The World Bank Implementation Status & Results Report Indonesia Health Systems Strengthening Project (P180811) Indonesia Health Systems Strengthening Project (P180811) EAST ASIA AND PACIFIC | Indonesia | IBRD/IDA | Investment Project Financing (IPF) | FY 2024 | Seq No: 2 | Archived on 27- Aug-2024 | ISR00315 Implementing Agencies: Ministry of Health 1. OBJECTIVE 1.1 Development Objective Original Development Objective (Approved as part of Approval package on 07-Dec-2023) To increase the availability of functional equipment in public health facilities and improve the utilization of public health services across Indonesia Has the Development Objective been changed since Board Approval of the Project Objective? No 2. COMPONENTS Name Component 1: Public primary care equipment provision across Indonesia ("SOPHI"):(Cost 615,200,000.00) Component 2: Public referral hospital equipment across Indonesia (“SIHREN”):(Cost 455,000,000.00) Component 3: Public health laboratory equipment across Indonesia (“InPULS”):(Cost 275,400,000.00) Component 4: Project Management, Administration, Digitization and Training:(Cost 138,400,000.00) 3. OVERALL RATINGS Name Previous Current Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Satisfactory Satisfactory Overall Risk Rating Moderate Moderate 4. KEY ISSUES & STATUS Aug 27, 2024 Page 1 of 10 The World Bank Implementation Status & Results Report Indonesia Health Systems Strengthening Project (P180811) 4.1 Implementation Status and Key Decisions 5. SYSTEMATIC OPERATIONS RISK-RATING TOOL Rating at Approval Last Approved Rating Risk Category Approval Package - ISR Seq. 01 - 08 Mar Proposed Rating 08 Dec 2023 2024 Political and Governance Moderate Moderate Moderate Macroeconomic Moderate Moderate Moderate Sector Strategies and Policies Moderate Moderate Moderate Technical Design of Project or Program Substantial Substantial Substantial Institutional Capacity for Implementation and Moderate Moderate Moderate Sustainability Fiduciary Substantial Substantial Substantial Environment and Social Moderate Moderate Moderate Stakeholders Moderate Moderate Moderate Overall Moderate Moderate Moderate Aug 27, 2024 Page 2 of 10 The World Bank Implementation Status & Results Report Indonesia Health Systems Strengthening Project (P180811) 6. RESULTS 6.1 PDO Indicators by PDO Outcomes Improved utilization Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Puskesmas: Oct/2023 Baseline data 09-Aug-2024 Baseline data 09-Aug-2024 25% above. Dec/2028 295,358,582 apply - no apply - no Puskesmas: visits; KJSU update to update to 370,000,000 Hospitals: date. date. visits; KJSU 4,848,075 Hospitals: Number of annual outpatient visits 6,060,000 visits, disaggregated by visits gender (Number) Comments on a utilization indicator to measure the change in the number of outpatient visits to a achieving targets healthcare facility over a specific period compared to a baseline or reference period. The total number of outpatients will be counted for all healthcare services at Puskesmas, as well as for KJSU services, defined based on the leveling of the hospital's capacity and competency to provide services as set by MoH. 708 tests Oct/2023 Baseline data 09-Aug-2024 Baseline data 09-Aug-2024 8500 tests Dec/2028 apply - no apply - no Number of annual laboratory update to update to examinations for ILI-SARI date. date. diagnostics (Labkesmas level Comments on “Number of annual laboratory examinations for ILI-SARI diagnostics (Labkesmas level 1-5)" 1-5) (Number) achieving targets measures the annual number of diagnostic laboratory tests (molecular tests) for influenza- like illness (ILI) and severe acute respiratory infections (SARI) conducted in Labkesmas tiers 1-5. Improved availability Aug 27, 2024 Page 3 of 10 The World Bank Implementation Status & Results Report Indonesia Health Systems Strengthening Project (P180811) Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year 6.6% Oct/2023 Baseline data 09-Aug-2024 Baseline data 09-Aug-2024 90% Dec/2029 apply - no apply - no Percentage of Puskesmas update to update to (incl. Labkesmas tier 1) for date. date. which equipment meets 80 Comments on The indicator refers to the proportion of Puskesmas facilities (including Labkesmas Tier 1) percent of minimum achieving targets that have been provided with all the necessary medical equipment, supplies, and facilities to requirements (Percentage) meet at least 80% of the standard requirements, as defined by the applicable regulation (Permenkes 43 of 2019, as of October 2023), for delivering comprehensive healthcare services. 