The World Bank Implementation Status & Results Report Albania Emergency COVID-19 Response Project (P174101) Albania Emergency COVID-19 Response Project (P174101) EUROPE AND CENTRAL ASIA | Albania | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2021 | Seq No: 5 | ARCHIVED on 11-Jul-2023 | ISR55678 | Implementing Agencies: Ministry of Health and Social Protection, Republic of Albania Key Dates Key Project Dates Bank Approval Date: 30-Jul-2020 Effectiveness Date: 13-Jan-2021 Planned Mid Term Review Date: 21-Feb-2022 Actual Mid-Term Review Date: 21-Feb-2022 Original Closing Date: 30-Jun-2022 Revised Closing Date: 31-Dec-2022 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The objectives of the Project are to prevent, detect, and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness in the Republic of Albania. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Supporting the health sector’s COVID-19 response in the immediate and mid-term:(Cost $16.25 M) Project management:(Cost $0.55 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Moderately Satisfactory Satisfactory Overall Implementation Progress (IP) Moderately Satisfactory Satisfactory Overall Risk Rating Moderate Moderate Implementation Status and Key Decisions The Project was approved on July 30, 2020, the Loan became effective on January 13, 2021 and closed on December 31, 2022. Progress towards the achievement of the development objective as well as the Implementation Progress are rated Satisfactory. The targets of the two Project Development Objective level indicators were successfully achieved. The designated laboratories were equipped with diagnostic equipment, test, kits, and reagents which enabled public health laboratories to undertake massive testing for COVID-19. In addition, the percentage of infected healthcare workers was kept low at 1.9% (against a target of 2.0%). All Project activities have been successfully completed and the Project funds are fully disbursed. MPA Program Development Objective 7/11/2023 Page 1 of 6 The World Bank Implementation Status & Results Report Albania Emergency COVID-19 Response Project (P174101) MPA PDO Table The Program Development Objective is to prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness MPA Table Multiphase Programmatic Approach (MPA) Status MPA Table Body Sustained efforts continue to be made to advance the implementation of the 87 MPA operations. As of June 15, 2023, 88 MPA-projects have been approved with a total commitment of US$4.3 billion. One operation (Guatemala) was cancelled in mid-September 2021, at the request of the Government. Total disbursements as of June 15, 2023, amount to US$3.89 billion or 91% of overall commitments. This amount does not include disbursements under MPA-V operations which are reported together with AF-V operations. A large refund from the UN to the project account of the Myanmar operation was processed in late March due to the inability to implement the project. This transaction affected total disbursements. Also, (i) Loans and Credits denominated in SDRs and Euros are being affected because of fluctuations between the SDRs and Euros against the US dollar, and (ii) at this late stage of project implementation, several operations are processing refunds to the special/project accounts, which have an impact on total disbursements. Thirteen operations closed by the end of CY22. Thirty five operations have closing dates by the end of CY23. However, there are several projects that are/will be processing extensions so this number is likely to change. As with the Mid Term Review issued on March 25, 2023, no individual COVID-19 MPA operation will have to complete an ICR. Instead, one ICR will be prepared for the entire COVID-19 MPA Program after the closing date of the Program -- December 31, 2025. This Global ICR will be based on final ISRs packages prepared by country operations’ teams. A template for the final ISR was issued by OPCS on March 25, 2022. Several operations have/are preparing final ISR packages. The overall conclusion of the MTR was that the COVID-19 MPA Program embodied a rapid, innovative approach to new lending for human health response. The MTR concluded that the COVID-19 MPA has been successful, notwithstanding considerable uncertainty and multiple constraints in the early stages of the pandemic. The Bank’s emergency response was remarkably swift in the most vulnerable countries facing human capital losses and development setbacks. Further, the MTR concluded that notwithstanding the challenges, the MPA is on track to achieve its PrDO, “prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness.“ Seventy one (71) country projects or 83 percent of projects approved have reached 70-100+ percent disbursement (reasons for >100% disbursements relate to fluctuations between the Euro and the SDR against the US$). Out of the 71 operations, 59 operations or 83% have disbursed 90+% of commitments. Out of the 71 operations, 38 operations are fully disbursed and sixteen (16) operations have disbursed 95-99% of commitments. As reported in mid-April, there are six operations with disbursements of 50 percent or less. Out of these six operations, one has not disbursed (AFW), and one operation has disbursed 30 percent (AFW). The projects are benefitting around 3.7 billion people or 50% of the global population. When countries with AF-V operations are counted, the projects are benefitting 4.1 billion of 51 percent of the global population. This is because some countries that do not have a parent project have AF-V operations. Eighty-six (86) or 99% of projects approved are disbursing. ECA has the highest percentage of disbursements at 99%, followed by MNA with 96%, SAR with 94%, LAC with 92%, EAP with 85%, AFE and AFW with 78%. Disbursements for EAP operations are being affected by relatively low disbursements in Fiji, Kiribati, Samoa, and Solomon Islands. AFE lower disbursements compared to other regions are a result of low disbursements under two operations. In the case of AFW low overall disbursements are a result of no disbursements under one operation and only 30 percent under another. Retroactive Financing (RF) continues to represent 20 percent of commitments. SAR has the highest percentage of RF at 37 percent, followed by ECA at 18 percent. IDA continues to represent 39 percent and IBRD 41 percent of disbursements. Streamlined procedures, delegated approvals, coupled with flexible project design and intensified efforts across the Bank have contributed to the progress. Implementation is being guided by Bank teams working in parallel with other health related projects, including Additional Financing operations supporting vaccine procurement and deployment efforts. 