The World Bank Implementation Status & Results Report Investing in Maternal, Child and Adolescent Health (P162042) Investing in Maternal, Child and Adolescent Health (P162042) WESTERN AND CENTRAL AFRICA | Senegal | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2020 | Seq No: 6 | ARCHIVED on 21-Jun-2022 | ISR50907 | Implementing Agencies: Ministry of Health and Social Action, Republic of Senegal Key Dates Key Project Dates Bank Approval Date: 26-Sep-2019 Effectiveness Date: 14-Apr-2020 Planned Mid Term Review Date: 18-Jul-2022 Actual Mid-Term Review Date: Original Closing Date: 31-Dec-2024 Revised Closing Date: 31-Dec-2024 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The proposed Project Development Objective is to improve utilization of essential reproductive, maternal, neonatal, child and adolescent health and nutrition (RMNCAH-N) services meeting quality standards in Priority Regions. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name 1. Improving availability of RMNCAH-N services of adequate quality:(Cost $50.00 M) 2. Promoting adolescent health and women’s empowerment:(Cost $20.00 M) 3. Supporting reforms to strengthen governance, equity, and financing sustainability in the health sector:(Cost $60.00 M) 4. Contingency Emergency Response Component (CERC) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Moderately Satisfactory Moderately Satisfactory Overall Implementation Progress (IP) Moderately Satisfactory Moderately Satisfactory Overall Risk Rating Moderate Moderate Implementation Status and Key Decisions This is the sixth ISR covering the period of January 2022-April 2022. The project was approved on September 26, 2019 and became effective on April 14, 2020. This ISR is informed by a supervision mission as well as a technical mission for Component 2. Progress has been noted in disbursement as well as implementation of activities. Additional emphasis will need to take place on the launching of the pilot activities under Component 2 as well as the quality of care activities and finalization of the recruitment of health workers under Component 1. 6/21/2022 Page 1 of 8 The World Bank Implementation Status & Results Report Investing in Maternal, Child and Adolescent Health (P162042) Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance Moderate Moderate Moderate Macroeconomic Moderate Moderate Moderate Sector Strategies and Policies Moderate Moderate Moderate Technical Design of Project or Program Substantial Substantial Substantial 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 Moderate Moderate Moderate Results PDO Indicators by Objectives / Outcomes Increased utilization of RMNCAH-N services in the targeted regions IN01124633 ►Utilization of health services by patients covered by a community-based insurance mechanism (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 15.00 15.00 78.31 40.00 Date 08-Jul-2019 27-Jul-2021 21-Feb-2022 31-Dec-2024 Numerator: number of people covered by an insurance mechanism that have used at least once the Comments: health services over the last year Denominator: number of people covered by an insurance mechanism IN01124635 ►Percentage of children under 5 suffering from childhood stunting in Senegal (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 17.00 17.00 17.00 10.00 Date 30-Jun-2017 27-Jul-2021 27-Jul-2021 31-Dec-2024 6/21/2022 Page 2 of 8 The World Bank Implementation Status & Results Report Investing in Maternal, Child and Adolescent Health (P162042) Numerator: Number of children aged 0 to 59 months suffering from stunting in the three regions of the Comments: initiative (Ziguinchor, Sedhiou, Kedougou) Denominator: Number of children aged 0 to 59 months in the three regions of the initiative IN01124742 Percentage of children under 5 suffering from childhood stunting in the priority regions (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 22.30 22.30 22.30 10.00 Date 31-Dec-2019 27-Jul-2021 27-Jul-2021 31-Dec-2024 IN01124743 ►Contraceptive prevalence rate (Percentage) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 26.00 26.00 20.20 36.00 Date 08-Jul-2019 27-Jul-2021 21-Feb-2022 31-Dec-2024 Numerator: Number of adolescents girl in a relationship aged 15-19 using modern contraceptive methods Comments: Denominator: Number of adolescent girls in a relationship aged 15-19 Improved quality of health services in the 6 priority regions IN01124634 ►Quality index of health services (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 76.00 76.00 76.00 85.00 Date 18-Sep-2018 27-Jul-2021 27-Jul-2021 31-Dec-2024 Comments: Average quality score of health services across 12 core indicators IN01124741 ►Completion rate for ANCs (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 66.00 65.40 61.20 81.00 Date 28-Dec-2018 27-Jul-2021 21-Feb-2022 31-Dec-2024 Numerator: Number of pregnant women having 4 antenatal care visits at standard quality Denominator: Comments: Total number of pregnant women Overall Comments PDO Most of these indicators cannot be updated without the Demographic Health Surveys (DHS). The country is expected to finalize the DHS in the coming months with a draft available in September 2022. It is also important to note that the COVID-19 pandemic has impacted maternal and child health services, particularly the contraceptive prevalence rate. The quality index is also being finalized and the task team expects an update in the next supervision mission. 6/21/2022 Page 3 of 8 The World Bank Implementation Status & Results Report Investing in Maternal, Child and Adolescent Health (P162042) Intermediate Results Indicators by Components 1. Improve availability of RMNCAH and nutrition services IN01124744 ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1,068,212.00 761,544.00 2,843,864.00 Date 08-Jul-2019 27-Jul-2021 21-Feb-2022 31-Dec-2024 IN01124749 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 0.00 278,294.00 61,295.00 1,189,760.00 IN01124752 Number of children immunized (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 238,219.00 102,104.00 826,108.00 Date 08-Jul-2019 27-Jul-2021 21-Feb-2022 31-Dec-2024 IN01124754 Number of women and children who have received basic nutrition services (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 360,903.00 499,289.00 1,148,169.00 Date 18-Sep-2018 27-Jul-2021 21-Feb-2022 31-Dec-2024 IN01124756 Number of deliveries attended by skilled health personnel (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 190,796.00 98,856.00 869,587.00 Date 18-Sep-2018 27-Jul-2021 21-Feb-2022 31-Dec-2024 IN01124757 ►Percentage of C-sections in the priority regions (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 3.16 3.50 3.30 4.50 Date 31-Dec-2019 27-Jul-2021 21-Feb-2022 31-Dec-2024 Nominator: Number of births in health centers with a functional EmONC base in the six regions of the Comments: project Denominator: Total number of expected births in the 6 regions 6/21/2022 Page 4 of 8 The World Bank Implementation Status & Results Report Investing in Maternal, Child and Adolescent Health (P162042) IN01124758 ►Percentage of newborns who benefited from an immediate care package at birth (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 83.00 83.00 90.00 97.00 Date 30-May-2019 27-Jul-2021 21-Feb-2022 31-Dec-2024 Numerator: Number of newborns who receive immediate care after birth according to MOHSA guidelines Comments: Denominator: Number of newborns during the reference period IN01124759 ►Percentage of deliveries in health facilities (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 60.00 75.00 96.00 80.00 Date 31-Dec-2019 27-Jul-2021 21-Feb-2022 31-Dec-2024 Numerator: number of deliveries taking place in health facilities with more than 500 births a year Comments: Denominator: total number of expected births 2. Promote adolescent health and women’s empowerment IN01124746 ►Number of adolescent girls who benefited from cash transfers (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 191,155.00 Date 08-Jul-2019 27-Jul-2021 21-Feb-2022 31-Dec-2024 Number of adolescent girls who benefited from credits and cash transfers. Cumulative number. Cash Comments: transfers targeting the poorest adolescent girl quintile, with year 1 being the pilot project implemented in 6 districts only. IN01124748 ►Adolescent girls pregnancy rate among the beneficiaries of cash transfer initiatives (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 16.00 16.00 16.00 4.00 Date 30-May-2019 27-Jul-2021 27-Jul-2021 31-Dec-2024 Numerator: Number of beneficiaries of cash transfer who report a