The World Bank Report No: ISR6786 Implementation Status & Results Peru PE- (APL2) Health Reform Program (P095563) Public Disclosure Copy Operation Name: PE- (APL2) Health Reform Program (P095563) Project Stage: Implementation Seq.No: 7 Status: ARCHIVED Archive Date: 22-Sep-2012 Country: Peru Approval FY: 2009 Product Line: IBRD/IDA Region: LATIN AMERICA AND CARIBBEAN Lending Instrument: Adaptable Program Loan Implementing Agency(ies): Ministry of Health - Programa de Apoyo a la Reforma del Sector Salud Key Dates Board Approval Date 17-Feb-2009 Original Closing Date 31-Jan-2015 Planned Mid Term Review Date 30-Oct-2012 Last Archived ISR Date 23-Jan-2012 Effectiveness Date 15-Dec-2009 Revised Closing Date 31-Jan-2015 Actual Mid Term Review Date 30-Nov-2012 Project Development Objectives Project Development Objective (from Project Appraisal Document) Framed within the long-term objective of the Health Reform Program (APL in all its phases) to reduce maternal and infant mortality rates in the nine poorest regions of the country (Amazonas, Huanuco, Huancavelica, Ayacucho, Apurimac, Cusco, Cajamarca, Ucayali and Puno); the project development objectives are to: (i) improve family care practices for women (during pregnancy, delivery and breast-feeding), and children under the age of three; (ii) strengthen health services networks with capacity to solve obstetric, neonatal and infant emergencies and to provide comprehensive health services to women (during pregnancy, delivery and breast-feeding) and children under the age of three; and (iii) support MINSA's governance functions of regulation, quality, efficiency and equity for improving the new health delivery model of maternal and child health care in a decentralized environment. Has the Project Development Objective been changed since Board Approval of the Project? Yes No Component(s) Component Name Component Cost Improving health practices at the household level for women and children under age three in rural 6.00 areas of the nine targeted Regions Increasing the capacity to provide better maternal and child health services for the poor 142.30 Public Disclosure Copy Strengthening government capacities to offer more equitable and efficient health system in a 5.20 decentralized environment Project Coordination, and Monitoring & Evaluation 8.90 Overall Ratings Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Satisfactory Satisfactory Overall Risk Rating Moderate Page 1 of 5 The World Bank Report No: ISR6786 Implementation Status Overview Project implementation status is Satisfactory. The Project is progressing towards its development objectives, with noteworthy advances in all indicators. A new Parsalud Coordinator Dr. Walter Vigo was recently selected after a competitive selection process. Public Disclosure Copy Locations Country First Administrative Division Location Planned Actual Peru Not Entered Departamento de Ucayali Peru Not Entered Departamento de Huánuco Peru Not Entered Departamento de Cajamarca Peru Not Entered Departamento de Amazonas Peru Not Entered Departamento de Puno Peru Not Entered Departamento de Huancavelica Peru Not Entered Departamento de Cusco Peru Not Entered Departamento de Ayacucho Peru Not Entered Departamento de Apurímac Results Project Development Objective Indicators Indicator Name Core Unit of Measure Baseline Current End Target Increase the proportion of pregnant women of Percentage Value 20.00 67.50 45.00 the nine regions with at least 1 prenatal control Date 30-Dec-2005 09-Dec-2011 30-Dec-2013 during the first trismester of pregnancy from Comments Target achieved. Percentage 20% (2005) to 45% (2013) has increased substantially. Public Disclosure Copy Increase the proportion of institutional Percentage Value 44.00 65.00 78.00 deliveries in rural areas of the nine selected Date 30-Dec-2005 28-Feb-2012 30-Dec-2013 Regions from 44% (2005) to 78% (2013) Comments Progress on this indicator