The World Bank Implementation Status & Results Report COVID-19 Response Project (P175131) COVID-19 Response Project (P175131) EUROPE AND CENTRAL ASIA | Turkmenistan | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2021 | Seq No: 3 | ARCHIVED on 28-Jun-2022 | ISR52200 | Implementing Agencies: Ministry of Finance and Economy of Turkmenistan, Ministry of Health and Medical Industry of Turkmenistan Key Dates Key Project Dates Bank Approval Date: 30-Jun-2021 Effectiveness Date: 23-Sep-2021 Planned Mid Term Review Date: 20-Jun-2022 Actual Mid-Term Review Date: 21-Jun-2022 Original Closing Date: 30-Jun-2023 Revised Closing Date: 30-Jun-2023 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The Program Development Objective is to prevent, detect, and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness in Turkmenistan. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Improving COVID-19 Prevention, Detection and Emergency Response:(Cost $5.90 M) Improving Health System Preparedness for COVID-19:(Cost $12.10 M) Project Management and Monitoring and Evaluation:(Cost $2.00 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Satisfactory Satisfactory Overall Risk Rating Substantial Substantial Implementation Status and Key Decisions The Project is rated satisfactory for both achievement towards the Project Development Objective (PDO) and implementation progress. Activities under most components are being implemented on schedule, despite challenges reported earlier, e.g. extensive delivery periods (up to 6 months for some items), high demand for some items (especially medicine), challenges along the transit routes, limitation on transportation options (no regular flights and limited entry points), limitations on domestic travel hampering the delivery of WHO and UNICEF activities as well as other logistical issues. To date actual delivery of goods and services worth around US$8.1 million has been completed. Goods delivered include: PCR labs, PCR tests, centrifuges, thermostats, autoclaves, sterilizers, IT equipment, antibody tests, water distillers, lab incubators, biosafety boxes, IT equipment, cardio monitors, defibrillators, mobile X-ray units, mobile ultrasound units, ECG units, pulse oximeters, mobile disinfecting units, vehicles for labs as well as several items from the list of medications approved for procurement under the project. Additional deliveries of goods are expected in the course of the next months. 6/28/2022 Page 1 of 9 The World Bank Implementation Status & Results Report COVID-19 Response Project (P175131) UNICEF is responsible for activities under the Risk Communication component and has delivered several communication and outreach activities, including a country wide information campaign among schools, which entailed developing Risk Communication and Community Engagement posters with the participation of over 300 schools, including the exhibition of posters; Currently UNICEF is developing materials for pregnant and breastfeeding women and for children aged 5 to 8. UNCIF is discussing engagement of an international partner institution to review the current National Emergency Communication Plan and prepare trainings module for frontline healthcare and social workers. WHO is in charge of the Training and Capacity Building sub-component and has delivered a series of training sessions for physicians and nurses in the capital and provinces on infection prevention and control, on case management. WHO has also assist in strengthening the capacity of lab specialists and is supporting the review of clinical protocols and other relevant documents per the agreed workplan. MPA Program Development Objective MPA PDO Table The Program Development Objective is to prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness MPA Table Multiphase Programmatic Approach (MPA) Status MPA Table Body As of June 15, 2022, 88 MPA-projects had been approved with a total commitment of US$4.3 billion. One operation (Guatemala) was cancelled in mid-September 2021, at the request of the Government. Six parent projects have been restructured to include vaccine-related procurement. Total disbursements as of June 15, 2022, amount to US$3.6 billion or 84% of overall commitments. This amount does not include disbursements under MPA-V operations which are reported together with AF-V operations. Sixty-seven (67) country projects or 77% of projects approved have reached 70-100% disbursement (reasons for >100% disbursements relate to fluctuations between the Euro and the SDR against the US$). Out of the 67 operations, 48 operations or 72% have disbursed over 90% of commitments. Of these, 30 operations are fully disbursed. There are thirteen (13) operations with closing dates by the end of FY22. Other 10 operations which had closing dates by the end of the FY have extended their closing dates. There are 12 operations with disbursements under 50%. Out of these 12 operations, one has not disbursed, and four have disbursed 30 percent or less. The projects are benefitting around 3.7 billion people or 50% of the global population. Of the 87 active