The World Bank Implementation Status & Results Report Mali - Accelerating Progress Towards Universal Health Coverage (P165534) Mali - Accelerating Progress Towards Universal Health Coverage (P165534) WESTERN AND CENTRAL AFRICA | Mali | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2019 | Seq No: 11 | ARCHIVED on 15-Dec-2023 | ISR58810 | Implementing Agencies: Ministère de la Santé et du Développement Social, Republic of Mali Key Dates Key Project Dates Bank Approval Date: 19-Mar-2019 Effectiveness Date: 27-Dec-2019 Planned Mid Term Review Date: 02-May-2022 Actual Mid-Term Review Date: 03-May-2022 Original Closing Date: 31-Dec-2023 Revised Closing Date: 30-Jun-2024 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The objective of the project is to improve the utilization and quality of reproductive, maternal, neonatal, child, adolescent health and nutrition services, especially among the poorest households, in targeted areas. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Strengthening Health Service Delivery through Performance Based Financing:(Cost $67.40 M) Strengthening Community Health Activities:(Cost $10.00 M) Strengthening Stewardship for Improved Health System Performance:(Cost $12.00 M) Contingent Emergency Response (CERC) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Highly Satisfactory Overall Implementation Progress (IP) Satisfactory Highly Satisfactory Overall Risk Rating Substantial Moderate Implementation Status and Key Decisions Project implementation has shown remarkable progress across its components and objectives. Notably, all five indicators aligned with the project objectives have exceeded their end-of-project targets, except for a vaccination sub-indicator due to antigen shortages. Eight intermediate indicators have achieved their end-project goals, with the remaining five making steady progress. Component 1, focusing on health service strengthening through performance-based financing, has seen outstanding service provision enhancements. Component 2, centered on community health activities, demonstrates substantial advancements in digitalizing health services, evident in the deployment of the DISC-Mali tool and its integration into the national health system. This support facilitated the targeting of new family planning users, aided nutritional interventions for thousands of children, and provided essential training and support across various health-related sectors. Meanwhile, Component 3's efforts in enhancing health system performance and management have been commendable, involving diverse activities such as data collection, workforce training, and the establishment of committees for identifying indigents and promoting health service utilization among beneficiaries. 12/15/2023 Page 1 of 8 The World Bank Implementation Status & Results Report Mali - Accelerating Progress Towards Universal Health Coverage (P165534) La mise en œuvre du projet a montré des progrès remarquables à travers ses composantes et ses objectifs. Notamment, les cinq indicateurs liés aux objectifs du projet ont dépassé leurs objectifs de fin de projet, à l'exception d'un sous-indicateur de vaccination en raison de pénuries d'antigènes. Huit indicateurs intermédiaires ont atteint leurs objectifs de fin de projet, tandis que les cinq autres progressent régulièrement. La composante 1, axée sur le renforcement des services de santé grâce au financement basé sur la performance, a connu des améliorations remarquables dans la prestation de services. La composante 2, centrée sur les activités de santé communautaire, montre des avancées substantielles dans la numérisation des services de santé, avec le déploiement de l'outil DISC-Mali et son intégration dans le système national de santé. Ce soutien a facilité le ciblage de nouveaux utilisateurs de planification familiale, des interventions nutritionnelles pour des milliers d'enfants, et a fourni une formation et un soutien essentiels dans divers secteurs liés à la santé. Pendant ce temps, les efforts de la composante 3 visant à améliorer la performance et la gestion du système de santé ont été louables, impliquant diverses activités telles que la collecte de données, la formation de la main-d'œuvre et la création de comités pour l'identification des indigents et la promotion de l'utilisation des services de santé parmi les bénéficiaires. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance High High High Macroeconomic Moderate High High Sector Strategies and Policies Moderate Substantial Moderate Technical Design of Project or Program Substantial Substantial Moderate Institutional Capacity for Implementation and Substantial Substantial Moderate Sustainability Fiduciary Substantial Moderate Moderate Environment and Social Moderate Moderate Moderate Stakeholders Moderate Moderate Moderate Other High High High Overall Substantial Substantial Moderate Results PDO Indicators by Objectives / Outcomes Increased utilization of maternal, child, neonatal, and adolescent services IN01368938 ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 2,039,228.00 2,698,305.00 2,500,000.00 12/15/2023 Page 2 of 8 The World Bank Implementation Status & Results Report Mali - Accelerating Progress Towards Universal Health Coverage (P165534) Date 31-Oct-2018 12-Apr-2023 21-Nov-2023 30-Jun-2024 IN01369051 People who have received essential health, nutrition, and population (HNP) services - Female (RMS requirement) (Number, Corporate Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1,019,614.00 1,349,153.00 1,250,000.00 IN01369052 Number of children immunized (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 239,657.00 384,238.00 440,000.00 Date 31-Oct-2018 12-Apr-2023 21-Nov-2023 30-Jun-2024 IN01369053 Number of women and children who have received basic nutrition services (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1,530,655.00 1,929,885.00 1,780,000.00 Date 01-Dec-2012 12-Apr-2023 21-Nov-2023 30-Jun-2024 IN01369054 Number of deliveries attended by skilled health personnel (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 268,916.00 384,182.00 392,000.00 Date 31-Oct-2018 12-Apr-2023 21-Nov-2023 30-Jun-2024 IN01369055 ►Percentage of girls, aged 15-19, who are currently using any method of contraception (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 5.80 13.00 16.00 13.50 Date 31-Oct-2018 12-Apr-2023 21-Nov-2023 30-Jun-2024 Improve the quality of health services in targeted areas. IN01368937 ►Percentage of pregnant women receiving at least 4 antenatal care visits from health provider (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 13.30 36.00 36.00 25.00 Date 31-Oct-2018 12-Apr-2023 21-Nov-2023 30-Jun-2024 IN01368940 12/15/2023 Page 3 of 8 The World Bank Implementation Status & Results Report Mali - Accelerating Progress Towards Universal Health Coverage (P165534) ►Average score of the quality of care checklist (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 66.00 81.00 70.00 Date 31-Dec-2018 12-Apr-2023 21-Nov-2023 30-Jun-2024 Increased utilization of essential health services among the poorest households. IN01368939 ►Number of indigents managed within PBF health facilities (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 30,000.00 98,891.00 221,163.00 106,000.00 Date 31-Oct-2018 12-Apr-2023 21-Nov-2023 30-Jun-2024 This indicator was revised during the second restructuring to take into account the number of indigents Comments: (RAMED beneficiary) individuals instead of the number of RAMED beneficiary households. Overall Comments PDO The five PDO indicators have exceeded their end-of-project targets. However, the sub-indicator on vaccination is below the expected level due to antigen stockouts. Intermediate Results Indicators by Components Strengthening Health Service Delivery through Performance Based Financing at Facility Level IN01369056 ►Health facilities receiving PBF grants on time (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 28.00 76.00 80.00 Date 31-Oct-2018 12-Apr-2023 21-Nov-2023 30-Jun-2024 The delay is explained by the time need to restructure the project and raise ceiling for the Netherlands Comments: trust fund (MDTF). IN01369059 ►Number of new curative consultations per capita/year (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.20 0.41 0.29 0.40 Date 31-Oct-2018 12-Apr-2023 21-Nov-2023 30-Jun-2024 IN01369061 12/15/2023 Page 4 of 8 The World Bank Implementation Status & Results Report Mali - Accelerating Progress Towards Universal Health Coverage (P165534) ►Percentage of facilities with 100% tracer drugs available in targeted health facilities on the day of the visit (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 65.00 86.00 40.00 Date 31-Oct-2018 12-Apr-2023 