The World Bank Implementation Status & Results Report The Gambia COVID-19 Preparedness and Response Project (P173798) The Gambia COVID-19 Preparedness and Response Project (P173798) WESTERN AND CENTRAL AFRICA | Gambia, The | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2020 | Seq No: 4 | ARCHIVED on 20-Jun-2022 | ISR51955 | Implementing Agencies: Ministry of Health, The Gambia Key Dates Key Project Dates Bank Approval Date: 02-Apr-2020 Effectiveness Date: 03-Apr-2020 Planned Mid Term Review Date: 12-Nov-2021 Actual Mid-Term Review Date: 10-Nov-2021 Original Closing Date: 31-Mar-2022 Revised Closing Date: 31-Mar-2023 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) To prevent, detect and respond to the threat posed by COVID-19 and strengthen national system for public health preparedness Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Component 1: Emergency COVID-19 Response:(Cost $24.00 M) Component 2: Strengthening Multi-sector, National Institutions and Platforms for Policy Development and Coordination of Prevention and Preparedness using One Health approach.:(Cost $0.60 M) Component 3: Supporting National and Sub-national, Prevention and Preparedness:(Cost $5.91 M) Component 4: Implementation Management and Monitoring and Evaluation:(Cost $0.40 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 progress towards achieving the Project Development Objective and overall implementation are rated Satisfactory. A third additional financing of US$12.0 million was approved on June 6, 2022 for scaling up of the following activities under Component 1: a) purchase of COVID-19 vaccine; b) deployment of COVID-19 vaccine delivery including risk communication and community engagement; and c) adverse events following immunization (AEFI) testing (laboratory equipment and supplies); and d) AEFI treatment (including medical equipment for COVID-19 treatment centers). All the targets of the PDO-level indicators have been met except for the COVID-19 vaccination rate which is currently 18.5 percent against a target of 40 percent by June 30, 2023. 6/20/2022 Page 1 of 10 The World Bank Implementation Status & Results Report The Gambia COVID-19 Preparedness and Response Project (P173798) 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 The Additional Financing (MPA AF-V) to the COVID-19 Strategic Preparedness and Response Program utilizing the Multiphase Programmatic Approach (“Global COVID-19 MPA”) was approved by the Board on October 13, 2021. The AF-V is significantly expanding Bank support to client countries for COVID-19 vaccination, with the aim to support vaccination of 1 billion people globally. The AF-V was approved with an envelope of US$12 billion ($6 billion from IDA and $6 billion from IBRD) in financing. On June 30, 2021, President Malpass announced the expansion of financing available for COVID-19 vaccine financing to $20 billion over the next 18 months, adding $8 billion to the previously announced $12 billion. This financing is critical to expand affordable and equitable financing for vaccine purchase and deployment. The AF-V is expected to enable vaccination for up to 750 million people, with potential surge capacity for an additional 250 million people in the poorest countries (depending on the delivered price of approved vaccines) while scaling support to strengthen immunization delivery, with design flexibility at the country level. The AF-V is a scale-up of planned vaccination activities anticipated and supported under the Global COVID-19 MPA and a key contribution to the WBG’s overall COVID-19 response. As of June 15, 2022, the Bank has approved 105 operations (including MPA-V operations) to support vaccine procurement and rollout in 77 countries amounting to $9.6 billion. The 105 operations approved, include 6 operations that involved restructuring of parent projects (Bhutan, Cameroon, North Macedonia, Philippines, and Pakistan) and in the case of Lebanon, restructuring of the Health Resilience Project. Of the 105 approved operations: (i) 56 are in Africa – 26 in AFE and 30 in AFW; (ii) 9 in East Asia and the Pacific; (iii) 11 in Europe and Central Asia; (iv) 11 in Latin America and the Caribbean; (v) 9 in Middle East and North Africa; and (vi) 9 in South Asia. Fifty-three (53) projects are disbursing. Total disbursements as of June 15, 2022, under these projects amount to US$3.4 billion or 35% of overall commitments. Disbursements under MPA-V operations are included in this total while disbursements under the six restructured projects are counted under parent projects. Sixteen (16) operations have disbursed over 70% of their commitments. Out