The World Bank Implementation Status & Results Report Eswatini COVID-19 Emergency Response Project (P173883) Eswatini COVID-19 Emergency Response Project (P173883) EASTERN AND SOUTHERN AFRICA | Eswatini | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2020 | Seq No: 5 | ARCHIVED on 28-Jun-2022 | ISR51804 | Implementing Agencies: Kingdom of Eswatini, Ministry of Health Key Dates Key Project Dates Bank Approval Date: 20-Apr-2020 Effectiveness Date: 30-Apr-2020 Planned Mid Term Review Date: 30-Jun-2022 Actual Mid-Term Review Date: 09-May-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 Program Development Objective is to prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness in Eswatini. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Component 1: Emergency COVID-19 Response:(Cost $10.00 M) Component 3: Implementation Management and Monitoring and Evaluation:(Cost $1.00 M) Component 2: Strengthening Capacity in Preparedness for Health Emergencies:(Cost $3.00 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Moderately Satisfactory Overall Implementation Progress (IP) Satisfactory Moderately Satisfactory Overall Risk Rating High High Implementation Status and Key Decisions The Eswatini COVID-19 Emergency Response Project was approved by the World Bank’s Regional Vice President on April 20, 2020 and became effective on April 30, 2020. Additional financing was approved on April 16, 2021. Significant progress towards meeting the project development objective has been made with 100 percent of the parent project funds (US$6 million) already disbursed. To date, 40 percent of the IBRD component of the AF (US$5m) has been disbursed. The grant portion (US$3m) has not yet disbursed due to on-going preparatory work to agree on the roadmap. MPA Program Development Objective 6/28/2022 Page 1 of 9 The World Bank Implementation Status & Results Report Eswatini COVID-19 Emergency Response Project (P173883) 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 As of May 16, 2022, 88 MPA-projects had been approved with a total commitment of US$4.3 billion. One operation (Guatemala) was cancelled in mid-September 2021, at the request of the Government. Six parent projects have been restructured to include vaccine-related procurement. Total disbursements as of May 16, 2022, amount to US$3.6 billion or 83% of overall commitments. This amount does not include disbursements under MPA-V operations which are reported together with AF-V operations. Sixty-seven (67) country projects or 77% of projects approved have reached 70-100% disbursement (reasons for >100% disbursements relate to fluctuations between the Euro and the SDR against the US$). Out of the 67 operations, 48 operations or 72% have disbursed over 90% of commitments. Of these, 30 operations are fully disbursed. There are twelve (12) operations with disbursements under 50%. The projects are benefitting around 3.7 billion people or 50% of the global population. Of the 87 active projects: (i) 33 are in Africa – 12 in AFE and 21 in AFW; (ii) 12 in East Asia; (iii) 14 in Europe and Central Asia; (iv) 11 in Latin America and the Caribbean; (v) 8 in Middle East and North Africa; and (vi) 9 in South Asia. Eighty-six (86) or 99% of projects approved are disbursing. Two operations closed last CY. Closing dates for several operations have been extended beyond the end of the FY; twelve (12) operations have closing dates by the end of FY22. Country teams for operations which have been under implementation for twelve months or more by June 30, 2022, are preparing Mid-Term Review (MTR) ISRs to inform the Global MPA MTR, which will be prepared early next FY. Streamlined procedures, delegated approvals, coupled with flexible project design and intensified efforts across the Bank have contributed to the progress. Implementation is being guided by Bank teams working in parallel with other health related projects, including Additional Financing operations supporting vaccine procurement and deployment efforts. Implementation continues to face challenges as several countries are still under different levels of mobility restrictions, and counterparts and Bank teams are operating from home or partially from home. Some Bank teams continue to conduct implementation support missions virtually, which is challenging for both Bank teams and counterparts. Bank staff are operating in a hybrid environment with some days at the office and others at home. Notwithstanding the challenges, the MPA is on track to achieve its PrDO, which is to prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness. The significant level of disbursements attests to the strong implementation of the Bank' response thanks to the commitment of counterparts supported by Bank country teams. The Additional Financing (MPA AF-V) to the COVID-19 Strategic Preparedness and Response Program utilizing the Multiphase Programmatic Approach (“Global COVID-19 MPA”) was approved by the Board on October 13, 2021. The AF-V is significantly expanding Bank support to client countries for COVID-19 vaccination, with the aim to support vaccination of 1 billion people globally. The AF-V was approved with an envelope of US$12 billion ($6 billion from IDA and $6 billion from IBRD) in financing. On June 30, 2021, President Malpass announced