The World Bank Implementation Status & Results Report AFR RI-East Africa Public Health Laboratory Networking Project (P111556) AFR RI-East Africa Public Health Laboratory Networking Project (P111556) AFRICA | Africa | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2010 | Seq No: 20 | ARCHIVED on 22-Jun-2020 | ISR41632 | Implementing Agencies: Ministry of Finance and Economic Planning (Uganda), Ministry of Finance, Budget and Privatization (Burundi), Ministry of Health (Uganda), Ministry of Finance (Tanzania), Ministry of Health, Community Development, Gender, Elderly and Children, Ministry of Health (Kenya), The National Treasury and Planning (Kenya) 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-2021 pdoTable 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 Components Table 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) Moderately Satisfactory Moderately Satisfactory Overall Risk Rating Substantial Moderate Implementation Status and Key Decisions The four East African Community member states participating in the second phase of the project (Kenya, Tanzania, Uganda, and Burundi) continue to collaborate regionally, conducting joint cross border disease surveillance and disease outbreak preparedness; carrying out annual peer audits of participating laboratories; implementing joint training and research activities; and sharing/disseminating good practices. Roughly 88 percent of project supported laboratories have reached three stars on the Stepwise Laboratory Improvement Process towards Accreditation, fifteen have attained international accreditation, and two have been recommended or undergoing international accreditation, which surpasses the end of project targets and represents a major achievement. Training and capacity building activities continue to boost human resources capacity with a cumulative total of over 19,000 health personnel trained. Roll out of new molecular technologies has improved access to TB diagnostic services, strengthened 6/22/2020 Page 1 of 8 The World Bank Implementation Status & Results Report AFR RI-East Africa Public Health Laboratory Networking Project (P111556) turnaround time, and picked up missing cases. With the introduction of the GeneXpert machines, project-supported facilities conducted about 370,000 tests, accurately diagnosing multi-drug resistant TB within several hours, rather than waiting months for culture results. The Rwanda project is completed but stakeholders continue to stay engaged on several key regional activities including the recent annual peer audit where all previously supported laboratories scored at least three stars and one scored four stars. The project was extended to September 30, 2020 (Uganda, Tanzania and Burundi components) and to March 30, 2021 for the Uganda component to allow completion of the Mulago isolation center. Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance -- Substantial Substantial Macroeconomic -- Moderate Substantial Sector Strategies and Policies -- Moderate Moderate Technical Design of Project or Program -- Substantial Moderate Institutional Capacity for Implementation and -- Substantial Moderate Sustainability Fiduciary -- Substantial Substantial Environment and Social -- Substantial Substantial Stakeholders -- Moderate Moderate Other -- -- -- Overall -- Substantial Moderate Results PDO Indicators by Objectives / Outcomes Increase capacity for specialized laboratory diagnostic services and disease surveillance. IN00838972 ►Direct project beneficiaries (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 144,887.00 1,651,253.00 1,810,887.00 1,066,435.00 Date 25-May-2010 30-Oct-2019 31-Mar-2020 30-Mar-2020 Achieved to date/target for fiscal year: Uganda: 424,145/500,000 Tanzania: 110,240/170,000 