The World Bank Implementation Status & Results Report Benin Health System Enhancement Program (P172940) (P172940) Benin Health System Enhancement Program (P172940) (P172940) WESTERN AND CENTRAL AFRICA | Benin | Health, Nutrition & Population Global Practice | Requesting Unit: AWCF2 | Responsible Unit: HAWH2 IBRD/IDA | Program-for-Results Financing | FY 2022 | Team Leader(s): Zenab Konkobo Kouanda, Teegwende Valerie Porgo Seq No: 4 | ARCHIVED on 14-Feb-2024 | ISR58567 | Created by: Teegwende Valerie Porgo on 01-Nov-2023 | Modified by: Teegwende Valerie Porgo on 07-Feb-2024 Program Development Objectives PDO Table Program Development Objective (from Program Appraisal Document) To improve the quality of and access to primary health care services with a focus on reproductive, maternal, neonatal, child, adolescent health and nutrition (RMNCAH+N) and strengthen public health emergency preparedness and response capacity Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Moderately Unsatisfactory Overall Implementation Progress (IP) Satisfactory Moderately Satisfactory Implementation Status and Key Decisions The Benin Health System Enhancement Program was approved by the Board of Directors of the World Bank on April 27, 2022. The Program was declared effective date on July 27, 2022. The achievement of the program's development objective (PDO) is rated Moderately Unsatisfactory as only one out of the seven PDO indicator (14%) is on track and the progress in implementation is rated Moderately Satisfactory Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P172940 IDA-70800 Effective USD 93.50 93.50 0.00 20.41 61.03 25% P172940 IDA-E0020 Effective USD 93.50 93.50 0.00 21.64 63.85 25% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P172940 IDA-70800 Effective 27-Apr-2022 10-May-2022 27-Jul-2022 30-Jun-2027 30-Jun-2027 P172940 IDA-E0020 Effective 27-Apr-2022 10-May-2022 27-Jul-2022 30-Jun-2027 30-Jun-2027 2/14/2024 Page 1 of 15 The World Bank Implementation Status & Results Report Benin Health System Enhancement Program (P172940) (P172940) DLI Disbursement Achievement Disbursed amount in Disbursement % for DLI ID DLI Type Description Coc DLI Amount Status Coc DLI Loan: IDA70800-001 DLI3, full imunztion 3 Regular EUR 20,000,000.00 Not Achieved 0.00 children 12-23 mos DLI5, health pro compltd 5 Regular EUR 26,460,000.00 Not Achieved 0.00 epidem/lab tng DLI7, health fac w/ hcare 7 Regular EUR 33,250,000.00 Not Achieved 0.00 buildgs constr DLI8, opera of health sect 8 Regular EUR 3,790,000.00 Not Achieved 0.00 quality assur Loan: IDAE0020-001 DLI1, Health facilities 1 Regular XDR 14,400,000.00 Not Achieved 0.00 offering BEMONC DLI2, proprtion long 2 Regular XDR 14,000,000.00 Not Achieved 0.00 contracptive users DLI4, health facilities w/no 4 Regular XDR 14,500,000.00 Not Achieved 0.00 stock-out DLI6,propr birth attndd 6 Regular XDR 12,780,000.00 Not Achieved 0.00 skilld helth pro DLI8, op health sect 8 Regular XDR 11,420,000.00 Not Achieved 0.00 quality assur Program Action Plan Action Description Recruitment by the Ministry of Health of the firm and working group in support of works. Source DLI# Responsibility Timing Timing Value Status Project Coordination Technical Due Date 30-Nov-2022 Completed Unit (PCU) Recruitment of: - The firm in charge of the detailed design and supervision of the construction, rehabilitation, and extension works of Completion Measurement the health infrastructures supported by the programme - The working group for the preparation of tender documents Comments The AISEM has an operational manual for the preparation of tender documents. Action Description Development of the Procedure Manual Source DLI# Responsibility Timing Timing Value Status Ministry of Health Technical Due Date 31-Dec-2022 Completed (MOH), ANSSO 2/14/2024 Page 2 of 15 The World Bank Implementation Status & Results Report Benin Health System Enhancement Program (P172940) (P172940) The Program's Procedure Manual is developed by the ANSSP. The World Bank approves the Procedure Manual. Completion Measurement 120 days after entry into force of the programme. Comments The manual was completed and approved as an effectiveness condition Action Description Strengthening the Program Environmental and Social Management system. Source DLI# Responsibility