The World Bank Implementation Status & Results Report Primary Health Care Investment Program (P173168) Primary Health Care Investment Program (P173168) WESTERN AND CENTRAL AFRICA | Ghana | Health, Nutrition & Population Global Practice | Requesting Unit: AWCW1 | Responsible Unit: HAWH3 IBRD/IDA | Program-for-Results Financing | FY 2022 | Team Leader(s): Dorothee Chen, Elisha Kipkemoi Ngetich Seq No: 4 | DRAFT | ISR59077 | Created by: Monica Moura Porcidonio Silva on 30-Nov-2023 | Modified by: Monica Moura Porcidonio Silva on 04- Dec-2023 Program Development Objectives PDO Table Program Development Objective (from Program Appraisal Document) To improve the quality, utilization and equity of primary health care services. Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Satisfactory Satisfactory Implementation Status and Key Decisions The Ghana Primary Health Care Investment Program (the Program) was approved by the Government of Ghana’s Cabinet and subsequently by the Parliament on May 2, 2023. The Financing Agreement (FA) and the two Global Financing Facility (GFF) Grant Agreements (GAs) were signed on May 22, 2023. The development and adoption of the Program Operation Manual (POM), which was an effectiveness condition of the Program, has been met, and the Program was declared effective on June 6, 2023. The implementing agencies have made some progress towards the achievement of disbursement-linked results (DLRs) such as the development of preparatory documents (standards, mapping) towards the establishment of NoPs and MoHCs and the completion of ten health Policies, Plans and Standards. There is however a need to both improve reporting systems (DHIMS2 and GILMIS) and address stockouts at lower-level facilities to achieve expected improvements in the availability of essential drugs. A comprehensive action plan to address both above challenges will be shared with the World Bank by January 31, 2024. Additionally, GHS reported that most health centers do not have electricity backup systems, and it was agreed that these will be included in the design of new and rehabilitated MoHCs by April 30, 2024. The approval of an Additional Financing (AF) of US$ 14.815 million is being finalized to accommodate available resources from the GAC, the Gavi Alliance and FCDO. The first tranche of these funds amounting to US$ 5.48 million has been received by the World Bank. The signing and effectiveness of an AF to absorb these funds and an accompanying restructuring of the Program are expected before December 31, 2023. Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P173168 IDA-71450 Effective USD 150.00 150.00 0.00 21.64 128.36 14% P173168 TF-B8557 Effective USD 15.00 15.00 0.00 0.72 14.28 4.8% P173168 TF-B8558 Effective USD 16.00 16.00 0.00 2.31 13.69 14% Key Dates (by loan) 12/21/2023 Page 1 of 18 The World Bank Implementation Status & Results Report Primary Health Care Investment Program (P173168) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P173168 IDA-71450 Effective 10-Jun-2022 22-May-2023 06-Jun-2023 30-Jun-2026 30-Jun-2026 P173168 TF-B8557 Effective 10-Jun-2022 22-May-2023 06-Jun-2023 30-Jun-2026 30-Jun-2026 P173168 TF-B8558 Effective 10-Jun-2022 22-May-2023 06-Jun-2023 30-Jun-2026 30-Jun-2026 DLI Disbursement Achievement Disbursed amount in Disbursement % for DLI ID DLI Type Description Coc DLI Amount Status Coc DLI Loan: TFB8558-001 Health policies,stds&Plans 3 Regular USD 2,050,000.00 Not Achieved 0.00 are dvlpd and Nat H.Insurance sch. cov. 4 Regular USD 2,990,000.00 Not Achieved 0.00 is expded& fin Public Fin.Mgt for PHCS is 5 Regular USD 722,000.00 Not Achieved 0.00 improved imprv.Utilization of 6 Regular USD 7,810,000.00 Not Achieved 0.00 selected.Prim healt capacities,accountability&q 2 Regular USD 2,428,000.00 Not Achieved 0.00 uality of net Program Action Plan MoH shall develop an Environmental and Social Management and Monitoring Framework for Primary Health Care at Action Description the Sub-District level in accordance with the relevant national environmental and social policies, laws and regulations. Source DLI# Responsibility Timing Timing Value Status At the end of the first Environmental and Social MoH, GHS Other year of program Not Yet Due Systems implementation