The World Bank Implementation Status & Results Report The Gambia COVID-19 Preparedness and Response Project (P173798) The Gambia COVID-19 Preparedness and Response Project (P173798) AFRICA WEST | Gambia, The | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2020 | Seq No: 2 | ARCHIVED on 25-Mar-2021 | ISR46065 | Implementing Agencies: Ministry of Health, The Gambia Key Dates Key Project Dates Bank Approval Date: 02-Apr-2020 Effectiveness Date: 03-Apr-2020 Planned Mid Term Review Date: 12-Nov-2021 Actual Mid-Term Review Date: Original Closing Date: 31-Mar-2022 Revised Closing Date: 31-Mar-2022 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) To prevent, detect and respond to the threat posed by COVID-19 and strengthen national system for public health preparedness 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 $4.23 M) Component 2: Strengthening Multi-sector, National Institutions and Platforms for Policy Development and Coordination of Prevention and Preparedness using One Health approach.:(Cost $0.60 M) Component 3: Supporting National and Sub-national, Prevention and Preparedness:(Cost $5.71 M) Component 4: Implementation Management and Monitoring and Evaluation:(Cost $0.40 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Satisfactory Satisfactory Overall Risk Rating Moderate Moderate Implementation Status and Key Decisions The progress towards the Project Development Objective and overall implementation are rated Satisfactory As of March 22, 2021, disbursements amount to US$9.47 million (94 percent of commitments). Further, the AF of US$0.94 million from the PEF, which was approved on December 18, 2020, to finance the scale-up of selected activities such as procurement of laboratory equipment is expected to be fully disbursed by March 31, 2021. Results achieved so far include: a. In April 2020, when there was an acute global shortage of COVID-19 medical equipment and supplies, including in the United States and Europe, the World Bank supported the MOH in procuring critical medical equipment and supplies. These included the following: 10 high- quality, well-equipped ambulances for intensive care and critical life-saving medical equipment and supplies including 60 intensive care unit beds, 600,000 surgical masks, 1.2 million gloves, 5,000 oxygen masks, four ultrasound machines, 20,000 face shields, 25,000 units of 3/25/2021 Page 1 of 9 The World Bank Implementation Status & Results Report The Gambia COVID-19 Preparedness and Response Project (P173798) personal protective equipment (PPE, coverall), 30,000 respirators (N95), 205 oxygen flowmeters, three digital 4D color ultrasound machines, four ultrasound scanners, and 100 non-touch thermometers. b. A state-of-the-art health care waste treatment machine, AMB Ecosteryl 250 (www.ecosteryl.com), was delivered in July 2020 and one AMB Ecosteryl 75 plus was delivered in December 2020. c. The project procured six pickup trucks and 18 motorcycles to facilitate contact tracing and response. d. The 1025 toll-free call center has been enhanced, and a media monitoring and public information center has been established. This is being used for scaling up the current grievance redress mechanism (GRM) and establishing a model that will be efficient, robust, and sustainable during and post COVID-19. e. The project is supporting risk communication and community engagement. For instance, during July 25−26, 2020, the project supported the orientation of all district chiefs in-country on COVID-19, conducted by the Risk Communication and Community Engagement subcommittee of the NHEC. The aim was to sensitize the chiefs on WHO/MOH guidelines and safety measures on COVID-19 awareness and prevention. The chiefs were commissioned to go back to their various communities and hold step-down trainings on their orientation session. f. The project supported the renovation of the Ndemban Clinic (which has not been used in years) and is now functional as a COVID-19 treatment center. The GoTG signed an agreement with the United Nations Development Programme for the project to finance the renovation. International (IDOM) and local (GAP Consultants) consulting firms have completed the architectural design and are finalizing the bills of quantities for the proposed Emergency treatment centre, MOH, Farato, comprising a) National Emergency Treatment Centre Intensive Care Unit (20 beds), b) the National Emergency Observation and Treatment Centre General Ward (84 beds), c) the National Public Health Laboratory and Training Center and d) Conference Centre (100 seat). The National Blood Transfusion Centre, which is part of the Emergency treatment centre, MOH, Farato, is financed under The Gambia Essential Health Services Strengthening Project (P173287). 