The World Bank Implementation Status & Results Report Nepal: COVID-19 Emergency Response and Health Systems Preparedness Project (P173760) Nepal: COVID-19 Emergency Response and Health Systems Preparedness Project (P173760) SOUTH ASIA | Nepal | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2020 | Seq No: 4 | DRAFT | ISR48422 | Implementing Agencies: Ministry of Health and Population, Government of Nepal Key Dates Key Project Dates Bank Approval Date: 03-Apr-2020 Effectiveness Date: 07-Apr-2020 Planned Mid Term Review Date: 31-Oct-2022 Actual Mid-Term Review Date: Original Closing Date: 16-Jul-2022 Revised Closing Date: 15-Jul-2024 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The project development objective is to prevent, detect and respond to the threat posed by COVID-19 and to strengthen national systems for public health preparedness in Nepal. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name 1. Emergency COVID-19 Response:(Cost $98.50 M) 2. Community Engagement and Risk Communication:(Cost $3.00 M) 3. Implementation Management and Monitoring and Evaluation:(Cost $2.50 M) 4. Contingency Emergency Response Component Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Satisfactory -- Overall Implementation Progress (IP) Satisfactory -- Overall Risk Rating High -- Implementation Status and Key Decisions The overall implementation progress of the Project, in support of the COVID-19 health response in Nepal, is satisfactory. The MOHP with support of its Departments, Divisions and Centers and in coordination with development partners, continues to launch a strong public health response to COVID-19 management with provision of policy and operational guidance, hardware and software support in deployment of test, trace, treat and vaccination strategies, risk communications and monitoring and evaluation. Overall, 15 out of 22 PDO and intermediate results indicators have exceeded targets and five indicators are partially achieved. The project has disbursed 80.7 percent of original credit and 13.5 percent of the additional financing, with commitments of US$33.6 million for procurement of 4 million doses of Moderna vaccines through the COVAX cost-share option. The Bank Team together with MOHP and its implementing entities will prioritize for the next six months, procurement of additional vaccines fulfilling the Bank's vaccine approval criteria to vaccinate population >12 years of age; strengthened annual work plan and budget in line with project priorities; improvement in quality of reporting; and compliance with social and environment safeguards. 9/23/2021 Page 1 of 8 The World Bank Implementation Status & Results Report Nepal: COVID-19 Emergency Response and Health Systems Preparedness Project (P173760) 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 Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance Substantial High -- Macroeconomic Substantial Substantial -- Sector Strategies and Policies Moderate Moderate -- Technical Design of Project or Program Moderate High -- Institutional Capacity for Implementation and High Substantial -- Sustainability Fiduciary Substantial Substantial -- Environment and Social Substantial Substantial -- Stakeholders Moderate Moderate -- Other Moderate Substantial -- Overall Substantial High -- Results PDO Indicators by Objectives / Outcomes Prevent, detect and respond and strengthen MoHP systems for public health prepredness IN01044386 ►Percentage of suspected cases of COVID-19 cases reported and investigated based on national guidelines (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 90.00 Date 10-Jan-2020 15-Jul-2021 15-Jul-2021 15-Jul-2024 9/23/2021 Page 2 of 8 The World Bank Implementation Status & Results Report Nepal: COVID-19 Emergency Response and Health Systems Preparedness Project (P173760) This indicator is no longer practicable to track Comments: IN01044387 ►Proportion of prioritized population fully vaccinated, as per protocol, disaggregated by gender (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 5.20 5.20 40.00 Date 01-Jan-2021 15-Jul-2021 15-Jul-2021 15-Jul-2024 (1,127,282/21,756,763) Gender disaggregated data not available Comments: (Source: IMU) IN01044388 ►Proportion of cold chain capacity gaps filled. