The World Bank Implementation Status & Results Report Health Sector Development Support Project (P125229) Health Sector Development Support Project (P125229) AFRICA EAST | Zimbabwe | Health, Nutrition & Population Global Practice | Recipient Executed Activities | Investment Project Financing | FY 2012 | Seq No: 17 | ARCHIVED on 18-Sep-2020 | ISR43368 | Implementing Agencies: Republic of Zimbabwe, Stichting Cordaid Key Dates Key Project Dates Bank Approval Date: 29-Sep-2011 Effectiveness Date: 08-Dec-2011 Planned Mid Term Review Date: 11-Feb-2013 Actual Mid-Term Review Date: 22-Feb-2013 Original Closing Date: 31-Dec-2019 Revised Closing Date: 30-Sep-2020 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The Project Development Objective (PDO) is to increase coverage of key maternal and child health interventions in targeted ruraldistricts consistent with the Recipient's ongoing health initiatives. 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 is to increase coverage and quality of key health interventions with an emphasis on MCH services in targeted rural and urban districts and strengthen capacity for results-based financing contract management, consistent with the Recipients’ ongoing health initiatives. Components Table Name Delivery of Packages of Key Maternal, Child and Other Related Health Services:(Cost $33.20 M) Management and capacity building in Results-Based Financing:(Cost $17.40 M) Monitoring, Documentation, and Verification of Results under Performance-based Contracts:(Cost $2.40 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Moderately Satisfactory Overall Implementation Progress (IP) Moderately Satisfactory Moderately Satisfactory Overall Risk Rating Moderate Moderate Implementation Status and Key Decisions The total grant financing for the Health Sector Development Support (HSDS) Project is US$53 million, made up of the original US$15 million grant approved in September 2011, a US$20 million Additional Financing (AF) grant approved in July 2013, a second US$10 million AF approved in December 2015, a third US$5 million AF approved in July 2017, and a fourth US$3 million AF approved in January 2019. 9/18/2020 Page 1 of 9 The World Bank Implementation Status & Results Report Health Sector Development Support Project (P125229) The HSDS Project has made significant progress since July 2011. It performs moderately satisfactorily toward the attainment of its Project Development Objectives. As of June 2020 (latest data available), six out of 11 PDO indicators have been achieved while three are close to being met. Nine out of 15 intermediate results indicators have been met with five close to being achieved. In June 2020, the World Bank Management approved an extension of the project Closing Date to September 30, 2020. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance -- Substantial Substantial Macroeconomic -- High High Sector Strategies and Policies -- Low Low Technical Design of Project or Program -- Low Low Institutional Capacity for Implementation and -- Moderate Moderate Sustainability Fiduciary -- Moderate Moderate Environment and Social -- Low Low Stakeholders -- Moderate Moderate Other -- Low Low Overall -- Moderate Moderate Results PDO Indicators by Objectives / Outcomes Increase coverage of key MCH services in participating districts IN00889745 ►Percentage of pregnant women who receive antenatal care during their visit to a health provider in participating rural districts (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 70.00 80.00 80.00 72.00 Date 31-Dec-2012 30-Sep-2019 30-Jun-2020 30-Sep-2020 IN00889878 ►Percentage of births attended by skilled health personnel in a health institution in participating rural districts based on survey data (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target 9/18/2020 Page 2 of 9 The World Bank Implementation Status & Results Report Health Sector Development Support Project (P125229) Value 58.00 88.00 82.00 88.00 Date 30-Jan-2012 01-Sep-2014 31-Dec-2019 30-Sep-2020 IN00889880 Percentage of births attended by skilled health personnel in a health institution in participating rural districts based on facility-based HMIS (Percentage, Custom Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 91.00 91.00 91.00 94.00 IN00889883 ►Percentage of women 15-49 years who currently use any of the modern family family planning methods in participating rural