The World Bank Implementation Status & Results Report Comprehensive Approach to Health System Strengthening (P166013) Comprehensive Approach to Health System Strengthening (P166013) AFRICA | Comoros | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2020 | Seq No: 1 | ARCHIVED on 02-Oct-2019 | ISR38692 | Implementing Agencies: UNION OF COMOROS, MINISTRY OF HEALTH, SOLIDARITY, SOCIAL PROTECTION AND GENDER PROMOTION Key Dates Key Project Dates Bank Approval Date: 02-Jul-2019 Effectiveness Date: -- Planned Mid Term Review Date: -- Actual Mid-Term Review Date: Original Closing Date: 30-Sep-2024 Revised Closing Date: 30-Sep-2024 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) (i) To improve utilization of quality PHC and (ii) strengthen capacity of institutions which are critical to quality PHC Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Improve PHC infrastructure, workforce and service delivery platforms:(Cost $22.00 M) Strengthening institutions and governance which are critical to (i) quality PHC and (ii) response to disease outbreaks:(Cost $5.00 M) Citizen Engagement and Empowerment, Project Management, Monitoring and Evaluation,:(Cost $3.00 M) Contingent Emergency Response Component Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO -- Satisfactory Overall Implementation Progress (IP) -- Satisfactory Overall Risk Rating -- High Implementation Status and Key Decisions The project is expected to be effective in January 2020 and is still in too early stage for meaningful progress. 10/2/2019 Page 1 of 8 The World Bank Implementation Status & Results Report Comprehensive Approach to Health System Strengthening (P166013) Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance High -- High Macroeconomic Substantial -- Substantial Sector Strategies and Policies Moderate -- Moderate Technical Design of Project or Program Substantial -- Substantial Institutional Capacity for Implementation and Sustainability High -- High Fiduciary High -- High Environment and Social Moderate -- Moderate Stakeholders Moderate -- Moderate Other -- -- -- Overall High -- High Results PDO Indicators by Objectives / Outcomes (i) to Improve utilization of quality PHC and (ii) strengthen capacity of institutions which are cri IN00748096 ►PHC facilities with accreditation level 2 above as per the facility accreditation program (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 40.00 Date 31-Dec-2017 -- 30-Sep-2019 30-Sep-2024 The Project is not effective yet Comments: IN00748097 ►PHC facilities participating in the PBF scheme supported by the project which reimburses for both quantity and quality of service (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 80.00 Date 31-Dec-2017 -- 30-Sep-2019 30-Sep-2024 The Project is not effective yet Comments: IN00748098 ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target 10/2/2019 Page 2 of 8 The World Bank Implementation Status & Results Report Comprehensive Approach to Health System Strengthening (P166013) Value 0.00 -- 0.00 106,500.00 Date 31-Dec-2017 -- 30-Sep-2019 30-Sep-2024 The Project is not effective yet Comments: IN00748099 Number of children immunized (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 15,000.00 Date 31-Dec-2018 -- 30-Sep-2019 30-Sep-2024 IN00748100 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 75,000.00 Date 31-Dec-2018 -- 30-Sep-2019 30-Sep-2024 IN00748101 Number of deliveries attended by skilled health personnel (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 16,500.00 Date 31-Dec-2018 -- 30-Sep-2019 30-Sep-2024 IN00748102 ►Functional community health sites (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 69.00 -- 0.00 172.00 Date 31-Oct-2019 -- 30-Sep-2019 30-Sep-2024 The Project is not effective yet Comments: IN00748103 ►Annual District and National Health Assemblies (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 18.00 Date 31-Oct-2019 -- 30-Sep-2019 30-Sep-2024 The Project is not effective yet Comments: Intermediate Results Indicators by Components Component 1 Improving PHC infrastructure, workforce and service delivery platforms IN00748104 10/2/2019 Page 3 of 8 The World Bank Implementation Status & Results Report Comprehensive Approach to Health System Strengthening (P166013) ►PHC facilities renovated (minor renovations) and/or equipped among the PHC structures in need of these renovations and/or equipment (percentage) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 100.00 Date 31-Dec-2019 -- 30-Sep-2019 30-Sep-2024 The Project is not effective yet Comments: IN00748108 ►PHC health workers receiving annual CME (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 70.00 Date 31-Dec-2019 -- 30-Sep-2019 30-Sep-2024 The Project is not effective yet Comments: IN00748111 ►Revision of the pre-service nurse training curriculum to make it competency-based (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No -- No Yes Date 31-Dec-2019 -- 30-Sep-2019 30-Sep-2024 The Project is not effective yet Comments: IN00748114 ►Recipients of scholarships for pre-service training in selected clinical disciplines, public health and health management (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 35.00 Date 31-Dec-2019 -- 30-Sep-2019 30-Sep-2024 The Project is not effective yet Comments: IN00748117 ►Community health workers trained to provide health and nutrition services (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 516.00 Date 31-Dec-2019 -- 30-Sep-2019 30-Sep-2024 The Project is not effective yet Comments: IN00748119 ►PHC facilities with at least one quality improvement initiative with the team based problem solving approach (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 60.00 10/2/2019 Page 4 of 8 The World Bank Implementation Status & Results Report Comprehensive Approach to Health System Strengthening (P166013) Date 31-Dec-2019 -- 30-Sep-2019 30-Sep-2024 The Project is not effective yet Comments: IN00748120 ►Functional Emergency Medical Transportation with a dedicated hotline on each island (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 5.00 Date 31-Dec-2017 -- 30-Sep-2019 30-Sep-2024 The Project is not effective yet Comments: IN00748121 ►Community health workers trained to provide health and nutrition services (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 516.00 Date 31-Oct-2019 -- 30-Sep-2019 30-Sep-2024 The Project is not effective yet Comments: Component 2 Strengthening institutions and governance which are critical to (i) quality PHC and (ii) IN00748105 ►National Health Strategies and Plans adopted (Quality of Care, NCDs, Human Resources for Health) (number) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 3.00 Date 30-Jun-2019 -- 30-Sep-2019 30-Sep-2024 The Project is not effective yet Comments: IN00748109 ►PHC health workers benefiting from annual clinical mentorship and/or coaching (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 100.00 Date 31-Dec-2019 -- 30-Sep-2019 30-Sep-2024 The Project is not effective yet Comments: IN00748112 ►PHC facilities self-monitoring a set of quality of care indicator quarterly for quality improvement (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 50.00 Date 31-Dec-2019 -- 30-Sep-2019 30-Sep-2024 Comments: Theh project is not effective yet 10/2/2019 Page 5 of 8 The World Bank Implementation Status & Results Report Comprehensive Approach to Health System Strengthening (P166013) IN00748115 ►Membership of health professional associations (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 100.00 Date 31-Dec-2017 -- 30-Sep-2019 30-Sep-2024 The Project is not effective yet Comments: Component 3 Citizen Engagement and Empowerment, Project Management, Monitoring and Evaluation IN00748106 ►Operational hotline for patient complaints and feedbacks (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No -- No Yes Date 31-Dec-2019 -- 30-Sep-2019 30-Sep-2024 The Project is not effective yet Comments: IN00748110 ►Patient associations/support groups established (diabetes, hypertension, chronic lung diseases, cancer) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 4.00 Date 31-Dec-2019 -- 30-Sep-2019 30-Sep-2024 The Project is not effective yet Comments: IN00748113 ►Primary health care facilities submitting monthly report according to national guidelines (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 70.00 Date 31-Dec-2019 -- 30-Sep-2019 30-Sep-2024 The Project is not effective yet Comments: IN00748116 ►Nationally representative patient experience surveys conducted (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 2.00 Date 31-Dec-2019 -- 30-Sep-2019 30-Sep-2024 The Project is not effective yet Comments: IN00748118 10/2/2019 Page 6 of 8 The World Bank Implementation Status & Results Report Comprehensive Approach to Health System Strengthening (P166013) ►Complaints for grievances timely addressed (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 75.00 Date 31-Dec-2017 -- 30-Sep-2019 30-Sep-2024 Component 4 Contingent Emergency Response Component (CERC) IN00748107 ►Emergency Action Plan validated (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Emergency Action Emergency Action Plan Plan officially validated Value -- Not Yet Due prepared before CERC activation Date 31-Dec-2019 -- 30-Sep-2019 30-Sep-2024 The Project is not effective yet Comments: Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed Not P166013 IDA-64670 USD 15.00 15.00 0.00 0.00 15.11 0% Effective Not P166013 IDA-D5050 USD 15.00 15.00 0.00 0.00 14.91 0% Effective Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date Not P166013 IDA-64670 02-Jul-2019 -- -- 30-Sep-2024 30-Sep-2024 Effective Not P166013 IDA-D5050 02-Jul-2019 -- -- 30-Sep-2024 30-Sep-2024 Effective Cumulative Disbursements 10/2/2019 Page 7 of 8 The World Bank Implementation Status & Results Report Comprehensive Approach to Health System Strengthening (P166013) Restructuring History There has been no restructuring to date. Related Project(s) There are no related projects. 10/2/2019 Page 8 of 8