The World Bank Implementation Status & Results Report Transforming Health Systems for Universal Care (P152394) Transforming Health Systems for Universal Care (P152394) EASTERN AND SOUTHERN AFRICA | Kenya | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2016 | Seq No: 15 | ARCHIVED on 14-Apr-2023 | ISR54937 | Implementing Agencies: Ministry of Health, Republic of Kenya Key Dates Key Project Dates Bank Approval Date: 15-Jun-2016 Effectiveness Date: 04-Jul-2016 Planned Mid Term Review Date: 11-Mar-2019 Actual Mid-Term Review Date: 25-Mar-2019 Original Closing Date: 30-Sep-2021 Revised Closing Date: 30-Sep-2023 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The project development objective is to improve utilization and quality of primary health care services with a focus on reproductive, maternal, newborn, child, and adolescent health services. Has the Project Development Objective been changed since Board Approval of the Project Objective? Yes Board Approved Revised Project Development Objective (If project is formally restructured) The project development objective is to improve utilization and quality of primary health care services with a focus on reproductive, maternal, newborn, child and adolescent health services and to provide immediate and effective response to an eligible crisis or emergency . Components Table Name Improving Primary Health Care Results:(Cost $141.00 M) Strengthening Institutional Capacity:(Cost $28.70 M) Contingency Emergency Response:(Cost $10.00 M) Cross-county and Intergovernmental Collaboration, and Project Management:(Cost $11.40 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Moderately Satisfactory Moderately Satisfactory Overall Implementation Progress (IP) Moderately Satisfactory Moderately Satisfactory Overall Risk Rating Substantial Substantial Implementation Status and Key Decisions The Transforming Health Systems for Universal Care Project (THS-UCP) aims to improve utilization and quality of primary healthcare services with a focus on reproductive, maternal, newborn, child, and adolescent health (RMNCAH) services. An implementation support mission conducted in February 2023 showed that overall implementation is progressing well and on track to complete activities by the project closing date of September 30, 2023. County governments are implementing activities prioritized in their annual work 4/14/2023 Page 1 of 8 The World Bank Implementation Status & Results Report Transforming Health Systems for Universal Care (P152394) plans. In response to the Government of Kenya's request to trigger the Contingency Emergency Response Component (CERC) to respond to the COVID-19 pandemic, the Bank allocated US$ 10M to support the Kenya COVID-19 Contingency Plan. The CERC has been fully implemented. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance High Substantial Substantial Macroeconomic Moderate Moderate Moderate Sector Strategies and Policies Moderate Moderate Moderate Technical Design of Project or Program Substantial Substantial Substantial Institutional Capacity for Implementation and High High High Sustainability Fiduciary Substantial Substantial Substantial Environment and Social Low Moderate Moderate Stakeholders Substantial Substantial Substantial Other -- -- -- Overall Substantial Substantial Substantial Results PDO Indicators by Objectives / Outcomes Improved utilization and quality of primary health care services IN01249063 ►Children immunized with the third dose of Pentavalent (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 79.50 87.50 82.50 84.00 Date 31-Dec-2015 24-Jun-2022 21-Feb-2023 30-Sep-2023 IN01249065 ►Pregnant women attending at least four ANC visits (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 39.70 51.80 50.50 52.00 4/14/2023 Page 2 of 8 The World Bank Implementation Status & Results Report Transforming Health Systems for Universal Care (P152394) Date 31-Dec-2015 24-Jun-2022 21-Feb-2023 30-Sep-2023 IN01249091 ►Births attended by skilled health personnel (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 57.00 79.10 75.80 67.00 Date 31-Dec-2015 24-Jun-2022 21-Feb-2023 30-Sep-2023 IN01249092 ►Women between the ages of 15-49 years currently using a modern FP method (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 47.80 37.50 37.00 52.00 Date 31-Dec-2015 24-Jun-2022 21-Feb-2023 30-Sep-2023 The definition of the indicator remains under review by the MoH and family planning technical working Comments: group as it inadequately measures utilization of long-acting family planning methods. IN01249093 ►Inspected facilities meeting safety standards (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 30.00 30.00 50.00 Date 31-Dec-2015 24-Jun-2022 21-Feb-2023 30-Sep-2023 This activity had a slow start. It was implemented in year 2 of the no cost extension. This indicator's value Comments: will be updated after additional analysis of the inspections data. IN01249094 ►Pregnant women attending ANC supplemented with IFA (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 31.00 77.40 75.30 73.00 Date 31-Dec-2015 24-Jun-2022 21-Feb-2023 30-Sep-2023 Provision of immediate and effective response to an eligible crisis or emergency IN01249064 ►Reported suspected cases of COVID-19 cases investigated based on national guidelines (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 100.00 80.00 Date 18-Mar-2020 24-Jun-2022 21-Feb-2023 31-Dec-2021 4/14/2023 Page 3 of 8 The World Bank Implementation Status & Results