The World Bank Implementation Status & Results Report Strengthening Primary Health Care and Surveillance in Haiti (P167512) Strengthening Primary Health Care and Surveillance in Haiti (P167512) LATIN AMERICA AND CARIBBEAN | Haiti | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2019 | Seq No: 6 | ARCHIVED on 28-Oct-2022 | ISR52189 | Implementing Agencies: Ministry of Public Health and Population, Project Management Unit, Republic of Haiti Key Dates Key Project Dates Bank Approval Date: 16-May-2019 Effectiveness Date: 28-Aug-2019 Planned Mid Term Review Date: 16-May-2022 Actual Mid-Term Review Date: 15-Jun-2022 Original Closing Date: 31-Dec-2024 Revised Closing Date: 31-Dec-2024 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The PDO of the proposed Project is to: (i) increase utilization of primary health care services in selected geographical areas; and (ii) strengthen surveillance capacity especially for cholera. 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) The PDO of the proposed Project is to: (i) increase utilization of primary health care services in selected geographical areas; (ii) strengthen surveillance capacity especially for cholera, and (iii) provide an immediate and effective response to an eligible crisis or emergency. Components Table Name Strengthening Primary Health Care Service Delivery:(Cost $55.60 M) Strengthening Surveillance and Control for Infectious Diseases:(Cost $29.60 M) Supporting Project Management and Implementation Support:(Cost $7.00 M) Contingent Emergency Response Component:(Cost $20.00 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 High Implementation Status and Key Decisions The Project was approved by the Board on May 16, 2019 and declared effective on August 28, 2019. The Project’s development objective is to (i) increase utilization of primary health care services in selected geographical areas; and (ii) strengthen surveillance capacity especially for cholera. In spite of the deterioration of the operational environment, Project implementation continues. Activities co-financed by the Global Fund to Fight Aids, 10/28/2022 Page 1 of 7 The World Bank Implementation Status & Results Report Strengthening Primary Health Care and Surveillance in Haiti (P167512) Tuberculosis, and Malaria (GF) under the Project continue to complement and scale up priority health systems strengthening activities in Haiti (supply chain, laboratory systems, community health). On June 16, 2022, an additional financing was approved as part of the WB support to the Government’s response to the August 2021 earthquake in the southern peninsula. The Government and health partners continue to coordinate to support the health system strengthening, particularly to respond to the COVID-19 pandemic and undertake post-earthquake reconstruction efforts in the southern peninsula. After 3 years with no cholera case, Haiti is being hit with a growing outbreak of cholera. As October 25th, 2118 suspected cases have been notified mostly concentrated in the Metropolitan area of Port-au-Prince. A joint health-water/sanitation response is needed to contain cholera cases to as few localities as possible. The Bank health and water teams are working closely with government and partners to support the response. Key cross-sectoral priorities include: (i) enabling the production and delivery of drinkable water in the affected areas and their vicinity; (ii) Facilitating the deployment of rapid response teams for each suspected case, and (iii) reinitiate mass communication activities for cholera prevention. The ongoing PROSYS health Project (P167512) will support all the pillars for the health cholera response, with financing immediately available. Specific priority activities are being urgently defined by the Ministry of Health in coordination with partners. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance High High High Macroeconomic High High High Sector Strategies and Policies Substantial Substantial Substantial Technical Design of Project or Program Substantial Substantial Substantial Institutional Capacity for Implementation and Substantial Substantial Substantial Sustainability Fiduciary High Substantial Substantial Environment and Social Moderate Moderate Moderate Stakeholders Moderate Moderate Moderate Other Substantial Substantial High Overall Substantial Substantial High Results PDO Indicators by Objectives / Outcomes Increase utilization of primary health care services in selected geographical areas IN01162933 ►Percentage of children aged between 12 and 23 months fully vaccinated in Project intervention areas (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 45.30 45.30 45.30 51.00 Date 30-Jun-2018 17-Feb-2022 15-Sep-2022 31-Dec-2024 10/28/2022 Page 2 of 7 The World Bank Implementation Status & Results Report Strengthening Primary Health Care and Surveillance in Haiti (P167512) This indicator will be reported on once the next Demographic and Health Surveys (DHS) round will be Comments: completed (tentatively expected at the end of 2023). IN01162941 ►Percentage of institutional deliveries in Project intervention areas (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 38.20 38.20 38.20 44.00 Date 30-Jun-2018 17-Feb-2022 15-Sep-2022 31-Dec-2024 This indicator will be reported on once the next DHS round will be completed (tentatively planned for end Comments: of 2023). Strengthen surveillance capacity especially for cholera IN01162934 ►Percentage of notifications of suspected cases of cholera for which laboratory results are available to the Health Departmental Directorates (DDSs) within 10 days of collection (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 45.00 100.00 100.00 70.00 Date 24-Nov-2018 31-Dec-2021 14-Oct-2022 31-Dec-2024 New cholera cases have been confirmed in Haiti since October 1st 2022. Comments: Provide an immediate and effective response to an eligible crisis or emergency IN01162935 ►Number of health facilities rehabilitated or reconstructed (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 46.00 49.00 85.00 Date 30-Jun-2019 08-Feb-2022 15-Sep-2022 31-Dec-2024 Three new rehabilitations were completed during the reporting