The World Bank Implementation Status & Results Report Rwanda COVID-19 Emergency Response Project (P173855) Rwanda COVID-19 Emergency Response Project (P173855) EASTERN AND SOUTHERN AFRICA | Rwanda | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2020 | Seq No: 4 | ARCHIVED on 27-Jun-2022 | ISR50649 | Implementing Agencies: Ministry of Finance and Economic Planning (MINECOFIN), Ministry of Health (MoH) / Rwanda Biomedical Center (RBC) Key Dates Key Project Dates Bank Approval Date: 07-Apr-2020 Effectiveness Date: 20-Apr-2020 Planned Mid Term Review Date: 30-Sep-2022 Actual Mid-Term Review Date: 31-May-2022 Original Closing Date: 30-Jun-2022 Revised Closing Date: 30-Jun-2025 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The objective of the Project is to prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness in the Republic of Rwanda. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Component 1. Case Detection, Confirmation and Contact Tracing:(Cost $6840000.00 M) Component 2: Public Health Measures and Clinical Care Capacity:(Cost $69250000.00 M) Component 3. Implementation Management and Monitoring and Evaluation:(Cost $1100000.00 M) Component 4. Contingency Emergency Response Component (CERC) Component 5. Protecting Essential Health Services:(Cost $15000000.00 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Satisfactory Satisfactory Overall Risk Rating Moderate Moderate Implementation Status and Key Decisions The Rwanda COVID 19 Emergency Response Project has been under implementation for 25 months with steady progress towards achieving the Project Development Objective. To date, the World Bank has disbursed a total of 48 million dollars (52.48%) through the Project. The Project has benefitted from three rounds of additional Financing, including the first through the Pandemic Emergency Financing Facility, the second and the third through International Development Association (IDA) for vaccines. The second AF includes a grant of US$15 million from the Global Financing Facility (GFF) to strengthen the continuity of essential health services during and beyond the pandemic. The project continues to be effectively implemented through an experienced implementation unit which has a solid track record working with the World Bank.  6/27/2022 Page 1 of 8 The World Bank Implementation Status & Results Report Rwanda COVID-19 Emergency Response Project (P173855) 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 Risk Category Rating at Approval Previous Rating Current Rating Political and Governance Low Low Low Macroeconomic Substantial Moderate Moderate Sector Strategies and Policies Moderate Moderate Moderate 6/27/2022 Page 2 of 8 The World Bank Implementation Status & Results Report Rwanda COVID-19 Emergency Response Project (P173855) Technical Design of Project or Program Moderate Moderate Moderate Institutional Capacity for Implementation and Substantial Moderate Moderate Sustainability Fiduciary Substantial Moderate Moderate Environment and Social Substantial Substantial Substantial Stakeholders Moderate Moderate Moderate Other -- -- -- Overall Substantial Moderate Moderate Results PDO Indicators by Objectives / Outcomes Prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems IN01151368 ►Proportion of suspected cases of COVID-19 reported and investigated based on national guidelines (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 80.00 100.00 100.00 100.00 Date 07-Apr-2020 29-Oct-2021 31-May-2022 30-Jun-2023 IN01151440 ►Number of designated laboratories with COVID-19 diagnostic capacity (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 1.00 151.00 155.00 151.00 Date 07-Apr-2020 29-Oct-2021 31-May-2022 30-Jun-2025 The figure includes 51 public hospitals and 100 private health facilities that have been accredited to provide Rapid Test. The overachievement can be explained by the fact that during the design phase, the Comments: engagement of the private sector in COVID-19 