the expansion of financing available for COVID-19 vaccine financing to $20 billion over the next 18 months, adding $8 billion to the previously announced $12 billion. This financing is critical to expand affordable and equitable financing for vaccine purchase and deployment. The AF-V is expected to enable vaccination for up to 750 million people, with potential surge capacity for an additional 250 million people in the poorest countries (depending on the delivered price of approved vaccines) while scaling support to strengthen immunization delivery, with design flexibility at the country level. The AF-V is a scale-up of planned vaccination activities anticipated and supported under the Global COVID-19 MPA and a key contribution to the WBG’s overall COVID-19 response. As of May 16, 2022, the Bank has approved 96 operations (including MPA-V operations) to support vaccine procurement and rollout in 73 countries amounting to $8.1 billion. The 96 operations approved, include 6 operations that involved restructuring of parent projects (Bhutan, 6/28/2022 Page 2 of 9 The World Bank Implementation Status & Results Report Eswatini COVID-19 Emergency Response Project (P173883) Cameroon, North Macedonia, Philippines, and Pakistan) and in the case of Lebanon, restructuring of the Health Resilience Project. Of the 96 approved operations: (i) 54 are in Africa – 24 in AFE and 30 in AFW; (ii) 9 in East Asia and the Pacific; (iii) 10 in Europe and Central Asia; (iv) 8 in Latin America and the Caribbean; (v) 7 in Middle East and North Africa; and (vi) 8 in South Asia. Fifty (50) projects are disbursing. Twenty-two (22) new operations are under various stages of processing. Total disbursements as of May 16, 2022, under these projects amount to US$3.3 billion or 40% of overall commitments. Disbursements under MPA-V operations are included in this total while disbursements under the six restructured projects are counted under parent projects. Fifteen (15) operations have disbursed over 70% of their commitments. Eighty-five (85) loan/financing agreements have been signed. Also, eighty (80) loan/financing agreements have become effective; several others are expected to become effective in the coming weeks. As with the MPA operations, streamlined procedures, delegated approval, coupled with flexible project design, and intensified efforts across the Bank have contributed to the rapid design and processing of the operations. Implementation of the AF-V operations, as with MPA operations is facing challenges as several countries are still under different levels of mobility restrictions and counterparts and Bank teams are operating in a hybrid environment with some days at the office and some at home. Also, countries are dealing with new waves of infections, as the Omicron variant continues to spread rapidly among populations. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance Substantial Substantial Substantial Macroeconomic Substantial High High Sector Strategies and Policies Low Low Low Technical Design of Project or Program Moderate Moderate Moderate Institutional Capacity for Implementation and Substantial Substantial Substantial Sustainability Fiduciary Substantial Substantial Substantial Environment and Social Substantial Substantial Substantial Stakeholders Moderate Moderate Moderate Other -- -- -- Overall Substantial High High Results PDO Indicators by Objectives / Outcomes To prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems IN01151956 ►Percentage of suspected cases reported that are tested according to national guidelines (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target 6/28/2022 Page 3 of 9 The World Bank Implementation Status & Results Report Eswatini COVID-19 Emergency Response Project (P173883) Value 85.00 99.00 99.00 95.00 Date 31-Mar-2020 31-Dec-2021 31-Mar-2022 31-Mar-2024 IN01151957 ►Percentage of confirmed COVID-19 cases managed as per national protocol (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 95.00 95.00 95.00 95.00 Date 31-Mar-2020 31-Dec-2021 31-Mar-2022 31-Mar-2024 IN01151958 ►Number of public hospitals and health centers with COVID-19 triage capacity (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 1.00 14.00 14.00 14.00 Date 31-Mar-2020 31-Dec-2021 31-Mar-2022 31-Mar-2024 IN01151959 ►Percentage of the population vaccinated, as defined in national plan (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 25.00 28.00 40.00 Date 18-Mar-2021 31-Dec-2021 31-Mar-2022 31-Mar-2024 IN01151960 Percentage of females vaccinated, as defined in national plan (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 30.00 40.00 Date 18-Mar-2021 30-Jun-2021 31-Mar-2022 31-Mar-2024 IN01151961 ►Number of health emergency preparedness and response simulation exercises completed (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 5.00 Date 30-Apr-2021 30-Jun-2021 31-Mar-2022 31-Mar-2024 Intermediate Results Indicators by Components Emergency COVID-19 Response IN01151963 6/28/2022 Page 4 of 9 The World Bank Implementation Status & Results Report Eswatini COVID-19 Emergency Response Project (P173883) ►Number of health staff trained in COVID-19 infection prevention and control per MOH-approved protocols (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 1,154.00 7,431.00 7,481.00 10,000.00 