Public Disclosure Copy The World Bank Implementation Status & Results Report AFCC2/RI-East Africa Public Health Laboratory Networking Project (P111556) AFCC2/RI-East Africa Public Health Laboratory Networking Project (P111556) AFRICA | Africa | Health, Nutrition & Population Global Practice | IBRD/IDA | Specific Investment Loan | FY 2010 | Seq No: 12 | ARCHIVED on 22-Dec-2015 | ISR21631 | Implementing Agencies: Ministry of Finance and Economic Development Planning (Burundi) Key Dates Key Project Dates Bank Approval Date:25-May-2010 Effectiveness Date:07-Sep-2010 Planned Mid Term Review Date:28-Jun-2013 Actual Mid-Term Review Date:03-Mar-2014 Original Closing Date:30-Mar-2016 Revised Closing Date:30-Mar-2020 Project Development Objectives Project Development Objective (from Project Appraisal Document) To establish a network of efficient, high quality, accessible public health laboratories for the diagnosis and surveillance of tuberculosis and other communicable diseases. Has the Project Development Objective been changed since Board Approval of the Project Objective? No PHRPDODEL Components Name Regional Diagnostic and Surveillance Capacity:(Cost $44.90 M) Joint Training and Capacity Building:(Cost $9.90 M) Joint Operational Research and Knowledge Sharing/Regional Coordination and Program Management:(Cost $8.70 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO  Satisfactory  Satisfactory Overall Implementation Progress (IP)  Satisfactory  Satisfactory Overall Risk Rating  Substantial  Substantial 12/22/2015 Page 1 of 16 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report AFCC2/RI-East Africa Public Health Laboratory Networking Project (P111556) Implementation Status and Key Decisions Participating countries continue to demonstrate strong leadership in their respective technical areas, implementation continues to be generally strong, and disbursements remain on track. The majority of project-supported laboratories have made excellent progress on the stepwise laboratory improvement process towards accreditation; the Uganda National TB Reference Laboratory has reached international accreditation; and surveillance, training and research activities remain strong. Additional Financing of US$50 million was approved by the Board for Burundi, Kenya, Tanzania and Uganda to scale up successful activities to additional facilities in cross border areas and broaden and deepen the range of interventions to be funded in order to boost disease outbreak preparedness. 12/22/2015 Page 2 of 16 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report AFCC2/RI-East Africa Public Health Laboratory Networking Project (P111556) 12/22/2015 Page 3 of 16 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report AFCC2/RI-East Africa Public Health Laboratory Networking Project (P111556) 12/22/2015 Page 4 of 16 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report AFCC2/RI-East Africa Public Health Laboratory Networking Project (P111556) 12/22/2015 Page 5 of 16 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report AFCC2/RI-East Africa Public Health Laboratory Networking Project (P111556) 12/22/2015 Page 6 of 16 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report AFCC2/RI-East Africa Public Health Laboratory Networking Project (P111556) Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance  --  High  High Macroeconomic  --  Moderate  Moderate Sector Strategies and Policies  --  Moderate  Moderate Technical Design of Project or Program  --  Substantial  Substantial Institutional Capacity for Implementation and Sustainability  --  Substantial  Substantial Fiduciary  --  Substantial  Substantial Environment and Social  --  Substantial  Substantial Stakeholders  --  Moderate  Moderate Other  --  --  -- Overall  --  Substantial  Substantial Results Project Development Objective Indicators PHINDPDOTBL  Satellite laboratories awarded two star status under regional accreditation program based on WHO/AFRO five-step accreditation approa ch (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 26.00 26.00 30.00 Date 25-May-2010 31-Mar-2014 03-Dec-2015 30-Mar-2016 Comments These scores will be updated following the fifth round of peer assessments which are scheduled for January 2016. 12/22/2015 Page 7 of 16 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report AFCC2/RI-East Africa Public Health Laboratory Networking Project (P111556) As reflected in the Additional Financing package, this indicator will not be tracked subsequently and will be replaced by the indicator below measuring progress towards at least a 3-three star status. PHINDPDOTBL  People receiving TB drug susceptibility tests among DOTS treated TB cases not responding to treatment (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 8056.00 9772.00 14056.00 14390.00 Date 25-May-2010 31-Mar-2014 03-Dec-2015 30-Mar-2020 PHINDPDOTBL  Outbreaks for which cross border investigations undertaken (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 2.00 0.00 19.00 Date 25-May-2010 31-Mar-2014 03-Dec-2015 30-Mar-2016 Comments For