The World Bank Implementation Status & Results Report Cambodia Nutrition Project (P162675) Cambodia Nutrition Project (P162675) EAST ASIA AND PACIFIC | Cambodia | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2019 | Seq No: 3 | ARCHIVED on 24-Oct-2020 | ISR43436 | Implementing Agencies: Ministry of Health, Kingdom of Cambodia, National Committee for Sub-National Democratic Development Secretariat Key Dates Key Project Dates Bank Approval Date: 04-Apr-2019 Effectiveness Date: 10-Oct-2019 Planned Mid Term Review Date: 26-Jan-2022 Actual Mid-Term Review Date: Original Closing Date: 30-Jun-2024 Revised Closing Date: 30-Jun-2024 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The PDO is to improve utilization and quality of priority maternal and child health and nutrition services for targeted groups in Cambodia. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Component 1: Strengthening the delivery of priority health services:(Cost $24.00 M) Component 2: Stimulating demand and accountability at the community level:(Cost $10.80 M) Component 3: Ensuring an effective and sustainable response:(Cost $18.20 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 Moderate Implementation Status and Key Decisions The second implementation support mission (ISM) for the CNP was conducted from July 21 to 30, 2020. Due to the outbreak of COVID-19 in early 2020 and associated travel restrictions, the mission was conducted entirely in a virtual format with connections to Phnom Penh. No field trips were conducted. MOH and NCDDS have made significant progress since the first ISM (January 2020). They have respectively completed key actions such as the opening of bank accounts, processing of first withdrawal applications (WAs), approval of annual workplans and budgets (AWPBs), submission of operational manuals (OMs) in both Khmer and English, and recruitment of the majority of Project consultants. Despite this progress, COVID-19 has caused inevitable delays in the rollout of activities, such as Project orientations and safeguards training, and roll out of Service Delivery Grant (SDG) and Commune/Sangkat (C/S) SDG and Health Equity Fund (HEF) activities. 10/24/2020 Page 1 of 14 The World Bank Implementation Status & Results Report Cambodia Nutrition Project (P162675) Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance Substantial Substantial Moderate Macroeconomic Low Low Low Sector Strategies and Policies Low Low Low Technical Design of Project or Program Substantial Substantial Moderate Institutional Capacity for Implementation and Substantial Substantial Substantial Sustainability Fiduciary Substantial Substantial Substantial Environment and Social Low Low Low Stakeholders Low Low Low Other Low Low Substantial Overall Substantial Substantial Moderate Results PDO Indicators by Objectives / Outcomes To improve utilization of priority maternal and child health and nutrition services IN00891635 ►Percent of children born in the last 24 months who were put to the breast within one hour of birth (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 56.50 56.50 56.50 68.00 Date 01-Jul-2019 01-Jul-2019 01-Jul-2019 28-Jun-2024 Original baseline derived from Cambodia DHS 2014. Baseline data to be collected in household survey in Comments: December 2020 and updated subsequently. IN00891807 ►Number of children under 12 months of age in target areas receiving DPT-HepB-Hib 3 in the last calendar year (annual) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 38,500.00 38,500.00 38,885.00 41,000.00 10/24/2020 Page 2 of 14 The World Bank Implementation Status & Results Report Cambodia Nutrition Project (P162675) Date 31-Dec-2018 01-Jul-2019 31-Dec-2019 31-Dec-2023 Updated based on 2019 Heath Achievement Report. Comments: To improve quality of priority maternal and child health and nutrition services IN00891634 ►Percent of children 6-23 months of age in target provinces who receive foods from 4 or more food groups, by gender (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 40.00 40.00 40.00 50.00 Date 31-Dec-2018 01-Jul-2019 31-Dec-2018 31-Dec-2023 Original baseline derived from Cambodia DHS 2014. Baseline data to be collected in household survey in Comments: December 2020 and updated