diagnosis was not envisaged. IN01151443 ►Proportion of designated healthcare facilities with isolation capacity (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 20.00 100.00 100.00 100.00 Date 07-Apr-2020 29-Oct-2021 31-May-2022 30-Jun-2023 COVID-19 Vaccine Coverage IN01151370 ►Percentage of population 18 years and above receiving a booster, which is included in the population targets defined in the national plan, disaggregated by sex (Percentage, Custom) 6/27/2022 Page 3 of 8 The World Bank Implementation Status & Results Report Rwanda COVID-19 Emergency Response Project (P173855) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 36.00 50.00 Date 28-Feb-2022 -- 31-May-2022 30-Jun-2025 IN01151439 ►Percentage of the population fully vaccinated which is included in the priority population targets as defined in the national plan disaggregated by sex, age group and location. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 13.00 65.50 86.00 Date 05-Feb-2021 29-Oct-2021 31-May-2021 30-Jun-2025 The vaccination coverage rate is calculated against the total population of the country (estimated at over 13 million in 2021). As of May 31, 2022, over 8.54 M people aged 12 years and above have been fully vaccinated. With respect to the targeted population of 11.25 M, the vaccination progress (implementation) rate is 76%. Although, it was possible to estimate 10% female and 11%. Male and female are equally Comments: reached with the vaccination. Depending on the availability of pediatric formulation, from the second half of the year 2022, the vaccination campaign will shift toward children aged 5-11 years (2.189 M people), equivalent to 17% of the population. IN01151442 ►Number of doses of COVID-19 vaccine procured with Project funding (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 3,601,440.00 6,000,000.00 Date 29-Jan-2021 -- 31-May-2022 30-Jun-2025 Overall Comments PDO Indicator description aligned to current situation: (i) vaccination currently open to all (from 12 years), (ii) there is a plan to reach children aged 5-11 years; (iii) WB supports vaccine procurement, as well as the deployment cost for any approved vaccines irrespective of the source of the vaccines. Intermediate Results Indicators by Components Component 1: Case Detection, Confirmation and Contact Tracing IN01151432 ►Number of laboratory staff trained to conduct COVID-19 diagnosis (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 110.00 129.00 50.00 Date 07-Apr-2020 29-Oct-2021 31-May-2022 30-Jun-2023 IN01151438 6/27/2022 Page 4 of 8 The World Bank Implementation Status & Results Report Rwanda COVID-19 Emergency Response Project (P173855) ►Percentage of grievances documented, processed and resolved within 30 days (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 100.00 Date 20-Oct-2020 29-Oct-2021 31-May-2022 30-Jun-2025 No grievance reported Comments: IN01151441 ►Total tests performed by the Government facilities, disaggregated by sex (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 27,112,552.00 0.00 0.00 Date 20-Oct-2020 29-Oct-2021 31-May-2022 30-Jun-2023 MoH is working on the disaggregation of tests by type of facility. Comments: Time response to COVID-19 IN01151434 ►Proportion of targeted healthcare facilities with clinical capacity for COVID-19 patients (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 20.00 100.00 100.00 100.00 Date 07-Apr-2020 29-Oct-2021 31-May-2022 30-Jun-2023 IN01151437 ►Number of health staff trained in infection prevention and control (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 20.00 2,825.00 3,115.00 2,000.00 Date 07-Apr-2020 29-Oct-2021 31-May-2022 30-Jun-2023 COVID-19 Vaccine Knowledge, Acceptance, and Safety IN01151433 ►Number of mass media campaigns on COVID-19 prevention and vaccination (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 100.00 90.00 Date 05-Feb-2021 29-Oct-2021 31-May-2022 30-Jun-2023 IN01151445 ►Proportion of serious events following