Public Disclosure Copy The World Bank Implementation Status & Results Report Hospital Waste Management Support Project (P119090) Hospital Waste Management Support Project (P119090) EAST ASIA AND PACIFIC | Vietnam | Health, Nutrition and Population Global Practice | IBRD/IDA | Specific Investment Loan | FY 2011 | Seq No: 8 | ARCHIVED on 02-Apr-2015 | ISR18232 | Implementing Agencies: MINISTRY OF HEALTH Key Dates Key Project Dates Board Approval date:29-Mar-2011 Effectiveness Date:29-Aug-2011 Planned Mid Term Review Date:31-Aug-2014 Actual Mid-Term Review Date:18-Aug-2014 Original Closing Date:31-Aug-2017 Revised Closing Date:31-Aug-2017 Project Development Objectives Project Development Objective (from Project Appraisal Document) The project development objective is to reduce environmental degradation and potential risks for human health through the improved management of health care waste in Vietnam's hospitals. Has the Project Development Objective been changed since Board Approval of the Project Objective? No PHRPDODEL Components Name Component 1: Policy and Institutional Environment Strengthening:(Cost $9.00 M) Component 2: Hospital Waste Management Improvement Facility:(Cost $134.00 M) Component 3: Project Implementation Support and Coordination:(Cost $7.00 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO  Moderately Unsatisfactory  Moderately Unsatisfactory Overall Implementation Progress (IP)  Moderately Unsatisfactory  Moderately Unsatisfactory Overall Risk Rating  --  Substantial 4/2/2015 Page 1 of 14 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Hospital Waste Management Support Project (P119090) Implementation Status and Key Decisions There has been insufficient progress of the Project towards meeting its Development Objective thus far, largely due to implementation challenge. Implementation targets were agreed as part of the Project Restructuring in August 2014 in order to improve project performance. The project has been made progress towards achievement of those short term targets. The project management team is re-organized and project management and coordination are strengthened. The progress under Component One is very encouraging: the inter-sectoral Executive Committee on medical waste management has been established, an inter-ministerial Circular was issued, the healthcare waste management regulation was revised, three technical guidelines and seven training curricula were developed, and training on hospital waste managed was delivered to a large number of trainers and managers. Under the Component Two, one sub-grant for hospital was fully verified, fourteen sub-grants mostly completed, and twenty three other sup- grants are under implementation, resulting in a slight improvement in achieving the project development objectives and targets. The project is also planning to prepare the feasibility study report for a centralized waste treatment system as a pilot. 4/2/2015 Page 2 of 14 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Hospital Waste Management Support Project (P119090) Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance  --  --  Low Macroeconomic  --  --  Low Sector Strategies and Policies  --  --  Substantial Technical Design of Project or Program  --  --  Substantial Institutional Capacity for Implementation and Sustainability  --  --  Moderate Fiduciary  --  --  Moderate Environment and Social  --  --  Substantial Stakeholders  --  --  Moderate Other  --  --  -- Overall  --  --  Substantial Results Project Development Objective Indicators PHINDPDOTBL  Increased share of hospitals' wastewater meeting the environmental standards (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 6.00 40.00 Date 29-Aug-2011 09-Jan-2014 31-Dec-2014 30-Jun-2017 Comments 1. Description: Estimated as incremental contribution by project to environmentally safe discharge of hospital wastewater 2. Calculation: 1. Numerator: volume of project hospital wastewater meeting environmental standard (m3/day) 2. Denominator: total volume of hospital wastewater in the country at the project appraisal time. (= 187,843 beds * 0.65 m3/bed/day = 122,000 m3/day). 3. Thanks to wastewater treatment plants constructed, volume hospital wastewater meeting standards reaches 7600 m3/day. Please note that while waiting for final verification, quality of wastewater effluent is analyzed by laboratory contracted by the hospitals. 4/2/2015 Page 3 of 14 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Hospital Waste Management Support Project (P119090) PHINDPDOTBL  Increased share of properly segregated and treated infectious health care waste (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 8.00 40.00 Date 29-Aug-2011 09-Jan-2014 31-Dec-2014 30-Jun-2017 Comments 4. Description: Estimated as incremental contribution of the project to environmentally safe treatment of hazardous solid waste. 