survivors provided with clinical management of rape services IN00757421 ►Number of health care workers trained in-service (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 2,411.00 400.00 Date 31-Dec-2018 07-May-2019 31-Aug-2019 31-Jan-2021 ICRC: 359 UNICEF: 2052 Number of health care workers trained in-service in topics such as safe motherhood, integrated Comments: management of childhood illnesses (IMNCI), effective vaccine management and immunization in practice, and malaria testing and treatment IN00757422 ►Number of community health workers trained to implement integrated community case management (iCCM) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target 11/27/2019 Page 5 of 8 The World Bank Implementation Status & Results Report South Sudan Provision of Essential Health Services Project (P168926) Value 0.00 0.00 0.00 200.00 Date 31-Dec-2018 07-May-2019 31-Aug-2019 31-Jan-2021 Number of community health workers trained to implement integrated community case management Comments: (iCCM) Monitoring, Evaluation and Learning IN00757413 ►Proportion of functional health facilities submitting standardized HMIS monthly reports into the DHIS2 or HMIS equivalent system within one month of the reporting month (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 60.00 0.00 87.00 75.00 Date 31-Dec-2018 07-May-2019 31-Aug-2019 31-Jan-2021 ICRC: 100% UNICEF: 86% Comments: Proportion of functional health facilities submitting standardized HMIS monthly reports into the DHIS2 or HMIS equivalent system within one month of the reporting month IN00757415 ►Proportion of health facilities with structured supervision visit within a month (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 40.00 0.00 43.00 70.00 Date 31-Dec-2018 07-May-2019 31-Aug-2019 31-Jan-2021 ICRC: 84% UNICEF: 40% (on average) Comments: Proportion of health facilities with structured supervision visit using a standardized Supervisory Tool/Checklist to assess and monitor quality of care within a month IN00757418 ►Number of monitoring reports submitted (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 0.00 Date 31-Dec-2018 07-May-2019 31-Aug-2019 31-Jan-2021 ICRC: 2 UNICEF: 2 Number of monitoring reports (including both health facility and LQAS) submitted in areas where external monitoring will be conducted. The performance monitoring methodology and reports will include citizen Comments: engagement mechanisms such as exit interviews conducted during data verification visits. The questionnaires will be customized to capture key domains on satisfaction and perceived quality of care, in order to capture community feedback on service delivery. Results from the quarterly reports will be used to engage with citizens on key elements related to improving service delivery in targeted communities. Emergency Preparedness and Response IN00757416 ►Number of state-level Rapid Response Teams trained on investigation of alerts and immediate outbreak response (Number, Custom) 11/27/2019 Page 6 of 8 The World Bank Implementation Status & Results Report South Sudan Provision of Essential Health Services Project (P168926) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 10.00 Date 31-Dec-2018 07-May-2019 31-Aug-2019 31-Jan-2021 Number of state-level rapid response teams, in particular health and WASH personnel, on investigation of Comments: alerts and immediate outbreak response, as well as requirements for IPC associated with the preparation of disinfectants of different concentrations, excreta disposal and monitoring of water quality. Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P168926 IDA-D4270 Effective USD 73.40 73.40 0.00 54.86 17.84 75% P168926 IDA-D4280 Effective USD 32.00 32.00 0.00 14.55 17.16 46% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P168926 IDA-D4270 Effective 27-Feb-2019 28-Feb-2019 11-Mar-2019 31-Dec-2021 31-Dec-2021 P168926 IDA-D4280 Effective 27-Feb-2019 01-Mar-2019 19-Mar-2019 31-Dec-2021 31-Dec-2021 Cumulative Disbursements 11/27/2019 Page 7 of 8 The World Bank Implementation Status & Results Report South Sudan Provision of Essential Health Services Project (P168926) Restructuring History There has been no restructuring to date. Related Project(s) There are no related projects. 11/27/2019 Page 8 of 8