Timing Timing Value Status UCP, Beninese Environmental and Social Environment Agency Due Date 15-Feb-2024 Completed Systems (ABE) Development of a Civic Engagement Plan and implementation of the civic engagement mechanism. No later than six Completion Measurement (6) months after the date of entry into force of the program and its implementation throughout the life cycle of the program. The consultant to develop the Civic Engagement Plan is hired. The civic engagement plan is being developed. The Comments validation of the plan is expected January 31, 2024. Action Description Strengthening the Program Environmental and Social Management system. Source DLI# Responsibility Timing Timing Value Status Environmental and Social UCP, ABE Due Date 30-Nov-2022 In Progress Systems Inter-institutional agreement (PCU/ABE) during the first quarter after the Program's effective date. Different structures Completion Measurement interacting with the Agency in the implementation of the Program, validation of impact studies, benefits: monitoring, focal poi The draft agreement is available. The counterpart wishes to finalize the Technical Manual for Environmental and Comments Social Management of the Program before finalizing and signing the agreement. Action Description Strengthening the Program's Environmental and Social Management System. Source DLI# Responsibility Timing Timing Value Status Environmental and Social UCP, MS (CEGCC), Due Date 30-Sep-2022 In Progress Systems ABE, ANDF Development and implementation of the Technical Manual for Environmental and Social Management of the Completion Measurement Program. Preparation no later than three (3) months after the date of entry intro force of the program and implementation throughout the life cycle The contract of the consultant to draft the technical manual for environmental and social management of the Program Comments is signed. The adoption of the manual is expected for end of March 2024. Action Description Strengthening the technical and institutional capacities of actors and stakeholders Source DLI# Responsibility Timing Timing Value Status 2/14/2024 Page 3 of 15 The World Bank Implementation Status & Results Report Benin Health System Enhancement Program (P172940) (P172940) UCP, MS, ABE, Environmental and Social ANDF, DDS, Recurrent Continuous In Progress Systems DDCVDD Organization of training sessions directly targeting the parties involved in the implementation of the project. Start of Completion Measurement sessions in the first half of the year after the date of entry into force of the program. Refresher sessions throughout the life Awaiting finalization of various environmental and social documents of the Program including the citizen engagement Comments plan and the technical manual for Environmental and Social Management to start training sessions. Action Description Capacity building (technical and institutional) of actors and stakeholders Source DLI# Responsibility Timing Timing Value Status Environmental and Social UCP, MS (CEGCC) Due Date 30-Aug-2022 In Progress Systems Appointment/recruitment of four environmental specialists (2) and social specialists (2), for the PCU and within MOH Completion Measurement (CEGCC) and within the MOH (Gender Environment Unit (1) and Climate Change (1) (CEGCC) at the start of implementation. This is partially completed as only two environmental specialists and one social specialist from the Gender and Environment Unit of the Ministry of Health have been appointed to support the ANSSP. Comments Action Description Capacity building (technical and institutional) of actors and stakeholders Source DLI# Responsibility Timing Timing Value Status Environmental and Social UCP, MC (CEGCC), Recurrent Continuous In Progress Systems ABE Information/Awareness-raising actions on the environmental and social management of the Program. The Initiatives Completion Measurement should take place during the first year of the Program and to be maintained throughout the life cycle of the program. Awaiting finalization of various documents including the citizen engagement plan and the technical manual for the Comments Environmental and Social management to start training sessions Action Description Strengthening the Program Environmental and Social Management System. Source DLI# Responsibility Timing Timing Value Status Environmental and Social UCP, MS (CEGCC), Due Date 30-Nov-2023 In Progress Systems DPHAB Development and implementation of a guide for the development of waste management plans (biomedical waste). No Completion Measurement later than 90 days after the date of entry into force of the program. (Biomedical and other waste). NB: waste produced in health facilities The consultant has been recruited. The plan will be validated by early February 2024. There has been an exchange Comments and document sharing with REDISSE. 