of the 16, seven have disbursed 90%. Retroactive Financing represents 44% of overall commitments. Thirteen (13) new operations are under various stages of processing. As with the MPA operations, streamlined procedures, delegated approval, coupled with flexible project design, and intensified efforts across the Bank have contributed to the rapid design and processing of the operations. Eighty-eight (88) loan/financing agreements have been signed. Also, eighty-six (86) loan/financing agreements have become effective; several others are expected to become effective in the coming weeks. Implementation of the AF- V operations, as with MPA operations is facing challenges as several countries are still under different levels of mobility restrictions and counterparts and Bank teams are operating in a hybrid environment with some days at the office and some at home. Countries are dealing with new waves of infections, as the Omicron variant continues to spread rapidly among populations. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance High Substantial Substantial 6/20/2022 Page 2 of 10 The World Bank Implementation Status & Results Report The Gambia COVID-19 Preparedness and Response Project (P173798) Macroeconomic Substantial Substantial Substantial Sector Strategies and Policies Moderate Moderate Moderate Technical Design of Project or Program Moderate Moderate Moderate Institutional Capacity for Implementation and Substantial Moderate Moderate 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 Strengthen the national public health preparedness capacity to prevent, detect and respond IN01156283 ►Suspected cases of COVID-19 cases reported and investigated per approved protocol (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 100.00 50.00 Date 02-Mar-2020 29-Oct-2021 31-Mar-2022 31-Mar-2023 IN01156284 ►Isolation and treatment centers with pandemic preparedness and response plans per Ministry of Health Guidelines (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 100.00 50.00 Date 02-Mar-2020 29-Oct-2021 31-Mar-2022 31-Mar-2023 IN01156285 ►Health staff trained in infection prevention per MOH-approved protocols (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1,307.00 2,614.00 500.00 Date 02-Mar-2020 29-Oct-2021 31-Mar-2022 31-Mar-2023 IN01156286 ►Diagnosed cases treated per approved protocol (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 55.00 100.00 50.00 6/20/2022 Page 3 of 10 The World Bank Implementation Status & Results Report The Gambia COVID-19 Preparedness and Response Project (P173798) Date 02-Mar-2020 29-Oct-2021 31-Mar-2022 31-Mar-2023 IN01156287 ►Population vaccinated, which is included in the priority population targets defined in national plan (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 9.70 18.50 40.00 Date 31-Mar-2021 15-Nov-2021 02-Jun-2022 30-Jun-2023 IN01156288 Population vaccinated, which is included in the priority population targets defined in national plan, female (Percentage, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 5.20 10.40 20.00 Date 26-Feb-2021 15-Nov-2021 02-Jun-2022 30-Jun-2023 Intermediate Results Indicators by Components Component 1: Emergency COVID-19 Response IN01156290 ►Public Health Emergency Operation Center (PHEOC) activated and operationalized to support coordination and planning for COVID-19 or other future emergencies (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target PHEOC operational - PHEOC operational - has has dedicated toll-free dedicated toll-free 1025 1025 number, number, equipped with equipped with computers and computers and Value Not operational communication Operational communication equipment and equipment and emergency vehicles, and emergency vehicles, a designated National and a designated Focal Point National Focal Point Date 02-Mar-2020 29-Oct-2021 31-Mar-2022 30-Jun-2022 IN01156291 ►Points of Entries equipped and staff trained in SOPs (including for infection prevention and control, screening of passengers (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 9.00 13.00 9.00 Date 02-Mar-2020 29-Oct-2021 31-Mar-2022 30-Jun-2023 The number of staff at the points of entry (POEs) has increased. For instance, there were 20 personnel from MOH assigned to POEs prior to COVID-19 but it has since increased to 43. A total of 105 POE staff (including police, immigration and 43 MOH POE staff) have been trained on a comprehensive POE Comments: standard operating procedures that cover infection prevention and control, International Health Regulations, contact tracing, surveillance, quarantine, border issues, and transportation of suspected cases. Additionally, 30 