The World Bank Implementation Status & Results Report Central African Republic COVID-19 Preparedness and Response Project (P173832) Central African Republic COVID-19 Preparedness and Response Project (P173832) AFRICA WEST | Central African Republic | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2020 | Seq No: 1 | ARCHIVED on 31-Jul-2020 | ISR42459 | Implementing Agencies: Central African Republic, Ministry of Health and Population Key Dates Key Project Dates Bank Approval Date: 20-Apr-2020 Effectiveness Date: 27-Apr-2020 Planned Mid Term Review Date: -- Actual Mid-Term Review Date: Original Closing Date: 30-Jun-2022 Revised Closing Date: 30-Jun-2022 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) To prepare for and respond to the threat posed by COVID-19 in the Central African Republic. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Preparedness and Response:(Cost $6.90 M) Project implementation:(Cost $0.60 M) Contingent Emergency Response Component Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO -- Satisfactory Overall Implementation Progress (IP) -- Satisfactory Overall Risk Rating -- High Implementation Status and Key Decisions The Central African Republic COVID-19 Preparedness and Response Project became effective on March 24, 2020. The project is working with the Ministry of Health, UNICEF and WHO to procure essential supplies and medicines for the response. A large portion of funding is also managed by the Ministry of Health, where communication, rehabilitation and equipping of isolation and treatment centers. MPA Program Development Objective MPA PDO Table 7/31/2020 Page 1 of 6 The World Bank Implementation Status & Results Report Central African Republic COVID-19 Preparedness and Response Project (P173832) 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 Impressive efforts have been made to advance the implementation of the MPA-funded projects. As of June 30, 2020, 73 projects had been approved providing a total commitment of US$4.7 billion. The projects benefit around 4.7 billion people or 62% of the global population. Of the 73 approved projects: (i) 28 are in Africa; (ii) 11 in East Asia; (iii) 11 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. Total disbursements as of June 30, 2020 under these projects amount to US$1,294.5 billion or 28% of overall commitment. In addition, $233.4 billion have been committed under signed contracts with UNICEF and Bank Facilitated Procurement (BFP), bringing to 32% actual disbursements and committed amounts. Flexible project design and streamlined procedures as well as intensified efforts across the Bank have contributed to the progress. The implementation faces significant challenges as seventy three percent (73%) of countries with MPA projects were reported still in lockdown at the end of May. Some specific challenges identified by teams include: (i) ) several countries have not adopted emergency procedures for signing of financing agreements, processing procurement and payments – bureaucracy in making decisions and approving procurement, contracts, and payments continue to be a bottleneck; (ii) fear of future audits/investigations by national audit agencies and accountability offices is one of the reasons that is holding back the use of BFP; (iii) limited face-to-face meetings makes it difficult to communicate and engage with counterparts; (iv) a fundamental implementation challenge is that some government officials are not equipped to carry out their roles and responsibility during country lockdowns, with many trying to operate with cell phones; (v) Retroactive Financing has little or no uptake in some countries, mainly because the reimbursed funds will go to central government (MOF) and not to the ministries of health. Notwithstanding these challenges, the MPA is on track to achieving its PrDO – to prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness. The significant level of disbursement in less than three months attest to the strong implementation of the Bank response thanks to the commitment of country teams. However, the capacityof teams is being stretched to meet delivery demands and provide enhanced implementation support to clients, this may not be sustainable in the long term. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance High -- High Macroeconomic High -- High Sector Strategies and Policies Substantial -- Substantial Technical Design of Project or Program High -- High Institutional Capacity for Implementation and High -- High Sustainability Fiduciary High -- High 7/31/2020 Page 2 of 6 The World Bank Implementation Status & Results Report Central African Republic COVID-19 Preparedness and Response Project (P173832) Environment and Social Substantial -- Substantial Stakeholders Substantial -- Substantial Other -- -- -- Overall High -- High Results PDO Indicators by Objectives / Outcomes To prepare for and respond to the threat posed by COVID-19 in the Central African Republic. IN00865131 ►Health staff trained in infection prevention per MOH-approved