The World Bank Implementation Status & Results Report KOMPAS - Kosovo Comprehensive Approach to Health System Strengthening (P179831) KOMPAS - Kosovo Comprehensive Approach to Health System Strengthening (P179831) EUROPE AND CENTRAL ASIA | Kosovo | IBRD/IDA | Investment Project Financing (IPF) | FY 2024 | Seq No: 2 | Archived on 12-May-2025 | ISR03844 Implementing Agencies: Ministry of Health 1. OBJECTIVE 1.1 Development Objective Original Development Objective (Approved as part of Approval package on 07-May-2024) The Project Development Objective (PDO) is to strengthen institutional capacity and governance for quality of care in the Kosovo health system. Has the Development Objective been changed since Board Approval of the Project Objective? No 2. COMPONENTS Name 1. Strengthening key health system building blocks for quality of care :(Cost 6,950,000.00) 2. Developing an integrated health information system :(Cost 12,200,000.00) 3. Project Management, Monitoring, and Evaluation:(Cost 850,000.00) 3. OVERALL RATINGS Name Previous Current Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Satisfactory Satisfactory Overall Risk Rating Moderate Moderate 4. KEY ISSUES & STATUS May 12, 2025 Page 1 of 11 The World Bank Implementation Status & Results Report KOMPAS - Kosovo Comprehensive Approach to Health System Strengthening (P179831) 4.1 Implementation Status and Key Decisions The project was approved by the World Bank Board of Executive Directors on May 7, 2024. Following the Board approval, the Financing Agreement was signed by the Bank and the Ministry of Finance on June 28, 2024. The project is currently pending Parliament approval to be declared effective. Meanwhile, the Ministry of Health has filled key positions in the Project Coordination Unit (PCU) and is preparing bidding documents for key procurement activities to allow for quick Project implementation as soon as the Project becomes effective. 5. SYSTEMATIC OPERATIONS RISK-RATING TOOL Rating at Approval Last Approved Rating Risk Category Approval Package - ISR Seq. 01 - 16 Oct Proposed Rating 07 May 2024 2024 Political and Governance Moderate Moderate Moderate Macroeconomic Moderate Moderate Moderate Sector Strategies and Policies Substantial Substantial Substantial Technical Design of Project or Program Moderate Moderate Moderate Institutional Capacity for Implementation and Substantial Substantial Substantial Sustainability Fiduciary Moderate Moderate Moderate Environment and Social Moderate Moderate Moderate Stakeholders Moderate Moderate Moderate Overall Moderate Moderate Moderate May 12, 2025 Page 2 of 11 The World Bank Implementation Status & Results Report KOMPAS - Kosovo Comprehensive Approach to Health System Strengthening (P179831) 6. RESULTS 6.1 PDO Indicators by PDO Outcomes 1. Strengthen key health system building blocks for quality of care Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Ratings on a five-point scale 1 Jan/2024 1 03-Oct-2024 1 10-Apr-2025 3 Mar/2029 for indicators in the CAESAR Comments on project not yet effective Network Assessment achieving targets (Number) Ratings on a five-point 1 Jan/2024 1 03-Oct-2024 1 10-Apr-2025 3 Mar/2029 scale for indicator #8 Comments on project not yet effective (IPC in human health achieving targets care) (Number) Ratings on a five-point 1 Jan/2024 1 03-Oct-2024 1 10-Apr-2025 3 Mar/2029 scale for indicator #9 Comments on project not yet effective (Optimizing achieving targets antimicrobial use in human health) (Number) PHC facilities and hospitals 0 Jan/2024 0 03-Oct-2024 0 10-Apr-2025 80 Mar/2029 reporting on a set of Comments on project not yet effective Numerator: Total number of facilities (PHC facilities/hospitals) nationally adopted QoC achieving targets which produced a quality indicator report at least quarterly and shared it in the public indicators in the public domain. domain (Percentage) Denominator: Total number of facilities (PHC/hospitals) from KAS. 0 0 0 88 May 12, 2025 Page 3 of 11 The World Bank Implementation Status & Results Report KOMPAS - Kosovo Comprehensive Approach to