Public Disclosure Copy The World Bank Implementation Status & Results Report Karnataka Health System Development and Reform Project (P071160) Karnataka Health System Development and Reform Project (P071160) SOUTH ASIA | India | Health, Nutrition and Population Global Practice | IBRD/IDA | Specific Investment Loan | FY 2007 | Seq No: 17 | ARCHIVED on 03-Feb-2015 | ISR18008 | Implementing Agencies: Key Dates Key Project Dates Board Approval date:22-Aug-2006 Effectiveness Date:11-Jan-2007 Planned Mid Term Review Date:01-Dec-2008 Actual Mid-Term Review Date:16-Jul-2010 Original Closing Date:31-Mar-2012 Revised Closing Date:31-Mar-2016 Project Development Objectives Project Development Objective (from Project Appraisal Document) To improve health service delivery, public-private collaboration, and financing, particularly for the benefit of underserved andvulnerable groups in Karnataka. Has the Project Development Objective been changed since Board Approval of the Project Objective? No PHRPDODEL Components Name Component 1. Strengthening existing government health programs:(Cost $75.30 M) Component 2. Innovations in service delivery and health financing:(Cost $115.80 M) Component 3. Project Management, Monitoring and Evaluation:(Cost $20.70 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO  Moderately Satisfactory  Moderately Satisfactory Overall Implementation Progress (IP)  Moderately Unsatisfactory  Moderately Satisfactory Overall Risk Rating  --  Moderate 2/3/2015 Page 1 of 7 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Karnataka Health System Development and Reform Project (P071160) Implementation Status and Key Decisions Overall, project implementation in last 6 months has shown significant improvement. The activities agreed during the last mission are on track, notably in the areas of non-communicable disease (NCD) control, quality assurance (QA), organization development, and emergency health services/road safety. The project has made good progress in areas of institutional and capacity development of the state government's scheme financing hospital care for the poor. Ongoing activities supported by the project are proceeding well, including investment in Primary Health Centers (PHCs) providing round- the-clock services, where the target of 47% of PHCs in the state providing 24x7 services has been achieved. The construction and renovation of health facilities and other infrastructure planned under the original project are completed. With this, most of the new activities under the additional financing are now under active implementation, and the PDO-level indicators in the results framework have shown steady improvement. The indicators such as share of institutional births/deliveries, and number of claims paid by the health insurance pilot program benefiting Below Poverty Line (BPL) households have achieved or surpassed their targets. Similarly, the performance on intermediate indicators has also made good progress/ Most of the indicators are close to the targets set for 2015-16, such as births (deliveries) attended by skilled health personnel, health facilities constructed, renovated and/or equipped, Primary Health Centers (PHCs) providing round- the-clock services, development of training materials on non-communicable disease and trauma care guidelines, etc. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance  --  --  Low Macroeconomic  --  --  Moderate Sector Strategies and Policies  --  --  Low Technical Design of Project or Program  --  --  Low Institutional Capacity for Implementation and Sustainability  --  --  Moderate Fiduciary  --  --  Moderate Environment and Social  --  --  Low Stakeholders  --  --  Low Other  --  --  -- Overall  --  --  Moderate Results Project Development Objective Indicators PHINDPDOTBL  Percent of births/deliveries occuring in a health facility (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 65.00 86.00 99.03 90.00 2/3/2015 Page 2 of 7 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Karnataka Health System Development and Reform Project (P071160) Date 31-Mar-2006 31-Mar-2009 31-Dec-2014 31-Mar-2016 PHINDPDOTBL  Percent of birth/deliveries occuring in a health facility among the poor (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 37.00 45.00 45.00 55.00 Date 31-Mar-2004 31-Mar-2008 31-Mar-2008 31-Mar-2016 PHINDPDOTBL  Percent of population receiving outpatient care in government facilities in 7 less-developed