is very positive trend and is on track to be achieved in 2013. Reduce the prevalence of anemia among Percentage Value 69.50 63.00 60.00 children under age 3 in the nine regions from Date 30-Dec-2005 24-Feb-2012 30-Dec-2013 69.5% (2005) to 60% (2013) Comments This indicator is on track to be achieved in 2013. Page 2 of 5 The World Bank Report No: ISR6786 Increase from 64% to 80% the share of Percentage Value 64.00 89.50 80.00 children in the nine selected regions who are Date 30-Dec-2005 28-Feb-2011 30-Dec-2013 exclusively breastfed until 6 months of age Comments Indicator achieved and Public Disclosure Copy surpassed. Intermediate Results Indicators Indicator Name Core Unit of Measure Baseline Current End Target Component 1: % of SIS affiliated children who Percentage Value 34.00 51.10 66.00 received growth and development controls Date 30-Dec-2005 24-Feb-2012 30-Dec-2013 (CRED) according to their age Comments The evaluation data on SIS population will be available in 2012. Component 1: % of children who received Percentage Value 22.60 28.80 34.00 growth and development controls (CRED) Date 30-Dec-2007 24-Feb-2012 30-Dec-2013 according to their age Comments Indicator on track to be achieved. Component 2: % of SIS affiliated rural pregnant Percentage Value 37.00 45.00 80.00 women with laboratory tests on hemoglobin, Date 30-Dec-2005 24-Feb-2012 30-Dec-2013 urine and syphilis Comments Buildings under construction, including labs in 23 hospitals, are delaying the trend for achieving this indicator. Component 2: % of pregnant women under SIS Percentage Value 37.00 52.30 80.00 that receive iron and folic acid supplements Date 30-Dec-2005 24-Feb-2012 30-Dec-2013 Comments Progress on this indicator has just begun. The Project is undertaking significant efforts to improve supply distribution in particular. Public Disclosure Copy Component 2: % of cesareans in SIS affiliated Percentage Value 3.00 3.95 5.00 pregnant rural women Date 30-Dec-2005 28-Feb-2012 30-Dec-2013 Comments Hospitals under construction are delaying the achievement of this indicator. However, there are minor improvements in some specificregions. Page 3 of 5 The World Bank Report No: ISR6786 Component 2: % of health facilities with Percentage Value 0.00 12.00 90.00 improvement in infrastructure (minor Date 30-Dec-2005 24-Feb-2012 30-Dec-2013 construction and / new equipment) Comments Project has initiated massive Public Disclosure Copy infrastructure works in all regions, and some of them are already initiating its funtioning. Component 2: % of women satisfied with the Percentage Value 1.00 1.00 25.00 services in selected facilities by confidence Date 30-Dec-2005 24-Feb-2012 30-Dec-2013 index Comments To be re-evaluated during the MTR Component 3: % of SIS affiliated households Percentage Value 67.30 60.00 25.00 that make out-of-pocket expenditures in Date 30-Dec-2005 24-Feb-2012 30-Dec-2013 medicines Comments An evaluation of households out-of-pocket expenditures on medicine will be undertaken in 2012. However, progress has been made modest advances so far. Data on Financial Performance (as of 17-May-2012) Financial Agreement(s) Key Dates Project Ln/Cr/Tf Status Approval Date Signing Date Effectiveness Date Original Closing Date Revised Closing Date P095563 IBRD-76430 Effective 17-Feb-2009 16-Nov-2009 15-Dec-2009 31-Jan-2015 31-Jan-2015 Disbursements (in Millions) Project Ln/Cr/Tf Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P095563 IBRD-76430 Effective USD 15.00 15.00 0.00 4.05 10.95 27.00 Public Disclosure Copy Disbursement Graph Page 4 of 5 The World Bank Report No: ISR6786 Public Disclosure Copy Key Decisions Regarding Implementation Project implementation is Satisfactory, and a new Project Coordinator was selected after a competitive selection process. Restructuring History There has been no restructuring to date. Related Projects There are no related projects. Public Disclosure Copy Page 5 of 5