The World Bank Implementation Status & Results Report Samoa Health System Strengthening Program (P164382) Samoa Health System Strengthening Program (P164382) EAST ASIA AND PACIFIC | Samoa | Health, Nutrition & Population Global Practice | Requesting Unit: EAPCF (6680) | Responsible Unit: HEAH1 (9317) IBRD/IDA | Program-for-Results Financing | FY 2020 | Team Leader(s): Kari L. Hurt, Tonny Brian Mungai Muthee Seq No: 8 | Archived on 18-Aug-2024 | ISR01326 | Created by: Kari L. Hurt on 17-Jul-2024 | Modified by: Martha P. Vargas on 14-Aug-2024 1. PROJECT DEVELOPMENT OBJECTIVE 1.1 Development Objective Original Development Objective (Approved as part of Approval package on 05-Dec-2019) The Program Development Objective (PDO) is to improve the quality and efficiency of NCD prevention and control in Samoa. Current Development Objective (Approved as part of Additional Financing package Seq. 1 on 05-Apr-2023) The Program Development Objective (PDO) is to improve the quality and efficiency of NCD prevention and control in Samoa. 2. OVERALL RATINGS Name Previous Current Progress towards achievement of PDO Moderately Satisfactory Moderately Satisfactory Overall Implementation Progress (IP) Moderately Satisfactory Moderately Satisfactory Overall Risk Rating Moderate Moderate 3. KEY ISSUES & STATUS 3.1 Implementation Status and Key Decisions 4. DATA ON FINANCIAL PERFORMANCE Apr 12, 2025 Page 1 of 19 The World Bank Implementation Status & Results Report Samoa Health System Strengthening Program (P164382) 4.1 Disbursements (by loan) Loan/Credit/TF Status Original Revised Cancelled Disbursed Undisbursed % Disbursed IDA-D5270 Effective 9.30 9.07 0.00 4.35 4.90 46.99% TF-C0742 Effective 1.29 1.29 0.00 0.00 1.29 0% 4.2 Key Dates (by loan) Loan/Credit/TF Status Approval Signing Effectiveness Orig. Closing Rev. Closing IDA-D5270 Effective 05-Dec-2019 28-Feb-2020 27-May-2020 31-Dec-2025 31-Dec-2027 TF-C0742 Effective 05-Apr-2023 19-Apr-2023 01-May-2023 31-Dec-2027 31-Dec-2027 4.3 Program Action Plan 1. Develop a systematic M&E framework for NCD control program and implement Action Description throughout the Program implementation. Source DLI# Responsibility Timing Timing Value Status Recurrent. The framework be adopted no later than three Technical NA MOH Other months after In Progress Effective date and be implemented accordingly thereafter. Completion The draft M&E framework to be submitted to the World Bank for review no later than one Measurement month after Program effectiveness date. The draft M&E framework has been submitted to the Bank for review, and was returned for Comments revision and update to incorporate the latest progress, such as the progress of the e-Health system in the country including patient tracking system and m-Supply. Apr 12, 2025 Page 2 of 19 The World Bank Implementation Status & Results Report Samoa Health System Strengthening Program (P164382) 2. Complete, issue and adopt the updated oganizational structure of MOH, which includes at Action Description least one functional unit, to be responsible for procurement, with mandate, composition, and resources. Source DLI# Responsibility Timing Timing Value Status Updated organizational structure of MOH Technical NA MOH Other be adopted no Completed later than three months after Effective Date. Completion Submit to the Association the updated organizational structure of MOH for information. Measurement The procurement unit has been established and confirmed, however, the detailed positions Comments for each of the divisions under the new organizational structure are still pending, so Government is yet to share the final structure. Action Description 14. Ensure sufficient capacity for the Program implementation Source DLI# Responsibility Timing Timing Value Status Technical NA MOH Due Date 30-Jun-2023 In Progress Multi-year (3 years) Contract with the international Procurement consultant signed by May Completion 31, 2023. Measurement Multi-year (3 years) Contract with the PEN Fa’ a Samoa Physician signed by June 30, 2023. New action, added with AF. Contract for the procurement consultant has been signed; PEN Comments Fa’ a Samoa Physician will need to be readvertised after another unsuccessful recruitment process. The job description and specifications are being reviewed. 