immunization (AEFI) reported and investigated, by sex (Percentage, Custom) 6/27/2022 Page 5 of 8 The World Bank Implementation Status & Results Report Rwanda COVID-19 Emergency Response Project (P173855) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 62.00 95.00 Date 05-Feb-2021 29-Oct-2021 31-May-2021 30-Jun-2025 Health System Strengthening IN01151431 ►Number of people screened for underlying chronic conditions, disaggregated sex and age group (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 363,248.00 300,000.00 Date 08-Mar-2021 29-Oct-2021 31-May-2022 30-Jun-2025 July 15, 2021: 185,000. (100,000 Female) Comments: IN01151436 ►Percentage of targeted hospitals with functioning oxygen therapy system (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 48.00 100.00 Date 08-Mar-2021 29-Oct-2021 31-May-2022 30-Jun-2023 Maintaining Essential Health Services during and beyond COVID-19 IN01151369 ►Number of outpatient consultations, disaggregated by age and sex (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 18,860,619.00 0.00 15,210,832.00 19,622,500.00 Date 24-Mar-2021 29-Oct-2021 31-May-2022 30-Jun-2025 IN01151435 ►Number of new acceptors of modern contraception (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 238,392.00 0.00 222,926.00 248,023.00 Date 24-Mar-2021 29-Oct-2021 31-May-2021 30-Jun-2023 IN01151444 ►Number of deliveries conducted within the facility (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 315,814.00 0.00 255,663.00 328,573.00 6/27/2022 Page 6 of 8 The World Bank Implementation Status & Results Report Rwanda COVID-19 Emergency Response Project (P173855) Date 24-Mar-2021 29-Oct-2021 31-May-2022 30-Jun-2023 IN01151446 ►Number of pregnant women receiving four antenatal care visits (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 128,415.00 190,280.00 Date 24-Mar-2021 29-Oct-2021 31-May-2021 30-Jun-2023 IN01151447 ►Number of infants receiving Pentavalent 3 vaccine (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 345,423.00 0.00 258,959.00 352,330.00 Date 24-Mar-2021 29-Oct-2021 31-May-2022 30-Jun-2023 Overall Comments IR Indicator "Total tests performed by the Government facilities, disaggregated by sex" - MoH is working on the disaggregation of tests by type of facility. Performance-Based Conditions Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P173855 IDA-66150 Effective USD 14.25 14.25 0.00 15.04 0.00 100% P173855 IDA-68710 Effective USD 15.00 15.00 0.00 14.84 0.05 100% P173855 IDA-70920 Effective USD 16.00 16.00 0.00 0.00 15.09 0% P173855 IDA-D8050 Effective USD 15.00 15.00 0.00 14.92 0.03 100% P173855 IDA-E0220 Effective USD 16.00 16.00 0.00 0.00 15.36 0% P173855 TF-B4324 Closed USD 0.94 0.93 0.01 0.93 0.00 100% P173855 TF-B6226 Effective USD 15.00 15.00 0.00 2.99 12.01 20% Key Dates (by loan) 6/27/2022 Page 7 of 8 The World Bank Implementation Status & Results Report Rwanda COVID-19 Emergency Response Project (P173855) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P173855 IDA-66150 Effective 07-Apr-2020 09-Apr-2020 20-Apr-2020 30-Jun-2022 30-Jun-2022 P173855 IDA-68710 Effective 16-Apr-2021 22-Apr-2021 21-Jun-2021 30-Jun-2023 30-Jun-2023 P173855 IDA-70920 Effective 31-Mar-2022 07-Apr-2022 06-Jun-2022 30-Jun-2025 30-Jun-2025 P173855 IDA-D8050 Effective 16-Apr-2021 22-Apr-2021 21-Jun-2021 30-Jun-2023 30-Jun-2023 P173855 IDA-E0220 Effective 31-Mar-2022 07-Apr-2022 06-Jun-2022 30-Jun-2025 30-Jun-2025 P173855 TF-B4324 Closed 30-Nov-2020 06-Dec-2020 06-Dec-2020 31-Jan-2021 28-Feb-2021 P173855 TF-B6226 Effective 02-Sep-2021 02-Sep-2021 02-Sep-2021 30-Jun-2023 30-Jun-2023 Cumulative Disbursements Restructuring History Level 2 Approved on 29-Jan-2021 ,Level 2 Approved on 14-Jun-2021 Related Project(s) P175252-Additional Financing for Rwanda COVID-19 Emergency Response Project ,P176304-Additional Financing to the COVID-19 Emergency Response Project ,P178282-Third Additional Financing Rwanda COVID-19 Emergency Response Project 6/27/2022 Page 8 of 8