The World Bank Implementation Status & Results Report Health Service Delivery & System Support Project (P153064) Health Service Delivery & System Support Project (P153064) AFRICA | Sierra Leone | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2016 | Seq No: 6 | ARCHIVED on 19-Apr-2019 | ISR36002 | Implementing Agencies: Ministry of Finance, Ministry of Health and Sanitation Key Dates Key Project Dates Bank Approval Date: 23-Jun-2016 Effectiveness Date: 02-Nov-2016 Planned Mid Term Review Date: 25-Jun-2018 Actual Mid-Term Review Date: 25-Jun-2018 Original Closing Date: 30-Sep-2019 Revised Closing Date: 30-Sep-2019 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The project development objective (PDO) of the Health Service Delivery and System Support Project is to (a) increase the utilization and improve the quality of essential maternal and child health services; and (b) in the event of an Eligible Crisis or Emergency, to provide immediate and effective response to said Eligible Crisis or Emergency. Has the Project Development Objective been changed since Board Approval of the Project Objective? Yes Board Approved Revised Project Development Objective (If project is formally restructured) The project development objective (PDO) of the Health Service Delivery and System Support Project is to (a) increase the utilization and improve the quality of essential maternal and child health services; and (b) in the event of an Eligible Crisis or Emergency, to provide immediate and effective response to said Eligible Crisis or Emergency. Components Table Name Health Service Delivery:(Cost $12.40 M) Health System Support:(Cost $3.10 M) Contingency Emergency Response Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Moderately Satisfactory Moderately Satisfactory Overall Implementation Progress (IP) Moderately Satisfactory Moderately Satisfactory Overall Risk Rating Substantial Substantial Implementation Status and Key Decisions 4/19/2019 Page 1 of 7 The World Bank Implementation Status & Results Report Health Service Delivery & System Support Project (P153064) During December 2018 implementation mission, Government and the World Bank team confirmed that Project Development Objectives and the design of two technical components remain valid and pertinent, however, the number of activities need to be reduced, and planned activities in the remaining phase need to focus more on quality. The consensus on such a principle has been reflected in the agreed action plan for the project’s remaining period. Both sides had a follow up discussion on project restructuring. Following the mission, the Integrated Health Projects Administration Unit (IHPAU) was fully staffed on March 1, 2019. The IHPAU has completed an initial orientation session for its all staff. The project restructuring was approved by the Bank on March 29,2019 in response to the Government's request. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance Moderate Substantial Substantial Macroeconomic Substantial Substantial Substantial Sector Strategies and Policies Moderate Moderate Moderate Technical Design of Project or Program Substantial Substantial Substantial Institutional Capacity for Implementation and Sustainability Substantial Substantial Substantial Fiduciary Substantial Substantial Substantial Environment and Social Moderate Moderate Moderate Stakeholders Moderate Moderate Moderate Other -- -- -- Overall Substantial Substantial Substantial Results PDO Indicators by Objectives / Outcomes to increase the utilization and improve the quality of essential maternal and child health services IN00686220 ►Percentage of pregnant women attended 4 or more times by skilled health personnel (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 78.90 -- 87.00 91.00 Date 31-Dec-2013 -- 31-Dec-2018 30-Jun-2021 IN00686272 ►Percentage of births attended by skilled health personnel (doctors, midwives, nurses and MCH Assistants) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target 4/19/2019 Page 2 of 7 The World Bank Implementation Status & Results Report Health Service Delivery & System Support Project (P153064) Value 72.40 -- 53.50 83.00 Date 31-Dec-2013 -- 31-Dec-2018 30-Jun-2021 IN00686280 ►Child 0-23 months fully immunized for age with all the recommended vaccines (BCG, OPV 0-3, Penta 1-3, PCV 1-3, Rota 1- 2, MCV1, YF & MCV2) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 49.00 -- 55.00 60.00 Date 30-Jun-2016 -- 29-Jun-2018 30-Jun-2021 IN00686282 ►Average Health Facility Quality of Care Score (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 36.50 40.00 Date 30-Nov-2016 -- 29-Jun-2018 30-Jun-2021 to provide immediate and effective response to said Eligible Crisis or