The World Bank Implementation Status & Results Report Health System Support and Strengthening Project (P164953) Health System Support and Strengthening Project (P164953) AFRICA WEST | Central African Republic | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2019 | Seq No: 5 | ARCHIVED on 23-Dec-2020 | ISR44426 | Implementing Agencies: Ministry of Public Health and Population, Ministry of Economy, Planning and Cooperation Key Dates Key Project Dates Bank Approval Date: 27-Sep-2018 Effectiveness Date: 07-Feb-2019 Planned Mid Term Review Date: 18-Jan-2021 Actual Mid-Term Review Date: Original Closing Date: 31-Dec-2021 Revised Closing Date: 31-Dec-2021 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) To increase utilization and improve the quality of essential health services in targeted areas in the territory of the Recipient. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Improving the quality and utilization of essential health services at facility and community levels through performance-based financing (PBF):(Cost $36.00 M) Reinforcing the capacity of the Recipient’s health system and addressing Gender-Based Violence:(Cost $18.00 M) Contingent Emergency Response Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Moderately Unsatisfactory Moderately Unsatisfactory Overall Implementation Progress (IP) Unsatisfactory Moderately Unsatisfactory Overall Risk Rating Substantial Substantial Implementation Status and Key Decisions There has been progress in SENI project implementation in this latest reporting period. The positive implementation progress is attributed to : i) the effective presence of a complete coordination team with the new Coordinator, the REDISSE focal point and all SENI-REDISE staff now onboarded and trained on different aspects of Bank-project management including procurement, financial management and safeguards; ii) a strengthened project monitoring and supervision system with geo-enabled monitoring and supervision (GEMS) that show progress of essential medicine and finance delivery; iii) a strengthened governance and financial management system are in place; and iv) the verification mechanism for the effective implementation of the performance-based finance (PBF) component is now in place in all 5 SENI-supported regions, and advance on performance payments have been made to 392 health facilities; and v) Gender-based violence (GBV) implementation has progressed, where all SENI-supported GBV facilities have been provided with post-rape drugs and kits, psychosocial agents and GBV focal points placed in their respective districts, 12/23/2020 Page 1 of 7 The World Bank Implementation Status & Results Report Health System Support and Strengthening Project (P164953) ambulances and transport mechanism have been launched by the President and the Minister of Health in Bambari district and in Bangui, and international NGOs have been recruited in all the 5 zones. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance High High High Macroeconomic Substantial Substantial Substantial Sector Strategies and Policies High High Substantial Technical Design of Project or Program Moderate High Substantial Institutional Capacity for Implementation and Substantial Substantial Substantial Sustainability Fiduciary High High Substantial Environment and Social Moderate Moderate Moderate Stakeholders Moderate Substantial Substantial Other High High High Overall Substantial Substantial Substantial Results PDO Indicators by Objectives / Outcomes Improve utilization & quality of essential health services in facilities & communities through PBF IN00921535 ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 52,809.00 214,881.00 474,066.00 Date 28-Sep-2018 17-Jun-2020 11-Dec-2020 31-Dec-2021 IN00921606 People who have received essential health, nutrition, and population (HNP) services - Female (RMS requirement) (Number, Corporate Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 24,111.00 65,738.00 328,725.00 12/23/2020 Page 2 of 7 The World Bank Implementation Status & Results Report Health System Support and Strengthening Project (P164953) IN00921607 Number of children immunized (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 8,693.00 70,931.00 98,186.00 Date 28-Sep-2018 16-Jun-2020 11-Dec-2020 31-Dec-2021 IN00921608 Number of women and children who have received basic nutrition services (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 20,136.00 78,212.00 192,496.00 Date 28-Sep-2018 16-Jun-2020 11-Dec-2020 31-Dec-2021 IN00921609 Number of deliveries attended by skilled health personnel (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 16,251.00 65,738.00 183,384.00 Date 28-Sep-2018 16-Jun-2020 11-Dec-2020 31-Dec-2021 IN00921610 ►Quality average score of health centers in targeted areas (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 