The World Bank Implementation Status & Results Report Angola Health System Performance Strengthening Project (HSPSP) (P160948) Angola Health System Performance Strengthening Project (HSPSP) (P160948) EASTERN AND SOUTHERN AFRICA | Angola | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2018 | Seq No: 9 | ARCHIVED on 21-Jun-2022 | ISR51627 | Implementing Agencies: Ministry of Health, Republic of Angola Key Dates Key Project Dates Bank Approval Date: 29-Mar-2018 Effectiveness Date: 24-Oct-2018 Planned Mid Term Review Date: 30-Nov-2021 Actual Mid-Term Review Date: 26-Apr-2022 Original Closing Date: 30-Sep-2023 Revised Closing Date: 30-Sep-2023 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The Project Development Objective (PDO) is to increase the utilization and the quality of health care services in target provinces and municipalities. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Improving the Quality of Health Services Delivery in Target Provinces:(Cost $74.70 M) Strengthening System-wide Enabling Factors that Support Delivery of Quality Health Services:(Cost $35.00 M) Contingent Emergency Response Component (CERC) Project Management and Monitoring and Evaluation:(Cost $10.00 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 Substantial Implementation Status and Key Decisions The Project implementation remains on course despite some setbacks. Key achievements include the agility in response to public health emergencies, including both nutrition crisis and COVID-19, as well as health system strengthening at the municipal level. The Mid-Term Review process held between November 2021 and April 2022 has been concluded. The key findings of this process highlight that, although the Project was able to achieve some of the indicator targets required for the achievement of the Project Development Goal, the channeling of more than 63% of the funds for the response to public health emergencies, and the prolonged suspension of activities has impacted the implementation of the original project activities foreseen at project design. In view of these unanticipated events, the WB has agreed with MINSA/MINFIN to proceed with restructuring of the project and an extension of its closing date. The restructuring will allow for the project to reflect modifications made during implementation and ensure reporting on results achieved in the emergency response. 6/21/2022 Page 1 of 9 The World Bank Implementation Status & Results Report Angola Health System Performance Strengthening Project (HSPSP) (P160948) Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance Substantial Substantial Substantial Macroeconomic High High High Sector Strategies and Policies Moderate Moderate Moderate Technical Design of Project or Program Moderate Moderate Moderate Institutional Capacity for Implementation and Substantial Substantial Substantial Sustainability Fiduciary Substantial Substantial Substantial Environment and Social Moderate Moderate Moderate Stakeholders Substantial Substantial Substantial Other -- -- -- Overall Substantial Substantial Substantial Results PDO Indicators by Objectives / Outcomes Increase quality of health care services IN01146774 ►Percentage of pregnant women who receive four antenatal (ANC) consultations (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 17.40 19.00 18.20 36.00 Date 29-Dec-2017 31-Dec-2020 31-Dec-2021 30-Jun-2023 IN01146971 ►Pregnant women who are HIV positive who deliver at health facilities and receive ART (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 10.50 16.00 14.00 40.00 Date 29-Dec-2017 31-Dec-2020 31-Dec-2021 30-Jun-2023 IN01146973 6/21/2022 Page 2 of 9 The World Bank Implementation Status & Results Report Angola Health System Performance Strengthening Project (HSPSP) (P160948) ►Percentage of pregnant women receiving two tetanus vaccines during pregnancy (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 30.50 48.51 49.00 48.00 Date 29-Dec-2017 31-Dec-2020 31-Dec-2021 30-Jun-2023 Missing information for Q4 in several municipalities for the calendar year of 2020 due to COVID19 impact. Comments: IN01146975 ►Number of health