The World Bank Implementation Status & Results Report Moldova Emergency COVID-19 Response Project (P173776) Moldova Emergency COVID-19 Response Project (P173776) EUROPE AND CENTRAL ASIA | Moldova | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2020 | Seq No: 8 | ARCHIVED on 28-Nov-2023 | ISR58613 | Implementing Agencies: Ministry of Health, Republic of Moldova Key Dates Key Project Dates Bank Approval Date: 24-Apr-2020 Effectiveness Date: 28-May-2020 Planned Mid Term Review Date: 23-Feb-2022 Actual Mid-Term Review Date: 23-Feb-2022 Original Closing Date: 30-Apr-2022 Revised Closing Date: 31-Mar-2024 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The objectives of the Project are to prevent, detect and respond to the threat posed by the COVID-19 pandemic in Republic of Moldova. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Emergency COVID-19 Response:(Cost $90.78 M) Implementation Management and Monitoring and Evaluation:(Cost $0.60 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 Substantial Substantial Implementation Status and Key Decisions Progress towards achievement of the project development objective and implementation progress are both rated Moderately Satisfactory. One remaining PDO indicator is “Number of designated hospitals with fully equipped and functional ICUs” (currently 14 out of 19 achieved). Similarly, IR 10 “Percentage of individuals that will accept a safe and effective COVID-19 vaccine”, IR 14 “Number of public health warehouses built or rehabilitated”, and IR 15 “Number of public health centers renovated” remain to be achieved. Both performance-based conditions have been accomplished. As of November 21, 2023, the overall disbursement level for the project has reached 76% of total financing. The project supported the procurement of laboratory equipment, diagnostic supplies, and vehicles to transport diagnostic samples from regions. It has financed personal protective equipment and disinfectants for health personnel, ambulances, computer tomography systems, and equipment for intensive care units (ventilators, syringe pumps, pulse oximeters, oxygen generators, mobile X-rays, functional beds, etc.). Refurbishment of select intensive care units is ongoing and: works continue in 5 out of 11 locations. 11/28/2023 Page 1 of 9 The World Bank Implementation Status & Results Report Moldova Emergency COVID-19 Response Project (P173776) MPA Program Development Objective MPA PDO Table The Program Development Objective is to prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness MPA Table Multiphase Programmatic Approach (MPA) Status MPA Table Body Sustained efforts continue to be made to advance the implementation of the 87 MPA operations. After a great deal of activity (restructurings and disbursements) processed at the end of FY23 when several operations were restructured just before or on June 30, 2023, the past three months have seen a slower period of disbursements. The overall level of disbursements is being affected by three main reasons: (i) low disbursements in six countries, (ii) pausing of disbursements in two other countries – Afghanistan, and Myanmar, and (iii) processing of refunds to the project accounts at this late stage of project implementation. In addition, (i) a large refund from the UN to the project account of the Myanmar operation was processed in late March due to the inability to implement the project, and (ii) the amounts of Loans and Credits denominated in SDRs and Euros have been affected because of fluctuations between the SDRs and Euros against the US dollar. As of November 16, 2023, 88 MPA-projects had been approved with a total commitment of US$4.27 billion. One operation (Guatemala) was cancelled in mid-September 2021, at the request of the Government. Total disbursements as of November 16, 2023, amount to US$3.97 billion or 93% of overall commitments. This amount does not include disbursements under MPA-V operations which are reported together with AF-V operations. Ten operations closed by the end of CY22 and nine operations closed on June 30, 2023. While there are thirteen (13) operations with closing dates by the