The World Bank Implementation Status & Results Report Moldova Emergency COVID-19 Response Project (P173776) Moldova Emergency COVID-19 Response Project (P173776) EUROPE AND CENTRAL ASIA | Moldova | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2020 | Seq No: 2 | ARCHIVED on 29-Sep-2020 | ISR43492 | Implementing Agencies: Republic of Moldova, Ministry of Health, Labor and Social Protection. Key Dates Key Project Dates Bank Approval Date: 24-Apr-2020 Effectiveness Date: 28-May-2020 Planned Mid Term Review Date: 03-May-2021 Actual Mid-Term Review Date: Original Closing Date: 30-Apr-2022 Revised Closing Date: 30-Apr-2022 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The objectives of the Project are to prevent, detect and respond to the threat posed by the COVID-19 pandemic in Republic of Moldova. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Emergency COVID-19 Response:(Cost $57.30 M) Implementation Management and Monitoring and Evaluation:(Cost $0.60 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Moderately Satisfactory Moderately Satisfactory Overall Implementation Progress (IP) Moderately Satisfactory Moderately Satisfactory Overall Risk Rating Moderate Moderate Implementation Status and Key Decisions The Project was approved by the Regional Vice President on April 24, 2020, and declared effective on May 28, 2020. Project implementation is underway. The Procurement Plan and Project Operational Manual have been adopted and the Environment and Social Management Framework has been prepared and will undergo public consultations in October 2020. Since the June 2020 ISR, notable progress has been made on the following activities: (i) Legal Covenants: The Project has complied with all Legal Covenants: a. The Project Implementation Manual was finalized and adopted (July 2020). b. The Environmental and Social Specialists have been hired (August 2020) and the PIU is now fully staffed. (ii) Safeguards: After a delay, the Environment and Social Management Framework (ESMF) was prepared and found to be acceptable to the Bank (September 2020). Public consultations (virtual) are planned for October 2020. Based on this, the E&S ratings have been upgraded from MU to MS. 9/29/2020 Page 1 of 7 The World Bank Implementation Status & Results Report Moldova Emergency COVID-19 Response Project (P173776) (iii) Performance-based Conditions: Following the Government's approval of the supplemental budget allocations and expanded coverage for Ajutor Social, both of the performance-based conditions have been met. To-date, progress has been made in expanding the financing and coverage of the Ajutor Social program and on average 58,000 families have received cash benefits totaling US$ 15.4 million during April-July, Additionally, on the health component, US$9.3 million has already been disbursed for critical procurements, including emergency equipment and consumables (ICU beds and Equipment, PPEs, Testing Kits, Ambulances, etc.). 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 September 10, 2020, 81 projects have been approved providing a total commitment of US$3.9 billion. The projects benefit around 3.7 billion people or 48% of the global population. Of the 81 approved projects: (i) 31 are in Africa –12 in AFE and 19 in AFW; (ii) 12 in East Asia; (iii) 12 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 (63) projects are disbursing. Total disbursements as of September 10, 2020 under these projects amount to US$1.2 billion or 31% of overall commitment. In addition, $291.2 million have been committed under signed contracts with UNICEF and Bank Facilitated Procurement (BFP), bringing to 38% 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. The implementation faces significant challenges as seventy three percent (73%) of countries with MPA projects were reported still in lockdown at the end of May. This was identified by a survey to TTLs conducted by OPCS and the OEC. The findings of the survey indicated that a fundamental implementation challenge was (and still is) that government officials are not sufficiently equipped to carry out their roles and responsibilities during a lockdown, with most facing severe mobility constrains and relying to operate with cell phones. The constrains posed by the lockdown, along with the limited number of staff to do different jobs simultaneously, and existing government norms that prevent hiring of consultants, further aggravated already weak institutional and operational capacity in some countries. Another fundamental challenge for implementation, apart from lock-downs or partial lockdowns, relates to travel restrictions, as they caused multiple delays and constraints to monitoring and supervision. These problems were exacerbated by limited face-to-face meetings, which made it difficult to communicate and engage with counterparts. Working remotely with variable internet capacity also created difficulties transmitting large procurement files; ensuring team work; and coordinating multiple donors funded activities at the same time. In some countries, knowledge of the pandemic was variable and response plans have to be adjusted frequently. Bank teams had to follow up regularly with counterparts to ensure that procurement plans are adapted to rapidly evolving or changing circumstances. Other specific challenges identified by teams include: (i) several countries have not adopted emergency procedures for signing of financing agreements, processing procurement and payments – bureaucracy in making