pregnancy in the calendar year. Comments: Denominator: Total number of girls who benefited from a cash transfer in that calendar year. IN01124751 ►Utilisation rate of modern contraceptive methods by adolescent girls in a relationship, aged 15-19 (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 8.00 7.60 16.19 18.50 Date 19-Sep-2018 27-Jul-2021 21-Feb-2022 31-Dec-2024 6/21/2022 Page 5 of 8 The World Bank Implementation Status & Results Report Investing in Maternal, Child and Adolescent Health (P162042) Numerator: Total number of women aged 15 to 49 years using a modern method of contraception Comments: Denominator: Total number of women aged 15 to 49 years Support reforms to strengthen equity and financing sustainability in the health sector IN01124745 ►Number of beneficiaries of the CBHIS (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 816,393.00 1,952,363.00 3,989,524.00 2,837,532.00 Date 31-Dec-2018 27-Jul-2021 21-Feb-2022 31-Dec-2024 Comments: Number of people covered by a Community Based Health Insurance Scheme IN01124747 ►Number of vulnerable beneficiaries (children aged 0-5) covered by the CBHIS (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 52,116.00 35,489.00 954,465.00 Date 30-May-2019 27-Jul-2021 21-Feb-2022 31-Dec-2024 Number of vulnerable beneficiaries (children aged 0-5 and pregnant women) covered by the Community Comments: Based Health Insurance Scheme IN01124750 ►Number of vulnerable beneficiaries (pregnant women) covered by the CBHIS (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 184,830.00 Date 31-Dec-2020 27-Jul-2021 21-Feb-2022 31-Dec-2024 IN01124753 ►Completion rate of health facilities data reports (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 91.50 85.00 85.00 99.00 Date 30-May-2019 27-Jul-2021 27-Jul-2021 31-Dec-2024 Numerator: number of reports provided by health facilities (health centers and health posts) that report Comments: SRSE health data for the 6 regions of the project Denominator: number of expected reports IN01124755 ►Number of Scorecards made and disseminated annually at regional and national level (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 15.00 Date 30-Aug-2018 27-Jul-2021 21-Feb-2022 31-Dec-2024 6/21/2022 Page 6 of 8 The World Bank Implementation Status & Results Report Investing in Maternal, Child and Adolescent Health (P162042) Cumulative number of Scorecards made and disseminated annually at regional and national level (2 at the Comments: national level and 2 per region annually). The scorecards include feedback from beneficiaries and the civil society, as well as monitoring the effectiveness of the responses to the GRM and satisfaction surveys. Overall Comments IR For the Component 1 indicators, some progress has been noted with indicators related to percentage of C-sections and percentage of deliveries in health facilities surpassing their targets. Component 2 activities have not been fully implemented and therefore, no updates on these indicators are available at this time. The task team expects some updates once the pilot is completed. For Component 3 indicators, the majority are linked to a report that should be shared by the ANACMU on Community-based Health Insurance Schemes (CBHIS), but it was not available during the mission. The task team also notes some retraction in the completion rate of health facilities data reports mostly due to the COVID-19 pandemic. The Scorecards have also not been finalized and the task team expects to obtain more details in the next year. Performance-Based Conditions Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P162042 IDA-64950 Effective USD 140.00 120.00 20.00 20.72 93.83 18% P162042 TF-B0766 Effective USD 10.00 10.00 0.00 10.00 0.00 100% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P162042 IDA-64950 Effective 26-Sep-2019 21-Feb-2020 14-Apr-2020 31-Dec-2024 31-Dec-2024 P162042 TF-B0766 Effective 26-Sep-2019 07-Feb-2020 14-Apr-2020 31-Dec-2024 31-Dec-2024 Cumulative Disbursements 6/21/2022 Page 7 of 8 The World Bank Implementation Status & Results Report Investing in Maternal, Child and Adolescent Health (P162042) Restructuring History Level 2 Approved on 09-Jun-2021 ,Level 2 Approved on 26-Jan-2022 Related Project(s) There are no related projects. 6/21/2022 Page 8 of 8