the current year there were no outbreaks which required cross border investigations. As part of the Additional Financing approved in July 2015, this indicator has been revised, to better reflect both cross border and cross district investigations, with the new indicator included below. PHINDPDOTBL  Direct project beneficiaries (Number, Core) Baseline Actual (Previous) Actual (Current) End Target Value 144887.00 473465.00 860839.00 1066435.00 Date 25-May-2010 31-Mar-2014 03-Dec-2015 30-Mar-2020 12/22/2015 Page 8 of 16 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report AFCC2/RI-East Africa Public Health Laboratory Networking Project (P111556) Comments The trend in this core IDA indicator reflects, in part, improvements in reporting over the past few years. The initial end target was set too modestly and has been revised recently. With the Additional Financing approved on July 7, 2015 the indicator has been rephrased as number of beneficiaries which in fact represents the direct beneficiaries (i.e. patients who utilize the laboratories supported under the project). PHINDPDOTBL  Female beneficiaries (Percentage, Core Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 76790.00 232516.00 541189.00 646189.00 PHINDPDOTBL  Share of reported communicable disease outbreaks having laboratory confirmation of etiological agent (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value -- -- 100.00 -- Date 25-May-2010 31-Mar-2014 03-Dec-2015 30-Mar-2020 Comments Baseline figures: Kenya: 20% Rwanda: 0 Tanzania: 10% Uganda: 10% End of Project figures: Tanzania: 100% Kenya: 80% Uganda: 100% Burundi:100% PHINDPDOTBL  Average turn-around time for TB liquid culture tests (Days, Custom) Baseline Actual (Previous) Actual (Current) End Target Value -- -- -- -- Date 25-May-2010 26-Nov-2013 03-Dec-2015 30-Mar-2016 12/22/2015 Page 9 of 16 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report AFCC2/RI-East Africa Public Health Laboratory Networking Project (P111556) Comments Baseline: Kenya: 31 days Rwanda: 35 days Tanzania: 28 days Uganda: 63 days December 2015: Kenya: 21 days Rwanda: 14 days Tanzania: 21 days Uganda: 45 days This indicator has been discontinued with the Additional Financing, as it is not amenable to change and depends on national policies. PHINDPDOTBL  Average Turnaround Time for TB GeneXpert Test (Hours, Custom) Baseline Actual (Previous) Actual (Current) End Target Value -- -- -- 24.00 Date 07-Jul-2015 -- 03-Dec-2015 30-Mar-2020 Comments Baseline: Burundi: 24 hrs. Kenya: 48 hrs. Tanzania: 48 hrs. Uganda: 48 hrs. Current: Burundi: 24 hrs. Kenya: 48 hrs. Tanzania: 48 hrs. Uganda: 48 hrs. PHINDPDOTBL  Satellite laboratories awarded at least 3 star status under the regional accreditation program based on the WHO/AFRO five- step accreditation approach (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 17.00 -- 17.00 29.00 Date 07-Jul-2015 -- 03-Dec-2015 30-Mar-2020 Comments Baseline: Burundi: 4 12/22/2015 Page 10 of 16 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report AFCC2/RI-East Africa Public Health Laboratory Networking Project (P111556) Kenya: 4 Tanzania: 5 Uganda: 4 End Target: Burundi:8 Kenya: 7 Tanzania:7 Uganda: 7 PHINDPDOTBL  Proportion of outbreaks in cross border areas that joint investigations were done (both in country and inter-country joint investigations) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value -- -- -- -- Date 07-Jul-2015 -- 03-Dec-2015 30-Mar-2020 Comments Baseline/Actual: Burundi: 20% Kenya: 50% Tanzania: 50% Uganda: 50% End Target: Burundi: 85% Kenya: 80% Tanzania: 60% Uganda: 95% Overall Comments The Results Framework has been updated to reflect indicators which are no longer being monitored, to include new indicators which will be tracked going forward, and to amend the end project targets, in line with the Additional Financing package approved in July 2015. Baseline, current, and end targets have been included for all indicators for all participating countries. The M&E Officer based at ECSA-HC in Arusha continues to provide regular support to all participating countries and consolidates reports at the regional level. On balance, all countries are generally on track on the key indicators we are tracking to measure the PDO. There is some variability in attainment of the intermediate indicators but good overall progress. Achievement of the PDO indicators for the current year is estimated at 80% for all countries, and attainment of intermediate indicators is over 63% in comparison to 66% and 44%, respectively, for the previous year. Several countries (Kenya, Uganda and Rwanda) have met or surpassed the majority of their targets for the current year with a few exceptions. The other two countries (Tanzania and Burundi) are also making good progress in achieving the targets with many met, few surpassed, and others which require additional effort. Intermediate Results Indicators 12/22/2015 Page 11 of 16 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report AFCC2/RI-East Africa Public Health Laboratory Networking Project (P111556) PHINDIRITBL  