A comprehensive Environmental and Social Management and Monitoring Framework prepared (content is described Completion Measurement in Annex 5 of the PAD) The MoH has shortlisted four E&S assessors. The completion of the recruitment process is expected by December Comments 31, 2023, the delivery of the ESMMF is expected by June 7, 2024. Ministry of Health shall conduct annual E&S audit in accordance with Government of Ghana’s laws, rules and Action Description policies. Source DLI# Responsibility Timing Timing Value Status Every year throughout Environmental and Social MoH, GHS Other the Program Not Yet Due Systems implementation Completion Measurement E&S Audit Report (the scope is described in Annex 5 of the PAD) 12/21/2023 Page 2 of 18 The World Bank Implementation Status & Results Report Primary Health Care Investment Program (P173168) Comments Action Description MoH shall assign and train Focal Persons at regional level to be responsible for environment and social safeguards Source DLI# Responsibility Timing Timing Value Status Assign Focal Personnel during Program inception and maintain these positions throughout Program Environmental and Social implementation. Train MoH, GHS Other Not Yet Due Systems implementing agencies commencing first year of implementation and periodically throughout Program implementation E&S Focal Persons assigned and positions maintained throughout Program Implementation. Training report to show Completion Measurement completion of E&S training. Existing government staff will be appointed as regional focal points instead of appointing new staff. Focal persons will Comments be appointed by January 31, 2024. Completion of training of focal persons is expected by February 28, 2024. Action Description Ministry of Health shall review the Health Sector Gender Policy, prepare an Action Plan to implement the Policy Source DLI# Responsibility Timing Timing Value Status Review and prepare the Action Plan within Environmental and Social the first 18 months of MoH, GHS Other Not Yet Due Systems the Program and implement throughout the Program Completion Measurement Revised Health Sector Gender Policy and Action Plan approved. The policy has been completed with technical support from UNICEF. Outstanding activities include the preparation of Comments an action plan, an M&E plan, stakeholder engagement. The completion of outstanding activities is expected by March 31, 2024. Develop/improve on the Procurement Complaint Management Mechanism as stipulated in Act 663 as amended to Action Description ensure timely follow ups on tracking and handling procurement complaints/disputes. Source DLI# Responsibility Timing Timing Value Status Throughout Program Fiduciary Systems MoH, GHS, NHIA Other Not Yet Due implementation Completion Measurement Annual procurement report 12/21/2023 Page 3 of 18 The World Bank Implementation Status & Results Report Primary Health Care Investment Program (P173168) Standard Operating Procedures have been finalized and will be submitted to Chief Director of the MoH for signing Comments immediately. The next annual procurement report is expected to have an annex on the log of complaints and how they were redressed. Annual Procurement audit to be conducted on procurements undertaken under the Program in accordance with the Action Description Audit Service Act and Regulations, including (when necessary) hire a firm to carry out annual Independent Procurement Audit. Source DLI# Responsibility Timing Timing Value Status Each year throughout Fiduciary Systems MoH, GHS Other Program Not Yet Due implementation Completion Measurement Annual Procurement Audit report MoH’s Finance Department has drafted a letter, which is expected to be signed by the Chief Director of the MoH Comments immediately after the mission. The MoH will clarify by December 31, 2023 if an independent consultant will be required. Action Description Develop a Procurement Management information System to track and monitor Procurement. Source DLI# Responsibility Timing Timing Value Status Throughout Program Fiduciary Systems MoH, GHS Other Not Yet Due implementation Completion Measurement Annual Procurement Implementation Plans The TORs for the development of the procurement