The World Bank Implementation Status & Results Report Togo Essential Quality Health Services For Universal Health Coverage Project (P174266) Togo Essential Quality Health Services For Universal Health Coverage Project (P174266) WESTERN AND CENTRAL AFRICA | Togo | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2021 | Seq No: 9 | ARCHIVED on 28-Jun-2024 | ISR60839 | Implementing Agencies: Ministry of Health and Public Hygiene, Ministry of Universal Access to Healthcare, Office of President, Republic of Togo Key Dates Key Project Dates Bank Approval Date: 11-Mar-2021 Effectiveness Date: 05-Aug-2021 Planned Mid Term Review Date: 13-May-2024 Actual Mid-Term Review Date: 13-May-2024 Original Closing Date: 30-Apr-2026 Revised Closing Date: 30-Apr-2026 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) To improve the provision of essential health and nutrition services and quality of care for pregnant women, children and vulnerable populations Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Increasing demand and supply of quality health and nutrition services:(Cost $32600.00 M) Bringing health facilities and services close to households:(Cost $30000.00 M) Strengthening the national social health insurance scheme:(Cost $4300.00 M) Improving stewardship, oversight and management:(Cost $3100.00 M) Contingency Emergency Response Component Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Moderately Satisfactory Overall Implementation Progress (IP) Satisfactory Moderately Satisfactory Overall Risk Rating Substantial Substantial Implementation Status and Key Decisions The Togo Essential Quality Health Services for Universal Health Coverage (SSEQCU) project was approved in March 2021 and became effective in August 2021. At mid-term review, the progress towards the achievement of the Project Development Objective is rated moderately satisfactory with one of the four PDO indicators surpassed, and four out of 14 intermediate results indicators reached/surpassed. Implementation of the activities need to be accelerated in all three major components. 6/28/2024 Page 1 of 12 The World Bank Implementation Status & Results Report Togo Essential Quality Health Services For Universal Health Coverage Project (P174266) Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance Moderate Moderate Moderate Macroeconomic Moderate Moderate Moderate Sector Strategies and Policies Substantial Substantial Substantial Technical Design of Project or Program Substantial Substantial Substantial Institutional Capacity for Implementation and Substantial Substantial Substantial Sustainability Fiduciary Substantial Substantial Substantial Environment and Social Moderate Moderate Moderate Stakeholders Moderate Moderate Moderate Other Moderate Moderate Moderate Overall Substantial Substantial Substantial Results PDO Indicators by Objectives / Outcomes People who have received essential health, nutrition and population services (Number) IN01433561 ►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 2,754,656.00 15,015,200.00 Date 31-Dec-2020 27-Oct-2023 27-Jun-2024 30-Apr-2026 Current value to be validated by the IACV. Updates will be made accordingly once the validated report is Comments: received from the PCU. IN01433565 People who have received essential health, nutrition, and population (HNP) services - Female (RMS requirement) (Number, Corporate Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 405,095.00 7,270,459.00 Persons receiving services from newly established health facilities (Number) IN01433562 6/28/2024 Page 2 of 12 The World Bank Implementation Status & Results Report Togo Essential Quality Health Services For Universal Health Coverage Project (P174266) ►Persons receiving services from newly established health facilities (Number (Thousand), Custom, PBC) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 14,550,000.00 Date 31-Dec-2020 27-Oct-2023 27-Jun-2024 30-Apr-2026 No progress on this indicator as the new construction of health facilities have yet to be completed. Comments: IN01433566 Females receiving services from newly established health facilities (Number (Thousand), Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 7,275,000.00 Date 30-Dec-2020 27-Oct-2023 27-Jun-2024 30-Apr-2026 Health facilities accredited to provide essential health services under insurance IN01433563 ►Health facilities on health insurance contract passing national accreditation standards (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 548.00 548.00 500.00 Date 31-Dec-2020 27-Oct-2023 27-Jun-2024 30-Apr-2026 This indicator has surpassed its final target. Comments: Tracer drug