Public Disclosure Copy The World Bank Implementation Status & Results Report AO-Municipal Health Service Strengthening (Revitalização) (P111840) AO-Municipal Health Service Strengthening (Revitalização) (P111840) AFRICA | Angola | Health, Nutrition & Population Global Practice | IBRD/IDA | Specific Investment Loan | FY 2010 | Seq No: 12 | ARCHIVED on 13-Dec-2016 | ISR26170 | Implementing Agencies: Ministry of Health Key Dates Key Project Dates Bank Approval Date:08-Jun-2010 Effectiveness Date:02-Mar-2012 Planned Mid Term Review Date:31-Dec-2012 Actual Mid-Term Review Date:15-Sep-2014 Original Closing Date:31-Dec-2015 Revised Closing Date:31-Dec-2017 Project Development Objectives Project Development Objective (from Project Appraisal Document) The development objective of the project is to improve the population‘s access to and quality of maternal and child health care services. 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)PHRPDODEL The proposed new development objective of the project would be to improve the population’s utilization of maternal and child healthcare services. Components Name II. Training of health staff and strengthening training capacity of the MOH:(Cost $12.65 M) I - Improvement of Health Service Delivery:(Cost $44.92 M) III- Project Management and Monitoring and Evaluation:(Cost $17.73 M) 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 12/13/2016 Page 1 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report AO-Municipal Health Service Strengthening (Revitalização) (P111840) Implementation Status and Key Decisions The project was restructured on November 16, 2015 which extended the project closing date from December 31, 2015 to December 31 2017. Implementation during this extension period has focused on the construction of maternity rooms, developing a cadre of Community Development and Health Agents (ADECOS in its Portuguese acronym), and training of health staff to further expand access to maternal and child health services in target provinces. The training of health professional covers a wide range of areas and include both pre and post-graduate training, and refresher courses in clinical and management areas to improve the care effectiveness. Furthermore, the project was able to support the Government of Angola in its response and containment of the yellow fever epidemic by providing US$5 million for yellow fever vaccines and materials for 20 municipalities outside of Luanda with confirmed cases of locally transmitted yellow fever. It also allowed for the financing of an additional 800,000 doses to partially cover another 10 municipalities with confirmed cases of local transmission. Given the current Project's contributions to strengthening central, provincial and municipal health systems, the Government of Angola has expressed interest in continuing the Bank's support to the country's health sector. The potential for future collaboration between the Government and Bank will be discussed in further detail during the upcoming implementation support mission in 2017. 12/13/2016 Page 2 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report AO-Municipal Health Service Strengthening (Revitalização) (P111840) 12/13/2016 Page 3 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report AO-Municipal Health Service Strengthening (Revitalização) (P111840) Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance  --  Moderate  Moderate Macroeconomic  --  Substantial  Substantial Sector Strategies and Policies  --  Moderate  Moderate Technical Design of Project or Program  --  Moderate  Moderate Institutional Capacity for Implementation and Sustainability  --  Substantial  Substantial Fiduciary  --  Substantial  Substantial Environment and Social  --  High  High Stakeholders  --  Moderate  Moderate 12/13/2016 Page 4 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report AO-Municipal Health Service Strengthening (Revitalização) (P111840) Other  --  --  -- Overall  --  Substantial  Substantial Results Project Development Objective Indicators PHINDPDOTBL  Institutional deliveries (%) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 41.00 63.00 50.10 60.00 Date 30-Jun-2009 08-Mar-2016 08-Mar-2016 31-Dec-2017 PHINDPDOTBL  Children 0-1 year immunized with Pentavalent vaccine 3rd dose (%) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 27.00 80.00 80.00 38.00 Date 30-Jun-2009 08-Mar-2016 08-Mar-2016 31-Dec-2017 PHINDPDOTBL  Children 0-1 year immunized with Pentavalent vaccine 3rd dose (number) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 244624.00 110253.00 26011.00 80000.00 Date 31-Dec-2014 08-Mar-2016 08-Mar-2016 31-Dec-2017 Comments Current value reflects 1st trimester 2016 (Jan-Mar). End target of 80,000 proposed during July 2016 mission. PHINDPDOTBL  Pregnant women receiving antenatal care during a visit to a health provider (number) (Number, Core) Baseline Actual (Previous) Actual (Current) End Target 12/13/2016 Page 5 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report AO-Municipal Health Service Strengthening (Revitalização) (P111840) Value 81000.00 