The World Bank Implementation Status & Results Report Health System Strengthening for Human Capital Development in Eswatini (P168564) Health System Strengthening for Human Capital Development in Eswatini (P168564) AFRICA EAST | Eswatini | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2020 | Seq No: 2 | ARCHIVED on 26-Mar-2021 | ISR45929 | Implementing Agencies: Kingdom of Eswatini, Ministry of Health Key Dates Key Project Dates Bank Approval Date: 22-Jun-2020 Effectiveness Date: 10-Dec-2020 Planned Mid Term Review Date: 20-Mar-2023 Actual Mid-Term Review Date: Original Closing Date: 30-Sep-2025 Revised Closing Date: 30-Sep-2025 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The project development objective is to improve the coverage and quality of key reproductive, maternal, neonatal, child and adolescent health (RMNCAH), nutrition and NCD services (hypertension and diabetes) in Eswatini. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Component 1: Improve health service delivery to increase the coverage and quality of health services to build human capital:(Cost $14.50 M) Component 2. Increase community demand for RMNCAH, nutrition and NCD services:(Cost $2.00 M) Component 3. Strengthen the MOH’s stewardship capacity to manage essential health and nutrition services and project activities:(Cost $3.50 M) Component 4: Contingent Emergency Response 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 project was approved by the Board on June 22, 2020 and became effective on December 10, 2020. The project is part of the broader development agenda to support Eswatini's response to the COVID-19 pandemic and its economic recovery during and post-COVID-19 to foster sustainable development, primarily through strengthening the health system to deliver high quality services to the people and boosting Eswatini's human capital. Since the project effectiveness, the Ministry of Health (MOH) has been working proactively to complete the initiation activities: (a) the inter- ministerial policy advisory group and technical committee were set up and the first meetings were held in February 2021; (b) the project 3/26/2021 Page 1 of 7 The World Bank Implementation Status & Results Report Health System Strengthening for Human Capital Development in Eswatini (P168564) implementation unit (PIU)'s hiring of key staff is almost complete; (c) the Project Operations Manual has been finalized; (d) the annual work plan and budget has been revised to reflect the activities for FY21/22; and (e) the MOH/PIU has started preparing terms of references to engage technical advisors to conduct various reviews/assessments. The PIU and World Bank teams are meeting bi-weekly to review the implementation progress and address any implementation challenges. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance Substantial Substantial Substantial Macroeconomic Substantial High High Sector Strategies and Policies Low Low Low Technical Design of Project or Program Moderate Moderate Moderate Institutional Capacity for Implementation and Substantial Substantial Substantial Sustainability Fiduciary Moderate Moderate Moderate Environment and Social Moderate Moderate Moderate Stakeholders Moderate Moderate Moderate Other -- -- -- Overall Moderate Moderate Moderate Results PDO Indicators by Objectives / Outcomes Improved coverage of key RMNCAH, nutrition and NCD services IN00968184 ►Percentage of patients diagnosed with hypertension and diabetes who are managed at the PHC level (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 80.00 Date 31-Jan-2020 31-Aug-2020 22-Mar-2021 30-Sep-2025 IN00968251 ►Percentage of children under 5 years of age provided with a basic package of nutrition specific services (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target 3/26/2021 Page 2 of 7 The World Bank Implementation Status & Results Report Health System Strengthening for Human Capital Development in Eswatini (P168564) Value 0.00 0.00 0.00 85.00 Date 31-Jan-2020 31-Aug-2020 22-Mar-2021 30-Sep-2025 IN00968252 ►Percentage of adolescents served or reached with quality sexual and reproductive health services (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 70.00 Date 31-Jan-2020 31-Aug-2020 22-Mar-2021 30-Sep-2025 Improved quality of RMNCAH, nutrition and NCD services IN00968185 ►Percentage of pregnant women receiving at least 4 ANC visits that meet defined quality standards (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 35.00 35.00 60.00 Date 31-Jan-2020 31-Aug-2020 22-Mar-2021 30-Sep-2025 IN00968253 ►Percentage of health facilities that meet a minimum standard of quality as measured by a Health Facility Quality Index (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 80.00 Date 31-Jan-2020 31-Aug-2020 22-Mar-2021 30-Sep-2025 Overall Comments PDO The project became effective on Dec 10, 2020 and the project implementation just started. The project will start reporting results from the next ISR. Intermediate Results Indicators by Components Improve health service delivery to increase coverage