subsequently. IN00891806 Female (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 40.00 40.00 40.00 50.00 Date 01-Feb-2019 01-Jul-2019 31-Dec-2018 30-Jun-2024 IN00891808 Males (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 40.00 40.00 40.00 50.00 Date 26-Feb-2019 01-Jul-2019 31-Dec-2018 30-Jun-2024 IN00891809 ►Percent of pregnant women in target areas receiving micronutrient supplementation in accordance with national guidelines (annual) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 80.20 80.20 86.70 90.00 Date 31-Dec-2018 01-Jul-2019 31-Dec-2019 31-Dec-2023 Based on 2019 Annual Health Report. Comments: IN00891810 ►Number of health facilities in target areas scoring over 60 percent on their Maternal and Child Health and Nutrition Scorecards (annual) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 90.00 Date 01-Feb-2019 01-Jul-2019 30-Sep-2020 31-Dec-2023 MCHN-S rollout delayed until 2021. Comments: 10/24/2020 Page 3 of 14 The World Bank Implementation Status & Results Report Cambodia Nutrition Project (P162675) IN00891811 ►Number of commune/sangkats in target areas receiving Commune/Sangkat Service Delivery Grants (C/S-SDGs) for women and children (annual) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 271.00 Date 31-Dec-2018 01-Jul-2019 30-Sep-2020 31-Dec-2023 C/S SDG roll out delayed until 2021 due to COVID-19. Comments: Intermediate Results Indicators by Components Component 1: Strengthening the Delivery of Priority Health Services IN00891812 ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 224,624.00 1,060,000.00 Date 31-Dec-2018 01-Jul-2019 31-Dec-2019 31-Dec-2023 In year 1, essential nutrition services limited only to receipt of Vitamin A, as CPWC activities not yet rolled Comments: out. IN00891816 Number of children immunized (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 38,885.00 200,000.00 Date 31-Dec-2018 01-Jul-2019 31-Dec-2019 28-Jun-2024 IN00891818 Number of deliveries attended by skilled health personnel (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 38,332.00 160,000.00 Date 31-Dec-2018 01-Jul-2019 31-Dec-2019 31-Dec-2023 IN00891821 Number of women and children who have received basic nutrition services (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 147,407.00 700,000.00 Date 31-Dec-2018 01-Jul-2019 31-Dec-2019 31-Dec-2023 IN00891823 ►Number of coaching sessions conducted in target areas with participation of NMCHC (cumulative) (Number, Custom) 10/24/2020 Page 4 of 14 The World Bank Implementation Status & Results Report Cambodia Nutrition Project (P162675) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 60.00 Date 31-Dec-2018 01-Jul-2019 30-Sep-2020 31-Dec-2023 Coaching will accompany MCHN-S rollout and is delayed until 2021. Comments: IN00891826 ►Average health center staff score (%) on GMP vignette in target areas (annual) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 65.00 Date 31-Dec-2018 01-Jul-2019 30-Sep-2020 31-Dec-2023 This vignette is a component of the MCHN-S and is delayed until 2021. Comments: IN00891828 ►Number of integrated outreach sessions in target areas supported by the project (cumulative) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 5,000.00 Date 31-Dec-2018 01-Jul-2019 30-Sep-2020 31-Dec-2023 Rollout of project activities delayed due to COVID-19. Comments: IN00891830 ►Percent of children 12-23 months in target areas fully immunized (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 63.04 63.04 63.04 75.00 Date 20-Aug-2014 01-Jul-2019 01-Jul-2019 28-Jun-2024 Original baseline derived from Cambodia DHS 2014. Baseline data to be collected in household survey in Comments: December 2020 and updated subsequently. IN00891831 Bottom 40% of households (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 56.30 56.30 56.30 68.00 Date 30-Jun-2014 01-Jul-2019 01-Jul-2019 30-Jun-2024 IN00891832 Upper 60% of households (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 77.80 77.80 77.80 85.00 10/24/2020 Page 5 of 14 The World Bank Implementation Status & Results Report Cambodia Nutrition Project (P162675) Date 30-Jun-2014 01-Jul-2019 01-Jul-2019 30-Jun-2024 IN00891833 ►Utilization of outpatient HEF services in target areas in the last calendar year (annual) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 232,872.00 232,872.00 237,800.00 256,000.00 Date 31-Dec-2018 01-Jul-2019 31-Dec-2019 31-Dec-2023 From Health Achievement Report of HMIS data. Released annually in March for previous calendar year. Comments: Component 2. Stimulating Demand and Accountability at the Community Level IN00891814 ►Number of citizens in target areas providing feedback on commune services for women and children (cumulative) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 20,000.00 Date 31-Dec-2018 01-Jul-2019 30-Sep-2020 31-Dec-2023 Rollout of project activities delayed due to COVID-19. Comments: IN00891817 ►Number of communes in target areas incorporating C/S-SDG beneficiary feedback in Commune Investment Program (annual) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 200.00 Date 31-Dec-2018 01-Jul-2019 30-Sep-2020 31-Dec-2023 Rollout of project activities delayed due to COVID-19. Comments: IN00891820 ►Number of villages in target areas with active VHSGs trained according to guidelines (annual) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 1,050.00 Date 31-Dec-2018 01-Jul-2019 30-Sep-2020 31-Dec-2023 Rollout of project activities delayed due to COVID-19. Comments: IN00891822 ►Number of VHSGs in target areas trained by the project to implement CPWC and HEF promotion (cumulative) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 1,200.00 10/24/2020 Page 6 of 14 The World Bank Implementation Status & Results Report Cambodia Nutrition Project (P162675) Date 31-Dec-2018 01-Jul-2019 30-Sep-2020 31-Dec-2023 Rollout of project activities delayed due to COVID-19. Comments: IN00891824 Number of VHSGs trained by the project to implement CPWC and HEF promotion-female (cumulative) (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 720.00 Date 31-Dec-2018 01-Jul-2019 30-Sep-2020 31-Dec-2023 IN00891825 ►Number of community health and nutrition events for women and children under 2 convened in target areas (cumulative) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 35,000.00 Date 31-Dec-2018 01-Jul-2019 30-Sep-2020 31-Dec-2023 Rollout of project activities delayed due to COVID-19. Comments: IN00891827 ►Number of caregivers of children age 0-2 years participating in any CPWC event in the last calendar year (annual) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 20,000.00 Date 31-Dec-2018 01-Jul-2019 30-Sep-2020 31-Dec-2023 Rollout of project activities delayed due to COVID-19. Comments: IN00891829 ►Percent of commune/sangkats in target areas receiving C/S-SDG payment within specified timelines (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 85.00 Date 31-Dec-2018 01-Jul-2019 30-Sep-2020 31-Dec-2023 Rollout of project activities delayed due to COVID-19. Comments: Component 3. Ensuring an Effective and Sustainable Response IN00891813 ►Number of public health providers trained in MIYCN package (cumulative) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 250.00 Date 31-Dec-2018 01-Jul-2019 30-Sep-2020 31-Dec-2023 10/24/2020 Page 7 of 14 The World Bank Implementation Status & Results Report Cambodia Nutrition Project (P162675) Rollout of project activities delayed due to COVID-19. Comments: IN00891815 Of which female (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 145.00 Date 31-Dec-2018 01-Jul-2019 01-Jul-2019 31-Dec-2023 IN00891819 ►Percent of health facilities receiving MCHN scorecard SDG payment within specified timelines (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 80.00 Date 31-Dec-2018 01-Jul-2019 30-Sep-2020 31-Dec-2023 Rollout of project activities delayed due to COVID-19. Comments: Performance-Based Conditions IN00899229 ►PBC 1 DLI A: Subnational capacity building and rollout of C/S-SDG system (Text, Output, 700,000.00, 42.86%) Year 4: October 1, 2022-September 30, Baseline Actual (Previous) Actual (Current) 2023 1. C/S-SDG checklists and readiness guidelines distributed to all C/S and D/K in target provinces - achieved, 50,000 paid. 2. NCDDS is adequately staffed to carry out C/S- C/S-SDG system and 1. Training on C/S- SDG implementation training package not SDG processes Value -- according to mutually designed rolled out as per agreed staffing plan - year 3 plan achieved, 200,000 paid. 3. Plans for