districts (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 56.00 70.00 70.00 70.00 Date 17-Jan-2012 30-Sep-2014 30-Sep-2014 30-Sep-2020 Modern family planning methods defined as oral contraceptives, injectable, IUDs or implants. The RBF Comments: impact evaluation sampled women who had a pregnancy related outcome in the preceding two years as proxy. IN00889884 ►Percentage of women who had their first ANC visit during the first sixteen weeks of pregnancy in participating rural districts (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 10.00 24.00 23.00 22.00 Date 31-Dec-2012 30-Sep-2019 30-Jun-2020 30-Sep-2020 Comments: IN00889885 ►Percentage of children under 5 with diarrhea receiving ORT and Zinc in participating districts (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 13.80 15.00 16.50 16.00 Date 01-Sep-2015 31-Dec-2018 30-Jun-2020 30-Sep-2020 Increase quality of key MCH services in participating districts IN00889876 ►Average quality scores by health facilities in participating rural and urban districts (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 68.10 82.00 82.00 81.00 Date 31-Dec-2012 30-Sep-2019 30-Jun-2020 30-Sep-2020 9/18/2020 Page 3 of 9 The World Bank Implementation Status & Results Report Health Sector Development Support Project (P125229) IN00889879 ►Percentage of maternal deaths given audits as per protocol in participating districts (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 75.00 76.00 80.00 Date 01-Sep-2015 30-Sep-2019 30-Jun-2020 30-Sep-2020 IN00889881 ►Percentage of partographs correctly filled in participating districts (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 60.00 62.50 65.00 Date 01-Sep-2015 30-Sep-2019 30-Jun-2020 30-Sep-2020 IN00889882 ►Percentage of children under 5 years with Pneumonia correctly managed in the participating districts (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 87.00 89.00 87.00 Date 01-Sep-2015 30-Sep-2019 30-Jun-2020 30-Sep-2020 Target met but decreased by 0.5 percent since June 2019 (87.5%) but improved since December 2018 Comments: (86.2%). Strengthen institutional capacity in RBF Contract Management IN00889877 ►Percentage of health facilities managed under RBF contracts by the MOHCC Program Coordination Unit in participating rural districts (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 23.00 23.00 32.00 Date 31-Dec-2012 30-Sep-2019 30-Jun-2020 30-Sep-2020 Intermediate Results Indicators by Components Component 1: Delivery of Packages of Key Maternal, Child and Other Related Health Services IN00889891 ►Cumulative number of health facilities enrolled in RBF program in participating districts (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 422.00 424.00 426.00 Date 31-Dec-2012 30-Sep-2019 30-Jun-2020 30-Sep-2020 9/18/2020 Page 4 of 9 The World Bank Implementation Status & Results Report Health Sector Development Support Project (P125229) IN00889892 ►Cumulative number of pregnant women living with HIV who are initiated on anti-retrovirals to reduce the risk of MTCT in participating rural districts (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 9,399.00 55,724.00 58,114.00 60,000.00 Date 31-Dec-2012 30-Sep-2019 30-Jun-2020 30-Sep-2020 IN00889893 ►Cumulative number of births attended by skilled health personnel in health institutions in participating urban districts (Number) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 51,115.00 57,700.00 39,469.00 Date 31-Dec-2012 30-Sep-2019 30-Jun-2020 30-Sep-2020 IN00889894 ►Cumulative number of pregnant women receiving first antenatal care during a visit to a health provider in participating urban districts (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 12,737.00 86,553.00 95,103.00 89,031.00 Date 31-Dec-2014 30-Sep-2019 30-Jun-2020 30-Sep-2020 IN00889895 ►Cumulative number of pregnant women receiving first antenatal care before16 weeks of gestation period during a visit to a health provider in participating urban districts (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 572.00 4,119.00 4,575.00 4,035.00 Date 31-Dec-2012 30-Sep-2019 30-Jun-2020 30-Sep-2020 IN00889896 ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 3,479,781.00 3,785,283.00 4,021,394.00 Date 31-Dec-2012 30-Sep-2019 30-Jun-2020 30-Sep-2020 IN00889897 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 1,845,649.00 1,964,562.00 2,087,103.00 IN00889898 Number of children immunized (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target 9/18/2020 Page 5 of 9 The World Bank Implementation Status & Results Report Health Sector Development Support Project (P125229) Value 0.00 709,929.00 768,251.00 663,409.00 Date 31-Dec-2012 30-Sep-2019 30-Jun-2020 30-Sep-2020 IN00889899 Number of women and children who have received basic nutrition services (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1,923,727.00 2,090,767.00 1,544,493.00 Date 31-Dec-2012 30-Sep-2019 30-Jun-2020 30-Sep-2020 IN00889900 Number of deliveries attended by skilled health personnel (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 846,125.00 926,251.00 762,573.00 Date 31-Dec-2012 30-Sep-2019 30-Jun-2020 30-Sep-2020 IN00889901 ►Cumulative number of births attended by skilled health personnel in health institutions in participating rural districts (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 795,010.00 868,565.00 723,104.00 Date 31-Dec-2012 30-Sep-2019 30-Jun-2020 30-Sep-2020 Component 2. Management and Capacity Building in RBF IN00889886 ►Number of health personnel receiving training in participating districts (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 4,072.00 4,084.00 4,000.00 Date 31-Dec-2012 30-Sep-2019 30-Jun-2020 30-Sep-2020 Comments: IN00889888 ►Percentage of health facilities implementing Continuous Quality Improvement model in the participating rural districts. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 11.00 15.00 23.00 Date 01-Sep-2015 30-Sep-2019 30-Jun-2020 30-Sep-2020 IN00889890 ►Percentage of RBF contracted facilities in Continuous Quality Improvement (CQI) Districts with CQI Standard Operating Procedures (Percentage, Custom) 9/18/2020 Page 6 of 9 The World Bank Implementation Status & Results Report Health Sector Development Support Project (P125229) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 46.00 72.00 80.00 Date 01-Sep-2015 31-Dec-2018 30-Jun-2020 30-Sep-2020 Component 3.Monitoring, Documenta Verification of Results under Performance-based Financing IN00889887 ►Number of District Health Executives (DHEs) in participating districts using quality tool for supervision of health facilities. (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 20.00 20.00 20.00 Date 17-Jan-2012 30-Sep-2019 30-Jun-2020 30-Sep-2020 Comments: IN00889889 ►Process evaluation to examine cost-effective options for verifying results under RBF approach finalized and disseminated to key stakeholders (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No No No Yes Date 31-Dec-2012 31-Dec-2018 30-Jun-2020 30-Sep-2020 Performance-Based Conditions Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P125229 TF-10748 Closed USD 15.00 15.00 0.00 15.00 0.00 100% P125229 TF-15111 Closed USD 20.00 20.00 0.00 20.00 0.00 100% P125229 TF-A1598 Closed USD 10.00 10.00 0.00 10.00 0.00 100% P125229 TF-A5311 Closed USD 5.00 5.00 0.00 5.00 0.00 100% P125229 TF-A9037 Effective USD 3.00 3.00 0.00 3.00 0.00 100% Key Dates (by loan) 9/18/2020 Page 7 of 9 The World Bank Implementation Status & Results Report Health Sector Development Support Project (P125229) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P125229 TF-10748 Closed 27-Sep-2011 27-Sep-2011 08-Dec-2011 31-Jul-2014 31-Jul-2014 P125229 TF-15111 Closed 30-Jul-2013 30-Jul-2013 25-Sep-2013 30-Oct-2015 28-Feb-2017 P125229 TF-A1598 Closed 23-Dec-2015 12-Jan-2016 14-Mar-2016 28-Feb-2017 30-Jan-2018 P125229 TF-A5311 Closed 21-Jul-2017 26-Jul-2017 24-Oct-2017 30-Jun-2018 31-Dec-2019 P125229 TF-A9037 Effective 03-Nov-2018 20-Feb-2019 29-Mar-2019 31-Dec-2019 30-Sep-2020 Cumulative Disbursements 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 01-Sep-2015 ,Level 2 Approved on 21-Feb-2017 ,Level 2 Approved on 27-Jun-2018 ,Level 2 Approved on 20-Dec-2018 ,Level 2 Approved on 06-Dec-2019 ,Level 2 Approved on 29-Jun-2020 Related Project(s) P144532-Additional Financing Health Sector Development Support Project ,P156879-Zimbabwe Health Sector Development Support Project AF II ,P163976-Zimbabwe Health Sector Development Support Project III - AF ,P168734-Zimbabwe Health Sector Development Support Project IV - AF ,P173132-Health Sector Development Support Project - Additional Financing V ,P175232-Health Sector Development Support 9/18/2020 Page 8 of 9 The World Bank Implementation Status & Results Report Health Sector Development Support Project (P125229) 9/18/2020 Page 9 of 9