The World Bank Report No: ISR9180 Implementation Status & Results Iraq Second Emergency Assistance Program for Primary Health Care (P123689) Public Disclosure Copy Operation Name: Second Emergency Assistance Program for Primary Health Project Stage: Implementation Seq.No: 3 Status: ARCHIVED Archive Date: 31-Dec-2012 Care (P123689) Country: Iraq Approval FY: 2011 Product Line: Recipient Executed Activities Region: MIDDLE EAST AND NORTH AFRICA Lending Instrument: Emergency Recovery Loan Implementing Agency(ies): Key Dates Board Approval Date 14-Apr-2011 Original Closing Date 31-May-2013 Planned Mid Term Review Date 07-Jan-2013 Last Archived ISR Date 05-May-2012 Effectiveness Date 23-Jun-2011 Revised Closing Date 31-May-2013 Actual Mid Term Review Date Project Development Objectives Project Development Objective (from Project Appraisal Document) The overall objectives of the proposed project are: (i) to improve the availability of basic health services in a fragile social and political environment - the southern Iraqi marshlands and Babil through selected health facilities, with a particular focus on vulnerable groups, including pregnant women and children; and (ii) support a partnership between public providers, an international NGO, and community representatives for improvement of community-based health services in a conflict affected country. This objective would be achieved through: (i) improving service delivery and community outreach, including civil works rehabilitation, provision of essential equipment, furniture and supplies, and outreach activities to communities; and (ii) health education and promotion of behavior change, including training of medical professionals in provision of primary health care, and training of school instructors and the women volunteers involved in providing information to the community on basic health and hygiene practices; and (iii) improving the monitoring of health status of the population and building the capacity of the ministry and local authorities for regional and local planning in the health sector. The proposed project would aim to achieve the following outcomes: (i) sustain present capacity and further increase availability of quality primary health care services, based on international best practice, in the southern Iraqi marshlands; (ii) expand the present project#s primary health care activities into Babil Governorate; (iii) enhance the skills of Iraqi primary health care professionals in southern Iraq through regular training and continuous professional development; (iv) increase the level of health awareness among communities within the catchment areas of AMAR#s primary health care services; (v) increase the capacity of the Ministry of Health (MOH) and local health authorities and secure their increased ownership of primary health care activities within the areas covered by the project. The project cost is estimated at US$1.3 million, and the project implementation period will be two years. Public Disclosure Copy Has the Project Development Objective been changed since Board Approval of the Project? Yes No Page 1 of 5 The World Bank Report No: ISR9180 Component(s) Component Name Component Cost Improving Service Delivery and Community Outreach 0.80 Public Disclosure Copy Health Education and Promotion of Behavior Change 0.10 Health Monitoring and Engaging Local Health Authorities 0.06 Project Management 0.20 Overall Ratings Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Moderately Satisfactory Satisfactory Overall Risk Rating Moderate Moderate Implementation Status Overview Project implementation is proceeding well, with all project activities ongoing and the major procurements, both civil works and goods, completed. Regular training is being provided to 689 medical professionals and an additional 64 Mother and Child Health (MCH) specialists working in the Primary Health Care Centers (PHCCs), tuberculosis (TB) clinics and mobile clinics each month. The three mobile clinics are actively providing an average of 1837 medical consultations monthly in the three Marshlands Governorates. The 600 Women Health Volunteers conduct home health education visits to an average 23,770 families per month. The four TB clinics are fully operational. International health management training was provided for 14 Director of Health (DOH) senior health managers and four AMAR International Charitable Foundation senior health managers at the American University Beirut in August 2012, and further training for health professionals is planned, building on the achievements of this first international training course. The Health Education in Schools (HES) program has been active since October 2011, providing basic health education to students. The Health Education in the Community (HEC) program, delivered by HES teachers and supervisors, began in all four targeted governorates in October 2011. The Ministry of Health (MOH) has shown an interest in all the above community based programs, and has indicated a desire to scale them up at a national level. The project is also providing support to developing a health profile for the project area, based on data collected on the health status of the population in the catchment area of the 23 PHCCs supported by the project. Regular liaison meetings are being held between AMAR staff and DOH and MOH officials, along with management training. Levels of engagement vary across governorates. Locations Public Disclosure Copy No Location data has been entered Results Project Development Objective Indicators Page 2 of 5 The World Bank Report No: ISR9180 Indicator Name Core Unit of Measure Baseline Current End Target • % of live births attended by skilled Percentage Value 94.70 75.00 healthcare provider Date 25-Mar-2012 17-Dec-2012 31-May-2013 Public Disclosure Copy Comments The percentage needs to be There are no new data taken with care as this is well above the national average. Data will need to be cleaned and analyzed. • % of pregnant women receiving at Percentage Value 94.40 84.00 least one antenatal care session with a skilled Date 25-Mar-2012 17-Dec-2012 31-May-2013 healthcare provider Comments The percentage needs to be There are no new data taken with care as this is well above the national average. Data will need to be cleaned and analyzed.It would be useful in the next round to include questions as to 3 and 4 antenatal visits by pregnant women. • % of children age 0-1 year immunized Percentage Value 70.30 83.00 for measles Date 25-Mar-2012 17-Dec-2012 31-May-2013 Comments The percentage needs to be There are no new data taken with care as this is well above the national average. Data will need to be cleaned and analyzed. • % of population using improved Percentage Value 72.10 73.00 sanitation, as measured by regular hand Date 25-Mar-2012 washing Comments Handwashing after using the toilet is 75.2%. The Public Disclosure Copy percentage needs to be taken with care as this is well above the national average. Data will need to be cleaned and analyzed. • % of children age 0-5 years with Percentage Value 60.10 95.00 health cards Date 25-Mar-2012 Comments (Those that did not show card but have are 33%, and previously had were 4.6%). Page 3 of 5 The World Bank Report No: ISR9180 The percentage needs to be taken with care as this is well above the national average. Data will need to be cleaned Public Disclosure Copy and analyzed. Intermediate Results Indicators Indicator Name Core Unit of Measure Baseline Current End Target • Number of TB clinics established and Number Value 0.00 4.00 4.00 equipped Date 01-Dec-2011 17-Sep-2012 31-May-2013 Comments Target met • Number of WHVs trained in Number Value 360.00 600.00 600.00 community outreach Date 01-Jun-2011 17-Dec-2012 31-May-2013 Comments There are no new data • Number of primary healthcare Number Value 0.00 12.00 12.00 facilities refurbished and equipped Date 01-Dec-2011 17-Dec-2012 31-May-2013 Comments Target met. Work completed • Number of household visits per month Number Value 10000.00 22936.00 30000.00 by WHVs in project areas Date 01-Dec-2011 17-Dec-2012 31-May-2013 Comments per month per month per month Data on Financial Performance (as of 26-Nov-2012) Financial Agreement(s) Key Dates Project Ln/Cr/Tf Status Approval Date Signing Date Effectiveness Date Original Closing Date Revised Closing Date P123689 TF-99542 Effective 17-Jun-2011 23-Jun-2011 23-Jun-2011 31-May-2013 31-May-2013 Disbursements (in Millions) Project Ln/Cr/Tf Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed Public Disclosure Copy P123689 TF-99542 Effective USD 1.20 1.20 0.00 0.98 0.22 82.00 Disbursement Graph Page 4 of 5 The World Bank Report No: ISR9180 Public Disclosure Copy Key Decisions Regarding Implementation NA Restructuring History There has been no restructuring to date. Related Projects There are no related projects. Public Disclosure Copy Page 5 of 5