The World Bank Implementation Status & Results Report Ebola Emergency Response Project (P152359) Ebola Emergency Response Project (P152359) WESTERN AND CENTRAL AFRICA | Western and Central Africa | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2015 | Seq No: 18 | ARCHIVED on 17-Aug-2023 | ISR56645 | Implementing Agencies: Liberia Ministry of Health, Ministry of Health and Sanitation, Sierra Leone, Ministry of Health, Guinea, Republic of Guinea, Republic of Liberia, Republic of Sierra Leone Key Dates Key Project Dates Bank Approval Date: 16-Sep-2014 Effectiveness Date: 19-Sep-2014 Planned Mid Term Review Date: 23-Mar-2015 Actual Mid-Term Review Date: 23-Mar-2015 Original Closing Date: 30-Sep-2015 Revised Closing Date: 31-Dec-2023 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The Project Development Objective is to contribute in the short term to the control of the Ebola Virus Disease (EVD) outbreak and the availability of selected essential health services, and mitigate the socio-economic impact of EVD in Guinea, Liberia, and Sierra Leone. Has the Project Development Objective been changed since Board Approval of the Project Objective? Yes Board Approved Revised Project Development Objective (If project is formally restructured) To contribute to the control of the Ebola Virus Disease (EVD) outbreaks and the recovery of selected essential health services in Guinea, Liberia, and Sierra Leone. Components Table Name Component 1: Support to the EVD Outbreak Response Plans and Strengthening Essential Health Services:(Cost $224.00 M) Component 2: Human Resources Scale up for Outbreak Response and Essential Health Services:(Cost $109.00 M) Component 3: Provision of Food and Basic Supplies to Quarantined Populations and EVD Affected Households:(Cost $29.00 M) Component 4: Provision of Essential Public Services:(Cost $25.00 M) Component 5: Pre-Investment Assessment of New Ebola Therapies, Diagnostics and Vaccines:(Cost $3.00 M) 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 Moderate Moderate 8/17/2023 Page 1 of 8 The World Bank Implementation Status & Results Report Ebola Emergency Response Project (P152359) Implementation Status and Key Decisions The Emergency Ebola Response Project covers Guinea, Liberia and Sierra Leone. All the planned activities for Guinea and Sierra Leone have been completed and closed. All the five (5) project development objective (PDO) level indicators under the project were met in 2021. For the intermediate indicators, only two out of the 12 indicators have not been achieved. These are: (i) Redemption Hospital Phase 1 (maternity and pediatric hospital) constructed, and (ii) Total food distributed. Food distribution ended in 2016 after all the countries were declared Ebola free, and therefore, food distribution ceased at that time. The only outstanding activity under the project is the construction of the New Redemption Hospital in Liberia. Other than the delayed construction of the New Redemption Hospital, the other project components and activities in Liberia have progressed well. Since February 2023, there has been significant progress in the implementation of planned activities. In particular, the Ministry of Health has finalized the contracts for the new contractor and supervision firm, the construction site has been handed over to the new contractor, preparation of the construction site has been undertaken, and construction has resumed on the shell of the building. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance -- Substantial Substantial Macroeconomic -- Substantial Substantial Sector Strategies and Policies -- Low Low Technical Design of Project or Program -- Moderate Moderate Institutional Capacity for Implementation and -- Moderate Moderate Sustainability Fiduciary -- Substantial Substantial Environment and Social -- Moderate Moderate Stakeholders -- Low Low Other -- -- -- Overall -- Moderate Moderate Results PDO Indicators by Objectives / Outcomes Contribute to control of EVD outbreaks IN01305373 ►Availability (at any given time) of at least two weeks needs of PPEs and other required IPC supplies in the Ebola Treatment Centers (ETCs) and referral centers (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 100.00 80.00 8/17/2023 Page 2 of 8 The World Bank Implementation Status & Results Report Ebola Emergency Response Project (P152359) Date 18-Sep-2014 31-Dec-2016 31-Dec-2016 31-Dec-2016 IN01305375 ►Registered contacts followed up (during the mandated period) to detect new EVD cases (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 100.00 100.00 Date 16-Sep-2014 30-Jun-2016 30-Jun-2016 30-Jun-2016 No further reporting of this indicator since the Ebola outbreak. As per discussions with each of the three countries and WHO, the original indicator statement "New confirmed EVD cases from registered contacts" (and therefore its purpose) is not clear. This indicator was a NEW indicator introduced at the 2016 restructuring, when the peak of the outbreak was declining. Therefore, it is assumed that the indicator was meant to measure the system readiness to measure