The World Bank Implementation Status & Results Report Kiribati Health Systems Strengthening Project (P176306) Kiribati Health Systems Strengthening Project (P176306) EAST ASIA AND PACIFIC | Kiribati | IBRD/IDA | Investment Project Financing (IPF) | FY 2022 | Seq No: 5 | Archived on 30- Sep-2024 | ISR00187 Implementing Agencies: Ministry of Health and Medical Services 1. OBJECTIVE 1.1 Development Objective Original Development Objective (Approved as part of Approval package on 03-Apr-2022) To improve equitable access and quality of health services in targeted areas and in case of an Eligible Crisis or Emergency, respond promptly and effectively to it. Has the Development Objective been changed since Board Approval of the Project Objective? No 2. COMPONENTS Name Component 1: Improving Equitable Access and Quality of Health Services on the Outer Islands:(Cost 4,800,000.00) Component 2: Strengthening Quality and Range of Services Provided Through Hospitals:(Cost 7,300,000.00) Component 3: Project Management and Health Information system Enhancement:(Cost 1,900,000.00) Component 4: Contingent Emergency Response Component:(Cost 0.00) 3. 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 Substantial Moderate 4. KEY ISSUES & STATUS Sep 30, 2024 Page 1 of 8 The World Bank Implementation Status & Results Report Kiribati Health Systems Strengthening Project (P176306) 4.1 Implementation Status and Key Decisions The Kiribati Health Systems Strengthening Project (HSSP) is making progress across its key components, including improving primary health care, upgrading outer island health facilities, and enhancing hospital services. A capacity assessment of 76 outer island health facilities is nearly complete, with renovations set to start in North Tarawa. Procurement of medical equipment for these facilities has been finalized, and additional training programs for health workers are being rolled out, including Gender-Based Violence training. The construction and delivery of the first Sea Ambulance to service the Gilbert Islands is on track for delivery by March 2024. Significant progress has been made on the Kiritimati Island District Hospital, with site preparation and UXO remediation expected to be completed by October 2024. Procurement for the hospital's design and supervision contract is underway. Infection prevention control and healthcare waste management efforts are also advancing, with equipment procurement set to commence in October 2024. 5. SYSTEMATIC OPERATIONS RISK-RATING TOOL Rating at Approval Last Approved Rating Risk Category Approval Package - ISR Seq. 04 - 05 Mar Proposed Rating 04 Apr 2022 2024 Political and Governance Moderate Moderate Moderate Macroeconomic Moderate Moderate Moderate Sector Strategies and Policies Moderate Moderate Moderate Technical Design of Project or Program Moderate Moderate Moderate Institutional Capacity for Implementation and Substantial Substantial Moderate Sustainability Fiduciary Substantial Substantial Substantial Environment and Social Substantial Substantial Substantial Stakeholders Low Low Low Overall Substantial Substantial Moderate Sep 30, 2024 Page 2 of 8 The World Bank Implementation Status & Results Report Kiribati Health Systems Strengthening Project (P176306) 6. RESULTS 6.1 PDO Indicators by PDO Outcomes Equitable access and quality of health services in the outer islands Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Percentage of women with a 70.50 Dec/2021 13.00 28-Feb-2024 N/A 05-Sep-2024 83 Sep/2028 live birth who received antenatal care four times or more (Percentage) Outer Islands 72 Sep/2024 TBD 72 05-Sep-2024 80 Sep/2028 (Percentage) South Tarawa 83 Sep/2024 TBD 83 05-Sep-2024 85 Sep/2028 (Percentage) Percentage of targeted outer 0 Dec/2021 74.00 28-Feb-2024 0 04-Sep-2024 100 Sep/2028 island health facilities that meet the minimum equipment and infrastructure needs as per Ministry of Health and Medical Services requirements (Percentage) Quality and range of health services in hospitals Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Construction, equipping, and No existing Dec/2021 No existing 01-Jun-2024 New KDH fully Sep/2028 Page 3 of 8 The World Bank Implementation