The World Bank Report No: ISR15603 Implementation Status & Results Cambodia Cambodia Second Health Sector Support Program (P102284) Public Disclosure Copy Operation Name: Cambodia Second Health Sector Support Program Project Stage: Implementation Seq.No: 8 Status: ARCHIVED Archive Date: 22-Nov-2014 (P102284) Country: Cambodia Approval FY: 2008 Product Line: IBRD/IDA Region: EAST ASIA AND PACIFIC Lending Instrument: Specific Investment Loan Implementing Agency(ies): Key Dates Board Approval Date 19-Jun-2008 Original Closing Date 30-Jun-2014 Planned Mid Term Review Date 14-Sep-2011 Last Archived ISR Date 27-Apr-2014 Effectiveness Date 19-Jan-2009 Revised Closing Date 31-Dec-2015 Actual Mid Term Review Date 14-Nov-2011 Project Development Objectives Cambodia Second Health Sector Support Program (P102284) Project Development Objective (from Project Appraisal Document) To support the implementation of the Government's Health Strategic Plan 2008-2015 in order to improve health outcomes through strengthening institutional capacity and mechanisms by which the Government and Program Partners can achieve more effective and efficient sector performance. Has the Project Development Objective been changed since Board Approval of the Program? Yes No Component(s) Component Name Component Cost Strengthening Health Service Delivery 55.00 Improving Health Financing 21.00 Strenthening Human Resources 12.50 Strengthening Health System Stewardship Functions 28.50 Public Disclosure Copy Overall Ratings Previous Rating Current Rating Progress towards achievement of PDO Moderately Satisfactory Satisfactory Overall Implementation Progress (IP) Moderately Satisfactory Satisfactory Overall Risk Rating Substantial Implementation Status Overview This ISR is an update following the Joint Review Mission (JRM) which took place from April 28 - May 23, 2014, and based also on ongoing implementation review by the task team. Page 1 of 7 The World Bank Report No: ISR15603 The Second Additional Financing (AF2) was approved on September 29, 2014. Under the AF2 the Program's results framework has been revised to only include targets that can be attributed to the Program's activities and can be measured. In some cases, the type of indicator has also been revised, such as from Project Development Objective (PDO) level to intermediate level and vice-versa. All relevant core indicators are included. The PDO remains unchanged. Public Disclosure Copy The Program's development objectives and implementation ratings have been upgraded to as Satisfactory. The upgrade in progress towards the PDO is based on a DfID Program Completion Review covering the period May 2008-December 2013 which rated the HSSP2 as an “A+” project that moderately exceeded expectation. According to the assessment, factors that contributed to this progress include: (a) large health facility infrastructure improvements; (b) a coherent safety net with wide and expanding population coverage; (c) improvements in the numbers of health staff (notably midwives); (d) improved outreach; and (e) facility and individual incentives through HEFs and SDGs to Special Operating Agencies. Together, there have been large increases in public health service coverage and access for the poor. The HSSP2 has succeeded in building the capacity – both human and physical – to sustain these achievements. Over time, government financial commitment to HEFs and SDGs has risen progressively from 10 percent in the first year of the project to 40 percent of the budget in 2014. The implementation progress has also improved with significant progress in procurement of civil works and high value procurement of medical