projects: (i) 33 are in Africa – 12 in AFE and 21 in AFW; (ii) 12 in East Asia; (iii) 14 in Europe and Central Asia; (iv) 11 in Latin America and the Caribbean; (v) 8 in Middle East and North Africa; and (vi) 9 in South Asia. Eighty-six (86) or 99% of projects approved are disbursing. MNA has the highest percentage of disbursements, followed by SRA, EAP, ECA and LAC, AFE and AFW. Retroactive Financing represents 26% of commitments. Country teams for operations, which have been under implementation for twelve months or more by June 30, 2022, are preparing Mid-Term Review (MTR) ISRs to inform the Global MPA MTR, which will be prepared early next FY. Streamlined procedures, delegated approvals, coupled with flexible project design and intensified efforts across the Bank have contributed to the progress. Implementation is being guided by Bank teams working in parallel with other health related projects, including Additional Financing operations supporting vaccine procurement and deployment efforts. Implementation continues to face challenges as several countries are still under different levels of mobility restrictions. Bank staff are operating in a hybrid environment with some days at the office and others at home. Notwithstanding the challenges, the MPA is on track to achieve its PrDO, which is to prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness. The significant level of disbursements attests to the strong implementation of the Bank' response thanks to the commitment of counterparts supported by Bank country teams. Risks Systematic Operations Risk-rating Tool 6/28/2022 Page 2 of 9 The World Bank Implementation Status & Results Report COVID-19 Response Project (P175131) Risk Category Rating at Approval Previous Rating Current Rating Political and Governance Moderate Moderate Moderate Macroeconomic Substantial Substantial Substantial Sector Strategies and Policies Moderate Moderate Moderate Technical Design of Project or Program Substantial Substantial Substantial Institutional Capacity for Implementation and Substantial Substantial Substantial Sustainability Fiduciary Moderate Moderate Moderate Environment and Social Substantial Substantial Substantial Stakeholders Moderate Moderate Moderate Other -- -- -- Overall Substantial Substantial Substantial Results PDO Indicators by Objectives / Outcomes Strengthened government capacity to prevent COVID-19 IN01163261 ►PDO Indicator 1: Development and periodic update of a comprehensive national COVID-19 risk communication plan, including standardized, evidence-based information targeted to different population group (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target The tender for A comprehensive international expert The tender for national COVID-19 risk institution to conduct international expert communication plan the review of the plan institution to conduct the has been developed No comprehensive is finalized and the review of the plan is and is periodically national COVID-19 risk consultant institution Value finalized. The selected updated to include communication plan has been identified. institution will commence standardized, exists Introductory meetings the review and evidence-based were held with the development in Q3 of information targeted to client and the activities 2022. different population are to be implemented groups. during Q3 of 2022. Date 29-Jan-2021 31-Mar-2022 23-Jun-2022 30-Jun-2023 Comments: Assesses the capacity of the health system to prevent COVID-19 IN01163263 ►PDO Indicator 4: A National Pandemic Preparedness and Response Plan is regularly updated and tailored for each region. (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target A National Pandemic A National Pandemic The National A national Pandemic Preparedness and Preparedness and Pandemic Preparedness and Response Plan was Response Plan was Preparedness and Value Response Plan has been approved in 2021, and, approved in 2021, and, Response Plan adopted exists as of March 31, 2022, it as of March 31, 2022, tailored to each region has been in it has been in is regularly updated 6/28/2022 Page 3 of 9 The World Bank Implementation Status & Results Report COVID-19 Response Project (P175131) implementation. No implementation. No revisions and updates revisions and updates are currently envisaged. are currently envisaged. Date 29-Jan-2021 31-Mar-2022 23-Jun-2022 30-Jun-2023 Assesses national systems for public health preparedness Comments: Strengthened government capacity to detect COVID-19 IN01163262 ►PDO Indicator 2: Number of COVID-19 designated laboratories with verified diagnostic equipment and test kits. (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 13.00 13.00 5.00 Date 29-Jan-2021 31-Mar-2022 23-Jun-2022 30-Jun-2023 Comments: Measures the capacity of the health system to detect COVID-19 Strengthened government capacity to treat COVID-19 IN01163145 ►PDO Indicator 3: Number of designated beds for COVID-19 patients with access to continuous oxygen supply (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1,000.00 1,000.00 600.00 Date 29-Jan-2021 31-Mar-2022 