1 district Oct/2023 Baseline data 09-Aug-2024 Baseline data 09-Aug-2024 514 districts Dec/2028 apply - no apply - no Number of districts in update to update to Indonesia with at least 1 date. date. Madya-level referral hospital Comments on The "Number of districts with at least 1 Madya-level referral hospital for KJSU" is used to for KJSU (Number) achieving targets measure the availability of specific medical services or specialties in hospitals in various districts over a given period. Functionality Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year N/A Oct/2023 Baseline data 09-Aug-2024 Baseline data 09-Aug-2024 Less than 10% Dec/2029 Number of instances in the apply - no apply - no of devices last 6 months where update to update to procured equipment downtime date. date. under the exceeded the benchmarks project set under the Project Comments on This indicator measures the number of times equipment downtime exceeded the contracts (Number) achieving targets benchmarks set under the Project contract. It aims to ensure procured equipment remain Aug 27, 2024 Page 4 of 10 The World Bank Implementation Status & Results Report Indonesia Health Systems Strengthening Project (P180811) function after delivery and throughout the lifetime of the Project. Downtime can occur for various reasons, including maintenance, repairs, technical failures, or system upgrades. 6.2 Intermediate Results Indicators by Components Component 1: Public primary care equipment provision across Indonesia ("SOPHI") Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Percentage of target 0% Oct/2023 Baseline data 09-Aug-2024 Baseline data 09-Aug-2024 90% Dec/2029 Puskesmas under the project apply - no apply - no for which key energy- update to update to efficient equipment types date. date. have been procured, Comments on It refer to specific types of energy-efficient equipment that has been identified as crucial for delivered, installed, and HR achieving targets reducing energy consumption and promoting sustainability in healthcare facilities. Human in facilities received Resources received operational training from the vendor, where applicable: This indicator operational training from evaluates the percentage of facilities where the necessary human resources have received vendor (Percentage) operational training from vendor. 80% Oct/2023 Baseline data 09-Aug-2024 Baseline data 09-Aug-2024 90% Dec/2029 Percentage of under-5 apply - no apply - no children, receiving growth update to update to monitoring and promotion date. date. (GMP) services, Comments on It refers to the proportion of children under the age of 5, disaggregated by gender, who have disaggregated by gender achieving targets received growth monitoring and promotion services. Growth monitoring and promotion (Percentage) (GMP) services aim to monitor normal development and identify potential issues or development delays as early as possible. Percentage of 13% Oct/2023 Baseline data 09-Aug-2024 Baseline data 09-Aug-2024 80% Dec/2028 Pustu/Poskesdes within the apply - no apply - no Aug 27, 2024 Page 5 of 10 The World Bank Implementation Status & Results Report Indonesia Health Systems Strengthening Project (P180811) scope of this project for update to update to which equipment meets date. date. minimum requirements Comments on It refers to the proportion of Pustu/Poskesdes covered by the project that is equipped with (Percentage) achieving targets medical equipment meeting the predefined minimum standards or criteria, as defined by the applicable MoH regulation (ILP Guideline – KMK no 2015 of 2023). 45.8% Oct/2023 Baseline data 09-Aug-2024 Baseline data 09-Aug-2024 60% Dec/2028 Percentage of adolescent apply - no apply - no girls tested for anemia in the update to update to target facilities date. date. (disaggregated by gender, in Comments on "Percentage of adolescent girls tested for anemia in the target facilities (Puskesmas and Puskesmas and Pustu) achieving targets Pustu)" refers to the count of screenings conducted to identify cases of anemia within the (Percentage) Puskesmas and Pustu. Component 2: Public referral hospital equipment across Indonesia (“SIHREN”) Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Percentage of target public 0% Oct/2023 Baseline data 09-Aug-2024 Baseline data 09-Aug-2024 90% Dec/2028 hospitals under the project apply - no apply - no for which key energy- update to update to efficient equipment types date. date. have been