Public Disclosure Copy The World Bank Implementation Status & Results Report Central North Region Health Support Project (P095275) Central North Region Health Support Project (P095275) EAST ASIA AND PACIFIC | Vietnam | Health, Nutrition and Population Global Practice | IBRD/IDA | Specific Investment Loan | FY 2010 | Seq No: 7 | ARCHIVED on 09-Dec-2014 | ISR17092 | Implementing Agencies: Key Dates Key Project Dates Board Approval date:06-Apr-2010 Effectiveness Date:23-Aug-2010 Planned Mid Term Review Date:23-Sep-2013 Actual Mid-Term Review Date:23-Sep-2013 Original Closing Date:31-Aug-2016 Revised Closing Date:31-Aug-2016 Project Development Objectives Project Development Objective (from Project Appraisal Document) The Project development objective is to strengthen district-level curative and preventive health services and improving their accessibility for the economically vulnerable population in the Central North Provinces. Intermediate objectives are: Increasing health insurance coverage among the near-poor population; Upgrading capacities of district hospitals and District Preventive Health Centers; Improving supply and quality of health care personnel. Has the Project Development Objective been changed since Board Approval of the Project Objective? No PHRPDODEL Components Name Supporting health insurance for the near poor population:(Cost $9.11 M) Strengthening district health services:(Cost $32.20 M) Improving supply and quality of human resources for health:(Cost $15.99 M) Project management, monitoring and evaluation:(Cost $7.71 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO  Moderately Satisfactory  Moderately Satisfactory Overall Implementation Progress (IP)  Moderately Satisfactory  Moderately Satisfactory 12/9/2014 Page 1 of 8 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Central North Region Health Support Project (P095275) Overall Risk Rating  --  Moderate Implementation Status and Key Decisions The project will close by August 31, 2016. By the mission, the project is on track to meet the Project Development Objective. The utilization rate of district hospitals by of the poor and near poor have been slightly increased towards the targets. District hospitals and health centers are in the process of receiving training and equipment to improve their performance in order to fulfill their technical requirement by the MOH. The disbursement rate by September 31, 2014 was 58%, a little bit behind the schedule, and the rate is not the same across different components. The project contributed to bring up the HI coverage of the near poor people up to 79% by September 30 2014, in which the project provided direct financial support to 68% of the near poor in the region. The achievement is above the target of 40% by end of the project. With this coverage, it is expected to help to increase service utilization by the poor and near poor in local hospitals. The indicator for post graduate training support is also overachieved of 165% against the original target. 30 district preventive health centers were completed the construction and received major equipment to improve their performance in order to meet the MOH’s operation criteria. . Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance  --  --  Low Macroeconomic  --  --  Low Sector Strategies and Policies  --  --  Moderate Technical Design of Project or Program  --  --  Low Institutional Capacity for Implementation and Sustainability  --  --  Moderate Fiduciary  --  --  Moderate Environment and Social  --  --  Low 12/9/2014 Page 2 of 8 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Central North Region Health Support Project (P095275) Stakeholders  --  --  Moderate Other  --  --  -- Overall  --  --  Moderate Results Project Development Objective Indicators PHINDPDOTBL  10% increase in the utilization of inpatient and outpatient services by the poor (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target inpatient - inpatient - 5.6/100 inpatient - 6.9/100 6.2/100 Value NA outpatient - 11/100 outpatient - 12.8/100 outpatient - 12.1/100 Date 31-Dec-2010 31-Dec-2013 31-Oct-2014 28-Feb-2016 Comments This indicator is updated by bi-annual VLSS; Therefore it will be available by next mission. PHINDPDOTBL  10% increase in the utilization of inpatient and outpatient services by the near-poor (Text, Custom Breakdown) Baseline Actual (Previous) Actual (Current) End Target inpatient - inpatient – 5.1/100 inpatient - 10.1/100 5.6/100 Value NA outpatient - 11.6/100 outpatient - 11/100 outpatient - 12.8/100 Date 31-Dec-2010 31-Dec-2013 31-Oct-2014 28-Feb-2016 Comments PHINDPDOTBL  Average number of new technical services that a district hospital (among 30 projet district hospitals) can perform with project intervention (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 15.00 -- 20.00 Date 31-Dec-2010 31-Dec-2013 31-Oct-2014 28-Feb-2016 12/9/2014 Page 3 of 8 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Central North Region Health Support Project (P095275) Comments This indicator is updated annually; Therefore it will be available by next mission. PHINDPDOTBL  Health facilities constructed, renovated, and/or equipped (number) (Number, Core) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 30.00 30.00 67.00 Date 31-Dec-2010 31-Aug-2013 31-Aug-2013 26-Feb-2016 Comments The construction of all 30 District Preventive Health Centers were completed and in operation. Necessary equipment are providing by the project (up to now: 70-80%) to District Preventive Health