The World Bank Implementation Status & Results Report Lesotho Nutrition and Health System Strengthening Project (P170278) Lesotho Nutrition and Health System Strengthening Project (P170278) AFRICA EAST | Lesotho | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2021 | Seq No: 1 | ARCHIVED on 22-Oct-2021 | ISR48417 | Implementing Agencies: Kingdom of Lesotho, Ministry of Health Key Dates Key Project Dates Bank Approval Date: 25-Jun-2021 Effectiveness Date: 19-Aug-2021 Planned Mid Term Review Date: 22-Jan-2024 Actual Mid-Term Review Date: Original Closing Date: 30-Jun-2026 Revised Closing Date: 30-Jun-2026 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The objective is to increase the utilization and quality of key nutrition and health services and improve selected nutrition behaviors known to reduce stunting. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Community-Based Health and Nutrition Services:(Cost $14.80 M) District level health system strengthening:(Cost $8.00 M) Strengthen Government Stewardship, Project Management, and M&E:(Cost $3.60 M) Contingency Emergency Response Component Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO -- Satisfactory Overall Implementation Progress (IP) -- Satisfactory Overall Risk Rating -- Substantial Implementation Status and Key Decisions The project was approved by the World Bank Board of Executive Directors on 25 June 2021 and became effective on19 August 2021. The Ministry of Health (MOH) had consultations on the project with stakeholders and beneficiaries and is ready for project implementation, with a Project Implementation Manual (PIM) finalized and a Project Implementation Unit (PIU) in place. The first project implementation support mission is planned for November 2021. mpaTable Multiphase Programmatic Approach (MPA) Status 10/22/2021 Page 1 of 7 The World Bank Implementation Status & Results Report Lesotho Nutrition and Health System Strengthening Project (P170278) mpaTableBody Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance Substantial -- Substantial Macroeconomic Substantial -- Substantial Sector Strategies and Policies Substantial -- Substantial Technical Design of Project or Program Substantial -- Substantial Institutional Capacity for Implementation and Substantial -- Substantial Sustainability Fiduciary Substantial -- Substantial Environment and Social Moderate -- Moderate Stakeholders Moderate -- Moderate Other -- -- -- Overall Substantial -- Substantial Results PDO Indicators by Objectives / Outcomes To increase the utilization and quality of key nutrition and health services. IN01044159 ►Women ages 15-49 who took iron tablets for 90+ days during the pregnancy of the most recent birth (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 51.00 -- 51.00 66.00 Date 31-Dec-2018 -- 11-Oct-2021 08-Oct-2025 % of women age 15-49 with a live birth in the 5 years preceding the survey who took iron tablets during Comments: pregnancy for 90+ days IN01044162 ►Women ages 15-19 currently using a modern contraceptive method (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 45.20 -- 45.20 50.00 Date 31-Dec-2018 -- 11-Oct-2021 08-Oct-2025 Comments: Modern contraceptive use based on survey data (DHS and MICS) 10/22/2021 Page 2 of 7 The World Bank Implementation Status & Results Report Lesotho Nutrition and Health System Strengthening Project (P170278) To improve selected nutrition behaviors known to reduce stunting IN01044161 ►Children ages 6-23 months with minimum dietary diversity (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 23.00 -- 23.00 28.00 Date 31-Mar-2020 -- 11-Oct-2021 08-Oct-2025 Comments: Based on survey data (DHS and MICS) IN01044164 ►Children under 6 months exclusively breastfed. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 59.00 -- 59.00 67.00 Date 31-Mar-2020 -- 11-Oct-2021 08-Oct-2025 Comments: Based on MICS and DHS surveys. Improve quality of selected health services IN01044160 ►Women with institutional deliveries (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 89.40 -- 89.40 92.00 Date 31-Dec-2018 -- 11-Oct-2021 08-Oct-2025 % of deliveries that take place in health facilities. Based on survey data. Supplemented by HMIS routine Comments: data. IN01044163 ►Health facilities certified as Level 2 or above with quality rating system (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 50.00 Date 30-Nov-2020 -- 11-Oct-2021 08-Oct-2025 Number of facilities certified at level 2 or above (level 2: 60-70 percent score, level 3: >70 percent)/Number Comments: of facilities enrolled IN01044165 ►Bed occupancy rate in regional and district hospitals (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 32.00 -- 32.00 50.00 Date 27-Sep-2019 -- 11-Oct-2021 08-Oct-2025 Intermediate Results Indicators by Components 10/22/2021 Page 3 of 7 The World Bank Implementation Status & Results Report Lesotho Nutrition and Health System Strengthening Project (P170278) Community-based health and