The World Bank Report No: ISR15384 Implementation Status & Results Pakistan Pakistan: Revitalizing Health Services in KP (P126426) Public Disclosure Copy Operation Name: Pakistan: Revitalizing Health Services in KP (P126426) Project Stage: Implementation Seq.No: 6 Status: ARCHIVED Archive Date: 28-Jun-2014 Country: Pakistan Approval FY: 2012 Product Line: Recipient Executed Activities Region: SOUTH ASIA Lending Instrument: Emergency Recovery Loan Implementing Agency(ies): Department of Health Key Dates Board Approval Date 12-Apr-2012 Original Closing Date 30-Jun-2015 Planned Mid Term Review Date 09-Apr-2013 Last Archived ISR Date 17-Feb-2014 Effectiveness Date 12-Apr-2012 Revised Closing Date 30-Jun-2015 Actual Mid Term Review Date 09-Apr-2013 Project Development Objectives Project Development Objective (from Project Appraisal Document) Project development objective: The project development objective (PDO) is to improve the availability, accessibility and delivery of primary and secondary health care services at the district level. Has the Project Development Objective been changed since Board Approval of the Project? Yes No Component(s) Component Name Component Cost Component 1: Revitalizing health care services. (MDTF US$ 8.2mil lion& GoKP US$ 15.0 mil) 8.20 Component 3: Establish and operationalise a robust monitoring and evaluation system at district and 2.00 provincial level. (MDTF US$ 2.0 million) Overall Ratings Previous Rating Current Rating Public Disclosure Copy Progress towards achievement of PDO Unsatisfactory Unsatisfactory Overall Implementation Progress (IP) Moderately Unsatisfactory Moderately Unsatisfactory Overall Risk Rating High High Implementation Status Overview The project has been in problem status due to extensive implementation delays especially in the procurement process of the six district management contracts. The project was restructured in June 2014.The overall project objective remains the same but the scope of work has decreased due to the limited time available for implementation, one year of the original three years planned. Component 2 of the project involving civil works has been cancelled as the reduced time left for implementation will not allow for the completion of the planned works. The administrative arrangements of the project are changed and an independent project management unit is established instead of having the project managed by Health Sector Reform Unit. The Project Management Unit is being transferred directly under the administrative control of Secretary Health and the Project Coordinator is being given Page 1 of 5 The World Bank Report No: ISR15384 requisite financial powers. A change is made in the definition of Incremental Operating Costs to include the salary and allowances of the Project Coordinator as civil servant to be made eligible expenditure retroactively from February 2014. The project cost by component has been changed as follows: Component 1 - decreased to US$8.2 million; Component 2 - deleted; and Component 3 - decreased to US$2.0 million. The total project cost is now reduced to US$10.2 million. Public Disclosure Copy Locations Country First Administrative Division Location Planned Actual Pakistan North West Frontier Province North-West Frontier Province ✔ ✔ Pakistan North-West Frontier Province Mansehra ✔ Pakistan North-West Frontier Province Dir ✔ Pakistan North-West Frontier Province Dera Ismail Khan ✔ Results Project Development Objective Indicators Indicator Name Core Unit of Measure Baseline Current End Target People with access to a basic package of Number Value 0.00 0.00 3956119.00 health, nutrition, or reproductive health services Date 30-Jun-2015 (number) Comments Percent of children with Severe Acute Percentage Value 0.00 