end of CY23, there are plans for some projects to process extensions so this number will change. As with the Mid Term Review (MTR) issued on March 25, 2023, no individual COVID-19 MPA operation will need an ICR. Only one ICR will be prepared upon completion of the SPRP COVID-19 MPA Program, which closes on December 31, 2025. The Global ICR will be based on final ISRs packages prepared by country operations’ teams. A template for the final ISR was issued by OPCS on March 21, 2023. Several operations have/are preparing final ISR packages. The overall conclusion of the MTR was that: (i) the COVID-19 MPA Program embodied a rapid, innovative approach to new lending for human health response; (ii) the COVID-19 MPA has been successful, notwithstanding considerable uncertainty and multiple constraints in the early stages of the pandemic; (iii) the Bank’s emergency response was remarkably swift in the most vulnerable countries facing human capital losses and development setbacks; and (iv) notwithstanding the challenges, the MPA is on track to achieve its PrDO, “prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness.“ Seventy-three (73) country projects or 86 percent of projects approved have reached 70-100+ percent disbursement (reasons for 100% disbursements relate to fluctuations between the Euro and the SDR against the US$). Out of the 73 operations, 63 operations or 86 percent have disbursed 90+ percent of commitments. Out of the 73 operations, 49 operations or 67 percent are fully disbursed and ten (10) operations have disbursed 95-99 percent of commitments. There are four operations with disbursements of 50 percent or less. Out of these four operations, one operation has disbursed 35 percent (AFW), two operations in EAP have disbursed 46-48 percent and one operation in SAR has disbursed 49 percent. The projects are benefitting about 3.7 billion people or 50% of the global population. When countries with AF-V operations are counted, the projects are benefitting about 4.1 billion of 51 percent of the global population. This is because some countries that do not have a parent project have AF-V operations. All projects approved are disbursing. Operations in ECA and MNA are fully disbursed. In other regions, disbursements have reached: (i) LAC 97 percent, (ii) SAR 95 percent, (iii) EAP 87 percent, (iv) AFW 85 percent, and (v) AFE 79 percent. Disbursements for EAP operations are being affected by low disbursements in three country projects that have disbursed between 46 and 56 percent. AFE lower disbursements compared to other regions are a result of low disbursements under two operations, which have disbursed 55-66 percent respectively. In the case of AFW low overall disbursements are a result of low disbursements under one operation (35 percent). Retroactive Financing (RF) represents 20 percent of commitments. SAR has the highest percentage of RF at 37 percent, followed by ECA at 18 percent. Direct 11/28/2023 Page 2 of 9 The World Bank Implementation Status & Results Report Moldova Emergency COVID-19 Response Project (P173776) Payment (DP) disbursements represent 22 percent of commitments. EAP has the highest level of disbursements using DP – 80 percent, followed by AFW at 38 percent. IDA continues to represent 40 percent while IBRD represents 60 percent of disbursements. Streamlined procedures, delegated approvals, coupled with flexible project design and intensified efforts by counterparts and Bank teams have contributed to the progress. Implementation is being guided by Bank teams working in parallel with other health related projects, including Additional Financing operations which have supported vaccine procurement and deployment efforts. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance Substantial Moderate Moderate Macroeconomic High Substantial Substantial Sector Strategies and Policies Moderate Moderate Moderate Technical Design of Project or Program Moderate Moderate Moderate Institutional Capacity for Implementation and Moderate Moderate Moderate Sustainability Fiduciary Substantial Substantial Substantial Environment and Social Substantial Substantial Substantial Stakeholders Moderate Moderate Moderate Other Moderate Moderate Moderate Overall Substantial Substantial Substantial Results PDO Indicators by Objectives / Outcomes To prevent, detect, and respond to the threat posed by the COVID-19 pandemic IN01363421 ►Number of designated hospitals with fully equipped and functional intensive care units (ICUs). (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 14.00 14.00 19.00 Date 24-Apr-2020 10-May-2023 10-Nov-2023 31-Mar-2024 IN01363422 ►Percentage of designated hospitals with personal protection equipment and infection control products and supplies (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target 11/28/2023 Page 3 of 9 The World Bank Implementation Status & Results Report Moldova Emergency COVID-19 Response Project (P173776) Value 0.00 90.00 90.00 80.00 Date 24-Apr-2020 10-May-2023 10-May-2023 30-Apr-2023 This indicator was achieved in 2022. Comments: IN01363423 ►Number of people tested for coronavirus (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 8,149.00 3,794,249.00 3,794,249.00 250,000.00 Date 24-Apr-2020 20-Oct-2022 20-Oct-2022 30-Apr-2023 This indicator was achieved in 2022. Comments: IN01363424 ►Number of Ajutor Social recipients during the emergency period (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 47,569.00 71,802.00 71,802.00 65,000.00 Date 24-Apr-2020 20-Oct-2022 20-Oct-2022 30-Apr-2023 This indicator was achieved in 2022. Comments: Intermediate Results Indicators by Components Emergency COVID-19 Response IN01363425 ►Number of ventilators purchased (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 292.00 292.00 292.00 Date 24-Apr-2020 20-Oct-2022 20-Oct-2022 30-Apr-2023 This indicator was achieved in 2022. Comments: IN01363426 ►Number of personal protection equipment (PPE) purchased. (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 500,000.00 500,000.00 500,000.00 Date 24-Apr-2020 20-Oct-2022 20-Oct-2022 30-Apr-2023 This indicator was achieved in 2022. Comments: 11/28/2023 Page 4 of 9 The World Bank Implementation Status & Results Report Moldova Emergency COVID-19 Response Project (P173776) IN01363427 ►Number of designated laboratories with COVID-19 diagnostic equipment, test kits, and reagents per MoHLSP guidelines. (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 5.00 5.00 4.00 Date 24-Apr-2020 20-Oct-2022 20-Oct-2022 30-Apr-2023 This indicator was achieved in 2022. Comments: IN01363428 ►Number of activities in National Communications Strategy for COVID-19 implemented (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 44.00 44.00 10.00 Date 24-Apr-2020 20-Oct-2022 20-Oct-2022 30-Apr-2023 This indicator was achieved in 2022. Comments: IN01363429 ►Number of Ajutor Social recipients (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 47,659.00 54,231.00 54,231.00 53,000.00 Date 24-Apr-2020 20-Oct-2022 20-Oct-2022 30-Apr-2023 This indicator was achieved in 2022. Comments: IN01363430 ►Budget Allocation for Ajutor Social Program (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Value MDL 495,461,700 MDL 708,749,800 MDL 708,749,800 MDL 697,361,700 Date 24-Apr-2020 20-Oct-2022 20-Oct-2022 30-Apr-2023 This indicator was achieved in 2022. Comments: IN01363431 ►Average Ajutor Social benefit amount (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Value MDL 828 MDL 1079 MDL 1079 MDL 1099 Date 24-Apr-2020 20-Oct-2022 20-Oct-2022 30-Apr-2023 This indicator was achieved in 2022. Comments: IN01363432 11/28/2023 Page 5 of 9 The World Bank Implementation Status & Results Report Moldova Emergency COVID-19 Response Project (P173776) ►Percentage of hospitals (i) establishing approved citizen engagement platforms (in-facilities or online), (ii) responding to citizen views (in- facilities or online), and (iii) reporting (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 78.69 78.69 25.00 Date 16-Oct-2020 20-Oct-2022 20-Oct-2022 30-Apr-2023 This indicator was achieved in 2022. Comments: IN01363433 ►Review of the VIRAT-VRAF 2.0 or updated tool, completed (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No Yes Yes Yes Date 15-Feb-2021 20-Oct-2022 20-Oct-2022 30-Apr-2023 This indicator