The World Bank Report No: ISR10904 Implementation Status & Results Sudan Sudan Multi-donor Trust Fund for Decentralized Health System Development Project (P098483) Public Disclosure Copy Operation Name: Sudan Multi-donor Trust Fund for Decentralized Health Project Stage: Implementation Seq.No: 12 Status: ARCHIVED Archive Date: 24-Jun-2013 System Development Project (P098483) Country: Sudan Approval FY: 2007 Product Line: Recipient Executed Activities Region: AFRICA Lending Instrument: Emergency Recovery Loan Implementing Agency(ies): Key Dates Board Approval Date 30-Oct-2006 Original Closing Date 31-Dec-2009 Planned Mid Term Review Date Last Archived ISR Date 31-Dec-2012 Effectiveness Date 24-Jan-2007 Revised Closing Date 30-Jun-2013 Actual Mid Term Review Date Project Development Objectives Project Development Objective (from Project Appraisal Document) To improve access to basic health services by conflict-affected and underserved populations in four target states while establishing the basis for reform, sustainable financing, and development of the decentralized health system. Has the Project Development Objective been changed since Board Approval of the Project? Yes No Component(s) Component Name Component Cost 1. Expanding access to primary health care services by underserved populations ($1.4 M grant) 5.00 2. Establishing the basis for reform and development of the decentralized health system ($4.5 M 13.40 grant) Overall Ratings Public Disclosure Copy Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Satisfactory Satisfactory Overall Risk Rating Substantial Implementation Status Overview This is the final implementation status update as the project will close on June 30, 2013. The project has achieved positive results: all five project development objective indicators - namely outpatient consultations per person per year; % of pregnant women who attended at least one antenatal care consultation; births attended by skilled health staff (incl. village midwives; % of households who possess at least one insecticide-treated net; and no. of health personnel receiving training - were surpassed. The project has also made satisfactory progress on the five intermediate indicators. Page 1 of 5 The World Bank Report No: ISR10904 Locations Country First Administrative Division Location Planned Actual Sudan Not Entered Red Sea State Public Disclosure Copy Sudan Not Entered Blue Nile State Sudan Not Entered Southern Kordofan State Sudan Not Entered Kassala State Results Project Development Objective Indicators Indicator Name Core Unit of Measure Baseline Current End Target outpatient consultations per person per year in Number Value 0.16 0.41 0.30 target health facilities Date 31-Dec-2009 31-May-2013 30-Jun-2013 Comments Recalculated from 2008-09 Information collected from the The end target was kept in HMIS database (2009 SHHS HMIS database. the project's restructuring in report not yet available). December 2012 (for the 2nd additional financing). % pregnant women who attended at least one Percentage Value 48.00 68.00 65.00 antenatal care consultation in target areas Date 31-Dec-2009 31-May-2013 31-Dec-2012 Comments Recalculated from 2008-09 Information collected from The end target was kept in Reproductive Health Dept Reproductive Health Dept the project's restructuring in database (2009 SHHS report database. December 2012 (for the 2nd not yet available by that time) additional financing). births attended by skilled health staff (% of total Percentage Value 19.00 63.00 55.00 births) in target areas (skilled health staff = Date 31-Dec-2009 31-May-2013 30-Jun-2013 doctor, nurse, midwife, trainedvillage midwife) Comments Recalculated from the Information collected from End target was revised in the 2008-09 Reproductive Health Reproductive Health Dept project's restructuring in Public Disclosure Copy Dept database (2009 SHHS database at state level. December 2012 (2nd report not yet available by that additional financing) time). % households who possess at least one Percentage Value 18.00 42.00 42.00 insecticide-treated net in target areas Date 01-Nov-2006 01-Mar-2009 30-Jun-2011 Comments Estimate from 2006 SHHS for Current status is from HMIS One-time intervention-under rural areas of the four target and the denominator is the the initial project (completed) states estimated number of households in 13 Localities targeted by the ITN Page 2 of 5 The World Bank Report No: ISR10904 distribution supported by DHSDP (237,500 households). Health personnel receiving training (number) Number Value 40.00 3095.00 3000.00 Public Disclosure Copy Date 30-Nov-2009 31-May-2012 30-Jun-2013 Comments Information collected from End target was revised in the project reports. project's restructuring in December 2012 (for the 2nd additional financing) Intermediate Results Indicators Indicator Name Core Unit of Measure Baseline Current End Target Long-lasting insecticide-treated malaria nets Number Value 0.00 179100.00 179100.00 purchased and/or distributed (number) Date 01-Nov-2006 01-Mar-2009 30-Jun-2011 Comments Source: distribution report Completed under the initial project. annual per capita USD value of drugs/ Amount(USD) Value 0.17 0.41 0.40 consumables and operational support provided Date 09-Dec-2009 31-Dec-2012 30-Jun-2013 to target health facilities & midwives Comments Per capita value estimated on Measured annually. the basis of approx. 