The World Bank Implementation Status & Results Report Health and Nutrition Services Access Project (P166165) Health and Nutrition Services Access Project (P166165) EAST ASIA AND PACIFIC | Lao People's Democratic Republic | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2020 | Seq No: 5 | ARCHIVED on 01-Aug-2022 | ISR51968 | Implementing Agencies: Lao People's Democratic Republic, Ministry of Health Key Dates Key Project Dates Bank Approval Date: 12-Mar-2020 Effectiveness Date: 22-Jul-2020 Planned Mid Term Review Date: 29-Jul-2022 Actual Mid-Term Review Date: Original Closing Date: 31-Dec-2025 Revised Closing Date: 31-Dec-2025 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) To improve access to quality health and nutrition services in targeted areas of Lao PDR. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Component 1: Integrating Service Delivery Performance with National Health Insurance Payments:(Cost $12.20 M) Component 2: Service Delivery and Nutrition Convergence:(Cost $17.80 M) Component 3: Adaptive Learning and Project Management:(Cost $6.00 M) Component 4: Contingent Emergency Response Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Moderately Satisfactory Moderately Satisfactory Overall Implementation Progress (IP) Moderately Satisfactory Satisfactory Overall Risk Rating Substantial Substantial Implementation Status and Key Decisions The project implementation started to resume normality after COVID-19 restrictions eased and the country has reopened for tourism in May 2022: Quality Performance Scorecard (QPS) covered eight provinces, four nutrition convergence provinces and additional four provinces of Vientiane, Bolikhamsay, Sekong and Attapeu. The total of 374 health centers were assessed and verified by external 3rd party verification agency with 223 health centers in four nutrition convergence provinces had received their first QPS payment, transferred directly by National Health Insurance Bureau to the health center bank account. Later this year, QPS is expected to scale up and cover eight additional provinces or 83 percent of all health centers in the country. Nutrition and maternal and child health related targets were on track, with 846/881 villages having implemented at least 10 monthly nutrition social behavior changes and communication sessions, and 908 Zone 2 and Zone 3 villages received at least three quarterly integrated outreach sessions during the disbursement linked indicator year 2 period, above the target of 500. COVID-19 aftermath remains, and in some cases reversed the progress made. Only 20/50 target districts on Penta3 are expected to achieve the disbursement linked 8/1/2022 Page 1 of 14 The World Bank Implementation Status & Results Report Health and Nutrition Services Access Project (P166165) indicator year 2 condition, and similarly for the tuberculosis (TB) program which experienced the interruption of sputum transportation and active case-finding at the community level posing challenges for the renewed efforts to detect more TB cases in the communities. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance Substantial Substantial Substantial Macroeconomic Substantial High High Sector Strategies and Policies Substantial Substantial Moderate Technical Design of Project or Program High High Substantial Institutional Capacity for Implementation and High High High Sustainability Fiduciary Substantial Substantial Substantial Environment and Social Moderate Moderate Moderate Stakeholders Substantial Substantial Substantial Other -- Substantial High Overall Substantial Substantial Substantial Results PDO Indicators by Objectives / Outcomes Improved access to quality healthcare services IN01156599 ►Number of deliveries attended by a skilled birth attendant (DLI I) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 114,124.00 61,582.00 123,473.00 119,830.00 Date 31-May-2019 30-Nov-2021 31-May-2022 31-Dec-2025 Exceeded the end target. The current actual data is the nationwide data reported between June2021 to May 2022. This surpassed the end target. If this trend could be maintained throughout the project