The World Bank Report No: ISR2728 Implementation Status & Results Brazil Public Disclosure Copy Second Family Health Extension Adaptable Lending (P095626) Operation Name: Second Family Health Extension Adaptable Lending Project Stage: Implementation Seq.No: 6 Status: ARCHIVED Last Modified Date: 10-Feb-2011 (P095626) Country: Brazil Approval FY: 2008 Product Line: IBRD/IDA Region: LATIN AMERICA AND CARIBBEAN Lending Instrument: Adaptable Program Loan Implementing Agency(ies): Ministry of Health Key Dates Board Approval Date 25-Apr-2008 Original Closing Date 30-Mar-2012 Planned Mid Term Review Date 19-Sep-2011 Last Archived ISR Date 30-Jun-2010 Effectiveness Date 15-Oct-2009 Revised Closing Date 30-Mar-2013 Actual Mid Term Review Date Project Development Objectives Project Development Objective (from Project Appraisal Document) The objectives of the second phase APL are: (i) increase access to Family Health-based primary care in large, urban municipalities; (ii) raise the technical quality of and patient satisfaction with primary care; and (iii) improve the efficiency and effectiveness of Family Health service providers as well as the broader delivery system. Has the Project Development Objective been changed since Board Approval of the Project? Yes No Component(s) Component Name Component Cost Expansion and Consolidation of Family Health Care in Municipalities 133450.00 Strengthening State Capacity for Supervision, Monitoring and Technical Support of Family Health 17450.00 Services Public Disclosure Copy Strengthening Federal Oversight of the Family Health Program 16000.00 Overall Ratings Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Satisfactory Satisfactory Overall Risk Rating Implementation Status Overview The next supervision mission for the project is scheduled for February 14-25, 2011. Page 1 of 8 The World Bank Report No: ISR2728 Results Public Disclosure Copy Project Development Objective Indicators Indicator Baseline Current End Target Indicator Name Value Value Value Increase of per capita contact with primary care providers in 1.4 0.98 1.5 participating municipalities. Date Date Date 31-Dec-2003 07-Feb-2011 30-Mar-2012 Type Unit of Measure Comment Comment Comment Custom Indicator Text Indicator Baseline Current End Target Indicator Name Value Value Value Decrease of infant mortality per 1000 births in participating 17.8 13.91 17 municipalities. Date Date Date 31-Dec-2003 07-Feb-2011 30-Mar-2012 Type Unit of Measure Comment Comment Comment Custom Indicator Text Intermediate Results Indicators Indicator Baseline Current End Target Indicator Name Value Value Value Percentage of PSF population coverage in participating municipalities 33 36.2 37 (as a group). Date Date Date 31-Dec-2006 07-Feb-2011 30-Mar-2013 Type Unit of Measure Comment Comment Comment Public Disclosure Copy Custom Indicator Text Indicator Baseline Current End Target Indicator Name Value Value Value Ratio of patients with hypertension followed by PSF teams to estimated 0.48 number of patients w/ hypertension in participating municipalities (as a Date Date Date group). 07-Feb-2011 Type Unit of Measure Comment Comment Comment Custom Indicator Text Page 2 of 8 The World Bank Report No: ISR2728 Indicator Baseline Current End Target Public Disclosure Copy Indicator Name Value Value Value Percentage of infants < 1 with full vaccination regimen (DPT-H, polio, 71 98% 85 measles, tuberculosis) in participating municipalities (as agroup). Date Date Date 31-Dec-2006 07-Feb-2011 30-Mar-2012 Type Unit of Measure Comment Comment Comment Custom Indicator Text Indicator Baseline Current End Target Indicator Name Value Value Value Percentage of pregnant women attended by PSF teams that have 7 or 53 63.2% 70 more pre-natal consultations in participating municipalities (as a group). Date Date Date 31-Dec-2006 30-Nov-2009 30-Mar-2012 Type Unit of Measure Comment Comment Comment Custom Indicator Text Indicator Baseline Current End Target Indicator Name Value Value Value Percentage of total medical consultations referred from PSF to hospital 10 9.86% 10 specialty services in participating municipalities (as a group). Date Date Date 31-Dec-2006 31-Dec-2009 30-Mar-2012 Type Unit of Measure Comment Comment Comment Custom Indicator Text Indicator Baseline Current End Target Indicator Name Value Value Value Percentage of all PSF teams applied quality evaluation instrument and 7 NA (0%) 15 Public Disclosure Copy are ranked according to standard (AMQ system) in participating Date Date Date municipalities (as a group). 31-Dec-2006 07-Feb-2011 30-Mar-2013 Type Unit of Measure Comment Comment Comment Custom Indicator Text Page 3 of 8 The World Bank Report No: ISR2728 Indicator Baseline Current End Target Public Disclosure Copy Indicator Name Value Value Value Percentage of PSF teams in a sample of municipalities using evidence- NA 56.6% 15 based clinical guidelines for hypertension and diabetes (basedon Date Date Date sample survey) in participating municipalities (as a group). 