The World Bank Implementation Status & Results Report Kosovo Health Project (P147402) Kosovo Health Project (P147402) EUROPE AND CENTRAL ASIA | Kosovo | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2014 | Seq No: 17 | ARCHIVED on 27-Aug-2021 | ISR47954 | Implementing Agencies: Republic of Kosovo, Ministry of Health Key Dates Key Project Dates Bank Approval Date: 13-May-2014 Effectiveness Date: 20-May-2015 Planned Mid Term Review Date: 30-Oct-2017 Actual Mid-Term Review Date: 30-Oct-2017 Original Closing Date: 30-Oct-2019 Revised Closing Date: 31-Oct-2021 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) To contribute to improving financial protection from health spending for the poor and quality of care for priority maternal and child health and non communicable disease 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) To contribute to (i) developing the building blocks to introduce Social Health Insurance, (ii) strengthening Primary Health Care in selected regions and (iii) prevent, detect and respond to the threat posed by COVID-19. Components Table Name Support capacitiy building and establishment of building blocks for introduction of SHI:(Cost $5.20 M) Support primary health care strengthening:(Cost $4.90 M) Project management and communications:(Cost $0.70 M) COVID-19 emergency response:(Cost $4.00 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Moderately Satisfactory Moderately Satisfactory Overall Implementation Progress (IP) Moderately Satisfactory Moderately Satisfactory Overall Risk Rating Moderate Moderate Implementation Status and Key Decisions Rating for progress towards achievement of Project Development Objective (PDO) remains Moderately Satisfactory (MS). The status of the PDO indicator remains the same as in the previous reporting: two out of four PDO indicators have been achieved (Outpatient Drug Benefits Scheme (ODBS) established and Health Insurance Fund (HIF) information system functional); the third indicator (Number of municipalities participating in the Capitation Based Performance Payment (CBPPs) scheme) will only meet 90% of its end-of-project target value by the closing date (for reasons 8/27/2021 Page 1 of 6 The World Bank Implementation Status & Results Report Kosovo Health Project (P147402) outside of Project’s control); the fourth indicator (The quarantine area supported by the project has been updated, according to the approved instructions of the MOH) is expected to be achieved by Project closing. The overall implementation progress is rated MS. Most activities are implemented as planned. Current disbursement has reached to US$ 12.23 million, representing 81% percent of the total credit. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance -- Substantial Substantial Macroeconomic -- Moderate Moderate Sector Strategies and Policies -- Moderate Moderate Technical Design of Project or Program -- Moderate Moderate Institutional Capacity for Implementation and -- Substantial Substantial Sustainability Fiduciary -- Moderate Moderate Environment and Social -- Low Low Stakeholders -- Low Low Other -- Moderate Moderate Overall -- Moderate Moderate Results PDO Indicators by Objectives / Outcomes To contribute to developing the building blocks to introduce Social Health Insurance IN01030793 ►Outpatient (OP) drug benefit scheme established (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target The list of drugs for The list of drugs for List of drugs under the outpatient drug benefit outpatient drug benefit OPDBS presented to the Value No scheme adopted by scheme adopted by HIF Board and sent to the HIF is submitted to the HIF is submitted to MOH the Government the Government Date 13-May-2014 23-Oct-2020 19-Aug-2021 30-Jun-2021 The approval of the list is expected to be done when the new HIL is passed by the Government. Comments: IN01030795 8/27/2021 Page 2 of 6 The World Bank Implementation Status & Results Report Kosovo Health Project (P147402) ►HIFIS is functional (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No Yes Yes Yes Date 13-May-2013 23-Oct-2020 19-Aug-2021 30-Jun-2021 The system is functional as of December 2019. Comments: To contribute to strengthening Primary Health Care IN01030794 ►Number of municipalities participating in CBPP scheme (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 6.00 18.00 18.00 20.00 Date 13-May-2013 23-Oct-2020 19-Aug-2021 30-Jun-2021 Out of the 20 municipalities which were expected to participate in CBPP in 2019, the following 18 Municipalities did so: 1. Dragash, 2. Malisheva, 3. Prishtina, 4. Prizren, 5. Rahovec, 6. Suharekë, 7. Comments: Gllogoc, 8. Fushë Kosovë, 9. Lipjan , 10.Obiliq, 11.Podujevo, 12.Mamusha, 13.Gjilan, 14.Kamenica, 15.Novobërdë, 16.Viti, 17.Partesh, and 18.Ranillug. To prevent, detect, and respond