management information system will be finalized by December Comments 15, 2023. The staff of Budget Management Centres (BMCs) at the sub-district level will receive training in planning, budgeting, Action Description financial management and reporting including training on GIFMIS Source DLI# Responsibility Timing Timing Value Status Throughout Program Fiduciary Systems MoH, GHS Other Not Yet Due implementation Completion Measurement Training reports A training of trainers has just been completed and downstream training is yet to be conducted. Again, MoH and GHS Comments need to ensure complementarity between their respective training activities. The role of the financial monitoring units at the regional level is strengthened to do periodic validation of Internally- Action Description Generated Funds and other revenues collected by sub-district BMCs Source DLI# Responsibility Timing Timing Value Status Throughout Program Fiduciary Systems MoH,GHS Other Not Yet Due implementation 12/21/2023 Page 4 of 18 The World Bank Implementation Status & Results Report Primary Health Care Investment Program (P173168) Completion Measurement Ministry of Health annual financial report MoH and GHS need to ensure complementarity between their respective training activities. MoH’s revised workplan is Comments expected to include FM-related activities to support the achievement of this action. Action Description Increase information technology training for internal auditors at Budget Management Centres Source DLI# Responsibility Timing Timing Value Status Within the first year of Fiduciary Systems MoH, GHS Other program Not Yet Due implementation Completion Measurement Training report The completion of training of internal auditors is expected by March 31, 2023. This may be included in the MoH’s Comments revised workplan under the IPF component, or alternative sources of funds may be used (advance and or disbursement against results). Strengthen Audit Committees, including training on IT at all levels of implementation, particularly at the district and Action Description sub-district levels. Source DLI# Responsibility Timing Timing Value Status MoH, GHS and Throughout Program Fiduciary Systems Other Not Yet Due NHIA, and BMCs implementation Completion Measurement Training report Comments The MoH is expected to submit a training plan by December 31, 2023. Action Description The periodic financial report of the implementing agencies should reflect the Program’s IDA, GFF and MDTF funds. Source DLI# Responsibility Timing Timing Value Status Throughout Program Fiduciary Systems MoH, GHS Other Not Yet Due implementation Completion Measurement Half-year financial report separately indicates the Program funds Comments The Commission on Human Rights and Administrative Justice (CHRAJ) to sign a Memorandum of Understanding Action Description (MoU) with MoH and provide annual reports on corruption and fraud allegations Source DLI# Responsibility Timing Timing Value Status Fiduciary Systems MoH Recurrent Yearly Not Yet Due Completion Measurement Submission of annual reports on corruption and fraud allegations 12/21/2023 Page 5 of 18 The World Bank Implementation Status & Results Report Primary Health Care Investment Program (P173168) This is a new action, which was added through the AF. The MoH will provide clarifications about the way forward and Comments the agreement with CHRAJ by December 31, 2023. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance Low Low Moderate Macroeconomic Substantial Substantial Substantial 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 Moderate Moderate Moderate Environment and Social Moderate Moderate Moderate Stakeholders Low Low Low Other -- -- -- Overall Moderate Moderate Moderate RiskComments Comments The Political and Governance Risk Rating was changed to Moderate as per recommendation by the Country Director and Chair during the Concept Review Meeting of Additional Financing of the Ghana Primary Health Care Investment Program held on September 12, 2023. Results PDO Indicators by Objectives / Outcomes Quality IN01375523 ►Networks of Practice functioning according to the Standards for Networks of Practice (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 350.00 Date 