3. Create a new budget line item for Program identification under "Transactions on Behalf of Action Description the State" Category of MOH’s Budget, so that the country's financial information system can generate annual Program Budget & Expenditure Reports. Source DLI# Responsibility Timing Timing Value Status Fiduciary Systems NA MOH and MOF Recurrent Yearly Completed The system and the chart of account have been updated adding the program Identifier, and Completion are being used to generate the Program-specific annual budget and expenditure reports Measurement thereafter. Comments Completed Apr 12, 2025 Page 3 of 19 The World Bank Implementation Status & Results Report Samoa Health System Strengthening Program (P164382) 3. Personnel expenditures and indirect costs will be allocated to the Program in accordance Action Description with POM. Source DLI# Responsibility Timing Timing Value Status Fiduciary Systems NA MOH and MOF Recurrent Yearly Completed Completion The system and the chart of account are updated by May 31, 2020, and are being used to Measurement generate the Program-specific annual budget and expenditure reports thereafter. Comments This is recurrent work that MOH needs to update routinely during implementation 4. Ensure two performance audits for the Program are provided: one at the Program mid- Action Description term review and another by no later than 6 months before Program Closing Date. Source DLI# Responsibility Timing Timing Value Status Two audits during the implementation. Fiduciary Systems NA MOF and MOH Other Delayed Mid-term and 6 months before Closing Date. Completion Audit report to be submitted to the Association 3 months after the Audit is completed Measurement Comments MOF and MOH are processing the TOR for the Performance Audit. Action Description 5.Ensure an audit opinion on the full scope of the Program Financial Statements is provided Source DLI# Responsibility Timing Timing Value Status Fiduciary Systems NA MOF and MOH Recurrent Yearly Not Yet Due Completion As demonstrated in the audited Financial Statement of the Program. Measurement The MOF submitted the audit opinion on June 30, 2023, as agreed, which was accepted by Comments the Bank on July 10, 2023. Action Description 6. Include and implement detailed procurement capacity building program under DLI6. Source DLI# Responsibility Timing Timing Value Status Fiduciary Systems NA MOH Recurrent Yearly Delayed Provide a summary in the semi-annual progress report on: Completion Procurement training provided or received including number of MOH staff completing formal Measurement procurement training (online, face to face). Apr 12, 2025 Page 4 of 19 The World Bank Implementation Status & Results Report Samoa Health System Strengthening Program (P164382) Comments MOH has yet to update and share the procurement capacity-building plan. 7. Ensure transparency of Procurement related actions by a) Publishing Program annual Action Description procurement plan on both MOF and MOH websites; b) Publishing on the MOF website the contracts awarded under the Program. Source DLI# Responsibility Timing Timing Value Status Fiduciary Systems NA MOH and MOF Recurrent Yearly Delayed Publication of Program annual procurement plan on both MOF and MOH websites. Completion Contracts awarded under the Program published on the MOF website including the Measurement availability of historical contract-award information (prior Financial Years). MOH published its annual procurement plan without cost estimates on the MOH and MOF Comments websites but has yet to share the link with the Bank. 8. Implement and ensure the operation of the Pharmaceutical Logistics Information Action Description Management System, which will be used to procure the NCD drugs. Source DLI# Responsibility Timing Timing Value Status Fiduciary Systems NA MOH and MOF Other June 30, 2020 Completed Completion The Association will conduct site investigation upon confirmation from the MOH of the Measurement system operationalization. The mSupply system has been rolled out to all