equipment. The civil works will be completed within the extended period of the project closing date. Locations Country First Administrative Division Location Planned Actual Cambodia Not Entered Battambang Cambodia Not Entered Srŏk Tbong Khmŭm Cambodia Not Entered Svay Rieng Cambodia Not Entered Stung Treng Cambodia Not Entered Ŏtâr Méanchey Cambodia Not Entered Ratanakiri Cambodia Not Entered Ratanakiri Cambodia Not Entered Prey Veng Cambodia Not Entered Preah Vihear Public Disclosure Copy Cambodia Not Entered Prasat Preăh Vihéar Cambodia Not Entered Phnom Penh Cambodia Not Entered Pailin Cambodia Not Entered Môndól Kiri Cambodia Not Entered Kratie Cambodia Not Entered Kep Page 2 of 7 The World Bank Report No: ISR15603 Country First Administrative Division Location Planned Actual Cambodia Not Entered Koh Kong Public Disclosure Copy Cambodia Not Entered Kandal Cambodia Not Entered Kampot Cambodia Not Entered Kampong Thom Cambodia Not Entered Kampong Speu Cambodia Not Entered Kampong Chhnang Cambodia Not Entered Kampong Cham Cambodia Not Entered Sihanoukville Cambodia Not Entered Banteay Meanchey Cambodia Not Entered Takeo Results Project Development Objective Indicators Indicator Name Core Unit of Measure Baseline Current End Target Percentage of deliveries by trained personnel Percentage Value 58.00 84.00 85.00 Date 31-Dec-2008 31-Mar-2014 31-Dec-2015 Comments NSDP HMIS Percentage of birth deliveries by trained health Percentage Value 39.00 80.00 75.00 personnel at health facility Date 31-Dec-2008 31-Mar-2014 31-Dec-2015 Comments NSDP HMIS Percentage (and number) of children under Percentage Value 84.00 95.00 95.00 Public Disclosure Copy one year immunized with DPT-HepB3 Date 30-Dec-2010 31-Mar-2014 31-Dec-2015 Comments CDHS 2010 326,668 HMIS/JAPR Percentage (and number) of children age 6-59 Percentage Value 89.00 100.50 98.00 months who receives two doses of Vitamin A Date 31-Dec-2008 31-Mar-2014 31-Dec-2015 supplement within the last 12 months. Comments HMIS 1,182,995 HMIS, 3/14 Page 3 of 7 The World Bank Report No: ISR15603 Percentage of pregnant women receiving Iron Percentage Value 80.00 84.00 90.00 Folate supplementation Date 31-Dec-2008 31-Mar-2014 31-Dec-2015 Comments HSP2 M&E NNP Public Disclosure Copy Percent of poor population covered by Health Percentage Value 57.00 93.00 Equity Funds Date 31-Dec-2008 31-Mar-2014 31-Dec-2015 Comments DPHI HSSP2 Progress Report and N/A DPHI Intermediate Results Indicators Indicator Name Core Unit of Measure Baseline Current End Target Proportion of Operational Districts (ODs) Text Value NA 100% 100% implementing serivce delivery grants (SDGs) Date 31-Dec-2008 31-Mar-2014 31-Dec-2015 and internal contracting meeting at least 80%of Comments SDG performance review for their performance targets 2013. Health personnel receiving training (number) Number Value 0.00 22205.00 0.00 Date 31-Dec-2007 31-Mar-2014 31-Dec-2015 Comments HRD N/A for End target can be determined only when MoH delivers a Training Strategy and Plan. People with access to a basic package of Number Value 152213.00 1417495.00 0.00 health, nutrition, or reproductive health services Date 31-Dec-2007 31-Dec-2013 31-Dec-2015 (number) Comments JAPR report 2014. To be determined This indicator is not in the Project Result Framework of AF2.This core indicator has been retained. Health facilities constructed, renovated, and/or Number Value 0.00 154.00 equipped (number) Date 31-Dec-2007 31-Mar-2014 31-Dec-2015 Public Disclosure Copy Comments Construction of 53 Additional N/A for End Target Delivery Rooms and 15 RHs is underway. Pregnant women receiving antenatal care Number Value 291853.00 312151.00 during a visit to a