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 33.00 33.00 60.00 Date 01-Jan-2021 10-Sep-2021 10-Sep-2021 15-Jul-2024 300,000 doses of Pfizer are expected for delivery at one time # of vaccine Capacity per Total Capacity Total # of va Supplier No: of Freezer accommodated per freezer (litres) (litres) accommodat freezer Comments: COVAX 4 100 400 25,000 100,000 FHI 360 2 800 1600 250,000 500,000 With 4 COVAX freezers installed, 33% of required ultra cold chain capacity is available. IN01044389 ►Proportion of female community health volunteers fully vaccinated, as per protocol (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 42.00 42.00 60.00 Date 01-Jan-2021 15-Jul-2021 15-Jul-2021 15-Jul-2024 (20,631/49,481) Comments: (Source: FWD and FCHV number from DOHS annual report 2076/77) IN01044390 ►Proportion of vaccination sites/outreach with at least one female health care provider/volunteer (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 100.00 80.00 Date 01-Jan-2021 01-Jan-2021 01-Jan-2021 15-Jul-2024 Comments: Considering proportion of female health workers/volunteers at primary health care level and number of health workers, as well as the mandated composition of vaccination team, it is close to 100 percent likely 9/23/2021 Page 3 of 8 The World Bank Implementation Status & Results Report Nepal: COVID-19 Emergency Response and Health Systems Preparedness Project (P173760) that all vaccination centers have at least one female staff /volunteer during the vaccination campaign. However, a name based and sex-disaggregated system is yet to be established to collect the actual data from the vaccination sites. (Source: FWD) Intermediate Results Indicators by Components Emergency COVID-19 Response IN01044392 ►Number of health staff trained in infection prevention and control per MoHP approved protocols (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 8,705.00 8,705.00 1,000.00 Date 10-Jan-2020 15-Jul-2021 15-Jul-2021 15-Jul-2024 (58 essential critical care training + 8,647 critical care training) Comments: (Source: NHTC) IN01044394 ►Percentage of specimens submitted for SARS-COV2 laboratory testing and confirmed within WHO stipulated standard time (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 97.21 97.21 90.00 Date 10-Jan-2020 15-Jul-2021 15-Jul-2021 15-Jul-2024 24 hrs: 80.82% 48 hrs: 97.21% Comments: 72 hrs: 99.77% (Source: NPHL) IN01044397 ►Percentage of confirmed cases whose contacts were traced as per the MoHP protocol (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 80.00 Date 10-Jan-2020 15-Jul-2021 15-Jul-2021 15-Jul-2024 This indicator is no longer practicable to track Comments: IN01044399 ►Number of acute healthcare facilities with triage capacity (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 1.00 30.00 30.00 10.00 Date 10-Jan-2020 15-Jul-2021 15-Jul-2021 15-Jul-2024 9/23/2021 Page 4 of 8 The World Bank Implementation Status & Results Report Nepal: COVID-19 Emergency Response and Health Systems Preparedness Project (P173760) Comments: The designated hospitals for COVID response needs to have triage facility IN01044401 ►New/rehabilitated ICU beds established in the public hospitals for managing public health emergencies (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1,276.00 1,276.00 135.00 Date 10-Jan-2020 15-Jul-2021 15-Jul-2021 15-Jul-2024 New/ rehabilitated functioning ICU Beds established at Federal and Provincial level hospitals Comments: IN01044402 ►Number of designated laboratories with staff trained to conduct COVID-19 diagnosis (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 1.00 96.00 96.00 45.00 Date 10-Jan-2020 15-Jul-2021 15-Jul-2021 15-Jul-2024 Comments: The designated lab to test SARS-CoV2 should have at least one trained staff. IN01044403 ►Nepal has activated its public Health Emergency Operations Centre or a coordination mechanism for COVID-19 (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No Yes Yes Yes Date 10-Jan-2020 15-Jul-2021 15-Jul-2021 15-Jul-2024 IN01044404 ►Nepal adopted personal and community