58.40 55.30 80.00 Date 28-Sep-2018 21-Nov-2019 11-Dec-2020 31-Dec-2021 Data to be available in January 2021 Comments: Intermediate Results Indicators by Components Improve utilization & quality of essential health services in facilities & communities through PBF IN00921612 ►Ante-natal care visits (at least 4) received by pregnant women (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 30,994.00 227,721.00 569,000.00 Date 28-Sep-2018 16-Jun-2020 11-Dec-2020 31-Dec-2021 IN00921614 ►Children 6-59 months receiving vitamin A supplementation (twice per year) in total catchment area (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target 12/23/2020 Page 3 of 7 The World Bank Implementation Status & Results Report Health System Support and Strengthening Project (P164953) Value 0.00 2,653.00 6,881.00 67,532.00 Date 28-Sep-2018 16-Jun-2020 11-Dec-2020 31-Dec-2021 IN00921616 ►Women and adolescents who received family planning services (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 29,907.00 98,032.00 203,331.00 Date 28-Sep-2018 16-Jun-2020 11-Dec-2020 31-Dec-2021 IN00921618 ►Post-natal care visits received by women (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 14,412.00 63,337.00 173,958.00 Date 28-Sep-2018 16-Jun-2020 11-Dec-2020 31-Dec-2021 IN00921619 ►Pregnant women receiving two doses of intermittent preventive treatment (SP) for malaria (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 17,029.00 29,507.00 107,519.00 Date 28-Sep-2018 16-Jun-2020 11-Dec-2020 31-Dec-2021 IN00921620 ►People receiving health services free of charge (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 312,063.00 372,351.00 Date 30-Sep-2018 19-Jun-2020 11-Dec-2020 31-Dec-2021 IN00921621 ►People referred to health facilities by community workers (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 89,062.00 292,652.00 Date 28-Sep-2018 19-Jun-2020 11-Dec-2020 31-Dec-2021 Data not available. Comments: IN00921622 ►Quality satisfaction score of beneficiaries for health services in district hospitals. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target 12/23/2020 Page 4 of 7 The World Bank Implementation Status & Results Report Health System Support and Strengthening Project (P164953) Value 70.00 0.00 70.00 85.00 Date 31-Dec-2017 19-Jun-2020 11-Dec-2020 31-Dec-2021 Data not available. Comments: IN00921623 ►Quality average score of district hospitals (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 74.00 0.00 83.50 85.00 Date 31-Dec-2017 16-Jun-2020 11-Dec-2020 31-Dec-2021 IN00921624 ►Children (1-5 years old) receiving a deworming tablet in total catchment area (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 7,763.00 8,471.00 67,532.00 Date 28-Sep-2018 16-Jun-2020 11-Dec-2020 31-Dec-2021 IN00921625 ►Facilities receiving performance payments on time (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 80.00 Date 28-Sep-2018 19-Jun-2020 11-Dec-2020 31-Dec-2021 Data not available. Comments: Reinforcing institutional capacity for HSS incl. establishing district hospitals integrated GBV ser. IN00921611 ►Completeness of country health data in health management information system (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 3.00 66.00 80.00 80.00 Date 28-Sep-2018 16-Jun-2020 11-Dec-2020 31-Dec-2021 IN00921613 ►Number of Districts Hospitals with integrated GBV Services (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 5.00 3.00 Date 28-Sep-2018 16-Jun-2020 11-Dec-2020 31-Dec-2021 IN00921615 12/23/2020 Page 5 of 7 The World Bank Implementation Status & Results Report Health System Support and Strengthening Project (P164953) ►Availability of tracer drugs at health centers (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 84.00 76.90 94.60 90.00 Date 28-Sep-2018 16-Jun-2020 11-Dec-2020 31-Dec-2021 The essential medicine was delivered in July-August 2020 to most health facilities, verified by the GEMS Comments: mapping. IN00921617 ►Health professionals employed full-time in health facilities (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 1,189.00 4,306.00 Date 28-Sep-2018 19-Jun-2020 11-Dec-2020 31-Dec-2021 Data not available. Comments: Performance-Based Conditions Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P164953 IDA-D3750 Effective USD 43.00 43.00 0.00 15.67 27.59 36% P164953 TF-A8196 Effective USD 10.00 10.00 0.00 3.56 6.44 36% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P164953 IDA-D3750 Effective 27-Sep-2018 12-Dec-2018 07-Feb-2019 31-Dec-2021 31-Dec-2021 P164953 TF-A8196 Effective 27-Sep-2018 12-Dec-2018 07-Feb-2019 31-Dec-2021 31-Dec-2021 Cumulative Disbursements 12/23/2020 Page 6 of 7 The World Bank Implementation Status & Results Report Health System Support and Strengthening Project (P164953) 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. 12/23/2020 Page 7 of 7