Quartely publication of a regional surveillance bulletin by East Africa integrated disease surveillance network with country- specific data (yes/no) (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value N Y Y Y Date 25-May-2010 31-Mar-2014 03-Dec-2015 30-Mar-2020 PHINDIRITBL  Health facilities constructed, renovated, and/or equipped (number) (Number, Core) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 29.00 31.00 35.00 Date 25-May-2010 31-Mar-2014 03-Dec-2015 30-Mar-2020 Comments Current Situation: Kenya (6): 5 satellite laboratories constructed, equipped and to be handed over to county governments in early 2016; 1 central laboratory upgraded and equipped Rwanda (6): 5 satellite laboratories constructed, equipped and fully operational (of which one was constructed by Global Fund); one additional laboratory under construction Tanzania (7): all 7 facilities equipped; 2 facilities have completed civil works needs assessments of which construction has been initiated at one; national public health laboratory at bidding stage Uganda (6): all 6 facilities equipped; construction of new National TB Reference Laboratory underway Burundi (6):all 6 project supported facilities equipped; construction/renovation underway at all sites and expected to be completed in mid 2016 End of Project Targets: Kenya: 8 Tanzania: 10 Burundi: 9 Uganda: 8 PHINDIRITBL  Health personnel receiving training (number) (Number, Core) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 856.00 1362.00 23347.00 Date 25-May-2010 31-Mar-2014 03-Dec-2015 30-Mar-2020 Comments Cumulative End of Project Targets by Country: Tanzania: 7184 Kenya: 3878 Uganda: 1032 12/22/2015 Page 12 of 16 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report AFCC2/RI-East Africa Public Health Laboratory Networking Project (P111556) Burundi: 11253 PHINDIRITBL  Proportion of lab staff trained in liquid culture testing found to be proficient (percentage) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value -- -- -- -- Date 25-May-2010 31-Mar-2014 03-Dec-2015 30-Mar-2016 Comments Baseline: Kenya: 13% Rwanda: 0 Tanzania: 0 Uganda: 0 December 2015: Kenya: 80% Rwanda: 100% Tanzania: 67% Uganda: 100% Burundi: NA March 2016: Kenya: 80% Rwanda: 90% Tanzania: 90% Uganda: 80% This indicator has been dropped during the Additional Financing. PHINDIRITBL  Share of National and satellite laboratories that comply with Biomedical Waste Management requirements (number, percent) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 27.00 27.00 31.00 Date 25-May-2010 31-Mar-2014 03-Dec-2015 30-Mar-2020 12/22/2015 Page 13 of 16 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report AFCC2/RI-East Africa Public Health Laboratory Networking Project (P111556) PHINDIRITBL  Laboratory Client Satisfaction Rate (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value -- -- -- 80.00 Date 07-Jul-2015 -- 03-Dec-2015 30-Mar-2020 Comments Baseline: Burundi: 65% Kenya: 70% Tanzania: 70% Uganda: 56% Overall Comments Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed Disbursed P111556 IDA-47310 Effective XDR 10.00 10.00 0.00 8.20 1.80 82% P111556 IDA-47320 Effective XDR 15.50 15.50 0.00 14.14 1.36 91% P111556 IDA-47330 Effective XDR 6.60 6.60 0.00 5.95 0.65 90% Not P111556 IDA-56140 XDR 10.70 10.70 0.00 0.00 10.70 0% Effective Not P111556 IDA-56150 XDR 10.70 10.70 0.00 0.00 10.70 0% Effective Not P111556 IDA-56160 XDR 7.20 7.20 0.00 0.00 7.20 0% Effective Not P111556 IDA-D0470 XDR 7.20 7.20 0.00 0.00 7.20 0% Effective P111556 IDA-H5930 Effective XDR 9.90 9.90 0.00 8.46 1.44 85% P111556 IDA-H7740 Effective XDR 9.70 9.70 0.00 3.58 6.12 37% Key Dates (by loan) 12/22/2015 Page 14 of 16 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report AFCC2/RI-East Africa Public Health Laboratory Networking Project (P111556) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P111556 IDA-47310 Effective 25-May-2010 22-Jun-2010 07-Sep-2010 30-Mar-2016 30-Mar-2016 P111556 IDA-47320 Effective 25-May-2010 05-Jul-2010 01-Oct-2010 30-Mar-2016 30-Mar-2016 P111556 IDA-47330 Effective 25-May-2010 12-Aug-2010 31-Jan-2011 30-Mar-2016 30-Mar-2016 Not P111556 IDA-56140 07-Jul-2015 25-Sep-2015 -- 30-Mar-2020 30-Mar-2020 Effective Not P111556 IDA-56150 07-Jul-2015 -- -- 30-Mar-2020 30-Mar-2020 Effective Not P111556 IDA-56160 07-Jul-2015 21-Oct-2015 -- 30-Mar-2020 30-Mar-2020 Effective Not P111556 IDA-D0470 07-Jul-2015 -- -- 30-Mar-2020 30-Mar-2020 Effective P111556 IDA-H5930 Effective 25-May-2010 25-Jun-2010 25-Oct-2010 30-Mar-2016 30-Mar-2016 P111556 IDA-H7740 Effective 17-May-2012 28-Jun-2012 25-Sep-2012 30-Sep-2017 30-Sep-2017 Cumulative Disbursements Restructuring History There has been no restructuring to date. 12/22/2015 Page 15 of 16 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report AFCC2/RI-East Africa Public Health Laboratory Networking Project (P111556) Related Project(s) P129551-Burundi Public Health Laboratory Networking Project ,P153665-AFCC2/RI-3A EA PH Laboratory Networking Project Additional Financing 12/22/2015 Page 16 of 16 Public Disclosure Copy