The World Bank Implementation Status & Results Report
MONGOLIA COVID-19 EMERGENCY RESPONSE AND HEALTH SYSTEM PREPAREDNESS PROJECT (P173799)
MONGOLIA COVID-19 EMERGENCY RESPONSE AND HEALTH SYSTEM PREPAREDNESS PROJECT (P173799)
EAST ASIA AND PACIFIC | Mongolia | Health, Nutrition & Population Global Practice |
IBRD/IDA | Investment Project Financing | FY 2020 | Seq No: 4 | ARCHIVED on 30-Jun-2022 | ISR51344 |
Implementing Agencies: Ministry of Health, Mongolia
Key Dates
Key Project Dates
Bank Approval Date: 02-Apr-2020 Effectiveness Date: 24-Apr-2020
Planned Mid Term Review Date: 30-May-2022 Actual Mid-Term Review Date: 02-May-2022
Original Closing Date: 31-Mar-2023 Revised Closing Date: 31-Mar-2023
pdoTable
Project Development Objectives
Project Development Objective (from Project Appraisal Document)
The proposed project development objective is to strengthen Mongolia’s capacity to prevent and respond to the COVID-19 outbreak and strengthen
national systems for public health preparedness.
Has the Project Development Objective been changed since Board Approval of the Project Objective?
No
Components Table
Name
Component 1: Emergency COVID-19 Prevention and Response:(Cost $11.50 M)
Component 2: Strengthening Health Care Delivery Capacity:(Cost $64.20 M)
Component 3: Implementation management and Monitoring and Evaluation:(Cost $1.90 M)
Component 4: Contingent Emergency Response Component
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 Substantial Substantial
Implementation Status and Key Decisions
Overall, the Mid Term Review found that the Project has had notable achievements, good implementation progress, and satisfactory disbursement.
Feedback from stakeholders enabled some lessons to be learned; for example the need for a reliable supply of consumables for new equipment
and greater training for biomedical engineers. Rather than being generic nationally, risk communication materials also need to be adapted to local
circumstances, populations, and communication needs. There is a need for some course correction including expediting activities under Component
1. To address this issue, the MOH has appointed a Component 1 focal point by the MOH, who will be complemented by a Component 1 coordinator
in the IPIU. Given that Component 2 procurement of medical equipment is now lagging behind after a strong initial phase, the WB team
recommends the appointment of a similar focal point in the MOH. There has been some reprogramming of activities as well as new initiatives
proposed, such as the solarization of the Central Vaccine Storage. As these will take time, the WB recommends a six-month extension of the
Project, which would also provide an opportunity to update the results framework to better capture current Project activities.
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The World Bank Implementation Status & Results Report
MONGOLIA COVID-19 EMERGENCY RESPONSE AND HEALTH SYSTEM PREPAREDNESS PROJECT (P173799)
MPA Program Development Objective
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 June 15, 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 June 15, 2022, amount to US$3.6 billion or 84% of overall commitments. This amount does not include disbursements
under MPA-V operations which are reported together with AF-V operations. Sixty-seven (67) country projects or 77% of projects approved have
reached 70-100% disbursement (reasons for >100% disbursements relate to fluctuations between the Euro and the SDR against the US$). Out of
the 67 operations, 48 operations or 72% have disbursed over 90% of commitments. Of these, 30 operations are fully disbursed. There are
thirteen (13) operations with closing dates by the end of FY22. Other 10 operations which had closing dates by the end of the FY have
extended their closing dates. There are 12 operations with disbursements under 50%. Out of these 12 operations, one has not disbursed,
and four have disbursed 30 percent or less. 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. MNA has the
highest percentage of disbursements, followed by SRA, EAP, ECA and LAC, AFE and AFW. Retroactive Financing represents 26% of
commitments. 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. 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.
