The World Bank Report No: ISR3324 Implementation Status & Results Afghanistan Public Disclosure Copy Afghanistan - Support to Basic Package of Health Services (Strengthening Health Activity for Rural Poor (P120565) Operation Name: Afghanistan - Support to Basic Package of Health Services Project Stage: Implementation Seq.No: 2 Status: ARCHIVED Last Modified Date: 03-Jun-2011 (Strengthening Health Activity for Rural Poor (P120565) Country: Afghanistan Approval FY: 2010 Product Line: Recipient Executed Activities Region: SOUTH ASIA Lending Instrument: Specific Investment Loan Implementing Agency(ies): Ministry of Public Health Key Dates Board Approval Date 23-Dec-2009 Original Closing Date 14-Mar-2013 Planned Mid Term Review Date 30-Jun-2011 Last Archived ISR Date 22-Nov-2010 Effectiveness Date 14-Mar-2010 Revised Closing Date 14-Mar-2013 Actual Mid Term Review Date Project Development Objectives Project Development Objective (from Project Appraisal Document) The objective of the Project is to improve the health and nutritional status of the people of Afghanistan, with a greater focus on women and children by increasing accessibility and quality of the BPHS in the provinces of Balkh and Samangan and urban Kabul. Has the Project Development Objective been changed since Board Approval of the Project? Yes No Component(s) Component Name Component Cost Sustaining and Strengthening BPHS Delivery in rural areas 13.90 Piloting BPHS implementation in urban Kabul 3.50 Implementation and management support 0.25 Public Disclosure Copy Overall Ratings Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Moderately Satisfactory Overall Implementation Progress (IP) Satisfactory Moderately Satisfactory Overall Risk Rating Implementation Status Overview Overall project performance is downgraded to moderately satisfactory as service delivery performance of implementing partners in both provinces of Balk and Samangan declined in terms of quality of care and coverage of services in 2010 as compared to the previous years. In addition, development of urban BPHS proposal is making slow progress and taking much longer than envisaged. The Ministry of Public Health (MOPH) and Implementing partners have analyzed these negative trends of service delivery performance and are taking steps in each province to reverse them. Recent HMIS is indicating some reversal of declining trend in performance at least in Samangan province. MOPH has agreed on the revised Page 1 of 5 The World Bank Report No: ISR3324 basic package of health services, including more nutrition, mental health and disability interventions and plans are being developed including costing to initiate implementation in next three months in both provinces. In addition, it has taken concrete steps to start reforming and restructuring the procurement management system in the Ministry in line with the Public Disclosure Copy national procurement reforms. Results Project Development Objective Indicators Indicator Baseline Current End Target Indicator Name Value Value Value Pregnant women receiving antenatal care during a visit to a health 70353.00 79146.00 119127.00 provider Date Date Date 01-Jul-2009 10-Oct-2009 31-Mar-2013 Type Unit of Measure Comment Comment Comment Core Indicator Number Based on 32% coverage Based on 36%coverage (NRVA 50% ANC coverage (based on an (Household Survey 2006) 2008) and population estimate of estimate of 238,255 pregnant 219,852. No Latest Data likely to women) be available in October 2011 Indicator Baseline Current End Target Indicator Name Value Value Value Children immunized 74750.00 94536.00 142963.00 Date Date Date 20063112 10-Oct-2009 31-Mar-2013 Type Unit of Measure Comment Comment Comment Core Indicator Number DPT3 coverage was 34% in 2006. DPT3 coverage was 43% (2008 60% is the 2013 target. The The numeric value is based on the NRVA). The numeric value is numeric value is based on the estimated population in the based on 4% of population in the estimated population in the provinces financed by the Bank. intervention area as per CSO provinces financed by the Bank. statistics 2008-9)Latest Data likely Public Disclosure Copy to be available in October 2011 Indicator Baseline Current End Target Indicator Name Value Value Value Number of consultations per person per year 0.90 1.20 1.40 Date Date Date 20073112 30-May-2011 31-Mar-2013 Type Unit of Measure Comment Comment Comment Custom Indicator Number HMIS 2011 Intermediate Results Indicators Page 2 of 5 The World Bank Report No: ISR3324 Indicator Baseline Current End Target Public Disclosure Copy Indicator Name Value Value Value People with access to a basic package of health, nutrition, or 4671600.00 4671855.00 5062917.00 population services Date Date Date 07-Jan-2009 10-Oct-2009 31-Mar-2013 Type Unit of Measure Comment Comment Comment Core Indicator Number 85% of the population has access 85% of the population has access A target was not discussed with to BPHS. The numerical value has to BPHS. The numerical value has authorities during project been derived from an estimate of been derived from an estimate of preparation. The target presented 5,496,300 population in 11 Bank 5,496,300 populaiton in 11 Bank here is based on the maintenance financed provinces (as per CSO financed provinces (as per CSO of a 85% BPHS coverage Afghanistan. Afghanistan) throughout the project. Indicator Baseline Current End Target Indicator Name Value Value Value Births attended by skilled attendents 18.90 24.00 28.00 Date Date Date 31-Dec-2006 10-Oct-2009 31-Mar-2013 Type Unit of Measure Comment Comment Comment Custom Indicator Percentage Coverage based on Household SBA coverage was 24% (2008 28% is the 2013 target. The Survey 2006. Numeric value of NRVA). The numeric value 52764 numeric value of 61558 is based 41552 is based on 4% of is based on 4% of population in the on the estimated population in the population in the provinces intervention area as per CSO provinces financed by the Bank. financed by the Bank. statistics 2008-9). Latest data likely to be available in October 2011 Indicator Baseline Current End Target Indicator Name Value Value Value TB Treatment Success Rate 85.00 86.00 90.00 Public Disclosure Copy Date Date Date 31-Dec-2008 30-May-2011 31-Mar-2013 Type Unit of Measure Comment Comment Comment Custom Indicator Percentage HMIS 2008 HMIS 2009 (percentage) Target in percentage and is expected to be greater than 90% by end of the project) Page 3 of 5 The World Bank Report No: ISR3324 Indicator Baseline Current End Target Public Disclosure Copy Indicator Name Value Value Value Score on the balance scorecard examining quality of care in health 70.00 69.00 80.00 facilities Date Date Date 31-Dec-2007 30-May-2011 31-Mar-2013 Type Unit of Measure Comment Comment Comment Custom Indicator Number 2010 Balance Scorecard (Johns Hopkins University) Data on Financial Performance (as of 04-May-2011) Financial Agreement(s) Key Dates Project Loan No. Status Approval Date Signing Date Effectiveness Date Closing Date P120565 TF-95919 Effective 14-Mar-2010 14-Mar-2010 14-Mar-2010 14-Mar-2013 Disbursements (in Millions) Project Loan No. Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P120565 TF-95919 Effective USD 17.65 17.65 0.00 12.71 4.94 72.00 Disbursement Graph Public Disclosure Copy Key Decisions Regarding Implementation Page 4 of 5 The World Bank Report No: ISR3324 NA Public Disclosure Copy Restructuring History There has been no restructuring to date. 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