31-Dec-2006 07-Feb-2011 30-Mar-2012 Type Unit of Measure Comment Comment Comment Custom Indicator Text Indicator Baseline Current End Target Indicator Name Value Value Value Rate of hospital admissions of children <5 for ARI in participating 24/1000 24.1 22/1000 municipalities (as a group). Date Date Date 31-Dec-2006 07-Feb-2011 30-Mar-2012 Type Unit of Measure Comment Comment Comment Custom Indicator Text Indicator Baseline Current End Target Indicator Name Value Value Value Rate of hospital admissions for stroke in participating municipalities (as 27/1000 8.1 26/1000 a group). Date Date Date 31-Dec-2006 07-Feb-2011 30-Mar-2012 Type Unit of Measure Comment Comment Comment Custom Indicator Text Indicator Baseline Current End Target Indicator Name Value Value Value Percentage of municipalities apply quality evaluation instrument in the 0 19% 10 Public Disclosure Copy areas of PSF management and coordination (AMQ parts 1 & 2) in 184 municipalities Date Date participating municipalities (as a group). 31-Dec-2006 Date 30-Mar-2012 Type Unit of Measure Comment 07-Feb-2011 Comment Custom Indicator Text Comment Page 4 of 8 The World Bank Report No: ISR2728 Indicator Baseline Current End Target Public Disclosure Copy Indicator Name Value Value Value Percentage of states establish performance agreements with at least X 0 77.8% 40% states, 25% municipalities % municipalities with <100,000 population in participating states (as a Date Date Date group). 31-Dec-2006 07-Feb-2011 30-Mar-2012 Type Unit of Measure Comment Comment Comment Custom Indicator Text Indicator Baseline Current End Target Indicator Name Value Value Value Percentage of states with monitoring and evaluation plans 0 18.5% 50 implemented and evaluated in participating states (as a group) Date Date Date 31-Dec-2006 07-Feb-2011 30-Mar-2012 Type Unit of Measure Comment Comment Comment Custom Indicator Text Indicator Baseline Current End Target Indicator Name Value Value Value Percentage of municipalities with <100,000 population in X% states 0 15% SES with 10% SMS 50% SES with 10% SMS participate in quality assessment program (AMQ) - participating states Date Date Date as a group. 31-Dec-2006 07-Feb-2011 30-Mar-2012 Type Unit of Measure Comment Comment Comment Custom Indicator Text Indicator Baseline Current End Target Indicator Name Value Value Value Establishment, at federal level, of a results-based management system 0 System designed; module System developed and tested. Public Disclosure Copy that links project financing to states and municipalities. developed and implemented Date Date 31-Dec-2006 Date 30-Mar-2012 Type Unit of Measure Comment 07-Feb-2011 Comment Custom Indicator Text Comment Page 5 of 8 The World Bank Report No: ISR2728 Indicator Baseline Current End Target Public Disclosure Copy Indicator Name Value Value Value Cost accounting system (at federal level). 0 TOR developed for input-based Study concluded and system Date costing system developed. TOR under development for Date 31-Dec-2006 output-based costing system Type Unit of Measure Comment 30-Mar-2012 Date Custom Indicator Text Comment 07-Feb-2011 Comment Indicator Baseline Current End Target Indicator Name Value Value Value Six major research projects on PSF (at least one on chronic diseases, Not applicable 1 study concluded on defining 3 studies concluded. one on patient satisfaction, and one on PSF impact on hospital sensitive admission and basic care Date Date admissions). conditions 31-Dec-2006 30-Mar-2012 Date Type Unit of Measure Comment Comment 07-Feb-2011 Custom Indicator Text Comment Indicator Baseline Current End Target Indicator Name Value Value Value Impact evaluation. Baseline collected. NA Plans, methods and TOR Date Date Date 31-Dec-2006 07-Feb-2011 30-Mar-2012 Type Unit of Measure Comment Comment Comment Public Disclosure Copy Custom Indicator Text Indicator Baseline Current End Target Indicator Name Value Value Value Proficiency test of PSF professionals. 0 NA Test developed. Date Date Date 31-Dec-2006 07-Feb-2011 30-Mar-2012 Type Unit of Measure Comment Comment Comment Custom Indicator Text Page 6 of 8 The World Bank Report No: ISR2728 Indicator Baseline Current End Target Public Disclosure Copy Indicator Name Value Value Value Inter-municipal cooperation plan implemented in each state to 0 Project developed 1 per State (20 states) strengthen PSF, specifying activities in three areas: management, Date Date Date coordination, service Provision. 31-Dec-2006 07-Feb-2011 30-Mar-2012 Type Unit of Measure Comment Comment Comment Custom Indicator Text Indicator Baseline Current End Target Indicator Name Value Value Value Percentage of ESF implement results-based management system, 0 NA model developed and tested. including the signing of performance contracts. Date Date Date 31-Dec-2006 07-Feb-2011 30-Mar-2012 Type Unit of Measure Comment Comment Comment Custom Indicator Text Data on Financial Performance (as of 03-Feb-2011) Financial Agreement(s) Key Dates Project Loan No. Status Approval Date Signing Date Effectiveness Date Closing Date P095626 IBRD-75450 Effective 25-Apr-2008 09-Sep-2009 15-Oct-2009 30-Mar-2013 Disbursements (in Millions) Project Loan No. Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P095626 IBRD-75450 Effective USD 83.45 83.45 0.00 21.07 62.38 25.00 Disbursement Graph Public Disclosure Copy Page 7 of 8 The World Bank Report No: ISR2728 Public Disclosure Copy Key Decisions Regarding Implementation Not applicable Restructuring History There has been no restructuring to date. Related Projects There are no related projects. Public Disclosure Copy Page 8 of 8