Health System Strengthening (P179831) Hospitals reporting on Comments on project not yet effective a set of nationally achieving targets adopted QoC indicators in the public domain (Percentage) PHCs reporting on a set 0 Jan/2024 0 03-Oct-2024 0 10-Apr-2025 80 Mar/2029 of nationally adopted Comments on project not yet effective QoC indicators in the achieving targets public domain (Percentage) 2. Develop an integrated health information system Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year 0 Jan/2024 0 02-Oct-2024 0 10-Apr-2025 90 Mar/2029 Comments on project not yet effective Hospital outpatient specialist achieving targets visits with electronic referrals Numerator: Total number of hospital outpatient specialist (non-emergency) visits which (Percentage) were facilitated with an electronic referral. Denominator: Total number of hospital outpatient specialist (non-emergency) visits. 6.2 Intermediate Results Indicators by Components 1. Strengthening key health system building blocks for quality of care Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year 0 Mar/2024 0 03-Oct-2024 0 10-Apr-2025 14 Mar/2029 May 12, 2025 Page 4 of 11 The World Bank Implementation Status & Results Report KOMPAS - Kosovo Comprehensive Approach to Health System Strengthening (P179831) Comments on Number of UCCK hospital departments/regional hospitals participating in the AMR KHUCS clinics and General achieving targets stewardship program. Hospitals participating in the This SOPs for this program have been approved. The program will first be implemented in AMR stewardship program seven departments of UCCK (ICU adult, neonatal ICU, pediatrics, infectious disease, lung (Number) disease, surgery). It will be expanded to high-risk departments of regional hospitals. 0 Mar/2024 0 03-Oct-2024 0 10-Apr-2025 3,600 Mar/2029 Health workers trained in good Comments on Improved knowledge by health workers of good AMR, HAI and HCWM practices is key to AMR, HAI and HCWM achieving targets improving results in this area. This indicator would measure the cumulative number of practices (Number) health workers trained in any of the topics (AMR, HAI and HCWM) under the project. 0 Mar/2024 0 03-Oct-2024 0 10-Apr-2025 8 Mar/2029 Annual National and Regional Comments on Annual health forums which include citizen engagement and empowerment are a key Health Forums (including achieving targets activity to promote a quality-of-care culture throughout the health system. This indicator formalized citizen engagement would measure the cumulative number of national and regional health forums which and empowerment) included formalized citizen engagement and empowerment aspects as an integral part of (Number) the forum design. 0 Mar/2024 0 03-Oct-2024 0 10-Apr-2025 6 Mar/2029 Annual Regional Health Comments on project not yet effective Forums (Number) achieving targets 0 Mar/2024 0 03-Oct-2024 0 10-Apr-2025 2 Mar/2029 Annual National Health Comments on project not yet effective Forums (Number) achieving targets 0 Jan/2024 0 03-Oct-2024 0 10-Apr-2025 2 Mar/2029 Adoption of National Health Comments on National Health Resolutions will be adopted as an outcome of National Health Forums to Resolutions developed achieving targets address local feedback. Such multi-level platforms can help consolidate the voice of citizens through consultative citizen and and stakeholders from the bottom to the national level and give them more leverage in feedback (Number) influencing policies and monitoring policy implementation. 