Comments: Kenya: 1,122,766/180,000 Burundi: 153,736/202,218 6/22/2020 Page 2 of 8 The World Bank Implementation Status & Results Report AFR RI-East Africa Public Health Laboratory Networking Project (P111556) IN00838973 Female beneficiaries (Number (Thousand), Custom Supplement) Baseline Actual (Previous) Actual (Current) End Target Value 76,790.00 990,751.00 1,003,906.00 646,189.00 IN00838974 ►Average Turnaround Time for TB GeneXpert Test (Hours, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 48.00 18.80 15.00 24.00 Date 07-Jul-2015 30-Oct-2019 31-Mar-2020 30-Mar-2020 Achieved to date/Target Uganda: 19.3/24 Tanzania: 12.8/24 Comments: Kenya: 18.9/24 Burundi: 8.5/24 IN00838975 ►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 30.00 34.00 34.00 Date 07-Jul-2015 30-Oct-2019 31-Mar-2020 30-Mar-2020 Uganda: 8 Tanzania: 7 Comments: Kenya: 10 Burundi: 9 IN00838976 ►Share of reported communicable disease outbreaks having laboratory confirmation of etiological agent (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 100.00 100.00 100.00 Date 25-May-2010 30-Oct-2019 31-Mar-2020 30-Mar-2020 Uganda: 100% Tanzania: 100% Comments: Kenya: 100% Burundi: 100% IN00838977 ►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 0.00 100.00 100.00 80.00 Date 07-Jul-2015 30-Oct-2019 31-Mar-2020 30-Mar-2020 6/22/2020 Page 3 of 8 The World Bank Implementation Status & Results Report AFR RI-East Africa Public Health Laboratory Networking Project (P111556) Uganda: 100% Tanzania: 100% Comments: Kenya: 100% Burundi: 100% IN00838978 ►People receiving TB drug susceptibility tests among DOTS treated TB cases not responding to treatment. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 60.00 85.00 91.00 90.00 Date 28-Dec-2012 30-Oct-2019 31-Mar-2020 30-Mar-2020 Total to date/target 2018/19: Uganda: 7856/4000 Tanzania: 1112/1650 Comments: Kenya: 4160/8700 Burundi: 15/40 Intermediate Results Indicators by Components Regional Diagnostic and Surveillance Capacity IN00838979 ►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 5.00 4.00 31.00 Date 25-May-2010 30-Oct-2019 31-Mar-2020 30-Mar-2020 Uganda: 2 Tanzania: 0 Kenya: 2 Comments: Burundi: NA There was a drop this round. Based on the drop, the countries organized training of satellite sites on management of Laboratory waste. IN00838982 ►Health facilities constructed, renovated, and/or equipped (number) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 29.00 33.00 34.00 Date 25-May-2010 30-Oct-2019 31-Mar-2020 30-Mar-2020 Uganda: 8 Tanzania: 8 Comments: Kenya: 8 Burundi: 9 IN00838985 ►Satellite laboratories compliant with regionally WHO SOPs (Number, Custom) 6/22/2020 Page 4 of 8 The World Bank Implementation Status & Results Report AFR RI-East Africa Public Health Laboratory Networking Project (P111556) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 25.00 34.00 32.00 Date 29-Jun-2012 30-Oct-2019 31-Mar-2020 30-Mar-2020 Uganda: 8 Tanzania: 8 Comments: Kenya: 10 Burundi: 8 IN00838987 ►Satellite laboratories reporting stock-outs of tracer reagent for stools culture. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 80.00 24.00 35.00 0.00 Date 29-Jun-2012 30-Oct-2019 31-Mar-2020 30-Mar-2020 Uganda: 3 Tanzania: 1 Comments: Kenya: 2 Burundi: 6 IN00838988 ►Number of GeneXpert tests performed (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 50,000.00 86,263.00 58,044.00 67,700.00 Date 29-Jun-2012 30-Oct-2019 31-Mar-2020 30-Mar-2020 Uganda: 22,873 Tanzania: 12,119 Kenya:20,030 Comments: Burundi: 3,022 IN00838989 ►Number of laboratory tests performed per quarter (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 4,163,771.00 3,424,640.00 1,800,000.00 Date 29-Jun-2012 30-Oct-2019 31-Mar-2020 30-Mar-2020 Uganda: 1,114,626 Tanzania: 314,319 Comments: Kenya: 1,529,285 Burundi: 466,410 Joint Training and Capacity Building IN00838980 6/22/2020 Page 5 of 8 The World Bank Implementation Status & Results Report AFR RI-East Africa Public Health Laboratory Networking Project (P111556) ►Health personnel receiving training (number) (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 17,313.00 1,596.00 23,347.00 Date 25-May-2010 30-Oct-2019 31-Mar-2020 30-Mar-2020 Annual totals for current fiscal year: Uganda: 500 Tanzania: 100 Comments: Kenya: 161 Burundi: 835 IN00838983 ►Proportion of laboratory staff trained and found to be proficient (Competent) in performing assignments (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 93.00 91.00 100.00 Date 29-Jun-2012 30-Oct-2019 31-Mar-2020 30-Mar-2020 Uganda: 91% Tanzania:91.8% Comments: Kenya: 100% Burundi:82% Joint Operational Research and Knowledge Sharing/Regional Coordination and Program Management IN00838981 ►Laboratory Client Satisfaction Rate (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 80.50 82.50 80.00 Date 07-Jul-2015 30-Oct-2019 31-Mar-2020 30-Mar-2020 Uganda: 84.3% Tanzania:86.0% Comments: Kenya: 75.1% Burundi: 84.5% IN00838984 ►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 No Yes Yes Yes Date 25-May-2010 30-Oct-2019 30-Oct-2019 30-Mar-2020 IN00838986 ►Operational Research studies (Number, Custom) 6/22/2020 Page 6 of 8 The World Bank Implementation Status & Results Report AFR RI-East Africa Public Health Laboratory Networking Project (P111556) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 30.00 30.00 15.00 Date 29-Jun-2012 30-Oct-2019 30-Oct-2019 30-Mar-2020 Uganda: 3 (10 off shoot studies under preparation still) Tanzania:3 + 19 off shoot proposals Comments: Kenya:3 + 2 off shoot proposals Burundi: not yet implemented Performance-Based Conditions Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P111556 IDA-47310 Closed USD 15.05 15.05 0.00 14.92 0.00 100% P111556 IDA-47320 Closed USD 23.50 22.99 0.51 22.83 0.00 100% P111556 IDA-47330 Closed USD 10.10 9.84 0.26 9.52 0.00 100% P111556 IDA-56140 Effective USD 15.00 15.00 0.00 14.89 0.00 100% P111556 IDA-56150 Effective USD 15.00 15.00 0.00 14.70 0.15 99% P111556 IDA-56160 Effective USD 10.00 10.00 0.00 9.95 0.00 100% P111556 IDA-D0470 Effective USD 10.00 10.00 0.00 9.72 0.24 98% P111556 IDA-H5930 Closed USD 15.01 14.90 0.11 14.81 0.00 100% P111556 IDA-H7740 Closed USD 15.00 14.99 0.01 13.74 0.00 100% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P111556 IDA-47310 Closed 25-May-2010 22-Jun-2010 07-Sep-2010 30-Mar-2016 30-Mar-2017 P111556 IDA-47320 Closed 25-May-2010 05-Jul-2010 01-Oct-2010 30-Mar-2016 30-Mar-2016 P111556 IDA-47330 Closed 25-May-2010 12-Aug-2010 31-Jan-2011 30-Mar-2016 30-Mar-2016 P111556 IDA-56140 Effective 07-Jul-2015 25-Sep-2015 12-Jan-2016 30-Mar-2020 30-Sep-2020 P111556 IDA-56150 Effective 07-Jul-2015 11-Feb-2016 31-Mar-2016 30-Mar-2020 30-Mar-2021 P111556 IDA-56160 Effective 07-Jul-2015 21-Oct-2015 16-Feb-2016 30-Mar-2020 30-Sep-2020 6/22/2020 Page 7 of 8 The World Bank Implementation Status & Results Report AFR RI-East Africa Public Health Laboratory Networking Project (P111556) P111556 IDA-D0470 Effective 07-Jul-2015 01-Apr-2016 18-Jul-2016 30-Mar-2020 30-Sep-2020 P111556 IDA-H5930 Closed 25-May-2010 25-Jun-2010 25-Oct-2010 30-Mar-2016 30-Dec-2016 P111556 IDA-H7740 Closed 17-May-2012 28-Jun-2012 25-Sep-2012 30-Sep-2017 29-Mar-2019 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 18-Mar-2016 ,Level 2 Approved on 27-Sep-2017 ,Level Approved on 30-Mar-2020 ,Level 2 Approved on 09-May-2020 Related Project(s) P129551-Burundi Public Health Laboratory Networking Project ,P153665-AFCC2/RI-3A EA PH Laboratory Networking Project Additional Financing ,P167552-ITSOP Test AF 6/22/2020 Page 8 of 8