period, Comments: it would be likely to achieve the end target by 2025. IN01156602 ►Number of health centers scoring above 60% on a standard quality assessment system (DLI A) (Number, Custom) 8/1/2022 Page 2 of 14 The World Bank Implementation Status & Results Report Health and Nutrition Services Access Project (P166165) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 93.00 288.00 600.00 Date 31-May-2019 30-Nov-2021 31-May-2022 31-Dec-2025 On-track. The current actual data has shown 75 percent of assessed health centers scored above 60 percent for period between June 2021 to May 2022. A total 882 health centers are expected to be Comments: assessed between June 2022 to May 2023. Improved access to quality nutrition services IN01156601 ►Percentage of children under 2 years of age whose growth is adequately monitored as per national guidelines in the twelve nutrition convergence districts (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 36.00 29.51 51.00 80.00 Date 31-May-2020 30-Nov-2021 31-May-2022 31-Dec-2025 On-track. The current actual data reported between June 2021 to May 2022. Data source is DHIS2 tracker for growth monitoring. Denominator is estimated population single age 0 year and 1 year from Lao Comments: National Statistics Bureau. IN01156603 ►Percentage of pregnant women who receive 4 Antenatal Care contacts in the twelve nutrition convergence districts (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 52.00 79.70 66.00 62.00 Date 31-May-2019 30-Nov-2021 31-May-2022 31-Dec-2025 Exceeded the end target. The current actual data reported between June 2021 to May 2022 which sudden Comments: dropped from March-May 2022, when the Omicron variant highly spread across the country. Increasing the utilization of primary care and improving efficiency of public spending IN01156600 ►Share of outpatient cases delivered at the primary healthcare facilities among the total outpatient services delivered in the country (including hospitals) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 43.00 46.20 50.00 50.00 Date 31-May-2020 30-Nov-2021 31-May-2022 31-Dec-2025 On-track. The progress data is all OPD cases, provided by the health facilities supported by the project, reported between June 2021-2022. Event capture application is widely expanded, and the PHC at HCs Comments: are improving. Intermediate Results Indicators by Components 8/1/2022 Page 3 of 14 The World Bank Implementation Status & Results Report Health and Nutrition Services Access Project (P166165) Integrating Service Delivery Performance with National Health Insurance Payments IN01156604 ►Number of health centers that have had regular (twice per year) quality assessment visits and verified (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 800.00 Date 31-May-2020 30-Nov-2021 31-May-2022 31-Dec-2025 Off-track. Although 385 health centers have been assessed for the first round and partially done for the second round, verification by the Third Party has not been fully completed. Rolling out of the Quality and Performance Scorecard was delayed due to the community transmission of the COVID-19 in 2020, but Comments: has since been rolled out and expanded to cover 8 provinces with an additional 8 provinces expected to be covered by the end of this year. IN01156607 ►Number of health centers that received their payments within the prescribed timeline in the latest round of quality assessments (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 223.00 800.00 Date 31-May-2020 30-Nov-2021 31-May-2022 31-Dec-2025 Off-track. The current actual data of 223 health centers was the result of first payment for 4 nutrition provinces (Xiengkhuang, Houaphanh, Phongsaly, Oudomxay), which was successfully transferred from Comments: NHIB to the health centers within prescribed timeline of NHIB 30 days. Service Delivery and Nutrition Convergence IN01156605 ►Number of health centers which have at least 85% of 30 days' stock of agreed list of drugs and commodities (DLI C) (Number, Custom, PBC) Baseline Actual (Previous) Actual (Current) End Target Value 170.00 334.00 425.00 800.00 Date 31-May-2020 