4 Dec/2023 4 03-Oct-2024 4 10-Apr-2025 110 Mar/2029 May 12, 2025 Page 5 of 11 The World Bank Implementation Status & Results Report KOMPAS - Kosovo Comprehensive Approach to Health System Strengthening (P179831) Clinical practice Comments on Cumulative number of clinical practice guidelines, protocols and/or clinical pathways that guidelines/protocols/pathways achieving targets have been developed and approved. As of December 2023, 25 guidelines and protocols developed and approved have been developed with approval planned for 2024. An additional 21 guidelines and 10 (Number) protocols are planned to be developed in 2025. Health care workers attended 0 Mar/2024 0 03-Oct-2024 0 10-Apr-2025 2,500 Mar/2029 at least one in-service training Comments on Cumulative number of health workers who have attended at least one in-service training in in QoC in the past year achieving targets quality-of-care financed by the project. Excludes training in AMR, HAI, and HCWM practices, (Number) which is expected to be captured separately by indicator 1.2. PHC clinical audits and 0 Mar/2024 0 03-Oct-2024 0 10-Apr-2025 30 Mar/2029 feedback conducted by PHC Comments on Number of clinical audits (including feedback) that have been performed each year in PHC coordinators in the past year achieving targets facilities using the manual. using the new PHC clinical audit and feedback manual (Number) Health inspectors trained in 0 Mar/2024 0 03-Oct-2024 0 10-Apr-2025 100 Mar/2029 the new inspection standards Comments on Cumulative number of health inspectors who have been trained in the new standards under (Number) achieving targets the project. 0 Mar/2024 0 03-Oct-2024 0 10-Apr-2025 100 Mar/2029 Number of drugs included in Comments on As part of the limited set of health financing activities (awaiting adoption of new the ODBP (Number) achieving targets legislation), support will be provided for the implementation of the OPDBP. This indicator measures the number of outpatient drugs which are included as part of the benefit plan. Health workers and associated 153 Jan/2024 153 03-Oct-2024 153 10-Apr-2025 550 Mar/2029 professionals trained with the Comments on This indicator measures progress of trained healthcare workers and associated knowledge to recognize, achieving targets professionals, such as social workers, in selected facilities and who gain the knowledge to medically manage (as recognize and refer GBV victims and refer them for onward care. It builds off of work under applicable), and refer GBV P 173819, under which 86 doctors and 67 nurses (153 total staff) were trained as of January cases to appropriate services 2024. (Number) 0 Jan/2024 0 03-Oct-2024 0 10-Apr-2025 TBD Mar/2029 May 12, 2025 Page 6 of 11 The World Bank Implementation Status & Results Report KOMPAS - Kosovo Comprehensive Approach to Health System Strengthening (P179831) People benefitting from Comments on The number of people benefitting directly and indirectly from improvements in countries’ strengthened capacity to achieving targets capacity to prevent, detect, and respond to health emergencies. It will consider how prevent, detect, and respond interventions enhance the capacity of health systems to prevent, detect, and respond to to health emergencies outbreaks, and the projected individual benefit that is likely to come from Project (Number) investments. 2. Developing an integrated health information system Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year 0 Jan/2024 0 03-Oct-2024 0 10-Apr-2025 TBD Mar/2029 Comments on The number of people, public sector locations, and businesses who use new or enhanced People using digitally-enabled achieving targets digitally enabled services. This includes new digitally delivered services, previously- health services (Number) manual/analog services that are enhanced through digitalization, as well as enhancements to existing digitally delivered services. No Mar/2024 No 03-Oct-2024 No 03-Oct-2024 Yes Mar/2029 A digital health governance Comments on Implementation of IHIS is complex program that requires clear institutional responsibilities structure has been established achieving targets at least on: (i) policy and regulatory framework, (ii) executive implementation (Yes/No) management, and (iii) health data governance. This indicator measures whether a key prerequisite - the digital health governance structure - is in place. 0 Mar/2024 0 03-Oct-2024 0 03-Oct-2024 8 Mar/2029 Comments on This indicator measures how many of these registries have been created in an appropriate Foundational registries achieving targets electronic format. At minimum, the following foundational registries will be established as established (Number) electronic, online systems: Master Patient Index, registry of health facilities, registry of health professionals, diagnostic and procedure coding systems, and drugs coding and classification. 