2/14/2024 Page 4 of 15 The World Bank Implementation Status & Results Report Benin Health System Enhancement Program (P172940) (P172940) Action Description Strengthening the Program's Environmental and Social Management system. Source DLI# Responsibility Timing Timing Value Status Environmental and Social PCU, MOH Due Date 31-Mar-2024 In Progress Systems (CEGCC), DPHAB Development and implementation of the grievance mechanism (GRM). No later than six (6 months) after the date of Completion Measurement entry into force of the program and its implementation throughout the life cycle of the program. The draft of the grievance mechanism plan is underway. The adoption of the plan is scheduled for January 31, 2024. Comments Meanwhile, the Ministry of Health has implemented an online grievance mechanism through the setting up of a toll- free number. Action Description Report on and investigate fraud and corruption Source DLI# Responsibility Timing Timing Value Status Fiduciary Systems MOH Recurrent Semi-Annually Completed Report on suspected cases of corruption and fraud, and on the status of investigations. Based on the allegations, the Completion Measurement IGM/IGF will conduct investigations and follow up actions. Report to be produced per semester to be shared with the Bank and the MS/ Comments There is no suspected cases of corruption and fraud since the start of the Program. Action Description Implement the 2020 Public Procurement Code so SOBAPS operates with appropriate procurement regulations. Source DLI# Responsibility Timing Timing Value Status Fiduciary Systems MS/SOBAPS Due Date 30-Sep-2022 Completed - SOBAPS procurement regulations are enacted by decree (see CCJ) Completion Measurement Comments Action Description Procurement of works Source DLI# Responsibility Timing Timing Value Status Fiduciary Systems Ministry of Health Recurrent Continuous Completed Completion Measurement Update the standard plans for the construction of health infrastructure (see DG AISEM) Comments Action Description Management of works contracts 2/14/2024 Page 5 of 15 The World Bank Implementation Status & Results Report Benin Health System Enhancement Program (P172940) (P172940) Source DLI# Responsibility Timing Timing Value Status Fiduciary Systems Ministry of Health Due Date 30-Nov-2022 Completed Works contract management manual. Establishment of a contract performance management plan, definition of roles Completion Measurement and responsibilities of stakeholders. A first manual is needed and thereafter it must be continuously updated. Comments Action Description Budget planning Source DLI# Responsibility Timing Timing Value Status Fiduciary Systems Ministry of Health Recurrent Yearly Completed Transmission of the draft budget N + 1 budget and the DPPD N + 1 DPPD (Multi Annual expenditure Programming Completion Measurement Document) to IDA for technical opinion before 30/09/N (share with the Bank the draft budget each year, at the latest on 30 September. This action has not been implemented during this budget cycle. The Bank staff will continue to monitor this point for Comments the budget cycle. The Bank team noted that the govt forecasted a sufficient budget related to the PforR program expenditures. Action Description Cash Management Source DLI# Responsibility Timing Timing Value Status Fiduciary Systems MOH/MEF Recurrent Quarterly In Progress Transmission of the quarterly statement of payment arrears on the 60 days program at the end of each quarter. Completion Measurement (DPAF/DAF will have to issue the instances of payment of benefits. Clarify the situation with the Treasury. The project has just started the activities. No invoices have been received yet. The