facilities without stock-outs of reproductive health medicines and supplies (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 93.00 100.00 Date 29-Dec-2017 31-Dec-2020 31-Dec-2021 30-Jun-2023 Increase utilization of health care services IN01146773 ►Pregnant women who are HIV positive that deliver at a health facility (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 1,365.00 1,080.00 1,422.00 1,680.00 Date 29-Dec-2017 31-Dec-2020 31-Dec-2021 30-Jun-2023 IN01146775 ►Number of reproductive health consultations conducted through Mobile Brigades (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 9,567.00 20,434.00 6,000.00 Date 30-Dec-2017 31-Dec-2020 31-Dec-2021 30-Jul-2023 Reproductive health visits consider prenatal care and family planning consultations. For December 2020, there was a polio campaign through the Mobile Brigades and the records don’t Comments: provide distinction between FP, ANC and the number of polio vaccination IN01146972 ►Number of child health consultations in the 21 PFSS municipalities (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 784,612.00 1,069,699.00 6,000.00 Date 29-Dec-2017 31-Dec-2020 31-Dec-2021 30-Jun-2023 IN01146974 ►Number of child health consultations in the 13 Child Health Expansion municipalities (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target 6/21/2022 Page 3 of 9 The World Bank Implementation Status & Results Report Angola Health System Performance Strengthening Project (HSPSP) (P160948) Value 1,227,000.00 1,994,374.00 1,799,868.00 1,785,000.00 Date 15-Mar-2019 31-Dec-2020 31-Dec-2021 30-Dec-2022 Intermediate Results Indicators by Components Improving the Quality of Health Services Delivery in Target Provinces IN01146976 ►Health units implementing the minimum package of maternal and child health services (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 153.00 161.00 60.00 Date 29-Dec-2017 31-Dec-2020 31-Dec-2021 30-Jun-2023 Frequency: annual Comments: IN01146978 ►Municipalities implementing operational plans for Health Waste Management (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 21.00 Date 29-Dec-2017 31-Dec-2020 31-Dec-2021 30-Jun-2023 Frequency: annual Comments: IN01146980 ►Number of health units implementing patient feedback mechanisms and presenting results to the Provincial level (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 140.00 Date 18-Dec-2017 31-Dec-2020 31-Dec-2021 30-Jun-2023 IN01146982 ►Number of health facilities that provide TB diagnosis (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 21.00 39.00 22.00 Date 29-Dec-2017 31-Dec-2020 31-Dec-2021 30-Jun-2023 IN01146984 ►Percentage of female adolescents ages 12-15 that had a family planning consultation (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target 6/21/2022 Page 4 of 9 The World Bank Implementation Status & Results Report Angola Health System Performance Strengthening Project (HSPSP) (P160948) Value 5.00 1.10 2.00 14.00 Date 29-Dec-2017 31-Dec-2020 31-Dec-2021 30-Jun-2023 IN01146986 Number of female adolescents ages 12-15 that had a family planning consultation (Number, Custom Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 2,118.00 3,880.00 26,000.00 IN01146989 ►Number of women (ages 15-49) who had a family planning consultation (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 93,433.00 33,361.00 44,553.00 181,328.00 Date 29-Dec-2017 31-Dec-2020 31-Dec-2021 30-Jun-2023 IN01146990 Percentage of women (ages 15-49) who had a family planning consultation (Percentage, Custom Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 13.00 4.00 5.70 22.00 IN01146991 ►Children under-1 receiving Pentavalent third dose (Penta3) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 320,000.00 314,123.00 339,058.00 490,000.00 Date 29-Dec-2017 31-Dec-2020 31-Dec-2021 30-Jun-2023 This indicator includes data from HSPSP and GAVI additionally there is missing data for two Comments: municipalities for the month of December 2020. IN01146992 ►Children receiving first dose of Measles and Rubella (MR 1st dose) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 301,000.00 308,786.00 336,989.00 