Report Transforming Health Systems for Universal Care (P152394) Intermediate Results Indicators by Components Component 1: Improved primary health care results IN01249106 ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 12,781,741.00 14,740,155.00 10,060,000.00 Date 29-Sep-2016 24-Jun-2022 21-Feb-2023 30-Sep-2023 The baseline date corresponds the date at which the Project became effective. This is a corporate indicator capturing the cumulative number of people receiving essential health services over the Project Comments: lifecycle (# deliveries attended by skilled personnel and # children aged 0 to 5 who were immunized). No Nutrition services are supported by the Project. IN01249107 Number of children immunized (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 6,273,307.00 7,298,785.00 5,400,000.00 Date 29-Sep-2016 24-Jun-2022 21-Feb-2023 30-Sep-2023 IN01249108 Number of deliveries attended by skilled health personnel (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 6,508,434.00 7,441,370.00 4,660,000.00 Date 29-Sep-2016 24-Jun-2022 21-Feb-2023 30-Sep-2023 Component 2: Strengthened institutional capacity IN01249095 ►Facilities inspected for safety standards (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1,499.00 2,446.00 1,635.00 Date 11-Mar-2016 24-Jun-2022 21-Feb-2023 30-Sep-2023 This indicator's value will be updated after additional analysis of the inspections data. Comments: IN01249098 ►Reports submitted to DHIS in a timely manner. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 88.80 97.70 98.00 98.00 4/14/2023 Page 4 of 8 The World Bank Implementation Status & Results Report Transforming Health Systems for Universal Care (P152394) Date 31-Dec-2015 24-Jun-2022 21-Feb-2023 30-Sep-2023 IN01249100 ►Births registered within 6 months of occurrence (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 65.90 86.20 86.20 80.00 Date 31-Dec-2015 24-Jun-2022 21-Feb-2023 30-Sep-2023 Data is as of December 2021. Comments: IN01249103 ►RMNCAH related operations research completed to inform policy/strategy (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1.00 2.00 2.00 Date 11-Mar-2016 24-Jun-2022 21-Feb-2023 30-Sep-2023 IN01249104 ►A benefit package developed, costed, and disseminated (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1.00 1.00 1.00 Date 11-Mar-2016 24-Jun-2022 21-Feb-2023 30-Sep-2023 The benefit package has been developed and costed. Comments: IN01249105 ►Lessons learned from UHC Phase I documented and disseminated (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No Yes Yes Yes Date 20-Jun-2019 24-Jun-2022 21-Feb-2023 31-Dec-2019 This indicator was introduced after the mid term review of the project. The lessons learned from UHC Phase I were documented in a report and disseminated to key Comments: stakeholders. Component 3: Cross-county/intergovernmental collaboration and project management IN01249096 ►Functional community units (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 302.00 8,778.00 7,794.00 5,331.00 4/14/2023 Page 5 of 8 The World Bank Implementation Status & Results Report Transforming Health Systems for Universal Care (P152394) Date 31-Dec-2015 24-Jun-2022 21-Feb-2023 30-Sep-2023 IN01249099 ►Grievances registered related to delivery of project benefits that are addressed (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 100.00 80.00 Date 31-Dec-2015 24-Jun-2022 21-Feb-2023 30-Sep-2023 IN01249101 ►Implementing entities submitting the annual FM and technical report on time (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 98.00 100.00 95.00 Date 11-Mar-2016 24-Jun-2022 21-Feb-2023 30-Sep-2023 Component 4: Contingency Emergency Response IN01249097 ►Designated laboratories with COVID diagnostic equipment (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 2.00 41.00 41.00 8.00 Date 18-Mar-2020 24-Jun-2022 21-Feb-2023 31-Dec-2021 When the COVID-19 Health Emergency Response Project (CHERP, P173820) and CERC were designed, there were only 8 designated laboratories for COVID-19 testing. The number of laboratories equipped with Comments: diagnostic equipment has since increased to 41 laboratories. IN01249102 ►Vulnerable and marginalized communities reached in their indigenous language (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 100.00 80.00 Date 18-Mar-2020 24-Jun-2022 21-Feb-2023 31-Dec-2021 Performance-Based Conditions Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed 4/14/2023 Page 6 of 8 The World Bank Implementation Status & Results Report Transforming Health Systems for Universal Care (P152394) P152394 IDA-58360 Effective USD 150.00 150.00 0.00 140.91 6.94 95% P152394 TF-A2561 Effective USD 40.00 40.00 0.00 31.88 8.12 80% P152394 TF-A2792 Closed USD 1.10 0.95 0.15 0.95 0.00 100% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P152394 IDA-58360 Effective 15-Jun-2016 04-Jul-2016 29-Sep-2016 30-Sep-2021 30-Sep-2023 P152394 TF-A2561 Effective 15-Jun-2016 04-Jul-2016 29-Sep-2016 30-Sep-2021 30-Jun-2023 P152394 TF-A2792 Closed 15-Jun-2016 04-Jul-2016 04-Jul-2016 30-Jun-2020 31-May-2022 Cumulative Disbursements Restructuring History Level 2 Approved on 24-Jun-2019 ,Level 2 Approved on 31-Jan-2020 ,Level 2 Approved on 20-Oct-2020 ,Level 2 Approved on 26-Mar-2021 ,Level 2 Approved on 15-Sep-2021 Related Project(s) P174772-Additional Financing for THS-UCP 4/14/2023 Page 7 of 8 The World Bank Implementation Status & Results Report Transforming Health Systems for Universal Care (P152394) 4/14/2023 Page 8 of 8