The World Bank Implementation Status & Results Report Ghana - Maternal, Child Health and Nutrition Project (P145792) Ghana - Maternal, Child Health and Nutrition Project (P145792) AFRICA | Ghana | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2014 | Seq No: 11 | ARCHIVED on 05-Jun-2019 | ISR36768 | Implementing Agencies: Ministry of Health, Republic of Ghana, GHANA HEALTH SERVICES, National Health Insurance Agency Key Dates Key Project Dates Bank Approval Date: 20-May-2014 Effectiveness Date: 12-Feb-2015 Planned Mid Term Review Date: 16-Mar-2018 Actual Mid-Term Review Date: 21-Mar-2018 Original Closing Date: 30-Jun-2020 Revised Closing Date: 30-Jun-2020 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The project development objective is to improve utilization of community-based health and nutrition services by women of reproductive age, especially pregnant women, and children under the age of 2 years. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Component 1. Community-Based Maternal and Child Health and Nutrition Interventions:(Cost $62.00 M) Component 2: Institutional strengthening Capacity Building, Monitoring and Evaluation, and Project Management:(Cost $7.50 M) Component 3: Epidemic Preparedness and Control:(Cost $3.50 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Moderately Satisfactory Satisfactory Overall Risk Rating Low Low Implementation Status and Key Decisions The World Bank supported Maternal and Child Health and Nutrition Improvement Project (MCHNP) (Cr No.4563-GH) started implementation in February 2015. The project is successfully revitalizing community-based health and nutrition service delivery, based on progress on indicators of skilled birth attendance, antenatal care visits, contraceptive use, exclusive breast feeding, and growth monitoring. About 36% of project funds have been disbursed by Ghana Health Service (GHS) to communities. The funds released have facilitated outreach services, home visits, durbars (community level meetings on health-related topics), meetings of community health committees and service delivery by over 2,400 Community- Based Health Planning and Services (CHPS). The project also provides important support to reinforce the training curriculum for health 6/5/2019 Page 1 of 10 The World Bank Implementation Status & Results Report Ghana - Maternal, Child Health and Nutrition Project (P145792) professionals at the primary health care (PHC) level. Community-based Performance Based Financing (cPBF) is now launched in 8 pilot districts in the Upper East, Upper West, Northern and Volta Regions to test to incentivize Community Health Teams in the poorest communities to deliver services. An impact evaluation baseline has been concluded for the CPBF and an operational research agenda is expected to ensure learning around how to improve services to benefit the poorest communities. . 6/5/2019 Page 2 of 10 The World Bank Implementation Status & Results Report Ghana - Maternal, Child Health and Nutrition Project (P145792) 6/5/2019 Page 3 of 10 The World Bank Implementation Status & Results Report Ghana - Maternal, Child Health and Nutrition Project (P145792) 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 -- Low Low Technical Design of Project or Program -- Moderate Low Institutional Capacity for Implementation and Sustainability -- Moderate Low Fiduciary -- Moderate Moderate Environment and Social -- Low Low Stakeholders -- Low Low Other -- -- -- Overall -- Low Low Results PDO Indicators by Objectives / Outcomes Improve utilization of community-based health and nutrition services IN00693949 ►Births (deliveries) attended by skilled health personnel (annual, cumulative) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1,920,804.00 2,612,889.00 2,105,000.00 6/5/2019 Page 4 of 10 The World Bank Implementation Status & Results Report Ghana - Maternal, Child Health and Nutrition Project (P145792) Date 28-Jun-2013 30-Nov-2018 18-Apr-2019 30-Jun-2020 This indicator measures the cumulative number of women who delivered with the assistance of a health Comments: provider as a result of Bank-financed activities. IN00693950 Births attended by skilled health personnel at PHC level (Percentage, Custom Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 22.00 27.00 31.00 30.00 IN00694026 ►Pregnant women making the first antenatal visit before the fourth month of pregnancy at PHC level (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 184,372.00 48.00 241,257.00 364,761.00 Date 28-Jun-2013 30-Nov-2018 18-Apr-2019 30-Jun-2020 Annual percentage at national level has increased from 45 percent to 75 percent. Comments: IN00694055 Pregnant women making first antenatal visit in the first trimester at PHC level (percent at PHC level) (Percentage, Custom Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 43.00 -- 53.00 52.00 IN00694027 ►Children under two receiving at least one CIYCF visit per month (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 147,992.00 287,862.00 175,000.00 Date 28-Jun-2013 30-Nov-2018 19-Apr-2019 30-Jun-2020 IN00694028 ►New female acceptors (15-49 years) of modern family planning methods (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 382,535.00 517,826.00 540,457.00 600,000.00 Date 28-Jun-2013 30-Nov-2018 19-Apr-2019 30-Jun-2020 This indicator has accelerated with new investment in family planning services at PHC level. Comments: IN00694029 ►Women receiving post-natal care within 48 hours at PHC level (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 150,999.00 179,902.00 213,176.00 195,000.00 Date 28-Jun-2013 30-Nov-2018 19-Apr-2019 30-Jun-2020 Overall Comments PDO 6/5/2019 Page 5 of 10 The World Bank Implementation Status & Results Report Ghana - Maternal, Child Health