Public Disclosure Copy The World Bank Implementation Status & Results Report Sri Lanka - Second Health Sector Development Project (P118806) Sri Lanka - Second Health Sector Development Project (P118806) SOUTH ASIA | Sri Lanka | Health, Nutrition and Population Global Practice | IBRD/IDA | Sector Investment and Maintenance Loan | FY 2013 | Seq No: 5 | ARCHIVED on 22-Jun-2015 | ISR19359 | Implementing Agencies: Ministry of Health, Ministry of Local Government and Provinical Councils Key Dates Key Project Dates Board Approval date:27-Mar-2013 Effectiveness Date:12-Sep-2013 Planned Mid Term Review Date:14-Mar-2016 Actual Mid-Term Review Date:-- Original Closing Date:30-Sep-2018 Revised Closing Date:30-Sep-2018 Project Development Objectives Project Development Objective (from Project Appraisal Document) The project development objective (PDO) is to upgrade the standards of performance of the public health system and enable it to better respond to the challenges of malnutrition and non-communicable diseases. Has the Project Development Objective been changed since Board Approval of the Project Objective? No PHRPDODEL Components Name Support to priority areas under the National Health Development Plan:(Cost $190.00 M) Innovation, results monitoring and capacity building fund:(Cost $10.00 M) Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO  Satisfactory  Satisfactory Overall Implementation Progress (IP)  Satisfactory  Satisfactory Overall Risk Rating  Moderate  Moderate Implementation Status and Key Decisions 6/22/2015 Page 1 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Sri Lanka - Second Health Sector Development Project (P118806) An implementation support mission took place from May 5-15, 2015. The objective of the mission was to review implementation progress of the US$ 200 million Second Health Sector Development Project (SHSDP). Overall, the mission noted strong implementation progress and the project remains on track with strong likelihood of achieving the Project Development Objective. The Project Management and Monitoring Department of the Ministry of Policy Planning (earlier under the Ministry of Finance) produced a progress and results report for calendar year 2014. Commitment for achievement of the agreed targets by the implementing teams in the Ministry of Health and the nine Provinces is high as indicated by the progress against targets for most of the 20 indicators. A mid-term review of the project is tentatively planned for around March 2016. 6/22/2015 Page 2 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Sri Lanka - Second Health Sector Development Project (P118806) Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance  --  Moderate  Moderate Macroeconomic  --  Moderate  Moderate Sector Strategies and Policies  --  Moderate  Moderate Technical Design of Project or Program  --  Moderate  Moderate Institutional Capacity for Implementation and Sustainability  --  Moderate  Moderate Fiduciary  --  Moderate  Moderate Environment and Social  --  Moderate  Moderate Stakeholders  --  Moderate  Moderate Other  --  --  -- Overall  --  Moderate  Moderate 6/22/2015 Page 3 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Sri Lanka - Second Health Sector Development Project (P118806) Results Project Development Objective Indicators PHINDPDOTBL  % of persons (over 40 years) screened for selected NCDs (Diabetes, hypertension, cancer breast and oral) at healthy lifestyle centers (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 3.00 12.00 19.90 12.00 Date 30-Sep-2012 15-Dec-2014 09-Jun-2015 31-Dec-2017 Comments 1,054,831 persons out of 5,305,576 persons over 40 years of age (target) were screened. Results are as of December 31, 2014. PHINDPDOTBL  % of pregnant women with anaemia after the second trimester (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 34.00 34.00 34.00 20.00 Date 30-Sep-2012 15-Dec-2014 09-Jun-2015 31-Dec-2017 Comments Results will be reported from CY2015 onwards. As such there is no new data. PHINDPDOTBL  % of centrally managed health facilities with ETUs for that level of facility based on standard guidelines (DLI 1) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 10.00 14.30 40.00 Date 30-Sep-2012 15-Dec-2014 09-Jun-2015 31-Dec-2017 Comments 4/28 hospitals. Denominator is 28 as there are only 28 centrally managed hospitals which require ETU services. Results are as of December 31, 2014. 