MPA AF-V - ISR Write-up – June 15, 2022
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
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MONGOLIA COVID-19 EMERGENCY RESPONSE AND HEALTH SYSTEM PREPAREDNESS PROJECT (P173799)
$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 June 15, 2022, the Bank has approved 105 operations (including MPA-V operations) to support vaccine procurement and rollout in
77 countries amounting to $9.6 billion. The 105 operations approved, include 6 operations that involved restructuring of parent projects (Bhutan,
Cameroon, North Macedonia, Philippines, and Pakistan) and in the case of Lebanon, restructuring of the Health Resilience Project. Of the 105
approved operations: (i) 56 are in Africa – 26 in AFE and 30 in AFW; (ii) 9 in East Asia and the Pacific; (iii) 11 in Europe and Central Asia; (iv) 11 in
Latin America and the Caribbean; (v) 9 in Middle East and North Africa; and (vi) 9 in South Asia. Fifty-three (53) projects are disbursing. Total
disbursements as of June 15, 2022, under these projects amount to US$3.4 billion or 35% 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. Sixteen (16) operations have disbursed over 70% of their commitments. Out of the 16, seven have disbursed 90%. Retroactive
Financing represents 44% of overall commitments. Thirteen (13) new operations are under various stages of processing. 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. Eighty-eight (88) loan/financing agreements have been signed. Also, eighty-six (86)
loan/financing agreements have become effective; several others are expected to become effective in the coming weeks. 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. 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 High Substantial Substantial
Macroeconomic High Moderate Moderate
Sector Strategies and Policies Moderate Moderate Moderate
Technical Design of Project or Program Moderate Moderate Moderate
Institutional Capacity for Implementation and
Moderate Substantial Moderate
Sustainability
Fiduciary Moderate Substantial Substantial
Environment and Social Substantial Substantial Substantial
Stakeholders Substantial Substantial Substantial
Other -- Substantial Substantial
Overall Substantial Substantial Substantial
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MONGOLIA COVID-19 EMERGENCY RESPONSE AND HEALTH SYSTEM PREPAREDNESS PROJECT (P173799)
Results
PDO Indicators by Objectives / Outcomes
Emergency COVID-19 Prevention and Response
IN01138760
►Proportion of laboratory-confirmed cases of COVID-19 responded to within 48 hours (Percentage, Custom)
Baseline Actual (Previous) Actual (Current) End Target
Value 40.00 0.00 100.00 80.00
Date 18-Mar-2020 08-Nov-2021 30-May-2022 31-Mar-2023
Unable to verify actual value - proposed to mark for deletion during restructuring.
Denominator: Number of laboratory-confirmed cases of COVID-19. Numerator: Number of laboratory-
Comments: confirmed cases of COVID-19 where there was deployment of a rapid response team, contract tracing
was initiated, and public messaging was disseminated within 48 hours.
IN01138762
Share of females (Percentage, Custom Supplement)
Baseline Actual (Previous) Actual (Current) End Target
Value 0.00 0.00 39.00 50.00
IN01138763
►Samples from suspected cases of COVID-19 / SARI that are confirmed within the stipulated WHO standard time (Percentage, Custom)
Baseline Actual (Previous) Actual (Current) End Target
Value 0.00 0.00 75.00 75.00
Date 18-Mar-2020 10-Nov-2021 30-May-2022 31-Mar-2023
Unable to verify actual current value - proposed to mark for deletion during restructuring..
Denominator: Number of specimens submitted for COVID-19/SARI laboratory testing Numerator: Number
Comments: of specimens submitted for COVID-19/SARI laboratory testing confirmed within the stipulated WHO
standard time
IN01138764
►Percentage of population vaccinated, which is included in the priority population targets defined in national plan. (Percentage, Custom)
Baseline Actual (Previous) Actual (Current) End Target
Value 0.00 115.70 94.00 60.00
Date 10-Nov-2020 10-Nov-2021 30-May-2022 31-Mar-2023
This indicator is proposed to mark for updating and splitting into two different PDO indicators.