subnational capacity building and monitoring for C/S-SDG approved - achieved, 50,000 paid. Date -- -- 01-Jul-2020 -- IN00899412 10/24/2020 Page 8 of 14 The World Bank Implementation Status & Results Report Cambodia Nutrition Project (P162675) ►PBC 2 DLI B: Sustained timeliness of C/S-SDG payments and fiduciary oversight (Text, Output, 500,000.00, 20.00%) Year 4: October 1, 2022-September 30, Baseline Actual (Previous) Actual (Current) 2023 1. Plans for sub-national capacity building and 1. At least 85% of monitoring of financial C/S-SDG payments management (FM) are are made within the approved - achieved, prescribed time 50,000 paid. 2. Activities as per Capacity building and 2. NCDDS FM team the year 4 FM Value -- training not occurring receives training in its capacity building standard operating and monitoring plan procedures and World have been Bank’s Procurement completed for C/S- Regulations - achieved, SDG FM readiness 50,000 paid and roll out Date -- -- 01-Jul-2020 -- IN00899413 ►PBC 3 DLI C: C/S-SDG assessment and coaching in accordance with guidelines (Text, Output, 450,000.00, 11.11%) Year 4: October 1, 2022-September 30, Baseline Actual (Previous) Actual (Current) 2023 1.Implementation 1. At least 90% of guideline detailing C/S- target C/S receive SDG fund flow, rollout, timely C/S-SDG process, and oversight assessment C/S SDG System not arrangements is finalized 2. Actions taken as Value established and no -- and distributed among per C/S-SDG assessments conducted C/S, district, provincial, Operational Manual and central authorities - to address achieved, 50,000 paid. discrepancies in ex- ante and ex-post verification scores Date -- -- 01-Jul-2020 -- IN00899387 ►PBC 4 DLI D: Ongoing readiness and quality of priority nutrition services (Text, Output, 950,000.00, 10.53%) Year 4: October 1, 2022-September 30, Baseline Actual (Previous) Actual (Current) 2023 Value Incomplete complement of -- 1. The NNP of MOH is 1. The National qualified personnel to carry adequately staffed Nutrition Program of out project functions; according to the MOH’s MOH is adequately comprehensive package of relevant plan with full-time staffed nutrition interventions not qualified personnel and defined; and supervision, contractual staff to carry 10/24/2020 Page 9 of 14 The World Bank Implementation Status & Results Report Cambodia Nutrition Project (P162675) training and coaching plans out Project functions - for comprehensive nutrition achieved, 100,000 paid intervention not yet agreed Date -- -- 01-Jul-2020 -- IN00902229 ►PBC 5 DLI E. Delivery of an integrated outreach package including priority MCHN services (Text, Outcome, 600,000.00, 20.00%) Year 4: October 1, 2022-September 30, Baseline Actual (Previous) Actual (Current) 2023 1. Guidelines specifying integrated outreach package including minimum MCHN activities, 1. ODs in target frequency, and monitoring provinces with An integrated outreach protocol for central and health centers package, including priority OD levels is adopted (the conducting Value -- MCHN services not being Guidelines)- achieved, integrated outreach delivered 70,000 paid according to the 2. Procurement for the Guideline integrated outreach portable kits initiated - achieved, 50,000 paid Date -- -- 01-Jul-2020 -- IN00902445 ►PBC 6 DLI F. Comprehensive coaching conducted for MCHN Scorecard (Text, Output, 750,000.00, 13.33%) Year 4: October 1, 2022-September 30, Baseline Actual (Previous) Actual (Current) 2023 1.MCHN scorecard developed based on the criteria set out in the Verification Protocol - 1.MCHN scorecard An integrated outreach achieved, 50,000 paid. coaching conducted package, including priority Value -- 2.MCHN vignettes according to year 4 MCHN services not being finalized based on criteria plan delivered set out in the Verification Protocol - achieved, 50,000 paid Date -- -- 01-Jul-2020 -- IN00902633 ►PBC 7 DLI G. Communication materials, training, and supervision delivered for VHSGs and HEF Promotion (Text, Output, 900,000.00, 11.11%) 10/24/2020 Page 10 of 14 The World Bank Implementation Status & Results Report Cambodia Nutrition Project (P162675) Year 4: October 1, 2022-September 30, Baseline Actual (Previous) Actual (Current) 2023 1.NCHP undertakes