Emergency. IN00686219 ►Percentage of public health emergencies responded within a week's time and with good quality (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 50.00 50.00 50.00 85.00 Date 30-Dec-2016 27-Jul-2018 27-Jul-2018 30-Jun-2021 Overall Comments PDO The result framework has been revised to make sure they will be measurable and focus equally on quality of services in addition to service coverage. Intermediate Results Indicators by Components Component 1: Health service delivery IN00686218 ►Percentage of hard-to-reach communities with at least one active CHW present (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 37.00 -- 73.00 90.00 Date 31-Oct-2015 -- 31-Dec-2018 30-Jun-2021 IN00686273 ►Number of outpatient visits per 10,000 population (Number, Custom) 4/19/2019 Page 3 of 7 The World Bank Implementation Status & Results Report Health Service Delivery & System Support Project (P153064) Baseline Actual (Previous) Actual (Current) End Target Value 5,709.00 -- 5,339.00 6,950.00 Date 31-Dec-2013 -- 31-Dec-2018 30-Jun-2021 IN00686275 ►Percentage of health facilities that comply with medical waste management guidelines (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 80.00 Date 29-Jun-2018 -- 31-Dec-2018 30-Jun-2021 IN00686277 ►Percentage of pregnant women receiving Tetanus Toxoid (TT) 2 or more times (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 89.30 -- 99.00 96.00 Date 31-Dec-2013 -- 31-Dec-2018 30-Jun-2021 IN00686279 ►percentage of inspected households with improved sanitation facilities (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 15.00 -- 40.70 30.00 Date 30-Jun-2018 -- 31-Dec-2018 30-Jun-2021 IN00686281 ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 7,806,706.00 8,046,931.00 Date 30-Jun-2016 -- 31-Dec-2018 30-Jun-2021 IN00686283 People who have received essential health, nutrition, and population (HNP) services - Female (RMS requirement) (Number, Corporate Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 4,058,623.00 IN00686284 Number of children immunized (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 132,089.00 251,355.00 Date 30-Jun-2016 -- 31-Dec-2018 30-Jun-2020 IN00686285 Number of women and children who have received basic nutrition services (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target 4/19/2019 Page 4 of 7 The World Bank Implementation Status & Results Report Health Service Delivery & System Support Project (P153064) Value 0.00 -- 0.00 61,120.00 Date 31-Dec-2018 -- 31-Dec-2018 30-Jun-2021 IN00686286 Number of deliveries attended by skilled health personnel (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 183,770.00 280,717.00 Date 30-Jun-2016 -- 31-Dec-2018 30-Jun-2021 Component 2: Health system support IN00686271 ►Percentage of routine/HMIS reporting units submitting timely and complete reports according to national guidelines (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 75.00 -- 84.10 97.40 Date 31-Dec-2015 -- 31-Dec-2018 30-Jun-2021 IN00686274 ►Percentage of maternal deaths reviewed among suspected maternal deaths (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 85.40 90.00 Date 31-Dec-2013 -- 31-Dec-2018 30-Jun-2021 IN00686276 ►Percentage of SLA applications approved (or recommended for resubmission) within 6 weeks from the date of submission (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 75.00 100.00 Date 31-Dec-2013 -- 31-Dec-2018 30-Jun-2021 IN00686278 ►Number of graduates for midwifery (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 152.00 120.00 Date 29-Nov-2013 -- 31-Dec-2018 30-Sep-2019 Contigency emergency response IN00686217 ►percentage of public health emergencies responded within a week's time adn with good quality (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 50.00 50.00 50.00 85.00 4/19/2019 Page 5 of 7 The World Bank Implementation Status & Results Report Health Service Delivery & System Support Project (P153064) Date 30-Nov-2016 27-Jul-2018 27-Jul-2018 30-Sep-2019 Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P153064 IDA-58460 Effective USD 10.00 10.00 0.00 2.96 6.99 30% P153064 TF-A2598 Closed USD 5.50 5.50 0.00 5.06 0.44 92% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P153064 IDA-58460 Effective 23-Jun-2016 04-Aug-2016 02-Nov-2016 30-Sep-2019 30-Sep-2019 P153064 TF-A2598 Closed 23-Jun-2016 04-Aug-2016 02-Nov-2016 30-Sep-2019 31-Mar-2019 Cumulative Disbursements 4/19/2019 Page 6 of 7 The World Bank Implementation Status & Results Report Health Service Delivery & System Support Project (P153064) Restructuring History Level 2 Approved on 13-Apr-2018 ,Level 2 Approved on 29-Oct-2018 ,Level 2 Approved on 28-Mar-2019 Related Project(s) There are no related projects. 4/19/2019 Page 7 of 7