nutrition services IN01044166 ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target Value 1,913,531.00 -- 1,913,531.00 2,100,000.00 Date 31-Dec-2019 -- 11-Oct-2021 08-Oct-2025 IN01044171 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 345,563.00 -- 345,563.00 347,000.00 IN01044174 Number of children immunized (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 42,335.00 -- 42,335.00 43,000.00 Date 31-Dec-2019 -- 11-Oct-2021 28-Feb-2025 IN01044175 ►Villages benefitting from nutrition and health services package. (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 4,000.00 Date 31-Dec-2018 -- 11-Oct-2021 08-Oct-2025 Comments: Number of villages benefiting from nutrition-related project interventions IN01044177 ►Adolescents reached with youth package of services (15-19) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 160,000.00 Date 31-Dec-2019 -- 11-Oct-2021 08-Oct-2025 Comments: The package of services will be defined at a later stage. IN01044179 ►Active male village health workers in the Project’s area (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 70.00 -- 70.00 65.00 Date 01-Jun-2021 -- 11-Oct-2021 30-Jun-2026 Comments: Percentage of males among active village health workers in the Project's area 10/22/2021 Page 4 of 7 The World Bank Implementation Status & Results Report Lesotho Nutrition and Health System Strengthening Project (P170278) District Level Health System Strengthening IN01044167 ►Newborns breastfed within first hour of delivery (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 82.10 -- 82.10 87.00 Date 31-Dec-2018 -- 11-Oct-2021 08-Oct-2025 Comments: Number of newborns breastfed within first hour of delivery as a percentage of number of live births IN01044169 ►Hospitals which have received obstetric equipment as identified in the gap assessment (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 100.00 Date 30-Aug-2019 -- 11-Oct-2021 08-Oct-2025 Comments: Equipment Assessment IN01044172 ►Pregnant women screened for anaemia before 36 weeks of gestation (percentage of 1st ANC visits) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 77.10 -- 77.10 85.00 Date 31-Dec-2018 -- 11-Oct-2021 08-Oct-2025 Comments: Anemia screening during 1st ANC visits IN01044178 ►Spontaneous deliveries as percentage of total deliveries at top referral level (QMMH) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 66.00 -- 66.00 50.00 Date 31-Dec-2017 -- 11-Oct-2021 08-Oct-2025 Comments: % of spontaneous deliveries IN01044180 ►Number of facilities that have presented their Quality Improvement Plan for the semester (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 171.00 Date 29-Jan-2021 -- 11-Oct-2021 08-Oct-2025 Number of facilities that have submitted to the Health District Team their quality improvement plan for the Comments: semester. Strengthening stewardship functions and project management IN01044168 10/22/2021 Page 5 of 7 The World Bank Implementation Status & Results Report Lesotho Nutrition and Health System Strengthening Project (P170278) ►Referral guidelines developed and adopted (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No -- No Yes Date 08-Oct-2020 -- 11-Oct-2021 08-Oct-2025 Comments: Guidelines published and presented to providers IN01044170 ►Annual food and nutrition multisectoral steering committees meetings held (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 4.00 Date 31-Dec-2019 -- 11-Oct-2021 08-Oct-2025 Comments: Steering committees meetings as outlined in Food and Nutrition Strategy IN01044173 ►Creation and utilization of recurrent MOH budget line for quality and bonus grant financing (Yes/No, Custom) Baseline Actual (Previous) Actual (Current) End Target Value No -- No Yes Date 26-Jun-2020 -- 11-Oct-2021 15-Dec-2023 Comments: Creation and utilization of recurrent MOH budget line for quality and bonus grant financing IN01044176 ►Number of focus group discussions at the community level to record various perceptions about the project (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 -- 0.00 10.00 Date 27-May-2021 -- 11-Oct-2021 23-Jun-2026 Focus group discussions at the community level to record various perceptions about the project will be Comments: organized by Community Liaison Officers Performance-Based Conditions Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P170278 IDA-69310 Effective USD 22.00 22.00 0.00 0.88 20.83 4% P170278 TF-B5884 Effective USD 4.40 4.40 0.00 0.00 4.40 0% 10/22/2021 Page 6 of 7 The World Bank Implementation Status & Results Report Lesotho Nutrition and Health System Strengthening Project (P170278) Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P170278 IDA-69310 Effective 25-Jun-2021 19-Jul-2021 19-Aug-2021 30-Jun-2026 30-Jun-2026 P170278 TF-B5884 Effective 29-Jun-2021 19-Jul-2021 19-Aug-2021 28-Feb-2025 28-Feb-2025 Cumulative Disbursements Restructuring History There has been no restructuring to date. Related Project(s) There are no related projects. 10/22/2021 Page 7 of 7