The World Bank Implementation Status & Results Report Mali - Accelerating Progress Towards Universal Health Coverage (P165534) Mali - Accelerating Progress Towards Universal Health Coverage (P165534) WESTERN AND CENTRAL AFRICA | Mali | IBRD/IDA | Investment Project Financing (IPF) | FY 2019 | Seq No: 12 | Archived on 16-May-2024 | ISR00392 Implementing Agencies: Ministère de la Santé et du Développement Social 1. OBJECTIVE 1.1 Development Objective Original Development Objective (Approved as part of Approval package on 18-Mar-2019) The objective of the project is to improve the utilization and quality of reproductive, maternal, neonatal, child, adolescent health and nutrition services, especially among the poorest households, in targeted areas. Has the Development Objective been changed since Board Approval of the Project Objective? Yes Current Development Objective (Approved as part of Restructuring package Seq. 5 on 21-Feb-2024) The objective of the project is to improve the utilization and quality of reproductive, maternal, neonatal, child, adolescent health and nutrition services, especially among the poorest households, in targeted areas. 2. COMPONENTS Name Strengthening Health Service Delivery through Performance Based Financing:(Cost 67,400,000.00) Strengthening Community Health Activities:(Cost 10,000,000.00) Strengthening Stewardship for Improved Health System Performance:(Cost 12,000,000.00) Contingent Emergency Response (CERC):(Cost 0.00) 3. OVERALL RATINGS Name Previous Current Progress towards achievement of PDO Highly Satisfactory Highly Satisfactory Overall Implementation Progress (IP) Highly Satisfactory Highly Satisfactory Overall Risk Rating --- Moderate May 16, 2024 Page 1 of 9 The World Bank Implementation Status & Results Report Mali - Accelerating Progress Towards Universal Health Coverage (P165534) 4. KEY ISSUES & STATUS 4.1 Implementation Status and Key Decisions Mali Accelerating Progress Towards Universal Health Coverage Project’s (PACSU) implementation is highly satisfactory, and the project has continued to achieve significant progress in all project components. Two months prior to project's closure, it has already surpassed its objectives, with all five PDO indicators exceeding their end-of-project targets. Moreover, nine out of thirteen intermediate indicators have either met or exceeded their goals. 5. SYSTEMATIC OPERATIONS RISK-RATING TOOL Rating at Approval Last Approved Rating Risk Category Approval Package - RP Seq. 05 - 21 Feb Proposed Rating 19 Mar 2019 2024 Political and Governance High  High Macroeconomic Moderate  Moderate Sector Strategies and Policies Moderate  Moderate Technical Design of Project or Program Substantial  Low Institutional Capacity for Implementation and Substantial  Low Sustainability Fiduciary Substantial  Moderate Environment and Social Moderate Moderate Moderate Stakeholders Moderate  Moderate Other High  High Overall Substantial  Moderate May 16, 2024 Page 2 of 9 The World Bank Implementation Status & Results Report Mali - Accelerating Progress Towards Universal Health Coverage (P165534) 6. RESULTS 6.1 PDO Indicators by PDO Outcomes Increased utilization of maternal, child, neonatal, and adolescent services Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year People who have received 0.00 Oct/2018 2698305.00 21-Nov-2023 2500000.00 Jun/2024 essential health, nutrition, Comments on Achieved and population (HNP) achieving targets services (Number) People who have 0.00 1349153.00 1250000.00 received essential Comments on Achieved health, nutrition, and achieving targets population (HNP) services - Female (RMS requirement) (Number) 0.00 Oct/2018 486251 14-Apr-2024 486251 14-Apr-2024 440000.00 Jun/2024 Number of children Comments on Achieved immunized (Number) achieving targets Number of women and 0.00 Dec/2012 1929885.00 21-Nov-2023 1780000.00 Jun/2024 children who have Comments on Achieved received basic nutrition achieving targets services (Number) Number of deliveries 0.00 Oct/2018 508900 14-Apr-2024 508900 14-Apr-2024 392000.00 Jun/2024 attended by skilled Comments on Achieved health personnel achieving targets (Number) May 16, 2024 Page 3 of 9 The World Bank Implementation Status & Results Report Mali - Accelerating Progress Towards Universal Health Coverage (P165534) Percentage of girls, aged 15- 5.80 Oct/2018 13.3 14-Apr-2024 13.3 14-Apr-2024 13.50 Jun/2024 19, who are currently using Comments on Achieved any method of contraception achieving targets (Percentage) Improve the quality of health services in targeted areas. Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Percentage of pregnant 13.30 Oct/2018 36.00 21-Nov-2023 25.00 Jun/2024 women receiving at least 4 Comments on Achieved antenatal care visits from achieving targets health provider (Percentage) Average score of the quality 0.00 Dec/2018 81 14-Apr-2024 81 14-Apr-2024 70.00 Jun/2024 of care checklist Comments on Achieved (Percentage) achieving targets Increased utilization of essential health services among the poorest households. Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year 30,000.00 Oct/2018 221,163.00 21-Nov-2023 106,000.00 Jun/2024 Number of indigents Comments on This indicator was revised during the second restructuring to take into account the number of managed within PBF health achieving targets indigents (RAMED beneficiary) individuals instead of the number of RAMED facilities (Number) beneficiary households. 