The World Bank Implementation Status & Results Report The Gambia COVID-19 Preparedness and Response Project (P173798) The Gambia COVID-19 Preparedness and Response Project (P173798) AFRICA WEST | Gambia, The | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2020 | Seq No: 1 | ARCHIVED on 10-Aug-2020 | ISR42734 | Implementing Agencies: Ministry of Health, The Gambia Key Dates Key Project Dates Bank Approval Date: 02-Apr-2020 Effectiveness Date: 03-Apr-2020 Planned Mid Term Review Date: 31-Mar-2021 Actual Mid-Term Review Date: Original Closing Date: 31-Mar-2022 Revised Closing Date: 31-Mar-2022 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) To prevent, detect and respond to the threat posed by COVID-19 and strengthen national system for public health preparedness Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Component 1: Emergency COVID-19 Response:(Cost $4.00 M) Component 2: Strengthening Multi-sector, National Institutions and Platforms for Policy Development and Coordination of Prevention and Preparedness using One Health approach.:(Cost $0.60 M) Component 3: Supporting National and Sub-national, Prevention and Preparedness:(Cost $5.00 M) Component 4: Implementation Management and Monitoring and Evaluation:(Cost $0.40 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO -- Satisfactory Overall Implementation Progress (IP) -- Satisfactory Overall Risk Rating -- Moderate Implementation Status and Key Decisions Implementation progress is satisfactory with 75 percent of the allocated $10 million disbursed. The Ministry of Health is appreciative of World Bank support and the Minister indicates he has been conveying this to the President of The Gambia. The project has realized the following:  In April 2020, when there was acute global shortage of COVID-19 medical equipment and supplies, including in the United States and Europe, the WBG supported the Ministry of Health in procuring ten high-quality, well-equipped ambulances for intensive care treatment (ICU) en route, and critical lifesaving medical equipment and supplies including 60 ICU beds, 600,000 surgical masks, 1.2 million gloves, 5,000 oxygen masks, 4 ultrasound machines, 20,000 face shields, 25,000 personal protective equipment (coverall), 30,000 respirators (N95), 205 oxygen flowmeters, 3 digital 4D color ultrasound machines, 4 ultrasound scanners and 100 non-touch thermometers. 8/10/2020 Page 1 of 9 The World Bank Implementation Status & Results Report The Gambia COVID-19 Preparedness and Response Project (P173798)  A state-of-the-art healthcare waste treatment machine, AMB Ecosteryl 250 (www.ecosteryl.com), was delivered in July 2020 and an AMB Ecosteryl 75 plus is currently under production in Belgium for subsequent delivery. The Maternal and Child Nutrition and Health Results Project (MCNHRP) (P143650) financed the construction of 37 incinerators in five regions excluding the Western Regions but generally incinerators have drawbacks such as release of pollutants into the air, which are hazardous particularly when used in populated areas. That is why the microwave disinfection technology with a processing capacity of between 250 and 300 kg/hr (4000 liters/hr) is a viable solution for the urban regions.  The project procured 6 pickup trucks and 18 motorcycles to facilitate contact tracing and response.  The 1025 toll-free call center and media monitoring and public information center are being enhanced. This will go towards scaling up the current Grievance Redress System, and having a model that will be efficient, robust, and sustainable during and post COVID-19.  The project is supporting risk communication and community engagement. For instance, during July 25-26, 2020 the project supported orientation of all district chiefs in-country on COVID-19, conducted by the Risk Communication and Community Engagement sub- committee of the National Health Emergency Committee on COVID-19. The aim was to sensitize the chiefs on WHO/MoH guidelines and safety measures on COVID-19 awareness and prevention. The chiefs are expected to go back to their various communities and hold step- down trainings on their orientation session. MPA Program Development Objective MPA PDO Table The Program Development Objective is to prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness MPA Table Multiphase Programmatic Approach (MPA) Status MPA Table Body Impressive efforts have been made to advance the implementation of the MPA-funded projects. As of June 30, 2020, 73 projects had been approved providing a total commitment of US$4.7 billion. The projects benefit around 4.7 billion people or 62% of the global population. Of the 73 approved projects: (i) 28 