23-Jun-2022 30-Jun-2023 Number of designated beds for COVID-19 patients with access to continuous oxygen supply that are Comments: sourced from oxygen generating plants or liquid oxygen in bulk storage tanks. Intermediate Results Indicators by Components Component 1: Improving COVID-19 Prevention, Detection and Emergency Response IN01163264 ►Number of health staff (physicians and nurses) trained in infection prevention and control in accordance with approved protocols (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 88.00 273.00 4,000.00 Date 29-Jan-2021 31-Mar-2022 23-Jun-2022 30-Jun-2023 Comments: Measures outputs that will help the health system to prevent and respond to COVID-19. IN01163265 ►Clinical protocols, including a referral system, to care for COVID-19 patients are regularly reviewed or updated (Text, Custom) 6/28/2022 Page 4 of 9 The World Bank Implementation Status & Results Report COVID-19 Response Project (P175131) Baseline Actual (Previous) Actual (Current) End Target The Clinical protocols, including a referral The Clinical protocols, system, for COVID-19 including a referral patients care were Clinical protocols, system, for COVID-19 Clinical protocols, prepared and shared including a referral patients care were including a referral by WHO in March system, for COVID-19 Value prepared and shared by system, for COVID-19 2022. MOHMI initiated patients are regularly WHO in March 2022. patients established seminars and reviewed or updated MOHMI initiated workshops on the as necessary seminars and workshops protocols. As of June on the protocols. 2022, two round-tables were held. Date 29-Jan-2021 31-Mar-2022 23-Jun-2022 30-Jun-2023 Comments: Assesses capacity for surveillance and rapid response to suspected cases of COVID-19 IN01163267 ►Number of COVID-19 designated laboratories with staff trained to conduct COVID-19 diagnosis (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 13.00 13.00 13.00 Date 29-Jan-2021 31-Mar-2022 23-Jun-2022 30-Jun-2023 Comments: Measures outputs that will help the health system to detect COVID-19 IN01163269 ►Electronic program for tracking and monitoring contacts developed and set up in Sanitary and Epidemiological Safety and Control (SESC) offices in Ashgabat and in five velayats (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target IT equipment was delivered in June. During the next An electronic program Delivery of IT equipment months, the project will for tracking and No electronic program for equipment, delayed due provide further support monitoring contacts is Value tracking and monitoring to global supply with TA and additional set up in SESC offices contacts exists challenges, is expected equipment, software in Ashgabat and in five by the end April 2022. for establishment of a velayats contact tracing and epidemiological surveillance software. Date 29-Jan-2021 31-Mar-2022 23-Jun-2022 30-Jun-2023 Comments: Assesses capacity for surveillance of suspected cases of COVID-19, and prevention of pandemic spread IN01163270 ►National testing strategy, national hospital surge capacity plan and national case management strategy developed (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target No national testing This activity is being This activity was A national testing strategy, national implemented, including implemented through strategy, national hospital surge capacity through the EU funds. A additional funds, hospital surge capacity Value plan and national case detailed updated will be including from EU. No plan, and national case management strategy provided during the next revisions are required management strategy exist ISR. at this stage. are developed. 6/28/2022 Page 5 of 9 The World Bank Implementation Status & Results Report COVID-19 Response Project (P175131) Date 29-Jan-2021 31-Mar-2022 23-Jun-2022 30-Jun-2023 Comments: Measures outputs that will help the health system to respond to COVID-19 IN01163271 ►Number of focus groups conducted to engage communities, understand their needs and receive feedback on the project (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 16.00 Date 29-Jan-2021 31-Mar-2022 23-Jun-2022 30-Jun-2023 Comments: Supports monitoring and achievement of PDO indicator 1. IN01163272 ►Number of risk communication messages targeted to different population groups developed (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 3.00 3.00 4.00 Date 29-Jan-2021 31-Mar-2022 23-Jun-2022 30-Jun-2023 Comments: Measures outputs that will help the health system to prevent COVID-19 IN01163273 ►Number of gender-specific information campaigns delivered. (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1.00 1.00 2.00 Date 29-Jan-2021 31-Mar-2022 23-Jun-2022 30-Jun-2023 Comments: Measures outputs that will help the health system to prevent COVID-19 IN01163274 ►Percentage of participants in community meetings/events reporting that the local outreach and community engagement process is effective (disaggregated by gender) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 75.00 Date 29-Jan-2021 31-Mar-2022 23-Jun-2022 30-Jun-2023 Number of