The World Bank Implementation Status & Results Report Angola Health System Performance Strengthening Project (HSPSP) (P160948) Angola Health System Performance Strengthening Project (HSPSP) (P160948) AFRICA EAST | Angola | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2018 | Seq No: 5 | ARCHIVED on 27-Jul-2020 | ISR42823 | Implementing Agencies: Ministry of Health, Republic of Angola Key Dates Key Project Dates Bank Approval Date: 29-Mar-2018 Effectiveness Date: 24-Oct-2018 Planned Mid Term Review Date: 14-Sep-2020 Actual Mid-Term Review Date: Original Closing Date: 30-Sep-2023 Revised Closing Date: 30-Sep-2023 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The Project Development Objective (PDO) is to increase the utilization and the quality of health care services in target provinces and municipalities. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Improving the Quality of Health Services Delivery in Target Provinces:(Cost $74.70 M) Strengthening System-wide Enabling Factors that Support Delivery of Quality Health Services:(Cost $35.00 M) Contingent Emergency Response Component (CERC) Project Management and Monitoring and Evaluation:(Cost $10.00 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Satisfactory Moderately Satisfactory Overall Risk Rating Substantial Substantial Implementation Status and Key Decisions The project has been effective since October 24, 2018. It is recording steady progress. The project, through its existing structure and financing envelope, made available immediate financing to support the Government of Angola in its urgent health sector response to the COVID-19 pandemic. This financing has been utilized to support operational costs related to the response and strategic procurements for COVID-19 materials and equipment. The materials and equipment purchased under World Bank financing has arrived in country and distribution is underway. Outside of COVID, overall project implementation is underway for the operational plans for the 34 target municipalities (21 target municipalities funded by the World Bank and additional 13 urban/peri-urban municipalities funded by the Global Alliance Vaccine Initiative (Gavi) Additional Financing) The performance-based financing (PBF) pilot named PASSABEM in Angola has registered 20 percent of the target population with fixed transfers having been made to the municipalities based on the catchment population and the initial variable transfers having been made based on results achieved. The project has also finalized the field-based data collection to assess the health financing structure and the results and 7/27/2020 Page 1 of 9 The World Bank Implementation Status & Results Report Angola Health System Performance Strengthening Project (HSPSP) (P160948) recommendations will be presented in September 2020. In addition, the health center equipment purchased under the project which arrived in- country in January 2020 has been distributed to the municipal-level health centers. Lastly, the second Contingent Emergency Response Component (CERC2) was activated in July 2020, is financing multi-sectoral interventions to address the malnutrition crisis being aggravated by the drought in the southern provinces and further exacerbated by the COVID-19 limitations. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance Substantial Substantial Substantial Macroeconomic High High High Sector Strategies and Policies Moderate Moderate Moderate Technical Design of Project or Program Moderate Moderate Moderate Institutional Capacity for Implementation and Substantial Substantial Substantial Sustainability Fiduciary Substantial Substantial Substantial Environment and Social Moderate Moderate Moderate Stakeholders Substantial Substantial Substantial Other -- -- -- Overall Substantial Substantial Substantial Results PDO Indicators by Objectives / Outcomes Increase quality of health care services IN00872545 ►Percentage of pregnant women who receive four antenatal (ANC) consultations (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 17.40 16.00 5.00 36.00 Date 29-Dec-2017 30-Sep-2019 31-Mar-2020 30-Jun-2023 IN00872547 ►Pregnant women who are HIV positive who deliver at health facilities and receive ART (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target 