Status & Results Report Kiribati Health Systems Strengthening Project (P176306) operational readiness of the facility at new facility at new constructed, new Kiritimati District KDH site KDH site equipped, and Hospital (KDH) to support operationally improved delivery of essential ready, with health services (Text) essential infrastructure, medical equipment, and staffing in place to provide essential health services Proportion of culture and 31.00 28-Feb-2024 17 05-Sep-2024 TBD Sep/2028 sensitivity samples tested positive for Multidrug- resistant organisms (MROs) at Tungaru Central Hospital (TCH), Tarawa (Percentage) 6.2 Intermediate Results Indicators by Components Component 1: Improving Equitable Access and Quality of Health Services on the Outer Islands Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Number of outer island clinics 0.00 Dec/2021 0.00 28-Feb-2024 8 05-Sep-2024 23.00 Sep/2028 connected to the main Page 4 of 8 The World Bank Implementation Status & Results Report Kiribati Health Systems Strengthening Project (P176306) hospital (tele-health) (NHSP CI-26) (Number) Number of integrated 2 Dec/2023 2 05-Sep-2024 10 Sep/2028 outreach programs conducted in the outer islands (cumulative) (Number) No sea Dec/2023 No existing 05-Sep-2024 Assessment of Sep/2028 ambulance dedicated sea pilot program ambulance effectiveness and service. development of Establishing and sustaining a recommendations fully operational sea for scaling the sea ambulance service in Gilbert ambulance Islands group (Text) service to other regions of Kiribati Comments on Indicator added to track completion and operationalization of the first sea ambulance in achieving targets Kiribati. Percentage of medical TBD 28-Feb-2024 29% 05-Sep-2024 80 Sep/2028 assistants trained on GBV to recognize, medically manage, and refer GBV survivors to appropriate services (Percentage) Component 2: Strengthening Quality and Range of Services Provided Through Hospitals Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Number of health workers 60 Dec/2023 60.00 28-Feb-2024 288 05-Sep-2024 500 Sep/2028 trained in infection prevention and control and Page 5 of 8 The World Bank Implementation Status & Results Report Kiribati Health Systems Strengthening Project (P176306) waste management as per IPC guidelines (cumulative) (Number) Component 3: Project Management and Health Information system Enhancement Baseline Actual (Previous) Actual (Current) Closing Period Indicator Name Value Month/Year Value Date Value Date Value Month/Year Number of core health 0 Dec/2021 0.00 28-Feb-2024 0.00 05-Sep-2024 14 Sep/2029 indicator dashboard updates for health program managers (linked to 6.4.3 NHSP) (Number) Health Sector Coordination No Dec/2021 No 05-Sep-2024 Yes Sep/2028 Committee (HSCC) meetings convened annually (Yes/No) Percentage of beneficiaries 0.00 Dec/2021 0.00 28-Feb-2024 0 05-Sep-2024 80 Sep/2028 who expressed satisfaction with the project interventions, disagregated by sex (Percentage) Women (Percentage) 0 Dec/2021 0.00 05-Sep-2024 80 Sep/2028 Percentage of grievances 0.00 Dec/2021 0.00 28-Feb-2024 0.00 05-Sep-2024 80.00 Sep/2028 reported through the GM that are resolved on time (Percentage) Page 6 of 8 The World Bank Implementation Status & Results Report Kiribati Health Systems Strengthening Project (P176306) 7. DATA ON FINANCIAL PERFORMANCE 7.1 Cumulative Disbursements 7.2 Disbursements (by loan) Loan/Credit/TF Status Original Revised Cancelled Disbursed Undisbursed % Disbursed Historical Disbursed IDA-D9880 Effective 14.00 14.00 0.00 1.71 11.86 12.24% 14.00 7.3 Key Dates (by loan) Loan/Credit/TF Status Approval Signing Effectiveness Orig. Closing Rev. Closing IDA-D9880 Effective 04-Apr-2022 24-Apr-2022 27-May-2022 31-Mar-2027 31-Mar-2027 8. KEY DATES Sep 30, 2024 Page 7 of 8 The World Bank Implementation Status & Results Report Kiribati Health Systems Strengthening Project (P176306) Key Events Planned Actual Approval 04-Apr-2022 04-Apr-2022 Effectiveness 15-Jun-2022 27-May-2022 Mid-Term Review No. 01 27-May-2025 Operation Closing/Cancellation 31-Mar-2027 9. RESTRUCTURING HISTORY 10. ASSOCIATED OPERATION(S) There are no associated operations Sep 30, 2024 Page 8 of 8