0.00 20.00 Malnutrition provided adequate nutrition Date 30-Jun-2015 services Comments Percent of births attended by skilled health Percentage Value 24.00 30.00 personnel Date 30-Jun-2008 30-Jun-2012 30-Jun-2015 Comments MICS 2008 PSLSM 2012 Will be from 20-30 by district Batagram 40 Batagram 47 Buner 22 Buner 49 D. I. Khan 18 D. I. Khan 34 Public Disclosure Copy Kohistan 16 Kohistan 9 Lower Dir 44 Lower Dir 46 Tor Ghar N/A Tor Ghar 13 Contraceptive prevalence rate (any modern Percentage Value 14.30 20.00 method,) Date 30-Jun-2008 30-Jun-2015 Comments MICS 2008 Batagram 16.1 Buner 19.0 D. I. Khan 18.5 Page 2 of 5 The World Bank Report No: ISR15384 Kohistan 0.9 Lower Dir 24.0 Tor Ghar N/A Community satisfaction with health care Percentage Value 38.00 45.00 Public Disclosure Copy services delivery by public sector Date 30-Jun-2008 30-Jun-2012 30-Jun-2015 Comments PSLSM 2008 PSLSM 2012 Batagram 32.40 Batagram 38.44 Buner 64.42 Buner 71.9 D. I. Khan 61.72 D. I. Khan 38.56 Kohistan 02.66 Kohistan 17.00 Lower Dir 23.75 Lower Dir 17.95 Tor Ghar N/A Tor Ghar 26.86 Intermediate Results Indicators Indicator Name Core Unit of Measure Baseline Current End Target Number of districts contracted out for Number Value 0.00 0.00 6.00 management of services Date 01-Jan-2012 30-Jun-2015 Comments Health personnel receiving training (number) Number Value 0.00 100.00 Date 01-Jan-2012 30-Jun-2015 Comments This can be reflected best in a percentage value. Percentage of Hubs established and assessed Percentage Value 0.00 0.00 100.00 as fully functioning by DoH Date 01-Jan-2012 30-Jun-2015 Comments Health Facility Utilization Rate: Visits per Percentage Value 0.50 1.00 person per year Date 30-Jun-2015 Comments Best estimates HFUR: by Gender Percentage Value 1.00 Public Disclosure Copy Sub Type Date 30-Jun-2015 Breakdown Comments Baseline to be finalized Health facilities constructed, renovated, and/or Number Value 0.00 0.00 10.00 equipped (number) Date 01-Jan-2012 30-Jun-2015 Comments estimates # of DHQ hospitals refurbished Number Value 0.00 0.00 3.00 Sub Type Date 30-Jun-2015 Breakdown Comments Page 3 of 5 The World Bank Report No: ISR15384 Health facilities adequately refurbished Number Value 0.00 0.00 20.00 Sub Type Date 30-Jun-2015 Breakdown Comments Public Disclosure Copy Timely disbursement of funds to a consultant/ Days Value 100.00 NGO implementing contracting out Date 01-Jan-2012 30-Jun-2015 Comments Data is not available that can be quoted Biannual meetings held for Provincial Steering Number Value 0.00 0.00 2.00 Committee Date 01-Jan-2012 30-Jun-2015 Comments Number of Health facilities submitting monthly Percentage Value 50.00 90.00 reports on time to district Date 01-Jan-2012 30-Jun-2015 Comments Estimates Establishment within two months from the Number Value 1.00 0.00 6.00 contract date and operationalization of District Date 01-Jan-2012 30-Jun-2015 Health Management Team Comments Data on Financial Performance (as of 14-Jan-2014) Financial Agreement(s) Key Dates Project Ln/Cr/Tf Status Approval Date Signing Date Effectiveness Date Original Closing Date Revised Closing Date P126426 TF-11062 Effective 12-Apr-2012 12-Apr-2012 12-Apr-2012 30-Jun-2015 30-Jun-2015 Disbursements (in Millions) Project Ln/Cr/Tf Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P126426 TF-11062 Effective USD 16.00 16.00 0.00 3.00 13.00 19.00 Public Disclosure Copy Disbursement Graph Page 4 of 5 The World Bank Report No: ISR15384 Public Disclosure Copy Key Decisions Regarding Implementation The project has been restructured with a decrease in scope and change in management structure Restructuring History Level 2 CD Decision on 10-Jun-2014 Related Projects There are no related projects. 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