5. Calculation: 1. Numerator: Quantity of project hospital infectious waste treated in accordance with standard (kg/day) 2. Denominator: total volume of hospital infectious waste in the country at the project appraisal time. (= 187,843 beds * 0.2kg/bed/day = 37,570 kg/day) 6. Thanks to solid waste treatment systems installed, volume hospital infectious waste treated in accordance to standards reaches 3056 kg/day. Please note that while waiting for final verification, efficacy of solid waste treatment is analyzed by laboratory contracted by the hospitals. PHINDPDOTBL  Increased number of health care staff following correct occupational safety practices, including usage of personal protective equipment (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 100.00 90.00 Date 29-Aug-2011 09-Jan-2014 31-Dec-2014 30-Jun-2017 Comments 7. Description: Percent of project hospitals improving over their baseline 8. Calculation: 1. Numerator: Number of project hospitals improving over their baseline 2. Denominator: Number of project hospitals verified by IVAs PHINDPDOTBL  Improved perception among communities adjacent to project hospitals about health waste being properly managed (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 100.00 90.00 Date 29-Aug-2011 09-Jan-2014 31-Dec-2014 30-Jun-2017 Comments 9. Description: Percent of project hospitals improving over their baseline 4/2/2015 Page 4 of 14 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Hospital Waste Management Support Project (P119090) 10. Calculation: 1. Numerator: Number of project hospitals improving over their baseline 2. Denominator: Number of project hospitals verified by IVAs Overall Comments Intermediate Results Indicators PHINDIRITBL  Effective CPMU and TAG support to Component 2 beneficiaries (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 -- 80.00 Date 29-Aug-2011 09-Jan-2014 31-Dec-2014 30-Jun-2017 Comments The indicator is not measured since the CPMU did not conduct any survey to assess beneficiary hospitals' satisfaction with CPMU and TAG support. PHINDIRITBL  Effective monitoring (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 90.00 100.00 Date 29-Aug-2011 09-Jan-2014 31-Dec-2014 30-Jun-2017 Comments The CPMU can not measure 2 out of 17 indicators in the Result Framework, which are (i) effective CPMU and TAG support to component 2 beneficiaries, and (ii) central and provincial hospital receiving scheduled environmental monitoring visits. 4/2/2015 Page 5 of 14 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Hospital Waste Management Support Project (P119090) PHINDIRITBL  Number of hospital grants approved (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 62.00 59.00 150.00 Date 29-Aug-2011 09-Jan-2014 31-Dec-2014 30-Jun-2017 Comments It is clarified by the mission that the hospital grants are not approved by CPMU, but the MOH. So the number of hospital grants approved decreases from 62 (accepted by the CPMU) to 59 (approved by the MOH). PHINDIRITBL  Number of Health Care Waste Management Plans approved (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 36.00 14.00 60.00 Date 29-Aug-2011 09-Jan-2014 31-Dec-2014 30-Jun-2017 Comments It is clarified by the mission that Healthcare Waste Management Plans are not facility level plans, but provincial level plans. So the number of HCWM plans decreases from 36 (facility level plans) to 14 (provincial level plans). PHINDIRITBL  Central and provincial hospital receiving scheduled environmental monitoring visits (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- -- -- Date 29-Aug-2011 09-Jan-2014 31-Dec-2014 30-Jun-2017 Comments 11. Indicator definition: - Numerator: number of central and provincial hospitals received scheduled environmental monitoring visits - Denominator: number of central and provincial hospitals in the country 12. Comments: - As MOH is implementing a program monitoring environment in central hospitals, 100% of central hospitals receive scheduled environmental monitoring visits - It is impossible for CPMU and MOH to measure percentage of provincial hospitals receiving scheduled environmental monitoring visits. The CPMU and VIHEMA proposes to leave this indicator out of result framework in restrucuring proposal. 4/2/2015 Page 6 of 14 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Hospital Waste Management Support Project (P119090) PHINDIRITBL  Central Hospitals receiving scheduled environmnetal monitoring visits (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 100.00 50.00 Date 29-Aug-2011 23-Jan-2014 31-Dec-2014 30-Jun-2017 PHINDIRITBL  Improved knowledge and skills of key health personnel in health care waste management standards and practices (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 546.00 5463.00 Date 29-Aug-2011 09-Jan-2014 31-Dec-2014 30-Jun-2017 PHINDIRITBL  Number of trainers trained with 80% passing test score (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 95.00 276.00 Date 29-Aug-2011 09-Jan-2014 31-Dec-2014 30-Jun-2017 PHINDIRITBL  Number of leaders of health, DONRE, Environment Police, other agencies trained with 80% passing test score (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 269.00 2545.00 Date 29-Aug-2011 09-Jan-2014 31-Dec-2014 30-Jun-2017 4/2/2015 Page 7 of 14 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Hospital Waste Management Support Project (P119090) PHINDIRITBL  Number of HCWM administrators in DOH, health care facilities, preventive health centers trained with 80% passing test score (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 284.00 2332.00 Date 29-Aug-2011 09-Jan-2014 31-Dec-2014 -- PHINDIRITBL  Number of technical staff in environment monitoring agency trained with 80% passing test score (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 310.00 Date 29-Aug-2011 09-Jan-2014 31-Dec-2014 -- PHINDIRITBL  Health personnel receiving training (number) (Number, Core) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 7416.00 -- Date 29-Aug-2011 09-Jan-2014 