The World Bank Implementation Status & Results Report Anhui Aged Care System Demonstration Project (P154716) Anhui Aged Care System Demonstration Project (P154716) EAST ASIA AND PACIFIC | China | Social Protection & Jobs Global Practice | IBRD/IDA | Investment Project Financing | FY 2018 | Seq No: 7 | ARCHIVED on 28-Jun-2022 | ISR51406 | Implementing Agencies: Anhui Provincial Department of Civil Affairs, People's Republic of China Key Dates Key Project Dates Bank Approval Date: 19-Jun-2018 Effectiveness Date: 22-Oct-2018 Planned Mid Term Review Date: 28-Jun-2021 Actual Mid-Term Review Date: 28-Jun-2021 Original Closing Date: 31-Dec-2023 Revised Closing Date: 31-Dec-2023 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The project development objective (PDO) is to support the government of Anhui province in developing and managing a diversified, three-tiered aged care service delivery system for the elderly, particularly those with limited functional ability. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Supporting the Development of Government Stewardship Capacity:(Cost $10.45 M) Strengthening Community-based and Home-based Care Services:(Cost $42.64 M) Strengthening the Delivery and Management of Nursing Care:(Cost $136.90 M) Project Management, Monitoring and Evaluation:(Cost $2.68 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Moderately Satisfactory Moderately Satisfactory Overall Risk Rating Moderate Moderate Implementation Status and Key Decisions The project was approved by the World Bank Board on June 19, 2018 and became effective on October 22, 2018. The project was launched on September 26-27, 2018. The Mid-Term Review (MTR) was completed during June to September 2021. The project will be restructured to accommodate the changed circumstances. At the provincial level, progress made includes four areas: (a) the overall architecture design of the provincial information system is underway; (b) The needs assessment toolkit has been developed and will be piloted in 5 cities; (c) The quality standards on home- and community-based aged care were selected to be developed; and (d) the training plans for professional and managerial skills are under preparation and will be carried out in the latter of 2022. 6/28/2022 Page 1 of 8 The World Bank Implementation Status & Results Report Anhui Aged Care System Demonstration Project (P154716) At the municipal Level, progress has been made in establishment of the aged care facilities and provision of services. Anqing and Lu’An have made progress on upgrading community-based service stations, of which 82 stations have been upgraded. Anqing and Lu’An have implemented the purchase of basic aged care services following the Guidelines of Government Purchase of Basic Aged Care Services developed under the project. The civil works for the skilled nursing home in Lu’An and urban welfare homes in Ningguo and Xuanzhou are under construction. The upgrading design for rural welfare homes in Suzhou is now carried out. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance Low Low Low Macroeconomic Moderate Moderate Moderate Sector Strategies and Policies Moderate Moderate Moderate Technical Design of Project or Program Substantial Moderate Moderate Institutional Capacity for Implementation and Substantial Moderate Moderate Sustainability Fiduciary Substantial Substantial Substantial Environment and Social Moderate Moderate Moderate Stakeholders Substantial Moderate Moderate Other -- -- -- Overall Substantial Moderate Moderate Results PDO Indicators by Objectives / Outcomes Improve the access of aged care services IN01140532 ►Number of direct beneficiaries at project sites (Number, by gender and by tier) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 59,287.00 59,287.00 76,993.00 357,589.00 Date 30-Mar-2018 27-Oct-2021 31-Dec-2021 30-Jun-2019 The definition, baseline and target will be modified in the project restructuring. The direct beneficiaries include all elderly people that covered by the project. Due to changes in the project investment activities Comments: that would affect the scope and target values, 2020 will be chosen as a new baseline and the target value needs to be adjusted accordingly. IN01140534 6/28/2022 Page 2 of 8 The World Bank Implementation Status & Results Report Anhui Aged Care System Demonstration Project (P154716) Women (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 27,740.00 27,740.00 40,098.00 228,856.00 Date 30-Mar-2018 27-Oct-2021 31-Dec-2021 30-Jun-2023 IN01140535 Home-based services (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 