The World Bank Implementation Status & Results Report North East and Red River Delta Regions Health System Support Project (P122629) North East and Red River Delta Regions Health System Support Project (P122629) EAST ASIA AND PACIFIC | Vietnam | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2013 | Seq No: 12 | ARCHIVED on 28-Aug-2019 | ISR38206 | Implementing Agencies: Ministry of Health, Socialist Republic of Vietnam Key Dates Key Project Dates Bank Approval Date: 31-May-2013 Effectiveness Date: 17-Oct-2013 Planned Mid Term Review Date: 17-Jul-2017 Actual Mid-Term Review Date: 14-Jul-2017 Original Closing Date: 31-Dec-2019 Revised Closing Date: 31-Dec-2020 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The Project Development Objective is to increase the efficiency and equity in the use of hospital services in selected provinces ofthe North East and Red River Delta Regions. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Strengthening capacity of lower-level hospitals to deliver quality services:(Cost $127.50 M) Reducing the financial barriers to access by the economically vulnerable:(Cost $11.00 M) Project management, monitoring and evaluation:(Cost $7.00 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Moderately Satisfactory Moderately Satisfactory Overall Implementation Progress (IP) Moderately Satisfactory Moderately Satisfactory Overall Risk Rating Moderate Moderate Implementation Status and Key Decisions The mission recognized the significant effort of the Project team to improve implementation and disbursement from the previous mission, especially the procurement of large medical equipment packages in the last six months. The mission assessed that: (i) the objectives and design of the Project remain highly relevant to the Government’s policy priorities as defined by the MOH in its 5-year Sector Development Plan and as reported by the provinces; and (ii) Project implementation has contributed to expanding the provincial and district capacity for service delivery, as well as reducing financial barriers to access. As of June 30, 2019, 2,039 new techniques (712 at provincial level and 1,327 at district level) were transferred. In total, 38,886 patients have received new clinical techniques at provincial and district levels; 100% near-poor-people (214,558 people) in 13 Project provinces received health insurance cards subsidized from provincial budgets. The card is valid for 11.8 months. All Project hospitals implemented quality improvement 8/28/2019 Page 1 of 8 The World Bank Implementation Status & Results Report North East and Red River Delta Regions Health System Support Project (P122629) plans/activities and have improved their quality scores over time; 35 out of 74 Project hospitals have had their technical capacity upgraded, and five provincial hospitals received ISO certification for laboratory tests. Some indicators in the Results Framework have been achieved (or even surpassed) their target values. The disbursement rate increased from 61.3% in December 2018 to 66% by August 2019. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance -- Low Low Macroeconomic -- Low Low Sector Strategies and Policies -- Substantial Substantial Technical Design of Project or Program -- Moderate Moderate Institutional Capacity for Implementation and Sustainability -- Moderate Moderate Fiduciary -- Moderate Moderate Environment and Social -- Substantial Substantial Stakeholders -- Moderate Moderate Other -- Moderate Moderate 8/28/2019 Page 2 of 8 The World Bank Implementation Status & Results Report North East and Red River Delta Regions Health System Support Project (P122629) Overall -- Moderate Moderate Results PDO Indicators by Objectives / Outcomes Increase the efficiency and equity in the use of hospital services in selected provinces of the Nor IN00733448 ►Number of patients benefiting new clinical techniques in five intervention areas (cardiology (internal medicine); obstetrics/gynecology; pediatric; oncology; and trauma (surgical)) tranferred by the p (Number (Thousand), Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 7,224.00 12,374.00 12,500.00 Date 31-May-2013 31-Dec-2018 30-Jun-2019 31-Dec-2020 IN00733449 ►Number of patients benefiting new clinical techniques in three intervention areas (obstetrics/gynecology; pediatric; and injury (surgical) transferred by the Project at district hospitals (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 23,075.00 26,512.00 29,000.00 Date 31-May-2013 31-Dec-2018 30-Jun-2019 31-Dec-2020 IN00733450 ►At least fifteen percent increase in the use of inpatient and outpatient health services by the poor and insured near poor in the local hospitals. (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 0.00 Date 22-Feb-2013 31-Dec-2018 31-Dec-2018 31-Dec-2020 This is just the name of the indicators so no value is expected. The indicator values are for the sub- Comments: indicators below. IN00733451 Use of Inpatient services by the insured poor and near poor in the local hospitals (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.05 0.12 0.12 0.06 Date 30-Jun-2015 31-Dec-2018 31-Dec-2018 31-Dec-2020 IN00733452 Use of Outpatient services by the insured poor and near poor in the local hospitals (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.21 0.55 0.55 0.25 Date 30-Jun-2015 31-Dec-2018 31-Dec-2018 31-Dec-2020 Intermediate Results Indicators by Components 8/28/2019 Page 3 of 8 The World Bank Implementation Status & Results Report North East and Red River Delta Regions Health System Support Project (P122629) Strengthening capacity of lower-level hospitals to deliver quality services IN00733453 ►Number of new technical services is transferred from central to provincial hospitals and district