districts (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 46.00 87.00 87.00 78.00 Date 31-Mar-2006 31-Mar-2014 31-Mar-2014 31-Mar-2016 PHINDPDOTBL  Number of health claims paid by health insurance pilot program benefitting Below Poverty Line (BPL) households (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 56714.00 56714.00 45000.00 Date 31-Mar-2006 31-Mar-2014 31-Mar-2014 31-Mar-2016 PHINDPDOTBL  Number of women screened for cervical cancer in pilot districts (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 60000.00 Date 31-Mar-2006 31-Mar-2014 23-Jan-2015 31-Mar-2016 2/3/2015 Page 3 of 7 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Karnataka Health System Development and Reform Project (P071160) PHINDPDOTBL  Percent change in number of road traffic accident patients transported by 108 ambulance system who receive emergency care at government health facilities in pilot districts (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 -- 10.00 Date 31-Mar-2006 31-Mar-2014 31-Dec-2014 31-Mar-2016 PHINDPDOTBL  Direct project beneficiaries (Number, Core) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 282000000.00 327000000.00 306000000.00 Date 31-Mar-2006 31-Mar-2014 31-Dec-2014 31-Mar-2016 PHINDPDOTBL  Female beneficiaries (Percentage, Core Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 53.00 50.00 50.00 Date 31-Mar-2006 31-Mar-2014 31-Dec-2014 31-Mar-2016 Overall Comments Intermediate Results Indicators PHINDIRITBL  Health personnel receiving training (number) (Number, Core) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 26664.00 26664.00 25500.00 Date 22-Aug-2006 31-Mar-2014 31-Mar-2014 31-Mar-2016 2/3/2015 Page 4 of 7 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Karnataka Health System Development and Reform Project (P071160) PHINDIRITBL  Births (deliveries) attended by skilled health personnel (number) (Number, Core) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 4600000.00 4600000.00 5200000.00 Date 31-Mar-2005 31-Mar-2014 31-Mar-2014 31-Mar-2016 PHINDIRITBL  Health facilities constructed, renovated, and/or equipped (number) (Number, Core) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 329.00 329.00 375.00 Date 31-Mar-2006 31-May-2014 31-May-2014 31-Mar-2016 PHINDIRITBL  Number of mobile health clinics operational (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 107.00 107.00 125.00 Date 31-Mar-2006 31-Mar-2014 31-Mar-2014 31-Mar-2016 PHINDIRITBL  Percent of government Primary Health Centers (PHCs) providing round-the-clock services (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 47.33 47.33 47.00 Date 31-Mar-2006 31-Mar-2014 31-Mar-2014 31-Mar-2016 2/3/2015 Page 5 of 7 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Karnataka Health System Development and Reform Project (P071160) PHINDIRITBL  Training materials on non-communicable disease activities for clinical staff are developed (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value N Y Y Y Date 31-Mar-2006 31-Mar-2013 31-Mar-2013 31-Mar-2016 PHINDIRITBL  Guidelines and standards for trauma care services are developed (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value N Y Y Y Date 31-Mar-2006 31-Mar-2014 31-Mar-2014 31-Mar-2016 PHINDIRITBL  Information and communication technology (ICT) pilot starts implementation (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value N N N Y Date 31-Mar-2006 31-Mar-2014 31-Mar-2014 31-Mar-2016 Overall Comments Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed Disbursed P071160 IDA-42290 Effective USD 141.83 141.83 0.00 143.30 5.29 101% P071160 IDA-51610 Effective USD 70.00 70.00 0.00 14.34 52.04 20% P071160 TF-99435 Closed USD 0.40 0.40 0.00 0.23 0.17 59% 2/3/2015 Page 6 of 7 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Karnataka Health System Development and Reform Project (P071160) Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P071160 IDA-42290 Effective 22-Aug-2006 16-Oct-2006 11-Jan-2007 31-Mar-2012 31-Mar-2016 P071160 IDA-51610 Effective 27-Sep-2012 21-Nov-2012 22-Jan-2013 31-Mar-2016 31-Mar-2016 P071160 TF-99435 Closed 07-Oct-2011 14-Oct-2011 14-Oct-2011 31-Aug-2013 31-Aug-2014 Cumulative Disbursements Restructuring History Level Approved on 08-Dec-2010 ,Level Approved on 28-Feb-2012 ,Level Approved on 07-Aug-2012 ,Level Approved on 28-Dec-2012 Related Project(s) P130395-India: Karnataka Health Systems Additional Financing 2/3/2015 Page 7 of 7 Public Disclosure Copy