are in Africa; (ii) 11 in East Asia; (iii) 11 in Europe and Central Asia; (iv) 8 in Latin America and the Caribbean; (v) 7 in Middle East and North Africa; and (vi) 8 in South Asia. Total disbursements as of June 30, 2020 under these projects amount to US$1,294.5 billion or 28% of overall commitment. In addition, $233.4 billion have been committed under signed contracts with UNICEF and Bank Facilitated Procurement (BFP), bringing to 32% actual disbursements and committed amounts. Flexible project design and streamlined procedures as well as intensified efforts across the Bank have contributed to the progress. The implementation faces significant challenges as seventy three percent (73%) of countries with MPA projects were reported still in lockdown at the end of May. Some specific challenges identified by teams include: (i) ) several countries have not adopted emergency procedures for signing of financing agreements, processing procurement and payments – bureaucracy in making decisions and approving procurement, contracts, and payments continue to be a bottleneck; (ii) fear of future audits/investigations by national audit agencies and accountability offices is one of the reasons that is holding back the use of BFP; (iii) limited face-to-face meetings makes it difficult to communicate and engage with counterparts; (iv) a fundamental implementation challenge is that some government officials are not equipped to carry out their roles and responsibility during country lockdowns, with many trying to operate with cell phones; (v) Retroactive Financing has little or no uptake in some countries, mainly because the reimbursed funds will go to central government (MOF) and not to the ministries of health. Notwithstanding these challenges, the MPA is on track to achieving its PrDO – to prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness. The significant level of disbursement in less than three months attest to the strong implementation of the Bank response thanks to the commitment of country teams. However, the capacity of teams is being stretched to meet delivery demands and provide enhanced implementation support to clients, this may not be sustainable in the long term. 8/10/2020 Page 2 of 9 The World Bank Implementation Status & Results Report The Gambia COVID-19 Preparedness and Response Project (P173798) Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance High -- High Macroeconomic Substantial -- Substantial Sector Strategies and Policies Moderate -- Moderate Technical Design of Project or Program Moderate -- Moderate Institutional Capacity for Implementation and Substantial -- Substantial Sustainability Fiduciary Moderate -- Moderate Environment and Social Substantial -- Substantial Stakeholders Moderate -- Moderate Other -- -- -- Overall Substantial -- Moderate Results PDO Indicators by Objectives / Outcomes Strengthen the national public health preparedness capacity to prevent, detect and respond IN00869919 ►Suspected cases of COVID-19 cases reported and investigated per approved protocol (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 100.00 50.00 Date 02-Mar-2020 -- 30-Jun-2020 31-Mar-2022 The numerator is number of suspected cases COVID-19 cases that are reported and investigated per Comments: approved protocol and the denominator is number of suspected COVID-19 cases IN00869920 ►Isolation and treatment centers with pandemic preparedness and response plans per Ministry of Health Guidelines (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 100.00 50.00 Date 02-Mar-2020 -- 30-Jun-2020 31-Mar-2022 8/10/2020 Page 3 of 9 The World Bank Implementation Status & Results Report The Gambia COVID-19 Preparedness and Response Project (P173798) Numerator is number of Isolation and treatment centers with pandemic preparedness and response plans Comments: per Ministry of Health Guidelines and denominator is number of Isolation and treatment centers designated for COVID-19 isolation and treatment IN00869951 ►Health staff trained in infection prevention per MOH-approved protocols (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 807.00 500.00 Date 02-Mar-2020 -- 30-Jun-2020 31-Mar-2022 Comments: Number of health staff trained in infection prevention per MOH-approved protocols IN00869952 ►Hospitals with personal protective equipment and infection control products and supplies, without stock-outs on the first day of each quarter (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 100.00 50.00 Date 02-Mar-2020 -- 30-Jun-2020 31-Mar-2022 Numerator is number of hospitals with personal protective equipment and infection control products and Comments: supplies, without stock-outs on the first day