253701.00 62926.00 109000.00 Date 31-Dec-2009 08-Mar-2016 08-Mar-2016 31-Dec-2017 Comments Current value reflects 1st trimester 2016 (Jan-Mar). PHINDPDOTBL  Direct project beneficiaries (Number, Core) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 363954.00 88937.00 762672.00 Date 30-Jun-2009 08-Mar-2016 08-Mar-2016 31-Dec-2017 Comments Current value reflects 1st trimester 2016 (Jan-Mar). End target of 762,672 proposed during July 2016 mission. PHINDPDOTBL  Female beneficiaries (Percentage, Core Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 87.00 87.00 63.00 PHINDPDOTBL  Number of outpatient visits (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1461354.00 336316.00 1450000.00 Date 30-Jun-2009 08-Mar-2016 08-Mar-2016 31-Dec-2017 Comments Current value reflects 1st trimester 2016 (Jan-Mar). End target of 1,450,000 proposed during July 2016 mission. Baseline number of visits has not yet been established (thought it appears as 0). 12/13/2016 Page 6 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report AO-Municipal Health Service Strengthening (Revitalização) (P111840) Overall Comments Intermediate Results Indicators PHINDIRITBL  Health facilities constructed, renovated, and/or equipped (number) (Number, Core) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 36.00 Date 30-Jun-2009 08-Mar-2016 08-Mar-2016 31-Dec-2017 PHINDIRITBL  Number of health facilities receiving at least 2 supervision visits per year (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 256.00 256.00 230.00 Date 30-Jun-2011 08-Mar-2016 08-Mar-2016 31-Dec-2017 PHINDIRITBL  Staff houses built (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 24.00 Date 30-Jun-2011 08-Mar-2016 08-Mar-2016 31-Dec-2017 PHINDIRITBL  Health personnel receiving training (number) (Number, Core) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1575.00 905.00 1695.00 Date 30-Jun-2011 08-Mar-2016 08-Mar-2016 31-Dec-2017 Comments Current value reflects 1st trimester 2016 (Jan-Mar). End target modified from 1,680 to 1,695. 12/13/2016 Page 7 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report AO-Municipal Health Service Strengthening (Revitalização) (P111840) PHINDIRITBL  Community Health Workers (CHWs) trained (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 191.00 531.00 1080.00 Date 30-Jun-2011 08-Mar-2016 08-Mar-2016 31-Dec-2017 Comments Current value reflects 1st trimester 2016 (Jan-Mar). PHINDIRITBL  General nurses trained in Emergency Obstetric and Neonatal Care (EmONC) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 180.00 Date 30-Jun-2011 08-Mar-2016 08-Mar-2016 31-Dec-2017 PHINDIRITBL  Nurse midwives who received pre-service training (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 52.00 75.00 Date 30-Jun-2011 08-Mar-2016 08-Mar-2016 31-Dec-2017 Comments Current value reflects 1st trimester 2016 (Jan-Mar). 12/13/2016 Page 8 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report AO-Municipal Health Service Strengthening (Revitalização) (P111840) PHINDIRITBL  Nurses trained in Integrated Management of childhood Illnesses (IMCI) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 303.00 322.00 360.00 Date 30-Jun-2009 08-Mar-2016 08-Mar-2016 31-Dec-2017 Comments Current value reflects 1st trimester 2016 (Jan-Mar). End target modified from 345 to 360. PHINDIRITBL  Ambulances and 4x4 station wagons purchased (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 53.00 53.00 54.00 Date 30-Jun-2009 08-Mar-2016 08-Mar-2016 31-Dec-2017 PHINDIRITBL  Total number of visits by mobile teams (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 605.00 396.00 396.00 1372.00 Date 31-Dec-2014 08-Mar-2016 08-Mar-2016 31-Dec-2017 PHINDIRITBL  Motorcycles purchased for outreach teams (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 184.00 184.00 146.00 Date 30-Jun-2009 08-Mar-2016 08-Mar-2016 31-Dec-2017 12/13/2016 Page 9 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report AO-Municipal Health Service Strengthening (Revitalização) (P111840) PHINDIRITBL  Number of health staff trained in Health Management Information System use (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 267.00 -- 513.00 840.00 Date 31-Aug-2015 -- 08-Mar-2016 31-Dec-2017 Comments Current value reflects 1st trimester 2016 (Jan-Mar). End target increased from 513 to 840 trained staff. Overall Comments Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed Disbursed P111840 IDA-47490 Effective USD 70.80 70.80 0.00 54.36 12.57 77% P111840 TF-14221 Closed USD 2.11 2.11 0.00 0.94 1.16 45% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P111840 IDA-47490 Effective 08-Jun-2010 08-Sep-2011 02-Mar-2012 31-Dec-2015 31-Dec-2017 P111840 TF-14221 Closed 23-Oct-2013 23-Oct-2013 23-Oct-2013 31-Dec-2015 31-Dec-2015 Cumulative Disbursements 12/13/2016 Page 10 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report AO-Municipal Health Service Strengthening (Revitalização) (P111840) Restructuring History Level 1 Approved on 16-Nov-2015 Related Project(s) P160701-Angola Health Services Strengthening AF 12/13/2016 Page 11 of 11 Public Disclosure Copy