and quality of health services IN00968254 ►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 0.00 107,882.00 Date 31-Jan-2020 31-Aug-2020 22-Mar-2021 30-Sep-2025 IN00968259 3/26/2021 Page 3 of 7 The World Bank Implementation Status & Results Report Health System Strengthening for Human Capital Development in Eswatini (P168564) 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 0.00 82,000.00 Date 31-Jan-2020 31-Aug-2020 22-Mar-2021 30-Sep-2025 IN00968262 Number of deliveries attended by skilled health personnel (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 14,390.00 14,390.00 25,882.00 Date 31-Jan-2020 31-Aug-2020 22-Mar-2021 30-Sep-2025 IN00968263 ►Percentage of women receiving post-partum check-up within 7-14 days (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 84.70 0.00 0.00 90.00 Date 31-Jan-2020 31-Aug-2020 22-Mar-2021 30-Sep-2025 IN00968264 ►Number of people screened and diagnosed with hypertension (disaggregated by sex) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 22,160.00 32,335.00 32,335.00 31,230.00 Date 31-Jan-2020 31-Aug-2020 22-Mar-2021 30-May-2025 IN00968265 ►Number of people screened and diagnosed with diabetes (disaggregated by sex) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 1,682.00 7,591.00 7,591.00 8,000.00 Date 31-Jan-2020 31-Aug-2020 22-Mar-2021 30-Sep-2025 IN00968266 ►Number of HCWs trained to deliver high-quality RMCAH, nutrition and NCD services (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 150.00 Date 31-Jan-2020 31-Aug-2020 22-Mar-2021 30-Sep-2025 IN00968267 ►Number of facilities using eLMIS for supply management (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target 3/26/2021 Page 4 of 7 The World Bank Implementation Status & Results Report Health System Strengthening for Human Capital Development in Eswatini (P168564) Value 0.00 0.00 0.00 20.00 Date 31-Jan-2020 31-Aug-2020 22-Mar-2021 30-Sep-2025 IN00968268 ►Proportion of health facilities using CMIS for routine reporting (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 54.00 57.00 57.00 80.00 Date 31-Jan-2020 31-Aug-2020 22-Mar-2021 30-Sep-2025 IN00968269 ►Percentage of health facilities that have received at least one comprehensive quality assessment applying the appropriate checklist and protocol, and were provided adequate feedback from RHMT (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 90.00 Date 31-Jan-2020 31-Aug-2020 22-Mar-2021 30-Sep-2025 IN00968270 ►Satisfaction rates of clients with the quality of maternal, child and adolescent health services (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 50.00 50.00 50.00 75.00 Date 31-Jan-2020 31-Aug-2020 22-Mar-2021 30-Sep-2025 Increase community demand for RMNCAH, nutrition and NCD services IN00968255 ►Number of community health workers including RHMs trained to conduct community sensitization & outreach on RMNCAH, Nutrition and NCD services (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 5,000.00 Date 31-Jan-2020 31-Aug-2020 22-Mar-2021 30-Sep-2025 IN00968257 ►Number of mothers and adolescents reached with RMNCAH, Nutrition and NCDs specific communication as part of targeted SBCC interventions (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 82,000.00 Date 31-Jan-2020 31-Aug-2020 22-Mar-2021 30-Sep-2025 IN00968260 ►Number of client-based digital applications’ users (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target 3/26/2021 Page 5 of 7 The World Bank Implementation Status & Results Report Health System Strengthening for Human Capital Development in Eswatini (P168564) Value 0.00 0.00 0.00 41,000.00 Date 31-Jan-2020 31-Aug-2020 22-Mar-2021 30-Sep-2025 Strengthen MOH’s stewardship capacity to manage health & nutrition services and project activities IN00968256 ►Number of updated regulations, policies and strategies for MOH (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 4.00 Date 31-Jan-2020 31-Aug-2020 22-Mar-2021 30-Sep-2025 IN00968258 ►Number of MOH staff trained (technical and leadership) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 20.00 Date 31-Jan-2020 31-Aug-2020 22-Mar-2021 30-Sep-2025 IN00968261 ►Percentage of health facilities with a protocol to respond to gender-based violence in place (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 18.00 18.00 18.00 43.00 Date 31-Jan-2020 31-Aug-2020 22-Mar-2021 30-Sep-2025 Overall Comments IR The project became effective on Dec 10, 2020 and the project implementation just started. The project will start reporting results from the next ISR. Performance-Based Conditions Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P168564 IBRD-91260 Effective USD 20.00 20.00 0.00 1.45 18.55 7.2% Key Dates (by loan) 3/26/2021 Page 6 of 7 The World Bank Implementation Status & Results Report Health System Strengthening for Human Capital Development in Eswatini (P168564) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P168564 IBRD-91260 Effective 22-Jun-2020 04-Dec-2020 10-Dec-2020 30-Sep-2025 30-Sep-2025 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. 3/26/2021 Page 7 of 7