The World Bank Implementation Status & Results Report CAR Health Service Delivery and System Strengthening Project (SENI-Plus) (P177003) CAR Health Service Delivery and System Strengthening Project (SENI-Plus) (P177003) WESTERN AND CENTRAL AFRICA | Central African Republic | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2022 | Seq No: 1 | ARCHIVED on 12-Sep-2022 | ISR52156 | Implementing Agencies: Central African Republic, Ministry of Health and Population, Central African Republic Key Dates Key Project Dates Bank Approval Date: 03-Jun-2022 Effectiveness Date: -- Planned Mid Term Review Date: 31-Dec-2024 Actual Mid-Term Review Date: Original Closing Date: 30-Sep-2027 Revised Closing Date: 30-Sep-2027 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) To increase utilization of quality essential health services, especially for women and children, in targeted areas in the Central African Republic. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Component 1: Supporting Essential Health Service Delivery:(Cost $36.00 M) Component 2: Strengthening Health System Performance and Preparedness:(Cost $32.00 M) Component 3: Project Management, Coordination and Monitoring & Evaluation (M&E):(Cost $2.00 M) Component 4: Contingent Emergency Response Component (CERC) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO -- Satisfactory Overall Implementation Progress (IP) -- Satisfactory Overall Risk Rating -- Substantial Implementation Status and Key Decisions The project was approved by the Board on June 3, 2022, and the legal agreements were signed on June 28,2022. The project development objective is to increase utilization of quality essential health services, especially for women and children, in targeted areas in the Central African Republic. 9/12/2022 Page 1 of 8 The World Bank Implementation Status & Results Report CAR Health Service Delivery and System Strengthening Project (SENI-Plus) (P177003) Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance High -- High Macroeconomic Substantial -- Substantial Sector Strategies and Policies Substantial -- Substantial Technical Design of Project or Program Substantial -- Substantial Institutional Capacity for Implementation and Substantial -- Substantial Sustainability Fiduciary Substantial -- Substantial Environment and Social Substantial -- Substantial Stakeholders Moderate -- Moderate Other -- -- -- Overall Substantial -- Substantial Results PDO Indicators by Objectives / Outcomes Supporting Essential Health Service Delivery IN01161762 ►Children who have received 3 doses of Pentavalent vaccine (Penta3) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 43,059.00 -- 43,059.00 58,120.00 Date 01-Feb-2022 -- 21-Jun-2022 30-Sep-2027 Number of children who have received a third doses of Pentavalent vaccine from staff of facilities targeted Comments: by the Project in the previous 4 quarters. IN01161764 ►Facility deliveries attended by skilled health personnel (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 82,373.00 -- 82,373.00 90,060.00 Date 01-Feb-2022 -- 21-Jun-2022 30-Sep-2027 Number of deliveries attended by skilled health personnel in facilities targeted by the project in the Comments: previous 4 quarters. IN01161791 ►Modern contraceptive services received by women and adolescents (Number, Custom) 9/12/2022 Page 2 of 8 The World Bank Implementation Status & Results Report CAR Health Service Delivery and System Strengthening Project (SENI-Plus) (P177003) Baseline Actual (Previous) Actual (Current) End Target Value 104,053.00 -- 104,053.00 125,128.00 Date 01-Feb-2022 -- 21-Jun-2022 30-Sep-2027 Number of contraceptive services delivered in the previous 4 quarters by staff of facilities targeted by the Comments: Project. IN01161792 Modern contraceptive services received by women and adolescents – short-term (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 102,112.00 -- 102,112.00 111,640.00 Date 01-Mar-2022 -- 21-Jun-2022 30-Sep-2027 IN01161793 Modern contraceptive services received by women and adolescents – long-term and permanent (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 1,941.00 -- 1,941.00 13,518.00 Date 01-Mar-2022 -- 21-Jun-2022 30-Sep-2027 Strengthening Health System Performance and Preparedness IN01161763 ►Availability of tracer drugs at health centers in targeted districts (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 76.00 -- 76.00 85.00 Date 01-Feb-2022 -- 21-Jun-2022 30-Sep-2027 Average of the percentage of tracer drugs (as defined in the PBF quality assurance tool) available in each Comments: health centre for the previous four quarters (districts targeted by the Project). IN01161765 ►Average quality score of health centers in targeted districts (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 55.00 -- 55.00 80.00 Date 01-Feb-2022 -- 21-Jun-2022 30-Sep-2027 Average of PBF quality scores for the previous four quarters for health centers in districts targeted by the Comments: Project Intermediate Results Indicators by Components 1. SUPPORTING ESSENTIAL HEALTH SERVICE DELIVERY IN01161801 9/12/2022 Page 3 of 8 The World Bank Implementation Status & Results Report CAR Health Service Delivery and System Strengthening Project (SENI-Plus) (P177003) ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target Value 231,158.00 -- 231,158.00 1,219,720.00 Date 01-Feb-2022 -- 21-Jun-2022 30-Sep-2027 IN01161804 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 155,724.00 -- 155,724.00 821,720.00 IN01161806 Number of deliveries attended by skilled health personnel (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 82,373.00 -- 82,373.00 434,650.00 Date 01-Feb-2022 -- 21-Jun-2022 30-Sep-2027 IN01161808 Number of children immunized (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 