MOH POEs have been trained on COVID-19 Rapid Diagnostic Testing and the 6/20/2022 Page 4 of 10 The World Bank Implementation Status & Results Report The Gambia COVID-19 Preparedness and Response Project (P173798) DHIS2 platform. The staff at the POEs are now conducting test on incoming travelers and entering data in the DHIS2. Though some MOH staff had initial difficulty in accessing DHIS2 but this has improved. IN01156293 ►Rapid-response teams members trained and equipped to investigate cases and conduct contact tracing (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 36.70 36.70 80.00 Date 02-Mar-2020 29-Oct-2021 31-Mar-2022 30-Jun-2023 36.7 (55/150*100) Comments: IN01156295 ►Table-top simulation exercises and findings documented to inform future preparedness and response activities (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Report on table-top 1 table-top simulation 1 table-top simulation simulation exercises Value None exercise conducted exercise conducted with recommendations or lessons learned Date 02-Mar-2020 29-Oct-2021 31-Mar-2022 30-Jun-2023 IN01156296 ►Supervisory visits undertaken to nine Points of Entry (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 3.00 8.00 27.00 Date 02-Mar-2020 30-Jun-2020 31-Mar-2022 30-Jun-2023 Comments: Cumulative number of supervisory visits undertaken to all nine Points of Entry IN01156297 ►Border officers trained on COVID-19 prevention and control and contact tracing (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 135.00 162.00 50.00 Date 02-Mar-2020 29-Oct-2021 31-Mar-2022 30-Jun-2023 IN01156298 ►Community-based nurses and PHO trained on COVID-19 prevention and control and contact tracing (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 500.00 600.00 100.00 Date 02-Mar-2020 29-Oct-2021 31-Mar-2022 30-Jun-2022 382 PHOs and 218 Community Health Nurses Comments: IN01156299 6/20/2022 Page 5 of 10 The World Bank Implementation Status & Results Report The Gambia COVID-19 Preparedness and Response Project (P173798) ►Emergency Ambulances operational (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 18.00 18.00 20.00 Date 02-Mar-2020 29-Oct-2021 31-Mar-2022 30-Jun-2023 Currenrly, there are 18 ambulances Comments: IN01156300 ►MoU signed with Republic of Senegal PHES (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target No formal MoU signed No formal MoU signed but there has been but there has been Value None knowledge exchange knowledge exchange signed visits between the two visits between the two countries countries Date 02-Mar-2020 29-Oct-2021 31-Mar-2022 30-Jun-2023 IN01156301 ►Table-top simulation exercises conducted (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1.00 1.00 10.00 Date 02-Mar-2020 29-Oct-2021 31-Mar-2022 30-Jun-2023 IN01156302 ►Sites for treatment of healthcare waste established (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 7.00 7.00 Date 02-Mar-2020 29-Oct-2021 10-Jun-2022 30-Jun-2023 7 containerized environmentally friendly and energy efficient dual chamber incinerators have been Comments: installed. Two ecosteryl clinical waste treatment centers to be completed in July 2022 IN01156303 ►COVID-19 sensitization campaigns conducted in all regions (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 14.00 13,720.00 7.00 Date 02-Mar-2020 29-Oct-2021 31-Mar-2022 30-Jun-2023 13,720 COVID-19 sensitization campaigns were conducted in the 7 health regions using a mega phone system. 1 Comments: IN01156304 6/20/2022 Page 6 of 10 The World Bank Implementation Status & Results Report The Gambia COVID-19 Preparedness and Response Project (P173798) ►Grievances responded to within stipulated service standards for response (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 50.00 50.00 40.00 Date 31-Mar-2020 29-Oct-2021 31-Mar-2022 30-Jun-2023 A total of 32,707 calls to the 1025 toll-free line were logged. Calls received pertained to people sharing their concerns and asking questions on available support services such as how to get their sample Comments: collected for testing, seeking clarifications on quarantine, isolation and testing protocol and seeking information on vaccination services. IN01156305 ►Population vaccinated, which is included in the priority population targets defined in national plan (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 236,470.00 451,548.00 960,000.00 Date 26-Feb-2021 15-Nov-2021 02-Jun-2022 30-Jun-2023 IN01156306 Population vaccinated, which is included in the priority population targets defined in national plan, female (Number, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 145,865.00 254,837.00 480,000.00 Date 