The World Bank Implementation Status & Results Report Supporting Effective Universal Health Coverage in Argentina (P163345) Supporting Effective Universal Health Coverage in Argentina (P163345) LATIN AMERICA AND CARIBBEAN | Argentina | IBRD/IDA | Investment Project Financing (IPF) | FY 2018 | Seq No: 14 | Archived on 30-Aug-2024 | ISR01416 Implementing Agencies: National Ministry of Health 1. OBJECTIVE 1.1 Development Objective Original Development Objective (Approved as part of Approval package on 17-May-2018) The Development Objective of the proposed Project would be to: (i) increase effective and equitable coverage of key health services provided to the eligible population; and (ii) increase the institutional capacity of the MSN and MSPs to implement mechanisms for an integrated delivery system. Has the Development Objective been changed since Board Approval of the Project Objective? No 2. COMPONENTS Name Support the Strengthening of Effective Public Health Coverage:(Cost 493,240,000.00) Strengthening the Institutional Capacity of the National and Provincial Ministries of Health:(Cost 110,960,000.00) Supporting Management, Monitoring and Evaluation:(Cost 53,100,000.00) 3. OVERALL RATINGS Name Previous Current Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Moderately Satisfactory Moderately Satisfactory Overall Risk Rating --- Moderate 4. KEY ISSUES & STATUS Aug 30, 2024 Page 1 of 8 The World Bank Implementation Status & Results Report Supporting Effective Universal Health Coverage in Argentina (P163345) 4.1 Implementation Status and Key Decisions The Supporting Effective Universal Health Coverage in Argentina (P163345) Project is financed by two IBRD loans: a US$300 million IBRD loan approved by the WB Board of Directors on May 18, 2018 and declared effective on December 17, 2018, and an additional loan for US$250 million that was approved by the WB Board of Executive Directors on March 30, 2021. The Project was originally designed to support the Government of Argentina to increase effective and equitable coverage of key health services provided to the eligible population and to increase the institutional capacity of the National and Provincial Ministries of Health to implement mechanisms for an integrated health service delivery system. . The additional loan has helped to reduce the impact of the COVID-19 pandemic on essential health service delivery in the country and, in particular, improved care for maternal and child health and chronic conditions. Significant progress has been achieved across all key indicators, with an increased percentage of the eligible population now having effective health coverage, a higher rate of hypertension diagnosis among adults in regions with the poorest health outcomes, and improved institutional capacity leading to a greater proportion of the population being empaneled for continuous care. 5. SYSTEMATIC OPERATIONS RISK-RATING TOOL Rating at Approval Last Approved Rating Risk Category Approval Package - RP Seq. 03 - 23 Apr Proposed Rating 18 May 2018 2024 Political and Governance Moderate  Moderate Macroeconomic Moderate  High Sector Strategies and Policies Low  Low Technical Design of Project or Program Substantial  Moderate Institutional Capacity for Implementation and Substantial  Substantial Sustainability Fiduciary Substantial  Substantial Environment and Social Moderate Moderate Moderate Stakeholders Moderate  Moderate Overall Substantial  Moderate Aug 30, 2024 Page 2 of 8 The World Bank Implementation Status & Results Report Supporting Effective Universal Health Coverage in Argentina (P163345) 6. RESULTS 6.1 PDO Indicators by PDO Outcomes Increase effective and equitable coverage of key health services provided to the eligible population Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Percentage of eligible 26.70 Sep/2017 33.00 31-Dec-2023 35.00 Dec/2023 population with effective Comments on Still needs to be updated based on Provincial actualization health coverage. achieving targets (Percentage) Percentage of eligible adults 0.00 Oct/2017 21.50 31-Aug-2023 18.00 Dec/2023 with hypertension that are Comments on Project End Target achieved. Preliminary data as Program's information system (SIRGE) is diagnosed, in regions with achieving targets slowly being updated with the services delivered and invoiced by the Provinces in 2023 due poorest health outcomes to server migration done during June 2023 to December 2023. (Percentage) Increase institutional capacity to implement mechanisms for an integrated delivery system Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Percentage of eligible 0.00 Oct/2017 12.00 31-Dec-2023 12.00 Dec/2023 population enrolled and Comments on Project End Target achieved assigned to a health facility, achieving targets for continuous care (“empaneled”). (Percentage) 6.2 Intermediate Results Indicators by Components Aug 30, 2024 Page 3 of 8 The World Bank Implementation Status & Results Report Supporting Effective Universal Health Coverage in Argentina (P163345) Support the Strengthening of Effective Public Health Coverage Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Percentage of eligible 