The World Bank Implementation Status & Results Report Transforming Health Systems for Universal Care (P152394) Transforming Health Systems for Universal Care (P152394) AFRICA EAST | Kenya | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2016 | Seq No: 11 | ARCHIVED on 26-Jul-2021 | ISR47419 | Implementing Agencies: Republic of Kenya, Ministry of Health Key Dates Key Project Dates Bank Approval Date: 15-Jun-2016 Effectiveness Date: 04-Jul-2016 Planned Mid Term Review Date: 11-Mar-2019 Actual Mid-Term Review Date: 25-Mar-2019 Original Closing Date: 30-Sep-2021 Revised Closing Date: 30-Sep-2023 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The project development objective is to improve utilization and quality of primary health care services with a focus on reproductive, maternal, newborn, child, and adolescent health 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 improve utilization and quality of primary health care services with a focus on reproductive, maternal, newborn, child and adolescent health services and to provide immediate and effective response to an eligible crisis or emergency . Components Table Name Improving Primary Health Care Results:(Cost $141.00 M) Strengthening Institutional Capacity:(Cost $28.70 M) Contingency Emergency Response:(Cost $10.00 M) Cross-county and Intergovernmental Collaboration, and Project Management:(Cost $11.40 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Moderately Satisfactory Moderately Satisfactory Overall Implementation Progress (IP) Moderately Unsatisfactory Moderately Satisfactory Overall Risk Rating Substantial Substantial Implementation Status and Key Decisions The Transforming Health Systems for Universal Care Project (THS-UCP) aims to improve utilization and quality of primary healthcare services with a focus on reproductive, maternal, newborn, child, and adolescent health (RMNCAH) services. An implementation support mission conducted during May 31 – June 4, 2021 showed that overall implementation is progressing well including activities supported by the Policy and Human Resources Development grant. County governments are implementing activities prioritized in their 7/26/2021 Page 1 of 8 The World Bank Implementation Status & Results Report Transforming Health Systems for Universal Care (P152394) annual work plans. Procurement and distribution of RMNCAH strategic commodities is near complete. In response to the Government of Kenya's request to trigger the Contingency Emergency Response Component (CERC) to respond to the COVID-19 pandemic, the Bank allocated US$ 10M to support the Kenya COVID-19 Contingency Plan. To address concerns that have been in the public domain on the usage of COVID-19 related funds, including under the Kenya COVID-19 Emergency Response Project, the World Bank is working closely with the relevant organs of government to strengthen the fiduciary functions and accountability systems for the Project. The complaint handling and redress mechanism has also been strengthened to further improve transparency and accountability. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance High Substantial Substantial Macroeconomic Moderate Moderate Moderate Sector Strategies and Policies Moderate Substantial Moderate Technical Design of Project or Program Substantial Substantial Substantial Institutional Capacity for Implementation and High High High Sustainability Fiduciary Substantial Substantial Substantial Environment and Social Low Moderate Moderate Stakeholders Substantial High Substantial Other -- -- -- Overall Substantial Substantial Substantial Results PDO Indicators by Objectives / Outcomes Improved utilization and quality of primary health care services IN01013014 ►Children immunized with the third dose of Pentavalent (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 79.50 92.20 81.10 84.00 Date 31-Dec-2015 30-Sep-2020 31-Mar-2021 30-Sep-2023 IN01013016 ►Pregnant women attending at least four ANC visits (Percentage, Custom) 7/26/2021 Page 2 of 8 The World Bank Implementation Status & Results Report Transforming Health Systems for Universal Care (P152394) Baseline Actual (Previous) Actual (Current) End Target Value 39.70 57.70 45.00 52.00 Date 31-Dec-2015 30-Sep-2020 31-Mar-2021 30-Sep-2023 IN01013017 ►Births attended by skilled health personnel (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 57.00 81.10 74.40 67.00 Date 31-Dec-2015 30-Sep-2020 31-Mar-2021 30-Sep-2023 IN01013018 ►Women between the ages of 15-49 years currently using a modern FP method (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 47.80 49.80 35.30 52.00 Date 31-Dec-2015 30-Sep-2020 31-Mar-2021 30-Sep-2023 There was a decline in this indicator which could have been linked to disruption in primary health care Comments: services in the COVID-19 context and a shortage of long-term FP commodities. IN01013019 ►Inspected facilities meeting safety standards (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 34.90 33.00 50.00 Date 31-Dec-2015 30-Sep-2020 31-Mar-2021 30-Sep-2023 IN01013020 ►Pregnant women attending ANC supplemented with IFA (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 31.00 79.00 78.00 73.00 Date 31-Dec-2015 30-Sep-2020 31-Mar-2021 30-Sep-2023 Provision of immediate and effective response to an eligible crisis or emergency IN01013015 ►Reported suspected cases of COVID-19 cases investigated based on national guidelines (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 100.00 80.00 Date 18-Mar-2020 30-Sep-2020 31-Mar-2021 31-Dec-2021 7/26/2021 Page 3 of 8 The World Bank Implementation Status & Results Report Transforming Health Systems for Universal Care (P152394) Intermediate Results Indicators by Components Component 1: Improved primary health care results IN01013032 ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 8,996,064.00 10,162,388.00 10,060,000.00 Date 29-Sep-2016 30-Sep-2020 31-Mar-2021 30-Sep-2023 The baseline date corresponds