The World Bank Implementation Status & Results Report Meghalaya Health Systems Strengthening Project (P173589) Meghalaya Health Systems Strengthening Project (P173589) SOUTH ASIA | India | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2022 | Seq No: 6 | ARCHIVED on 09-May-2024 | ISR60000 | Implementing Agencies: Department of Health and Family Welfare, Government of Meghalaya, India Key Dates Key Project Dates Bank Approval Date: 30-Sep-2021 Effectiveness Date: 26-Nov-2021 Planned Mid Term Review Date: 23-Oct-2024 Actual Mid-Term Review Date: Original Closing Date: 31-Mar-2027 Revised Closing Date: 31-Mar-2027 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The project development objective (PDO) is to improve management capacity, quality and utilization of health services in Meghalaya. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Improving accountability, management and strengthening governance:(Cost $18.00 M) Strengthening systems to improve the quality of health services:(Cost $16.90 M) Increasing coverage and utilization of health services:(Cost $5.00 M) Contingent Emergency Response Component 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 project has met year two targets for four out of the five PDO indicators. However, the target for the PDO indicator concerning District Hospital National Quality Assurance Standards (NQAS) certification remains unmet. The progress across the 12 intermediate indicators has been varied, with seven indicators met year two targets, one indicator (timely payment of incentives) has not been achieved. Additionally, the four remaining indicators related to the stock-out of drugs, clinical vignette, and biomedical waste management score are yet to begin reporting. The Meghalaya Health Systems Strengthening Project (MHSSP) is making progress in implementing its activities across its different components and the overall progress is on track. 5/9/2024 Page 1 of 7 The World Bank Implementation Status & Results Report Meghalaya Health Systems Strengthening Project (P173589) Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance Moderate Moderate Moderate Macroeconomic Substantial Substantial Moderate Sector Strategies and Policies Moderate Moderate Moderate Technical Design of Project or Program Substantial Substantial Moderate Institutional Capacity for Implementation and Substantial Substantial Substantial Sustainability Fiduciary Substantial Substantial Substantial Environment and Social Moderate Moderate Moderate Stakeholders Moderate Moderate Moderate Other -- -- -- Overall Substantial Substantial Substantial Results PDO Indicators by Objectives / Outcomes To improve Management capacity, quality, and utilization of health services in Meghalaya. IN01404218 ►The percentage point increase in average performance score in targeted administrative units as per internal performance agreement from baseline. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 88.58 28.47 20.00 Date 01-Apr-2021 16-Oct-2023 31-Mar-2024 31-Mar-2026 Comments: IN01404219 ►Cumulative number of districts hospitals which are NQAS certified. (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 1.00 0.00 0.00 9.00 Date 01-Apr-2021 16-Oct-2023 31-Mar-2024 31-Mar-2026 IN01404220 5/9/2024 Page 2 of 7 The World Bank Implementation Status & Results Report Meghalaya Health Systems Strengthening Project (P173589) ►The percentage point increase in average quality index score for CHCs and PHC from baseline. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 85.66 27.25 20.00 Date 01-Apr-2021 16-Oct-2023 31-Mar-2024 31-Mar-2026 Comments: IN01404286 ►Increase in number of patients utilizing government health services OPD in targeted facilities. (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 1,650,932.00 1,937,314.00 1,817,210.00 1,800,000.00 Date 01-Apr-2021 17-Oct-2023 31-Mar-2024 31-Mar-2026 IN01404287 ►Percentage of claims settled within agreed turnaround time. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 50.00 57.00 64.60 90.00 Date 01-Apr-2021 16-Oct-2023 31-Mar-2024 31-Mar-2026 Intermediate Results Indicators by Components Improving accountability, management and strengthening governance. IN01404288 ►Percentage of internal performance agreements reviewed as per the operational manual. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 99.19 100.00 Date 01-Apr-2021 16-Oct-2023 31-Mar-2024 31-Mar-2026 IN01404291 ►Percentage of targeted facilities and administrative units that receive performance payment, as per operations manual . (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 0.00 100.00 Date 01-Apr-2021 16-Oct-2023 31-Mar-2024 31-Mar-2026 Comments: IN01404294 5/9/2024 Page 3 of 7 The World Bank Implementation Status & Results Report Meghalaya Health Systems Strengthening Project (P173589) ►Percentage point increase in average patient satisfaction score in targeted health facilities. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 77.90 40.70 25.00 Date 05-Apr-2021 16-Oct-2023 31-Mar-2024 31-Mar-2026 Comments: IN01404297 ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target Value 26,040.00 0.00 57,296.00 137,500.00 Date 05-Apr-2021 16-Oct-2023 31-Mar-2024 31-Mar-2026 IN01404299 Number of deliveries attended by skilled health personnel (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 26,040.00 0.00 57,296.00 137,500.00 Date 05-Apr-2021 16-Oct-2023 31-Mar-2024 31-Mar-2026 IN01404300 ►Percentage point decrease of targeted health facilities reported stock-out of essential drugs. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 10.00 Date 01-Apr-2021 16-Oct-2023 31-Mar-2024 31-Mar-2026 Data not available Comments: Strengthening systems to improve the quality of health services. IN01404289 ►The percentage point increase in score among those who participated in clinical vignettes. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 88.55 0.00 25.00 Date 01-Apr-2021 16-Oct-2023 31-Mar-2024 31-Mar-2026 Numerator: average clinical vignette score core in targeted health units – baseline average clinical vignette score *100 Target= Doctors and Nurses in Target Health facilities Target= 11DH+18CHC+66 Comments: PHC IN01404292 5/9/2024 Page 4 of 7 The World Bank Implementation Status & Results Report Meghalaya Health Systems Strengthening Project (P173589) ►Percentage of medical doctors and nurses from targeted facilities participated in clinical vignettes. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 98.37 0.00 90.00 Date 01-Apr-2021 16-Oct-2023 31-Mar-2024 31-Mar-2026 Target= Doctors and Nurses in Target Health facilities Target= 11DH+18CHC+66 PHC Comments: IN01404295 ►Average score for bio medical waste management in targeted health facilities at district, PHC and CHC level. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 2.93 0.00 30.00 Date 01-Apr-2021 16-Oct-2023 31-Mar-2024 31-Mar-2026 Numerator: Biomedical waste score* under Quality Index in targeted health facility Denominator: Number of Targeted Health Facilities; Target= 11DH+18CHC+66 PHC * Bio medical waste management: Color coded bins with cover [one each in OPD, each Ward, OT, Dressing, Injection room, emergency, labor room and lab], Needle cutter, Hypochlorite solution in laboratory. Mops with bucket and disinfectant. Comments: [separate for each OT, labor room] and general patient care including ward. Daily Collection of waste and mopping [schedule]. Treatment of infectious waste: [hypochlorite for sharps], microwave/autoclave. Functional sharps pit and deep burial pit with cover [no spillage outside] (All or None). IN01404298 ►Percentage of targeted facilities where quality scoring was done by higher level in last quarter. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 100.00 95.00 Date 05-Apr-2021 16-Oct-2023 31-Mar-2024 31-Mar-2026 Comments: Increasing coverage and utilization of health services. IN01404290 ►Increase in percentage coverage of households under health insurance scheme. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 56.00 73.00 77.00 80.00 Date 01-Apr-2021 16-Oct-2023 31-Mar-2024 31-Mar-2026 IN01404293 ►Increase in number of women patients utilizing government health services IPD in targeted facilities. (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target 5/9/2024 Page 5 of 7 The World Bank Implementation Status & Results Report Meghalaya Health Systems Strengthening Project (P173589) Value 84,055.00 0.00 100,353.00 123,064.00 Date 01-Apr-2021 16-Oct-2023 31-Mar-2024 31-Mar-2026 IN01404296 ►Percentage of local fund utilization (including performance grants and Insurance reimbursements) in targeted hospitals. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 62.20 30.00 80.00 Date 01-Apr-2021 16-Oct-2023 31-Mar-2024 31-Mar-2026 Performance-Based Conditions Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P173589 IBRD-92910 Effective USD 40.00 40.00 0.00 12.24 27.76 31% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P173589 IBRD-92910 Effective 30-Sep-2021 28-Oct-2021 26-Nov-2021 31-Mar-2027 31-Mar-2027 Cumulative Disbursements 5/9/2024 Page 6 of 7 The World Bank Implementation Status & Results Report Meghalaya Health Systems Strengthening Project (P173589) Restructuring History There has been no restructuring to date. Related Project(s) There are no related projects. 5/9/2024 Page 7 of 7