The World Bank Report No: ISR11380 Implementation Status & Results Lao People's Democratic Republic Health Services Improvement Project (P074027) Public Disclosure Copy Operation Name: Health Services Improvement Project (P074027) Project Stage: Implementation Seq.No: 10 Status: ARCHIVED Archive Date: 14-Sep-2013 Country: Lao People's Democratic Republic Approval FY: 2006 Product Line: IBRD/IDA Region: EAST ASIA AND PACIFIC Lending Instrument: Specific Investment Loan Implementing Agency(ies): Key Dates Board Approval Date 13-Sep-2005 Original Closing Date 30-Jun-2011 Planned Mid Term Review Date Last Archived ISR Date 02-Feb-2013 Effectiveness Date 22-Feb-2006 Revised Closing Date 30-Jun-2014 Actual Mid Term Review Date Project Development Objectives Project Development Objective (from Project Appraisal Document) To assist Lao PDR to increase utilization and quality of health services, particularly for poor women and children in rural areas in Project Provinces. Has the Project Development Objective been changed since Board Approval of the Project? � Yes No Component(s) Component Name Component Cost Improving the Quality and Utilization of Health Services 10.15 Strengthening Institutional Capacity for Health Service Provision 12.28 Improving Equity, Efficiency, and Sustainability of Helath Care Financing 2.57 Overall Ratings Previous Rating Current Rating Moderately Satisfactory Moderately Satisfactory Public Disclosure Copy Progress towards achievement of PDO Overall Implementation Progress (IP) Moderately Unsatisfactory Moderately Satisfactory Overall Risk Rating Moderate Implementation Status Overview Free Maternal and Child Health activities have begun implementation in Health Equity Fund districts, and Free Maternal Health activities have begun in an additional 32 Phase 1 and 2 districts, thus covering the five project provinces. Upgrades of health facilities to provide maternal and child health services have begun and both short-term and long-term formal training programs have commenced. The implementation of remaining Results-based Financing and Health Management Information System activities can now begin, once key technical assistance are on board. As a result of these positive developments, ratings are being upgraded. Page 1 of 7 The World Bank Report No: ISR11380 A Mid-term Review is tentatively scheduled for October 2013 to review progress and options prior to the scheduled closure of additional financing in June 2014, to ensure the achievement of development objectives. Locations Public Disclosure Copy Country First Administrative Division Location Planned Actual Laos Khoueng Xiangkhoang Khoueng Xiangkhoang ✔ Laos Khoueng Savannakhet Khoueng Savannakhet ✔ ✔ Laos Khoueng Salavan Khoueng Salavan ✔ ✔ Laos Khoueng Khammouan Khoueng Khammouan ✔ Laos Khoueng Champasak Khoueng Champasak ✔ ✔ Laos Khoueng Attapu Khoueng Attapu ✔ ✔ Laos Khoueng Xekong Khoueng Xekong ✔ ✔ Laos Khoueng Bolikhamxai Khoueng Bolikhamxai ✔ Results Project Development Objective Indicators Indicator Name Core Unit of Measure Baseline Current End Target Percentage of children under one (1) year of Percentage Value 69.00 60.00 85.00 age immunized against measles Date 30-Sep-2011 30-Sep-2012 30-Jun-2014 Comments The figure was collected from This figure was collected from the HSIP report in five the HSIP report in 2012. This provinces indicator will be revised and strengthened during the restructuring Percentage of children under one (1) year of Number Value 76.00 67.00 90.00 Public Disclosure Copy age who have received three (3) doses of Date 30-Sep-2011 30-Sep-2012 30-Jun-2014 diphtheria, pertussis and tetanus Comments The figure was collected from This figure was collected from the HSIP report in five the HSIP report in 2012. This provinces for half year period indicator will be revised and strengthened during the restructuring Percentage of births attended by trained health Percentage Value 39.00 43.00 50.00 