period. Comments: Intermediate Results Indicators by Components Component 1: Strengthening Primary Health Care Service Delivery IN01162942 ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 514,309.00 685,246.00 828,000.00 10/28/2022 Page 3 of 7 The World Bank Implementation Status & Results Report Strengthening Primary Health Care and Surveillance in Haiti (P167512) Date 01-Jun-2019 14-Feb-2022 15-Sep-2022 31-Dec-2024 IN01162944 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 18,468.00 38,481.00 79,000.00 IN01162946 Number of children immunized (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 440,603.00 551,904.00 260,000.00 Date 01-Jun-2019 14-Feb-2022 15-Sep-2022 31-Dec-2024 IN01162948 Number of women and children who have received basic nutrition services (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 64,439.00 113,888.00 500,000.00 Date 01-Jun-2019 14-Feb-2022 15-Sep-2022 31-Dec-2024 IN01162949 Number of deliveries attended by skilled health personnel (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 9,267.00 19,454.00 68,000.00 Date 01-Jun-2019 14-Feb-2022 15-Sep-2022 31-Dec-2024 IN01162950 ►Contracted service providers achieving the minimum quality score (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 71.00 94.54 95.00 78.00 Date 30-Jun-2018 14-Feb-2022 15-Sep-2022 31-Dec-2024 This indicator includes data from verification results for all of 2021, and part of the verification results from T1 2022. Updated data will be reported in the next ISR once more information on 2022 verifications is Comments: available. IN01162951 ►Contracted health providers supervised at least quarterly - maintained at 100 percent (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 100.00 100.00 57.00 100.00 Date 30-Jun-2018 14-Feb-2022 15-Sep-2022 31-Dec-2024 Comments: Growing security and access constraints, as well as severe fuel shortages decreased the capacity of departmental health authorities to perform supervision visits. The Contracting Unit at MSPP (UC/MSPP) 10/28/2022 Page 4 of 7 The World Bank Implementation Status & Results Report Strengthening Primary Health Care and Surveillance in Haiti (P167512) and technical assistance firms are working with departmental authorities to develop alternative supervision methods to overcome these challenges. IN01162952 ►Citizen Engagement: percentage of facilities under RBF that developed an action plan(s) based on the results of community satisfaction surveys (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 94.00 47.00 50.00 Date 01-Jun-2019 14-Feb-2022 15-Sep-2022 31-Dec-2024 This updated indicator is based on the last third-party verification results (verification of Jan-March 2022). Security, access constraints, as well as fuel shortages have prevented regular supervision and technical support to health facilities to develop their plans. However, results continue to show an average patient Comments: satisfaction score of 80% with the services rendered by health facilities being supported by the RBF program. IN01162953 ►Number of Community Health Workers who were trained based on the new Community Health Strategy (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 225.00 Date 22-Mar-2021 16-Feb-2022 15-Sep-2022 31-Dec-2023 The operational plans for the training of community health workers have been prepared for all 10 departments. Training of trainers of community health workers is expected to begin in all departments Comments: during the next quarter (followed by the roll out of the training to community health workers during the first semester of 2023) IN01162954 ►Number of peripheral storage warehouses upgraded based on identified need and in accordance with minimum national standards on storage of medical products (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 2.00 Date 22-Mar-2021 16-Feb-2022 15-Sep-2022 31-Dec-2023 The MSPP is conducted the evaluations of peripheral storage warehouses. Architectural plans are Comments: currently being developed. Civil works are expected to begin in January 2023. Component 2: Strengthening Surveillance and Control for Infectious Diseases IN01162943 ►Percentage of suspected cases of diphtheria investigated and responded to within 48h after notification (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 72.00 70.00 97.70 90.00 Date 30-Jun-2019 31-Dec-2021 15-Sep-2022 31-Dec-2024 Value for April-June 2022. Comments: IN01162945 10/28/2022 Page 5 of 7 The World Bank Implementation Status & Results Report Strengthening Primary Health Care and Surveillance in Haiti (P167512) ►Percentage of notified maternal deaths investigated per year (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 77.00 86.40 10.00 Date 28-Jun-2019 31-Dec-2021 15-Sep-2022 31-Dec-2024 In 2022, 103 maternal deaths were reported until June, 89 were investigated. Comments: IN01162947 ►Number of laboratories who comply with national standard requirements for infrastructure and equipment (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 6.00 6.00 10.00 Date 22-Mar-2021 31-Dec-2021 15-Sep-2022 31-Dec-2023 Performance-Based Conditions Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P167512 IDA-D4670 Effective USD 55.00 55.00 0.00 19.77 32.96 37% Not P167512 IDA-E0610 USD 20.00 20.00 0.00 0.00 19.18 0% Effective P167512 TF-B0067 Effective USD 15.00 15.00 0.00 2.45 12.55 16% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P167512 IDA-D4670 Effective 16-May-2019 05-Jun-2019 28-Aug-2019 31-Dec-2024 31-Dec-2024 Not P167512 IDA-E0610 16-Jun-2022 04-Aug-2022 -- 31-Dec-2024 31-Dec-2024 Effective P167512 TF-B0067 Effective 16-May-2019 05-Jun-2019 28-Aug-2019 31-Dec-2024 31-Dec-2024 Cumulative Disbursements 10/28/2022 Page 6 of 7 The World Bank Implementation Status & Results Report Strengthening Primary Health Care and Surveillance in Haiti (P167512) Restructuring History Level 2 Approved on 09-Apr-2021 ,Level 2 Approved on 03-May-2021 Related Project(s) P175761-AF Strengthening Primary Health Care and Surveillance in Haiti (PROSYS) ,P175949-AF Strengthening Primary Health Care and Surveillance in Haiti (PROSYS) ,P178755-AF Strengthening Primary Health Care and Surveillance in Haiti 10/28/2022 Page 7 of 7