7/27/2020 Page 2 of 9 The World Bank Implementation Status & Results Report Angola Health System Performance Strengthening Project (HSPSP) (P160948) Value 10.50 10.00 4.00 40.00 Date 29-Dec-2017 30-Sep-2019 31-Mar-2020 30-Jun-2023 IN00872549 ►Percentage of pregnant women receiving two tetanus vaccines during pregnancy (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 30.50 55.00 47.00 48.00 Date 29-Dec-2017 30-Sep-2019 31-Mar-2020 30-Jun-2023 IN00872551 ►Number of health facilities without stock-outs of reproductive health medicines and supplies (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 100.00 Date 29-Dec-2017 17-Jun-2019 31-Mar-2020 30-Jun-2023 Increase utilization of health care services IN00872544 ►Pregnant women who are HIV positive that deliver at a health facility (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 1,365.00 655.00 299.00 1,680.00 Date 29-Dec-2017 30-Sep-2019 31-Mar-2020 30-Jun-2023 IN00872546 ►Number of reproductive health consultations conducted through Mobile Brigades (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 8,002.00 6,838.00 6,000.00 Date 30-Dec-2017 30-Sep-2019 31-Mar-2020 30-Jul-2023 Reproductive health visits consider prenatal care and family planning consultations Comments: IN00872548 ►Number of child health consultations in the 21 PFSS municipalities (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 235,292.00 6,000.00 Date 29-Dec-2017 17-Jun-2019 31-Mar-2020 30-Jun-2023 IN00872550 ►Number of child health consultations in the 13 Child Health Expansion municipalities (Number, Custom) 7/27/2020 Page 3 of 9 The World Bank Implementation Status & Results Report Angola Health System Performance Strengthening Project (HSPSP) (P160948) Baseline Actual (Previous) Actual (Current) End Target Value 1,227,000.00 1,167,288.00 604,140.00 1,785,000.00 Date 15-Mar-2019 30-Sep-2019 31-Mar-2020 30-Dec-2022 Overall Comments PDO The Results Framework will be restructured as part of the ongoing proposed project AF restructuring. The restructured RF will inter alia capture a new PDO indicator on Nutrition. Intermediate Results Indicators by Components Improving the Quality of Health Services Delivery in Target Provinces IN00872552 ►Health units implementing the minimum package of maternal and child health services (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 60.00 Date 29-Dec-2017 30-Sep-2019 31-Mar-2020 30-Jun-2023 Frequency: annual Comments: IN00872554 ►Municipalities implementing operational plans for Health Waste Management (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 21.00 Date 29-Dec-2017 30-Sep-2019 31-Mar-2020 30-Jun-2023 Frequency: annual Comments: IN00872556 ►Number of health units implementing patient feedback mechanisms and presenting results to the Provincial level (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 140.00 Date 18-Dec-2017 17-Jun-2019 31-Mar-2020 30-Jun-2023 IN00872558 ►Number of health facilities that provide TB diagnosis (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 22.00 7/27/2020 Page 4 of 9 The World Bank Implementation Status & Results Report Angola Health System Performance Strengthening Project (HSPSP) (P160948) Date 29-Dec-2017 17-Jun-2019 31-Mar-2020 30-Jun-2023 IN00872560 ►Percentage of female adolescents ages 12-15 that had a family planning consultation (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 5.00 1.00 0.20 14.00 Date 29-Dec-2017 30-Sep-2019 31-Mar-2020 30-Jun-2023 IN00872562 Number of female adolescents ages 12-15 that had a family planning consultation (Number, Custom Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 389.00 26,000.00 IN00872565 ►Number of women (ages 15-49) who had a family planning consultation (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 93,433.00 93,433.00 6,916.00 181,328.00 Date 29-Dec-2017 17-Jun-2019 31-Mar-2020 30-Jun-2023 IN00872566 Percentage of women (ages 15-49) who had a family planning consultation (Percentage, Custom Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 13.00 13.00 1.00 22.00 IN00872567 ►Children under-1 receiving Pentavalent third dose (Penta3) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 320,000.00 65.00 60,864.00 490,000.00 Date 29-Dec-2017 29-Dec-2017 31-Mar-2020 30-Jun-2023 IN00872568 ►Children receiving