participants in community meeting/events reporting that local outreach and community Comments: engagement process is effective; denominator: total number of participants IN01163275 ►Number of public health specialists trained on climate-induced vector borne diseases and waterborne diseases (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 75.00 75.00 100.00 Date 29-Jan-2021 31-Mar-2022 23-Jun-2022 30-Jun-2023 6/28/2022 Page 6 of 9 The World Bank Implementation Status & Results Report COVID-19 Response Project (P175131) Comments: Number of public health specialists trained on climate-induced vector borne diseases. IN01163276 ►Percentage increase in risk awareness of COVID-19 among PHC nurses (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 50.00 50.00 50.00 Date 29-Jan-2021 31-Mar-2022 23-Jun-2022 30-Jun-2023 Numerator: Number of PHC nurses aware of the risks linked to COVID-19 Denominator: Total number of Comments: PHC nurses Component 2. Improving health system preparedness for COVID-19 IN01163266 ►Number of hospital and primary care physicians trained in the management of COVID-19 and SARI patients and adherence to COVID-19 protocols (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 357.00 480.00 2,000.00 Date 29-Jan-2021 31-Mar-2022 23-Jun-2022 30-Jun-2023 Measures outputs that will help the health system to prevent COVID-19. Number of hospital and primary Comments: care staff trained in the management of COVID-19 and SARI patients and adherence to COVID-19 protocols with a support from the project. IN01163268 ►List of equipment, consumables and medications for resuscitation and management of COVID-19 and SARI patients with lung function disorders is defined and regularly updated. (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target MOHMI adopted and approved a list of A verified list of MOHMI adopted and equipment and drugs. equipment, No verified list of approved a list of A working group for consumables and equipment, consumables equipment and drugs. the Review and update medications for and medications for UNDP initiated of the list of equipment resuscitation and resuscitation and Value establishment of the was established and management of management of COVID- MOHMI working group the first meeting took COVID-19 and SARI 19 and SARI patients for the Review and place in May. WHO patients with lung with lung function update of the list of provided relevant function disorders is disorders exists equipment. recommendations for defined and regularly the MOHMI's updated consideration. Date 29-Jan-2021 31-Mar-2022 23-Jun-2022 30-Jun-2023 Measures outputs that will help the health system to respond to COVID-19. List of equipment, Comments: consumables and medications for resuscitation and management of COVID-19 and SARI patients with lung function disorders is defined and regularly updated with a support from the project. Overall Comments IR Indicator: Number of health staff (physicians and nurses) trained in infection prevention and control in accordance with approved protocols. 6/28/2022 Page 7 of 9 The World Bank Implementation Status & Results Report COVID-19 Response Project (P175131)  Comment: Some trainings were conducted the capital and regions. A total of 273 epidemiologists were trained. This is behind the schedule; the implementation is impeded by restrictions and connectivity issues for on-line trainings. WHO is working to catch-up with the schedule. Indicator: Number of focus groups conducted to engage communities, understand their needs and receive feedback on the project  Comment: The focus groups are planned to be conducted in Q3-2022 within the information campaigns in schools. Indicator: Percentage of participants in community meetings/events reporting that the local outreach and community engagement process is effective (disaggregated by gender)  Comment: The feedback gathering meetings/focus group will start taking place in Q4 within information campaign in schools and percentage will be calculated subsequently. Indicator: Number of hospital and primary care physicians trained in the management of COVID-19 and SARI patients and adherence to COVID-19 protocols  Comment: The number trained on case management 480, or 48% of the interim target. The delay is caused by late receipt of advance payment, and limitations of the travel and poor internet connection in the regions. The WHO is taking measures to achieve the target by the end of June 2022. All trainings have been planned and approved by MOHMI and will continue through end Q2 - Q3 2022. Performance-Based Conditions Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P175131 IBRD-92850 Effective USD 20.00 20.00 0.00 15.01 4.99 75% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P175131 IBRD-92850 Effective 30-Jun-2021 26-Jul-2021 23-Sep-2021 30-Jun-2023 30-Jun-2023 Cumulative Disbursements 6/28/2022 Page 8 of 9 The World Bank Implementation Status & Results Report COVID-19 Response Project (P175131) Restructuring History There has been no restructuring to date. Related Project(s) There are no related projects. 6/28/2022 Page 9 of 9