30-Nov-2021 31-May-2022 31-Dec-2025 On-track. The current actual data reported between June 2021 to May 2022 from DLI C report which Comments: subjected to IAI verification. IN01156608 ►Number of health centers assessed and certified in financial management (DLI E) (Number, Custom, PBC) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 61.00 383.00 800.00 Date 31-May-2019 30-Nov-2021 31-May-2022 31-Dec-2025 On-track. The current actual data reported between June 2021 to May 2022 from DLI E report which Comments: subjected to IAI verification. IN01156610 8/1/2022 Page 4 of 14 The World Bank Implementation Status & Results Report Health and Nutrition Services Access Project (P166165) ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 599,882.00 1,840,507.00 1,200,000.00 Date 31-May-2020 30-Nov-2021 31-May-2022 31-Dec-2025 Exceeded the end target. The indicator is cumulative summation, in period June 2020 – May 2022, of the total for number of children who received penta3 (272,638), pregnant received 90 tablets of iron-folate (334,077), number of children under 2 years whose growth was adequately monitored as per national guidelines (193,027), and number of children 6-59 months of age who received vitamin A supplements Comments: (795,607), and number of deliveries by SBA (245,158) nationwide, over the project lifetime. This high value may be due to double count of the people, e.g. the number of pregnant women who received 90 tablets of iron-folic and the delivery attended by SBA, and number of children received growth monitoring and Penta3 and Vitamin A. The definition of the indicator needs to be revisited. IN01156611 People who have received essential health, nutrition, and population (HNP) services - Female (RMS requirement) (Number, Corporate Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 131,421.00 579,235.00 960,000.00 IN01156612 Number of children immunized (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 100,000.00 53,096.00 272,638.00 200,000.00 Date 31-May-2020 30-Nov-2021 31-May-2022 31-Dec-2025 IN01156613 Number of women and children who have received basic nutrition services (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 492,171.00 95,722.00 400,000.00 Date 31-May-2019 30-Nov-2021 31-May-2022 31-Dec-2025 IN01156614 Number of deliveries attended by skilled health personnel (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 54,615.00 245,158.00 400,000.00 Date 31-May-2019 30-Nov-2021 31-May-2022 31-Dec-2025 IN01156615 ►Number of villages in nutrition convergence districts which have conducted at least 10 monthly SBCC sessions in the last 12 months (DLI G) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 269.00 875.00 846.00 800.00 Date 31-May-2019 30-Nov-2021 31-May-2022 31-Dec-2025 8/1/2022 Page 5 of 14 The World Bank Implementation Status & Results Report Health and Nutrition Services Access Project (P166165) Over achieved. The current actual data reported between June 2021 to May 2022 from DLI C report which Comments: subjected to IAI verification. IN01156616 ►Number of villages in Zones 2 and 3 in nutrition convergence districts in which integrated outreach sessions are conducted (DLI H) (Number, Custom, PBC) Baseline Actual (Previous) Actual (Current) End Target Value 50.00 586.00 908.00 450.00 Date 31-May-2019 30-Nov-2021 31-May-2022 31-Dec-2025 Over achieved. The current actual data reported between June 2021 to May 2022 from DLI C report which Comments: subjected to IAI verification. IN01156617 ►Number of notified TB cases in all forms (per 100,000) (DLI J) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 91.00 109.70 109.70 81.00 Date 31-May-2019 30-Nov-2021 31-May-2022 31-Dec-2025 Remain unchanged from the previous mission. The report of indicator is based on the WHO tuberculosis profile report: (https://worldhealthorg.shinyapps.io/tb_profiles/). Currently the website reported 8,013 of total new and relapse cases for 2020 and population of 7.3 million. This is within the expectation as it is Comments: projected to go up. This indicator needs a closer follow up as project aim to reduce the number of cases. The