31-Dec-2021 30-Jun-2023 30-Jun-2023 31-Dec-2025 Approved Standards are the Standards for Networks of Practice referenced by DLR 1.1. Networks of Practice will be assessed and categorized into 5 maturity levels according to the maturity model specified as Comments part of Standards for Networks of Practice. Networks of Practice meeting at least maturity level 3 will be considered functioning according to standards. IN01375591 12/21/2023 Page 6 of 18 The World Bank Implementation Status & Results Report Primary Health Care Investment Program (P173168) ►Number of Model Health Centers functioning according to the Standards for Model Health Centers (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 400.00 Date 31-Dec-2021 30-Jun-2023 30-Jun-2023 31-Dec-2025 Approved Standards are the Standards for Model Health Centres referenced by DLR 1.1. Model Health Centres will be assessed and categorized into 5 maturity levels according to the maturity model specified as Comments part of DLR 1.1. Model Health Centres meeting at least maturity level 3 will be considered functioning according to standards. Utilization IN01375524 ►Annual increase in mother/newborn pairs receiving care in facilities providing Quality BEmONC services at the Sub-District level (cumulative) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 50,000.00 Date 31-Dec-2021 30-Jun-2023 30-Jun-2023 31-Dec-2025 Each year, this is the increase from the previous year in the number of mother/newborn pairs that are cared for in facilities that meet the standards for quality BEmONC (designated by the Ghana Health Service as Comments BEmONC-ready), including assessment, stabilization, referral and transport for mother/newborn pairs with complications. IN01375592 ►Annual increase in hypertensive patients diagnosed and referred at health services at the Sub-District and community levels (cumulative) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 120,000.00 Date 31-Dec-2021 30-Jun-2023 30-Jun-2023 31-Dec-2025 Each year, this is the increase from the previous year in the number of hypertensive patients diagnosed and Comments referred at health services at the Sub-District and community levels. IN01375594 Annual increase in the number of hypertensive patients diagnosed and referred at health services at the Sub-District and community levels - female (cumulative) (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 60,000.00 Date 31-Dec-2021 30-Jun-2023 30-Jun-2023 31-Dec-2025 Equity IN01375525 ►Increase in Indigent Persons who are active members of the National Health Insurance Scheme (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 1,200,000.00 Date 31-Dec-2021 30-Jun-2023 30-Jun-2023 31-Dec-2025 This is the increase over the 2021 baseline in the number of people categorized as indigent by the Comments government who are active National Health Insurance Scheme members. 12/21/2023 Page 7 of 18 The World Bank Implementation Status & Results Report Primary Health Care Investment Program (P173168) IN01375593 Increase in Indigent Persons who are active members of the National Health Insurance Scheme - female (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 600,000.00 Date 31-Dec-2021 30-Jun-2023 30-Jun-2023 31-Dec-2025 Intermediate Results Indicators by Results Areas 1. Development of Networks of Practice and Model Health Centres IN01375595 ►Model Health Centres with a solar and/or battery electricity backup system (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 100.00 Date 31-Dec-2021 30-Jun-2023 30-Jun-2023 31-Dec-2025 On the basis of a needs assessment, appropriate electricity back-up systems will be installed to ensure 24- Comments hour electricity supply for Health Centres (including solar energy and battery systems, but excluding diesel/petrol). IN01375598 ►Annual increase in health centers and Model Health Centers that have available selected Essential Medicines at least six (6) months of the Year (cumulative) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 400.00 Date 31-Dec-2021 30-Jun-2023 30-Jun-2023 31-Dec-2025 Each year, this is the increase from the previous year in the annual number of Health Centres/Model Health Comments Centers for which monthly reporting does not show any stock-out of