The World Bank Implementation Status & Results Report Transforming Health Systems for Universal Care (P152394) Transforming Health Systems for Universal Care (P152394) AFRICA EAST | Kenya | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2016 | Seq No: 10 | ARCHIVED on 26-Jan-2021 | ISR44054 | Implementing Agencies: Republic of Kenya, Ministry of Health Key Dates Key Project Dates Bank Approval Date: 15-Jun-2016 Effectiveness Date: 04-Jul-2016 Planned Mid Term Review Date: 11-Mar-2019 Actual Mid-Term Review Date: 25-Mar-2019 Original Closing Date: 30-Sep-2021 Revised Closing Date: 30-Sep-2021 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The project development objective is to improve utilization and quality of primary health care services with a focus on reproductive, maternal, newborn, child, and adolescent health 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) The project development objective is to improve utilization and quality of primary health care services with a focus on reproductive, maternal, newborn, child and adolescent health services and to provide immediate and effective response to an eligible crisis or emergency . Components Table Name Improving Primary Health Care Results:(Cost $141.00 M) Strengthening Institutional Capacity:(Cost $28.70 M) Contingency Emergency Response:(Cost $10.00 M) Cross-county and Intergovernmental Collaboration, and Project Management:(Cost $11.40 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Moderately Satisfactory Moderately Satisfactory Overall Implementation Progress (IP) Moderately Unsatisfactory Moderately Unsatisfactory Overall Risk Rating Substantial Substantial Implementation Status and Key Decisions The Transforming Health Systems for Universal Care Project (THS-UCP) aims to improve utilization and quality of primary healthcare services with a focus on reproductive, maternal, newborn, child, and adolescent health (RMNCAH) services. An implementation support mission conducted during November 30 - December 4, 2020 showed that overall implementation is progressing well. County governments are implementing activities prioritized in their annual work plans. Procurement and distribution of RMNCAH strategic 1/26/2021 Page 1 of 8 The World Bank Implementation Status & Results Report Transforming Health Systems for Universal Care (P152394) commodities is ongoing. In response to the Government of Kenya's request to trigger the Contingency Emergency Response Component (CERC) to respond to the COVID-19 pandemic, the Bank allocated US$ 10M to support the Kenya COVID-19 Contingency Plan. To address concerns that have been in the public domain on the usage of COVID-19 related funds, including under the Kenya COVID-19 Emergency Response Project, the World Bank is working closely with the relevant organs of government to strengthen the fiduciary functions and accountability systems for the Project. The complaint handling and redress mechanism will also be strengthened to further improve transparency and accountability. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance High High Substantial Macroeconomic Moderate Moderate Moderate Sector Strategies and Policies Moderate Substantial Substantial Technical Design of Project or Program Substantial Substantial Substantial Institutional Capacity for Implementation and High High High Sustainability Fiduciary Substantial Substantial Substantial Environment and Social Low Moderate Moderate Stakeholders Substantial High High Other -- -- -- Overall Substantial Substantial Substantial Results PDO Indicators by Objectives / Outcomes Improved utilization and quality of primary health care services IN00930941 ►Children immunized with the third dose of Pentavalent (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 79.50 80.75 92.20 84.00 Date 31-Dec-2015 30-Sep-2019 30-Sep-2020 31-Dec-2021 The data cover the period January-June 2020. Comments: 1/26/2021 Page 2 of 8 The World Bank Implementation Status & Results Report Transforming Health Systems for Universal Care (P152394) IN00930946 ►Pregnant women attending at least four ANC visits (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 39.70 52.45 57.70 52.00 Date 31-Dec-2015 30-Sep-2019 30-Sep-2020 30-Jun-2021 IN00930949 ►Births attended by skilled health personnel (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 57.00 68.40 81.10 67.00 Date 31-Dec-2015 30-Sep-2019 30-Sep-2020 30-Jun-2021 IN00930953 ►Women between the ages of 15-49 years currently using a modern FP method (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 47.80 43.15 49.80 52.00 Date 31-Dec-2015 30-Sep-2019 30-Sep-2020 31-Dec-2021 IN00930955 ►Inspected facilities meeting safety standards (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 34.90 50.00 Date 31-Dec-2015 29-Jun-2018 30-Sep-2020 31-Dec-2021 IN00930957 ►Pregnant women attending ANC supplemented with IFA (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 31.00 71.80 79.00 73.00 Date 31-Dec-2015 30-Sep-2019 30-Sep-2020 31-Dec-2021 Provision of immediate and effective response to an eligible crisis or emergency IN00930945 ►Reported suspected cases of COVID-19 cases investigated based on national guidelines (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 100.00 80.00 Date 18-Mar-2020 -- 30-Sep-2020 01-Sep-2021 1/26/2021 Page 3 of 8 The World Bank Implementation Status & Results Report Transforming Health Systems for Universal Care (P152394) Overall Comments PDO The Government of Kenya triggered the CERC to finance rapid response to the