data will be updated once WHO published the data for 2021. IN01156618 ►Percentage of women in nutrition convergence districts receiving at least 90 iron folic acid tablets at last pregnancy (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 55.40 99.00 70.00 Date 31-May-2019 30-Nov-2021 31-May-2022 31-Dec-2025 Exceeded the end target. The current actual data reported between June 2021 to May 2022 in the 12- nutrition convergence district. Denominator is 2021 estimated live birth in the nutrition districts. The end Comments: target and definition of the indicator need to be revisited. IN01156619 ►Percentage of children 6-59 months receiving vitamin A supplementation within the past 6 months in the twelve nutrition convergence districts (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 49.50 15.00 70.00 Date 31-May-2019 30-Nov-2021 31-May-2022 31-Dec-2025 Exceeded the end target. The current actual data reported between June 2021 to May 2022 in the 12- nutrition convergence district. Denominator is 2021 estimated live birth in the nutrition districts. The end Comments: target and definition of the indicator need to be revisited. IN01156620 ►Percentage of Children 0-59 months in the twelve nutrition convergence districts exclusively breastfed (Percentage, Custom) 8/1/2022 Page 6 of 14 The World Bank Implementation Status & Results Report Health and Nutrition Services Access Project (P166165) Baseline Actual (Previous) Actual (Current) End Target Value 56.20 83.90 83.90 62.00 Date 31-May-2019 30-Nov-2021 31-May-2022 31-Dec-2025 Exceeded the end target. The current actual data remains the same as the previous mission. It will be Comments: updated when the Midline of the KAP Survey is completed which is expected by end of 2022. IN01156621 ►Percentage Average score on the quality and performance scorecard for all health centers in the twelve nutrition convergence districts (DLI A) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 58.00 71.00 60.00 Date 31-May-2019 30-Nov-2021 31-May-2022 31-Dec-2025 Exceeded the end target. First round of QPS assessment that was validated and approved by QHC sub- Comments: committee. IN01156622 ►Percentage increase over baseline of children who have received DPT3 in nutrition convergence districts (DLI I) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 623.00 12.00 10.00 Date 31-May-2019 30-Nov-2021 31-May-2022 31-Dec-2025 Exceeded the end target. The previous actual data was in correct. The current actual data is the percentage increase between the baseline data for period between June 2019-May 2020 (93 percent) and Comments: the coverage for period between June 2021-May 2022 (104 percent). This maybe due to the estimated number of children, provided by the Lao National Statistics Bureau, is used by MOH as denominator. Adaptive learning and project management IN01156606 ►Number of health centers that undertake MCH tracker or event capture in DHIS2 (DLI F) (Number, Custom, PBC) Baseline Actual (Previous) Actual (Current) End Target Value 158.00 632.00 887.00 600.00 Date 31-May-2019 30-Nov-2021 31-May-2022 31-Dec-2025 Exceeded the end target. The progress data reported between June 2021 to May 2022 from DLI F report subjected to IAI verification. DHIS2 tracker expanded and covered more health facilities than the original Comments: plan. IN01156609 ►Number of citizens providing feedback on services provided at primary health care level (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 625.00 1,668.00 25,000.00 8/1/2022 Page 7 of 14 The World Bank Implementation Status & Results Report Health and Nutrition Services Access Project (P166165) Date 31-May-2019 30-Nov-2021 31-May-2022 31-Dec-2025 Likely to be off-track. This is based on the first and second round of the QPS assessments in 8 provinces – Phongsaly, Oudomxay, Huaphanh, Xiengkhuang, Vientiane, Bolikhamxay, Sekong, Attapeu. Although about 80 percent of health centers in the country are expected to be assessed, meaning more clients Comments: interviews will be done in the coming years, the project needs to ensure the patient interview happens and is captured