hospitals (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1,981.00 2,039.00 2,200.00 Date 22-Feb-2013 31-Dec-2018 30-Jun-2019 31-Dec-2020 IN00733456 ►Increase in the percent of project hospitals implementing Continuous Quality Improvement (CQI) or equivalent quality improvement process (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 25.00 100.00 100.00 75.00 Date 22-Feb-2013 31-Dec-2018 30-Jun-2019 31-Dec-2020 IN00733458 ►Health facilities constructed, renovated, and/or equipped (number) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 81.00 81.00 57.00 Date 01-Nov-2013 31-Dec-2018 30-Jun-2019 31-Dec-2020 IN00733460 ►Health personnel receiving training (number) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 1,192.00 4,401.00 4,864.00 4,050.00 Date 22-Feb-2013 31-Dec-2018 30-Jun-2019 31-Dec-2020 IN00733462 ►Increase of patient satisfied with (a) the overall quality of care, (b) reduction of waiting time, and (c) availability of services and (d) diagnostic facilities at provincial and district hospita (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 0.00 Date 30-Jun-2015 31-Dec-2018 31-Dec-2018 31-Dec-2020 This is just the name of the indicators so no value is expected. The indicator values are for the sub- Comments: indicators below. IN00733465 Provincial Level: Overall Quality (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 76.20 84.80 84.80 63.00 Date 30-Jun-2015 31-Dec-2018 31-Dec-2018 31-Dec-2020 IN00733467 District Level: Overall Quality (Percentage, Custom Breakdown) 8/28/2019 Page 4 of 8 The World Bank Implementation Status & Results Report North East and Red River Delta Regions Health System Support Project (P122629) Baseline Actual (Previous) Actual (Current) End Target Value 82.10 89.50 89.50 63.00 Date 30-Jun-2015 31-Dec-2018 31-Dec-2018 31-Dec-2020 IN00733468 Provincial Level: Waiting Time (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 67.50 80.30 80.30 63.00 Date 30-Jun-2015 31-Dec-2018 31-Dec-2018 31-Dec-2020 IN00733469 District Level: Waiting Time (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 74.90 89.40 89.40 63.00 Date 30-Jun-2015 31-Dec-2018 31-Dec-2018 31-Dec-2020 IN00733470 Provincial Level: Availability of services (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 77.20 88.30 88.30 63.00 Date 30-Jun-2015 31-Dec-2018 31-Dec-2018 31-Dec-2020 IN00733471 District Level: Availability of services (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 58.80 79.00 79.00 63.00 Date 30-Jun-2015 31-Dec-2018 31-Dec-2018 31-Dec-2020 IN00733472 Provincial level: Availability of diagnostic facilities (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 67.20 77.10 77.10 63.00 Date 30-Jun-2015 31-Dec-2018 31-Dec-2018 31-Dec-2020 IN00733473 District level: Avalability of diagnostic facilities (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 52.50 57.50 57.50 63.00 Date 30-Jun-2015 31-Dec-2018 31-Dec-2018 31-Dec-2020 Reducing the financial barriers to access by the economically vulnerable IN00733454 ►At least seventy percent of near poor have health insurance (Percentage, Custom) 8/28/2019 Page 5 of 8 The World Bank Implementation Status & Results Report North East and Red River Delta Regions Health System Support Project (P122629) Baseline Actual (Previous) Actual (Current) End Target Value 95.40 100.00 100.00 70.00 Date 22-Feb-2013 31-Dec-2018 30-Jun-2019 31-Dec-2020 IN00733457 ►People with access to a basic package of health, nutrition, or reproductive health services (number) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 11,942,834.00 13,034,660.00 14,415,859.00 10,882,272.00 Date 30-Jun-2015 31-Dec-2018 30-Jun-2019 31-Dec-2020 IN00733459 ►Increase in the knowledge on health insurance (a) benefit package; (b) rights, (c) responsibility; and (d) operation mechanism among near poor people (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 0.00 Date 18-Apr-2013 31-Dec-2018 31-Dec-2018 31-Dec-2020 IN00733461 Knows at least 3 benefits (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 16.40 21.50 21.50 50.00 Date 30-Jun-2015 31-Dec-2018 31-Dec-2018 31-Dec-2020 IN00733463 Knows at least 3 responsibilities (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 6.30 17.10 17.10 50.00 Date 30-Jun-2015 31-Dec-2018 31-Dec-2018 31-Dec-2020 IN00733464 Knows operation mechanism among near poor people (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 3.20 6.50 6.50 50.00 Date 30-Jun-2015 31-Dec-2018 31-Dec-2018 31-Dec-2020 IN00733466 Knows rights (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 3.20 7.80 7.80 50.00 Date 30-Jun-2015 31-Dec-2018 31-Dec-2018 31-Dec-2020 Project management, monitoring and evaluation IN00733455 8/28/2019 Page 6 of 8 The World Bank Implementation Status & Results Report North East and Red River Delta Regions Health System Support Project (P122629) ►Complete and Timely Project reporting, including Progress Reports, Monitoring and Evaluation Updates, Year 1, Midterm and End of Project surveys, Annual Plans (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Satifactory Value Not applicable Satisfactory Satisfactory assessment Date 18-Apr-2013 31-Dec-2018 30-Jun-2019 31-Dec-2020 Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P122629 IDA-52590 Effective USD 150.00 150.00 0.00 91.24 47.89 66% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P122629 IDA-52590 Effective 31-May-2013 01-Aug-2013 17-Oct-2013 31-Dec-2019 31-Dec-2020 Cumulative Disbursements 8/28/2019 Page 7 of 8 The World Bank Implementation Status & Results Report North East and Red River Delta Regions Health System Support Project (P122629) Restructuring History Level 2 Approved on 26-Jun-2018 ,Level 2 Approved on 28-May-2019 Related Project(s) There are no related projects. 8/28/2019 Page 8 of 8