The World Bank Implementation Status & Results Report Kiribati COVID-19 Emergency Response Project (P174219) Kiribati COVID-19 Emergency Response Project (P174219) EAST ASIA AND PACIFIC | Kiribati | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2020 | Seq No: 4 | ARCHIVED on 27-Jun-2022 | ISR51563 | Implementing Agencies: Ministry of Health and Medical Services, Republic of Kiribati Key Dates Key Project Dates Bank Approval Date: 25-Jun-2020 Effectiveness Date: 23-Jul-2020 Planned Mid Term Review Date: 04-Apr-2022 Actual Mid-Term Review Date: 03-May-2022 Original Closing Date: 30-Jun-2023 Revised Closing Date: 30-Jun-2023 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) To prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness in the Recipient’s territory. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Strengthening essential health service delivery capacity:(Cost $2.10 M) Implementation Management and Monitoring and Evaluation:(Cost $0.40 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Moderately Satisfactory Moderately Satisfactory Overall Implementation Progress (IP) Moderately Unsatisfactory Moderately Satisfactory Overall Risk Rating Substantial Substantial Implementation Status and Key Decisions This implementation status and results report (ISR) summarizes the findings from the midterm review/fourth implementation support mission conducted virtually between May 3 to 13, 2022. Both Project Development Objective level indicators are on track and the Government of Kiribati is making changes to the protocol for reporting and investigation of suspected COVID cases to reflect the changing epidemiology and response requirements. The Project has refurbished the warehouse at the Tungaru Central Hospital and procured information and communication technology equipment to improve connectivity of health facilities to a centralized health information management database and communication system. There have been delays in progressing the construction of the new warehouse. However, a technical firm has now been recruited to support the Ministry for Infrastructure and Sustainable Energy in the finalization of the warehouse design and specification, preparation of the construction site and related procurement documents for the construction. 6/27/2022 Page 1 of 6 The World Bank Implementation Status & Results Report Kiribati COVID-19 Emergency Response Project (P174219) MPA Program Development Objective MPA PDO Table The Program Development Objective is to prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness MPA Table Multiphase Programmatic Approach (MPA) Status MPA Table Body As of May 16, 2022, 88 MPA-projects had been approved with a total commitment of US$4.3 billion. One operation (Guatemala) was cancelled in mid-September 2021, at the request of the Government. Six parent projects have been restructured to include vaccine-related procurement. Total disbursements as of May 16, 2022, amount to US$3.6 billion or 83% of overall commitments. This amount does not include disbursements under MPA-V operations which are reported together with AF-V operations. Sixty-seven (67) country projects or 77% of projects approved have reached 70-100% disbursement (reasons for >100% disbursements relate to fluctuations between the Euro and the SDR against the US$). Out of the 67 operations, 48 operations or 72% have disbursed over 90% of commitments. Of these, 30 operations are fully disbursed. There are twelve (12) operations with disbursements under 50%. The projects are benefitting around 3.7 billion people or 50% of the global population. Of the 87 active projects: (i) 33 are in Africa – 12 in AFE and 21 in AFW; (ii) 12 in East Asia; (iii) 14 in Europe and Central Asia; (iv) 11 in Latin America and the Caribbean; (v) 8 in Middle East and North Africa; and (vi) 9 in South Asia. Eighty-six (86) or 99% of projects approved are disbursing. Two operations closed last CY. Closing dates for several operations have been extended beyond the end of the FY; twelve (12) operations have closing dates by the end of FY22. Country teams for operations which have been under implementation for twelve months or more by June 30, 2022, are preparing Mid-Term Review (MTR) ISRs to inform the Global MPA MTR, which will be prepared early next FY. Streamlined procedures, delegated approvals, coupled with flexible project design and intensified efforts across the Bank have contributed to the progress. Implementation is being guided by Bank teams working in parallel with other health related projects, including Additional Financing operations supporting vaccine procurement and deployment efforts. Implementation continues to face challenges as several countries are still under different levels of mobility restrictions, and counterparts and Bank teams are operating from home or partially from home. Some Bank teams continue to conduct implementation support missions virtually, which is challenging for both Bank teams and counterparts. Bank staff are operating in a hybrid environment with some days at the office and others at home. Notwithstanding the challenges, the MPA is on track to achieve its PrDO, which is to prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness. The significant level of disbursements attests to the strong implementation of the Bank' response thanks to the commitment of counterparts supported by Bank country teams. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance Low Low Low Macroeconomic Low Low Low Sector Strategies and Policies Low Low Low Technical Design of Project or Program Moderate Moderate Moderate 6/27/2022 Page 2 of 6 The World Bank Implementation Status & Results Report Kiribati COVID-19 Emergency Response Project (P174219) Institutional Capacity for Implementation and High High High Sustainability Fiduciary Substantial Substantial Substantial Environment and Social Moderate Moderate Moderate Stakeholders Low Low Low Other Low Low Low Overall Substantial Substantial Substantial Results PDO Indicators by Objectives / Outcomes Strengthen national systems for public health preparedness in Kiribati IN01145229 ►Emergency response protocols and plans revised and adopted (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No No Yes Yes Date 31-Dec-2020 15-Nov-2021 30-Apr-2022 30-Jun-2023 Response protocols continue to be revised and adopted to reflect the changing COVID-19 disease testing, prevention, transmission control and management requirements. Initial revisions include reduction in Comments: quarantine requirements from 14 days to 7 days, along with changes to testing and screening recommendations. IN01145230 ►Percentage of suspected cases of COVID-19 reported and investigated per approved protocol (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 100.00 100.00 Date 31-Dec-2020 15-Nov-2021 30-Apr-2022 30-Jun-2023 As of April 30, 2022, 3081 confirmed cases of COVID-19 and 13 deaths were recorded. Changes continue to be made to the government’s protocol for reporting and investigation of suspected COVID cases to reflect the changing epidemiology. MHMS has reduced testing to symptomatic patients Comments: presenting to health facilities and to meet the Government of Kiribati's surveillance targets of 100 tests/week. IN01145336 ►Availability of essential medicines and supplies at all health facilities (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 74.00 71.00 73.00 90.00 Date 31-Dec-2019 15-Nov-2021 30-Apr-2022 30-Jun-2023 6/27/2022 Page 3 of 6 The World Bank Implementation Status & Results Report Kiribati COVID-19 Emergency Response Project (P174219) MHMS is continuing to work with mSupply Foundation and Beyond Essential Systems teams for support to address problems with related ICT issues to enable more timely data monitoring and reporting. Comments: However, the persisting issue relating to poor connectivity continues to affect timely data monitoring and reporting. Intermediate Results Indicators by Components Strengthening essential health service delivery capacity IN01145337 ►Percentage of health facilities connected to a centralized health information management database and communication system to support telehealth services (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 13.00 13.00 70.00 Date 31-Dec-2020 15-Nov-2021 30-Apr-2022 30-Jun-2023 Only 13 percent of all health facilities are connected to a centralized health information database & communication system at the end of March 2022. It is anticipated that by the end of June 2022 after the Comments: new ICT equipment has arrived and been installed with tablets distributed to selected health facilities, about 83 percent of total health facilities will be connected to health information database. IN01145339 ►Increased storage capacity for COVID-19 buffer stocks and essential medicines (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No Yes Yes Yes Date 31-Dec-2020 15-Nov-2021 30-Apr-2022 30-Jun-2023 Current storage capacity has slightly increased following the completion of the upgrading works to TCH warehouse in March 2022. Shipping containers and rental properties continue to be used as temporary Comments: storage until the new warehouse is completed. Additional interim storage options need to be explored. IN01145341 ►Percentage of health facilities submitting completed surveillance reports within two weeks of the end of each month (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 10.00 83.00 70.50 80.00 Date 31-Dec-2020 15-Nov-2021 30-Apr-2022 30-Jun-2023 70.5 percent of clinics and health centers have submitted their reports on time for this 1st quarter. The 9 sentinel sites continue to send their data on Syndromic Surveillance every other day. They send data Comments: through a photo shot of their tally book through Gmail and messenger. For those that don’t report transport is provided to pick up their tally books. Implementation Management and Monitoring and Evaluation IN01145338 ►MHMS reporting at least every six months against its Strategic Health Plan core indicator set (Yes/No, Custom) 6/27/2022 Page 4 of 6 The World Bank Implementation Status & Results Report Kiribati COVID-19 Emergency Response Project (P174219) Baseline Actual (Previous) Actual (Current) End Target Value No No No Yes Date 31-Dec-2019 15-Nov-2021 30-Apr-2022 30-Jun-2023 The Health Information Unit is currently compiling data for 2021 Annual Health Bulletin which will inform 2021 Service Delivery Statement (SDS). Data up to 31 March 2022 is also being collated to inform the six- monthly SDS which is due June 2022. Comments: The Project Manager advised that the 2021 SDS has now been completed and is being reviewed by the MHMS Executive Management Committee for clearance before it can be shared publicly. IN01145340 ►Beneficiaries who expressed satisfaction with the project interventions, including on delivery and communication modalities (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 11.00 75.00 Date 01-Oct-2020 15-Nov-2021 30-Apr-2022 30-Jun-2023 Overall satisfaction with availability, ordering and delivery of medicines and medical supplies was rated in December 2021, by health care professionals as 11 percent satisfactory, 72 percent neutral and 17 Comments: percent dissatisfactory. Performance-Based Conditions Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P174219 IDA-D6900 Effective USD 2.50 2.50 0.00 0.76 1.82 29% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P174219 IDA-D6900 Effective 25-Jun-2020 07-Jul-2020 23-Jul-2020 30-Jun-2023 30-Jun-2023 Cumulative Disbursements 6/27/2022 Page 5 of 6 The World Bank Implementation Status & Results Report Kiribati COVID-19 Emergency Response Project (P174219) Restructuring History There has been no restructuring to date. Related Project(s) There are no related projects. 6/27/2022 Page 6 of 6