well during the QPS assessment. Performance-Based Conditions IN01156623 ►PBC 1 Quality performance and service readiness measurement conducted regularly at health center level (DLI A) (Text, Process, 1,500,000.00, 20.00%) (Year 4) June 1, Baseline Actual (Previous) Actual (Current) 2023 - May 31, 2024 1. Quality and Performance Scorecard rolled out to at least eighty percent (80%) of all health centers nationwide; ninety percent (90%) of health centers have 1. QPS rolled out to had regular (two (2) 385 health centers in 8 times/year/health provinces or 36% of all center) quality health centers nationwide; assessment and 60% (223/385) of health random independent QPS has been rolled out centers assessed two third-party in 4 nutrition times and 58% (223/385) verification;2. convergence provinces randomly verified by Thirty (30) and assessment is independent third-party percentage points ongoing in these verification Value TBC increase in the provinces. As of 2. 71% baseline average score from November 2021, QPS average score of health the baseline score of covered 232 health centers in the 12 nutrition health centers in the centers in 4 nutrition convergence districts twelve (12) nutrition convergence provinces. established convergence 3. 23% (11/43) districts on QPS health centers whose assessment;3. verification scores are Reduction more than 10% lower than by thirty percent assessment scores (30%) of health centers whose verification scores from previous year are more than ten percent (10%) lower than assessment scores.DLI value: 0 (added in AF) Date -- 30-Nov-2021 31-May-2022 -- 8/1/2022 Page 8 of 14 The World Bank Implementation Status & Results Report Health and Nutrition Services Access Project (P166165) IN01156624 ►PBC 2 Number of patients who pay out of pocket payment for “Free” Maternal and Child Services reduced (DLI B). (Text, Intermediate Outcome, 700,000.00, 21.43%) (Year 4) June 1, Baseline Actual (Previous) Actual (Current) 2023 - May 31, 2024 1. Ninety percent (90%) reduction in the 1. 82% reduction of number of health For condition 1: 73% of health health centers in center receiving the HCs in 4 selected 9 provinces their payments after convergence provinces received their payments the prescribed have received funds within 30 days (from NHIB timeline; within the prescribed to HCs) Value TBD 2. Eighty timeline. For condition 2: 2. 0% decrease percent (80%) the implementation of from baseline in the decrease from has been challenged and number of women not baseline in the it is unlikely to meet the receiving free MCH fully number of women Year-2 target. covered by NHI. not receiving free MCH fully covered by NHI. Date -- 30-Nov-2021 31-May-2022 -- IN01156625 ►PBC 3 Number of health centers which have at least 85% of 30 days' stock of agreed list of drugs and commodities (DLI C) (Number, Output, 1,650,000.00, 18.18%) (Year 4) June 1, Baseline Actual (Previous) Actual (Current) 2023 - May 31, 2024 Value 170.00 334.00 425.00 -- Date -- 30-Nov-2021 31-May-2022 -- IN01156626 ►PBC 4 Number of provinces in which the number of health centers without a clinical health worker, as reported in the DHIS2, has been reduced. l (DLI D). (Text, Intermediate Outcome, 800,000.00, 25.00%) (Year 4) June 1, Baseline Actual (Previous) Actual (Current) 2023 - May 31, 2024 Value TBD The number of health The number of health 1. At least centers without clinical center without clinical sixty percent (60%) health workers was workers reduced from 485 reduction from reduced from 485 from to 189 (39%) reduction baseline of number baseline to 181 health from baseline, or 82% of of health centers, or centers nationwide. all health centers at least eighty Based on DHIS2 nationwide have clinical percent (80%) of all monitoring system all 8 worker health centers in all provinces have a 8/1/2022 Page 9 of 14 The World Bank Implementation Status & Results Report Health and Nutrition Services Access Project (P166165) target provinces are on clinical health track to achieve target. worker, nationwide. Date -- 30-Nov-2021 31-May-2022 -- IN01156627 ►PBC 5 Number of health centers