31-Dec-2014 -- Comments Health personnel receive training including (i) those who receive training under the componnet 1, (ii) hospital personnel receive trainining under the sub-grants, and (iii) project managers receive training on HCWM investment and procurement under component 3. So far, 861 personnels are trained under the component 1; 6270 hospital personnel are trained under component 2; and 255 project officials are trained under the component 3. PHINDIRITBL  Number of hospital grants completed (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 1.00 150.00 Date 29-Aug-2011 09-Jan-2014 31-Dec-2014 -- Comments Indicator definition: Number of hospital grants completed final verification 4/2/2015 Page 8 of 14 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Hospital Waste Management Support Project (P119090) PHINDIRITBL  Number of hospitals meeting: (a) wastewater standards; (b) solid waste standards; (c) HCWM practice standard (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 3.00 140.00 Date 29-Aug-2011 09-Jan-2014 31-Dec-2014 -- Comments Number of hospitals meeting standards is identified by IVA contracted by the CPMU. PHINDIRITBL  Number of hospitals meeting wastewater standards (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 3.00 140.00 Date 29-Aug-2011 -- 31-Dec-2014 -- PHINDIRITBL  Number of hospitals meeting solid waste treatment standards (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 3.00 140.00 Date 29-Aug-2011 -- 31-Dec-2014 -- 4/2/2015 Page 9 of 14 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Hospital Waste Management Support Project (P119090) PHINDIRITBL  Number of hospital meeting HCWM practice standards (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 1.00 140.00 Date 29-Aug-2011 -- 31-Dec-2014 -- PHINDIRITBL  Four scientific institutes/Regional reference labs and provincial preventive health centers have strengthened capacity for testing of solid and liquid health care waste (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 4.00 Date 31-Aug-2011 09-Jan-2014 31-Dec-2014 -- PHINDIRITBL  Functional web based software application to provide up-to-date and transparent information about the status of HCWM in hospitals (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 250.00 Date 29-Aug-2011 09-Jan-2014 31-Dec-2014 -- Comments VIHEMA postpone development of software in order to prioritize other activities. PHINDIRITBL  Health facilities constructed, renovated, and/or equipped (number) (Number, Core) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 15.00 150.00 Date 29-Aug-2011 09-Jan-2014 31-Dec-2014 -- 4/2/2015 Page 10 of 14 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Hospital Waste Management Support Project (P119090) PHINDIRITBL  Smooth implementation and monitoring of grant implementation (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 -- 100.00 Date 29-Aug-2011 09-Jan-2014 31-Dec-2014 -- PHINDIRITBL  Credit resources committed (cumulative) (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 9.00 19.00 100.00 Date 29-Aug-2011 09-Jan-2014 31-Dec-2014 -- PHINDIRITBL  Credit resources disbursed (cumulative) (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 11.00 8.00 100.00 Date 29-Aug-2011 09-Jan-2014 31-Dec-2014 -- PHINDIRITBL  Health facilities constructed, renovated, and/or equipped (number) (Number, Core) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 15.00 100.00 Date -- 09-Jan-2014 31-Dec-2014 -- 4/2/2015 Page 11 of 14 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Hospital Waste Management Support Project (P119090) PHINDIRITBL  Fully functional Executive Committee for Environmental Protection in the Health Sector having regular inter-sectoral meetings (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 1.00 10.00 Date 29-Aug-2011 09-Jan-2014 31-Dec-2014 -- PHINDIRITBL  the number of new or revised policies, regulatory documents adopted and applied HCWM studies published and disseminated (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 36.00 -- Date 29-Aug-2011 09-Jan-2014 31-Dec-2014 -- PHINDIRITBL  Number of Policy and administrative documents (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 3.00 4.00 Date 29-Aug-2011 23-Jan-2014 31-Dec-2014 -- PHINDIRITBL  Number of Technical regulations (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 4.00 Date 29-Aug-2011 09-Jan-2014 31-Dec-2014 -- 4/2/2015 Page 12 of 14 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Hospital Waste Management Support Project (P119090) PHINDIRITBL  Number of Technical guidance manuals (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 10.00 5.00 Date 29-Aug-2011 09-Jan-2014 31-Dec-2014 -- PHINDIRITBL  Number of workshops with stakeholders (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 23.00 13.00 Date 29-Aug-2011 23-Jan-2014 31-Dec-2014 -- Overall Comments Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed Disbursed P119090 IDA-48990 Effective XDR 96.10 96.10 0.00 11.00 85.10 11% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P119090 IDA-48990 Effective 29-Mar-2011 31-May-2011 29-Aug-2011 31-Aug-2017 31-Aug-2017 Cumulative Disbursements 4/2/2015 Page 13 of 14 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Hospital Waste Management Support Project (P119090) Restructuring History There has been no restructuring to date. Related Project(s) There are no related projects. 4/2/2015 Page 14 of 14 Public Disclosure Copy