7/11/2023 Page 2 of 6 The World Bank Implementation Status & Results Report Albania Emergency COVID-19 Response Project (P174101) 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 Moderate Moderate Moderate Technical Design of Project or Program Moderate Moderate Moderate Institutional Capacity for Implementation and Moderate Moderate Moderate Sustainability Fiduciary Moderate Moderate Moderate Environment and Social Moderate Moderate Moderate Stakeholders Moderate Moderate Moderate Other Moderate Moderate Moderate Overall Moderate Moderate Moderate Results PDO Indicators by Objectives / Outcomes Health care delivery and health system strengthening IN01275419 ►Number of designated laboratories with diagnostic equipment, test kits, and reagents, as per MoHSP guidelines (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 4.00 4.00 Date 12-May-2020 17-Dec-2020 30-Dec-2022 30-Dec-2022 Target successfully achieved, including two laboratories at the Institute of Public health (IPH), one laboratory at Mother Tereza Hospital and one laboratory at Shefqet Ndroqi hospital (second Covid-19 Comments: hospital). In addition, all 413 PHC facilities were involved in rapid testing and 36 local Health Care units (part of PCR testing) have benefitted from the supply of goods. IN01275420 ►Percentage of COVID-19 cases that are health care workers (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 3.50 3.50 1.90 2.00 Date 12-May-2020 17-Dec-2020 30-Dec-2022 30-Dec-2022 Comments: Target successfully achieved. 7/11/2023 Page 3 of 6 The World Bank Implementation Status & Results Report Albania Emergency COVID-19 Response Project (P174101) Overall Comments PDO Both PDO indicators have been successfully achieved. Intermediate Results Indicators by Components Health care delivery and health system strengthening IN01275456 ►Upgraded infrastructure of the Infectious Disease Clinic in Mother Teresa Hospital completed (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No No Yes Yes Date 12-May-2020 17-Dec-2020 30-Dec-2022 30-Dec-2022 The Infectious Disease hospital infrastructure is successfully upgraded, despite delays resulted from implementation of works in the midst of the pandemic with a high number of hospitalized patients. The upgrade completely transformed the hospital, increasing its capacity by 62 percent, doubling the capacity Comments: of its Intensive Care Unit and improving the hospital's equipment, laboratories, testing facilities and emergency transport. Also, the investment included facilities for university students as well as rooms for medical practices. IN01275457 ►Number of volunteer healthcare staff covered with salaries for at least 3 months (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 100.00 300.00 Date 12-May-2020 17-Dec-2020 30-Dec-2022 30-Dec-2022 Target is partly achieved. A total of 100 health care staff were contracted in December, 2021 for a one- Comments: month period. IN01275458 ►Number of medical ambulances provided to Tirana tertiary hospital, regional hospitals, and IPH (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 28.00 20.00 Date 12-May-2020 17-Dec-2020 30-Dec-2022 30-Dec-2022 Target exceeded. A total of 28 medical ambulances assigned to the Mother Teresa Hospital, all regional hospitals, and the Institute of Public Health (IPH). Although 20 ambulances were initially planned, there Comments: was an increased need for ambulances during the pandemic. IN01275459 ►Number of medical staff in public health laboratories, trained to undertake field epidemiology (Number, Custom) 7/11/2023 Page 4 of 6 The World Bank Implementation Status & Results Report Albania Emergency COVID-19 Response Project (P174101) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 1,200.00 100.00 Date 12-May-2020 17-Dec-2020 30-Dec-2022 30-Jun-2022 Target is successfully achieved. The activity has jointly been supported by the MoHSP. Comments: IN01275460 ►Number of ICU beds supplied for the Infectious Disease Hospital (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 18.00 18.00 58.00 58.00 Date 12-May-2020 17-Dec-2020 30-Dec-2022 30-Dec-2022 Target successfully achieved. A total number of 58 ICU beds were delivered at the Infectious Disease Comments: Hospital and being used. IN01275461 ►Number of green zones, in a given month, in which the number of new cases on any day exceeds 12 (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target tbd pending project Value 6.00 0.00 0.00 effectiveness Date 12-May-2020 17-Dec-2020 30-Dec-2022 30-Dec-2022 Target successfully achieved. This is based on the Government definition of green zones and the Comments: reporting by the MoHSP. IN01275462 ►Number of social media events/interactions (e.g. Facebook, Twitter) which have facilitated citizen feedback and government response (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 240.00 2,520.00 1,000.00 Date 12-May-2020 19-Mar-2021 30-Dec-2022 30-Dec-2022 Target overachieved. Communication, through social media ( Facebook, Twtiter, MoHSP website, etc), Comments: has been among the highest priorities for the Government/MoHSP during the pandemic. Performance-Based Conditions Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed 7/11/2023 Page 5 of 6 The World Bank Implementation Status & Results Report Albania Emergency COVID-19 Response Project (P174101) P174101 IBRD-91600 Closed USD 16.80 16.80 0.00 17.07 0.19 99% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P174101 IBRD-91600 Closed 30-Jul-2020 15-Oct-2020 13-Jan-2021 30-Jun-2022 31-Dec-2022 Cumulative Disbursements Restructuring History Level 2 Approved on 01-Jun-2022 Related Project(s) There are no related projects. 7/11/2023 Page 6 of 6