Denominator: Total priority population targeted for vaccination. Numerator: Number of targeted priority
Comments:
populations received COVID-19 vaccine as per government regulation
IN01138765
Share of females (Percentage, Custom Supplement)
Baseline Actual (Previous) Actual (Current) End Target
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MONGOLIA COVID-19 EMERGENCY RESPONSE AND HEALTH SYSTEM PREPAREDNESS PROJECT (P173799)
Value 0.00 60.00 50.30 50.00
Strengthening Health Care Delivery Capacity
IN01138759
►Number of hospitals meeting MOH established standards to manage Severe Acute Respiratory Infections (SARI) patients including
intensive care (Number, Custom)
Baseline Actual (Previous) Actual (Current) End Target
Value 0.00 48.00 48.00 24.00
Date 18-Mar-2020 08-Nov-2021 30-May-2022 31-Mar-2023
Comments: Cumulative number of hospitals with capacity to manage SARI patients including intensive care
IN01138761
►Number of designated laboratories with COVID-19/SARI diagnostic capacities established per MOH guidelines (Number, Custom)
Baseline Actual (Previous) Actual (Current) End Target
Value 1.00 18.00 18.00 5.00
Date 20-Mar-2020 08-Nov-2021 30-May-2022 31-Mar-2023
Cumulative number of designated laboratories with COVID-19 diagnostic capacities. Corrected in October
2021. To be revised during restructuring to Number of hospitals with increased diagnostic capacity,
Comments:
including but not limited to laboratories and COVID19 (Number).
Intermediate Results Indicators by Components
Emergency COVID-19 Response
IN01138766
►Number of mass media messages disseminated on COVID-19 vaccine sequencing, target groups for COVID-19 vaccination and
prevention measures in the last six months (Number, Custom)
Baseline Actual (Previous) Actual (Current) End Target
Value 0.00 0.00 71.00 20.00
Date 18-Mar-2020 08-Nov-2021 30-May-2022 31-Mar-2023
Cumulative number mass media messages disseminated. Corrected in October 2021. This indicator will
Comments: be revised during restructuring.
IN01138769
►Proportion of identified contacts who are successfully traced (Percentage, Custom)
Baseline Actual (Previous) Actual (Current) End Target
Value 0.00 0.00 90.00 90.00
Date 18-Mar-2020 10-Nov-2021 30-May-2022 31-Mar-2023
Comments: Unable to verify actual current value - proposed to mark for deletion during restructuring.
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MONGOLIA COVID-19 EMERGENCY RESPONSE AND HEALTH SYSTEM PREPAREDNESS PROJECT (P173799)
Denominator: Number of contacts of COVID-19 cases identified. Numerator: Number of contacts of
COVID-19 cases successfully traced.
IN01138772
►Number of “One Health”-based simulation exercises conducted and certified by Ministry of Health/ Agriculture at national and sub-national
levels (Number, Custom)
Baseline Actual (Previous) Actual (Current) End Target
Value 0.00 0.00 0.00 3.00
Date 18-Mar-2020 09-Nov-2021 30-May-2022 31-Mar-2023
Cumulative number of “One Health”-based simulation exercises conducted
Comments:
IN01138775
►Number of health staff trained in provision of COVID-19 vaccination and infection prevention and control per MOH-approved protocols
(Number, Custom)
Baseline Actual (Previous) Actual (Current) End Target
Value 0.00 1,700.00 2,100.00 1,000.00
Date 18-Mar-2020 08-Nov-2021 30-May-2022 31-Mar-2023
Cumulative number of health staff trained in infection prevention and control. To be revised to Number of
health staff trained in infection prevention and control, medical waste management, field epidemiology and
Comments:
adverse effect of COVID-19 vaccination (Number)
IN01138778
Share of females (Percentage, Custom Supplement)
Baseline Actual (Previous) Actual (Current) End Target
Value 0.00 80.00 80.00 50.00
Health System Strengthening
IN01138767
►Number of ventilators provided to hospitals (Number, Custom)
Baseline Actual (Previous) Actual (Current) End Target
Value 0.00 215.00 215.00 200.00
Date 18-Mar-2020 10-Nov-2021 30-May-2022 31-Mar-2023
Comments: Cumulative number of ventilators supplied to hospitals.