of each quarter and the denominator is number of hospitals IN00869953 ►Diagnosed cases treated per approved protocol (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 55.00 50.00 Date 02-Mar-2020 -- 30-Jun-2020 31-Mar-2022 The numerator is number of diagnosed cases treated per approved protocol and the denominator is Comments: number of diagnosed cases Intermediate Results Indicators by Components Component 1: Emergency COVID-19 Response IN00869954 ►Public Health Emergency Operation Center (PHEOC) activated and operationalized to support coordination and planning for COVID-19 or other future emergencies (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target PHEOC activated to Value Not operational -- Operational coordinate response Date 02-Mar-2020 -- 30-Jun-2020 31-Mar-2022 Public Health Emergency Operation Center (PHEOC) has dedicated toll-free telephone lines, equipped Comments: with computers and communication equipment and emergency vehicles, and a designated National Focal Point IN00869957 ►Points of Entries equipped and staff trained in SOPs (including for infection prevention and control, screening of passengers (Number, Custom) 8/10/2020 Page 4 of 9 The World Bank Implementation Status & Results Report The Gambia COVID-19 Preparedness and Response Project (P173798) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 9.00 9.00 Date 02-Mar-2020 -- 30-Jun-2020 31-Mar-2022 Comments: All 9 Points of Entries are equipped and the staff trained IN00869959 ►Rapid-response teams members trained and equipped to investigate cases and conduct contact tracing (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 35.00 80.00 Date 02-Mar-2020 -- 30-Jun-2020 31-Mar-2022 Numerator is number of rapid-response teams members trained and equipped to investigate cases and Comments: conduct contact tracing and denominator is number of rapid-response teams members IN00869961 ►Table-top simulation exercises and findings documented to inform future preparedness and response activities (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Report on table-top 1 table-top simulation simulation exercises Value None -- exercise conducted with recommendations or lessons learned Date 02-Mar-2020 -- 30-Jun-2020 31-Mar-2022 Table-top simulation exercises are carried out and the findings documented to inform future preparedness Comments: and response activities IN00869963 ►Supervisory visits undertaken to nine Points of Entry (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 3.00 27.00 Date 02-Mar-2020 -- 30-Jun-2020 31-Mar-2022 Comments: Cumulative number of supervisory visits undertaken to all nine Points of Entry IN00869965 ►Border officers trained on COVID-19 prevention and control and contact tracing (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 105.00 50.00 Date 02-Mar-2020 -- 30-Jun-2020 31-Mar-2020 Comments: Cumulative number of border officers trained on COVID-19 prevention and control and contact tracing IN00869966 ►Community-based nurses and PHO trained on COVID-19 prevention and control and contact tracing (Number, Custom) 8/10/2020 Page 5 of 9 The World Bank Implementation Status & Results Report The Gambia COVID-19 Preparedness and Response Project (P173798) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 243.00 100.00 Date 02-Mar-2020 -- 30-Jun-2020 31-Mar-2022 Cumulative number of community-based nurses and PHO trained on COVID-19 prevention and control Comments: and contact tracing IN00869967 ►Emergency Ambulance Services operational within one month of start of project (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 8.00 9.00 Date 02-Mar-2020 -- 30-Jun-2020 31-Mar-2022 Comments: Number of Emergency Ambulances for COVID-19 operational within one month of start of project IN00869968 ►MoU signed with Republic of Senegal PHES (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target No formal MoU signed but there is Value None -- communication signed between the two countries Date 02-Mar-2020 -- 30-Jun-2020 31-Mar-2022 Comments: MoU signed with Republic of Senegal PHES within one year of start of project IN00869969 ►Table-top simulation exercises conducted (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 1.00 10.00 Date 02-Mar-2020 -- 30-Jun-2020 31-Mar-2022 Comments: Cumulative number of table-top simulation exercises conducted IN00869970 ►Non-incineration cluster treatment of healthcare waste from several health facilities established (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Healthcare waste treatment equipment procured and process Value None -- ongoing for building Established the structure for the clinical waste treatment center Date 02-Mar-2020 -- 30-Jun-2020 