The World Bank Implementation Status & Results Report Improving Access to and Value from Health Services in PNG: Financing the Frontlines (P167184) Improving Access to and Value from Health Services in PNG: Financing the Frontlines (P167184) EAST ASIA AND PACIFIC | Papua New Guinea | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2020 | Seq No: 2 | ARCHIVED on 29-Jun-2021 | ISR46129 | Implementing Agencies: Independent State of Papua New Guinea, National Department of Health Key Dates Key Project Dates Bank Approval Date: 22-Apr-2020 Effectiveness Date: 16-Dec-2020 Planned Mid Term Review Date: -- Actual Mid-Term Review Date: Original Closing Date: 30-Jun-2026 Revised Closing Date: 30-Jun-2026 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The development objective is to contribute to increasing the utilization of quality essential health services in Project-supported provinces of the Recipient. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Component 1: Increase service delivery readiness and community-based service delivery:(Cost $12.40 M) Component 2: Improve frontline service delivery performance:(Cost $14.60 M) Component 3: Project management:(Cost $3.00 M) Component 4: Contingent emergency response Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Moderately Satisfactory Satisfactory Overall Implementation Progress (IP) Moderately Satisfactory Satisfactory Overall Risk Rating Substantial Moderate Implementation Status and Key Decisions The Project became effective in December 2020. Despite the challenges and changing priorities resulting from the on-going pandemic, the Government of PNG including the National Department of Health and the Provincial Health Authorities in Enga and East New Britain have remain committed to the Project. The NDOH, supported by its Project Coordination Unit, is working diligently towards achieving the first year performance targets. The first year Disbursement Linked Indicators (DLIs) are expected to be met; those DLIs are expected to be verified, starting the flow of funds to the Project provinces before the end of the calendar year. 6/29/2021 Page 1 of 12 The World Bank Implementation Status & Results Report Improving Access to and Value from Health Services in PNG: Financing the Frontlines (P167184) Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance High Substantial Substantial Macroeconomic Substantial Substantial Substantial Sector Strategies and Policies Moderate Low Low Technical Design of Project or Program Substantial Moderate Moderate Institutional Capacity for Implementation and Substantial Moderate Moderate Sustainability Fiduciary High High High Environment and Social Moderate Moderate Moderate Stakeholders High Substantial Moderate Other Low Substantial Substantial Overall High Substantial Moderate Results PDO Indicators by Objectives / Outcomes To improve the quality of essential health services IN00975046 ►Percentage of Eligible Level 2-4 Health Care Facilities in Selected Provinces that have achieved a Minimum Service Quality Score (Text, Custom, PBC) Baseline Actual (Previous) Actual (Current) End Target (a) For Early Adopter Provinces (first two Selected Provinces): Percentage of Eligible Level 2-4 Health Care Facilities in each Early Integrated Facility Adopter Province that Supervision Checklist have achieved a Integrated Facility Integrated Facility expected to be Minimum Service Supervision Checklist to Supervision Checklist to Value approved by June 30 Quality Score is at measure quality not measure quality not and piloted in Early least thirty percent implemented implemented Adopter Provinces (30%) over the thereafter. Baseline. (b) For Expansion Provinces (subsequent two Selected Provinces): Percentage of Eligible Level 2-4 Health Care 6/29/2021 Page 2 of 12 The World Bank Implementation Status & Results Report Improving Access to and Value from Health Services in PNG: Financing the Frontlines (P167184) Facilities in each Expansion Province that have achieved a Minimum Service Quality Score is at least twenty percent (20%) over the Baseline. Date 03-Jun-2019 13-Nov-2020 23-Jun-2021 30-Jun-2025 This indicator is not yet measured. The Year 1 and Year 2 targets are to adopt the integrated facility supervision checklist and then to establish the baseline. Improvements will be measured starting in Year Comments: 3. To increase the utilization of essential health services IN00975047 ►Percentage increase in the number of Outreach Visits in Selected Provinces (Text, Custom, PBC) Baseline Actual (Previous) Actual (Current) End Target Twenty-five percent (25%) increase in the number of Outreach Visits over the Baseline in each Early Adopter Province (first two Selected Provinces). Value 0% 0% 0% Twenty percent (20%) increase in the number of Outreach Visits over the Baseline in each Expansion Province (Subsequent two