the date at which the Project became effective. This is a corporate indicator capturing the cumulative number of people receiving essential health services over the Project Comments: lifecycle (# deliveries attended by skilled personnel and # children aged 0 to 5 who were immunized). No Nutrition services are supported by the Project. IN01013033 Number of children immunized (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 4,322,214.00 4,925,604.00 5,400,000.00 Date 29-Sep-2016 30-Sep-2020 31-Mar-2021 30-Sep-2023 IN01013034 Number of deliveries attended by skilled health personnel (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 4,670,155.00 5,236,784.00 4,660,000.00 Date 29-Sep-2016 30-Sep-2020 31-Mar-2021 30-Sep-2023 Component 2: Strengthened institutional capacity IN01013021 ►Facilities inspected for safety standards (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 152.00 625.00 1,635.00 Date 11-Mar-2016 30-Sep-2020 31-Mar-2021 30-Sep-2023 IN01013024 ►Reports submitted to DHIS in a timely manner. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 88.80 96.30 96.60 98.00 Date 31-Dec-2015 30-Sep-2020 31-Mar-2021 30-Sep-2023 7/26/2021 Page 4 of 8 The World Bank Implementation Status & Results Report Transforming Health Systems for Universal Care (P152394) IN01013026 ►Births registered within 6 months of occurrence (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 65.90 71.90 82.90 80.00 Date 31-Dec-2015 30-Sep-2020 31-Dec-2020 30-Sep-2023 Actual achievement measures 2020 data (report not yet published). Comments: IN01013029 ►RMNCAH related operations research completed to inform policy/strategy (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 2.00 Date 11-Mar-2016 15-Dec-2020 31-Mar-2021 30-Sep-2023 Kangaroo Mother Care: The Division of Child Health is undertaking an operation research on Kangaroo Mother Care to evaluate the implementation progress. Data collection was completed in 35 health facilities spread across six counties and analysis is ongoing. Iron and folic acid supplementation: The operation research on the uptake of iron and folic acid supplements among women of reproductive age planned by the Division of Nutrition has not progressed Comments: since the last mission. A consultant to deliver this study was contracted, but the contract expired before completion of the study due to challenges related to COVID-19. The MoH has initiated the process to procure the consultant to complete this exercise. IN01013030 ►A benefit package developed, costed, and disseminated (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 1.00 Date 11-Mar-2016 15-Dec-2020 31-Mar-2021 30-Sep-2023 The benefit package has been developed and costed. This is subject to reviews and validation. Comments: IN01013031 ►Lessons learned from UHC Phase I documented and disseminated (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No Yes Yes Yes Date 20-Jun-2019 15-Dec-2020 15-Dec-2020 31-Dec-2019 This indicator was introduced after the mid term review of the project. The lessons learned from UHC Phase I were documented in a report and disseminated to key Comments: stakeholders. Component 3: Cross-county/intergovernmental collaboration and project management IN01013022 7/26/2021 Page 5 of 8 The World Bank Implementation Status & Results Report Transforming Health Systems for Universal Care (P152394) ►Functional community units (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 302.00 6,500.00 8,442.00 5,331.00 Date 31-Dec-2015 30-Sep-2020 31-Mar-2021 30-Sep-2023 IN01013025 ►Grievances registered related to delivery of project benefits that are addressed (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 100.00 80.00 Date 31-Dec-2015 30-Sep-2020 31-Mar-2021 30-Sep-2023 IN01013027 ►Implementing entities submitting the annual FM and technical report on time (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 98.00 95.00 Date 11-Mar-2016 30-Sep-2020 31-Mar-2021 30-Sep-2023 Component 4: Contingency Emergency Response IN01013023 ►Designated laboratories with COVID diagnostic equipment (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 2.00 41.00 41.00 8.00 Date 18-Mar-2020 30-Sep-2020 31-Mar-2021 31-Dec-2021 When the COVID-19 Health Emergency Response Project (CHERP, P173820) and CERC were designed, there were only 8 designated laboratories for COVID-19 testing. The number of laboratories equipped with Comments: diagnostic equipment has since increased to 41 laboratories. IN01013028 ►Vulnerable and marginalized communities reached in their indigenous language (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 66.00 80.00 Date 18-Mar-2020 30-Sep-2020 31-Mar-2021 31-Dec-2021 Performance-Based Conditions Data on Financial Performance 7/26/2021 Page 6 of 8 The World Bank Implementation Status & Results Report Transforming Health Systems for Universal Care (P152394) Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P152394 IDA-58360 Effective USD 150.00 150.00 0.00 132.25 15.93 89% P152394 TF-A2561 Effective USD 40.00 40.00 0.00 29.30 10.70 73% P152394 TF-A2792 Effective USD 1.10 1.10 0.00 0.71 0.39 64% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P152394 IDA-58360 Effective 15-Jun-2016 04-Jul-2016 29-Sep-2016 30-Sep-2021 30-Sep-2023 P152394 TF-A2561 Effective 15-Jun-2016 04-Jul-2016 29-Sep-2016 30-Sep-2021 30-Sep-2021 P152394 TF-A2792 Effective 15-Jun-2016 04-Jul-2016 04-Jul-2016 30-Jun-2020 30-Sep-2021 Cumulative Disbursements PBC Disbursement Achievement Disbursed amount in Disbursement % PBC ID PBC Type Description Coc PBC Amount Status Coc for PBC 7/26/2021 Page 7 of 8 The World Bank Implementation Status & Results Report Transforming Health Systems for Universal Care (P152394) Restructuring History Level 2 Approved on 24-Jun-2019 ,Level 2 Approved on 31-Jan-2020 ,Level 2 Approved on 20-Oct-2020 ,Level 2 Approved on 26-Mar-2021 Related Project(s) P174772-Additional Financing for THS-UCP 7/26/2021 Page 8 of 8