procured, Comments on Percentage of target public hospitals under the project for which key energy-efficient delivered, installed, and achieving targets equipment types have been procured, delivered, installed, and human resources in facilities human resources in facilities received operational training from the vendor, where applicable. received operational (Percentage) Component 3: Public health laboratory equipment across Indonesia (“InPULS”) Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Percentage of target public 0% Oct/2023 Baseline data 09-Aug-2024 Baseline data 09-Aug-2024 80% Dec/2028 laboratories under the apply - no apply - no Aug 27, 2024 Page 6 of 10 The World Bank Implementation Status & Results Report Indonesia Health Systems Strengthening Project (P180811) project for which key energy update to update to efficient equipment types date. date. have been procured, Comments on Percentage of target public laboratories under the project for which key energy efficient delivered, installed, and HR achieving targets equipment types have been procured, delivered, installed, and human resources in facilities in facilities received received operational training from the vendor, where applicable. operational training (Percentage) 0% Oct/2023 Baseline data 09-Aug-2024 Baseline data 09-Aug-2024 80% Dec/2028 apply - no apply - no update to update to Percentage of facilities date. date. (Labkesmas) in which DM Comments on The "Percentage of facilities (Labkesmas tier 2) in which DM tests are regularly reported tests are regularly reported achieving targets through the dedicated Data Recording and Reporting System" refers to the proportion of (Percentage) Labkesmas (tier 2) where test results for Diabetes Mellitus (DM) (including zero case/sero test) are regularly, according to the relevant regulation, reported through the dedicated data recording and reporting system. Component 4: Project Management, Administration, Digitization and Training Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year 4,221,115 Oct/2023 Baseline data 09-Aug-2024 Baseline data 09-Aug-2024 4,500,000 Dec/2029 reported apply - no apply - no reported screenings update to update to screenings Number of high-risk date. date. (Annual) pregnancy screenings Comments on It refers to the screenings for pregnant individuals that are conducted in healthcare facilities reported by facilities achieving targets to identify pregnancies that may have an increased risk of complications. These screenings (Number) are performed to assess factors such as maternal age, medical history, and specific conditions that may increase complications during pregnancy, allowing healthcare providers to appropriate care/monitoring. Aug 27, 2024 Page 7 of 10 The World Bank Implementation Status & Results Report Indonesia Health Systems Strengthening Project (P180811) The share of feedback, Yes Oct/2023 Baseline data 14-Feb-2024 Baseline data 14-Feb-2024 Yes Dec/2029 grievances, inquiries, and apply - no apply - no other interactions submitted update to update to using LAPOR that have been date. date. adequately responded Comments on It aims to ensure cases of feedback, grievances, inquiries, and other interactions submitted remains above 90 percent achieving targets using LAPOR in relation to their interactions with healthcare services provided by the throughout project primary care centers, hospitals, and laboratories, to which an adequate response has been implementation (Yes/No) given. The details will be clarified in the POM. Aug 27, 2024 Page 8 of 10 The World Bank Implementation Status & Results Report Indonesia Health Systems Strengthening Project (P180811) 7. DATA ON FINANCIAL PERFORMANCE 7.1 Cumulative Disbursements 7.2 Disbursements (by loan) Loan/Credit/TF Status Original Revised Cancelled Disbursed Undisbursed % Disbursed IBRD-96260 Effective 1,484.00 1,484.00 0.00 7.72 1,476.51 0.52% 7.3 Key Dates (by loan) Loan/Credit/TF Status Approval Signing Effectiveness Orig. Closing Rev. Closing IBRD-96260 Effective 08-Dec-2023 31-Dec-2023 31-Dec-2023 30-Jun-2029 30-Jun-2029 8. KEY DATES Aug 27, 2024 Page 9 of 10 The World Bank Implementation Status & Results Report Indonesia Health Systems Strengthening Project (P180811) Key Events Planned Actual Approval 08-Dec-2023 08-Dec-2023 Effectiveness 04-Jan-2024 04-Jan-2024 Mid-Term Review No. 01 30-Jun-2026 Operation Closing/Cancellation 30-Jun-2029 9. RESTRUCTURING HISTORY 10. ASSOCIATED OPERATION(S) There are no associated operations Aug 27, 2024 Page 10 of 10