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 Sustained efforts continue to be made to advance the implementation of the MPA-funded projects. As of December 14, 2020, 83 MPA-projects have been approved providing a total commitment of US$4.14 billion. In addition, 12 PEF funded projects have been approved to complement the COVID response. Disbursements have continued to increase at a rapid pace. Twenty-four (24) country projects or 29% of projects approved have reached 70-100% disbursements. The projects benefit around 3.7 billion people or 50% of the global population. Of the 83 approved projects: (i) 32 are in Africa – 11 in AFE and 21 in AFW; (ii) 11 in East Asia; (iii) 12 in Europe and Central Asia; (iv) 12 in Latin America and the Caribbean; (v) 7 in Middle East and North Africa; and (vi) 9 in South Asia. Seventy (70) projects are disbursing. Total disbursements as of December 14, 2020 under these projects amount to US$1.76 billion or 43% of overall commitments (a 7% increase in the past month). In addition, $465 million have been committed undersigned contracts with UNICEF and Bank Facilitated Procurement (BFP), bringing to 53% actual disbursements and committed amounts. Streamlined procedures, 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. This creates connectivity challenges. 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 disbursements in just nine months attest to the strong implementation of the Bank response thanks to the commitment of counterparts supported by country teams. Risks Systematic Operations Risk-rating Tool 3/25/2021 Page 2 of 9 The World Bank Implementation Status & Results Report The Gambia COVID-19 Preparedness and Response Project (P173798) Risk Category Rating at Approval Previous Rating Current Rating Political and Governance High Moderate Substantial Macroeconomic Substantial Moderate Substantial Sector Strategies and Policies Moderate Moderate Moderate Technical Design of Project or Program Moderate Moderate Moderate Institutional Capacity for Implementation and Substantial Moderate Moderate Sustainability Fiduciary Moderate Moderate High Environment and Social Substantial Substantial Substantial Stakeholders Moderate Moderate Moderate Other -- -- Moderate Overall Substantial Moderate Moderate Results PDO Indicators by Objectives / Outcomes Strengthen the national public health preparedness capacity to prevent, detect and respond IN00972731 ►Suspected cases of COVID-19 cases reported and investigated per approved protocol (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 100.00 50.00 Date 02-Mar-2020 30-Jun-2020 22-Mar-2021 31-Mar-2022 The numerator is number of suspected COVID-19 cases that are reported and investigated per approved Comments: protocol and the denominator is number of suspected COVID-19 cases IN00972732 ►Isolation and treatment centers with pandemic preparedness and response plans per Ministry of Health Guidelines (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 80.00 50.00 Date 02-Mar-2020 30-Jun-2020 22-Mar-2021 31-Mar-2022 Numerator is number of Isolation and treatment centers with pandemic preparedness and response plans Comments: per Ministry of Health Guidelines and denominator is number of Isolation and treatment centers designated for COVID-19 isolation and treatment IN00972733 ►Health staff trained in infection prevention per MOH-approved protocols (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target 3/25/2021 Page 3 of 9 The World Bank Implementation Status & Results Report The Gambia COVID-19 Preparedness and Response Project (P173798) Value 0.00 807.00 1,407.00 500.00 Date 02-Mar-2020 30-Jun-2020 22-Mar-2021 31-Mar-2022 Comments: Number of health staff trained in infection prevention per MOH-approved protocols IN00972734 ►Hospitals with personal protective equipment and infection control products and supplies, without stock-outs on the first day of each quarter (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 50.00 50.00 Date 02-Mar-2020 30-Jun-2020 22-Mar-2021 31-Mar-2022 Numerator is number of hospitals with personal protective equipment and infection control products and Comments: supplies, without stock-outs on the first day of each quarter and the denominator is number of hospitals IN00972735 ►Diagnosed cases treated per approved protocol (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 55.00 100.00 50.00 Date 02-Mar-2020 30-Jun-2020 22-Mar-2021 31-Mar-2022 The numerator is number of diagnosed cases treated per approved protocol and the denominator is Comments: number of diagnosed cases Intermediate Results Indicators by Components Component 1: Emergency COVID-19 Response IN00972736 ►Public Health Emergency Operation Center (PHEOC) activated and operationalized to support coordination and planning for COVID-19 or other future emergencies (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target PHEOC activated to Value Not operational Operational Operational coordinate response Date 02-Mar-2020 30-Jun-2020 22-Mar-2021 31-Mar-2022 Public Health Emergency Operation Center (PHEOC) has dedicated toll-free telephone lines, equipped Comments: with computers and communication equipment and emergency vehicles, and a designated National Focal Point IN00972739 ►Points of Entries equipped and staff trained in SOPs (including for infection prevention and control, screening of passengers (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 9.00 9.00 9.00 Date 02-Mar-2020 30-Jun-2020 22-Mar-2021 31-Mar-2022 IN00972741 3/25/2021 Page 4 of 9 The World Bank Implementation Status & Results Report The Gambia COVID-19 Preparedness and Response Project (P173798) ►Rapid-response teams members trained and equipped to investigate cases and conduct contact tracing (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 35.00 36.70 80.00 Date 02-Mar-2020 30-Jun-2020 22-Mar-2021 31-Mar-2022 Numerator is number of rapid-response teams members trained and equipped to investigate cases and Comments: conduct contact tracing and denominator is number of rapid-response teams members IN00972743 ►Table-top simulation exercises and findings documented to inform future preparedness and response activities (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Report on table-top Only 1 table-top 1 table-top simulation simulation exercises Value None simulation exercise exercise conducted with recommendations conducted or lessons learned Date 02-Mar-2020 30-Jun-2020 22-Mar-2021 31-Mar-2022 Table-top simulation exercises are carried out and the findings documented to inform future preparedness Comments: and response activities IN00972744 ►Supervisory visits undertaken to nine Points of Entry (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 3.00 7.00 27.00 Date 02-Mar-2020 30-Jun-2020 22-Mar-2021 31-Mar-2022 Comments: Cumulative number of supervisory visits undertaken to all nine Points of Entry IN00972746 ►Border officers trained on COVID-19 prevention and control and contact tracing (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 105.00 105.00 50.00 Date 02-Mar-2020 30-Jun-2020 22-Mar-2021 31-Mar-2020 IN00972747 ►Community-based nurses and PHO trained on COVID-19 prevention and control and contact tracing (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 243.00 600.00 100.00 Date 02-Mar-2020 30-Jun-2020 22-Mar-2021 31-Mar-2022 382 PHOs Comments: 218 Community Health Nurses IN00972748 ►Emergency Ambulance Services operational within one month of start of project (Number, Custom) 3/25/2021 Page 5 of 9 The World Bank Implementation Status & Results Report The Gambia COVID-19 Preparedness and Response Project (P173798) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 8.00 18.00 9.00 Date 02-Mar-2020 30-Jun-2020 22-Mar-2021 31-Mar-2022 IN00972749 ►MoU signed with Republic of Senegal PHES (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target No MoU signed as yet. No formal MoU signed No MoU prepared and but there is tabled for signing. Value None signed communication between Although a joint the two countries workplan has been developed. Date 02-Mar-2020 30-Jun-2020 22-Mar-2021 31-Mar-2022 Comments: MoU signed with Republic of Senegal PHES within one year of start of project IN00972750 ►Table-top simulation exercises conducted (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1.00 1.00 10.00 Date 02-Mar-2020 30-Jun-2020 22-Mar-2021 31-Mar-2022 Comments: Cumulative number of table-top simulation exercises conducted IN00972751 ►Non-incineration cluster treatment of healthcare waste from several health facilities established (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Two AMB Ecosteryl healthcare waste machines (250 and 75 plus series) have been Healthcare waste procured. The design treatment equipment of the buildings for procured and process Value None Clinical Waste Established ongoing for building the Treatment Centres structure for the clinical have been completed waste treatment center and a contractor is being competitively selected to initiate the construction. Date 02-Mar-2020 30-Jun-2020 22-Mar-2021 31-Mar-2022 IN00972752 ►COVID-19 sensitization campaigns conducted in all regions (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 