6/22/2015 Page 4 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Sri Lanka - Second Health Sector Development Project (P118806) PHINDPDOTBL  % of provincially managed health facilities with ETUs for that level of facility based on standard guidelines (DLI 2) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 28.80 50.00 Date 30-Sep-2012 15-Dec-2014 31-Dec-2014 31-Dec-2017 Comments 157/545 hospitals. The denominator is 545 hospitals - which is the total number of provinces managed hospitals requiring ETU services. Results are as of December 31, 2014 PHINDPDOTBL  % of MOH managed health facilities sending indoor morbidity data through e-IMMR (DLI 3) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 2.00 49.00 49.00 80.00 Date 30-Sep-2012 15-Dec-2014 09-Jun-2015 31-Dec-2017 Comments 23/47 hospitals. The denominator is the number of centrally managed hospitals that require an electronic indoor patient information system. Results are as of December 31, 2014. PHINDPDOTBL  % of provincially managed health facilities sending indoor morbidity data through e-IMMR (DLI 4) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 1.00 14.46 33.00 70.00 Date 30-Sep-2012 15-Dec-2014 09-Jun-2015 31-Dec-2017 Comments 173/525 hospitals. The denominator is the number of provincially managed hospitals that require an electronic indoor patient information system. Results are as of December 31, 2014. Overall Comments Five of the six PDO level indicator targets for 2014 have been achieved or surpassed (GoSL officially reports results once per year for the previous calendar year). The PDO indicator for "% of pregnant women with anemia after the second trimester" will only be reported on from 2015 and, as such, there is no new data for the 2014 results year. 6/22/2015 Page 5 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Sri Lanka - Second Health Sector Development Project (P118806) Intermediate Results Indicators PHINDIRITBL  % of MCH clinics that have an agreed package of equipment and supplies for the provision of care for pregnant women and children under five years. (DLI 5) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 20.00 40.00 41.90 95.00 Date 30-Sep-2012 15-Dec-2014 09-Jun-2015 31-Dec-2017 Comments 1627/3883 MCH clinics. The denominator is the number of maternal and child health field clinics in Sri Lanka. Results are as of December 31, 2014. PHINDIRITBL  % of Medical Officer of Health areas with at least three health and nutrition community support groups (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 10.00 75.00 65.50 90.00 Date 30-Sep-2012 15-Dec-2014 09-Jun-2015 31-Dec-2017 Comments 216/330. The denominator is the number of Medical officer of health areas (preventive health areas) in Sri Lanka. Results are as of December 31, 2014. Please note that the December 15, 2014 (ISR 4) inadvertently reported the achievement as 75% when it should have been reported as 55%. PHINDIRITBL  % of CEMOC facilities providing 24x7 CEMOC services. (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 45.00 75.00 75.30 75.00 Date 30-Sep-2012 15-Dec-2014 09-Jun-2015 31-Dec-2017 Comments 55/73. The denominator is the number of central and province managed secondary and tertiary care hospitals that are providing Comprehensive Emergency Obstetric services in Sri Lanka. Results are as of December 31, 2014. 6/22/2015 Page 6 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Sri Lanka - Second Health Sector Development Project (P118806) PHINDIRITBL  % of Medical Officer of Health areas with at least two healthy lifestyle centers (DLI 6) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 10.00 70.00 49.30 90.00 Date 30-Sep-2012 15-Dec-2014 09-Jun-2015 31-Dec-2017 Comments 164/324. The denominator is the number of Medical officer of health areas (preventive health areas) relevant to providing Healthy Life Style centres in Sri Lanka. Results are as of December 31, 2014. PHINDIRITBL  No. of provinces with at least one health facility providing rehabilitation services (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 1.00 3.00 3.00 7.00 Date 30-Sep-2012 15-Dec-2014 09-Jun-2015 31-Dec-2017 Comments The denominator is the number of Medical officer of health areas (preventive health areas) in Sri Lanka. Results are as of December 31, 2014. PHINDIRITBL  % of primary health care institutions having one month’s buffer stock for 16 selected NCD drugs (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 2.00 70.00 43.40 60.00 Date 30-Sep-2012 15-Dec-2014 09-Jun-2015 31-Dec-2017 Comments 371/855. The denominator is the number of Hospitals that are defined as Primary Health care institutions in Sri Lanka. Results are as of December 