non-pharmaceutical interventions (schools closures, telework and remote meetings, reduce/cancel mass gatherings (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No Yes Yes Yes Date 10-Jan-2020 15-Jul-2021 15-Jul-2021 15-Jul-2024 IN01044405 ►Number of designated laboratories with COVID-19 diagnostic equipment, test kits, and reagents (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 1.00 96.00 96.00 45.00 Date 10-Jan-2020 15-Jul-2021 15-Jul-2021 15-Jul-2024 IN01044406 ►Number of acute healthcare facilities with isolation capacity (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target 9/23/2021 Page 5 of 8 The World Bank Implementation Status & Results Report Nepal: COVID-19 Emergency Response and Health Systems Preparedness Project (P173760) Value 1.00 78.00 78.00 50.00 Date 10-Jan-2020 15-Jul-2021 15-Jul-2021 15-Jul-2024 IN01044407 ►A National Deployment and Vaccination Plan (NDVP) is approved and adopted (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No Yes Yes Yes Date 01-Jan-2021 15-Jul-2021 15-Jul-2021 15-Jul-2024 Community Engagement and Risk Communication IN01044393 ►Symposium on surveillance, treatment and prophylaxis conducted (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 4.00 Date 10-Jan-2020 15-Jul-2021 15-Jul-2021 15-Jul-2024 Conference and workshops at national level for advocacy, and information on surveillance, treatment and Comments: prophylaxis. The targets are the cumulative figure. IN01044395 ►Nepal has contextualized its risk communication and community engagement strategies (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No Yes Yes Yes Date 10-Jan-2020 15-Jul-2021 15-Jul-2021 15-Jul-2024 Nepal has adopted risk communication and community engagement strategies which include Comments: development of different communication materials and dissemination through various media channels including community engagement. IN01044398 ►Proportion of callers to COVID-19 helplines satisfied with support/services provided (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 60.00 Date 01-Jan-2021 15-Jul-2021 15-Jul-2021 15-Jul-2024 Satisfaction Survey Pending Comments: IN01044400 ►Proportion of SEA/SH calls received by COVID-19 helplines referred to OCMC or Women’s Commission for appropriate support (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 80.00 9/23/2021 Page 6 of 8 The World Bank Implementation Status & Results Report Nepal: COVID-19 Emergency Response and Health Systems Preparedness Project (P173760) Date 01-Jan-2021 15-Jul-2021 15-Jul-2021 15-Jul-2024 Data not available Comments: Implementation Management and Monitoring and Evaluation IN01044391 ►M&E system established to monitor COVID-19 preparedness and response plan (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No Yes Yes Yes Date 10-Jan-2020 15-Jul-2021 15-Jul-2021 15-Jul-2024 Comments: A monitoring, recording and reporting mechanism for COVID-19 is in place-either digital or manual. IN01044396 ►Joint supervision and monitoring visits conducted (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 7.00 7.00 4.00 Date 10-Jan-2020 15-Jul-2021 15-Jul-2021 15-Jul-2024 Joint supervision and monitoring visits to each province in July 2021 Comments: Performance-Based Conditions Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P173760 IDA-66040 Effective USD 29.00 29.00 0.00 23.96 5.81 80% P173760 IDA-68470 Effective USD 75.00 75.00 0.00 10.00 63.99 14% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P173760 IDA-66040 Effective 03-Apr-2020 07-Apr-2020 07-Apr-2020 16-Jul-2022 15-Jul-2024 P173760 IDA-68470 Effective 18-Mar-2021 02-Apr-2021 06-Apr-2021 15-Jul-2024 15-Jul-2024 Cumulative Disbursements 9/23/2021 Page 7 of 8 The World Bank Implementation Status & Results Report Nepal: COVID-19 Emergency Response and Health Systems Preparedness Project (P173760) PBC Disbursement Achievement Disbursed amount in Disbursement % PBC ID PBC Type Description Coc PBC Amount Status Coc for PBC Restructuring History Level 2 Approved on 11-May-2021 Related Project(s) P175848-Additional Financing: Nepal COVID-19 Emergency Response and Health Systems Preparedness Project 9/23/2021 Page 8 of 8