Centers and District Hospitals. PHINDPDOTBL  20 new District Preventive Health Centers constructed with adequate facilities and equipment to provide the full range of preventive health services accordingto the government norms (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 30.00 30.00 20.00 Date 31-Dec-2010 31-Aug-2013 31-Aug-2013 28-Feb-2016 Comments The construction of all 30 District Preventive Health Centers were completed and in operation. Necessary equipment are providing by the project (up to now: 70-80%) to the Centers. Overall Comments Intermediate Results Indicators 12/9/2014 Page 4 of 8 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Central North Region Health Support Project (P095275) PHINDIRITBL  40% of the near poor are covered by the health insurance program (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 10.00 65.40 79.00 40.00 Date 31-Dec-2010 31-Dec-2013 30-Sep-2014 28-Feb-2016 Comments By September 30, 2014, coverage of HI for the near poor in the region was almost 79%. Among those, who haven’t received fully support by the Government, the project supported 68% of them to buy HI card; 88% enrolled as a whole family. PHINDIRITBL  People with access to a basic package of health, nutrition, or reproductive health services (number) (Number, Core) Baseline Actual (Previous) Actual (Current) End Target Value 420000.00 913011.00 7730427.00 600000.00 Date 31-Dec-2010 30-Jun-2012 31-Dec-2013 28-Feb-2016 Comments The overal health insurance coverage of the region by December 31, 2013 is 73.4%, equivalent to 7,730,427 people. PHINDIRITBL  The share of near-poor households spending 25% of more of their non-food consumption on health is reduced to 12% or less (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 18.40 16.00 16.00 12.00 Date 31-Dec-2010 31-Dec-2013 31-Dec-2013 28-Feb-2016 Comments This indicator will be updated by VLSS 2014 data, which will be available by next mission. 12/9/2014 Page 5 of 8 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Central North Region Health Support Project (P095275) PHINDIRITBL  The share of district hosptials in claims reimbursed by health insurance (VSS) is 50% or more (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 47.90 50.50 50.50 50.00 Date 31-Dec-2010 31-Mar-2014 31-Mar-2014 28-Feb-2016 Comments This indicator is yearly updated; therefore it will be available by next mission. PHINDIRITBL  50% of patients satisfied with (a) overall quality of care at district hospitals, (b) reduction of waiting time, and (c) availability of services and diagnostic facilities (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target (a) 35% (a) 50% Value (b) 35% -- NA (b) 50% (c) 32% (c) 50% Date 31-Dec-2010 10-May-2014 10-May-2014 28-Feb-2016 Comments Waiting for recruitment of consultant to do the survey. Results will be available by next mission. PHINDIRITBL  Lecturers of Vinh Medical University trained for post-graduate degrees (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Value Nil 44 44 50 Date 31-Dec-2010 31-Mar-2014 31-Mar-2014 28-Feb-2016 Comments In progress 12/9/2014 Page 6 of 8 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Central North Region Health Support Project (P095275) PHINDIRITBL  Health personnel receiving training (number) (Number, Core) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1192.00 1192.00 854.00 Date 31-Dec-2010 31-Mar-2014 31-Mar-2014 28-Feb-2016 Comments There is a typo of the value for the previous mission. The correct number is 1092. The implementation of this indicator is in progress and will exceed the original targets. 804 Assistant Doctors are under training to be full-fledged doctors. 287 staffs are taking Specialist level 1st training (compare to last mission: 1 dropped from Quang Binh province) PHINDIRITBL  175 Doctors from District Hospitals trained for Level 1 specialization and at least 680 health professionals trained for MD degree (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1192.00 1091.00 854.00 Date 31-Dec-2010 31-Mar-2014 30-Sep-2014 28-Feb-2016 Comments There is a typo of the value for the previous mission. The correct number is 1092. The implementation of this indicator is in progress and will exceed the original targets. 804 Assistant Doctors are under training to be full- fledged doctors. 287 staffs are taking Specialist level 1st training (compare to last mission: 1 dropped from Quang Binh province) PHINDIRITBL  80% of medical professional return to their original place of work/residence after long-term training supported by the project (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value -- 99.30 99.48 80.00 Date 31-Dec-2010 31-Aug-2013 30-Sep-2014 28-Feb-2016 Comments -111/112 post graduate trainees come back from training (1 left from QB) = 99%. -81/81 MD trainees come back from training (100%). In general, it is 99.48%. The training is still on-going. Overall Comments Data on Financial Performance 12/9/2014 Page 7 of 8 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Central North Region Health Support Project (P095275) Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed Disbursed P095275 IDA-46880 Effective XDR 41.50 41.50 0.00 23.97 17.53 58% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P095275 IDA-46880 Effective 06-Apr-2010 25-May-2010 23-Aug-2010 31-Aug-2016 31-Aug-2016 Cumulative Disbursements Restructuring History There has been no restructuring to date. Related Project(s) There are no related projects. 12/9/2014 Page 8 of 8 Public Disclosure Copy