The World Bank Implementation Status & Results Report South Sudan COVID-19 Emergency Response and Health Systems Preparedness Project (P176480) South Sudan COVID-19 Emergency Response and Health Systems Preparedness Project (P176480) AFRICA EAST | South Sudan | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2021 | Seq No: 1 | ARCHIVED on 30-Sep-2021 | ISR47911 | Implementing Agencies: UNICEF, International Committee of the Red Cross, World Health Organization, World Health Organization, UNICEF, International Committee of the Red Cross Key Dates Key Project Dates Bank Approval Date: 28-Jun-2021 Effectiveness Date: 01-Jul-2021 Planned Mid Term Review Date: -- Actual Mid-Term Review Date: Original Closing Date: 31-Jul-2023 Revised Closing Date: 31-Jul-2023 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 in South Sudan, increase access to an essential package of health services in the states of Upper Nile and Jonglei, and develop South Sudan government health sector stewardship and system preparedness capacity. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Vaccine deployment, Cold Chain Equipment, and Community Engagement:(Cost $7.50 M) Continued Provision of Essential Health Services in the states of Upper Nile and Jonglei:(Cost $51.00 M) Building Institutional Capacity and Strengthening Health Emergencies Preparedness:(Cost $2.93 M) Monitoring, Evaluation, and Learning:(Cost $2.50 M) Contingent Emergency Response Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO -- Satisfactory Overall Implementation Progress (IP) -- Satisfactory Overall Risk Rating -- High Implementation Status and Key Decisions This is the first ISR for the Project. The Project was approved by the World Bank’s Board of Executive Directors on June 28, 2021 and became effective on July 1, 2021. The World Bank task team has conducted a number of technical discussion meetings with the three implementing partners (UNICEF, WHO and ICRC) since the project was approved to discuss the launching of the project activities including finalizing the micro- plans for implementation of vaccine deployment and consultations with communities. 9/30/2021 Page 1 of 8 The World Bank Implementation Status & Results Report South Sudan COVID-19 Emergency Response and Health Systems Preparedness Project (P176480) 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 MPA - ISR Write-up as of September 17, 2021 The implementation of the MPA-funded projects continues to progress well. As of September 17, 2021, 87 MPA-projects have been approved providing a total commitment of US$4.2 billion. Disbursements during the past month have increased at a rapid pace. Forty-nine (49) country projects or 56% of projects approved have reached 70-100% disbursements. The projects benefit around 3.7 billion people or 50% of the global population. Of the 87 approved 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) 12 in Latin America and the Caribbean; (v) 7 in Middle East and North Africa; and (vi) 9 in South Asia. Eighty-one (81) or 93% projects are disbursing. Total disbursements as of September 17, 2021, amount to $2,901.9m or $2.9 billion or 69% of overall commitments. Streamlined procedures, delegated approval coupled with flexible project design and intensified efforts across the Bank have contributed to the progress. Several projects have/are being restructured to include vaccine related procurement. Implementation is being guided by Bank teams working in parallel in other health related projects, including Additional Financing operations supporting vaccine procurement and deployment efforts in countries. Implementation continues to face challenges as many countries are still under different levels of lockdown or mobility restrictions and counterparts and Bank teams are operating from home or partially from home. Also, countries are phasing new waves of infections with the Delta variant spreading rapidly among populations. Most Bank teams continue to conduct implementation support missions virtually, which is challenging for both Bank teams and counterparts. This “virtual” world poses connectivity challenges as internet is not reliable in many countries, especially IDA countries. Notwithstanding challenges, the MPA is on track to achieving its PrDO – 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 in just over 19 months attest to the strong implementation efforts of the Bank response thanks to the commitment of counterparts supported by Bank country teams. MPA AF-V - ISR Write-up – September 17, 2021 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. 