public health facilities. Relevant staff continue Comments to be trained to enter data into the system and use the system to request delivery of medicines to the RDHs. 12. Manage Social impacts by (a) Implementing the grievance process and (b) Considering Action Description the vulnerable groups. Source DLI# Responsibility Timing Timing Value Status Environmental and NA MOH Recurrent Semi-Annually In Progress Social Systems Submission to the Association in the semi-annual progress report: Completion a) Evidence of implementation of grievance process, including report on the number of Measurement grievances received, timeliness of resolutions. b) Evidence that all capacity building and train To update Complaints and Grievance Policy 2015 to handle cases of SEA/SH and VAC to be Comments submitted to the Association for review, following January 2024 discussion. 9. Procure and commission waste management/treatment infrastructure as recommended Action Description by the HCWM review. Apr 12, 2025 Page 5 of 19 The World Bank Implementation Status & Results Report Samoa Health System Strengthening Program (P164382) Source DLI# Responsibility Timing Timing Value Status Environmental and By December 31, NA MOH Other In Progress Social Systems 2020 Completion Waste management/treatment infrastructure commissioned and operational, as evidenced Measurement by satisfactory audit findings. The construction contract for the simple housing of the incinerator was signed on April 18, Comments 2023 and design works are complete. Construction to be completed in first half of 2024. 10. Develop/update and implement the Implementation Plan of HCWM Policy and HCWM Action Description Strategy. Source DLI# Responsibility Timing Timing Value Status Environmental and NA MOH Recurrent Yearly In Progress Social Systems a) By August 31, 2023: formulate National HCWM Strategy Implementation plan and Completion implement. b) Year 4-7: implement measures identified though annual external auditing c) Measurement The TOR of the external auditing is to be submitted to the for review Aug 31 2023 Comments In progress. HCWM consultant to support this work contracted as of November 2023. 11. HCWM Staff receive training on HCWM, OSH and environmental health as part of HPAC- Action Description approved Annual Capacity Building Plan (DLI6). Source DLI# Responsibility Timing Timing Value Status Environmental and NA MOH Recurrent Yearly In Progress Social Systems Completion Report in the semi-annual progress report the HCWM/environment health training received Measurement including number of MOH staff completing training (online, face to face and etc.). Intensive HCWM training related to Covid19 preparations and prevention has been Comments undertaken since early 2020. Professional development related to OHS and Environmental Health have been included in the capacity building Plan for Year 2. 12. Manage Social impacts by (a) Implementing the grievance process and (b) Considering Action Description the vulnerable groups. Source DLI# Responsibility Timing Timing Value Status Environmental and NA MOH Recurrent Semi-Annually Delayed Social Systems Completion c) Update of the MOH Complaints and Grievance Policy 2015 to handle cases of SEA/SH and Measurement VAC to be submitted to the Association for review no later than December 1, 2023 Apr 12, 2025 Page 6 of 19 The World Bank Implementation Status & Results Report Samoa Health System Strengthening Program (P164382) Comments Still in progress as of MTR. 13. Land access- For any proposed site where land leases are required which has not Action Description previously been in the control of MOH. (a) undertake screening for impacts including brief assessment of physical and livelihood impacts. Source DLI# Responsibility Timing Timing Value Status Environmental and NA MOH and MNRE Recurrent Semi-Annually Not Yet Due Social Systems Land access information (if any) to be reported in the semi-annual program progress report, Completion including lease agreement letters signed by land owners, compensation agreement and Measurement payment, records of impact screening. Comments Not yet due. 13. Land access- For any proposed