and Nutrition Project (P145792) There is significant progress made over the last year with all the indicators moving in the right direction or surpassed the project target. This is due mainly to improvements made to the project coordination mechanisms and tighter supportive supervision to ensure that resources were aligned with performance. We anticipate that this strong performance will continue into the coming years. Intermediate Results Indicators by Components Component 1: Community-Based Maternal and Child Health and Nutrition Interventions IN00694035 ►Children under five years with diarrhea treated in the two weeks preceding the survey given ORT (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 62.00 62.00 62.00 67.00 Date 28-Jun-2013 30-Nov-2018 19-Apr-2019 30-Jun-2020 This indicator will be available in the MICS survey in 2019. Comments: IN00694042 ►Children age 12 months to 23 months that are immunized measles 2 (PHC level) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 69.00 77.00 80.00 86.00 Date 28-Jun-2013 30-Nov-2018 19-Apr-2019 30-Jun-2020 IN00694043 ►Persons receiving essential package of PHC services (annual) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 9,529,025.00 8,585,787.00 11,612,450.00 10,000,000.00 Date 28-Jun-2013 30-Nov-2018 19-Apr-2019 30-Jun-2020 IN00694044 ►Home visits conducted in the community (annual) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 462,747.00 1,186,032.00 1,523,763.00 1,500,000.00 Date 28-Jun-2013 30-Nov-2018 19-Apr-2019 30-Jun-2020 IN00694045 ►Attendants with NHIS at PHC level (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 83.00 87.00 95.00 90.00 Date 28-Jun-2013 30-Nov-2018 19-Apr-2019 30-Jun-2020 6/5/2019 Page 6 of 10 The World Bank Implementation Status & Results Report Ghana - Maternal, Child Health and Nutrition Project (P145792) This indicator is estimated from the percent of outpatients at CHPS, maternity homes and health centers Comments: that have an NHIS. Component 2: Institutional Strengthening Capacity Building, M&E and Project Management IN00694030 ►Community-based Planning and Services Zones receiving supervision visits from Sub-District level (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 80.00 Date 28-Jun-2013 07-Mar-2018 19-Apr-2019 30-Jun-2020 IN00694032 ►Community health personnel trained in approved in-service curriculum and upgrade training (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 7,825.00 10,608.00 12,000.00 Date 28-Jun-2013 07-Mar-2018 19-Apr-2019 30-Jun-2020 This indicator measures the cumulative number of health personnel receiving training through a Bank- Comments: financed project. IN00694034 ►Community satisfaction with the utilization of the essential package of services (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 48.00 48.00 48.00 60.00 Date 28-Jun-2013 07-Mar-2018 19-Apr-2019 30-Jun-2020 IN00694037 ►Stock out of essential commodities at PHC level (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 41.00 7.00 6.00 5.00 Date 28-Jun-2013 30-Nov-2018 19-Apr-2019 30-Jun-2020 IN00694039 ►New national policy for PHC package developed (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No No No Yes Date 28-Jun-2013 30-Nov-2018 19-Apr-2019 30-Jun-2020 IN00694041 ►Functional CHPS zones (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 38.00 53.00 63.00 60.00 Date 28-Jun-2013 30-Nov-2018 19-Apr-2019 30-Jun-2020 6/5/2019 Page 7 of 10 The World Bank Implementation Status & Results Report Ghana - Maternal, Child Health and Nutrition Project (P145792) Component 3: Epidemic Preparedness and Control IN00694038 ►Functional public health emergency management centre established (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No No No Yes Date 28-Jun-2013 30-Nov-2018 19-Apr-2019 30-Jun-2020 IN00694040 ►Completeness of Integrated disease surveillance report (IDSR) report (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 53.00 96.00 98.00 98.00 Date 28-Jun-2013 30-Nov-2018 19-Apr-2019 30-Jun-2020 IN00694160 ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 6,090,994.00 6,186,000.00 Date 23-Jun-2013 -- 19-Apr-2019 30-Jun-2022 IN00694226 Number of children immunized (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 2,718,230.00 3,206,000.00 Date 23-Jun-2013 -- 19-Apr-2019 30-Jun-2020 IN00694227 Number of women and children who have received basic nutrition services (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 759,875.00 875,000.00 Date 23-Jun-2013 -- 19-Apr-2019 30-Jun-2022 IN00694228 Number of deliveries attended by skilled health personnel (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 2,612,889.00 2,105,000.00 Date 23-Jun-2013 -- 19-Apr-2019 30-Jun-2022 Overall Comments IR There is good observation progress made to date to date and provides reasonable levels of comfort that the results can be attained. 6/5/2019 Page 8 of 10 The World Bank Implementation Status & Results Report Ghana - Maternal, Child Health and Nutrition Project (P145792) Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P145792 IDA-54630 Effective USD 68.00 68.00 0.00 31.49 29.80 51% P145792 TF-16617 Effective USD 5.00 5.00 0.00 2.37 2.63 47% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P145792 IDA-54630 Effective 20-May-2014 05-Jan-2015 12-Feb-2015 30-Jun-2020 30-Jun-2020 P145792 TF-16617 Effective 05-Jan-2015 05-Jan-2015 12-Feb-2015 30-Jun-2020 30-Jun-2020 Cumulative Disbursements 6/5/2019 Page 9 of 10 The World Bank Implementation Status & Results Report Ghana - Maternal, Child Health and Nutrition Project (P145792) Restructuring History Level 2 Approved on 29-Jul-2015 ,Level 2 Approved on 30-Dec-2015 ,Level 2 Approved on 17-Dec-2018 Related Project(s) There are no related projects. 6/5/2019 Page 10 of 10