IN01138770
►Percentage of Aimag/district hospitals with pandemic preparedness and response plans per Ministry of Health Guidelines and (ii)
microplans for deployment of COVID 19 vaccine as per MOH guidelines (Percentage, Custom)
Baseline Actual (Previous) Actual (Current) End Target
Value 0.00 100.00 100.00 90.00
Date 18-Mar-2020 10-Nov-2021 30-May-2022 31-Mar-2023
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Unable to verify actual current value - proposed to mark for deletion during restructuring. Numerator:
Number of Aimag/district hospitals with pandemic preparedness plans Denominator: Total number of
Comments:
Aimag/district hospitals
IN01138773
►Percentages of provincial and district general hospitals with personal protective equipment and infection control products and supplies,
without stock-outs in preceding two weeks (Percentage, Custom)
Baseline Actual (Previous) Actual (Current) End Target
Value 0.00 0.00 100.00 80.00
Date 18-Mar-2020 10-Nov-2021 30-May-2022 31-Mar-2023
Unable to verify actual current value - marked for deletion.
Numerator: Number of provincial and district general hospitals with personal protective equipment and
Comments: infection control products and supplies, without stock-outs in preceding two weeks Denominator: Total
number of provincial and district general hospitals
IN01138776
►Share of vaccination units fully equipped with adequate and functioning cold chain (Percentage, Custom)
Baseline Actual (Previous) Actual (Current) End Target
Value 0.00 100.00 100.00 95.00
Date 10-Nov-2020 10-Nov-2021 30-May-2022 31-Mar-2023
IN01138777
►Share of vaccinated persons with records of vaccine vial used (Percentage, Custom)
Baseline Actual (Previous) Actual (Current) End Target
Value 0.00 0.00 100.00 95.00
Date 10-Nov-2020 10-Nov-2021 30-May-2022 31-Mar-2023
Unable to verify actual current value - marked for deletion.
Comments:
IN01138779
►Distribution of female PPE matches daily needs of female health workers (Yes/No, Custom)
Baseline Actual (Previous) Actual (Current) End Target
Value No Yes Yes Yes
Date 10-Nov-2020 10-Nov-2021 10-Nov-2021 31-Mar-2023
Unable to verify - marked for deletion.
Comments:
Implementation Management and Monitoring and Evaluation
IN01138768
►Independent review of equipment purchase and utilization carried out annually (Text, Custom)
Baseline Actual (Previous) Actual (Current) End Target
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MONGOLIA COVID-19 EMERGENCY RESPONSE AND HEALTH SYSTEM PREPAREDNESS PROJECT (P173799)
Value NA No No Yes
Date 18-Mar-2020 10-Nov-2021 30-May-2022 31-Mar-2023
Planned
Comments:
IN01138771
►Six monthly reports prepared and circulated in a timely manner (Yes/No, Custom)
Baseline Actual (Previous) Actual (Current) End Target
Value No Yes Yes Yes
Date 31-Mar-2020 10-Nov-2021 30-May-2022 31-Mar-2023
Comments: Six monthly project performance reports
IN01138774
►Beneficiary feedback and response mechanisms on COVID-19 prevention and vaccination established and carried out with reporting on
every six months (Yes/No, Custom)
Baseline Actual (Previous) Actual (Current) End Target
Value No Yes Yes Yes
Date 10-Nov-2020 10-Nov-2021 30-May-2022 31-Mar-2023
Performance-Based Conditions
Data on Financial Performance
Disbursements (by loan)
Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed
P173799 IBRD-90820 Effective USD 13.80 13.80 0.00 13.17 0.63 95%
P173799 IDA-65940 Effective USD 13.10 13.10 0.00 10.94 2.68 80%
P173799 IDA-68330 Effective USD 50.70 50.70 0.00 32.50 16.94 66%
Key Dates (by loan)
Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date
P173799 IBRD-90820 Effective 02-Apr-2020 09-Apr-2020 24-Apr-2020 31-Mar-2023 31-Mar-2023
P173799 IDA-65940 Effective 02-Apr-2020 09-Apr-2020 24-Apr-2020 31-Mar-2023 31-Mar-2023
P173799 IDA-68330 Effective 11-Feb-2021 15-Feb-2021 08-Jun-2021 31-Mar-2023 31-Mar-2023
Cumulative Disbursements
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MONGOLIA COVID-19 EMERGENCY RESPONSE AND HEALTH SYSTEM PREPAREDNESS PROJECT (P173799)
Restructuring History
Level 2 Approved on 05-Jun-2021
Related Project(s)
P175730-Mongolia COVID-19 Emergency Response and Health System Preparedness Project Additional Financing
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