essential tracer medicines in at least six months of the previous year. The target is the cumulative increase over the full implementation period. IN01375601 ►Increase in Physician Assistants at post in Health Centres and Polyclinics (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 680.00 Date 31-Dec-2021 30-Jun-2023 30-Jun-2023 31-Dec-2025 This is the increase from the 2021 baseline in the number of Physician Assistants at post in Health Centres Comments and Polyclinics. IN01375604 ►Annual increase in Networks of Practice that score Green on the Community Scorecard for at least one quarter (cumulative) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 150.00 Date 31-Dec-2021 30-Jun-2023 30-Jun-2023 31-Dec-2025 Each year, this is the increase from the previous year in the number of Networks of Practice that have an Comments overall score of Green for at least one quarter. Each quarter, Community Scorecards will grade the performance of Networks of Practice on a 3-level scale (Red, Yellow, Green) across different dimensions of 12/21/2023 Page 8 of 18 The World Bank Implementation Status & Results Report Primary Health Care Investment Program (P173168) performance, from which an overall grading (of Red, Yellow or Green) will be calculated. The target is the cumulative increase over the full implementation period. IN01375607 ►Annual increase in Networks of Practice that received at least one clinical support visit in each quarter from the District Hospital level (cumulative) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 150.00 Date 31-Dec-2021 30-Jun-2023 30-Jun-2023 31-Dec-2025 Each year, this is the increase from the previous year in the number of Networks of Practice receiving at Comments least one clinical support visit at least once every quarter by staff of a District Hospital or of a facility at the level of the District Hospital. The target is the cumulative increase over the full implementation period. 2. Primary health care policy and financing IN01375597 ►Health Policies, Plans and Standards are approved (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 29.00 Date 31-Dec-2021 30-Jun-2023 30-Jun-2023 31-Dec-2025 Comments Key health sector Policies and Plans are described in the Verification Protocol for DLR 3.1. IN01375600 ►Annual expenditures from the national budget on capital investments and operational costs of health services at the Sub-District and community levels (Ghana Cedis millions) (cumulative) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 60.00 Date 31-Dec-2021 30-Jun-2023 30-Jun-2023 31-Dec-2025 The annual Financial Report of the Ghana Health Service will provide expenditures from the national budget Comments on capital investments and operational costs made at the Sub-District and community levels (denominated in GHC millions). The target is the cumulative increase over the full implementation period. IN01375602 ►Increase in people who are active members of the National Health Insurance Scheme (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 7,600,000.00 Date 31-Dec-2021 30-Jun-2023 30-Jun-2023 31-Dec-2025 This is the increase from the 2021 baseline in the number of people who are active National Health Comments Insurance Scheme members. IN01375606 Increase in people who are active members of the National Health Insurance Scheme - female (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 3,800,000.00 Date 31-Dec-2021 30-Jun-2023 30-Jun-2023 31-Dec-2025 IN01375608 12/21/2023 Page 9 of 18 The World Bank Implementation Status & Results Report Primary Health Care Investment Program (P173168) ►Annual increase in the percentage of insurance claims for Primary Health Care Services paid by the National Health Insurance Authority within 90 days of receipt (percentage points) (cumulative) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 77.00 Date 31-Dec-2021 30-Jun-2023 30-Jun-2023 31-Dec-2025 Each year, this is the increase from the previous year in the percentage of insurance claims submitted by providers at the Sub-District and community levels that are paid within 90 days of receipt by the National Comments Health Insurance Authority. The target is the cumulative percentage point increase over the full implementation