Bank will continue to track this Comments information with the DAF of ANSSP Action Description Conduct Internal Audits Source DLI# Responsibility Timing Timing Value Status Fiduciary Systems MoH/ MEF Recurrent Semi-Annually In Progress Conduct two internal audit missions of the Program per year by the IGF and the IGM with transmission of reports to Completion Measurement IDA 60 days after the end of the semester. Compilation of the reports of the different missions in one semester: IGM/IGF. The team noted that ANSSP has its own internal audit unit consisting of two auditors. The internal audit of the Comments Program should be conducted by this unit under the supervision of the IGF/IGM which has been demonstrating human resource constraints. Action Description Transmission of external audit reports 2/14/2024 Page 6 of 15 The World Bank Implementation Status & Results Report Benin Health System Enhancement Program (P172940) (P172940) Source DLI# Responsibility Timing Timing Value Status Fiduciary Systems MOH Recurrent Yearly In Progress Completion Measurement Transmission of the external audit report nine (9) months after the end of each budgetary year (i.e. 30 September). Comments No audit reports are due right now. The next audit report is expecting 30 September 2024 Action Description Recruitment of independent external auditor Source DLI# Responsibility Timing Timing Value Status Fiduciary Systems MOH/SAI Due Date 28-Jan-2022 Completed Recruitment of an independent external auditor within six (6) months of entry into force to conduct an annual audit of Completion Measurement the Program. (Legal Commitment) We agreed with the governement to use the current external auditor of the ANSSP as the auditor for the PforR Comments Program audit Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance Moderate -- Moderate Macroeconomic Moderate -- Moderate Sector Strategies and Policies Substantial -- Moderate Technical Design of Project or Program Substantial -- Moderate Institutional Capacity for Implementation and Substantial -- Moderate Sustainability Fiduciary Substantial -- Moderate Environment and Social Substantial -- Moderate Stakeholders Moderate -- Moderate Other -- -- -- Overall Substantial -- Moderate Results PDO Indicators by Objectives / Outcomes Quality IN01362176 2/14/2024 Page 7 of 15 The World Bank Implementation Status & Results Report Benin Health System Enhancement Program (P172940) (P172940) ►Pregnant women who receive four ante-natal care (ANC) consultations (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 70.00 0.00 0.00 80.00 Date 30-Jun-2022 24-Jul-2023 05-Feb-2024 30-Jun-2026 The percentage of women aged 15-49 with a live birth in a given time period that received antenatal care four or more times. Due to data limitations, it is not possible to determine the type of provider for each visit. Comments Numerator: The number of women aged 15-49 with a live birth in a given time period that received antenatal care four or more times. Denominator: Total number of women aged 15-49 with a live birth in the same period. IN01362178 ►Long-Acting Contraceptive users (DLI 2) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 6.20 0.00 0.00 9.70 Date 30-Jun-2020 24-Jul-2023 05-Feb-2024 30-Jun-2025 The indicator is defined as the number of women who are currently using, at least one modern Comments contraceptive method as a proportion of the number of women of reproductive age who are either using any. method of contraception or having an unmet need for family planning. IN01362180 ►Full immunization coverage for children between the ages of 12 to 23 months (DLI 3) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 57.00 0.00 0.00 65.00 Date 30-Jun-2019 24-Jul-2023 05-Feb-2024 30-Jun-2024 This indicator measures the percentage of one-year-olds who have received one dose of Bacille Calmette- Guérin (BCG) vaccine, three doses of polio vaccine, three doses of the combined diphtheria, tetanus toxoid and pertussis (DTP3) vaccine, and one dose of measles vaccine. The indicator is calculated as follows: Comments Numerator: Number of children aged 12–23 months receiving one dose of BCG vaccine, three doses of polio vaccine, three doses of DTP3 vaccine, and one dose of measles vaccine; Denominator: Total number of