29,164.00 29,164.00 6,130.00 195,672.00 Date 30-Mar-2018 27-Oct-2021 31-Dec-2021 30-Jun-2023 IN01140536 Community-based services (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 27,359.00 27,359.00 67,578.00 155,097.00 Date 30-Mar-2018 27-Oct-2021 31-Dec-2021 30-Jun-2023 IN01140537 Institutional-based services (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 2,764.00 2,764.00 3,285.00 6,820.00 Date 30-Mar-2018 27-Oct-2021 31-Dec-2021 30-Jun-2023 Srenghtern government capacity to exercise stewardship over a diversified aged care service system IN01140529 ►Percentage of dedicated public outlays for elderly care spent on purchasing aged care services from non-public providers in urban areas in the project sites (Percentage, arithmetic average) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 10.00 19.60 19.60 27.00 Date 30-Mar-2018 27-Oct-2021 31-Dec-2021 30-Jun-2023 The percentage in 2021 has declined because the increased public outlays for elderly care went for Comments: quality and safety enhancement, instead of purchasing aged care services. Improve the quality of aged care services across three tiers IN01140531 ►Share of aged care service providers who meet the requirements of construction and service standards at the project sites (Percentage) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 34.00 82.00 84.80 98.00 6/28/2022 Page 3 of 8 The World Bank Implementation Status & Results Report Anhui Aged Care System Demonstration Project (P154716) Date 30-Mar-2018 27-Oct-2021 31-Dec-2021 30-Jun-2023 In accordance with the policy change, “meeting the requirements” is measured by the classification and accreditation of aged care institutions who meet at least level 1 (minimum level) of the aged care quality Comments: standards. Srengthern delivery capacity of a diversified aged care service provision system IN01140530 ►Number of aged care managerial staff who received training certificates financed by the project, disaggregated by gender (Number, by gender) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 500.00 500.00 5,500.00 Date 30-Mar-2018 27-Oct-2021 31-Dec-2021 30-Jun-2023 IN01140533 Women (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 50.00 50.00 0.00 Date 30-Mar-2018 27-Oct-2021 31-Dec-2021 30-Jun-2023 Intermediate Results Indicators by Components Component 4. Project Management, Monitoring and Evaluation IN01140541 ►Intermediate Result Indicator 4.1. Satisfaction of consumers and their families with aged care services (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 0.00 Date 30-Jun-2020 27-Oct-2021 31-Dec-2021 30-Jun-2023 The Provincial Project Management Office (PPMO) has finalized the TOR to engage a consulting firm to conduct beneficiary surveys to establish the baseline and targets. Data will be updated when the survey report is available. Comments: For the purchasing of based aged care services, Anqing conducted sample survey of 863 beneficiaries in Q4 2021. The overall satisfaction rate is 84.3 percent. Feedback from the beneficiaries will inform the service providers to improve their services. IN01140545 Women (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 0.00 Date 30-Mar-2018 27-Oct-2021 31-Dec-2021 30-Jun-2023 IN01140547 6/28/2022 Page 4 of 8 The World Bank Implementation Status & Results Report Anhui Aged Care System Demonstration Project (P154716) ►Intermediate Result Indicator 4.2 Weekly time use of family caregivers who provided aged care to their elderly recipients (Hours, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 73.70 73.70 73.70 0.00 Date 30-Mar-2018 27-Oct-2021 27-Oct-2021 30-Jun-2023 The baseline value was set up based on a household survey. This indicator has been proposed to drop in the upcoming project restructuring. The weekly time use of family caregivers who provided aged care to Comments: their elderly recipients does not present a linear pattern from literature review and the empirical findings by using representative household data in China, because it is determined by multiple factors IN01140551 Women (Hours, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 76.50 76.50 76.50 0.00 Date 30-Mar-2018 27-Oct-2021 27-Oct-2021 30-Jun-2023 Component 3. Strengthening the Delivery and Management of Nursing Care IN01140540 ►Intermediate Result Indicator 3.1. Number of newly constructed or upgraded nursing care beds at the project sites (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 40.00 432.00 432.00 6,340.00 Date 30-Mar-2018 27-Oct-2021 31-Dec-2021 30-Jun-2023 IN01140544 ►Intermediate Result Indicator 3.2 Occupancy rates