66,449.00 -- 66,449.00 350,620.00 Date 01-Feb-2022 -- 21-Jun-2022 30-Sep-2027 IN01161809 Number of women and children who have received basic nutrition services (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 82,336.00 -- 82,336.00 434,450.00 Date 01-Feb-2022 -- 21-Jun-2022 30-Sep-2027 1.1: Increasing Health Service Utilization and Quality through PBF IN01161794 ►Pregnant women who have attended 4 antenatal care visits (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 38,907.00 -- 38,907.00 66,710.00 Date 01-Feb-2022 -- 21-Jun-2022 30-Sep-2027 Number of pregnant women who have attended a fourth antenatal care visit in facilities targeted by the Comments: project in the previous 4 quarters. IN01161802 ►Patients under the Free Health Services (Gratuité Ciblé) scheme who report receiving their service and medication at no charge (Percentage, Custom) 9/12/2022 Page 4 of 8 The World Bank Implementation Status & Results Report CAR Health Service Delivery and System Strengthening Project (SENI-Plus) (P177003) Baseline Actual (Previous) Actual (Current) End Target Value 81.00 -- 81.00 90.00 Date 01-Feb-2022 -- 21-Jun-2022 30-Sep-2027 Average across the last four quarters of the percentage of eligible patients in the PBF community survey Comments: who report not having paid any charges for services or medication. IN01161805 ►Facilities receiving performance payments on time (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 60.00 -- 60.00 80.00 Date 01-Feb-2022 -- 21-Jun-2022 30-Sep-2027 Average across the last four quarters of the percentage of facilities eligible for performance payments that Comments: received them in accordance with the timelines set out in the PBF Manual. IN01161807 ►Quality satisfaction score of beneficiaries for health services in district hospitals (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 60.00 -- 60.00 80.00 Date 01-Feb-2022 -- 21-Jun-2022 30-Sep-2027 Average of patient satisfaction scores for the previous four quarters for district hospitals targeted by the Comments: Project. 1.2 Strengthening community-based essential health service delivery IN01161795 ►People referred to health facilities by community workers (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 76,496.00 -- 76,496.00 97,550.00 Date 01-Feb-2022 -- 21-Jun-2022 30-Sep-2027 Number of patient referrals by community health workers to facilities (with proof of receipt at the facility) in Comments: the previous 4 quarters.. 1.3: Providing Holistic Support to GBV Survivors IN01161798 ►District hospitals with integrated GBV services (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 5.00 -- 5.00 15.00 Date 01-Feb-2022 -- 21-Jun-2022 30-Sep-2027 9/12/2022 Page 5 of 8 The World Bank Implementation Status & Results Report CAR Health Service Delivery and System Strengthening Project (SENI-Plus) (P177003) Number of hospitals supported by the Project that have a psychosocial agent and staff trained in GBV Comments: services. 2. STRENGTHENING HEALTH SYSTEM PERFORMANCE AND PREPAREDNESS IN01161800 ►NHDP/Investment Case performance reports discussed at quarterly meetings of the Comite de Pilotage Unique (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 15.00 Date 01-Feb-2022 -- 21-Jun-2022 30-Sep-2027 Cumulative number of quarters in which PNDS and/or Investment Case performance reports were Comments: presented and discussed at a meeting of the country platform (Comité de Pilotage Unique). 2.2: Upgrading Hospitals to Improve Domestic Diagnostic and Treatment Capacity IN01161797 ►Number of hospitals scoring 80% or higher on the 'diagnostic capacity' components of the PBF quality assurance checklist (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 12.00 Date 01-Feb-2022 -- 21-Jun-2022 30-Sep-2027 Number of hospitals scoring an average of 80% or higher over the past four quarters for the new Comments: 'diagnostic capacity' sub-score of the PBF quality checklist for hospitals. 2.3: Implementation Support for Key Health Sector Reforms IN01161799 ►Number of additional health professionals employed full-time in health facilities (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 326.00 Date 01-Feb-2022 -- 21-Jun-2022 30-Sep-2027 Number of health professionals employed in facilities targeted by the Project as reported in the latest Comments: quarterly PBF submissions. IN01161803 Number of additional health professionals employed full-time in health facilities in targeted districts - female (disaggregation) (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 190.00 Date 01-Feb-2022 -- 21-Jun-2022 30-Sep-2027 2.4: Integrating Pandemic Preparedness in Health System Strengthening IN01161796 9/12/2022 Page 6 of 8 The World Bank Implementation Status & Results Report CAR Health Service Delivery and System Strengthening Project (SENI-Plus) (P177003) ►CHWs trained on epidemic surveillance and preparedness (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 1,650.00 Date 01-Feb-2022 -- 21-Jun-2022 30-Sep-2027 Cumulative number of community health workers (CHWs) trained on epidemic surveillance and Comments: preparedness with support from the project. Performance-Based Conditions Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed Not P177003 IDA-E0480 USD 58.00 58.00 0.00 0.00 54.69 0% Effective Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date Not P177003 IDA-E0480 03-Jun-2022 28-Jun-2022 -- 30-Sep-2027 30-Sep-2027 Effective Cumulative Disbursements 9/12/2022 Page 7 of 8 The World Bank Implementation Status & Results Report CAR Health Service Delivery and System Strengthening Project (SENI-Plus) (P177003) Restructuring History There has been no restructuring to date. Related Project(s) There are no related projects. 9/12/2022 Page 8 of 8