The World Bank Implementation Status & Results Report Maldives COVID-19 Emergency Response and Health Systems Preparedness Project (P173801) Maldives COVID-19 Emergency Response and Health Systems Preparedness Project (P173801) SOUTH ASIA | Maldives | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2020 | Seq No: 2 | ARCHIVED on 23-Nov-2020 | ISR43876 | Implementing Agencies: Ministry of Health (MOH), Republic of Maldives Key Dates Key Project Dates Bank Approval Date: 02-Apr-2020 Effectiveness Date: 04-Apr-2020 Planned Mid Term Review Date: 30-Sep-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 proposed project development objective is to respond to and mitigate the threat posed by COVID-19 and strengthen national systems for public health preparedness in the Maldives. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Component 1: Implementation Emergency Response for COVID-19 Prevention:(Cost $3.35 M) Component 2: Emergency Health System Capacity Strengthening for COVID-19 Case Management:(Cost $10.60 M) Component 3: Implementation Management and Monitoring and Evaluation:(Cost $0.65 M) Component 4: Contingent Emergency Response Component (CERC) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Satisfactory Satisfactory Overall Risk Rating High Substantial Implementation Status and Key Decisions The Maldives COVID-19 Emergency Response and Health Systems Preparedness Project (MV COVID-19 Project) was approved by the World Bank Board of Directors on April 2, 2020. The MV COVID-19 Project aims to respond to and mitigate the threat posed by COVID-19 and strengthen national systems for public health preparedness in Maldives. The implementing agency for the project is the Ministry of Health (MOH). The MV COVID-19 Project has progressed well over the last six months with activities implemented under all components. The project has contributed to successful implementation of the government's strategy of early detection, contact tracing, quarantine/isolation and case management. Specific examples include:  the provision of personal protective equipment (PPE) for health care workers early in the outbreak,  increased testing capacity in Male and the atolls (RT-PCR testing kits, consumables), and 11/23/2020 Page 1 of 6 The World Bank Implementation Status & Results Report Maldives COVID-19 Emergency Response and Health Systems Preparedness Project (P173801)  the provision of medical equipment to health facilities (e.g. chest x-ray machines). Other activities have also been launched (including on risk communication and community engagement, grievance redressal mechanisms, healthcare waste management), and pace of implementation is expected to accelerate over the next few months now that there is nearly fully staffed Project Management Unit (PMU). As expected, implementation focus in this initial stage has been on immediate emergency response, with actions on longer term investments on strengthening health systems for pandemic preparedness just starting. . 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 Impressive efforts continue to be made to advance the implementation of the MPA-funded projects. As of October 14, 2020, 83 projects have been approved providing a total commitment of US$3.98 billion. The projects benefit around 3.7 billion people or 49% of the global population. Of the 83 approved projects: (i) 30 are in Africa – 10 in AFE and 20 in AFW; (ii) 14 in East Asia; (iii) 13 in Europe and Central Asia; (iv) 10 in Latin America and the Caribbean; (v) 7 in Middle East and North Africa; and (vi) 9 in South Asia. Sixty six (66) projects are disbursing. Total disbursements as of October 14, 2020 under these projects amount to US$1.32 billion or 33% of overall commitment. In addition, $364 million have been committed under signed contracts with UNICEF and Bank Facilitated Procurement (BFP), bringing to 42% actual disbursements and committed amounts. Streamlined procedures and delegated approval coupled with flexible project design and intensified efforts across the Bank have contributed to the progress. Implementation faces significant challenges as some countries are still under different levels of lockdown or mobility restrictions and counterparts and Bank teams are operating from home. Notwithstanding challenges, the MPA is on track to achieving its PDO – to prevent, detect and respond to the threat posed by COVID-19 and strengthen national systems for public health preparedness. The significant level of disbursement in just over six months attest to the strong implementation of the Bank response thanks to the commitment of counterparts supported by country teams. However, the capacity of teams is being stretched to meet delivery demands and provide enhanced implementation support to clients, this may not be sustainable in the long-term. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance Moderate Moderate Moderate Macroeconomic High High High Sector Strategies and Policies Moderate Moderate Moderate Technical Design of Project or Program Substantial Substantial Moderate Institutional Capacity for Implementation and High High Moderate Sustainability Fiduciary High Substantial Substantial Environment and Social Substantial Substantial Substantial 11/23/2020 Page 2 of 6 The World Bank Implementation Status & Results Report Maldives COVID-19 Emergency Response and Health Systems Preparedness Project (P173801) Stakeholders Low Low Low Other -- -- -- Overall High High Substantial Results PDO Indicators by Objectives / Outcomes Respond /mitigate the threat posed by COVID-19 & strengthen national systems for public health prep. IN00905481 ►GOM has activated its public health National Emergency Operations Centre (NEOC) or a coordination mechanism for COVID-19 (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No Yes Yes Yes Date 01-Mar-2020 23-Apr-2020 23-Apr-2020 31-Dec-2023 IN00905482 ►Number of designated laboratories with COVID-19 diagnostic equipment, test kits, and reagents per MOH guidelines (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 1.00 1.00 9.00 5.00 Date 01-Mar-2020 23-Apr-2020 15-Oct-2020 31-Dec-2023 IN00905483 ►GoM adopted personal and community non-pharmaceutical interventions (school closures, telework and remote meetings, reduce/cancel mass gatherings). (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No Yes Yes Yes Date 01-Mar-2020 23-Apr-2020 23-Apr-2020 31-Dec-2023 Overall Comments PDO At the PDO level, there is substantial progress on results indicators. Intermediate Results Indicators by Components Component 1: Emergency Response for COVID-19 Prevention IN00905484 ►Proportion of hospitals with adequate personal protective equipment within a given month. (Percentage, Custom) 11/23/2020 Page 3 of 6 The World Bank Implementation Status & Results Report Maldives COVID-19 Emergency Response and Health Systems Preparedness Project (P173801) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 70.00 Date 01-Mar-2020 23-Apr-2020 23-Apr-2020 31-Dec-2023 Component 2: Emergency Health System Capacity Strengthening for COVID-19 Case Management IN00905485 ►Number of regions with ICU capacity (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 1.00 1.00 5.00 5.00 Date 01-Mar-2020 23-Apr-2020 15-Oct-2020 31-Dec-2023 IN00905487 ►Proportion of health professionals trained in infection prevention and control per MOH-approved protocols. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 40.00 70.00 Date 01-Mar-2020 23-Apr-2020 15-Oct-2020 31-Dec-2023 IN00905488 ►Number of designated laboratories with staff trained to conduct COVID-19 diagnosis. (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 1.00 1.00 9.00 5.00 Date 01-Mar-2020 16-Jun-2020 15-Oct-2020 31-Dec-2023 IN00905489 ►Number of total daily testing capacity for SARS-CoV-2 in the country including five regional laboratories (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 350.00 350.00 1,500.00 1,500.00 Date 22-Mar-2020 22-Mar-2020 15-Oct-2020 31-Dec-2023 IN00905490 ►Average transport time for COVID-19 lab specimen from health facility to a regional testing center (Hours, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 30.00 30.00 30.00 12.00 Date 15-Jun-2020 15-Jun-2020 15-Jun-2020 31-Dec-2023 Component 3: Implementation Management and Monitoring and Evaluation 11/23/2020 Page 4 of 6 The World Bank Implementation Status & Results Report Maldives COVID-19 Emergency Response and Health Systems Preparedness Project (P173801) IN00905486 ►Proportion of hospitals who have submitted complete monthly reports on the number of suspected cases identified, number of cases tested, number of contacts traced, the presence of personal protective (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 100.00 80.00 Date 01-Mar-2020 23-Apr-2020 15-Oct-2020 31-Dec-2023 Proportion of health facilities that have submitted complete monthly reports on the number of suspected Comments: cases identified, number of cases tested, number of contacts traced, the presence of personal protective equipment, and the presence of an isolation unit Overall Comments IR Intermediate indicators are progressing well with many having already been achieved and the others on track to being achieved. A new beneficiary feedback indicator will need to be introduced in the results framework for future ISRs (but will not require a restructuring of the project). The team will work with the government over the next few weeks to discuss and agree on an indicator for inclusion. Performance-Based Conditions Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P173801 IDA-65910 Effective USD 3.65 3.65 0.00 0.48 3.34 12% P173801 IDA-D5950 Effective USD 3.65 3.65 0.00 1.68 2.11 44% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P173801 IDA-65910 Effective 02-Apr-2020 03-Apr-2020 04-Apr-2020 31-Dec-2023 31-Dec-2023 P173801 IDA-D5950 Effective 02-Apr-2020 03-Apr-2020 04-Apr-2020 31-Dec-2023 31-Dec-2023 Cumulative Disbursements 11/23/2020 Page 5 of 6 The World Bank Implementation Status & Results Report Maldives COVID-19 Emergency Response and Health Systems Preparedness Project (P173801) 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 15-Jul-2020 Related Project(s) There are no related projects. 11/23/2020 Page 6 of 6