the follow up of all registered contacts to detect new cases. The reporting in previous ISRs indicates that 100% of all registered contacts were followed up for the mandated period of time for new case detection- thereby indicating the robustness of the system. Hence, the indicator statement is being changed. The Comments: country-specific data indicating the proportion of new cases diagnosed from all the registered contacts followed up, that was available is for different periods: Guinea - 594 confirmed EVD cases from 34,944 registered contacts – cumulative data for outbreak. Liberia 1,468 confirmed EVD cases from 33,627 registered contacts between March 2014 to February 2015. Sierra Leone - 373 confirmed EVD cases from 431 registered contacts between January 2015 to October 2015. Contribute to recovery of selected essential health services IN01305374 ►Births (deliveries) attended by skilled health personnel (number) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 2,553,547.00 2,553,547.00 24,000.00 Date 16-Sep-2014 31-Mar-2021 31-Mar-2021 31-Mar-2021 This indicator is being added to intermediate indicators as sub-CRI but it is also being retained as PDO indicator since it captures the second part of the PDO. The basis of the end target has not been determined. The numbers are based on annual calendar year reporting from DHIS2 for each country: Guinea: 55,684 in 2014, 226,900 in 2015, 245,323 in 2016 and 271,303 in 2017. Cumulative number is Comments: 799,210 (2014-2017). Liberia: 2014-2017 cumulative number is 324,738. Disaggregated data being ascertained. Sierra Leone: 462,123 during the EBV outbreak period. Ascertaining disaggregated data, but not available till date. Total Actual (Current): 1,586,071 for 31 December 2017. IN01305431 ►Number of health workers trained on IPC and Ebola (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 44,887.00 44,887.00 30,000.00 Date 16-Sep-2014 31-Mar-2021 31-Mar-2021 31-Mar-2021 8/17/2023 Page 3 of 8 The World Bank Implementation Status & Results Report Ebola Emergency Response Project (P152359) No methodology or process was developed and agreed with the three countries to measure the knowledge of trained health workers. Therefore, the original indicator statement "Percentage of trained health workers with knowledge of Ebola and IPC" is being changed. End target is being changed to March 2021: 30,000. Actual Total: 32,579 (30 Nov 2018). Guinea: 12,218 (111 doctors, 309 nurses, 39 laboratory assistants, 767 hygienists and 10,992 health Comments: workers private – 3,876 and public – 7,116 structures); Liberia: 20,361; Sierra Leone: health workers training on Ebola and IPC was financed by DFID, so no reporting for this indicator under EERP. IN01305432 ►Number of health centers rehabilitated according to national IPC standard (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 200.00 200.00 125.00 Date 16-Sep-2014 31-Mar-2021 31-Mar-2021 31-Mar-2021 The original indicator statement "Percentage of health centers rehabilitated according to national IPC standard" is being changed. Current total: 200 (21 May 2021); End Target: 125 Guinea: 5/54; Comments: Liberia: 41/48 (included expansion of maternity wings of clinics, health centers, and hospitals, isolation units); Sierra Leone: 23/23 Intermediate Results Indicators by Components Component 1: Support to the EVD Outbreak Response Plans and Strengthening Essential Health Services IN01305433 ►Total food distribution (Metric ton, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 18,987.50 18,987.50 22,900.00 Date 18-Sep-2014 30-Jun-2016 30-Jun-2016 30-Jun-2016 No further activity or reporting after the Ebola outbreak. For better and complete reporting, the task team (for the 2019 restructuring of the RF) tried to get the data for different reporting periods during the Ebola outbreak (15 Sep 2014, 15 March 2015, 15 Sep 2015, 15 March 2016, and 15 Sep 2016). Comments: End Target of Total 22,900 metric tons (Guinea: 8,100, Liberia: 8,100, Sierra Leone: 6,700). Actual (June 30, 2016) 11,164.73 metric tons (Guinea: 1,717.13, Liberia: 4,261.90, Sierra Leone: 5,185.7). IN01305435 ►Number of people in the quarantined areas and other Ebola-affected households who received food and other basic supplies (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 766,170.00 766,170.00 544,000.00 8/17/2023 Page 4 of 8 The World Bank Implementation Status & Results Report Ebola Emergency Response Project (P152359) Date 16-Sep-2014 30-Jun-2016 30-Jun-2016 30-Jun-2016 No further activity or reporting since Ebola outbreak. For better and complete reporting, the task team (for the 2019 restructuring of the RF) tried to get the data for different reporting periods during the Ebola outbreak (15 Sep 2014, 15 March 2015, 15 Sep 2015, 15 Comments: March 2016, and 15 Sep 2016). End target of Total 544,000 (Guinea: 175,000, Liberia: 169,000, Sierra Leone: 200,000). Actual (June 30, 2016) 1,536,720 (Guinea: 973,000; Liberia: 125,400; Sierra Leone: 438,320) IN01305438 ►Community health and social mobilization staff deployed for door-to-door communication