personnel Date 30-Sep-2011 30-Sep-2012 30-Jun-2014 Page 2 of 7 The World Bank Report No: ISR11380 Comments The figure was collected from This figure was collected from the HSIP report in five the HSIP report in 2012. This provinces indicator will be revised and strengthened during the Public Disclosure Copy restructuring Outpatient department cases per capita at Number Value 0.30 0.39 0.50 public health centers and district hospitals. Date 30-Sep-2011 30-Sep-2012 30-Jun-2014 Comments The figure was collected from This figure was collected from the HSIP report in five the HSIP report in 2012. This provinces indicator will be revised and strengthened during the restructuring Number of district hospitals that meet the MOH Number Value 0.00 0.00 28.00 ten (10) minimum requirements of MOH for Date 30-Sep-2011 31-Mar-2013 30-Jun-2014 defining and monitoring the standards and Comments Paying for Quality which quality of health facilities builds on the 10 MR is not yet implementing. In addition, this indicator will be revised once the intervention has been designed. Percentage of villages receiving outreach (via Percentage Value 95.00 health days, integrated outreach and/or mobile Date 30-Sep-2011 30-Jun-2014 clinics) visits according to the agreed schedule Comments This indicator will be revised and strengthened during the restructuring Number of skilled birth attendants working in Number Value 0.00 0.00 273.00 health centers and district hospitals. Date 30-Sep-2011 30-Sep-2012 30-Jun-2014 Comments This indicator will be revised and strengthened during the restructuring Public Disclosure Copy Intermediate Results Indicators Indicator Name Core Unit of Measure Baseline Current End Target Project Beneficiaries: Expected number of Number Value 2297.00 2297.00 39067.00 women benefiting from free deliveries Date 30-Sep-2011 30-Sep-2012 30-Jun-2014 Comments This indicator will be considered for revision in the next coming months. Project Beneficiaries: Outreach services Number Value 0.00 51678.00 Page 3 of 7 The World Bank Report No: ISR11380 Date 30-Sep-2011 30-Jun-2012 30-Jun-2014 Comments This indicator will be revised and strengthened during the Public Disclosure Copy restructuring Project Beneficiaries: Outreach services Number Value 0.00 36048.00 (female) Date 30-Sep-2011 30-Sep-2012 30-Jun-2014 Comments This indicator will be revised and strengthened during the restructuring Number of impregnated bed nets per person Number Value 0.25 0.50 residing in high-risk villages Date 31-Dec-2005 31-Dec-2010 Comments No longer tracked but included to capture progress made in HSIP Percentage of villages with village drug kit Percentage Value 40.00 70.00 maintaining a minimum of 4 essential drugs Date 31-Dec-2005 31-Dec-2010 30-Jun-2014 Comments No longer tracked but included to capture progress made in the HSIP. In-patient Department discharges per capita at Number Value 0.03 0.06 district hospitals Date 30-Sep-2011 30-Jun-2014 Comments Not being tracked and will be revised during next restructuring to reflect child inpatient utilization. Number of operational Integrated Community Number Value 26.00 34.00 Health Centers (ICHC) Date 31-Dec-2005 31-Dec-2010 30-Jun-2014 Comments No longer tracked but not removed as it captured Public Disclosure Copy progress from the original HSIP Health facilities constructed, renovated, and/or Number Value 37.00 37.00 100.00 equipped (number) Date 30-Sep-2011 30-Sep-2012 30-Jun-2014 Comments This indicator will be revised and strengthened during the restructuring. Pregnant women receiving antenatal care Number Value 0.00 537.00 during a visit to a health provider (number) Date 04-Jan-2012 30-Jun-2012 30-Jun-2014 Page 4 of 7 The World Bank Report No: ISR11380 Comments Baseline for additional This indicator will be revised financing effective Jan 4, and strengthened during the 2012 restructuring Public Disclosure Copy Percentage of women practicing modern Percentage Value 