21-Nov-2023 30-Jun-2024 IN01369064 ►Percentage of health facilities benefiting from quarterly technical supervision visits by district health services (ECD) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 50.00 94.00 99.00 80.00 Date 31-Oct-2018 12-Apr-2023 21-Nov-2023 30-Jun-2024 IN01369067 ►Number of CHWs benefiting from a supervision (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1,534.00 3,123.00 3,000.00 Date 31-Oct-2018 12-Apr-2023 21-Nov-2023 30-Jun-2024 Note: there was an error in calculation of previous report. Value of the indicator for November 22 Comments: (previous ISR) should read as 647 instead of 5,384 IN01369068 ►Percentage of beneficiaries satisfied with quality of services provided in health facilities (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 88.00 87.00 75.00 Date 31-Oct-2018 12-Apr-2023 21-Nov-2023 30-Jun-2024 Strengthening Community Health Activities IN01369057 ►Number of households receiving CHW home visits (Number (Thousand), Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 390.20 494.43 335.00 Date 31-Oct-2018 12-Apr-2023 21-Nov-2023 30-Jun-2024 IN01369060 ►Percentage of children under 5 with confirmed malaria who received an appropriate antimalarial treatment (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 99.45 99.80 70.00 12/15/2023 Page 5 of 8 The World Bank Implementation Status & Results Report Mali - Accelerating Progress Towards Universal Health Coverage (P165534) Date 31-Oct-2018 12-Apr-2023 21-Nov-2023 30-Jun-2024 Percentage of children under 5 with confirmed malaria who received antimalarial treatment within 24 Comments: hours of symptom onset. IN01369062 ►Number of Couple-Year Protections (CYP) reached through project interventions (Number (Thousand), Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 715.60 1,045.08 743.00 Date 31-Oct-2018 12-Apr-2023 21-Nov-2023 30-Jun-2024 IN01369065 ►Percentage of children aged 6-59 months screened by community health workers for acute malnutrition (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 50.00 89.00 91.00 90.00 Date 31-Oct-2018 12-Apr-2023 21-Nov-2023 30-Jun-2024 Institutional strengthening for improved stewardship and health system performance IN01369058 ►Timely completion rate of monthly primary care health facilities DHIS2 reports (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 50.00 81.00 79.00 90.00 Date 31-Oct-2018 12-Apr-2023 21-Nov-2023 30-Jun-2024 IN01369063 ►Number of private health facilities assessed for accreditation by MoH (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 273.00 167.00 210.00 Date 31-Oct-2018 12-Apr-2023 21-Nov-2023 30-Jun-2024 IN01369066 ►Percentage of health facilities producing quarterly action-plans validated by Contract Development and Verification Agency (CDVA) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 87.00 96.00 95.00 Date 31-Oct-2018 12-Apr-2023 21-Nov-2023 30-Jun-2024 The indicator label (and formula) changed from Q3 of 2022. Hence the comparison with previous values is Comments: not possible. Overall Comments IR 12/15/2023 Page 6 of 8 The World Bank Implementation Status & Results Report Mali - Accelerating Progress Towards Universal Health Coverage (P165534) Eight intermediate results indicators have reached their end-of-project targets; the remaining five are on track. Most indicators have met their targets or are very close to doing so. Performance-Based Conditions Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P165534 IDA-D4420 Effective USD 50.00 50.00 0.00 45.76 2.69 94% P165534 TF-A9738 Effective USD 10.00 10.00 0.00 9.04 0.96 90% P165534 TF-B3548 Effective USD 30.40 30.40 0.00 24.82 5.58 82% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P165534 IDA-D4420 Effective 19-Mar-2019 31-May-2019 27-Dec-2019 31-Dec-2023 30-Jun-2024 P165534 TF-A9738 Effective 19-Mar-2019 31-May-2019 27-Dec-2019 31-Dec-2021 30-Jun-2024 P165534 TF-B3548 Effective 31-May-2019 07-Jan-2021 07-Jan-2021 31-Dec-2023 30-Jun-2024 Cumulative Disbursements 12/15/2023 Page 7 of 8 The World Bank Implementation Status & Results Report Mali - Accelerating Progress Towards Universal Health Coverage (P165534) Restructuring History Level 2 Approved on 22-Jun-2020 ,Level 2 Approved on 27-Apr-2021 ,Level 2 Approved on 19-Sep-2022 ,Level 2 Approved on 31-Jul-2023 Related Project(s) There are no related projects. 12/15/2023 Page 8 of 8