1 mill catchment population of the target h.facilities National Health Accounts completed Yes/No Value No Yes Yes Date 30-Nov-2009 31-May-2011 30-Jun-2013 Comments WHO's report on the NHA completed and submitted by end May 2011. Health facilities constructed, renovated, and/or Number Value 0.00 18.00 18.00 equipped (number) Date 30-Nov-2006 30-Sep-2010 30-Jun-2011 Public Disclosure Copy Comments Completed under the initial All works under the initial project. Information collected project have been completed. from project reports. number of rural hospitals upgraded and Number Value 0.00 5.00 6.00 equipped for emergency obstetric care (EOC) Date 30-Nov-2009 31-May-2012 30-Jun-2012 Comments All works were completed in 5 These include both the rehab out of 6 target rural hospitals, of 6 RHs' surgical units & and in 3 out of 4 midwifery maternity wards and the training schools. construction of 4 midwifery training schools. Page 3 of 5 The World Bank Report No: ISR10904 Data on Financial Performance (as of 23-May-2013) Financial Agreement(s) Key Dates Project Ln/Cr/Tf Status Approval Date Signing Date Effectiveness Date Original Closing Date Revised Closing Date Public Disclosure Copy P098483 TF-57324 Effective 29-Oct-2006 29-Oct-2006 24-Jan-2007 31-Dec-2009 30-Jun-2013 Disbursements (in Millions) Project Ln/Cr/Tf Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P098483 TF-57324 Effective USD 14.00 14.00 0.00 13.78 0.22 98.00 Disbursement Graph Key Decisions Regarding Implementation Public Disclosure Copy RESULTS. Under the 1st and 2nd Additional Financings, the project's results are as follows: PDO 1 (Outpatient consultations per person per year in the project’s target areas): Against a target of 0.30, the project achieved 0.32 (107%) as of December 31, 2012 (and 0.41 for the first quarter of 2013). PDO 2 (Percentage of deliveries attended by skilled personnel-doctor, nurse, midwife-in rural areas of the four target states): Against a target of 55%, the project achieved 52% (95%) as of December 31, 2012 (and 63% for the first quarter of 2013). PDOs 3 and 4 (Number of LLINs and Percentage of households with at least one net): No change, as the objective was achieved under the original credit and not retained for the additional financing. PDO 5 (Percentage of pregnant women who attended at least one antenatal care consultation): Against a target of 65%, the project achieved 68% (105%) as of December 31, 2012 (and 68% for the first quarter of 2013). Among the Intermediate Objectives (as of December 31, 2012): (i) all of the planned 18 PHC facilities had been renovated and equipped; (ii) 4 of the 7 midwifery nursing schools were completed (and the other 3 to be completed before project closing); (iii) 6 of 9 rural hospitals had been renovated (and the other three to be completed before project closing; (iv) Page 4 of 5 The World Bank Report No: ISR10904 3,095 health workers had been trained, against a target of 3,000; and (v) the annual per capita US$ value of drugs/consumables and operational support provided to target health facilities & midwives had been sustained above forty cents for the period 2010-12. DISBURSEMENTS: The undisbursed fund is US$202,290, while the undocumented balance in the Designated Account is US$ 426,773. Final payments - for services delivered within Public Disclosure Copy the project's timeframe - are expected to be completed ahead of the grace period of October 31, 2013. FINAL REPORTING: The Bank's 1st mission for Project's Implementation Completion Report will start by end June, and an initial draft is expected by end October 2013. Restructuring History RVP Approval on 08-Dec-2009, Level two Approved on 21-Jun-2011, Level two Approved on 06-Jul-2012 Related Projects P117274-Additional Financing North Sudan Decentralized Health System Development Project, P132980-Sudan Multi-donor Trust Fund for Decentralized Health Systems Development Project Additional Financing, P144040-Second Additional Financing to the North Sudan Decentralized Health System Development Project Public Disclosure Copy Page 5 of 5