was achieved in 2022. Comments: IN01363434 ►Percentage of individuals that will accept a safe and effective COVID-19 vaccine: (a) Males; and (b) Females (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target (a) 31% (a) 38.8% (a) 38.8% (a) 70% Value (b) 31% (b) 68.2% (b) 68.2% (b) 70% Date 15-Feb-2021 11-May-2023 11-May-2023 30-Apr-2023 At the moment WHO performs another round of the study, and the figures will be available at the Comments: beginning of December. IN01363435 ►Percentage of applicants that have benefited from the Ajutor Social Program that are: (a) Males; and (b) Females (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target (a) 30% (a) 30% (a) 30% (a) 30% Value (b) 70% (b) 70% (b) 70% (b) 70% Date 15-Feb-2021 20-Oct-2022 20-Oct-2022 30-Apr-2023 This indicator was achieved in 2022. Comments: IN01363436 ►Average monthly benefit received by applicants to the Ajutor Social Program: (a) Males; and (b) Females (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Value (a) MDL 708 (a) MDL 981 (a) MDL 981 (a) MDL 800 (b) MDL 874 (b) MDL 1975 (b) MDL 1975 (b) MDL 1000 A correction for the A correction for the actual previous from actual previous from October 20, 2022: October 20, 2022: (a) MDL 958 (a) MDL 958 11/28/2023 Page 6 of 9 The World Bank Implementation Status & Results Report Moldova Emergency COVID-19 Response Project (P173776) (b) MDL 1924 (b) MDL 1924 Date 15-Feb-2021 01-Mar-2023 01-Mar-2023 30-Apr-2023 This indicator was achieved in 2023. Comments: IN01363437 ►Percentage of workers associated with the project who have participated in an information session on the code of conduct (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 78.00 100.00 100.00 Date 15-Feb-2021 11-May-2023 02-Nov-2023 30-Apr-2023 This indicator was achieved in 2023. Comments: IN01363438 ►Number of public health warehouses built or rehabilitated (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 3.00 Date 10-May-2023 10-May-2023 10-Nov-2023 31-Mar-2024 This indicator was introduced during the 2022 restructuring of the project. The civil works are in progress Comments: in planned facilities and are expected to be completed by March 31, 2024. IN01363439 ►Number of public health centers renovated (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 1.00 7.00 Date 11-May-2023 11-May-2023 10-Nov-2023 31-Mar-2024 This indicator was introduced during the 2022 restructuring of the project. The civil works are in progress Comments: in planned facilities and are expected to be completed by March 31, 2024. Performance-Based Conditions IN01363440 ►PBC 1 Supplement budget increasing allocations for the Ajutor Social program by 39% adopted. (Percentage, Outcome, 17,000,000.00, 0.00%) Baseline Actual (Previous) Actual (Current) Completed Value 0.00 39.80 39.80 39.00 Date -- 02-Jun-2020 02-Jun-2020 -- 11/28/2023 Page 7 of 9 The World Bank Implementation Status & Results Report Moldova Emergency COVID-19 Response Project (P173776) IN01363441 ►PBC 2 Increase of the benefit and the coverage by 10% achieved (Percentage, Outcome, 7,000,000.00, 0.00%) Baseline Actual (Previous) Actual (Current) Completed Value 0.00 34.80 34.80 10.00 Date -- 24-Apr-2020 24-Apr-2020 -- Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P173776 IDA-66320 Effective USD 57.90 57.90 0.00 61.93 0.42 99% P173776 IDA-68730 Effective USD 30.00 30.00 0.00 4.72 21.57 18% P173776 TF-B4344 Closed USD 3.48 3.48 0.00 3.48 0.00 100% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P173776 IDA-66320 Effective 24-Apr-2020 28-Apr-2020 28-May-2020 30-Apr-2022 31-Mar-2024 P173776 IDA-68730 Effective 23-Apr-2021 09-Aug-2021 04-Feb-2022 30-Apr-2023 31-Mar-2024 P173776 TF-B4344 Closed 23-Dec-2020 23-Dec-2020 23-Dec-2020 31-Jan-2021 31-Jan-2021 Cumulative Disbursements 11/28/2023 Page 8 of 9 The World Bank Implementation Status & Results Report Moldova Emergency COVID-19 Response Project (P173776) Restructuring History There has been no restructuring to date. Related Project(s) P174761-Moldova Pandemic Emergency Financing for COVID-19 ,P175816-Moldova Emergency COVID-19 Response Project - Additional Financing 11/28/2023 Page 9 of 9