health provider (number) Date 31-Dec-2009 31-Mar-2014 31-Dec-2015 Comments ANC2 visits ANC2 (JAPR 2014) Target - 84% Base line- 68% (2007. HSP2) (Pre-JAPA 2011) Page 4 of 7 The World Bank Report No: ISR15603 Consultations (new cases) per year of children Number Value 1.10 1.43 2.00 under 5 years Date 30-Oct-2008 31-Mar-2014 31-Dec-2015 Comments JAPR 2010 JAPR Public Disclosure Copy Percentage of health centers having at least Percentage Value 75.00 100.00 one secondary midwife Date 01-Oct-2014 31-Dec-2015 Comments New Indicator Donor Partners Dengue case fatality rate reported by public Percentage Value 0.68 0.30 0.50 health facilities Date 31-Dec-2008 31-Mar-2014 31-Dec-2015 Comments NSDP CNM Percent of health centers implementing Percentage Value 69.00 98.00 Integrated Management Childhood Illnesses Date 31-Dec-2008 31-Mar-2014 31-Dec-2015 services Comments NSDP, JAPA 2010 Department of Communicable N/A for End Target. Disease Control Note: Decline from 2011 to 2012 due to attrition of staff and increase in number of HCs; Indicator refers to minimum number of 2 staff trained in Integrated Management Childhood Illness per HC Percentage of referral hospitals implementing Percentage Value 61.00 66.67 Health Equity Funds Date 31-Dec-2008 31-Mar-2014 31-Dec-2015 Comments DPHI DPHI N/A for End Target Percent of Health Centers implementing Health Percentage Value 13.00 50.00 Equity Funds Date 31-Dec-2008 31-Mar-2014 31-Dec-2015 Comments JAPR,2010 DPHI N/A for End Target Number of cases receiving Health Equity Fund Number Value 152000.00 assistance Date 31-Dec-2008 31-Dec-2015 Public Disclosure Copy Comments DPHI Please see below break down N/A for End Target OPD Number Value 312713.00 1204179.00 Sub Type Date 31-Dec-2009 31-Mar-2014 Breakdown Comments DPHI IPD Number Value 102205.00 151668.00 Sub Type Date 31-Dec-2009 31-Mar-2014 Breakdown Comments DPHI Deliveries Number Value 15629.00 61648.00 Page 5 of 7 The World Bank Report No: ISR15603 Sub Type Date 31-Dec-2009 31-Mar-2014 Breakdown Comments DPHI Public Disclosure Copy Data on Financial Performance (as of 07-Oct-2014) Financial Agreement(s) Key Dates Project Ln/Cr/Tf Status Approval Date Signing Date Effectiveness Date Original Closing Date Revised Closing Date P102284 IDA-44700 Effective 19-Jun-2008 17-Jul-2008 19-Jan-2009 30-Jun-2014 31-Dec-2015 P102284 TF-93574 Effective 14-Jan-2009 14-Jan-2009 14-Jan-2009 30-Jun-2014 31-Dec-2015 Disbursements (in Millions) Project Ln/Cr/Tf Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P102284 IDA-44700 Effective USD 30.00 30.00 0.00 25.46 2.89 85.00 P102284 TF-93574 Effective USD 112.23 112.23 0.00 97.35 14.88 87.00 Disbursement Graph Public Disclosure Copy Key Decisions Regarding Implementation Priority will be placed on scaling up Universal Health Coverage through expansion of Health Equity Fund (HEFs) schemes toward reaching the national coverage in 2015; ensuring Special Operating Agencies (SOAs) with remote population, including ethnic minorities, make use of available operating funding (35 percent of SDGs) to prioritize outreach services; and strengthening the performance management and monitoring of the current SOAs, including monitoring quality of care. Page 6 of 7 The World Bank Report No: ISR15603 Restructuring History Level two Approved on 19-Dec-2010, Level two Approved on 27-Sep-2012, Level 2 CD Decision on 11-Jun-2014 Public Disclosure Copy Related Projects P145507-Second Health Sector Support Program Additional Financing, P146271-Additional Financing for the Second Health Sector Support Project, P150472-Cambodia Second Health Sector Support Program-Additional Financing 2 Public Disclosure Copy Page 7 of 7