Selected Provinces). Date 03-Jun-2019 13-Nov-2020 23-Jun-2021 30-Jun-2026 This indicator will start to be measured in Year 2. The data collection effort of the PHA Performance Comments: Framework will help to establish the baseline for the indicator. IN00975048 ►Percentage increase in the number of pregnant women who have received four or more antenatal care check-ups (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Thirty percent (30%) increase over baseline for Early Adopter Provinces (first two Selected Provinces) Value Zero percent (0%) Zero percent (0%) Zero percent (0%) Twenty percent (20%) increase over baseline for Expansion Provinces (subsequent two Selected Provinces) 6/29/2021 Page 3 of 12 The World Bank Implementation Status & Results Report Improving Access to and Value from Health Services in PNG: Financing the Frontlines (P167184) Date 03-Jun-2019 13-Nov-2020 23-Jun-2021 31-Dec-2025 This indicator will start to be measured in Year 3. Comments: IN00975049 ►Percentage increase in the number of children under one year of age who have received DPT-3 (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Thirty percent (30%) increase over baseline for Early Adopter Provinces (first two Selected Provinces) Zero percent (0%) Twenty percent (20%) Value Zero percent (0%) Zero percent (0%) increase over baseline for Expansion Provinces (subsequent two Selected Provinces) Date 03-Jun-2019 13-Nov-2020 23-Jun-2021 30-Jun-2025 This indicator will start to be measured in Year 3. Comments: IN00975050 ►Increase in the number of registered DSTB patients on treatment who have been cured (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Thirty percent (30%) increase over baseline for Early Adopter Provinces (first two Selected Provinces) Zero percent (0%) Twenty percent (20%) Value Zero percent (0%) Zero percent (0%) increase over baseline for Expansion Provinces (subsequent two Selected Provinces) Date 03-Jun-2019 13-Nov-2020 23-Jun-2021 31-Dec-2025 This indicator will start to be measured in Year 3. Comments: Intermediate Results Indicators by Components Component 1: Increase service delivery readiness and community-based service delivery IN00975051 ►Number of staff trained in RMNCH-N and PFM under the Project (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target At least 50 % of Value None None None eligible staff was 6/29/2021 Page 4 of 12 The World Bank Implementation Status & Results Report Improving Access to and Value from Health Services in PNG: Financing the Frontlines (P167184) trained in each of the Selected Provinces Date 03-Jun-2019 13-Nov-2020 30-Jun-2021 31-Dec-2025 Comments: Number of staff participating in training IN00975052 ►Innovations for community-based service delivery trialed and scaled up in Selected Provinces (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target One innovation Innovations not Innovations not Innovations not implemented in each Value implemented implemented implemented of the Selected Provinces Date 03-Jun-2019 13-Nov-2020 30-Jun-2021 31-Dec-2025 Contracted NGO or Church service provider implementing community-based service delivery innovation in Comments: line with proposal received IN00975053 ►Percentage of health facilities that have implemented patient feedback mechanisms and responded to issues identified (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Forty percent (40%) increase over baseline for Early Adopter Provinces (first two To be established in To be established in To be established in Year Selected Provinces) Year 2 for Early Year 2 for Early Adopter 2 for Early Adopter Thirty percent (30%) Value Adopter Provinces and Provinces and Year 3 for Provinces and Year 3 for increase over baseline Year 3 for Expansion Expansion Provinces Expansion Provinces for Expansion Provinces Provinces (subsequent two Selected Provinces) Date 03-Jun-2019 13-Nov-2020 30-Jun-2021 31-Dec-2025 Percentage of health facilities that implemented patient feedback mechanisms and responded to issues identified. The health facilities in the denominator would be level 2-4 facilities in the four selected Early Comments: Adopter and Expansion Provinces. The indicator will be measured through the Integrated Facility Supervision Checklist. Component 2: Improve frontline service delivery performance IN00975054 ►Timely transfer of PHA Performance Funds (Text, Custom, PBC) Baseline Actual (Previous) Actual (Current) End Target Transfer of PHA Performance Funds from NDOH within 10 working days of the No transfer of PHA No transfer of PHA No transfer of PHA Value date of receipt of an Performance Funds Performance Funds Performance Funds equivalent amount of financing proceeds from the World Bank for such purpose 6/29/2021 Page 5 of 12 The World Bank Implementation Status & Results Report Improving Access to and Value from Health Services in PNG: Financing the Frontlines (P167184) Date 03-Jun-2019 13-Nov-2020 30-Jun-2021 30-Jun-2026 Transfer of PHA Performance Funds from NDOH within 10 working days of the date of receipt of an Comments: equivalent amount of financing proceeds from the World Bank for such purpose IN00975055 ►National Performance Dashboard developed and updated (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target No National Performance National Performance Dashboard. NDOH No National Performance No National Performance Dashboard updated Value has endorsed Dashboard Dashboard and available online framework to be approved by the first two project provinces. Date 03-Jun-2019 13-Nov-2020 30-Jun-2021 31-Dec-2025 Comments: National Performance Dashboard developed, updated annually and published on the NDOH website IN00975056 ►Number of Selected PHAs with a complete Annual Implementation Plan submitted in a timely manner and in accordance with NDOH specifications (Text, Custom, PBC) Baseline Actual (Previous) Actual (Current) End Target Annual Status of the Annual Implementation Plans Baseline value to be Implementation Plans Baseline value to be submitted in a timely determined upon in Enga and ENB to be Value determined upon manner and to NDOH selection of Provinces determined following selection of Provinces specification in each of process of DLI the Selected Provinces verification. Date 03-Jun-2019 13-Nov-2020 30-Jun-2021 31-Dec-2025 PHAs in Selected Provinces have correctly prepared an Annual Implementation Plan using NDOH's Comments: template and submitted it to NDOH before the deadline identified in NDOH's budget circular. IN00975057 ►Number of PHA Boards that have used routine data for decision making (Text, Custom, PBC) Baseline Actual (Previous) Actual (Current) End Target No PHA has a Provincial Performance Dashboard; No PHA has a Supportive Provincial Supervision Plan. Performance No PHA has a Provincial No PHA has a Provincial Provincial Dashboard updated Performance Dashboard; Performance Dashboard; Performance and annual Supportive Value No PHA has a No PHA has a Dashboard Framework Supervision Plan Supportive Supervision Supportive Supervision expected to be prepared in each Plan Plan approved by June 30 Selected Province and Supportive Supervision Plan expected to be approved by end of the year. Date 03-Jun-2019 13-Nov-2020 23-Jun-2021 31-Dec-2025 6/29/2021 Page 6 of 12 The World Bank Implementation Status & Results Report Improving Access to and Value from Health Services in PNG: Financing the Frontlines (P167184) (i) Province performance dashboard for use by PHA Board developed and updated every six months Comments: using eNHIS data; and (ii) Supportive Supervision Plan to address performance concerns adopted by PHA Board Performance-Based Conditions IN00975058 ►PBC 1 N-DLI 1: Memoranda of Understanding (MoU) signed with up to 4 Selected Provincial Health Authorities (PHAs) (Text, Output, 600,000.00, 0.00%) Baseline Actual (Previous) Actual (Current) Year 5 2 MOUs expected to be Value No MoU signed No MoU signed -- signed by June 30, 2021 Date -- 08-Jul-2020 23-Jun-2021 -- IN00975059 ►PBC 2 N-DLI 2: Integrated Facility Supervision Checklist adopted and updated (Text, Output, 600,000.00, 0.00%) Baseline Actual (Previous) Actual (Current) Year 5 No Integrated Facility Integrated Facility No Integrated Facility Supervision Checklist Supervision Checklist Value Supervision Checklist -- implemented expected to be endorsed implemented by June 30, 2021 Date -- 08-Jul-2020 23-Jul-2021 -- IN00975060 ►PBC 3 Timely transfer of PHA Performance Funds (Text, Output, 1,500,000.00, 0.00%) Baseline Actual (Previous) Actual (Current) Year 5 Transfer of funds expected only after the No transfer of PHA No transfer of PHA Value verification of the initial -- Performance Funds Performance Funds results (i.e. before end of calendar year) Date -- 13-Nov-2020 23-Jun-2021 -- IN00975061 ►PBC 4 N-DLI 4: Number of Selected Provinces that have achieved all Provincial DLIs. (Text, Output, 1,000,000.00, 0.00%) Baseline Actual (Previous) Actual (Current) Year 5 6/29/2021 Page 7 of 12 The World Bank Implementation Status & Results Report Improving Access to and Value from Health Services in PNG: Financing the Frontlines (P167184) At least one (1) Selected Province has fully achieved DLI Targets of all Value No annual targets met No annual targets met No annual targets met Provincial DLIs for Year 5. Targeted for up to four (4) Selected Provinces. Date -- 08-Jul-2020 23-Jun-2021 -- IN00975062 ►PBC 5 Number of Selected PHAs with a complete Annual Implementation Plan submitted in a timely manner and in accordance with NDOH specifications (Text, Output, 1,600,000.00, 11%) Baseline Actual (Previous) Actual (Current) Year 5 Baseline value to be Baseline value to be Baseline value to be determined upon selection Value determined upon