The World Bank Implementation Status & Results Report Strategic Purchasing and Alignment of Resources & Knowledge in Health Project (SPARK-Health) (P167959) Strategic Purchasing and Alignment of Resources & Knowledge in Health Project (SPARK-Health) (P167959) AFRICA WEST | Cote d'Ivoire | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2019 | Seq No: 4 | ARCHIVED on 30-Nov-2021 | ISR48254 | Implementing Agencies: Government of Côte d'Ivoire, Ministere de la Sante et de l'Hygiene Publique (MSHP) Key Dates Key Project Dates Bank Approval Date: 22-Mar-2019 Effectiveness Date: 18-Jul-2019 Planned Mid Term Review Date: -- Actual Mid-Term Review Date: Original Closing Date: 30-Jun-2025 Revised Closing Date: 30-Jun-2025 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) To improve the utilization and quality of health services towards reducing maternal and infant mortality in the Recipient's territory. 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) To improve the utilization and quality of health services towards reducing maternal and infant mortality, and to provide immediate and effective response to an eligible crisis or emergency, in the Recipient's territory. Components Table Name Scale-Up of Strategic Purchasing:(Cost $97.26 M) Health System Strengthening to Improve Performance:(Cost $70.71 M) Project Management:(Cost $12.02 M) Contingency Emergency Response:(Cost $40.00 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Moderately Satisfactory Moderately Satisfactory Overall Implementation Progress (IP) Moderately Unsatisfactory Moderately Satisfactory Overall Risk Rating Substantial Moderate Implementation Status and Key Decisions The project was approved on March 22, 2019, became effective on July 18, 2019 and is expected to close on June 30, 2025. On May 8, 2020, the Bank approved the activation of the CERC component of the project for an amount of US$40 million (Euro 36 million) to support the Government of Côte d’Ivoire’s (CIV) response to the COVID-19 pandemic. Since the last ISR of February 4, 2021, the Ministry of Health has accelerated the implementation of activities under each component of the Project. All PDO level indicators are trending in a positive direction, one PDO level indicator and four Intermediate Results Indicators have already reached the project end target. Despite the progress made, challenges remain in 11/30/2021 Page 1 of 8 The World Bank Implementation Status & Results Report Strategic Purchasing and Alignment of Resources & Knowledge in Health Project (SPARK-Health) (P167959) the implementation of the National Health Insurance Program (Couverture Maladie Universelle program; CMU) under Component 1, and consequently, the results indicator is lagging (number of poor and vulnerable supported by the CMU = 148,358; end of project target in June 2025 = 12,879,219). The Task Team will work closely with the Client to improve the operationalization of the CMU program. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance Substantial Substantial Low Macroeconomic Substantial Substantial Substantial Sector Strategies and Policies Moderate High Low Technical Design of Project or Program Substantial Substantial Moderate Institutional Capacity for Implementation and Substantial Moderate Moderate Sustainability Fiduciary Substantial Moderate Moderate Environment and Social Moderate Moderate Moderate Stakeholders Moderate Moderate Moderate Other -- -- -- Overall Substantial Substantial Moderate Results PDO Indicators by Objectives / Outcomes People who have received essential health, nutrition, and population (HNP) services IN01039618 ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target Value 723,244.00 1,315,750.00 2,297,644.00 4,398,683.00 Date 04-Jan-2019 01-Dec-2020 31-Aug-2021 30-Jun-2025 Current data for number of children immunized and number of deliveries by skilled personnel are much lower than expected, chiefly because of a change in the calculation method. The team is reviewing the Comments: methodology of these indicators and will update the figures and/or targets as soon as possible. IN01039621 Number of children immunized (Number, Corporate Breakdown) 11/30/2021 Page 2 of 8 The World Bank Implementation Status & Results Report Strategic Purchasing and Alignment of Resources & Knowledge in Health Project (SPARK-Health) (P167959) Baseline Actual (Previous) Actual (Current) End Target Value 234,095.00 164,738.00 269,211.00 1,525,326.00 Date 04-Jan-2019 01-Dec-2020 31-Aug-2021 30-Jun-2025 IN01039622 Number of deliveries attended by skilled health personnel (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 489,149.00 153,808.00 255,455.00 3,182,938.00 Date 04-Jan-2019 01-Dec-2020 31-Aug-2021 30-Jun-2025 Average Health Facility Quality Score IN01039619 ►Average Health Facility Quality Score (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 48.00 82.00 81.00 75.00 Date 30-Jun-2017 01-Dec-2020 31-Aug-2021 30-Jun-2025 The actual value corresponds to the current 21 districts under PBF. It is reasonable to expect that, once Comments: additional districts are covered by PBF, the actual value will decline. Utilization of Health Services IN01039617 ►Utilization of Health Services (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 39.00 44.00 43.00 60.00 Date 04-Jan-2019 01-Dec-2020 31-Aug-2021 30-Jun-2025 This value corresponds to the 21 current districts under PBF. It is reasonable to expect that, once Comments: additional districts are covered by PBF, the actual value will decline. The target for 2021 is 52%. Direct Project Beneficiaries (% Female) IN01039620 ►Direct Project Beneficiaries (% Female) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 3,459,597.00 5,825,255.00 59,270,770.00 Date 04-Jan-2019 01-Dec-2020 31-Aug-2021 30-Jun-2025 5,825,255 direct beneficiaries of which 3,320,395 are women (57%). Comments: 11/30/2021 Page 3 of 8 The World Bank