decisions and approving procurement, contracts, and payments continue to be a bottleneck; (ii) fear of future audits/investigations by national audit agencies and accountability offices is one of the reasons that is holding back the use of BFP; (iii) limited face-to-face meetings makes it difficult to communicate and engage with counterparts; (iv) Retroactive Financing has little or no uptake in some countries, mainly because the reimbursed funds will go to central government (MOF) and not to the ministries of health. Notwithstanding these 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 four months attest to the strong 9/29/2020 Page 2 of 7 The World Bank Implementation Status & Results Report Moldova Emergency COVID-19 Response Project (P173776) implementation of the Bank response thanks to the commitment of 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 Moderate Moderate Macroeconomic High Substantial Substantial Sector Strategies and Policies Moderate Moderate Moderate Technical Design of Project or Program Moderate Moderate Moderate Institutional Capacity for Implementation and Moderate Moderate Moderate Sustainability Fiduciary Substantial Substantial Substantial Environment and Social Substantial -- Substantial Stakeholders Moderate Moderate Moderate Other Moderate Moderate Moderate Overall Substantial Moderate Moderate Results PDO Indicators by Objectives / Outcomes To prevent, detect, and respond to the threat posed by the COVID-19 pandemic IN00893575 ►Number of designated hospitals with fully equipped and functional intensive care units (ICUs). (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 19.00 Date 24-Apr-2020 24-Apr-2020 24-Sep-2020 29-Apr-2022 IN00893586 ►Percentage of designated hospitals with personal protection equipment and infection control products and supplies (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 90.00 80.00 Date 24-Apr-2020 24-Apr-2020 24-Sep-2020 29-Apr-2022 IN00893587 9/29/2020 Page 3 of 7 The World Bank Implementation Status & Results Report Moldova Emergency COVID-19 Response Project (P173776) ►Number of people tested for coronavirus identification (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 8,149.00 8,149.00 150,877.00 100,000.00 Date 24-Apr-2020 24-Apr-2020 24-Sep-2020 29-Apr-2022 IN00893588 ►Number of Ajutor Social recipients during the emergency period (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 47,569.00 70,660.00 71,732.00 65,000.00 Date 24-Apr-2020 07-May-2020 24-Sep-2020 29-Apr-2022 Intermediate Results Indicators by Components Emergency COVID-19 Response IN00893589 ►Number of ventilators purchased (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 22.00 295.00 Date 24-Apr-2020 24-Apr-2020 24-Sep-2020 29-Apr-2022 IN00893590 ►Number of personal protection equipment (PPE) purchased. (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 280,000.00 1,000,000.00 Date 24-Apr-2020 24-Apr-2020 24-Sep-2020 29-Apr-2022 IN00893591 ►Number of designated laboratories with COVID-19 diagnostic equipment, test kits, and reagents per MoHLSP guidelines. (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 5.00 4.00 Date 24-Apr-2020 24-Apr-2020 24-Sep-2020 29-Apr-2022 IN00893592 ►Number of activities in National Communications Strategy for COVID-19 implemented (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 2.00 10.00 9/29/2020 Page 4 of 7 The World Bank Implementation Status & Results Report Moldova Emergency COVID-19 Response Project (P173776) Date 24-Apr-2020 24-Apr-2020 24-Sep-2020 29-Apr-2022 IN00893593 ►Number of Ajutor Social recipients (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 47,659.00 64,264.00 48,526.00 53,000.00 Date 24-Apr-2020 02-Jun-2020 03-Aug-2020 29-Apr-2022 IN00893594 ►Budget Allocation for Ajutor Social Program (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Value MDL 495,461,700 MDL 708,749,800 MDL 708,749,800 MDL 697,361,700 Date 24-Apr-2020 25-Jun-2020 25-Jun-2020 29-Apr-2022 IN00893595 ►Average Ajutor Social benefit amount (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Value MDL 828 MDL 1139 MDL 1139 MDL 1099 Date 24-Apr-2020 02-Jun-2020 02-Jun-2020 29-Apr-2022 Performance-Based Conditions IN00893596 ►PBC 1 Supplement budget increasing allocations for the Ajutor Social program by 39% adopted. (Percentage, Outcome, 17,000,000.00, 0%) Baseline Actual (Previous) Actual (Current) Completed Value 0.00 39.80 39.80 39.00 Date -- 02-Jun-2020 02-Jun-2020 -- IN00893597 ►PBC 2 Increase of the benefit and the coverage by 10% achieved (Percentage, Outcome, 7,000,000.00, 0.00%) Baseline Actual (Previous) Actual (Current) Completed Value 0.00 34.80 34.80 10.00 9/29/2020 Page 5 of 7 The World Bank Implementation Status & Results Report Moldova Emergency COVID-19 Response Project (P173776) Date -- 24-Apr-2020 24-Apr-2020 -- Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P173776 IDA-66320 Effective USD 57.90 57.90 0.00 9.26 52.30 15% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P173776 IDA-66320 Effective 24-Apr-2020 28-Apr-2020 28-May-2020 30-Apr-2022 30-Apr-2022 Cumulative Disbursements PBC Disbursement Achievement Disbursed amount in Disbursement % PBC ID PBC Type Description Coc PBC Amount Status Coc for PBC 9/29/2020 Page 6 of 7 The World Bank Implementation Status & Results Report Moldova Emergency COVID-19 Response Project (P173776) Restructuring History There has been no restructuring to date. Related Project(s) P174761-Moldova Pandemic Emergency Financing for COVID-19 9/29/2020 Page 7 of 7