11.60 Mar/2024 11.60 03-Oct-2024 11.60 03-Oct-2024 95 Mar/2029 Primary care visits registered Comments on Percent of total primary care visits that are registered in the BHIS (among the 29 in the BHIS (Percentage) achieving targets municipalities that are currently using the system). Numerator: number of primary care visits registered in the BHIS. May 12, 2025 Page 7 of 11 The World Bank Implementation Status & Results Report KOMPAS - Kosovo Comprehensive Approach to Health System Strengthening (P179831) Denominator: number of primary care visits in the relevant municipalities as reported by NIPH. 32.80 Mar/2024 32.80 03-Oct-2024 32.80 03-Oct-2024 95 Mar/2029 Comments on Percent of PHC facilities (among the 29 municipalities that are currently using the system) PHC facilities that have fully achieving targets which have addressed these issues and have a fully functional BHIS. functional BHIS (Percentage) Numerator: number of PHC facilities which have deployed the upgraded BHIS and fully addressed connectivity and hardware issues. Denominator: total number of PHC facilities in the relevant municipalities. 0 Mar/2024 0 03-Oct-2024 0 03-Oct-2024 30 Mar/2029 Comments on Cumulative number of clinical pathways that have been coded into BHIS. Electronic care pathways achieving targets Adherence to clinical care pathways to maintain standards of clinical care is most effective integrated in BHIS (Number) when integrated into the BHIS. This indicator monitors the integration of these pathways into the BHIS. 0 Mar/2024 0 03-Oct-2024 0 03-Oct-2024 12,000 Mar/2029 Health workers trained in Comments on Cumulative number of health workers, administrative, managerial, and technical facility enhanced BHIS and HMIS achieving targets personnel trained in the new information systems (HMIS, BHIS and change management) (Number) under the project. 0 Mar/2024 0 03-Oct-2024 0 03-Oct-2024 37 Mar/2029 Comments on Installed and in operation: (a) clinical information can be entered at the bedside in over Regional Hospitals and UCCK achieving targets 50% of hospital beds currently in use; (b) over 50% of the specialist physicians working in clinics that have HMIS installed the facility use the information system to enter clinical data on patient encounters; (c) over and in operation (Number) 50% of data capable laboratory analyzers are connected to the system and passing laboratory results into patient files. Number of Regional 0 Mar/2024 0 03-Oct-2024 0 03-Oct-2024 7 Mar/2029 Hospitals that have HMIS installed and in operation (Number) Number of UCCK clinics 0 Mar/2024 0 03-Oct-2024 0 03-Oct-2024 30 Mar/2029 that have HMIS installed May 12, 2025 Page 8 of 11 The World Bank Implementation Status & Results Report KOMPAS - Kosovo Comprehensive Approach to Health System Strengthening (P179831) and in operation (Number) May 12, 2025 Page 9 of 11 The World Bank Implementation Status & Results Report KOMPAS - Kosovo Comprehensive Approach to Health System Strengthening (P179831) 7. DATA ON FINANCIAL PERFORMANCE 7.1 Cumulative Disbursements 7.2 Disbursements (by loan) Loan/Credit/TF Status Original Revised Cancelled Disbursed Undisbursed % Disbursed Not IDA-75410 20.00 19.92 0.00 0.00 19.92 0% Effective 7.3 Key Dates (by loan) Loan/Credit/TF Status Approval Signing Effectiveness Orig. Closing Rev. Closing Not IDA-75410 07-May-2024 28-Jun-2024 31-Mar-2029 31-Mar-2029 Effective May 12, 2025 Page 10 of 11 The World Bank Implementation Status & Results Report KOMPAS - Kosovo Comprehensive Approach to Health System Strengthening (P179831) 8. KEY DATES Key Events Planned Actual Approval 07-May-2024 07-May-2024 Effectiveness 15-Jul-2024 Mid-Term Review No. 01 22-Feb-2027 Operation Closing/Cancellation 31-Mar-2029 9. RESTRUCTURING HISTORY 10. ASSOCIATED OPERATION(S) There are no associated operations May 12, 2025 Page 11 of 11