Implementation Status & Results Report Strategic Purchasing and Alignment of Resources & Knowledge in Health Project (SPARK-Health) (P167959) Intermediate Results Indicators by Components Scale-up of Strategic Purchasing IN01039623 ►Number of Health Districts Covered (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 17.00 21.00 68.00 86.00 Date 30-Jun-2017 01-Dec-2020 31-Aug-2021 30-Jun-2025 This is the number of health districts for which all target health facilities were put under performance Comments: during a given period IN01039627 ►Number of Poor and vulnerable supported by the CMU (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 31,872.00 31,872.00 148,358.00 12,879,217.00 Date 04-Jan-2019 01-Dec-2020 31-Aug-2021 30-Jun-2025 The CMU is expanding its poor and vulnerable data base but we do not yet have the new figures Comments: Health System Strengthening to Improve Performance IN01039625 ►Health Facilities rehabilitated and / or equipped (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 10.00 301.00 890.00 Date 04-Jan-2019 01-Dec-2020 31-Aug-2021 30-Jun-2025 Contracts being processed Comments: IN01039629 ►Number of Women completing at least 4 prenatal visits (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 131,733.00 54,407.00 86,511.00 974,648.00 Date 04-Jan-2019 01-Dec-2020 31-Aug-2021 30-Jun-2025 This is the number of pregnant women who performed 4 prenatal consultations according to the current Comments: schedule IN01039631 11/30/2021 Page 4 of 8 The World Bank Implementation Status & Results Report Strategic Purchasing and Alignment of Resources & Knowledge in Health Project (SPARK-Health) (P167959) ►Number of women of reproductive age who are new users of modern contraceptive methods (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 89,700.00 214,749.00 317,075.00 1,300,625.00 Date 04-Jan-2019 01-Dec-2020 31-Aug-2021 30-Jun-2025 The number is below the baseline because of recent changes in the methodology for calculation. The Comments: team will discuss with government and update as soon as possible. IN01039633 ►Number of "Healthy" children 12-59 months seen for Nutritional consultation visit (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 310,450.00 552,727.00 991,910.00 2,592,390.00 Date 04-Jan-2019 01-Dec-2020 31-Aug-2021 30-Jun-2025 IN01039634 ►Number of people trained (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1,083.00 5,401.00 31,764.00 Date 04-Jan-2019 01-Dec-2020 31-Aug-2021 30-Jun-2025 Comments: IN01039635 ►Number of Women completing at least 3 CPoN visits (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 278,099.00 108,598.00 179,963.00 1,822,389.00 Date 04-Jan-2019 01-Dec-2020 31-Aug-2021 30-Jun-2025 IN01039636 ►Citizens and/or communities involved in planning/implementation/evaluation of development programs (Yes/No) (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No No Yes Yes Date 28-Feb-2019 01-Dec-2020 04-Oct-2021 30-Jun-2025 Comments: Project Management 11/30/2021 Page 5 of 8 The World Bank Implementation Status & Results Report Strategic Purchasing and Alignment of Resources & Knowledge in Health Project (SPARK-Health) (P167959) IN01039626 ►Availability of last year's RASS in the first half of the following year (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No No Yes Yes Date 04-Jan-2019 01-Dec-2020 31-Aug-2021 30-Jun-2025 Contingent Emergency Response Component (CERC) IN01039624 ►Number of emergency response beneficiaries (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1,935,749.00 12,911,536.00 20,000.00 Date 04-Jan-2019 01-Dec-2020 31-Aug-2021 30-Jun-2025 In case of emergency this is the number of people who will specifically benefit from the proceeds of the Comments: project interventions. IN01039628 ►Rapid response teams supported by the Project (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 93.00 100.00 Date 05-May-2020 01-Dec-2020 31-Aug-2021 30-Jun-2025 The formulation of this indicator needs to be revised to change the baseline to the number of Rapid Response Teams supported by the project instead of health districts covered. The project supports all active rapid response teams in CIV, but the Ministry of Health no longer has rapid response teams in Comments: every districts, which is why the indicator has gone down to 93%. The indicator will be updated as part of the restructuring of the project. IN01039630 ►Health districts receiving personal protection equipment and/or drugs financed by the Project (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 100.00 100.00 Date 05-May-2020 01-Dec-2020 31-Aug-2021 30-Jun-2025 IN01039632 ►Visits to the COVID-19 page of the U-Report social platform (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 1,185,715.00 3,205,102.00 3,206,100.00 3,185,715.00 Date 24-May-2020 01-Dec-2020 31-Aug-2021 30-Jun-2025 11/30/2021 Page 6 of 8 The World Bank Implementation Status & Results Report Strategic Purchasing and Alignment of Resources & Knowledge in Health Project (SPARK-Health) (P167959) Performance-Based Conditions Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P167959 IDA-63870 Effective USD 200.00 200.00 0.00 116.04 87.51 57% P167959 TF-A9692 Effective USD 20.00 20.00 0.00 3.40 16.60 17% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P167959 IDA-63870 Effective 22-Mar-2019 19-Apr-2019 18-Jul-2019 30-Jun-2025 30-Jun-2025 P167959 TF-A9692 Effective 22-Mar-2019 19-Apr-2019 18-Jul-2019 31-Dec-2021 31-Dec-2021 Cumulative Disbursements PBC Disbursement Achievement Disbursed amount in Disbursement % PBC ID PBC Type Description Coc PBC Amount Status Coc for PBC 11/30/2021 Page 7 of 8 The World Bank Implementation Status & Results Report Strategic Purchasing and Alignment of Resources & Knowledge in Health Project (SPARK-Health) (P167959) Restructuring History Level 2 Approved on 29-Sep-2020 Related Project(s) There are no related projects. 11/30/2021 Page 8 of 8