The World Bank Implementation Status & Results Report Health Service Delivery Network Project (P164453) Health Service Delivery Network Project (P164453) LATIN AMERICA AND CARIBBEAN | Bolivia | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2018 | Seq No: 10 | ARCHIVED on 28-Sep-2023 | ISR57374 | Implementing Agencies: Ministry of Health, Ministry of Health - Agencia de Infraestructura en Salud y Equipamiento Medico (AISEM), Plurinational State of Bolivia Key Dates Key Project Dates Bank Approval Date: 14-Jun-2018 Effectiveness Date: 21-Mar-2019 Planned Mid Term Review Date: 14-Mar-2022 Actual Mid-Term Review Date: 20-Apr-2022 Original Closing Date: 31-Jul-2023 Revised Closing Date: 31-Jan-2024 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The project development objective (PDO) is to improve access to, and quality of, health service delivery in selected health networks. 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 improve access to, and quality of, health service delivery in selected health networks and to respond to the threat posed by COVID-19 Components Table Name Strengthening Health Service Delivery Networks:(Cost $108.00 M) Improving Quality of Health Service Delivery and Human Resource Capacity Development:(Cost $14.00 M) Project Management:(Cost $8.00 M) Strenthening Public Health Emergency Response to COVID-19:(Cost $170.00 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Moderately Unsatisfactory Moderately Unsatisfactory Overall Implementation Progress (IP) Moderately Unsatisfactory Moderately Unsatisfactory Overall Risk Rating High High Implementation Status and Key Decisions The Bolivia Health Service Delivery Network Project is financed by a US$48 million IDA credit (IDA-62480) and a US$252 million IBRD loan (IBRD- 88680), approved by the Board of Directors on June 14, 2018, and declared effective on March 21, 2019, with an original closing date of July 31, 2023. The Project was designed to improve access to, and quality of, health service delivery in selected health networks. The Project was restructured twice in March and April 2020, respectively, to reallocate US$170 million (56.6 percent of the total Project financing) to a new Project component to support critical activities related to the COVID-19 pandemic response. On July 31, the Bank approved a request from the Government to extend the Project closing date until January 31, 2024 which will allow the orderly closing of activities under the Project. 9/28/2023 Page 1 of 6 The World Bank Implementation Status & Results Report Health Service Delivery Network Project (P164453) The Project is now comprised of four components: (1) Strengthening Health Service Delivery Networks; (2) Improving Quality of Health Service Delivery and Human Resource Capacity Development; (3) Project Management; and (4) Strengthening of Public Health Emergency Response to COVID-19. The Project Development Objective (PDO) was adjusted accordingly to reflect the broader scope. The Project activities include the: (i) construction of selected new hospitals and primary health care centers in selected municipalities; (ii) the rehabilitation or expansion of existing health facilities in selected health networks; as well as (iii) other activities, such as training for medical specialists, nurses, and other health professionals, development and updating of norms and tools for dissemination, among others. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance Substantial High High Macroeconomic Substantial Substantial Substantial Sector Strategies and Policies Substantial Substantial Substantial Technical Design of Project or Program Moderate Moderate Moderate Institutional Capacity for Implementation and High High High Sustainability Fiduciary High High High Environment and Social Moderate Moderate Moderate Stakeholders Moderate Moderate Moderate Other -- -- -- Overall High High High Results PDO Indicators by Objectives / Outcomes Improve access to, and quality of, health service and to respond to the threat posed by COVID-19 IN01343072 ►Health facilities of targeted networks aplying updated clinic health standards (normas de atención clínica) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 60.00 Date 31-May-2018 20-Jun-2023 