COVID-19 pandemic while an emergency project was being prepared to provide additional support for larger and longer term investments (P167814). This is an ex-post restructuring to reflect CERC indicators. Intermediate Results Indicators by Components Component 1: Improved primary health care results IN00930959 ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 6,562,330.00 8,996,064.00 10,060,000.00 Date 29-Sep-2016 30-Sep-2019 30-Sep-2020 30-Jun-2021 The baseline date corresponds the date at which the Project became effective. This is a corporate indicator capturing the cumulative number of people receiving essential health services over the Project Comments: lifecycle (# deliveries attended by skilled personnel and # children aged 0 to 5 who were immunized). No Nutrition services are supported by the Project. IN00930960 Number of children immunized (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 3,487,223.00 4,322,214.00 5,400,000.00 Date 29-Sep-2016 30-Sep-2019 30-Sep-2020 30-Jun-2021 IN00930961 Number of deliveries attended by skilled health personnel (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 3,075,107.00 4,670,155.00 4,660,000.00 Date 29-Sep-2016 30-Sep-2019 30-Sep-2020 30-Jun-2021 Component 2: Strengthened institutional capacity IN00930942 ►Facilities inspected for safety standards (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 152.00 1,635.00 Date 11-Mar-2016 30-Sep-2019 30-Sep-2020 30-Jun-2021 IN00930947 1/26/2021 Page 4 of 8 The World Bank Implementation Status & Results Report Transforming Health Systems for Universal Care (P152394) ►Reports submitted to DHIS in a timely manner. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 88.80 97.43 96.30 98.00 Date 31-Dec-2015 30-Sep-2019 30-Sep-2020 31-Dec-2021 IN00930950 ►Births registered within 6 months of occurrence (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 65.90 73.60 71.90 80.00 Date 31-Dec-2015 30-Sep-2019 30-Sep-2020 30-Jun-2021 No new data available - this indicator is measured annually and results for 2019 are not yet available. Comments: IN00930954 ►RMNCAH related operations research completed to inform policy/strategy (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 2.00 Date 11-Mar-2016 30-Sep-2019 15-Dec-2020 30-Jun-2021 IN00930956 ►A benefit package developed, costed, and disseminated (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 1.00 Date 11-Mar-2016 30-Sep-2019 15-Dec-2020 30-Jun-2021 A benefit package has been developed and costed but not yet disseminated. Comments: IN00930958 ►Lessons learned from UHC Phase I documented and disseminated (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No No Yes Yes Date 20-Jun-2019 30-Sep-2019 15-Dec-2020 31-Dec-2019 This indicator was introduced after the mid term review of the project. The lessons learned from UHC Phase I were documented in a report and disseminated to key Comments: stakeholders. Component 3: Cross-county/intergovernmental collaboration and project management IN00930943 1/26/2021 Page 5 of 8 The World Bank Implementation Status & Results Report Transforming Health Systems for Universal Care (P152394) ►Functional community units (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 302.00 4,895.00 6,500.00 5,331.00 Date 31-Dec-2015 30-Sep-2019 30-Sep-2020 30-Jun-2021 IN00930948 ►Grievances registered related to delivery of project benefits that are addressed (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 80.00 Date 31-Dec-2015 30-Sep-2019 30-Sep-2020 30-Jun-2021 IN00930951 ►Implementing entities submitting the annual FM and technical report on time (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 100.00 95.00 Date 11-Mar-2016 30-Sep-2019 30-Sep-2020 30-Jun-2021 Component 4: Contingency Emergency Response IN00930944 ►Designated laboratories with COVID diagnostic equipment (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 2.00 -- 41.00 8.00 Date 18-Mar-2020 -- 30-Sep-2020 01-Sep-2021 IN00930952 ►Vulnerable and marginalized communities reached in their indigenous language (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 80.00 Date 18-Mar-2020 -- 30-Sep-2020 01-Sep-2021 Overall Comments IR The Government of Kenya triggered the CERC to finance rapid response to the COVID-19 pandemic while an emergency project was being prepared to provide additional support for larger and longer term investments (P167814). This is an ex-post restructuring. Performance-Based Conditions 1/26/2021 Page 6 of 8 The World Bank Implementation Status & Results Report Transforming Health Systems for Universal Care (P152394) Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P152394 IDA-58360 Effective USD 150.00 150.00 0.00 110.49 38.05 74% P152394 TF-A2561 Effective USD 40.00 40.00 0.00 24.06 15.94 60% P152394 TF-A2792 Effective USD 1.10 1.10 0.00 0.67 0.43 61% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P152394 IDA-58360 Effective 15-Jun-2016 04-Jul-2016 29-Sep-2016 30-Sep-2021 30-Sep-2021 P152394 TF-A2561 Effective 15-Jun-2016 04-Jul-2016 29-Sep-2016 30-Sep-2021 30-Sep-2021 P152394 TF-A2792 Effective 15-Jun-2016 04-Jul-2016 04-Jul-2016 30-Jun-2020 30-Sep-2021 Cumulative Disbursements 1/26/2021 Page 7 of 8 The World Bank Implementation Status & Results Report Transforming Health Systems for Universal Care (P152394) 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 24-Jun-2019 ,Level 2 Approved on 31-Jan-2020 ,Level 2 Approved on 20-Oct-2020 ,Level Approved on 02-Dec-2020 Related Project(s) P174772-Additional Financing for THS-UCP 1/26/2021 Page 8 of 8