determined upon selection -- of Provinces selection of Provinces of Provinces Date -- 13-Nov-2020 30-Jun-2021 -- IN00975063 ►PBC 6 Percentage of Eligible Level 2-4 Health Care Facilities in Selected Provinces that have achieved a Minimum Service Quality Score (Text, Output, 2,100,000.00, 0.00%) Baseline Actual (Previous) Actual (Current) Year 5 Integrated Facility Integrated Facility Integrated Facility Supervision Checklist Supervision Checklist to Supervision Checklist to expected to be approved Value -- measure quality not measure quality not by June 30 and piloted in implemented implemented Early Adopter Provinces thereafter. Date -- 13-Nov-2020 23-Jun-2021 -- IN00975064 ►PBC 7 Number of PHA Boards that have used routine data for decision making (Text, Output, 1,200,000.00, 5.5%) Baseline Actual (Previous) Actual (Current) Year 5 No PHA has a Provincial No PHA has a Provincial No PHA has a Provincial Performance Dashboard; Performance Dashboard; Performance Dashboard; Value No PHA has a -- No PHA has a Supportive No PHA has a Supportive Supportive Supervision Supervision Plan Supervision Plan Plan Date -- 13-Nov-2020 23-Jun-2021 -- 6/29/2021 Page 8 of 12 The World Bank Implementation Status & Results Report Improving Access to and Value from Health Services in PNG: Financing the Frontlines (P167184) IN00975065 ►PBC 8 Percentage increase in the number of Outreach Visits in Selected Provinces (Text, Output, 2,100,000.00, 0.00%) Baseline Actual (Previous) Actual (Current) Year 5 Value 0% 0% 0% -- Date -- 13-Nov-2020 23-Jun-2021 -- IN00975066 ►PBC 9 C-DLI 1: Percentage increase in the number of pregnant women who have received four or more antenatal care check-ups (Text, Intermediate Outcome, 1,200,000.00, 0.00%) Baseline Actual (Previous) Actual (Current) Year 5 NDOH has furnished to the Association a report, in form and substance described in the DLI Operational Manual, setting forth the list of Competitive DLI Provinces with a top two (2) highest percentage increase 0%. Increase in ANC in the number of Value 0% 0% visits not yet expected. pregnant women who have received four (4) or more antenatal care check-ups in Year 5, compared to their respective results in Year 4, as determined in accordance with the details set forth in the DLI Operational Manual. Date -- 08-Jul-2020 23-Jun-2021 -- IN00975067 ►PBC 10 C-DLI 2: Percentage increase in the number of children aged under one (1) year who have received DPT-3 (Text, Intermediate Outcome, 1,200,000.00, 0.00%) Baseline Actual (Previous) Actual (Current) Year 5 6/29/2021 Page 9 of 12 The World Bank Implementation Status & Results Report Improving Access to and Value from Health Services in PNG: Financing the Frontlines (P167184) NDOH has furnished to the Association a report, in form and substance described in the DLI Operational Manual, setting forth the list of Competitive DLI Provinces with a top two (2) highest 0%. Increase in percentage increase Value 0% 0% immunization rates not yet in the number of expected. children under one (1) year of age who have received DPT- 3 in Year 5, compared to their respective results in Year 4, as determined in accordance with the details set forth in the DLI Operational Manual. Date -- 08-Jul-2020 23-Jun-2021 -- IN00975068 ►PBC 11 C-DLI 3: Increase in the number of registered DSTB patients on treatment who have been cured (Text, Intermediate Outcome, 1,500,000.00, 0.00%) Baseline Actual (Previous) Actual (Current) Year 5 NDOH has furnished to the Association a report, in form and substance described in the DLI Operational Manual, setting forth the list of Competitive DLI Provinces with a top two (2) highest increase in the 0% 0%. Increase not yet Value 0% number of registered expected. drug susceptible tuberculosis patients on treatment who have been cured in Year 5, compared to their respective results in Year 4, as determined in accordance with the details set forth in the DLI Operational Manual. 6/29/2021 Page 10 of 12 The World Bank Implementation Status & Results Report Improving Access to and Value from Health Services in PNG: Financing the Frontlines (P167184) Date -- 08-Jul-2020 23-Jun-2021 -- Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P167184 IDA-64970 Effective USD 30.00 30.00 0.00 0.09 31.28 0.3% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P167184 IDA-64970 Effective 22-Apr-2020 22-Jul-2020 16-Dec-2020 30-Jun-2026 30-Jun-2026 Cumulative Disbursements PBC Disbursement Achievement Disbursed amount in Disbursement % PBC ID PBC Type Description Coc PBC Amount Status Coc for PBC 6/29/2021 Page 11 of 12 The World Bank Implementation Status & Results Report Improving Access to and Value from Health Services in PNG: Financing the Frontlines (P167184) Restructuring History There has been no restructuring to date. Related Project(s) There are no related projects. 6/29/2021 Page 12 of 12