protocols (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 375.00 500.00 Date 27-Apr-2020 -- 22-Jun-2020 30-Jun-2022 The number of staff trained is estimated to be more, though this figure was derived by revising all the terms of references of the project that included the mention of training of health staff in infection Comments: prevention, and they were counted among the trained staff. IN00865132 ►Personal protective equipment (PPE) kit (masks, face shield, gloves, gown) delivered to targeted health facilities (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 5,000.00 Date 27-Apr-2020 -- 22-Jun-2020 30-Jun-2022 PPE is being procured by WHO, and is yet to be delivered. As one PPE kit ordered by WHO was composed of multiple items, we have narrowed down a "PPE kit" to a minimal to be composed of masks, Comments: face shield, gown and gloves. IN00865080 ►COVID-19 risk communication messages broadcasted to communities (number of days) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 78.00 90.00 Date 27-Apr-2020 -- 26-Jun-2020 30-Jun-2022 Mobile COVID-19 voice messages began being transmitted since April 27, 2020, and has been active for Comments: everyday. Overall Comments PDO 7/31/2020 Page 3 of 6 The World Bank Implementation Status & Results Report Central African Republic COVID-19 Preparedness and Response Project (P173832) Results achieved so far: Nine targeted hospitals/health facilities (100%) received selected drugs required to respond to the surge of patients due to COVID19 (target 90%); a risk communication strategy has been developed and used; 73 additional patients beds have been ordered and waiting until they are available in care centers and hospitals (target 70%). The project have supported training of the frontline workers on infection control protocol (IPC),(target 500). Personal protective equipment (PPE) items have been ordered by WHO and are yet to arrive and be delivered. Arrival date is still not known. Intermediate Results Indicators by Components Component 1: Preparedness and response IN00865136 ►Additional patient "beds" made available in designated care centers and hospitals (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 73.00 70.00 Date 27-Apr-2020 -- 22-Jun-2020 30-Jun-2022 73 additional beds and sleeping mattresses have been purchased for the initial patients needing care. Comments: IN00865141 ►Laboratories with trained staff and consumables for collecting COVID-19 samples and transporting to Pasteur Institute laboratory (IBP) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 1.00 -- 85.00 15.00 Date 27-Apr-2020 -- 22-Jun-2020 30-Jun-2022 IN00865142 ►Risk comminication strategy developed and disseminated (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No -- Yes Yes Date 27-Apr-2020 -- 22-Jun-2020 30-Jun-2022 Strategy has been elaborated and the govt is starting to use it in parts. Comments: IN00865137 ►Targeted facilities that have received selected drugs required to respond to the surge in patients due to COVID-19 (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target 7/31/2020 Page 4 of 6 The World Bank Implementation Status & Results Report Central African Republic COVID-19 Preparedness and Response Project (P173832) Value 0.00 -- 100.00 90.00 Date 27-Apr-2020 -- 22-Jun-2020 30-Jun-2022 Nine facilities have received selected drugs, and only nine are currently targeted. The total number of Comments: facilities targeted will increase. IN00865122 ►Targeted communities informed on hygiene behavior (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 90.00 Date 27-Apr-2020 -- 22-Jun-2020 30-Jun-2022 Not yet available. Comments: Component 2: Project Implementation, Monitoring and Supervision IN00865133 ►M&E system established to monitor COVID-19 preparedness and response (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No -- No Yes Date 27-Apr-2020 -- 22-Jun-2020 30-Jun-2022 Surveillance data on COVID19 cases are collected and reports are disseminated weekly and sometimes daily through the Emergency response committee (COUSP). But there is not yet an M&E system to Comments: monitor the preparedness and response. Overall Comments IR While the national Health information management system is being strengthened, surveillance data are being collected and reported weekly. Performance-Based Conditions Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P173832 IDA-D6170 Effective USD 7.50 7.50 0.00 5.44 2.15 72% Key Dates (by loan) 7/31/2020 Page 5 of 6 The World Bank Implementation Status & Results Report Central African Republic COVID-19 Preparedness and Response Project (P173832) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P173832 IDA-D6170 Effective 20-Apr-2020 22-Apr-2020 27-Apr-2020 30-Jun-2022 30-Jun-2022 Cumulative Disbursements PBC Disbursement Achievement Disbursed amount in Disbursement % PBC ID PBC Type Description Coc PBC Amount Status Coc for PBC Restructuring History There has been no restructuring to date. Related Project(s) There are no related projects. 7/31/2020 Page 6 of 6