The World Bank Implementation Status & Results Report Lao PDR COVID-19 Response Project (P173817) Lao PDR COVID-19 Response Project (P173817) EAST ASIA AND PACIFIC | Lao People's Democratic Republic | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2020 | Seq No: 2 | ARCHIVED on 20-Nov-2020 | ISR44023 | Implementing Agencies: Ministry of Finance, Ministry of Health Key Dates Key Project Dates Bank Approval Date: 06-Apr-2020 Effectiveness Date: 07-Apr-2020 Planned Mid Term Review Date: 30-Apr-2021 Actual Mid-Term Review Date: Original Closing Date: 31-Dec-2022 Revised Closing Date: 31-Dec-2022 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) To respond to the COVID-19 outbreak and strengthen national systems for public health emergency preparedness in Lao PDR. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Component 1: Emergency COVID-19 Response:(Cost $12.83 M) Component 2: Strengthening System for Emergency Response:(Cost $3.67 M) Component 3: Project Management and Monitoring and Evaluation:(Cost $1.50 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Satisfactory Satisfactory Overall Risk Rating Substantial Substantial Implementation Status and Key Decisions The first virtual implementation support mission (ISM) for the project has been conducted from October 12 to 19, 2020. Overall progress towards achievement of Project Development Objective and Implementation Progress is Satisfactory. Significant progress has been made under Component 1, where US$4.13 million or 32 percent of the component budget has been disbursed mostly for the procurement of laboratory and medical equipment. The implementation progress under Component 2 is slower than anticipated, with US$78,543 (2.1 percent) disbursed; the priority activity for fiscal year 2020 is the construction of treatment and isolation facilities in the existing hospitals. The Ministry of Health received an additional grant of US$1 million from the Pandemic Emergency Financing Facility. The grant was approved and channeled through UNICEF and WHO for the procurement of vaccines for the immunization program and health facility training respectively. Procurement of vaccines is already complete. The health facility training at national level has been completed, and training at provincial and district levels will be completed by January 31, 2021. The Ministries of Finance and Health have been informed about the availability of additional financing for procurement of COVID-19 vaccines and deployment. The Ministry of Health, with support from the partners will conduct the COVID-19 vaccine readiness assessment to identify capacity 11/20/2020 Page 1 of 6 The World Bank Implementation Status & Results Report Lao PDR COVID-19 Response Project (P173817) and financing gaps as well as investment needs to effectively deploy COVID-19 vaccines to target beneficiaries. This will inform on the need for additional financing, restructuring, application to COVAX facility, and development of the COVID-19 deployment plan. . 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 $1,687.7 or 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 Substantial Substantial Substantial Macroeconomic Substantial Substantial Substantial Sector Strategies and Policies Moderate Moderate Moderate Technical Design of Project or Program Moderate Moderate Moderate Institutional Capacity for Implementation and Substantial Substantial Substantial Sustainability Fiduciary Substantial Substantial Substantial Environment and Social Substantial Substantial Substantial Stakeholders Moderate Moderate Moderate Other -- Substantial Substantial 11/20/2020 Page 2 of 6 The World Bank Implementation Status & Results Report Lao PDR COVID-19 Response Project (P173817) Overall Substantial Substantial Substantial Results PDO Indicators by Objectives / Outcomes Timely detection response, and containment of COVID-19 cases IN00910581 ►Number of suspected cases of COVID-19 tested for COVID-19 based on the national guidelines (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 783.00 1,177.00 59,183.00 71,000.00 Date 03-Apr-2020 19-Jun-2020 19-Oct-2020 31-Dec-2022 The country has completely locked down since the first COVID-19 positive cased was announced on March 23, 2020. 