31, 2014. Please note that the reported results in December 2014 was provisional and is corrected down as of December 2014 data in this ISR. 6/22/2015 Page 7 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Sri Lanka - Second Health Sector Development Project (P118806) PHINDIRITBL  % of training institutes managed by the Ministry of Health meeting national standards (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 5.00 5.00 40.00 Date 30-Sep-2012 15-Dec-2014 09-Jun-2015 31-Dec-2017 Comments There are 32 Ministry of Health managed health training schools in Sri Lanka. The 2013 result was achieved by completing the National Standards. Currently, 4 training schools have taken initiatives to meet the national standards. Results are as of December 31, 2014. PHINDIRITBL  % of laboratories in health facilities (base hospitals and above) participating in the external quality assurance program for selected tests conducted by the Medical Research Institute (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 10.00 55.00 94.20 80.00 Date 30-Sep-2012 15-Dec-2014 09-Jun-2015 31-Dec-2017 Comments 65/69 eligible hospitals. The denominator is the number of secondary care hospitals in Sri Lanka that have Laboratories to provide selected tests. Results are as of December 31, 2014. PHINDIRITBL  Case detection rate for Tuberculosis (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 69.00 66.60 66.10 78.00 Date 30-Sep-2012 15-Dec-2014 09-Jun-2015 31-Dec-2017 Comments The TB case detection rate achievement is not on track to targets expected. Results are as of December 31, 2014. 6/22/2015 Page 8 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Sri Lanka - Second Health Sector Development Project (P118806) PHINDIRITBL  % of hospitals (base hospitals and above) that have obtained EPL and HWL (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 5.00 6.00 6.00 40.00 Date 30-Sep-2012 15-Dec-2014 09-Jun-2015 31-Dec-2017 Comments 4/69 base hospitals-A and above. The denominator is the number of Base Hospitals A and above (secondary care hospitals) in Sri Lanka. Results are as of December 31, 2014. PHINDIRITBL  % of fully functioning quality management Units (QMUs) in MOH managed base hospitals and above (DLI 7) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 9.00 23.00 38.10 95.00 Date 30-Sep-2012 15-Dec-2014 09-Jun-2015 31-Dec-2017 Comments Results are as of December 31, 2014. PHINDIRITBL  % of fully functioning quality management Units (QMUs) in provincially managed base hospitals and above (DLI 8) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 6.00 -- 43.70 90.00 Date 30-Sep-2012 15-Dec-2014 09-Jun-2015 31-Dec-2017 Comments The denominator is the number of Medical officer of health areas (preventive health areas) in Sri Lanka. Results are as of December 31, 2014. 6/22/2015 Page 9 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Sri Lanka - Second Health Sector Development Project (P118806) PHINDIRITBL  % of National Competitive Bidding (NCB) contracts awarded within the first nine months of the previous calendar year from 2014 onwards (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 75.00 73.60 80.00 Date 30-Sep-2012 15-Dec-2014 09-Jun-2015 31-Dec-2017 Comments 218/296. The denominator is the number of total National Competitive Bidding Contracts awarded in 2014 by the Ministry of Health in 2014. Results are as of December 31, 2014. PHINDIRITBL  % of the six-monthly cash forecast (for non-salary recurring and capital expenditures) released (DLI 9) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 81.00 92.00 92.00 90.00 Date 30-Sep-2012 15-Dec-2014 09-Jun-2015 31-Dec-2017 Comments Results are as of December 31, 2014. Overall Comments Most recent data for this ISR is from the GoSL progress and results report for the calendar year 2014. It is noted that 10 of the 14 Intermediate level indicators have been achieved while 5 of the 6 PDO level indicators have also been achieved. Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed Disbursed P118806 IDA-52280 Effective XDR 129.80 129.80 0.00 40.01 89.79 31% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P118806 IDA-52280 Effective 27-Mar-2013 19-Aug-2013 12-Sep-2013 30-Sep-2018 30-Sep-2018 Cumulative Disbursements 6/22/2015 Page 10 of 11 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Sri Lanka - Second Health Sector Development Project (P118806) Restructuring History There has been no restructuring to date. Related Project(s) There are no related projects. 6/22/2015 Page 11 of 11 Public Disclosure Copy