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 already anticipated and supported under the Global COVID-19 MPA and a key contribution to the WBG’s overall COVID-19 response. As of September 17, 2021, the Bank has approved 56 operations to support vaccine procurement and rollout in 54 countries amounting to $4.6 billion. The 56 AF-V operations approved, includes 3 operations that involved restructuring of parent projects (Philippines and Pakistan) and in the case of Lebanon, restructuring of the Health Resilience Project. One other parent project is being restructured in LAC. Of the 56 approved operations: (i) 30 are in Africa – 15 in AFE and 15 in AFW; (ii) 7 in East Asia; (iii) 6 in Europe and Central Asia; (iv) 4 in Latin America and the Caribbean; (v) 4 in Middle East and North Africa; and (vi) 5 in South Asia. Twenty-two (22) projects are disbursing. Total disbursements as of 9/30/2021 Page 2 of 8 The World Bank Implementation Status & Results Report South Sudan COVID-19 Emergency Response and Health Systems Preparedness Project (P176480) September 17, 2021, under these projects amount to US$500.1 million or 11% of overall commitments. As with the MPA operations, streamlined procedures, delegated approval, coupled with flexible project design and intensified efforts across the Bank contributed to the rapid design and processing of the operations. Fifty-two (52) loan/financing agreements have already been signed. Also, forty-one (41) loan/financing agreements have become effective; several others are expected to become effective in the coming days/weeks. Implementation of the AF-V operations, as with MPA operations is facing challenges as many countries are still under different levels of lockdown or mobility restrictions and counterparts and Bank teams are operating from home. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance High -- High Macroeconomic High -- High Sector Strategies and Policies Substantial -- Substantial Technical Design of Project or Program Substantial -- Substantial Institutional Capacity for Implementation and High -- High Sustainability Fiduciary Substantial -- Substantial Environment and Social High -- High Stakeholders High -- High Other Substantial -- Substantial Overall High -- High Results PDO Indicators by Objectives / Outcomes To support COVID-19 vaccine deployment, provision of services, and build institutional capacity IN01029384 ►Percentage of priority population fully vaccinated against COVID-19, based on the targets defined in national plan (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 10.00 Date 01-Jul-2021 -- 22-Sep-2021 30-Dec-2022 Percentage of the population for whom the project will support COVID-19 vaccination through financing to Comments: vaccine deployment (equivalent to national coverage target for phase-1 of 20% of the population) IN01029385 9/30/2021 Page 3 of 8 The World Bank Implementation Status & Results Report South Sudan COVID-19 Emergency Response and Health Systems Preparedness Project (P176480) ►People who have received essential health, nutrition, and population (HNP) services (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 500,000.00 Date 01-Jul-2021 -- 22-Sep-2021 30-Dec-2022 The indicator measures the actual utilization of the services. This would be reflected through the number Comments: of the project beneficiaries, who have received services supported by the project, i.e. number of direct project beneficiaries. IN01029386 ►Conducted tailored training/coaching for MOH staff on identified project management aspects (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 80.00 Date 01-Jul-2021 -- 22-Sep-2021 30-Dec-2022 Completion of the identified training plan for the selected MOH staff on the project management aspects including FM and Procurement to enable MOH to achieve the agreed upon milestones( explained in the Comments: PAD, Annex-5).This includes agreed upon milestones such as, but not limited to, on Financial Management, Procurement, Safeguards, contract management, Monitoring and Evaluation Intermediate Results Indicators by Components Vaccine deployment, Cold Chain Equipment, and Community Engagement IN01029392 ►Climate-friendly and energy-efficient cold chain is adopted by the client (Number) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 25.00 Date 01-Jul-2021 -- 22-Sep-2021 30-Dec-2022 targeted sites have functional climate-friendly cold chain equipment, which are used for COVID-19 Comments: vaccinations, routine vaccinations, and / or other health products needing refrigeration. IN01029396 ►Standard operating procedures (SOPs) or guidelines updated for collection and disposal of medical waste for COVID-19 (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No -- No Yes Date 01-Jul-2021 -- 22-Sep-2021 30-Dec-2022 Comments: SOPs or guidelines updated to account for COVID-19 vaccination roll out IN01029398 ►Comprehensive Emergency Obstetric and Newborn Care centers (CEmONC) have adequate solar power (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target 9/30/2021 Page 4 of 8 The World Bank Implementation Status & Results Report South Sudan COVID-19 Emergency Response and Health Systems Preparedness Project (P176480) Value 0.00 -- 0.00 8.00 Date 26-Jul-2021 -- 22-Sep-2021 31-Dec-2022 Comments: Targeted CEmONC Centers have adequate solar power, which is used to deliver health services. Continued Provision of Essential Health Services in the states of Upper Nile and Jonglei IN01029388 ►Number of health facilities providing at least 75 percent of the essential package of health services (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 200.00 Date 01-Jul-2021 -- 22-Sep-2021 30-Dec-2022 Number of health facilities providing at least 75 percent of the essential package