20-Jun-2023 30-Jun-2025 IN01343116 ►Number of diagnosed cases treated per approved COVID-19 protocol (Number, Custom) 9/28/2023 Page 2 of 6 The World Bank Implementation Status & Results Report Health Service Delivery Network Project (P164453) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 15,000.00 15,000.00 15,000.00 Date 30-Mar-2020 20-Jun-2023 20-Jun-2023 30-Jun-2025 IN01343120 ►Network referral centers operational with at least 60% of the required medical staff and providing health services (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 7.00 Date 28-Jun-2018 -- 31-Jul-2023 31-Jul-2023 IN01343122 ►Doctors checking the MoH clinical guidelines application at least once in the last 60 days (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 45.00 Date 28-Jun-2018 -- 28-Jun-2023 31-Jul-2023 Intermediate Results Indicators by Components Strengthening Health Service Delivery Networks IN01343075 ►Grievance Redress Mechanism (GRM) designed and operational available to attend in indigenous languages of the region (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No Yes Yes Yes Date 31-May-2018 16-Dec-2022 16-Dec-2022 31-Jul-2023 IN01343121 ►New hospitals equipped (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 10.00 Date 28-Jun-2018 -- 31-Jul-2023 31-Jul-2023 IN01343124 ►New hospitals that do not use incineration to treat hospital waste in the targeted networks (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 10.00 Date 28-Jun-2018 -- 31-Jul-2023 31-Jul-2023 9/28/2023 Page 3 of 6 The World Bank Implementation Status & Results Report Health Service Delivery Network Project (P164453) Improving Quality of Health Service Delivery and Human Resource Capacity Development IN01343073 ►Medical specialists enrolled in residency program supported by the project (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 500.00 Date 31-May-2018 23-Jun-2023 23-Jun-2023 30-Jun-2025 IN01343117 ►Healthcare professionales graduated from health diploma programs (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 500.00 Date 31-May-2018 20-Jun-2023 20-Jun-2023 30-Jun-2025 IN01343119 ►Patients reporting being satisfied with health services provided in the targeted networks desagregated by gender (including LGBTI) and self- ethnic identification (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 80.00 Date 31-May-2018 16-Dec-2022 16-Dec-2022 31-Jul-2023 IN01343125 Female patients reporting being satisfied with health services provided in the targeted networks (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 80.00 Date 31-May-2018 16-Dec-2022 16-Dec-2022 31-Jul-2023 IN01343123 ►Number of clinical guidelines updated, approved by the MoHS and officially disseminated (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 7.00 Date 31-May-2018 20-Jun-2023 20-Jun-2023 30-Jun-2025 Strenthening Public Health Emergency Response to COVID-19 IN01343074 ►Number of health facilities equipped to improve response to COVID-19 outbreak (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 110.00 110.00 30.00 9/28/2023 Page 4 of 6 The World Bank Implementation Status & Results Report Health Service Delivery Network Project (P164453) Date 10-Mar-2020 16-Dec-2022 16-Dec-2022 31-Dec-2020 IN01343118 ►Number of regional laboratories equipped to improve response to COVID-19 outbreak (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 3.00 3.00 3.00 Date 10-Mar-2020 16-Dec-2022 16-Dec-2022 31-Dec-2021 Performance-Based Conditions Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P164453 IBRD-88680 Effective USD 252.00 252.00 0.00 124.02 127.98 49% P164453 IDA-62480 Effective USD 48.00 48.00 0.00 2.62 45.38 5.5% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P164453 IBRD-88680 Effective 14-Jun-2018 21-Dec-2018 21-Mar-2019 31-Jul-2023 31-Jan-2024 P164453 IDA-62480 Effective 14-Jun-2018 21-Dec-2018 21-Mar-2019 31-Jul-2023 31-Jan-2024 Cumulative Disbursements 9/28/2023 Page 5 of 6 The World Bank Implementation Status & Results Report Health Service Delivery Network Project (P164453) Restructuring History Level 2 Approved on 22-Mar-2020 ,Level 2 Approved on 24-Apr-2020 ,Level 2 Approved on 30-Jun-2023 ,Level 2 Approved on 31-Jul-2023 Related Project(s) There are no related projects. 9/28/2023 Page 6 of 6