of beds at the project sites (Percentage) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 39.00 39.00 39.00 78.00 Date 30-Mar-2018 27-Oct-2021 27-Oct-2021 30-Jun-2023 Changes have been proposed in the scope, method of calculation, and the end target value of this indicator. The occupancy rates measure the beds financed by project including both existing and newly Comments: constructed ones at project sites. This indicator will be reported in the project restructuring. IN01140548 Urban Community stations (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 36.00 37.00 37.00 80.00 Date 30-Mar-2018 27-Oct-2021 27-Oct-2021 30-Jun-2023 IN01140550 Urban welfare homes (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target 6/28/2022 Page 5 of 8 The World Bank Implementation Status & Results Report Anhui Aged Care System Demonstration Project (P154716) Value 50.00 50.00 50.00 80.00 Date 30-Mar-2018 27-Oct-2021 27-Oct-2021 30-Jun-2023 IN01140552 Rural Welfare homes (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 30.00 30.00 30.00 75.00 Date 30-Mar-2018 27-Oct-2021 27-Oct-2021 30-Jun-2023 IN01140555 Skilled nursing homes (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 78.00 Date 30-Mar-2018 27-Oct-2021 27-Oct-2021 30-Jun-2023 Component 2. Strengthening Community-based and Home-based Care Services IN01140539 ►Intermediate Result Indicator 2.1 Number of newly constructed/upgraded community service stations at the project sites (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 83.00 85.00 158.00 Date 30-Mar-2018 27-Oct-2021 31-Dec-2021 15-Jun-2023 IN01140543 ►Intermediate Result Indicator 2.2 Number of family caregivers who received respite services at the project sites (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 15.00 50.00 50.00 970.00 Date 30-Mar-2018 27-Oct-2021 27-Oct-2021 30-Jun-2023 This indicator is proposed to be dropped. Neither Anqing nor Lu’An will continue implementing the respite Comments: services because aged care service providers are not willing to provide support Component 1 - Supporting the Development of Government Stewardship Capacity IN01140538 ►Intermediate Result Indicator 1.1 Number of modules developed and operating for the provincial information system (Number) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 4.00 Date 30-Mar-2018 27-Oct-2021 31-Dec-2021 30-Jun-2023 IN01140542 6/28/2022 Page 6 of 8 The World Bank Implementation Status & Results Report Anhui Aged Care System Demonstration Project (P154716) ►Intermediate Result Indicator 1.2 Number of users who utilize the provincial information system for the aged care business. (Number per year) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 18,255,678.00 Date 30-Mar-2018 27-Oct-2021 31-Dec-2021 30-Jun-2023 IN01140546 ►Intermediate Result Indicator 1.3 Number of aged care service standards developed at the provincial levels and financed by the project (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 13.00 13.00 48.00 Date 30-Mar-2018 27-Oct-2021 27-Oct-2021 30-Jun-2023 IN01140549 ►Intermediate Result Indicator 1.4 Number of aged care professionals participating in training activities (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 2,543.00 2,543.00 9,795.00 Date 30-Mar-2018 27-Oct-2021 31-Dec-2021 30-Jun-2023 IN01140553 Women (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1,479.00 1,479.00 0.00 Date 30-Mar-2018 27-Oct-2021 31-Dec-2021 30-Jun-2023 IN01140554 ►Intermediate Result Indicator 1.5 Proportion of the elderly benefiting from the project who received functional ability/needs assessments (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 23.00 35.00 35.00 92.00 Date 30-Mar-2018 27-Oct-2021 31-Dec-2021 30-Jun-2023 This actual value is decreased because starting from 2021 the needs assessment has been expanded to the elderly who received government purchase of aged care services, in addition to the institutional aged Comments: care services' beneficiaries. Performance-Based Conditions Data on Financial Performance Disbursements (by loan) 6/28/2022 Page 7 of 8 The World Bank Implementation Status & Results Report Anhui Aged Care System Demonstration Project (P154716) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P154716 IBRD-88820 Effective USD 118.00 118.00 0.00 29.32 88.68 25% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P154716 IBRD-88820 Effective 19-Jun-2018 10-Aug-2018 22-Oct-2018 31-Dec-2023 31-Dec-2023 Cumulative Disbursements Restructuring History There has been no restructuring to date. Related Project(s) There are no related projects. 6/28/2022 Page 8 of 8