period. IN01375611 ►Annual Ministry of Health Financial Reports (AMoHFR) including information on PHCS is completed by the Planned Deadline (cumulative) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 4.00 Date 31-Dec-2021 30-Jun-2023 30-Jun-2023 31-Dec-2025 The consolidated, unaudited Ministry of Health Financial Report for the previous government FY, disaggregated to the Sub-District level, is published online annually by the Planned Deadline: June 2022 for Comments FY21, April 2023 for FY22, February 2024 for FY23, February 2025 for FY24. The target is the cumulative number of reports that meet the deadline over the full implementation period. IN01375612 ►District Health Administrations (DHAs) with GIFMIS Capacity (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 261.00 Date 31-Dec-2021 30-Jun-2023 30-Jun-2023 31-Dec-2025 This is the number of District Health Administrations with the required human resources, training, equipment, software, and procedures, to make use of GIFMIS for public financial management, including for Comments primary health care services at the Sub-District level. Detailed requirements for readiness to implement GIFMIS will be documented in the Verification Manual. 3. Primary health care service improvements IN01375596 ►Annual increase in new family planning acceptors utilizing services at the Sub-District and community levels (cumulative) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 10,000.00 Date 31-Dec-2021 30-Jun-2023 30-Jun-2023 31-Dec-2025 Each year, this is the increase from the previous year in the number of new family planning acceptors Comments utilizing family planning services (modern methods) at the Sub-District and community levels (not including District Hospitals). The target is the cumulative increase over the full implementation period. IN01375599 ►Annual increase in adolescents utilizing health services at the Sub-District and community levels (cumulative) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 17,000.00 Date 31-Dec-2021 30-Jun-2023 30-Jun-2023 31-Dec-2025 12/21/2023 Page 10 of 18 The World Bank Implementation Status & Results Report Primary Health Care Investment Program (P173168) Each year, this is the increase from the previous year in the number of adolescents (ages 15-19 years) Comments utilizing health services at the Sub-District and community levels (not including District Hospitals). The target is the cumulative increase over the full implementation period. IN01375603 Annual increase in adolescents utilizing health services at the Sub-District and community levels – female (cumulative) (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 8,500.00 Date 31-Dec-2021 30-Jun-2023 30-Jun-2023 31-Dec-2025 IN01375605 ►Annual increase in children aged 0-23 months in Selected Districts who received Penta1 Vaccination (cumulative) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 25,000.00 Date 31-Dec-2021 30-Jun-2023 30-Jun-2023 31-Dec-2025 Each year, this is the increase from the previous year in the annual number of children aged 0-23 months Comments who received Penta1 vaccination in Selected Districts. The target is the cumulative increase over the full implementation period. IN01375609 Annual increase in children aged 0-23 months in Selected Districts who received Penta1 Vaccination – female (cumulative) (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 12,500.00 Date 31-Dec-2021 30-Jun-2023 30-Jun-2023 31-Dec-2025 IN01375610 ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 10,822,000.00 Date 31-Dec-2021 30-Jun-2023 30-Jun-2023 31-Dec-2025 Comments IN01375613 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 0.00 0.00 5,436,000.00 IN01375614 Number of deliveries attended by skilled health personnel (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 50,000.00 12/21/2023 Page 11 of 18 The World Bank Implementation Status & Results Report Primary Health Care Investment Program (P173168) Date 31-Dec-2021 30-Jun-2023 30-Jun-2023 31-Dec-2025 Disbursement Linked Indicators DLI_IND_TABLE ►DLI 1 Primary Health Care Networks of Practice and Model Health Centers are Developed (Output, 56,320,000.00, 0%) Baseline Actual (Previous) Actual (Current) 2022-25 Value - 0.00 0.00 -- Date -- 