6.2 Intermediate Results Indicators by Components Strengthening Health Service Delivery through Performance Based Financing May 16, 2024 Page 4 of 9 The World Bank Implementation Status & Results Report Mali - Accelerating Progress Towards Universal Health Coverage (P165534) Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year 0.00 Oct/2018 76.00 21-Nov-2023 76.00 21-Nov-2023 80.00 Jun/2024 Health facilities receiving PBF Comments on The delay is explained by the time need to restructure the project and raise ceiling for the grants on time (Percentage) achieving targets Netherlands trust fund (MDTF). Number of new curative 0.20 Oct/2018 0.29 21-Nov-2023 0.40 Jun/2024 consultations per capita/year Comments on Not achieved yet. Indicator affected by season (frequentation of health facilities) (Number) achieving targets Percentage of facilities with 0.00 Oct/2018 86.00 21-Nov-2023 40.00 Jun/2024 100% tracer drugs available Comments on Achieved in targeted health facilities achieving targets on the day of the visit (Percentage) Percentage of health facilities 50.00 Oct/2018 99.00 21-Nov-2023 80.00 Jun/2024 benefiting from quarterly Comments on Achieved technical supervision visits by achieving targets district health services (ECD) (Percentage) 0.00 Oct/2018 3,123.00 21-Nov-2023 3,000.00 Jun/2024 Number of CHWs benefiting Comments on Note: there was an error in calculation of previous report. Value of the indicator for from a supervision achieving targets November 22 (previous ISR) should read as 647 instead of 5,384 (Number) Percentage of beneficiaries 0.00 Oct/2018 87.00 21-Nov-2023 75.00 Jun/2024 satisfied with quality of Comments on Achieved services provided in health achieving targets facilities (Percentage) Strengthening Community Health Activities Indicator Name Baseline Actual (Previous) Actual (Current) Closing Period May 16, 2024 Page 5 of 9 The World Bank Implementation Status & Results Report Mali - Accelerating Progress Towards Universal Health Coverage (P165534) Value Month/Year Value Date Value Date Value Month/Year Number of households 0.00 Oct/2018 494.43 21-Nov-2023 335.00 Jun/2024 receiving CHW home visits Comments on Achieved (Number (Thousand)) achieving targets Percentage of children under 0.00 Oct/2018 99.80 21-Nov-2023 99.80 21-Nov-2023 70.00 Jun/2024 5 with confirmed malaria Comments on Percentage of children under 5 with confirmed malaria who received antimalarial treatment who received an appropriate achieving targets within 24 hours of symptom onset. antimalarial treatment (Percentage) Number of Couple-Year 0.00 Oct/2018 1388209 14-Apr-2024 1388209 14-Apr-2024 743.00 Jun/2024 Protections (CYP) reached Comments on Achieved through project interventions achieving targets (Number (Thousand)) Percentage of children aged 50.00 Oct/2018 90 14-Apr-2024 90 14-Apr-2024 90.00 Jun/2024 6-59 months screened by Comments on Achieved community health workers achieving targets for acute malnutrition (Percentage) Strengthening Stewardship for Improved Health System Performance Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Timely completion rate of 50.00 Oct/2018 79.00 21-Nov-2023 90.00 Jun/2024 monthly primary care health facilities DHIS2 reports (Percentage) Number of private health 0.00 Oct/2018 167.00 21-Nov-2023 210.00 Jun/2024 facilities assessed for accreditation by MoH (Number) May 16, 2024 Page 6 of 9 The World Bank Implementation Status & Results Report Mali - Accelerating Progress Towards Universal Health Coverage (P165534) Percentage of health facilities 0.00 Oct/2018 97 14-Apr-2024 97 14-Apr-2024 95.00 Jun/2024 producing quarterly action- Comments on The indicator label (and formula) changed from Q3 of 2022. Hence the comparison with plans validated by Contract achieving targets previous values is not possible. Development and Verification Agency (CDVA) (Percentage) May 16, 2024 Page 7 of 9 The World Bank Implementation Status & Results Report Mali - Accelerating Progress Towards Universal Health Coverage (P165534) 7. DATA ON FINANCIAL PERFORMANCE 7.1 Cumulative Disbursements 7.2 Disbursements (by loan) Loan/Credit/TF Status Original Revised Cancelled Disbursed Undisbursed % Disbursed TF-B3548 Effective 30.40 30.40 0.00 29.47 0.93 96.95% TF-A9738 Effective 10.00 10.00 0.00 9.85 0.15 98.52% IDA-V2000 Closed 2.00 0.00 2.00 0.00 0.00 0% IDA-D4420 Effective 50.00 50.00 0.00 48.42 0.00 96.84% 7.3 Key Dates (by loan) May 16, 2024 Page 8 of 9 The World Bank Implementation Status & Results Report Mali - Accelerating Progress Towards Universal Health Coverage (P165534) Loan/Credit/TF Status Approval Signing Effectiveness Orig. Closing Rev. Closing IDA-D4420 Effective 19-Mar-2019 31-May-2019 27-Dec-2019 31-Dec-2023 30-Jun-2024 TF-A9738 Effective 19-Mar-2019 31-May-2019 27-Dec-2019 31-Dec-2021 30-Jun-2024 TF-B3548 Effective 31-May-2019 07-Jan-2021 07-Jan-2021 31-Dec-2023 30-Jun-2024 8. KEY DATES Key Events Planned Actual Approval 19-Mar-2019 19-Mar-2019 Effectiveness 01-Aug-2018 01-Aug-2018 Mid-Term Review No. 01 02-May-2022 03-May-2022 Operation Closing/Cancellation 30-Jun-2024 9. RESTRUCTURING HISTORY Restructuring Level 2 Approved on 27-Apr-2021 Restructuring Level 2 Approved on 03-Aug-2022 Restructuring Level 2 Approved on 31-Jul-2023 Restructuring Level 2 Approved on 02-Jan-2024 Restructuring Level 2 Approved on 08-Jun-2020 10. ASSOCIATED OPERATION(S) There are no associated operations May 16, 2024 Page 9 of 9