Date 31-Mar-2020 31-Dec-2021 31-Mar-2022 31-Mar-2024 IN01151967 Number of female health staff trained in COVID-19 infection prevention and control per MOH-approved protocols (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 920.00 5,927.00 6,086.00 8,000.00 Date 18-Mar-2021 31-Dec-2021 31-Mar-2022 31-Mar-2024 IN01151969 ►Country is maintaining an up to date referral system to care for COVID-19 patients (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value Yes Yes Yes Yes Date 31-Mar-2020 31-Dec-2021 31-Mar-2022 31-Mar-2024 IN01151972 ►Number of hospitals with fully equipped ICU beds (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 2.00 3.00 3.00 3.00 Date 31-Mar-2020 31-Dec-2021 31-Mar-2022 31-Mar-2024 One hospital was removed because the ICU is no longer admitting COVID-19 patients. Patients requiring COVID 19 treatment in ICU are stabilized and transferred to other facilities. Comments: IN01151974 ►Number of COVID-19 tests conducted by the designated in-country laboratory (disaggregated by results) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 63,117.00 520,596.00 100,000.00 Date 31-Mar-2020 30-Jun-2021 31-Mar-2022 31-Mar-2024 IN01151975 ►Proportion of open border control sites with trained teams and the necessary means of control, isolation and transport to isolation and care sites (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 12.00 53.00 53.00 100.00 Date 31-Mar-2020 31-Dec-2021 31-Mar-2022 31-Mar-2024 IN01151976 6/28/2022 Page 5 of 9 The World Bank Implementation Status & Results Report Eswatini COVID-19 Emergency Response Project (P173883) ►Number of health staff trained in COVID-19 vaccination deployment per MOH-approved protocols (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 4,080.00 10,000.00 Date 18-Mar-2021 30-Jun-2021 31-Mar-2022 31-Mar-2024 IN01151977 Number of female health staff trained in COVID-19 vaccination deployment per MOH-approved protocols (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 8,000.00 Date 18-Mar-2021 30-Jun-2021 31-Mar-2022 31-Mar-2024 IN01151978 ►Percentage of frontline workers with the knowledge to provide quality and comprehensive care to GBV survivors (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 50.00 Date 18-Mar-2021 31-Dec-2021 31-Mar-2022 31-Mar-2024 Strengthening Capacity in Preparedness for Health Emergencies IN01151964 ►Updated National Action Plan for Health Security (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No No No Yes Date 18-Mar-2021 31-Dec-2021 31-Mar-2022 31-Mar-2024 IN01151966 ►Finalized and budgeted micro-plans for health emergency rapid procurements (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No No No Yes Date 18-Mar-2021 31-Dec-2021 31-Mar-2022 31-Mar-2024 IN01151970 ►Number of staff trained in surveillance and advanced data analytics, interpretation and use (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 40.00 Date 18-Mar-2021 31-Dec-2021 31-Mar-2022 31-Mar-2024 IN01151973 Number of female staff trained in surveillance and advanced data analytics, interpretation and use (Number, Custom Breakdown) 6/28/2022 Page 6 of 9 The World Bank Implementation Status & Results Report Eswatini COVID-19 Emergency Response Project (P173883) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 25.00 Date 25-Mar-2021 31-Dec-2021 31-Mar-2022 31-Mar-2024 Implementation Management and Monitoring and Evaluation IN01151962 ►M&E system established to monitor the COVID-19 preparedness and response plan (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No Yes Yes Yes Date 31-Mar-2020 31-Dec-2021 31-Mar-2022 31-Mar-2024 IN01151965 ►Percentage of grievances addressed within the stipulated timeframe in the Stakeholder Engagement Plan (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 95.00 86.00 70.00 Date 31-Mar-2020 31-Dec-2020 30-Apr-2022 31-Mar-2024 IN01151968 ►Percentage of health care facilities with functional patient feedback mechanism (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 50.00 Date 18-Mar-2021 31-Dec-2021 31-Mar-2022 31-Mar-2024 IN01151971 ►Percentage of women reached through information and education campaigns at community level (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 65.00 55.00 80.00 Date 18-Mar-2021 31-Dec-2021 31-Mar-2022 31-Mar-2024 Performance-Based Conditions Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed 6/28/2022 Page 7 of 9 The World Bank Implementation Status & Results Report Eswatini COVID-19 Emergency Response Project (P173883) P173883 IBRD-90980 Closed USD 6.00 6.00 0.00 6.00 0.00 100% P173883 IBRD-92310 Effective USD 5.00 5.00 0.00 2.00 3.00 40% P173883 TF-B5461 Effective USD 3.00 3.00 0.00 0.00 3.00 0% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P173883 IBRD-90980 Closed 20-Apr-2020 29-Apr-2020 30-Apr-2020 30-Apr-2022 30-Apr-2022 P173883 IBRD-92310 Effective 16-Apr-2021 26-Sep-2021 06-Oct-2021 31-Mar-2024 31-Mar-2024 P173883 TF-B5461 Effective 24-Sep-2021 26-Sep-2021 06-Oct-2021 31-Mar-2024 31-Mar-2024 Cumulative Disbursements Restructuring History Level 2 Approved on 22-Sep-2021 Related Project(s) P175875-Additional Financing Eswatini COVID-19 Emergency Response Project 6/28/2022 Page 8 of 9 The World Bank Implementation Status & Results Report Eswatini COVID-19 Emergency Response Project (P173883) 6/28/2022 Page 9 of 9