site where land leases are required which has not Action Description previously been in the control of MOH. (b) Consultation with the land owner is required and must be documented. Source DLI# Responsibility Timing Timing Value Status Environmental and NA MOH and MNRE Recurrent Semi-Annually Not Yet Due Social Systems Completion The Association will review the records and may conduct on-site review during the Measurement implementation support missions. Comments Not yet due. 13. Land access-For any proposed site where land leases are required which has not Action Description previously been in the control of MOH. (c) Evidence of compensation arrangements including assessment of value, payment of compensation consultation with affected land Source DLI# Responsibility Timing Timing Value Status Recurrent. Report Environmental and NA MOH and MNRE Other where there is Not Yet Due Social Systems land acquisition. Completion The Association will review the records and may conduct on-site review during the Measurement implementation support missions. Comments No land acquisition is needed at this moment. 15. Ensure sufficient capacity support for implementation of HCWM Strategy through the Action Description DLI (international HCWM consultant) Apr 12, 2025 Page 7 of 19 The World Bank Implementation Status & Results Report Samoa Health System Strengthening Program (P164382) Source DLI# Responsibility Timing Timing Value Status Environmental and NA MOH Due Date 31-May-2023 Completed Social Systems Completion Contract with the international HCWM consultant signed by May 31, 2023. Measurement Comments HCWM consultant commenced in November 2023 and has been engaged. 5. KEY DATES Key Events Planned Actual Approval 05-Dec-2019 05-Dec-2019 Effectiveness 27-May-2020 27-May-2020 Mid-Term Review No. 01 05-Aug-2024 Operation Closing/Cancellation 31-Dec-2027 6. SYSTEMATIC OPERATIONS RISK-RATING TOOL Rating at Approval Last Approved Rating Risk Category Approval Package - ISR Seq. 07 - 12 Feb Proposed Rating 05 Dec 2019 2024 Political and Governance Substantial Moderate Moderate Political and Governance Substantial Moderate Moderate Macroeconomic Moderate Moderate Moderate Sector Strategies and Policies Moderate Moderate Moderate Sector Strategies and Policies Moderate Moderate Moderate Technical Design of Project or Program Moderate Moderate Moderate Technical Design of Project or Program Moderate Moderate Moderate Apr 12, 2025 Page 8 of 19 The World Bank Implementation Status & Results Report Samoa Health System Strengthening Program (P164382) Institutional Capacity for Implementation and High Substantial Substantial Sustainability Institutional Capacity for Implementation and High Substantial Substantial Sustainability Fiduciary Substantial Substantial Substantial Fiduciary Substantial Substantial Substantial Environment and Social Moderate Moderate Moderate Stakeholders Moderate Moderate Moderate Overall High Moderate Moderate Apr 12, 2025 Page 9 of 19 The World Bank Implementation Status & Results Report Samoa Health System Strengthening Program (P164382) 7. RESULTS 7.1 PDO Indicators by PDO Outcomes Result Area 1. Address behavioral risk factors through population-based health promotion Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year 1.Percentage of children ages 0.00 Jan/2018 0.00 30-Sep-2022 0.00 30-Sep-2022 80.00 Jun/2027 5-12 years, screened as Comments on Numerator: Number of children classified as overweight, referred and managed under a overweight through school achieving targets health promotion program. Denominator: Total number of children aged 5 -12 years HEAL program, who are screened in school as overweight. referred to and managed under a health promotion program (Percentage) Result Area 2. Increase screening, referral and diagnosis of NCD high-risk group and NCD patients Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year 4. Number of districts with 2.00 Jan/2018 10.00 30-Sep-2022 10.00 30-Sep-2022 34.00 Jun/2027 PEN Fa’a Samoa rolled out Comments on according to the updated achieving targets The district has to meet the conditions that at least 70% of citizens, and at least 60% of men, protocol (at