assessed and certified in financial management (DLI E) (Number, Intermediate Outcome, 1,000,000.00, 25.00%) (Year 4) June 1, Baseline Actual (Previous) Actual (Current) 2023 - May 31, 2024 Value 0.00 61.00 383.00 -- Date -- 30-Nov-2021 31-May-2022 -- IN01156628 ►PBC 6 Number of health centers that undertake MCH tracker or event capture in DHIS2 (DLI F) (Number, Process, 1,000,000.00, 25.00%) (Year 4) June 1, Baseline Actual (Previous) Actual (Current) 2023 - May 31, 2024 Value 158.00 632.00 887.00 -- Date -- 30-Nov-2021 31-May-2022 -- IN01156629 ►PBC 7 Implementation of Social and Behavioral Change Communication and Growth Monitoring and Promotion activities at village-level (DLI G) (Text, Output, 1,561,500.00, 15.37%) (Year 4) June 1, Baseline Actual (Previous) Actual (Current) 2023 - May 31, 2024 1. Up to eight hundred eighty-one (881) villages, in Based on DHIS2 (Jun 1 – twelve (12) nutrition Oct 31, 2021), 861 convergence villages have conducted districts have SBCC session four conducted at least 846 villages had times, and 662 villages ten (10) monthly conducted at least 10 Value 269.00 five times. All target 881 SBCC sessions in SBCC sessions between villages are remained the past twelve (12) Jun-2021 to May-2022 within achievable target if months with a they could implement the prescribed set of SBCC activities as per activities including the plan. growth monitoring and promotion and have reported these in DHIS2. Date -- 30-Nov-2021 31-May-2022 -- 8/1/2022 Page 10 of 14 The World Bank Implementation Status & Results Report Health and Nutrition Services Access Project (P166165) IN01156630 ►PBC 8 Number of villages in Zones 2 and 3 in nutrition convergence districts in which integrated outreach sessions are conducted (DLI H) (Number, Output, 900,000.00, 16.67%) (Year 4) June 1, Baseline Actual (Previous) Actual (Current) 2023 - May 31, 2024 Value 50.00 586.00 908.00 -- Date -- 30-Nov-2021 31-May-2022 -- IN01156631 ►PBC 9 Number of Immunization Target Districts which have increased the Pentavalent 3 and deliveries with Skilled Birth Attendant (DLI I) (Text, Outcome, 1,800,000.00, 0.00%) (Year 4) June 1, Baseline Actual (Previous) Actual (Current) 2023 - May 31, 2024 1. Number of districts among the fifty (50) Immunization Target Districts which have achieved an increase of twelve (12) percentage points in the number of children less than twelve (<12) months covered by DPT- HepB-Hib over the Baseline value for DPT3 baseline or and SBA coverage in the Based on DHIS2, only 24 maintained a 50 targeted districts for DLI districts out of 50 districts coverage with DPT- I is available in annex 18 of 20/50 immunization are on track to achieve HepB-Hib of ninety- DLI Year 0 report. which (Penta 3) target districts the DLI Year-2 target five percent (95%) can be access via the are projected to achieve condition 1 (Penta-3) and or more. Value WBdoc links: DLI Y2 target43/50 target only 39 districts out of 50 2. Number of https://wbdocs.worldbank.o district are projected to districts are on track to districts in fifty (50) rg/wbdocs/drl/objectId/0902 achieve DLI Y2 SBA achieve condition 2 Immunization Target 24b0881d7c40 target (SBA). Districts which have https://wbdocs.worldbank.o received an increase rg/wbdocs/drl/objectId/0902 of nine (9) 24b0881d7c42 percentage points the number of women delivered by Skilled Birth Attendant over the baseline or reached or maintained a coverage with Skilled Birth Attendant of ninety percent (90%) or more. 8/1/2022 Page 11 of 14 The World Bank Implementation Status & Results Report Health and Nutrition Services Access Project (P166165) Date -- 30-Nov-2021 31-May-2022 -- IN01156632 ►PBC 10 Number of notified TB cases of all forms (i.e. bacteriologically confirmed and clinically diagnosed new and relapse cases) (DLI J). (Text, Process, 3,600,000.00, 8.33%) (Year 4) June 1, Baseline Actual (Previous) Actual (Current) 2023 - May 31, 2024 As of November 2021, 1. Provinces approximately 2,574 TB Baseline information on TB that achieved the cases were notified notified cases by province targeted number of during the first 5 months is available in the annex 1. 