59,138 suspected cased were tested and only 24 cases have tested positive. There has Comments: been no deaths and 22 positive cases have already recovered. Increased capacity of healthcare institutions for COVID-19 and other emergency responses IN00910582 ►Number of acute healthcare facilities with isolation capacity (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 1.00 24.00 24.00 21.00 Date 03-Apr-2020 19-Jun-2020 19-Oct-2020 31-Dec-2022 Currently the target for 2022 is surpassed. 24 health facilities have increased their capacity for COVID-19 and other emergency response. This includes 17 provincial hospitals and 7 central hospitals. The Comments: figures remain unchanged from the previous ISR. Intermediate Results Indicators by Components Component 1: Emergency COVID-19 Response IN00910583 ►Number of health staff trained in infection prevention and control per MOH-approved protocols (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 618.00 618.00 500.00 Date 26-Mar-2020 20-Jun-2020 19-Oct-2020 30-Dec-2022 This end target was under estimated, as by now 618 health staff were already trained. The team will work Comments: with Ministry of Health’s Department of Human Resources to determine an appropriate end target. 11/20/2020 Page 3 of 6 The World Bank Implementation Status & Results Report Lao PDR COVID-19 Response Project (P173817) IN00910586 ►Percentage of COVID-19 laboratory-confirmed cases notified, registered and reported within 24 hours (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 100.00 80.00 Date 03-Apr-2020 19-Jun-2020 19-Oct-2020 31-Dec-2022 This end target was underestimated. Ministry of Health agreed to revise the end target to 100 percent. Comments: The revision will be made through the project restructuring. Component 2: Strengthening System for Emergency Response IN00910584 ►Number of designated laboratories with staff trained to conduct COVID-19 diagnosis (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 4.00 4.00 4.00 10.00 Date 03-Apr-2020 19-Jun-2020 19-Jun-2020 31-Dec-2022 The current number of 4 laboratories is same as the baseline. The MOH has plans to increase the number of laboratories with staff trained to conduct COVID-19 diagnosis to 7 fixed sites and 17 mobiles sites by Comments: the end of 2020. IN00910587 ►Percentage of COVID-19 laboratory-confirmed cases treated as per national guidelines (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 100.00 75.00 Date 03-Apr-2020 19-Jun-2020 19-Jun-2020 31-Dec-2022 This end target was underestimated. Ministry of Health agreed to revise the end target to 100 percent. Comments: This will be done through the project restructuring. IN00910588 ►A referral system to care for COVID-19 patients in place (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No No No Yes Date 03-Apr-2020 22-Jun-2020 22-Jun-2020 31-Dec-2022 Department of Health Care and Rehabilitation is in charge of developing the guidelines with technical Comments: assistance from World Health Organization. These are expected to be completed by the end of 2020. Component 3: Project Management and Monitoring and Evaluation IN00910585 ►M&E system established to monitor COVID-19 preparedness and response plan (Yes/No, Custom) 11/20/2020 Page 4 of 6 The World Bank Implementation Status & Results Report Lao PDR COVID-19 Response Project (P173817) Baseline Actual (Previous) Actual (Current) End Target Value No Yes Yes Yes Date 03-Apr-2020 19-Jun-2020 19-Jun-2020 31-Dec-2022 This indicator has achieved the end target for 2022 ahead of time. Comments: IN00910621 ►Percentage of beneficiaries who expressed satisfaction with the project interventions, including on delivery and communication modalities (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Value TBD -- TBD TBD Date 19-Oct-2020 -- 19-Oct-2020 31-Dec-2022 This is a new indicator under Component 3 relating to citizen engagement which has been agreed to with Comments: the Ministry of Health. Performance-Based Conditions Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P173817 IDA-66060 Effective USD 18.00 18.00 0.00 6.36 12.18 34% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P173817 IDA-66060 Effective 06-Apr-2020 07-Apr-2020 07-Apr-2020 31-Dec-2022 31-Dec-2022 Cumulative Disbursements 11/20/2020 Page 5 of 6 The World Bank Implementation Status & Results Report Lao PDR COVID-19 Response Project (P173817) 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) P175771-AF- Lao PDR COVID-19 Response Project 11/20/2020 Page 6 of 6