and case identification in target chiefdoms/sub- districts/counties (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 55,136.00 55,136.00 7,800.00 Date 18-Sep-2014 30-Sep-2017 30-Sep-2017 30-Sep-2017 No active communication and case identification after the Ebola outbreak, so end target date is September 30, 2017. Comments: End target of 7,800 (Guinea 3,800, Liberia 2,000, and Sierra Leone 2,000). Actual (30 Sep 2017) 55,136 (Guinea: 12,538, Liberia: 10,434, Sierra Leone: 32,164) IN01305440 ►Proportion of beneficiary households who received cash transfers by 15th of every payment quarter (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 100.00 100.00 Date 16-Sep-2014 30-Jun-2016 30-Jun-2016 30-Jun-2016 No further activity or reporting since Ebola outbreak. Comments: Component 2: Human Resources Scale up for Outbreak Response and Essential Health Services IN01305434 ►Expatriate health workers deployed to provide medical care to EVD patients and for other essential health needs (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 740.00 740.00 725.00 Date 16-Sep-2014 31-Dec-2016 31-Dec-2016 31-Dec-2016 No further activity or reporting after the Ebola outbreak. Comments: IN01305436 ►Redemption Hospital Phase 1 (Maternity and Pediatric hospital) constructed (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No No No Yes Date 16-Sep-2014 01-Feb-2023 31-May-2023 31-Dec-2023 IN01305437 8/17/2023 Page 5 of 8 The World Bank Implementation Status & Results Report Ebola Emergency Response Project (P152359) ►Health facilities that received essential drugs (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1,900.00 1,900.00 804.00 Date 16-Sep-2014 31-Mar-2022 31-Mar-2022 31-Mar-2022 This was a one-time procurement and supply of essential drugs to the three countries. Comments: IN01305439 ►Number of health workers who received financial incentives (hazard/indemnity pay and death benefits) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 42,762.00 42,762.00 18,000.00 Date 16-Sep-2014 30-Jun-2016 30-Jun-2016 30-Jun-2016 No further activity or reporting since Ebola outbreak. End target of Total 18,000 (Guinea: 5,000, Liberia: 8,000, Sierra Leone: 5,000). Comments: Actual (June 30, 2016) 37,940 (Guinea: 7,785, Liberia: 6,958, Sierra Leone: 23,197). IN01305441 ►Number of health personnel who have completed selected training programs (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1,589.00 1,589.00 1,000.00 Date 16-Sep-2014 31-Mar-2022 31-Mar-2022 31-Mar-2022 IN01305442 ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 6,908,412.00 6,908,412.00 2,500,000.00 Date 16-Sep-2014 31-Mar-2022 31-Mar-2022 31-Mar-2022 This is a Corporate Result Indicator (CRI). This indicator reflects the total of the earlier indicators of births attended by SBA (1,605,678) and immunizations (2,205,048), which is 3,810,726. Nutrition services not Comments: provided in any of the 3 countries through EERP. IN01305443 Number of children immunized (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 3,933,994.00 3,933,994.00 1,500,000.00 Date 16-Sep-2014 21-May-2021 21-May-2021 31-Mar-2022 IN01305444 Number of deliveries attended by skilled health personnel (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target 8/17/2023 Page 6 of 8 The World Bank Implementation Status & Results Report Ebola Emergency Response Project (P152359) Value 0.00 2,458,381.00 2,458,381.00 24,000.00 Date 16-Sep-2014 01-Jun-2020 01-Jun-2020 31-Mar-2022 Performance-Based Conditions Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P152359 IDA-D0070 Closed USD 98.00 97.34 0.66 92.59 0.00 100% P152359 IDA-D0080 Effective USD 115.00 115.00 0.00 104.13 6.33 94% P152359 IDA-D0090 Closed USD 72.00 72.00 0.00 68.01 0.03 100% P152359 IDA-H9900 Closed USD 25.00 25.00 0.00 24.61 0.00 100% P152359 IDA-H9910 Closed USD 52.00 52.00 0.00 51.13 0.00 100% P152359 IDA-H9920 Closed USD 28.00 28.00 0.00 27.59 0.00 100% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P152359 IDA-D0070 Closed 18-Nov-2014 20-Nov-2014 03-Dec-2014 30-Sep-2015 31-Dec-2020 P152359 IDA-D0080 Effective 18-Nov-2014 24-Nov-2014 02-Dec-2014 30-Sep-2015 31-Dec-2023 P152359 IDA-D0090 Closed 18-Nov-2014 20-Nov-2014 26-Nov-2014 30-Sep-2015 31-Dec-2020 P152359 IDA-H9900 Closed 16-Sep-2014 17-Sep-2014 24-Sep-2014 30-Sep-2015 31-Dec-2020 P152359 IDA-H9910 Closed 16-Sep-2014 17-Sep-2014 19-Sep-2014 30-Sep-2015 31-Mar-2021 P152359 IDA-H9920 Closed 16-Sep-2014 17-Sep-2014 24-Sep-2014 30-Sep-2015 31-Dec-2020 Cumulative Disbursements 8/17/2023 Page 7 of 8 The World Bank Implementation Status & Results Report Ebola Emergency Response Project (P152359) Restructuring History Level 2 Approved on 10-Aug-2015 ,Level 2 Approved on 17-Mar-2016 ,Level 2 Approved on 28-Oct-2016 ,Level 1 Approved on 08-Dec-2016 ,Level 2 Approved on 30-Apr-2019 ,Level 2 Approved on 20-Dec-2019 ,Level 2 Approved on 27-Aug-2020 ,Level 2 Approved on 16-Feb-2022 Related Project(s) P152980-Ebola Emergency Response Project - Additional Financing ,P161097-Ebola Emergency Response Project – 2nd Additional Financing (FY17) 8/17/2023 Page 8 of 8