The World Bank Implementation Status & Results Report Kosovo Health Project (P147402) Kosovo Health Project (P147402) EUROPE AND CENTRAL ASIA | Kosovo | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2014 | Seq No: 12 | ARCHIVED on 15-Mar-2019 | ISR36182 | Implementing Agencies: Republic of Kosovo, Ministry of Health Key Dates Key Project Dates Bank Approval Date: 13-May-2014 Effectiveness Date: 20-May-2015 Planned Mid Term Review Date: 30-Oct-2017 Actual Mid-Term Review Date: 30-Oct-2017 Original Closing Date: 30-Oct-2019 Revised Closing Date: 30-Oct-2019 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) To contribute to improving financial protection from health spending for the poor and quality of care for priority maternal and child health and non communicable disease services. Has the Project Development Objective been changed since Board Approval of the Project Objective? Yes Board Approved Revised Project Development Objective (If project is formally restructured) The Project Development Objective is to contribute to (i) developing the building blocks to introduce Social Health Insurance; and (ii) strengthening Primary Health Care in selected municipalities. Components Table Name Support capacitiy building and establishment of building blocks for introduction of SHI:(Cost $5.82 M) Support primary health care strengthening:(Cost $9.10 M) Project management and communications:(Cost $0.77 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Moderately Unsatisfactory Moderately Satisfactory Overall Implementation Progress (IP) Moderately Unsatisfactory Moderately Satisfactory Overall Risk Rating High Substantial Implementation Status and Key Decisions This implementation status and results report covers the findings of the implementation support visit of February 4-8, 2019. Since the restructuring, the Ministry of Health and the Health Insurance Fund have been dedicated in accelerating the pace of implementation to achieve successful outcomes. As a result, over the past six months, progress has been made in the implementation of activities directly influencing the achievement of 3/15/2019 Page 1 of 5 The World Bank Implementation Status & Results Report Kosovo Health Project (P147402) the Project Development Objective. Some of the key progress noted in the implementation of the activities are as follows: key technical assistance to the Health Insurance Fund has been in place, including for (i) the preparation and implementation of the outpatient drug benefit scheme, (ii) IT systems, (iii) key functions of the HIF; an independent technical audit confirmed that the 2018 capitation-based performance payments (CBPPs) have been adequate; a web-based application that will allow for the continuation of CBPPs has been developed and piloted. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance -- High High Macroeconomic -- High Moderate Sector Strategies and Policies -- High High Technical Design of Project or Program -- High Substantial Institutional Capacity for Implementation and Sustainability -- High Substantial Fiduciary -- High High Environment and Social -- Low Low Stakeholders -- Substantial Substantial Other -- -- -- Overall -- High Substantial Results PDO Indicators by Objectives / Outcomes To contribute to developing the building blocks to introduce Social Health Insurance IN00675507 ►Outpatient (OP) drug benefit scheme established (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target The costed list of The list of drugs for drugs for the outpatient drug benefit outpatient drug benefit Value No -- scheme adopted by scheme is submitted to the HIF is submitted to the Steering Board of the Government the HIF Date 13-May-2014 28-Sep-2018 28-Feb-2019 30-Oct-2019 Health Insurance Law will be amended by April 2019, which will pave the way for the final adoption the Comments: list. IN00675509 ►HIFIS is functional (Text, Custom) 3/15/2019 Page 2 of 5 The World Bank Implementation Status & Results Report Kosovo Health Project (P147402) Baseline Actual (Previous) Actual (Current) End Target Value No -- No Yes Date 13-May-2013 23-Apr-2018 28-Feb-2019 30-Oct-2019 To contribute to strengthening Primary Health Care IN00675508 ►Number of municipalities participating in CBPP scheme (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 6.00 6.00 6.00 20.00 Date 13-May-2013 28-Sep-2018 28-Feb-2019 30-Oct-2019 It is expected that the web-based HIS application will be rolled out in 14 municipalities by April 2019, Comments: allowing for the signature of performance agreements with 20 municipalities. Intermediate Results Indicators by Components Establishing Building Blocks for the Introduction of Social Health Insurance IN00675510 ►Health personnel receiving training (number) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1,028.00 4,358.00 2,449.00 Date 13-May-2014 14-Sep-2018 28-Feb-2019 30-Oct-2019 The actual values were corrected. Previously, the number of individuals in the consolidated database of beneficiaries was factored in, while the value is now the sum of participants per training module Comments: IN00675526 ►Health facilities constructed, renovated, and/or equipped (number) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 11.00 11.00 11.00 Date 13-May-2014 14-Sep-2018 28-Feb-2019 30-Oct-2019 IN00675529 ►Percentage of patients using primary health care facilities who are satisfied with services (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 65.80 65.80 65.80 70.00 Date 31-Dec-2017 14-Sep-2018 28-Feb-2019 30-Oct-2019 Survey will be conducted later in 2019 and data will be updated Comments: 3/15/2019 Page 3 of 5 The World Bank Implementation Status & Results Report Kosovo Health Project (P147402) Strengthening Primary Health Care IN00675527 ►Number of patients registered in the HIS (Number (Thousand), Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 345,458.00 349,711.00 511,074.00 Date 13-May-2013 14-Sep-2018 28-Feb-2019 30-Oct-2019 IN00675528 Of which female (Percentage, Custom Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 56.00 56.00 78.00 IN00675530 ►Percentage of capitation-based performance payment budget spent at municipality level (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 48.42 72.14 95.00 Date 13-May-2014 04-Sep-2017 28-Feb-2019 30-Oct-2019 The percentage of funds spent is below the target value for 2018 due to delays in the transfer of funds to Comments: municipalities and the tight timeline to effectively use the funds. IN00675531 ►Percentage of participating municipalities with a performance improvement action plan (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 66.67 100.00 75.00 Date 13-May-2014 28-Sep-2018 28-Feb-2019 30-Oct-2019 Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P147402 IDA-54420 Effective USD 25.50 17.31 8.19 4.76 10.17 32% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P147402 IDA-54420 Effective 13-May-2014 15-Jan-2015 20-May-2015 30-Oct-2019 30-Oct-2019 3/15/2019 Page 4 of 5 The World Bank Implementation Status & Results Report Kosovo Health Project (P147402) Cumulative Disbursements Restructuring History Level 2 Approved on 12-Jun-2018 Related Project(s) There are no related projects. 3/15/2019 Page 5 of 5