Public Disclosure Copy The World Bank Implementation Status & Results Report PE- (APL2) Health Reform Program (P095563) PE- (APL2) Health Reform Program (P095563) LATIN AMERICA AND CARIBBEAN | Peru | Health, Nutrition and Population Global Practice | IBRD/IDA | Adaptable Program Loan | FY 2009 | Seq No: 12 | ARCHIVED on 17-Jun-2015 | ISR19320 | Implementing Agencies: PARSALUD Key Dates Key Project Dates Board Approval date:17-Feb-2009 Effectiveness Date:15-Dec-2009 Planned Mid Term Review Date:30-Oct-2012 Actual Mid-Term Review Date:26-Feb-2013 Original Closing Date:31-Jan-2015 Revised Closing Date:31-Dec-2015 Project Development Objectives Project Development Objective (from Project Appraisal Document) Framed within the long-term objective of the Health Reform Program (APL in all its phases) to reduce maternal and infant mortality rates in the nine poorest regions of the country (Amazonas, Huanuco, Huancavelica, Ayacucho, Apurimac, Cusco, Cajamarca, Ucayali and Puno); the project development objectives are to: (i) improve family care practices for women (during pregnancy, delivery and breast-feeding), and children under the age of three; (ii) strengthen health services networks with capacity to solve obstetric, neonatal and infant emergencies and to provide comprehensive health services to women (during pregnancy, delivery and breast-feeding) and children under the age of three; and (iii) support MINSA's governance functions of regulation, quality, efficiency and equity for improving the new health delivery model of maternal and child health care in a decentralized environment. Has the Project Development Objective been changed since Board Approval of the Project Objective? No PHRPDODEL Components Name Improving health practices at the household level for women and children under age three in rural areas of the nine targeted Regions:(Cost $6.00 M) Increasing the capacity to provide better maternal and child health services for the poor:(Cost $142.30 M) Strengthening government capacities to offer more equitable and efficient health system in a decentralized environment:(Cost $5.20 M) Project Coordination, and Monitoring & Evaluation:(Cost $8.90 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO  Satisfactory  Satisfactory 6/17/2015 Page 1 of 7 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report PE- (APL2) Health Reform Program (P095563) Overall Implementation Progress (IP)  Moderately Satisfactory  Moderately Satisfactory Overall Risk Rating  Low  Low Implementation Status and Key Decisions The Project is progressing well and its Project Development Objectives are likely to be achieved by Project closing in December 2015. As of June 2015, the project has disbursed 65% of the loan amount. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance  --  Low  Low Macroeconomic  --  Low  Low 6/17/2015 Page 2 of 7 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report PE- (APL2) Health Reform Program (P095563) Sector Strategies and Policies  --  Moderate  Moderate Technical Design of Project or Program  --  Low  Low Institutional Capacity for Implementation and Sustainability  --  Moderate  Moderate Fiduciary  --  Low  Low Environment and Social  --  Low  Low Stakeholders  --  Low  Low Other  --  Low  Low Overall  --  Low  Low Results Project Development Objective Indicators PHINDPDOTBL  Increase the proportion of institutional deliveries in rural areas of the nine selected Regions from 44% (2005) to 78% (2014) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 44.00 66.10 73.50 76.80 Date 30-Dec-2005 31-Dec-2013 30-Jun-2014 30-Dec-2014 PHINDPDOTBL  Reduce the prevalence of anemia among children under age 3 in the nine regions from 69.5% (2005) to 60% (2014) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 69.50 54.40 55.70 60.00 Date 30-Dec-2005 31-Dec-2013 30-Jun-2014 30-Dec-2014 Comments This anemail percentage of children under 3 increased according the last data, but it still under he end project target. PHINDPDOTBL  Increase from 64% to 80% the share of children in the nine selected regions who are exclusively breastfed until 6 months of age (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 64.00 80.00 86.90 80.00 Date 30-Dec-2005 31-Dec-2013 30-Jun-2014 30-Dec-2014 6/17/2015 Page 3 of 7 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report PE- (APL2) Health Reform Program (P095563) PHINDPDOTBL  Reduce the prevalence of anemia among pregnant women in the nine Regions from 41.5% (2005) to 35% (2014). (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 41.50 30.20 24.30 35.00 Date 30-Dec-2005 30-Dec-2013 30-Jun-2014 30-Dec-2014 PHINDPDOTBL  Reduce the hospital lethality rate among neonates in the nine selected Regions from 9.5% (2005) to 5% (2014). (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 9.50 4.20 4.90 5.00 Date 30-Dec-2005 31-Dec-2013 30-Jun-2014 30-Dec-2014 PHINDPDOTBL  Increase the proportion of pregnant women of the nine regions with at least 1 prenatal control during the first trimester of pregnancy from 20% (2005) to 45% (2014) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 20.00 68.00 69.40 45.00 Date 30-Dec-2005 31-Dec-2013 30-Jun-2014 30-Dec-2014 Overall Comments Intermediate Results Indicators 6/17/2015 Page 4 of 7 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report PE- (APL2) Health Reform Program (P095563) PHINDIRITBL  Component 1: % of SIS affiliated children who received growth and development controls (CRED) according to their age (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 34.00 58.50 59.10 66.00 Date 30-Dec-2005 31-Dec-2013 30-Jun-2014 30-Dec-2014 PHINDIRITBL  Component 2: % of SIS affiliated rural pregnant women with laboratory tests on hemoglobin, urine and syphilis (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 37.00 57.30 49.20 53.50 Date 30-Dec-2005 31-Dec-2013 30-Jun-2014 30-Dec-2014 PHINDIRITBL  Component 2: % of pregnant women under SIS that receive iron and folic acid supplements (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 37.00 88.02 58.90 61.30 Date 30-Dec-2005 31-Dec-2013 30-Jun-2014 30-Dec-2014 PHINDIRITBL  Component 2: % of cesareans in SIS affiliated pregnant rural women (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 3.00 9.40 10.20 10.00 Date 30-Dec-2005 31-Dec-2013 30-Jun-2014 30-Dec-2014 6/17/2015 Page 5 of 7 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report PE- (APL2) Health Reform Program (P095563) PHINDIRITBL  Component 3: % of SIS affiliated households that make out-of-pocket expenditures in medicines (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 67.30 67.30 56.80 55.00 Date 30-Dec-2005 31-Dec-2013 30-Jun-2014 30-Dec-2014 Overall Comments Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed Disbursed P095563 IBRD-76430 Effective USD 15.00 15.00 0.00 9.73 5.27 65% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P095563 IBRD-76430 Effective 17-Feb-2009 16-Nov-2009 15-Dec-2009 31-Jan-2015 31-Dec-2015 Cumulative Disbursements 6/17/2015 Page 6 of 7 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report PE- (APL2) Health Reform Program (P095563) Restructuring History Level Approved on 21-Jun-2011 ,Level 2 Approved on 25-Aug-2014 Related Project(s) There are no related projects. 6/17/2015 Page 7 of 7 Public Disclosure Copy