26-Feb-2021 29-Oct-2021 02-Jun-2022 30-Jun-2023 IN01156307 ►Health personnel (such as nurses and Public Health Officers) trained in capacity and skills to administer the COVID-19 vaccine (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 200.00 400.00 200.00 Date 26-Feb-2021 29-Oct-2021 31-Mar-2022 30-Jun-2023 IN01156308 ►Implementation of a civil society-based mechanism to monitor, report and facilitate responses to problems in the COVID-19 response (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target A comprehensive A comprehensive Gender-based Gender-based Violence, Violence, Sexual Sexual Exploitation and Exploitation and Abuse, and Sexual Abuse, and Sexual Civil society-based Civil society-based Harassment Harassment Value monitoring mechanism monitoring mechanism (GBV/SEA/SH) Action (GBV/SEA/SH) Action not in place in place Plan has been developed Plan has been with active participation developed with active of civil society and is participation of civil under implementation. society and is under implementation. Date 02-Mar-2020 29-Oct-2021 31-Mar-2022 30-Jun-2023 IN01156309 6/20/2022 Page 7 of 10 The World Bank Implementation Status & Results Report The Gambia COVID-19 Preparedness and Response Project (P173798) ►Health and community workers with the knowledge to provide quality and comprehensive care to GBV survivors (recognize, medically manage & refer survivors to appropriate services using survivor cente (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 60.00 Date 03-Apr-2020 03-Jun-2022 03-Jun-2022 30-Jun-2023 New indicator in the third AF approved on June 6 2022 Comments: Component 2: Strengthening Multi-sector, National Institutions and Platforms for Policy Development IN01156289 ►Electronic Integrated Disease Surveillance Response (IDSR) using DHIS2 platform interfaced with laboratory management information system established (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Electronic Integrated Electronic Integrated Disease Surveillance Disease Surveillance Response has been Response has been integrated into District integrated into District Health Information Health Information System 2 (DHIS2) System 2 (DHIS2) Value None Established produces weekly produces weekly aggregated data on aggregated data on human diseases but human diseases but does not include does not include indicators on animal indicators on animal health. health. Date 02-Mar-2020 29-Oct-2021 31-Mar-2022 30-Jun-2023 Component 3: Supporting National and Sub-national, Prevention and Preparedness IN01156292 ►Standard Operating Procedures (SOPs) on sample collection, packaging, transportation and testing of samples (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target SOPs on sample SOPs on sample collection, packaging, collection, packaging, transportation and transportation and testing testing are available are available and in and in place. All place. All laboratory Value None laboratory personnel SOP in place personnel involved in involved in COVID-19 COVID-19 response response have been have been trained. This trained. This was done was done with the with the support of support of AFENET. AFENET. Date 02-Mar-2020 29-Oct-2021 31-Mar-2022 30-Jun-2023 IN01156294 ►Treatment centres renovated/constructed and/or equipped (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 2.00 2.00 2.00 6/20/2022 Page 8 of 10 The World Bank Implementation Status & Results Report The Gambia COVID-19 Preparedness and Response Project (P173798) Date 02-Mar-2020 29-Oct-2021 30-Jun-2022 30-Jun-2023 Performance-Based Conditions Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P173798 IDA-D5970 Effective USD 10.00 10.00 0.00 10.01 0.10 99% P173798 IDA-D8020 Effective USD 8.00 8.00 0.00 5.23 2.57 67% P173798 TF-B4724 Closed USD 0.94 0.91 0.03 0.91 0.00 100% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P173798 IDA-D5970 Effective 02-Apr-2020 03-Apr-2020 03-Apr-2020 31-Mar-2022 31-Mar-2023 P173798 IDA-D8020 Effective 16-Apr-2021 28-Apr-2021 06-May-2021 31-Mar-2023 31-Mar-2023 P173798 TF-B4724 Closed 22-Dec-2020 22-Dec-2020 22-Dec-2020 31-Jan-2021 31-Jan-2021 Cumulative Disbursements 6/20/2022 Page 9 of 10 The World Bank Implementation Status & Results Report The Gambia COVID-19 Preparedness and Response Project (P173798) Restructuring History Level 2 Approved on 17-Jun-2021 ,Level 2 Approved on 14-Sep-2021 Related Project(s) P175740-AF to The Gambia COVID-19 Preparedness and Response Project ,P176125-Second AF to The Gambia COVID-19 Vaccine Preparedness and Response Project ,P178965-Third AF to The Gambia COVID-19 Vaccine Preparedness and Response Project 6/20/2022 Page 10 of 10