children aged 12–23 months surveyed. In certain countries, the time period of 12–23 months was adjusted to align with alternative national immunization periods (18–29 months or 15–26 months). IN01362182 ►Health Facilities with no stock-out of Maternal and Child Health Tracer Drugs in the past three (3) months (DLI 4) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 70.00 0.00 0.00 80.00 Date 30-Jun-2021 24-Jul-2023 05-Feb-2024 30-Jun-2025 DLI 4 will determine the proportion of health facilities that are adequately equipped to provide maternal and child health services according to national protocol. Currently, 70 percent of health facilities do not experience stock-outs of selected tracer medicines for maternal and child health care services, and the Comments PforR will support the government in achieving a proportion of 80 percent by the end of the implementation period DLI 6 will help measurethe proportion women of reproductive age who will be attended by skilled health personnel (doctor, midwife or nurse). Delivery with a skilled attendant reduces the risk of a woman or her child dying during delivery. Therefore, it assesses both the quality and coverage of delivery. Access IN01362177 ►Pregnant women of reproductive age accessing health facilities for reproductive health consultation (Percentage, Custom) 2/14/2024 Page 8 of 15 The World Bank Implementation Status & Results Report Benin Health System Enhancement Program (P172940) (P172940) Baseline Actual (Previous) Actual (Current) End Target Value 50.00 0.00 0.00 70.00 Date 30-Jun-2021 24-Jul-2023 05-Feb-2024 30-Jun-2026 Comments IN01362179 ►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 0.00 8,700,000.00 Date 30-Jun-2022 24-Jul-2023 05-Feb-2024 30-Jun-2025 Comments IN01362181 Children immunized (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 2,800,000.00 Date 30-Jun-2021 24-Jul-2023 05-Feb-2024 30-Jun-2025 IN01362184 Women and children who have received basic nutrition services (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 4,000,000.00 Date 30-Jun-2021 24-Jul-2023 05-Feb-2024 30-Jun-2025 IN01362185 Deliveries attended by skilled health personnel (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 90.50 0.00 0.00 1,900,000.00 Date 30-Jun-2021 24-Jul-2023 05-Feb-2024 30-Jun-2025 Emergency Preparedness and Response IN01362183 ►Operationalization of the health sector quality assurance system (DLI 8) (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No No No Yes Date 30-Jun-2022 24-Jul-2023 05-Feb-2024 30-Jun-2025 DLI 8 will allow that Z (number) health zones adopt and use the quality-of-care (QoC) score card to supervise primary health care within their jurisdiction. In the meantime, the ARS would be established and Comments would adopt a QoC policy to guide the accreditation of health agents and to measure quality of services provided at the primary level of care. 2/14/2024 Page 9 of 15 The World Bank Implementation Status & Results Report Benin Health System Enhancement Program (P172940) (P172940) Intermediate Results Indicators by Results Areas Access and Quality IN01362186 ►Proportion of Births attended by Skilled Health Professional (DLI 6) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 90.50 0.00 0.00 95.00 Date 30-Jun-2021 24-Jul-2023 05-Feb-2024 30-Jun-2026 Disbursement Linked Result: 4.5% increase in births attended by a Skilled Health Professional DLI 6 will help measure the proportion women of reproductive age who will be attended by skilled health personnel Comments (doctor, midwife or nurse). Delivery with a skilled attendant reduces the risk of a woman or her child dying during delivery. Therefore, it assesses both the quality and coverage of delivery IN01362188 ►Percentage of newborns attended by skilled provider within 48 hours of birth (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 41.00 0.00 0.00 60.00 Date 30-Jun-2021 24-Jul-2023 05-Feb-2024 30-Jun-2026 Comments The percentage of newborns attended by a healthcare provider during the first 48 hours following birth IN01362190 ►Number of children under 5 treated for moderate (MAM) or severe acute malnutrition (SAM) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 51.00 0.00 0.00 65.00 Date 30-Jun-2021 24-Jul-2023 05-Feb-2024 30-Jun-2026 Comments Number of