to the threat posed by COVID-19 IN01030792 ►Project-supported quarantine area has been upgraded, as per approved MoH guidelines (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No No No Yes Date 15-May-2020 23-Oct-2020 19-Aug-2021 30-Jun-2021 Civil works for the main COVID-19 hospital (UCCK) experienced some delays earlier, with the main reason being failure by the MOH to pay the contractor for the partial work done due to wrong categorization of the budget category. This problem with budget categorization has been fixed during the Comments: budget revisions in July 2021, which allowed the works to continue. At this stage 85% of works have been completed. Intermediate Results Indicators by Components Establishing Building Blocks for the Introduction of Social Health Insurance IN01030796 ►Health personnel receiving training (number) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 16,529.00 16,811.00 2,449.00 8/27/2021 Page 3 of 6 The World Bank Implementation Status & Results Report Kosovo Health Project (P147402) Date 13-May-2014 23-Oct-2020 19-Aug-2021 30-Jun-2021 Overachieved. Comments: IN01030798 ►Health facilities constructed, renovated, and/or equipped (number) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 11.00 11.00 11.00 Date 13-May-2014 23-Oct-2020 19-Aug-2021 30-Jun-2021 IN01030802 ►Percentage of patients using primary health care facilities who are satisfied with services (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 65.80 65.80 65.80 70.00 Date 31-Dec-2017 23-Oct-2020 19-Aug-2021 30-Jun-2021 Based on the results “Expectation and Perception of Population Towards Quality of Services in Primary Health Care and their Expectation Regarding the Outpatient Drug Benefit Scheme in the Republic of Kosovo” (February 2018), 65.8% of patients using primary health care services are satisfied with the Comments: services received. Due to special situation with COVID-19 it has been decided to cancel a follow on survey. Strengthening Primary Health Care IN01030800 ►Number of patients registered in the HIS (Number (Thousand), Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 528,625.00 528,625.00 511,074.00 Date 13-May-2013 23-Oct-2020 19-Aug-2021 30-Jun-2021 Target overachieved. In total 528,625, out of which 56% are female. Patients registered in AVICENNA are Comments: not transferred to PRA-HIS by the MOH-HIS Department. IN01030801 Of which female (Percentage, Custom Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 56.00 56.00 78.00 IN01030803 ►Percentage of capitation-based performance payment budget spent at municipality level (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 90.00 90.00 95.00 Date 13-May-2014 23-Jan-2021 19-Aug-2021 30-Jun-2021 8/27/2021 Page 4 of 6 The World Bank Implementation Status & Results Report Kosovo Health Project (P147402) The current value is as of January 2021. Comments: IN01030804 ►Percentage of participating municipalities with a performance improvement action plan (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 100.00 75.00 Date 13-May-2014 23-Oct-2020 19-Aug-2021 30-Jun-2021 The current value is as of January 2021. All participating municipalities have developed performance improvement action plans, have received their 4 payments, and have implemented the plans. Last Comments: payments are made in April 2021. Emergency response to COVID-19 IN01030797 ►Number of health staff trained in infection prevention and control per MOH approved protocols (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 375.00 841.00 400.00 Date 15-May-2020 23-Oct-2020 19-Aug-2021 30-Jun-2021 Overachieved. Comments: IN01030799 ►Number of volunteer healthcare staff covered with salaries (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 375.00 375.00 400.00 Date 15-May-2020 23-Oct-2020 19-Aug-2021 30-Jun-2021 Although the target was 400 at project design phase, the MOH ended up hiring 375 providers to respond Comments: to surge demand, given COVID-19 needs. Performance-Based Conditions Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P147402 IDA-54420 Effective USD 25.50 17.31 8.19 12.23 2.92 81% Key Dates (by loan) 8/27/2021 Page 5 of 6 The World Bank Implementation Status & Results Report Kosovo Health Project (P147402) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P147402 IDA-54420 Effective 13-May-2014 15-Jan-2015 20-May-2015 30-Oct-2019 31-Oct-2021 Cumulative Disbursements PBC Disbursement Achievement Disbursed amount in Disbursement % PBC ID PBC Type Description Coc PBC Amount Status Coc for PBC Restructuring History Level 2 Approved on 12-Jun-2018 ,Level 2 Approved on 24-Jul-2019 ,Level 2 Approved on 29-May-2020 ,Level 2 Approved on 28-Sep-2020 ,Level 2 Approved on 13-May-2021 Related Project(s) There are no related projects. 8/27/2021 Page 6 of 6