30-Jun-2023 30-Jun-2023 -- Comments IN01375616 DLI 1.1 Number of Networks of Practice functioning according to the Standards for Networks of Practice (Intermediate Outcome, 38,500,000.00, 0%) Unit of Measure: Text Indicator Type: Baseline Actual (Previous) Actual (Current) 2022-25 Value 0.00 0.00 0.00 350.00 Date -- 30-Jun-2023 30-Jun-2023 -- Comments IN01375617 DLI 1.2 Number of Model Health Centers functioning according to the Standards for Model Health Centers (Intermediate Outcome, 13,820,000.00, 0%) Unit of Measure: Text Indicator Type: Baseline Actual (Previous) Actual (Current) 2022-25 Value 0.00 0.00 0.00 400.00 Date -- 30-Jun-2023 30-Jun-2023 -- Comments IN01375618 DLI 1.3 Number of Model Health Centers with a solar and/or battery electricity backup system (Output, 4,000,000.00, 0%) Unit of Measure: Text Indicator Type: Baseline Actual (Previous) Actual (Current) 2022-25 Value 0.00 0.00 0.00 100.00 Date -- 30-Jun-2023 30-Jun-2023 -- 12/21/2023 Page 12 of 18 The World Bank Implementation Status & Results Report Primary Health Care Investment Program (P173168) Comments ►DLI 2 Capacities, Accountability and Quality of Networks of Practice are Improved (Intermediate Outcome, 18,800,000.00, 0%) Baseline Actual (Previous) Actual (Current) 2022-25 Value - 0.00 0.00 - Date -- 30-Jun-2023 30-Jun-2023 -- Comments IN01375620 DLI 2.1 Annual increase in the number of health centers and Model Health Centers that have available selected Essential Medicines at least six (6) months of the Year (Intermediate Outcome, 6,000,000.00, 0%) Unit of Measure: Text Indicator Type: Baseline Actual (Previous) Actual (Current) 2022-25 400 (cumulative Value 0.00 0.00 0.00 increase) Date -- 30-Jun-2023 30-Jun-2023 -- Comments IN01375621 DLI 2.2 Increase in the number of Physician Assistants at post in health centers and Polyclinics (Output, 6,800,000.00, 0%) Unit of Measure: Text Indicator Type: Baseline Actual (Previous) Actual (Current) 2022-25 Value 0.00 0.00 0.00 680.00 Date -- 30-Jun-2023 30-Jun-2023 -- Comments IN01375622 DLI 2.3 Annual increase in the number of Networks of Practice that score Green on the Community Scorecard for at least one quarter (Intermediate Outcome, 3,000,000.00, 0%) Unit of Measure: Text Indicator Type: Baseline Actual (Previous) Actual (Current) 2022-25 150 (cumulative Value 0.00 0.00 0.00 increase) Date -- 30-Jun-2023 30-Jun-2023 -- Comments 12/21/2023 Page 13 of 18 The World Bank Implementation Status & Results Report Primary Health Care Investment Program (P173168) IN01375623 DLI 2.4 Annual increase in the number of Networks of Practice that have received at least one clinical support visit in each quarter from the District Hospital level (Output, 3,000,000.00, 0%) Unit of Measure: Text Indicator Type: Baseline Actual (Previous) Actual (Current) 2022-25 150 (cumulative Value 0.00 0.00 0.00 increase) Date -- 30-Jun-2023 30-Jun-2023 -- Comments ►DLI 3 Health Policies, Standards and Plans are Developed and Financing for Primary Health care is Improved (Intermediate Outcome, 29,950,000.00, 0%) Baseline Actual (Previous) Actual (Current) 2022-25 Value - 0.00 0.00 - Date -- 30-Jun-2023 30-Jun-2023 -- Comments IN01375625 DLI 3.1 Health Policies, Plans and Standards are approved (Process, 18,850,000.00, 0%) Unit of Measure: Text Indicator Type: Baseline Actual (Previous) Actual (Current) 2022-25 Value 0.00 0.00 0.00 29.00 Date -- 30-Jun-2023 30-Jun-2023 -- Comments IN01375626 DLI 3.2 Annual expenditures from the national budget on capital investments and operational costs of health services at the Sub-District and community levels (Process, 11,100,000.00, 0%) Unit of Measure: Text Indicator Type: Baseline Actual (Previous) Actual (Current) 2022-25 60 million Cedis Value 0.00 0.00 0.00 (cumulative amount) Date -- 30-Jun-2023 30-Jun-2023 -- Comments 12/21/2023 Page 14 of 18 The World Bank Implementation Status & Results Report Primary Health Care Investment Program (P173168) ►DLI 4 National Health Insurance Scheme Coverage is expanded and Financing of Primary Health Care Services is prioritized (Output, 27,700,000.00, 0%) Baseline Actual (Previous) Actual (Current) 2022-25 Value - 0.00 0.00 - Date -- 30-Jun-2023 30-Jun-2023 -- Comments IN01375628 DLI 4.1 Increase in number of people