first dose of Measles and Rubella (MR 1st dose) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 301,000.00 301,000.00 69,861.00 460,000.00 Date 29-Dec-2017 17-Jun-2019 31-Mar-2020 30-Jun-2023 IN00872569 ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 35,450.00 160,000.00 7/27/2020 Page 5 of 9 The World Bank Implementation Status & Results Report Angola Health System Performance Strengthening Project (HSPSP) (P160948) Date 29-Dec-2017 17-Jun-2019 31-Mar-2020 30-Jun-2023 IN00872570 Number of children immunized (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 45,485.00 110,000.00 Date 29-Dec-2017 17-Jun-2019 31-Mar-2020 30-Jun-2023 IN00872571 Number of women and children who have received basic nutrition services (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 10,000.00 Date 29-Dec-2017 25-May-2018 31-Mar-2020 30-Jun-2023 IN00872572 Number of deliveries attended by skilled health personnel (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 11,764.00 40,000.00 Date 29-Dec-2017 17-Jun-2019 31-Mar-2020 30-Jun-2023 IN00872573 ►Number of municipalities with multiyear proforma indicative budget allocation for child health at municipal level (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 13.00 Date 15-Mar-2019 15-Mar-2019 31-Mar-2020 30-Dec-2022 Strengthening System-wide Enabling Factors that Support Delivery of Quality Health Services IN00872553 ►Technical Health Training Schools implementing new curricula (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 11.00 Date 29-Dec-2017 17-Jun-2019 31-Mar-2020 30-Jun-2023 Includes new curricula for training of health technicians on birth attendance, statistics, nursing, laboratory Comments: and clinical analysis and nutrition IN00872555 ►Development of a training module on adolescent-friendly reproductive health services (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No No No Yes 7/27/2020 Page 6 of 9 The World Bank Implementation Status & Results Report Angola Health System Performance Strengthening Project (HSPSP) (P160948) Date 29-Dec-2017 17-Jun-2019 31-Mar-2020 30-Jun-2023 IN00872557 ►Health personnel trained in adolescent-friendly reproductive health services (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 230.00 Date 31-Mar-2020 17-Jun-2019 31-Mar-2020 30-Jun-2023 IN00872559 ►Municipalities with staff trained on the operational and budgetary planning tool (FPOM) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 34.00 Date 31-Dec-2016 30-Sep-2019 31-Mar-2020 30-Jun-2023 IN00872561 ►Development of a protocol and tool for certifying health posts, health centers, and municipal hospitals (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No No No Yes Date 31-Dec-2016 30-Sep-2019 31-Mar-2020 31-Dec-2022 IN00872563 ►Emergency operations center reactivated (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No Yes Yes Yes Date 31-Dec-2016 30-Sep-2019 31-Mar-2020 31-Dec-2022 IN00872564 ►MICS survey conducted in 2020 (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No No No Yes Date 29-Dec-2017 30-Sep-2019 31-Mar-2020 30-Jun-2023 Overall Comments IR The Results Framework will be updated as part of the ongoing proposed project AF/restructuring. Performance-Based Conditions 7/27/2020 Page 7 of 9 The World Bank Implementation Status & Results Report Angola Health System Performance Strengthening Project (HSPSP) (P160948) Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P160948 IBRD-88350 Effective USD 110.00 110.00 0.00 49.99 60.01 45% P160948 TF-B0225 Effective USD 9.70 9.70 0.00 1.36 8.34 14% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P160948 IBRD-88350 Effective 22-Mar-2018 28-Jun-2018 24-Oct-2018 30-Sep-2023 30-Sep-2023 P160948 TF-B0225 Effective 29-Mar-2018 12-Jul-2019 12-Jul-2019 30-Sep-2023 30-Sep-2023 Cumulative Disbursements PBC Disbursement Achievement Disbursed amount in Disbursement % PBC ID PBC Type Description Coc PBC Amount Status Coc for PBC 7/27/2020 Page 8 of 9 The World Bank Implementation Status & Results Report Angola Health System Performance Strengthening Project (HSPSP) (P160948) Restructuring History There has been no restructuring to date. Related Project(s) P168956-Child Health Expansion Angola ,P172985-Angola Crisis Response and Resilience: Health and Nutrition Security 7/27/2020 Page 9 of 9