supervision of community level activities and any 1. Package of activities for remaining training the CPWC (including for Communications materials, programs defined for HCMC and VHSG) is training and supervision year 4 in the defined and Value currently not being -- Capacity Building implementation guidelines delivered for VHSGs and and Supervision prepared - achieved, HEF Promotion plan 100,000 paid 2.SBCC implementation plan for year 4 is completed Date -- -- 01-Jul-2020 -- IN00902711 ►PBC 8 DLI H. Sustainable institutional arrangements for HEF and SDG payment and certification (Text, Output, 1,300,000.00, 0.00%) Year 4: October 1, 2022-September 30, Baseline Actual (Previous) Actual (Current) 2023 1.Timely certification No sustainable institutional of MCHN Scorecard arrangements for HEF and Targets are not achieved scores as per Value -- SDG payment and yet MOH’s relevant certification guideline Date -- -- 08-Oct-2020 -- IN00902746 ►PBC 9 DLI I. MCHN service quality monitoring enhanced and mainstreamed in the MOH (Text, Output, 900,000.00, 16.67%) Year 4: October 1, 2022-September 30, Baseline Actual (Previous) Actual (Current) 2023 Value No enhanced service -- 1.MCHN scorecard 1.MCHN scorecard quality monitoring and not manual and guideline implemented in new mainstreamed in MOH finalized - achieved, provinces and health 50,000 paid. facilities as per mid- 2. MCHN scorecard term review guidance integrated into agreements for year SDG annual instruction for 4. implementation - 2.Quarterly joint achieved, 50,000 paid. review (QAO + 3.Protocol for reviewing NMCHC) of MCHN MCNH scorecard scores and developed and templates production of 10/24/2020 Page 11 of 14 The World Bank Implementation Status & Results Report Cambodia Nutrition Project (P162675) for quarterly and annual quarterly and annual MCHN scorecard reports reports produced - achieved, 50,000 paid. Date -- -- 01-Jul-2020 -- IN00902599 ►PBC 10 DLI J. Timeliness of MCHN-SDG and HEF payments ensured and continued FM capacity building for health centers (Text, Output, 900,000.00, 0.00%) Year 4: October 1, 2022-September 30, Baseline Actual (Previous) Actual (Current) 2023 1. At least 85% of MCHN-SDG and HEF payment are made within the MCHN-SDG and HEF prescribed time payments are not timely, 2. Activities as per Value and FM capacity building -- Targets not achieved yet the FM capacity for health centers is not building plan have continuous been completed for year 4 Date -- -- 08-Oct-2020 -- IN00902712 ►PBC 11 DLI K. Regularity of MCHN data availability enhanced (Text, Output, 300,000.00, 0.00%) Year 4: October 1, 2022-September 30, Baseline Actual (Previous) Actual (Current) 2023 1.Timely production of monthly, semi- annual and annual MCHN data is not regularly Value -- Targets not achieved yet. MCHN and HEF available utilization reports in year 4 Date -- -- 08-Oct-2020 -- Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed 10/24/2020 Page 12 of 14 The World Bank Implementation Status & Results Report Cambodia Nutrition Project (P162675) P162675 IDA-63940 Effective USD 15.00 15.00 0.00 0.55 14.31 3.7% P162675 TF-A9830 Effective USD 10.00 10.00 0.00 0.34 9.66 3.4% P162675 TF-A9833 Effective USD 5.00 5.00 0.00 0.19 4.81 3.8% P162675 TF-A9902 Effective USD 2.00 2.00 0.00 0.12 1.88 5.8% P162675 TF-B0827 Effective USD 2.00 2.00 0.00 0.31 1.69 15% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P162675 IDA-63940 Effective 04-Apr-2019 22-Aug-2019 10-Oct-2019 30-Jun-2024 30-Jun-2024 P162675 TF-A9830 Effective 04-Apr-2019 22-Aug-2019 10-Oct-2019 31-Dec-2021 31-Dec-2021 P162675 TF-A9833 Effective 04-Apr-2019 22-Aug-2019 10-Oct-2019 30-Jun-2023 30-Jun-2023 P162675 TF-A9902 Effective 04-Apr-2019 22-Aug-2019 10-Oct-2019 30-Jun-2021 30-Jun-2021 P162675 TF-B0827 Effective 03-Jul-2019 22-Aug-2019 10-Oct-2019 30-Jun-2024 30-Jun-2024 Cumulative Disbursements 10/24/2020 Page 13 of 14 The World Bank Implementation Status & Results Report Cambodia Nutrition Project (P162675) PBC Disbursement Achievement Disbursed amount in Disbursement % PBC ID PBC Type Description Coc PBC Amount Status Coc for PBC Restructuring History There has been no restructuring to date. Related Project(s) There are no related projects. 10/24/2020 Page 14 of 14