who are active members of the National Health Insurance Scheme (Output, 15,200,000.00, 0%) Unit of Measure: Text Indicator Type: Baseline Actual (Previous) Actual (Current) 2022-25 Value 0.00 0.00 0.00 7,600,000 Date -- 30-Jun-2023 30-Jun-2023 -- Comments IN01375629 DLI 4.2 Increase in the number of Indigent Persons who are active members of the National Health Insurance Scheme (Output, 4,800,000.00, 0%) Unit of Measure: Text Indicator Type: Baseline Actual (Previous) Actual (Current) 2022-25 Value 0.00 0.00 0.00 1,200,000 Date -- 30-Jun-2023 30-Jun-2023 -- Comments IN01375630 DLI 4.3 Annual increase in the percentage of insurance claims for Primary Health Care Services paid by the National Health Insurance Authority within 90 days of receipt (Output, 7,700,000.00, 0%) Unit of Measure: Text Indicator Type: Baseline Actual (Previous) Actual (Current) 2022-25 77 percentage Value 0.00 0.00 0.00 points (cumulative increase) Date -- 30-Jun-2023 30-Jun-2023 -- Comments 12/21/2023 Page 15 of 18 The World Bank Implementation Status & Results Report Primary Health Care Investment Program (P173168) ►DLI 5 Public Financial Management for Primary Health Care Services is improved (Output, 6,220,000.00, 0%) Baseline Actual (Previous) Actual (Current) 2022-25 Value - 0.00 0.00 - Date -- 30-Jun-2023 30-Jun-2023 -- Comments IN01375632 DLI 5.1 Annual Ministry of Health Financial Reports (AMoHFR) including information on PHCS is completed by the Planned Deadline (Process, 1,000,000.00, 0%) Unit of Measure: Text Indicator Type: Baseline Actual (Previous) Actual (Current) 2022-25 4 annual Financial Value 0.00 0.00 0.00 Reports meeting Planned Deadline Date -- 30-Jun-2023 30-Jun-2023 -- Comments IN01375633 DLI 5.2 Number of District Health Administrations (DHAs) with GIFMIS Capacity (Process, 5,220,000.00, 0%) Unit of Measure: Text Indicator Type: Baseline Actual (Previous) Actual (Current) 2022-25 Value 0.00 0.00 0.00 261.00 Date -- 30-Jun-2023 30-Jun-2023 -- Comments ►DLI 6 Improved Utilization of Selected Primary Health Care Services (Outcome, 11,010,000.00, 0%) Baseline Actual (Previous) Actual (Current) 2022-25 Value - 0.00 0.00 - Date -- 30-Jun-2023 30-Jun-2023 -- Comments IN01375635 DLI 6.1 Annual increase in the number of mother/newborn pairs receiving care in facilities providing Quality BEmONC services at the Sub-District level (Outcome, 3,500,000.00, 0%) Unit of Measure: Text Indicator Type: 12/21/2023 Page 16 of 18 The World Bank Implementation Status & Results Report Primary Health Care Investment Program (P173168) Baseline Actual (Previous) Actual (Current) 2022-25 50,000 (cumulative Value 0.00 0.00 0.00 increase) Date -- 30-Jun-2023 30-Jun-2023 -- Comments IN01375636 DLI 6.2 Annual increase in the number of new family planning acceptors utilizing services at the Sub-District and community levels (Outcome, 500,000.00, 0%) Unit of Measure: Text Indicator Type: Baseline Actual (Previous) Actual (Current) 2022-25 10,000 (cumulative Value 0.00 0.00 0.00 increase) Date -- 30-Jun-2023 30-Jun-2023 -- Comments IN01375637 DLI 6.3 Annual increase in the number of adolescents utilizing health services at the Sub-District and community levels (Outcome, 510,000.00, 0%) Unit of Measure: Text Indicator Type: Baseline Actual (Previous) Actual (Current) 2022-25 17,000 (cumulative Value 0.00 0.00 0.00 increase) Date -- 30-Jun-2023 30-Jun-2023 -- Comments IN01375638 DLI 6.4 Annual increase in the number of children aged 0-23 months in Selected Districts who received Penta1 Vaccination (Outcome, 500,000.00, 0%) Unit of Measure: Text Indicator Type: Baseline Actual (Previous) Actual (Current) 2022-25 25,000 (cumulative Value 0.00 0.00 0.00 increase) Date -- 30-Jun-2023 30-Jun-2023 -- Comments IN01375639 DLI 6.5 Annual increase in the number of hypertensive patients diagnosed and referred at health services at the Sub-District and community levels (Outcome, 6,000,000.00, 0%) Unit of Measure: Text 12/21/2023 Page 17 of 18 The World Bank Implementation Status & Results Report Primary Health Care Investment Program (P173168) Indicator Type: Baseline Actual (Previous) Actual (Current) 2022-25 120,000 (cumulative Value 0.00 0.00 0.00 increase) Date -- 30-Jun-2023 30-Jun-2023 -- Comments 12/21/2023 Page 18 of 18