57.40 61.80 55.00 contraceptive methods obtained from public Date 30-Sep-2011 30-Sep-2012 30-Jun-2014 health facilities Comments Missing data from Saravane Not being reported as will be province restructured as it does not reflect of project activities Percentage of deliveries occurring in a health Percentage Value 25.80 27.60 40.00 facility Date 30-Sep-2011 30-Sep-2012 30-Jun-2014 Comments Missing data from Saravane This figure was collected from province the HSIP report in 2012. Children immunized (number) Number Value 58032.00 71995.00 140472.00 Date 30-Sep-2011 30-Sep-2012 30-Jun-2014 Comments This indicator will be revised and strengthened during the restructuring Percentage of Health Centers that received Percentage Value supervision according to the MOH-agreed Date 30-Sep-2011 30-Jun-2014 model and schedule Comments This indicator will be revised and strengthened during the restructuring Number of districts implementing free deliveries Number Value 2.00 40.00 42.00 Date 30-Sep-2011 31-Mar-2013 30-Jun-2014 Comments Remaining two districts are covered by another development partners. Number of districts implementing free inpatient Number Value 0.00 0.00 42.00 care for children under 5 Date 30-Sep-2011 30-Sep-2012 30-Jun-2014 Public Disclosure Copy Comments Free Child Health which builds on the 10 MR is not yet implementing. In addition, this indicator will be revised once the intervention has been designed Number of Family Medicine Interns trained Number Value 102.00 102.00 Date 30-Sep-2011 31-Mar-2012 30-Jun-2014 Page 5 of 7 The World Bank Report No: ISR11380 Comments Not being reported as will be restructured as it does not reflect impact of project activities Public Disclosure Copy Number of ethnic minorities and students from Number Value 112.00 112.00 remote areas trained Date 30-Sep-2011 30-Sep-2012 30-Jun-2014 Comments This indicator will be revised and strengthened during the restructuring Health personnel receiving training (number) Number Value 0.00 332.00 Date 30-Sep-2011 30-Sep-2012 30-Jun-2014 Comments This indicator will be revised and strengthened during the restructuring Number of faculty at provincial training Number Value 0.00 0.00 institutions with increased qualifications Date 30-Sep-2011 30-Sep-2012 30-Jun-2014 Comments Not being reported as will be restructured as it does not reflect impact of project activities Number of people assisted by HEF for the Number Value 0.00 95704.00 63087.00 payment of health care costs (including free Date 04-Jan-2012 31-Mar-2013 30-Jun-2014 outpatient care and free ANC/PNC pilot) Comments Cumulative number up to March 2013 Percentage of districts submitting HMIS Percentage Value 90.00 quarterly reports on time Date 30-Sep-2011 30-Sep-2012 30-Jun-2014 Comments Indicator will be revised and strengthened during next restructuring Public Disclosure Copy Data on Financial Performance (as of 28-Aug-2013) Financial Agreement(s) Key Dates Project Ln/Cr/Tf Status Approval Date Signing Date Effectiveness Date Original Closing Date Revised Closing Date P074027 IDA-H1830 Closed 13-Sep-2005 08-Nov-2005 22-Feb-2006 30-Jun-2011 30-Jun-2012 P074027 IDA-H6950 Effective 09-Jun-2011 11-Oct-2011 04-Jan-2012 30-Jun-2014 30-Jun-2014 P074027 TF-10518 Effective 11-Oct-2011 11-Oct-2011 11-Oct-2011 30-Jun-2014 30-Jun-2014 Disbursements (in Millions) Page 6 of 7 The World Bank Report No: ISR11380 Project Ln/Cr/Tf Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P074027 IDA-H1830 Closed USD 15.00 14.99 0.01 16.02 0.00 107.00 P074027 IDA-H6950 Effective USD 10.00 10.00 0.00 3.82 5.92 38.00 Public Disclosure Copy P074027 TF-10518 Effective USD 2.40 2.40 0.00 0.39 2.01 16.00 Disbursement Graph Key Decisions Regarding Implementation This ISR reports on findings from a review mission conducted in June 2013. Restructuring History Level two Approved on 24-Apr-2012 Public Disclosure Copy Related Projects P124906-Health Services Improvement Project (AF) Page 7 of 7