460,000.00 Date 29-Dec-2017 31-Dec-2020 31-Dec-2021 30-Jun-2023 IN01146993 ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 161,145.00 294,349.00 160,000.00 Date 29-Dec-2017 31-Dec-2020 31-Dec-2021 30-Jun-2023 6/21/2022 Page 5 of 9 The World Bank Implementation Status & Results Report Angola Health System Performance Strengthening Project (HSPSP) (P160948) This indicator was substituted by “People who receive essential health services” and = Number of deliveries attended by skilled health personnel (area PFSS) + Number of Children under 1 year receiving Comments: PENTA3 (area PFSS). IN01146994 Number of children immunized (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 45,485.00 45,485.00 110,000.00 Date 29-Dec-2017 31-Dec-2020 31-Dec-2020 30-Jun-2023 IN01146995 Number of women and children who have received basic nutrition services (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 10,000.00 Date 29-Dec-2017 31-Dec-2020 31-Dec-2020 30-Jun-2023 IN01146996 Number of deliveries attended by skilled health personnel (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 47,296.00 43,992.00 40,000.00 Date 29-Dec-2017 31-Dec-2020 31-Dec-2021 30-Jun-2023 IN01146997 ►Number of municipalities with multiyear proforma indicative budget allocation for child health at municipal level (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 13.00 Date 15-Mar-2019 31-Dec-2020 31-Dec-2021 30-Dec-2022 Strengthening System-wide Enabling Factors that Support Delivery of Quality Health Services IN01146977 ►Technical Health Training Schools implementing new curricula (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 46.00 11.00 Date 29-Dec-2017 31-Dec-2020 31-Dec-2021 30-Jun-2023 Includes new curricula for training of health technicians on birth attendance, statistics, nursing, laboratory and clinical analysis and nutrition. Comments: IN01146979 ►Development of a training module on adolescent-friendly reproductive health services (Yes/No, Custom) 6/21/2022 Page 6 of 9 The World Bank Implementation Status & Results Report Angola Health System Performance Strengthening Project (HSPSP) (P160948) Baseline Actual (Previous) Actual (Current) End Target Value No Yes Yes Yes Date 29-Dec-2017 31-Dec-2020 31-Dec-2021 30-Jun-2023 IN01146981 ►Health personnel trained in adolescent-friendly reproductive health services (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 55.00 230.00 Date 31-Mar-2020 31-Dec-2020 31-Dec-2021 30-Jun-2023 IN01146983 ►Municipalities with staff trained on the operational and budgetary planning tool (FPOM) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 34.00 Date 31-Dec-2016 31-Dec-2020 31-Dec-2021 30-Jun-2023 IN01146985 ►Development of a protocol and tool for certifying health posts, health centers, and municipal hospitals (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No No No Yes Date 31-Dec-2016 31-Dec-2020 31-Dec-2021 31-Dec-2022 IN01146987 ►Emergency operations center reactivated (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No No No Yes Date 31-Dec-2016 31-Dec-2020 31-Dec-2021 31-Dec-2022 IN01146988 ►MICS survey conducted in 2020 (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No No No Yes Date 29-Dec-2017 31-Dec-2020 31-Dec-2021 30-Jun-2023 Performance-Based Conditions 6/21/2022 Page 7 of 9 The World Bank Implementation Status & Results Report Angola Health System Performance Strengthening Project (HSPSP) (P160948) Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P160948 IBRD-88350 Effective USD 110.00 110.00 0.00 103.34 6.66 94% P160948 TF-B0225 Effective USD 9.70 9.70 0.00 6.60 3.10 68% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P160948 IBRD-88350 Effective 22-Mar-2018 28-Jun-2018 24-Oct-2018 30-Sep-2023 30-Sep-2023 P160948 TF-B0225 Effective 29-Mar-2018 12-Jul-2019 12-Jul-2019 30-Sep-2023 30-Sep-2023 Cumulative Disbursements Restructuring History There has been no restructuring to date. Related Project(s) 6/21/2022 Page 8 of 9 The World Bank Implementation Status & Results Report Angola Health System Performance Strengthening Project (HSPSP) (P160948) P168956-Child Health Expansion Angola 6/21/2022 Page 9 of 9