The World Bank Implementation Status & Results Report Sindh Integrated Health and Population Project (P178530) Sindh Integrated Health and Population Project (P178530) SOUTH ASIA | Pakistan | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2023 | Seq No: 2 | ARCHIVED on 13-Jul-2023 | ISR56849 | Implementing Agencies: Province of Sindh, Department of Health, Islamic Republic of Pakistan Key Dates Key Project Dates Bank Approval Date: 19-Dec-2022 Effectiveness Date: 13-Jan-2023 Planned Mid Term Review Date: -- Actual Mid-Term Review Date: Original Closing Date: 30-Jun-2027 Revised Closing Date: 30-Jun-2027 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) To improve utilization and quality of basic RMNCAH+N, for poor and vulnerable populations, especially women and children, in targeted areas of Sindh Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Component 1: Improving RMNCAH+N services utilization and quality and support during public health emergencies:(Cost $180.00 M) Component 2: Strengthening demand for RMNCAH+N services including women’s empowerment for availing health services:(Cost $10.00 M) Component 3: Project Management, Monitoring and Evaluation and Research:(Cost $10.00 M) Component 4: Contingency Emergency Response Component (CERC) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Satisfactory Moderately Satisfactory Overall Risk Rating Substantial Substantial Implementation Status and Key Decisions The Sindh Integrated Health and Population Project aims to improve the utilization and quality of basic Reproductive, Maternal, Newborn, Child and Adolescent Health plus Nutrition (RMNCAH+N), for poor and vulnerable populations, especially women and children, in targeted areas of Sindh. The Project was approved by the World Bank’s Board of Executive Directors on December 19, 2022 and became effective on January 13, 2023. The Project Management Unit (PMU) has been established with some critical staff on board and the project’s designated account has also been opened. The procurement plan has been approved by the Bank, and the procurement activities have been initiated accordingly. Implementation will need to be expedited as the project’s development objective is dependent on the completion of the civil works related to the health facilities that 7/13/2023 Page 1 of 6 The World Bank Implementation Status & Results Report Sindh Integrated Health and Population Project (P178530) have been damaged during the flood. Accordingly, a timed action plan has been agreed with the project management unit to fast-track implementation progress. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance Substantial Substantial Substantial Macroeconomic High High High Sector Strategies and Policies Moderate Moderate Moderate 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 -- -- -- Overall Substantial Substantial Substantial Results PDO Indicators by Objectives / Outcomes To improve utilization of essential health and family planning services, for poor and vulnerable pop IN01311170 ►Married women who were counseled for family planning at GDs and availed FP services (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 2.00 2.00 2.00 30.00 Date 30-Jun-2022 02-Mar-2023 06-Jul-2023 30-Jun-2027 Numerator: Number of married women who counseled for family planning at HFs and availed FP services Comments: Denominator: Total number of married women (16%) in the catchment population of the health facility IN01311171 ►Pregnant women who have had at least 4 ANC visits at health facilities during their last pregnancy in the catchment population (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target 7/13/2023 Page 2 of 6 The World Bank Implementation Status & Results Report Sindh Integrated Health and Population Project (P178530) Value 15.00 15.00 15.00 50.00 Date 30-Jun-2022 02-Mar-2023 06-Jul-2023 30-Jun-2027 Numerator: Total Number of PWs who have had at least 4 ANC visits at HFs during their last pregnancy in Comments: the catchment population Denominator: Total number of PWs (3.6%) in the catchment population IN01311172 ►Pregnant women who had their deliveries conducted by skilled birth attendant at a health facility in the catchment population (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 9.00 9.00 9.00 40.00 Date 30-Jun-2022 02-Mar-2023 06-Jul-2023 30-Jun-2027 Numerator: Number of pregnant women who had their deliveries conducted by skilled birth attendant at a Comments: health facility in the catchment population Denominator: Total number of pregnant women (3.6%) in the catchment population IN01311173 ►Children between the ages of 12 to 23 months fully immunized as per the age specific protocol (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 47.00 47.00 47.00 70.00 Date 30-Jun-2022 02-Mar-2023 06-Jul-2023 30-Jun-2027 Numerator: number of children between the ages of 12 to 23 months fully immunized Denominator: total number of children between the ages of 12 to 23 months (3%). Full immunization should be defined by Comments: age group. By 23 months, full immunization would include BCG, Hep B, OPV 0-III, Pentavalent I-III, Pneumococcal I-III, Rotavirus I-II, IPV, Measles I. IN01311174 ►Children aged 6-23 months who receive yearly a minimum of 90 micronutrient sprinkles sachets for three months in intervention areas (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 1.70 1.70 1.70 30.00 Date 30-Jun-2022 02-Mar-2023 06-Jul-2023 30-Jun-2027 Numerator: Number of children aged 6-23 months who received yearly a minimum of 90 micronutrient Comments: sprinkles sachets for three months in the catchment area Denominator: Total number of children aged 6- 23 months (4.5%) in the catchment population. Intermediate Results Indicators by Components Improving RMNCAH+N services utilization and quality and support during public health emergencies IN01311176 ►Additional number of pregnant women received iron/folic acid supplementation during pregnancy as per standard protocols at HF level (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 1,500,000.00 7/13/2023 Page 3 of 6 The World Bank Implementation Status & Results Report Sindh Integrated Health and Population Project (P178530) Date 30-Jun-2022 02-Mar-2023 06-Jul-2023 30-Jun-2027 Comments: Number of pregnant women who have received IFA at the health facility IN01311178 ►Children 6-59 months having diarrhea treated with zinc and oral rehydration salts (ORS) as per standard protocols, % points above baseline (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target 20% points above Value To be measured To be measured To be measured baseline Date 30-Jun-2022 02-Mar-2023 06-Jul-2023 30-Jun-2027 Numerator: Number of children 6-59 months having diarrhea treated with zinc and oral rehydration salts Comments: (ORS) as per standard protocols Denominator: Total number of children with diarrhea visited the health facility for treatment IN01311179 ►Additional number of children aged 6-59 months screened for malnutrition (using MUAC tape) at health facility (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 1,000,000.00 Date 30-Jun-2022 02-Mar-2023 06-Jul-2023 30-Jun-2027 Comments: Number of children (6-59) visiting the health facility screened for malnutrition using MUAC tape IN01311180 ►Additional number of Severe Acute Malnourished (SAM) Children referred from GD/HF to OTP centers (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 2,000.00 Date 30-Jun-2022 02-Mar-2023 06-Jul-2023 30-Jun-2027 Numerator: Number of Severe Acute Malnourished (SAM) Children (6-59) referred from HF to OTP Comments: Denominator: Total number of children identified as severely malnourished without complication at the health facility IN01311181 ►GDs having no stock out of essential medicines, disagregated for FP commodities (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target 20% points above Value To be measured To be measured To be measured baseline Date 30-Jun-2022 02-Mar-2023 06-Jul-2023 30-Jun-2027 Numerator: Number of health facilities having zero days stock out of tracer drug medicine including FP Comments: commodities. Denominator: Total number of health facilities (392) IN01311182 ►Additional number of health care providers trained on FP, RMNCAH+N and GBV services (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 1,000.00 7/13/2023 Page 4 of 6 The World Bank Implementation Status & Results Report Sindh Integrated Health and Population Project (P178530) Date 30-Jun-2022 02-Mar-2023 06-Jul-2023 30-Jun-2027 Numerator: Number of health care providers trained on FP and RMNCAH+N services Denominator: Total Comments: number of HCPs at health facility IN01311183 ►GBV survivors presenting at health facilities provided with clinical-management of emergency services (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target 20% points above Value To be measured To be measured To be measured baseline Date 30-Jun-2022 02-Mar-2023 06-Jul-2023 30-Jun-2027 IN01311184 ►Newborn babies with chlorhexidine gel applied to umbilical cord, %points above baseline (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target 20% points above Value To be measured To be measured To be measured baseline Date 30-Jun-2022 02-Mar-2023 06-Jul-2023 30-Jun-2027 Strengthening demand for RMNCAH and Nutrition services and women empowerment IN01311177 ►Percent of women who are satisfied with health services provided (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 80.00 Date 30-Jun-2022 02-Mar-2023 06-Jul-2023 30-Jun-2027 Numerator: Number of beneficiaries who were satisfied with health services provided at the health facility Comments: Denominator: Total number of beneficiaries who utilized health services provided at the health facility Project Management, Monitoring and evaluation IN01311175 ►Cumulative number of facilities visited once a month by the District team of DMU/ DHO team (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 100.00 Date 30-Jun-2022 02-Mar-2023 06-Jul-2023 30-Jun-2027 Comments: The number of facilities where the DMU / DHO team paid visit once a month Performance-Based Conditions Data on Financial Performance 7/13/2023 Page 5 of 6 The World Bank Implementation Status & Results Report Sindh Integrated Health and Population Project (P178530) Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P178530 IDA-72370 Effective USD 200.00 200.00 0.00 10.00 198.68 4.8% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P178530 IDA-72370 Effective 19-Dec-2022 06-Jan-2023 13-Jan-2023 30-Jun-2027 30-Jun-2027 Cumulative Disbursements Restructuring History There has been no restructuring to date. Related Project(s) There are no related projects. 7/13/2023 Page 6 of 6