least 70% of aged 20 years old and older in the district has been screened, to qualify this indicator. citizens, and at least 60% of men, aged 20 years old and older in the district screened) (Number) 5. Percentage of NCD high 0.00 Jan/2018 44.00 30-Sep-2022 44.00 30-Sep-2022 70.00 Jun/2027 risk people, identified Comments on through Pen Fa’a Samoa achieving targets Numerator: Number of NCD high risk people identified, presented to a health facility within Apr 12, 2025 Page 10 of 19 The World Bank Implementation Status & Results Report Samoa Health System Strengthening Program (P164382) screening, who are 60 days for diagnosis Denominator: Total number of residents screened as high-risk group diagnosed within 60 days at for NCDs. designated health facility (Percentage) Result Area 3. Strengthen primary care and quality of NCD management Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year 7. Percentage of 19.00 Jan/2018 27.00 30-Sep-2022 27.00 30-Sep-2022 60.00 Jun/2027 hypertensive patients, Comments on Numerator: number of hypertensive patients, managed by the district hospitals following managed by rural health achieving targets standardized disease management protocols, who have their blood pressure under control. facilities, who have their WHO definition will be used to define the blood pressure is under control. condition under control Denominator: number of hypertensive patients, managed by the district hospitals following following WHO definition standardized disease management protocols. (Percentage) Result Area 4. Strengthen multisectoral NCD program stewardship and build institutional capacity Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year 15.00 Jan/2018 0.20 30-Sep-2022 0.20 30-Sep-2022 Annual Jun/2027 increase 14. Percentage of health compared to sector budget allocated to previous year primary health care and health promotion (Text) Comments on Numerator: annual health sector budget allocated to primary health care and health achieving targets promotion Denominator: total health sector budget The end target is the percentage increase every year 7.2 Intermediate Results Indicators by Results Areas Apr 12, 2025 Page 11 of 19 The World Bank Implementation Status & Results Report Samoa Health System Strengthening Program (P164382) Result Area 1. Address behavioral risk factors through population-based health promotion Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year 2. Percentage of residents in 0.00 Jan/2018 97.00 30-Sep-2022 97.00 30-Sep-2022 70.00 Jun/2027 Pen Fa’ a Samoa districts Comments on Numerator: total number of screened residents who have improved knowledge and with improved knowledge achieving targets awareness. and awareness of NCD risk Denominator: total number of residents screened. factors, disaggregated by gender (Percentage) of which females 0.00 Jan/2018 97.00 30-Sep-2022 97.00 30-Sep-2022 75.00 Dec/2027 (Percentage) of which males 0.00 Jan/2018 98.00 30-Sep-2022 98.00 30-Sep-2022 70.00 Dec/2027 (Percentage) 3. Percentage of primary 0.00 Jan/2018 60.00 30-Sep-2022 60.00 30-Sep-2022 50.00 Jun/2027 schools, identified in the Comments on previous year inspection as achieving targets Numerator: number of primary schools, identified in the previous year inspection as non- non-compliant with School compliant with School Nutrition Standards, becoming compliant. Denominator: total number Nutrition Standards, of primary schools identified in the previous year inspection as non-compliant with Shool becoming compliant. Nutrition Standards. (Percentage) Result Area 2. Increase screening, referral and diagnosis of NCD high-risk group and NCD patients. Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year 6. Percentage of non-NCD 0.00 Jan/2018 0.00 30-Sep-2022 0.00 30-Sep-2022 65.00 Jun/2027 patients aged 20 and above, Comments on Numerator: number of non-NCD patients aged 20 and above screened at rural health facility who present to a rural health achieving targets for NCDs Denominator: total number of non-NCD patients aged 20 and above presented at facility, screened for NCD rural health facility annually (Percentage) Result Area 3. Strengthen primary care and quality of NCD management Apr 12, 2025 Page 12 of 19 The World Bank Implementation Status & Results Report Samoa Health System Strengthening Program (P164382) Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year 8. Number of rural district 0.00 Jan/2018 3.00 30-Sep-2022 3.00 30-Sep-2022 8.00 Jun/2024 hospitals/health centers with Comments on a multi-disciplinary team in achieving targets Number of rural district hospitals staffed with multidisciplinary team according to the place (Number) defined TORs. 9. Percentage increase of the to be defined Sep/2022 n/a 30-Sep-2022 n/a 30-Sep-2022 Baseline +60% Jun/2027 essential technologies list in Y3 equipped in RDHs with MDTs Comments on Percentage increase is measured by comparison of % of the essential list equipped on in place (Text) achieving targets certain year against the % of previous year. 10. Percentage of people, 0 Jan/2018 not yet 30-Sep-2022 not yet 30-Sep-2022 65 Jun/2027 identified as high-risk available available through screening, tracked Comments on Numerator: number of NCD high-risk people tracked and managed by rural health facilities and managed by rural health achieving targets following standardized protocols Denominator: total number of people, identified as high- facilities following risk through screening standardized protocols (Text) 40.00 Jan/2018 not yet 30-Sep-2022 not yet 30-Sep-2022 <20% Jun/2027 11. (Reduction of) Stock-outs available available (more than 2 weeks) of all Comments on Numerator: number of essential medicines in rural health facilities that were out of stock for essential drugs in rural health achieving targets more than 4 months in a year Denominator: total number of essential medicines in rural facilities (Text) health facilities in accordance with Essential Medicines List.No data 12. Percentage of patients in 35.00 Sep/2022 0.00 30-Sep-2022 0.00 30-Sep-2022 65.00 Jun/2027 the diabetes registry tracked Comments on and managed by rural health achieving targets Numerator: number of registered diabetic patients followed up and managed by rural health facilities following facilities Denominator: total number of registered diabetic patients Following the protocol standardized disease includes 1) at least one visit a quarter to the rural health facility(or was visited by MDT team management protocols, through outreach services) to follow up on diabetes; 2) take the Hba1c test every quarter 3) Apr 12, 2025 Page 13 of 19 The World Bank Implementation Status & Results Report Samoa Health System Strengthening Program (P164382) disaggregated by gender BMI is measured 4) nutrition and health education: exchange knowledge on NCD risk factors, (Percentage) nutrition and healthy diet, active living and etc, check on patients' behavior related with NCD risk factors. Of which females 35.00 0.00 0.00 65.00 (Percentage) Of which males 35.00 0.00 0.00 65.00 (Percentage) 13. Percentage of diabetic N/A Jan/2018 not yet 30-Sep-2022 not yet 30-Sep-2022 40 Jun/2027 patients, managed by rural available available health facilities, having their Comments on Numerator is number of the diabetic patients having their glucose level under control blood glucose under control achieving targets following WHO definition; following WHO definition, disaggregated by gender Denominator is the total number of the diabetic patients that are in the diabetes registry (Text) and are under case management by the rural district hospita; Of which females N/A N/A N/A 40.00 (Text) Of which males (Text) N/A N/A N/A 40.00 Result Area 4. Strengthen multisectoral NCD program stewardship and build institutional capacity Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year 0.00 Jan/2018 73.00 30-Sep-2022 73.00 30-Sep-2022 70.00 Jun/2027 15. Implementation Comments on Numerator: number of capacity building activities in the Annual Capacity Building Plan that completion rate of Annual achieving targets have been fully implemented and completed according to the completion format / standard Capacity Building Plan for defined in the Plan. NCD program approved by the HPAC (Percentage) Denominator: number of capacity building activities defined in the Annual Capacity Building Plan for NCD program approved by the Samoa Health Program Advisory Committee (HPAC). 