14.70 Sep/2017 38.80 31-Aug-2022 22.00 Dec/2023 pregnant women with early Comments on Project End Target achieved. The figure reported is preliminary as Program's information antenatal care. achieving targets system (SIRGE) is slowly being updated with the services delivered and invoiced by the (Percentage) Provinces in 2023 due to server migration done during June 2023 to December 2023. Percentage of eligible women 19.60 Apr/2017 17.60 30-Sep-2023 24.00 Dec/2023 25 - 64 years of age with at Comments on On track to achieve the end target. The figure reported is preliminary as Program's least one cervical cancer achieving targets information system (SIRGE) is slowly being updated with the services delivered and invoiced screening according to by the Provinces in 2023 due to server migration done during June 2023 to December 2023. defined protocols. (Percentage) 0.00 Nov/2017 10.10 31-Aug-2023 15.00 Dec/2023 Percentage of eligible Comments on The MSN is working with the MSPs on action plans to address its weak performance. Also, population with hypertension achieving targets this information is prelimiary as Program's information system (SIRGE) is slowly being under treatment. updated with the services delivered and invoiced by the Provinces in 2023 due to server (Percentage) migration done during June 2023 to December 2023. Percentage of participating 0.00 Dec/2017 100.00 30-Sep-2023 21.00 Dec/2023 provinces with reported Comments on Project End Target surpassed health services for selected achieving targets key lines of care. (Percentage) Percentage of primary health 0.00 Oct/2017 56.40 31-Dec-2023 60.00 Dec/2023 care providers Comments on On track to achieve the end target georreferenced and with a achieving targets catchment area defined. (Percentage) Aug 30, 2024 Page 4 of 8 The World Bank Implementation Status & Results Report Supporting Effective Universal Health Coverage in Argentina (P163345) Strengthening the Institutional Capacity of the National and Provincial Ministries of Health Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Percentage of participating 0.00 Oct/2017 91.70 31-Dec-2023 37.50 Dec/2023 provinces implementing the Comments on End-Project Target surpassed. However, during March 2024 supervision mission a revision of agreed Interoperability Plan achieving targets this indicator was agreed to align the report to new priorities of the digital health agenda. for Information Systems. (Percentage) Percentage of health facilities 0.00 Oct/2017 22.70 31-Dec-2021 30.00 Dec/2023 with service delivery capacity Comments on Annual Target surpassed. In the next ISR the team will update this indicator as new medical strengthened for key lines of achieving targets equipment has been distributed to health care providers in 2024. care, through medical equipment provision. (Percentage) Percentage of participating 25.00 Oct/2017 54.10 31-Dec-2023 28.00 Dec/2023 public health facilities billing Comments on Project End Target surpassed. to the social security achieving targets institutions. (Percentage) Supporting Management, Monitoring and Evaluation Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Percentage of participating 61.00 Dec/2016 86.90 31-Dec-2023 78.00 Dec/2023 provinces successfully Comments on Project End Target surpassed. meeting their annual IPP achieving targets goals. (Percentage) Percentage of participating 54.00 Dec/2016 83.30 31-Dec-2023 79.00 Dec/2023 provinces implementing Comments on Project End Target surpassed. Although this indicator is still being measured as parts of the actions to disseminate achieving targets Results Framework, another citizen engagement indicator has been agreed upon and is information on the Project’s monitored as well, to comply with the WB Corporate Commitment. Aug 30, 2024 Page 5 of 8 The World Bank Implementation Status & Results Report Supporting Effective Universal Health Coverage in Argentina (P163345) grievance redress mechanism. (Percentage) Aug 30, 2024 Page 6 of 8 The World Bank Implementation Status & Results Report Supporting Effective Universal Health Coverage in Argentina (P163345) 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-92220 Effective 250.00 250.00 0.00 250.00 0.00 100.00% IBRD-88530 Effective 300.00 300.00 0.00 279.16 20.84 93.05% 7.3 Key Dates (by loan) Loan/Credit/TF Status Approval Signing Effectiveness Orig. Closing Rev. Closing IBRD-88530 Effective 18-May-2018 17-Dec-2018 17-Dec-2018 31-Dec-2022 30-Nov-2024 Aug 30, 2024 Page 7 of 8 The World Bank Implementation Status & Results Report Supporting Effective Universal Health Coverage in Argentina (P163345) IBRD-92220 Effective 30-Mar-2021 21-Jul-2021 26-Aug-2021 31-Dec-2023 30-Nov-2024 8. KEY DATES Key Events Planned Actual Approval 18-May-2018 18-May-2018 Effectiveness 19-Sep-2018 17-Dec-2018 Mid-Term Review No. 01 22-Nov-2021 22-Nov-2021 Operation Closing/Cancellation 30-Nov-2024 9. RESTRUCTURING HISTORY Restructuring Level 2 Approved on 22-Apr-2024 Restructuring Level 2 Approved on 08-Nov-2023 Restructuring Level 2 Approved on 13-Aug-2020 10. ASSOCIATED OPERATION(S) There are no associated operations Aug 30, 2024 Page 8 of 8