children under age five treated for moderate or severe acute malnutrition IN01362192 ►Number of Adolescent and Youth Friendly Centers (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 50.00 Date 30-Jun-2021 24-Jul-2023 05-Feb-2024 30-Jun-2026 Comments IN01362194 ►Children less than 6 months exclusively breastfed (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 42.00 0.00 0.00 55.00 Date 30-Jun-2021 24-Jul-2023 05-Feb-2024 30-Jun-2026 2/14/2024 Page 10 of 15 The World Bank Implementation Status & Results Report Benin Health System Enhancement Program (P172940) (P172940) Numerator: Number of children under six months of age who are exclusively breastfed * 100 Denominator: Comments Number of children under six months of age in the same area and period IN01362195 ►Percentage of beneficiaries satisfied with access, quality of services, quality of facilities, responsiveness to needs (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 80.00 Date 30-Jun-2021 24-Jul-2023 05-Feb-2024 30-Jun-2026 Comments Collecting, recording, and reporting on inputs received from beneficiaries IN01362196 ►Grievances responded and/or resolved within the stipulated service standards for response times (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 80.00 Date 30-Jun-2021 24-Jul-2023 05-Feb-2024 30-Jun-2026 This is an indicator on beneficiary feedback. The indicator captures feedback from citizens and will monitor Comments the number of grievances responded to and/or resolved within the stipulated service standards for response times IN01362197 ►Proportion of Targeted Basic Emergency Obstetric and Newborn Care (BEmONC) health facilities offering BEmONC (DLI1) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 35.00 0.00 0.00 60.00 Date 30-Jun-2021 24-Jul-2023 05-Feb-2024 30-Jun-2026 Disbursement Linked Result: 25% increase in targeted Health Facilities offering BEmONC services. DLI 1 reflects improvements in maternal and neonatal care, particularly Basic Emergency Obstetric Care (BEMonC). This is necessary to achieve further reductions in maternal mortality, which is still high. Comments Currently, 35 percent of relevant health facilities have the capacity to manage obstetric emergencies, and the PforR will support the government in achieving a target of 60 percent by the end of the implementation period. This DLI will evaluate both service delivery capacity and elements of quality of care Health System Capacity and Emergency Preparedness and Response IN01362187 ►Proportion of Health Facilities with the minimum standard of skilled health workers as per the national guidelines (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 75.00 Date 30-Jun-2021 24-Jul-2023 05-Feb-2024 30-Jun-2026 Comments IN01362189 ►Proportion of private health facilities whose data are fully integrated into the HMIS (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 75.00 2/14/2024 Page 11 of 15 The World Bank Implementation Status & Results Report Benin Health System Enhancement Program (P172940) (P172940) Date 30-Jun-2021 24-Jul-2023 05-Feb-2024 30-Jun-2026 Comments IN01362191 ►Number of Health Professionals who have completed an epidemiology or laboratory training on surveillance, preparedness, and response to public health emergencies (DLI 5) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 119.00 0.00 0.00 371.00 Date 30-Jun-2021 24-Jul-2023 05-Feb-2024 30-Jun-2026 Disbursement Linked Result: 252 Health Professionals have completed an epidemiology or laboratory training on surveillance, preparedness, and response to public health emergencies DLI 5 will measure the number of health professionals who will completed an epidemiology or laboratory training on surveillance, Comments preparedness, and response to public health emergencies. Hence, the DLI5 will enhance the epidemiologic and laboratory capacity of the public health workforce by providing training that will enable the countryrespond effectively to a wide range of disease outbreaks and other public health priorities by the end of implementation period IN01362193 ►Number of Health Facilities with new health care buildings constructed and equipped as further detailed in the POM (DLI 7) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 25.00 Date 30-Jun-2021 24-Jul-2023 05-Feb-2024 