31-Mar-2022 8/10/2020 Page 6 of 9 The World Bank Implementation Status & Results Report The Gambia COVID-19 Preparedness and Response Project (P173798) Non-incineration cluster treatment of healthcare waste from several health facilities established in Western Comments: regions 1 and 2 IN00869971 ►COVID-19 sensitization campaigns conducted in all regions (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 7,380.00 7.00 Date 02-Mar-2020 -- 30-Jun-2020 31-Mar-2022 Comments: Cumulative number of COVID-19 sensitization campaigns conducted Component 2: Strengthening Multi-sector, National Institutions and Platforms for Policy Development IN00869955 ►Electronic Integrated Disease Surveillance Response (IDSR) using DHIS2 platform interfaced with laboratory management information system and animal health surveillance system established (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Value None -- Ongoing Established Date 02-Mar-2020 -- 30-Jun-2020 31-Mar-2022 Electronic Integrated Disease Surveillance Response (IDSR) using DHIS2 platform interfaced with Comments: laboratory management information system and animal health surveillance system established within one year of start of project Component 3: Supporting National and Sub-national, Prevention and Preparedness IN00869956 ►Health centers reporting stock-out of tracer Infection prevention and control materials on the first day of each month (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 50.00 Date 02-Mar-2020 -- 30-Jun-2020 31-Mar-2022 Numerator is the number of health centers reporting stock-out of tracer infection prevention and control Comments: materials (such as detergents and disinfectants, gloves, surgical face masks/shields, and safety/sharp boxes) on the first day of each month; and denominator is the total number of health centers nationally IN00869958 ►Costed plan to collect, package and transport samples to the WHO recommended laboratories for COVID-19 and future emergencies developed and implemented (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Testing is currently being done at the National Public Health Value No plan -- Plan in place Laboratory so the plan is no longer necessary. Date 02-Mar-2020 -- 30-Jun-2020 31-Mar-2022 Costed plan is developed and implemented for collecting, packaging and transporting samples to the Comments: WHO recommended laboratories for COVID-19 and future emergencies 8/10/2020 Page 7 of 9 The World Bank Implementation Status & Results Report The Gambia COVID-19 Preparedness and Response Project (P173798) IN00869960 ►Standard Operating Procedures (SOPs) on sample collection, packaging, transportation and testing of samples (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target SOPs on sample collection, packaging, transportation and testing are available and in place. All Value None -- laboratory personnel SOP in place involved in COVID-19 response have been trained. This was done with the support of AFENET. Date 02-Mar-2020 -- 30-Jun-2020 31-Mar-2021 Comments: SOPs is developed for sample collection, packaging, transportation and testing of samples IN00869962 ►Health centers reporting stock-out of tracer Infection prevention and control materials on the first day of each month (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 50.00 Date 02-Mar-2020 -- 30-Jun-2020 31-Mar-2022 Numerator is the number of health centers reporting stock-out of tracer infection prevention and control Comments: materials (such as detergents and disinfectants, gloves, surgical face masks/shields, and safety/sharp boxes) on the first day of each month; and denominator is the total number of health centers nationally IN00869964 ►Treatment and isolation centres renovated and/or equipped (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 3.00 Date 02-Mar-2020 -- 30-Jun-2020 31-Mar-2022 Comments: Cumulative number of treatment and isolation centres renovated and/or equipped Performance-Based Conditions Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P173798 IDA-D5970 Effective USD 10.00 10.00 0.00 7.52 2.59 74% 8/10/2020 Page 8 of 9 The World Bank Implementation Status & Results Report The Gambia COVID-19 Preparedness and Response Project (P173798) Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P173798 IDA-D5970 Effective 02-Apr-2020 03-Apr-2020 03-Apr-2020 31-Mar-2022 31-Mar-2022 Cumulative Disbursements PBC Disbursement Achievement Disbursed amount in Disbursement % PBC ID PBC Type Description Coc PBC Amount Status Coc for PBC Restructuring History There has been no restructuring to date. Related Project(s) P174575-AF to the The Gambia COVID-19 Preparedness and Response Project 8/10/2020 Page 9 of 9