availability in peripheral unit health facilities IN01433564 ►Tracer drug availability in peripheral unit health facilities (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 75.00 Date 31-Dec-2020 27-Oct-2023 27-Jun-2024 30-Apr-2026 An audit by the PCU is ongoing to collect and verify the data before IACV validation. Comments: Overall Comments PDO One of the four PDO indicators have been surpassed. Intermediate Results Indicators by Components 6/28/2024 Page 3 of 12 The World Bank Implementation Status & Results Report Togo Essential Quality Health Services For Universal Health Coverage Project (P174266) Increasing demand and supply of quality health and nutrition services IN01433568 ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate, PBC) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 2,754,656.00 15,015,200.00 Date 31-Dec-2020 27-Oct-2023 27-Jun-2024 30-Apr-2026 Current value to be validated by the IACV. Updates will be made accordingly once the validated report is Comments: received from the PCU. IN01433571 People who have received essential health, nutrition, and population (HNP) services - Female (RMS requirement) (Number, Corporate Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 405,095.00 7,270,459.00 IN01433576 Number of children immunized (Number, Corporate Breakdown, PBC) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 618,151.00 4,726,015.00 Date 31-Dec-2020 27-Oct-2023 27-Jun-2024 30-Apr-2026 IN01433578 Number of women and children who have received basic nutrition services (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 396,264.00 5,151,714.00 Date 31-Dec-2020 27-Oct-2023 27-Jun-2024 30-Apr-2026 IN01433580 Number of deliveries attended by skilled health personnel (Number, Corporate Breakdown, PBC) Baseline Actual (Previous) Actual (Current) End Target Value 57,917.00 0.00 33,049.00 318,634.00 Date 31-Dec-2020 27-Oct-2023 27-Jun-2024 30-Apr-2026 IN01433581 Households visited by health workers, including CHWs (disaggregated by sex) (Number, Custom Supplement, PBC) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 530,168.00 3,336,711.00 IN01433583 ►Persons registered onto the health insurance scheme (Number, Custom, PBC) Baseline Actual (Previous) Actual (Current) End Target 6/28/2024 Page 4 of 12 The World Bank Implementation Status & Results Report Togo Essential Quality Health Services For Universal Health Coverage Project (P174266) Value 0.00 0.00 0.00 4,007,916.00 Date 31-Dec-2020 27-Oct-2023 27-Jun-2024 30-Apr-2026 This indicator and the sub-indicators have delays. The Government plans to enroll the vulnerable groups into the health insurance scheme once the Social register of persons and households and the biometric Comments: enrollment has been finalized (expected by the end of CY2024). This is a critical step due to the need to identify the most vulnerable populations in the country. IN01433584 Pregnant women registered onto the health insurance scheme (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 318,634.00 Date 31-Dec-2020 27-Oct-2023 27-Jun-2024 30-Apr-2026 IN01433585 Children under five years of age registered onto the health insurance scheme (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 1,056,403.00 Date 31-Dec-2020 27-Oct-2023 27-Jun-2024 30-Apr-2026 IN01433586 School-aged children at age of 6-19 registered onto the health insurance scheme (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 932,458.00 Date 31-Dec-2020 27-Oct-2023 27-Jun-2024 30-Apr-2026 IN01433587 Rural populations at the age 20 and above registered onto the health insurance scheme (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 1,700,419.00 Date 31-Dec-2020 27-Oct-2023 27-Jun-2024 30-Apr-2026 IN01433588 ►Newly recruited health professionals deployed to the four most deprived prefectures (Number, Custom, PBC) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 708.00 708.00 4,880.00 Date 31-Dec-2020 27-Oct-2023 27-Jun-2024 30-Apr-2026 There were some delays noted in the recruitment of health professionals as there were discussions regarding the adoption of a new HR strategy for the most deprived regions. Increased recruitment and Comments: redistribution of health professionals is expected in the coming months. IN01433589 Newly recruited doctors (generalists and specialists) deployed to the four most deprived regions (Number, Custom Breakdown, PBC) 6/28/2024 Page 5 of 12 The World Bank Implementation Status & Results Report Togo Essential Quality Health Services For Universal Health Coverage Project (P174266) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 41.00 41.00 300.00 Date 31-Dec-2020 