30-Jun-2026 Disbursement Linked Result: New health care buildings constructed and equipped in 25 selected Health Comments Facilities DLI 7 will measure the number of Health Facilities with new health care buildings constructed and equipped to focus on the functionality of health establishments. Disbursement Linked Indicators DLI_IND_TABLE ►DLI 1 Proportion of Targeted Health Facilities Offering Basic Emergency Obstetric and Newborn Care (BEmONC) Services (Outcome, 19,800,000.00, 0%) Baseline Actual (Previous) Actual (Current) CY2026 Value 35.00 0.00 0.00 60.00 Date -- 24-Jul-2023 01-Nov-2023 -- Comments ►DLI 2 Proportion of Long-Acting Contraceptive Users (Outcome, 19,600,000.00, 0%) Baseline Actual (Previous) Actual (Current) CY2026 Value 6.20 0.00 0.00 9.70 Date -- 24-Jul-2023 01-Nov-2023 -- Comments 2/14/2024 Page 12 of 15 The World Bank Implementation Status & Results Report Benin Health System Enhancement Program (P172940) (P172940) ►DLI 3 Proportion of full immunization coverage for children between the ages of 12 to 23 months (Outcome, 22,000,000.00, 0%) Baseline Actual (Previous) Actual (Current) CY2026 Value 57.00 0.00 0.00 65.00 Date -- 24-Jul-2023 01-Nov-2023 -- Comments ►DLI 4 Proportion of Health Facilities with no stock-out of Maternal and Child Health Tracer Drugs in the past three (3) months (Outcome, 20,000,000.00, 0%) Baseline Actual (Previous) Actual (Current) CY2026 Value 70.00 0.00 0.00 80.00 Date -- 24-Jul-2023 01-Nov-2023 -- Comments ►DLI 5 Number of Health Professionals who have completed an epidemiology or laboratory training on surveillance, preparedness, and response to public health emergencies (Outcome, 30,240,000.00, 0%) Baseline Actual (Previous) Actual (Current) CY2026 Value 119.00 0.00 0.00 371.00 Date -- 24-Jul-2023 01-Nov-2023 -- Comments ►DLI 6 Proportion of births attended by a Skilled Health Professional (Outcome, 18,000,000.00, 0%) Baseline Actual (Previous) Actual (Current) CY2026 Value 90.50 0.00 0.00 95.00 Date -- 24-Jul-2023 01-Nov-2023 -- Comments ►DLI 7 Number of Health Facilities with new health care buildings constructed and equipped as further detailed in the POM (Outcome, 37,500,000.00, 0%) Baseline Actual (Previous) Actual (Current) CY2026 Value 0.00 0.00 0.00 25.00 Date -- 24-Jul-2023 01-Nov-2023 -- 2/14/2024 Page 13 of 15 The World Bank Implementation Status & Results Report Benin Health System Enhancement Program (P172940) (P172940) Comments ►DLI 8 Operationalization of the Health Sector Quality Assurance System (Outcome, 20,000,000.00, 0%) Baseline Actual (Previous) Actual (Current) CY2026 Value No No No Yes Date -- 24-Jul-2023 01-Nov-2023 -- Comments IN01362206 DLI 8.1 DLR 8.1: A Regulatory Health Sector Authority is established and operational as evidenced by the achievement of specific milestones detailed in the POM on or before December 31, 2022 (Outcome, 4,000,000.00, 0%) Unit of Measure: Yes/No Indicator Type: Baseline Actual (Previous) Actual (Current) CY2026 Value No No No Yes Date -- 24-Jul-2023 01-Nov-2023 -- Comments IN01362207 DLI 8.2 DLR 8.2: The Health Sector Quality Assurance Policy has been adopted by the Regulatory Health Sector Authority on or before December 31, 2024 (Outcome, 4,000,000.00, 0%) Unit of Measure: Yes/No Indicator Type: Baseline Actual (Previous) Actual (Current) CY2026 Value No No No Yes Date -- 24-Jul-2023 01-Nov-2023 -- Comments IN01362208 DLI 8.3 DLR 8.3: 70% of Health Districts that have began implementing the Health Sector Quality Assurance Policy as evidenced by the achievement of key milestones further detailed in the POM (Outcome, 8,000,000.00, 0%) Unit of Measure: Percentage Indicator Type: Baseline Actual (Previous) Actual (Current) CY2026 Value 0.00 0.00 0.00 70.00 Date -- 24-Jul-2023 01-Nov-2023 -- Comments 2/14/2024 Page 14 of 15 The World Bank Implementation Status & Results Report Benin Health System Enhancement Program (P172940) (P172940) IN01362209 DLI 8.4 DLR 8.4: The Ministry of Health has approved an accreditation process for health personnel and certification process for Health Facilities on or before December 31, 2026 (Outcome, 4,000,000.00, 0%) Unit of Measure: Yes/No Indicator Type: Baseline Actual (Previous) Actual (Current) CY2026 Value No No No Yes Date -- 24-Jul-2023 01-Nov-2023 -- Comments 2/14/2024 Page 15 of 15