of health services as Comments: defined in the PIM. IN01029391 ►Number of deliveries attended by skilled health personnel (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 12,000.00 Date 01-Jul-2021 -- 22-Sep-2021 30-Dec-2022 Comments: Number of deliveries attended by skilled health personnel in targeted sites IN01029395 ►Proportion of disease outbreaks detected and responded to within 72 hours of confirmation (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 40.00 -- 40.00 60.00 Date 01-Jul-2021 -- 22-Sep-2021 30-Dec-2022 Comments: Proportion of disease outbreaks detected and responded to within 72 hours of confirmation IN01029397 ►Number of pregnant women receiving ANC four visits (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 20,000.00 Date 01-Jul-2021 -- 22-Sep-2021 30-Dec-2022 Comments: Number of pregnant women receiving ANC four visits in targeted sites. IN01029399 ►Number of health care workers trained in-service (Number, Custom) 9/30/2021 Page 5 of 8 The World Bank Implementation Status & Results Report South Sudan COVID-19 Emergency Response and Health Systems Preparedness Project (P176480) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 250.00 Date 01-Jul-2021 -- 22-Sep-2021 30-Dec-2022 Comments: Number of health care workers received in-service training Building Institutional Capacity and Strengthening Health Emergencies Preparedness IN01029387 ►Development of integrated human health and animal health policies (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No -- No Yes Date 01-Jul-2021 -- 22-Sep-2021 30-Dec-2022 Developing integrated human health and animal health policies to prevent health emergencies through Comments: development of One Health Plan that addresses preparedness and response to priority zoonotic diseases identified IN01029390 ►Number of people trained in Integrated Disease Surveillance and Response (IDSR) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 300.00 Date 20-Jul-2021 -- 22-Sep-2021 31-Dec-2022 Comments: Number of MOH workers trained in IDSR IN01029394 ►Development of disease surveillance data reporting and management system at the national and state level (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No -- No Yes Date 26-Jul-2021 -- 22-Sep-2021 31-Dec-2022 Data reporting and management system on disease surveillance data are in place at the national and Comments: state levels Monitoring, Evaluation and Learning IN01029389 ►Number of monitoring reports submitted (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 4.00 Date 01-Jul-2021 -- 22-Sep-2021 30-Dec-2022 9/30/2021 Page 6 of 8 The World Bank Implementation Status & Results Report South Sudan COVID-19 Emergency Response and Health Systems Preparedness Project (P176480) Number of monitoring reports submitted in areas where external monitoring will be conducted. The performance monitoring methodology and reports will include citizen engagement mechanisms such as exit interviews conducted during data verification visits. The questionnaires will be customized to capture Comments: key domains on satisfaction and perceived quality of care, in order to capture community feedback on service delivery. Results from the quarterly reports will be used to engage with citizens on key elements related to improving service delivery in targeted communities. IN01029393 ►Percentage of complaints to Grievance Redress Mechanisms satisfactorily addressed in a timely manner (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 40.00 -- 40.00 75.00 Date 30-Apr-2021 -- 22-Sep-2021 30-Dec-2022 Comments: Details in the Project Implementation Manual on standards for grievance handling and response. Overall Comments IR The project implementation has just been launched. The indicators will be updated following the first implementation support mission scheduled from September 29-October 8,2021. Performance-Based Conditions Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P176480 IDA-D8830 Effective USD 8.00 8.00 0.00 0.00 7.95 0% P176480 IDA-D8840 Effective USD 51.50 51.50 0.00 0.00 50.66 0% P176480 IDA-D8850 Effective USD 0.50 0.50 0.00 0.00 0.57 0% P176480 TF-B6004 Effective USD 2.00 2.00 0.00 0.00 2.00 0% P176480 TF-B6005 Effective USD 1.93 1.93 0.00 0.00 1.93 0% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P176480 IDA-D8830 Effective 28-Jun-2021 01-Jul-2021 01-Jul-2021 31-Jul-2023 31-Jul-2023 P176480 IDA-D8840 Effective 28-Jun-2021 01-Jul-2021 01-Jul-2021 31-Jul-2023 31-Jul-2023 P176480 IDA-D8850 Effective 28-Jun-2021 01-Jul-2021 01-Jul-2021 31-Jul-2023 31-Jul-2023 P176480 TF-B6004 Effective 01-Jul-2021 01-Jul-2021 01-Jul-2021 30-Jun-2023 30-Jun-2023 9/30/2021 Page 7 of 8 The World Bank Implementation Status & Results Report South Sudan COVID-19 Emergency Response and Health Systems Preparedness Project (P176480) P176480 TF-B6005 Effective 01-Jul-2021 01-Jul-2021 01-Jul-2021 30-Jun-2023 30-Jun-2023 Cumulative Disbursements PBC Disbursement Achievement Disbursed amount in Disbursement % PBC ID PBC Type Description Coc PBC Amount Status Coc for PBC Restructuring History There has been no restructuring to date. Related Project(s) There are no related projects. 9/30/2021 Page 8 of 8