0.00 Sep/2022 0.00 30-Sep-2022 0.00 30-Sep-2022 40.00 Jun/2027 Apr 12, 2025 Page 14 of 19 The World Bank Implementation Status & Results Report Samoa Health System Strengthening Program (P164382) 16. Number of Healthcare Comments on Number of health facilities generating healthcare waste in Samoa that have developed the Waste Management achieving targets Healthcare Waste Management Implementation Plans and adopted in daily practice. Implementation Plans developed and adopted by health facilities generating healthcare waste in Samoa (Number) 17.Percentage of program- 0.00 Nov/2022 0.00 30-Nov-2022 0.00 30-Nov-2022 70.00 Jun/2027 related grievances addressed Comments on Out of all the program-related grievances received, the % of them that were addressed within 30 days (Percentage) achieving targets within 30 days from time of receipt. 7.3 Disbursement Linked Indicators (DLI) Actual (Previous) Actual (Current) PBC Name Baseline Closing Period Value Date Value Date 1:DLI 1: Percentage Value 0.00 0.00 0.00 80.00 of children ages 5- 12 years, screened as overweight through school HEAL program, Allocated 30-Sep-2022 30-Sep-2022 referred to and 0.00 0.00 480,000.00 Amount managed under a health promotion program (Percentage) DLI allocation 2,880,000.00 Apr 12, 2025 Page 15 of 19 The World Bank Implementation Status & Results Report Samoa Health System Strengthening Program (P164382) 2:DLI 2: Number of Value 2.00 10.00 10.00 34.00 districts with PEN Fa’a Samoa rolled out according to the updated protocol (at least 70% of Allocated 30-Sep-2022 30-Sep-2022 citizens and at least 0.00 0.00 350,000.00 60% of men, aged Amount 20 years old and older in the district screened). (Percentage) DLI allocation 2,240,000.00 3:DLI 3. Percentage Value 0.00 44.00 44.00 70.00 of high-risk people identified through PEN Fa'a Samoa screening are Allocated 30-Sep-2022 30-Sep-2022 diagnosed within 60 0.00 0.00 350,000.00 Amount days at designated health facility (Percentage) DLI allocation 2,200,000.00 4:DLI 4: Functional Value 0.00 3.00 3.00 8.00 Multi-Disciplinary Allocated 30-Sep-2022 30-Sep-2022 Teams (Number) 0.00 0.00 2,530,000.00 Amount DLI allocation 3,490,000.00 Value 0.00 3.00 30-Sep-2022 3.00 30-Sep-2022 8.00 Apr 12, 2025 Page 16 of 19 The World Bank Implementation Status & Results Report Samoa Health System Strengthening Program (P164382) 4.1:DLR 4.1: Number of rural district hospitals Allocated with a 0.00 0.00 0.00 Amount multidisciplinary team in place (Number) DLI allocation 960,000.00 4.2:DLR 4.2: Value n/a N/a N/a baseline+60% Percentage of essential technologies list Allocated 30-Sep-2022 30-Sep-2022 is equipped in 0.00 0.00 422,000.00 RDHs with Amount MDTs in place (Text) DLI allocation 2,692,000.00 5:DLI 5: Percentage Value 19.00 27.00 27.00 60.00 of hypertensive patients, managed by the rural health facilities, who have Allocated 30-Sep-2022 30-Sep-2022 their condition 0.00 0.00 497,520.00 under control Amount following WHO definition (Percentage) DLI allocation 2,446,140.00 Value 0.00 73.00 30-Sep-2022 73.00 30-Sep-2022 70.00 Apr 12, 2025 Page 17 of 19 The World Bank Implementation Status & Results Report Samoa Health System Strengthening Program (P164382) 6:DLI 6: Implementation completion rate of annual capacity Allocated 0.00 0.00 140,000.00 building plan for Amount NCD program approved by HPAC (Percentage) DLI allocation 960,000.00 7:DLI7: Percentage Value 35.00 0.00 0.00 65.00 of patients in the diabetes registry managed by rural health facilities following Allocated 30-Sep-2022 30-Sep-2022 standardized 0.00 0.00 390,000.00 disease Amount management protocols, disaggregated by gender (Percentage) DLI allocation 1,680,000.00 8:DLI 8: Number of Value 0.00 0.00 0.00 40.00 Healthcare Waste Management Implementation Allocated 30-Sep-2022 30-Sep-2022 Plans developed 0.00 0.00 200,000.00 and adopted by Amount health facilities generating Apr 12, 2025 Page 18 of 19 The World Bank Implementation Status & Results Report Samoa Health System Strengthening Program (P164382) healthcare waste in Samoa (Number) DLI allocation 800,000.00 Apr 12, 2025 Page 19 of 19