7,380.00 22,322.00 7.00 3/25/2021 Page 6 of 9 The World Bank Implementation Status & Results Report The Gambia COVID-19 Preparedness and Response Project (P173798) Date 02-Mar-2020 30-Jun-2020 22-Mar-2021 31-Mar-2022 IN00972753 ►Grievances responded to within stipulated service standards for response (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 20.00 20.00 40.00 Date 31-Mar-2020 30-Jun-2020 30-Jun-2020 31-Mar-2022 Component 2: Strengthening Multi-sector, National Institutions and Platforms for Policy Development IN00972737 ►Electronic Integrated Disease Surveillance Response (IDSR) using DHIS2 platform interfaced with laboratory management information system and animal health surveillance system established (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Partially established. Electronic Integrated Disease Surveillance Response (IDSR) using DHIS2 platform is currently interfaced Value None Ongoing Established with laboratory management information system but not with an animal health surveillance system Date 02-Mar-2020 30-Jun-2020 22-Mar-2021 31-Mar-2022 Electronic Integrated Disease Surveillance Response (IDSR) using DHIS2 platform interfaced with laboratory management information system and animal health surveillance system established within one Comments: year of start of project Component 3: Supporting National and Sub-national, Prevention and Preparedness IN00972738 ►Health centers reporting stock-out of tracer Infection prevention and control materials on the first day of each month (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 50.00 Date 02-Mar-2020 30-Jun-2020 22-Mar-2021 31-Mar-2022 Numerator is the number of health centers reporting stock-out of tracer infection prevention and control materials (such as detergents and disinfectants, gloves, surgical face masks/shields, and safety/sharp Comments: boxes) on the first day of each month; and denominator is the total number of health centers nationally. IN00972740 ►Costed plan to collect, package and transport samples to the WHO recommended laboratories for COVID-19 and future emergencies developed and implemented (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target 3/25/2021 Page 7 of 9 The World Bank Implementation Status & Results Report The Gambia COVID-19 Preparedness and Response Project (P173798) No longer relevant Testing is currently being since the National done at the National Public Health Value No plan Public Health Laboratory Plan in place Laboratory now has so the plan is no longer the capacity for necessary. COVID-19 testing Date 02-Mar-2020 30-Jun-2020 22-Mar-2021 31-Mar-2022 Costed plan is developed and implemented for collecting, packaging and transporting samples to the Comments: WHO recommended laboratories for COVID-19 and future emergencies IN00972742 ►Standard Operating Procedures (SOPs) on sample collection, packaging, transportation and testing of samples (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target SOPs on sample SOPs on sample collection, packaging, collection, packaging, transportation and testing transportation and are available and in testing all available place. All laboratory and in place. All lab Value None SOP in place personnel involved in personnel involved in COVID-19 response COVID-19 response have been trained. This have been trained. was done with the This was done with the support of AFENET. support of AFENET Date 02-Mar-2020 30-Jun-2020 22-Mar-2021 31-Mar-2021 Comments: SOPs is developed for sample collection, packaging, transportation and testing of samples IN00972745 ►Treatment and isolation centres renovated and/or equipped (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 2.00 3.00 Date 02-Mar-2020 30-Jun-2020 22-Mar-2021 31-Mar-2022 Cumulative number of treatment and isolation centres renovated and/or equipped Comments: Performance-Based Conditions Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P173798 IDA-D5970 Effective USD 10.00 10.00 0.00 9.47 0.65 94% P173798 TF-B4724 Closed USD 0.94 0.94 0.00 0.53 0.41 57% 3/25/2021 Page 8 of 9 The World Bank Implementation Status & Results Report The Gambia COVID-19 Preparedness and Response Project (P173798) Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P173798 IDA-D5970 Effective 02-Apr-2020 03-Apr-2020 03-Apr-2020 31-Mar-2022 31-Mar-2022 P173798 TF-B4724 Closed 22-Dec-2020 22-Dec-2020 22-Dec-2020 31-Jan-2021 31-Jan-2021 Cumulative Disbursements 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) P175740-AF to The Gambia COVID-19 Preparedness and Response Project ,P176125-Second AF to The Gambia COVID-19 Vaccine Preparedness and Response Project 3/25/2021 Page 9 of 9