6,799 TB cases notified TB cases of of implementation. This 19a of the DLI Year 0 were notified or 90% of all forms; represents a 34% report which can be access DLI Y2 target is projected 2. Provinces achievement rate of the via the WBdoc links: to achieve which have reached Value set target of 7,537 for DLI https://wbdocs.worldbank.o 2. 100% or maintained one Year-2 condition 1, while rg/wbdocs/drl/objectId/0902 GeneXpert coverage hundred percent condition 2, GeneXpert 24b0881d7c40 reported (100%) GeneXpert coverage and utilization https://wbdocs.worldbank.o coverage. has remained high at rg/wbdocs/drl/objectId/0902 99% and is expected to 24b0881d7c42 DLI value: 0 (added meet the Year 2 target of in AF) 100%. Date -- 30-Nov-2021 31-May-2022 -- IN01156633 ►PBC 11 Increased coverage of a) HIV testing among key populations (female service women (FSW)) and men having sex with men (MSM)); b) and HIV treatment among people living with HIV (DLI K) (Text, Outcome, 2,900,000.00, 27.59%) (Year 4) June 1, Baseline Actual (Previous) Actual (Current) 2023 - May 31, 2024 Value TBD Condition 1 and 3 are on 1. 3% percentage 1. Two (2) track: 1,138 MSM have point increase over the percentage points been reached with HIV previous year year in HIV increase over the testing in the first five testing coverage of previous year in HIV months, thus achieving estimated FSW during the testing coverage of almost 52% of the Year-2 past 12 months estimated FSW target, and the number of 2. 13% percentage during the past HIV positive patients on points increase over the twelve (12) months; ART nationwide is up 4% previous year in HIV 2. Ten (10) as compared to the testing covereage of percentage points previous year. It will estimated MSM over the increase over the unlikely to achieve past 12 months previous year in HIV condition 2 as around 3. 10% percentage testing coverage of 1,961 FSW were reached points increase over the estimated MSM with HIV testing, previous year in number of during the past representing a 24% HIV positive cases twelve (12) months; achievement rate of the received ART 3. Five (5) Year-2 target. percentage points increase over the previous year in number of HIV positive cases receiving antiretroviral 8/1/2022 Page 12 of 14 The World Bank Implementation Status & Results Report Health and Nutrition Services Access Project (P166165) treatment nationwide. Date -- 30-Nov-2021 31-May-2022 -- IN01156634 ►PBC 12 Increase in national readiness for health security in responding to pandemics and health emergency at international boundaries (airports and ground crossings) (DLI L) (Text, Output, 389,500.00, 0.00%) (Year 4) June 1, Baseline Actual (Previous) Actual (Current) 2023 - May 31, 2024 1. Training activities as per national SOPs for four (4) additional formal ground crossings with less than one hundred 1. 6 formal ground fifty (<150,000) crossings with <150,000 travelers per year. travelers per year trained 2. Simulation The activities have been as per national SOPS exercises held at significantly delayed and 2. Simulation two (2) international Value 0.00 it is unlikely to meet the exercise were held at 2 airports and two (2) DLI-Y2 targets. international airports and 2 additional formal ground crossings with ground crossings >150,000 travelers with more than one hundred fifty (>150,000) travelers per year. .. DLI value: 0 (added in AF) Date -- 30-Nov-2021 31-May-2022 -- Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P166165 IDA-65570 Effective USD 23.00 23.00 0.00 7.21 16.23 31% P166165 TF-B2043 Effective USD 3.00 3.00 0.00 1.13 1.87 38% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P166165 IDA-65570 Effective 12-Mar-2020 28-Apr-2020 22-Jul-2020 31-Dec-2025 31-Dec-2025 8/1/2022 Page 13 of 14 The World Bank Implementation Status & Results Report Health and Nutrition Services Access Project (P166165) P166165 TF-B2043 Effective 12-Mar-2020 28-Apr-2020 22-Jul-2020 30-Jun-2023 30-Jun-2023 Cumulative Disbursements Restructuring History There has been no restructuring to date. Related Project(s) There are no related projects. 8/1/2022 Page 14 of 14