The World Bank Implementation Status & Results Report Mali - Accelerating Progress Towards Universal Health Coverage (P165534) Mali - Accelerating Progress Towards Universal Health Coverage (P165534) AFRICA WEST | Mali | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2019 | Seq No: 5 | ARCHIVED on 22-Aug-2021 | ISR47117 | Implementing Agencies: Ministère de la Santé et du Développement Social, Republic of Mali Key Dates Key Project Dates Bank Approval Date: 19-Mar-2019 Effectiveness Date: 27-Dec-2019 Planned Mid Term Review Date: 06-Dec-2021 Actual Mid-Term Review Date: Original Closing Date: 31-Dec-2023 Revised Closing Date: 31-Dec-2023 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The objective of the project is to improve the utilization and quality of reproductive, maternal, neonatal, child, adolescent health and nutrition services, especially among the poorest households, in targeted areas. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Strengthening Health Service Delivery through Performance Based Financing:(Cost $67.40 M) Strengthening Community Health Activities:(Cost $13.00 M) Strengthening Stewardship for Improved Health System Performance:(Cost $9.00 M) Contingent Emergency Response (CERC) 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 Mali Accelerating Progress Towards Universal Health Coverage Project has been under implementation for 17 months. Project implementation progress has been affected by the ongoing COVID-19 outbreak as well as by the current political situation i.e. a second military coup on May 24, 2021, less than 9 months after the coup that took place on August 18, 2020. The World Bank is currently reevaluating the operational environment under its Operational Policy 7.30. Disbursements are currently on hold until the completion of OP 7.30 assessment. Despite the difficult environment related to COVID-19 and the political transition, Project implementation continued and important progress was achieved through all Project components. Under the first component (Performance Based Financing), progress was made in the areas of performance grant payments towards health facilities, strengthening the capacity of regulatory actors such as regional health authorities (Directions Régionales de la Santé, DRS) and district health teams (Équipes Cadre de District, ECD), supporting activities to the Contract 8/22/2021 Page 1 of 8 The World Bank Implementation Status & Results Report Mali - Accelerating Progress Towards Universal Health Coverage (P165534) Development and Verification Agency (CDVA, CANAM), and conducting studies in PBF implementation. The second component (Community Health Workers and Nutrition Promoting Activities) also showed progress, including: strengthening of the routine information system, including digital equipment and training of staff to use the district health information system DHIS2; preparation of private sector facilities for their inclusion into the DHIS2 system; elaboration of the 2019 National Health Accounts; finalization of the reproductive, maternal, neonatal, and child health investment case; and finalization of the national sectoral strategy - Programme de Développement Socio-Sanitaire (Social Health Development Program); and training of decentralized stakeholder for PBF implementation (targeted to the Cellules d’Appui à la Décentralisation et à la Déconcentration). Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance High High High Macroeconomic Moderate High High Sector Strategies and Policies Moderate Substantial Substantial Technical Design of Project or Program Substantial Substantial Substantial Institutional Capacity for Implementation and Substantial Substantial Substantial Sustainability Fiduciary Substantial Moderate Moderate Environment and Social Moderate Moderate Moderate Stakeholders Moderate Moderate Moderate Other High High High Overall Substantial Substantial Substantial Results PDO Indicators by Objectives / Outcomes Increased utilization of maternal, child, neonatal, and adolescent services IN01004671 ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 69,051.00 3,300,000.00 Date 31-Oct-2018 30-Nov-2020 30-Jun-2021 07-Dec-2023 IN01004674 People who have received essential health, nutrition, and population (HNP) services - Female (RMS requirement) (Number, Corporate Supplement) 8/22/2021 Page 2 of 8 The World Bank Implementation Status & Results Report Mali - Accelerating Progress Towards Universal Health Coverage (P165534) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 34,489.00 710,000.00 IN01004675 Number of children immunized (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 70,165.00 250,000.00 Date 31-Oct-2018 30-Nov-2020 30-Jun-2021 07-Dec-2023 IN01004676 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 50,851.00 1,400,000.00 Date 01-Dec-2012 30-Nov-2020 30-Jun-2021 31-Dec-2023 IN01004677 Number of deliveries attended by skilled health personnel (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 53,310.00 72,018.00 225,000.00 Date 31-Oct-2018 30-Nov-2020 30-Jun-2021 07-Dec-2023 IN01004678 ►Percentage of girls, aged 15-19, who are currently using any method of contraception. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 5.80 8.47 5.50 20.00 Date 31-Oct-2018 30-Nov-2020 30-Jun-2021 07-Dec-2023 Comments: Percentage of girls, aged 15-19 who are currently using any method of contraception. Improve the quality of health services in targeted areas. IN01004635 ►Percentage of pregnant women receiving at least 4 antenatal care visits from health provider (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 13.30 25.92 23.36 25.00 Date 31-Oct-2018 30-Nov-2020 30-Jun-2021 07-Dec-2023 Percentage of pregnant women receiving at least 4 antenatal care visits from health provider in 14 Comments: targeted health districts. IN01004673 ►Average score of the quality of care checklist (Percentage, Custom) 8/22/2021 Page 3 of 8 The World Bank Implementation Status & Results Report Mali - Accelerating Progress Towards Universal Health Coverage (P165534) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 61.40 70.00 Date 31-Dec-2018 30-Nov-2020 30-Jun-2021 07-Dec-2023 Comments: Average of the quarterly quality score (%) of all the PBF facilities. Increased utilization of essential health services among the poorest households. IN01004672 ►Number of RAMED beneficiary individuals receiving free care for essential health services. (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 30,000.00 109,957.00 135,410.00 150,000.00 Date 31-Oct-2018 30-Nov-2020 30-Jun-2021 07-Dec-2023 Number of RAMED beneficiary households receiving free care for essential health services in the targeted Comments: health districts. Intermediate Results Indicators by Components Strengthening Health Service Delivery through Performance Based Financing at Facility Level IN01004679 ►Health facilities receiving PBF grants on time. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 100.00 80.00 Date 31-Oct-2018 30-Nov-2020 30-Jun-2021 07-Dec-2023 Comments: Percentage of targeted health facilities receiving PBF grants on time. IN01004682 ►Percentage of new curative consultations per capita/year. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.20 0.30 0.30 0.40 Date 31-Oct-2018 30-Nov-2020 30-Jun-2021 07-Dec-2023 Comments: New curative consultations per capita/year. IN01004685 ►Percentage of facilities with 100% tracer drugs available in targeted health facilities on the day of the visit. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 40.00 8/22/2021 Page 4 of 8 The World Bank Implementation Status & Results Report Mali - Accelerating Progress Towards Universal Health Coverage (P165534) Date 31-Oct-2018 30-Nov-2020 30-Jun-2021 07-Dec-2023 Comments: Percentage of facilities with 100% tracer drugs available in targeted health facilities on the day of the visit. IN01004688 ►Percentage of health facilities benefiting from quarterly technical supervision visits by district health services (ECD). (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 50.00 50.00 42.60 80.00 Date 31-Oct-2018 30-Nov-2020 30-Jun-2021 07-Dec-2023 Percentage of health facilities benefiting from quarterly technical supervision visits by district health Comments: services (ECD). IN01004691 ►Number of CHWs benefiting from dedicated supervision. (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 956.00 894.00 3,000.00 Date 31-Oct-2018 30-Nov-2020 30-Jun-2021 07-Dec-2023 Comments: Number of CHWs benefiting from dedicated supervision. IN01004692 ►Percentage of beneficiaries satisfied with quality of services provided in health facilities (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 89.20 75.00 Date 31-Oct-2018 30-Nov-2020 30-Jun-2021 07-Dec-2023 Beneficiaries satisfied with quality of services provided in health facilities (%). Numerator: number of Comments: health facility users (over past 12 months) satisfied with the quality of services provided in health facility Denominator: number of health facility users (over past 12 months) Strengthening Community Health Activities IN01004680 ►Number of households receiving CHW home visits. (Number (Thousand), Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 2,817.00 750.00 Date 31-Oct-2018 30-Nov-2020 30-Jun-2021 07-Dec-2023 Comments: Number of households receiving proactive CHW visits. IN01004683 ►Percentage of children under 5 with confirmed malaria who received an appropriate antimalarial treatment. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target 8/22/2021 Page 5 of 8 The World Bank Implementation Status & Results Report Mali - Accelerating Progress Towards Universal Health Coverage (P165534) Value 0.00 99.85 100.00 70.00 Date 31-Oct-2018 30-Nov-2020 30-Jun-2021 07-Dec-2023 Percentage of children under 5 with confirmed malaria who received antimalarial treatment within 24 Comments: hours of symptom onset. IN01004686 ►Number of Couple-Year Protections (CYP) reached through project interventions. (Number (Thousand), Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 74,079.00 240.50 1,000.00 Date 31-Oct-2018 30-Nov-2020 30-Jun-2021 07-Dec-2023 A couple year of protection (CYP) measures the estimated protection provided by family planning services during a one-year period, based upon the volume of all contraceptives sold or distributed to beneficiaries during that period. CYP is calculated by multiplying the quantity of each method distributed to clients by a Comments: standard conversion factor (which estimates the duration of contraceptive protection provided per unit of that method) to yield an estimate of the duration of protection provided by that method. CYP for each method is then summed for all methods to obtain a total CYP figure. IN01004689 ►Percentage of children aged 6-59 months screened by community health workers for acute malnutrition. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 50.00 15.05 0.00 90.00 Date 31-Oct-2018 30-Nov-2020 30-Jun-2021 07-Dec-2023 Comments: Percentage of children aged 6-59 months screened by community health workers for acute malnutrition. Institutional strengthening for improved stewardship and health system performance IN01004681 ►Timely completion rate of monthly primary care health facilities DHIS2 reports. (Number (Thousand), Custom) Baseline Actual (Previous) Actual (Current) End Target Value 50.00 96.49 98.48 90.00 Date 31-Oct-2018 30-Nov-2020 30-Jun-2021 07-Dec-2023 Completion rate of health facilities DHIS2 reports in targeted districts. Numerator: number of health Comments: facilities under PBF contract reporting complete DHIS2 reports in targeted districts. Denominator: total number of health facilities under PBF contract in targeted districts. IN01004684 ►Percentage of perinatal and neonatal deaths with determined cause of death (CoD). (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 50.00 Date 31-Oct-2018 30-Nov-2020 30-Jun-2021 07-Dec-2023 IN01004687 8/22/2021 Page 6 of 8 The World Bank Implementation Status & Results Report Mali - Accelerating Progress Towards Universal Health Coverage (P165534) ►Number of private health facilities assessed for accreditation by MoH. (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 250.00 Date 31-Oct-2018 30-Nov-2020 30-Jun-2021 07-Dec-2023 Comments: Number of private health facilities assessed for accreditation by MoH. IN01004690 ►Percentage of health facilities producing annual micro-plans validated by district health services (ECD). (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 95.00 Date 31-Oct-2018 30-Nov-2020 30-Jun-2021 07-Dec-2023 Percentage of health facilities producing annual micro-plans validated by district health services (ECD) in Comments: targeted districts. Performance-Based Conditions Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P165534 IDA-D4420 Effective USD 50.00 50.00 0.00 10.37 40.93 20% P165534 TF-A9738 Effective USD 10.00 10.00 0.00 2.12 7.88 21% P165534 TF-B3548 Effective USD 7.32 7.32 0.00 0.46 6.86 6.3% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P165534 IDA-D4420 Effective 19-Mar-2019 31-May-2019 27-Dec-2019 31-Dec-2023 31-Dec-2023 P165534 TF-A9738 Effective 19-Mar-2019 31-May-2019 27-Dec-2019 31-Dec-2021 31-Dec-2023 P165534 TF-B3548 Effective 31-May-2019 07-Jan-2021 07-Jan-2021 31-Dec-2023 31-Dec-2023 Cumulative Disbursements 8/22/2021 Page 7 of 8 The World Bank Implementation Status & Results Report Mali - Accelerating Progress Towards Universal Health Coverage (P165534) PBC Disbursement Achievement Disbursed amount in Disbursement % PBC ID PBC Type Description Coc PBC Amount Status Coc for PBC Restructuring History Level 2 Approved on 22-Jun-2020 ,Level 2 Approved on 27-Apr-2021 Related Project(s) There are no related projects. 8/22/2021 Page 8 of 8