27-Oct-2023 27-Jun-2024 30-Apr-2026 IN01433590 Newly recruited nurses, midwives and physician assistants deployed to the four most deprived regions (Number, Custom Breakdown, PBC) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 667.00 667.00 4,580.00 Date 31-Dec-2020 27-Oct-2023 27-Jun-2024 30-Apr-2026 IN01433591 ►Tracer drug available at the primary healthcare level (Percentage, Custom, PBC) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 75.00 Date 31-Dec-2020 02-Aug-2023 27-Jun-2024 30-Apr-2026 The baseline will be readjusted during the restructuring of the operation. The IACV will also validate the Comments: data in the coming months. Bringing health facilities and services close to households IN01433569 ►Primary health facilities newly built (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 200.00 Date 31-Dec-2020 27-Oct-2023 27-Jun-2024 30-Apr-2026 There are 16 constructions of healthcare facilities that are nearly complete in the Savanes region (expected to be completed by September 2024). New constructions of 70 healthcare facilities in Kara, Comments: Centrale and Plateaux began in April 2024 and expected to be finalized by CY2024. IN01433572 ►Primary health facilities renovated or refurbished (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 47.00 47.00 300.00 Date 31-Dec-2020 27-Oct-2023 27-Jun-2024 30-Apr-2026 Forty-seven (47) renovations are completed in the Savanes region. The remaining 13 renovations Comments: expected to be completed by September 2024. IN01433575 ►Newly built and refurbished health facilities with off-grid power solar electricity (Percentage, Custom) 6/28/2024 Page 6 of 12 The World Bank Implementation Status & Results Report Togo Essential Quality Health Services For Universal Health Coverage Project (P174266) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 500.00 Date 31-Dec-2020 27-Oct-2023 27-Jun-2024 30-Apr-2026 Solar panels for health facilities are being purchased in 2024 and expected to be installed within the Comments: following months. IN01433577 ►Newly built and refurbished health facilities with disability friendly designs of access and water and sanitation facilities (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 500.00 Date 31-Dec-2020 27-Oct-2023 27-Jun-2024 30-Apr-2026 Water and sanitation facilities in new constructions are ongoing and will be finalized in the coming Comments: months. IN01433579 ►Beneficiaries of these newly refurbished health facilities satisfied with the quality of services and facilities (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 80.00 Date 31-Dec-2020 27-Oct-2023 27-Jun-2024 30-Apr-2026 Satisfaction survey is expected in the coming months; starting with the Savanes region. Comments: IN01433582 ►Health facilities with Quality Improvement Plan (QIP) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 500.00 Date 31-Dec-2020 27-Oct-2023 27-Jun-2024 30-Apr-2026 Strengthening the national social health insurance scheme IN01433567 ►Established social health insurance scheme (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No Yes Yes Yes Date 31-Dec-2020 27-Oct-2023 27-Jun-2024 14-Oct-2021 This indicator has been achieved. Comments: IN01433574 ►Health facilities accredited to the TSHIA (Number, Custom) 6/28/2024 Page 7 of 12 The World Bank Implementation Status & Results Report Togo Essential Quality Health Services For Universal Health Coverage Project (P174266) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 548.00 548.00 500.00 Date 31-Dec-2020 27-Oct-2023 27-Jun-2024 30-Apr-2026 This indicator has been achieved. Comments: Improving stewardship, oversight and management IN01433570 ►Complaints for grievances responded and resolved within two weeks (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 91.50 96.67 75.00 Date 31-Dec-2020 27-Oct-2023 27-Jun-2024 30-Apr-2026 At this time, the indicator has surpassed its target. However, this is a continuous indicator and therefore, it Comments: will be updated at least every 6 months. IN01433573 ►Quarterly reports submitted in a timely manner (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 100.00 90.00 Date 31-Dec-2020 27-Oct-2023 27-Jun-2024 30-Apr-2026 This indicator has been surpassed. However, it is a continuous indicator which will be updated at least Comments: every 6 months. Overall Comments IR Four of the 14 intermediate indicators have been reached/surpassed. Performance-Based Conditions IN01433592 ►PBC 1 People who have received essential health, nutrition, and population (HNP) services (Number, Intermediate Outcome, 667,343.00, 0.00%) January - December Baseline Actual (Previous) Actual (Current) 2025 Value 0.00 0.00 2,754,656.00 -- Date -- 30-Nov-2023 27-Jun-2024 -- 6/28/2024 Page 8 of 12 The World Bank Implementation Status & Results Report Togo Essential Quality Health Services For Universal Health Coverage Project (P174266) PBC 1.1 Persons receiving services from newly established health facilities (Number (Thousand), Intermediate Outcome, 667,343.00, 0.00%) January - December Baseline Actual (Previous) Actual (Current) 2025 Value 0.00 0.00 0.00 -- Date -- 30-Nov-2023 27-Jun-2024 -- PBC 1.2 Number of children immunized (Number, Intermediate Outcome, 2,669,370.00, 0.00%) January - December Baseline Actual (Previous) Actual (Current) 2025 Value 0.00 0.00 618,151.00 -- Date -- 30-Nov-2023 27-Jun-2024 -- PBC 1.3 Number of deliveries attended by skilled health personnel (Number, Intermediate Outcome, 2,002,027.00, 0.00%) January - December Baseline Actual (Previous) Actual (Current) 2025 Value 57,917.00 57,917.00 33,049.00 -- Date -- 30-Nov-2023 27-Jun-2024 -- PBC 1.4 Households visited by health workers, including CHWs (disaggregated by sex) (Number, Intermediate Outcome, 1,334,684.00, 0.00%) January - December Baseline Actual (Previous) Actual (Current) 2025 Value 0.00 0.00 530,168.00 -- Date -- 30-Nov-2023 27-Jun-2024 -- IN01433597 ►PBC 2 Persons registered onto the health insurance scheme (Number, Intermediate Outcome, 8,000,000.00, 0.00%) January - December Baseline Actual (Previous) Actual (Current) 2025 Value 0.00 0.00 0.00 -- Date -- 30-Nov-2023 27-Jun-2024 -- PBC 2.1 Persons registered onto the health insurance scheme (Number, Intermediate Outcome, 641,266.00, 0.00%) January - December Baseline Actual (Previous) Actual (Current) 2025 6/28/2024 Page 9 of 12 The World Bank Implementation Status & Results Report Togo Essential Quality Health Services For Universal Health Coverage Project (P174266) Value 0.00 0.00 0.00 -- Date -- 30-Nov-2023 27-Jun-2024 -- PBC 2.2 Persons registered onto the health insurance scheme (Number, Intermediate Outcome, 3,046,015.00, 0.00%) January - December Baseline Actual (Previous) Actual (Current) 2025 Value 0.00 0.00 0.00 -- Date -- 30-Nov-2023 27-Jun-2024 -- PBC 2.3 Persons registered onto the health insurance scheme (Number, Intermediate Outcome, 2,164,274.00, 0.00%) January - December Baseline Actual (Previous) Actual (Current) 2025 Value 0.00 0.00 0.00 -- Date -- 30-Nov-2023 27-Jun-2024 -- PBC 2.4 Persons registered onto the health insurance scheme (Number, Intermediate Outcome, 2,164,274.00, 0.00%) January - December Baseline Actual (Previous) Actual (Current) 2025 Value 0.00 0.00 0.00 -- Date -- 30-Nov-2023 27-Jun-2024 -- IN01433602 ►PBC 3 Newly recruited health professionals deployed to the four most deprived prefectures (Number, Intermediate Outcome, 2,900,000.00, 0.00%) January - December Baseline Actual (Previous) Actual (Current) 2025 Value 0.00 708.00 708.00 -- Date -- 30-Nov-2023 27-Jun-2024 -- PBC 3.1 Newly recruited doctors (generalists and specialists) deployed to the four most deprived regions (Number, Intermediate Outcome, 1,171,200.00, 0.00%) January - December Baseline Actual (Previous) Actual (Current) 2025 Value 0.00 41.00 41.00 -- Date -- 30-Nov-2023 27-Jun-2024 -- PBC 3.2 Newly recruited nurses, midwives and physician assistants deployed to the four most deprived regions (Number, Intermediate Outcome, 1,756,800.00, 0.00%) 6/28/2024 Page 10 of 12 The World Bank Implementation Status & Results Report Togo Essential Quality Health Services For Universal Health Coverage Project (P174266) January - December Baseline Actual (Previous) Actual (Current) 2025 Value 0.00 667.00 667.00 -- Date -- 30-Nov-2023 27-Jun-2024 -- IN01433605 ►PBC 4 Tracer drug available at the primary healthcare level (Percentage, Intermediate Outcome, 15,015,200.00, 0.00%) January - December Baseline Actual (Previous) Actual (Current) 2025 Value 0.00 0.00 0.00 -- Date -- 30-Nov-2023 27-Jun-2024 -- Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P174266 IDA-68530 Effective USD 35.00 35.00 0.00 9.45 21.97 30% P174266 IDA-D7870 Effective USD 35.00 35.00 0.00 28.91 3.63 89% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P174266 IDA-68530 Effective 11-Mar-2021 31-Mar-2021 05-Aug-2021 30-Apr-2026 30-Apr-2026 P174266 IDA-D7870 Effective 11-Mar-2021 31-Mar-2021 05-Aug-2021 30-Apr-2026 30-Apr-2026 Cumulative Disbursements 6/28/2024 Page 11 of 12 The World Bank Implementation Status & Results Report Togo Essential Quality Health Services For Universal Health Coverage Project (P174266) Restructuring History There has been no restructuring to date. Related Project(s) P181510-AF SSEQCU 6/28/2024 Page 12 of 12