The World Bank Report No: ISR13626 Implementation Status & Results Kyrgyz Republic Kyrgyz Health Results Based Financing (P120435) Public Disclosure Copy Operation Name: Kyrgyz Health Results Based Financing (P120435) Project Stage: Implementation Seq.No: 2 Status: ARCHIVED Archive Date: 05-Mar-2014 Country: Kyrgyz Republic Approval FY: 2013 Product Line: Recipient Executed Activities Region: EUROPE AND CENTRAL ASIA Lending Instrument: Specific Investment Loan Implementing Agency(ies): Mandatory Health Insurance Fund, Ministry of Health Key Dates Board Approval Date 18-Apr-2013 Original Closing Date Planned Mid Term Review Date 20-Jan-2016 Last Archived ISR Date 02-Jul-2013 Effectiveness Date Revised Closing Date Actual Mid Term Review Date Project Development Objectives Project Development Objective (from Project Appraisal Document) The Project Development Objective is to (1) pilot performance-based payments and/or enhanced supervision for quality of maternal and neonatal care in randomly selected rayon hospitals; and (2) strengthen the Government’s and providers’ capacity in performance-based contracting and monitoring and evaluating for results. Has the Project Development Objective been changed since Board Approval of the Project? Yes No Component(s) Component Name Component Cost Component 1: Pilot Performance-Based Payments and Enhanced Supervision for Quality of Care 9.59 Component 2: Strengthen the Government's and Providers' Capacity in Performance-Based Payment 1.41 Reform and Monitoring and Evaluation f or Results Overall Ratings Previous Rating Current Rating Public Disclosure Copy Progress towards achievement of PDO Satisfactory Satisfactory Overall Implementation Progress (IP) Satisfactory Moderately Satisfactory Overall Risk Rating Moderate Implementation Status Overview The Grant Agreement for pilot project was signed on December 30, 2013. It is now pending ratification from Parliament in order to declare the pilot project effective. This is expected to take place by the end of June 2014. In addition, the following conditionsof effectiveness need to be met: issuance of the Legal Opinion; approval of the Project Operations Manual (POM); establishment of a RBF Secretariat, a RBF Technical Team and the RBF National Steering Committee. Preparation of the POM is at advanced stage and to be finalized by April 2014; RBF Secretariat has Page 1 of 5 The World Bank Report No: ISR13626 been established with core staff in place; Terms of References for the RBF Technical Team and National Steering Committee are being developed. The Government had demonstrated a strong commitment to the project during its preparation and remains committed to the project. The RBF pre-pilot project started in the fall 2013. Ministry of Health (MOH) issued its order committing to implementation of the pre-pilot project. Implementation of the pre-pilot project activities are ongoing in one district/rayon (Chui Public Disclosure Copy rayon). Ministry of Health (MOH) and Mandatory Health Insurance Fund (MHIF) have successfully conducted a Round table on Feb 5 2014 launching an implementation of the pre- pilot project and informing about results of the first round of peer-verification. Round Table was actively attended by various stakeholders such as MOH's and MHIF key staff, MCH development partners (WHO, UNICEF, UNFPA, KfW, etc), professional associations (Hospital Association, Association of midwifes, Alliance of Obstetricians, Association of Pediatricians) and Association of Village Health Committees who provided useful comments on the way forward. Comprehensive Baseline Impact Evaluation survey was conducted in the end of 2012 with a coverage of 66 rayon hospitals and 130 primary care facilities (PHC facilities were surveyed on the limited spectrum of aspects); data collected have been analyzed and Report is being currently finalized. Critical actions over the remaining part of the pre-pilot project's time will include: (i) development and testing of the RBF project processes, procedures and instruments (setting up accounts, flow of funds, verification and counter-verification process; (ii) meeting of the above mentioned project effectiveness conditions; (iii) design of monitoring system; and (iv) planning for the pilot project roll out, including establishing the necessary technical assistance Locations Country First Administrative Division Location Planned Actual Kyrgyz Republic Osh Osh Oblasty ✔ Kyrgyz Republic Batken Batken Oblasty ✔ Kyrgyz Republic Talas Talas Oblasty ✔ Kyrgyz Republic Naryn Naryn Oblasty ✔ Kyrgyz Republic Ysyk-Koel Issyk-Kul'skaya Oblast' ✔ Kyrgyz Republic Bishkek Gorod Bishkek ✔ Kyrgyz Republic Jalal-Abad Jalal-Abad Oblasty ✔ Kyrgyz Republic Chuy Chuy Oblasty ✔ Public Disclosure Copy Results Project Development Objective Indicators Indicator Name Core Unit of Measure Baseline Current End Target Proportion of quarterly peer verification records Percentage Value 0.00 100.00 for Groups 1 and 2 rayon hospitals submitted Date 31-Dec-2015 to MHIF within one week after the end of each Comments No peer verification Yr1: 80% quarter Yr2: 100% Yr3: 100% Page 2 of 5 The World Bank Report No: ISR13626 Proportion of eligible rayon hospitals that Percentage Value 0.00 100.00 received the authorized performance-based Date 31-Dec-2015 payments within two weeks after the MHIF’s Comments No performance based Yr1: 80% receipt of payment invoices Public Disclosure Copy payments Yr2: 100% Yr3: 100% Number of counter-verification carried out for a Number Value 0.00 8.00 subset of Group 1 rayon hospitals and Group 2 Date 31-Dec-2015 rayon hospitals every six months Comments No counterverification Yr1: 8 Yr2: 8 Yr3: 8 Impact Evaluation Surveys completed on Text Value No surveys Atleast 2 round of serveys schedule to generate evidence for policy implmented by the end of the project Date 31-Dec-2015 Comments Yr1: Baseline survey completed before pilot start YR3: Follow-up survey completed at the end of the project Intermediate Results Indicators Indicator Name Core Unit of Measure Baseline Current End Target Performance Contracts signed with the Group Number Value 0.00 20.00 1 rayon hospitals (20) and updated annually Date 31-Dec-2015 based on any modifications introduced to the Comments No contract signed Yr1: Contracts signed with 20 Balanced Scorecard rayon hospitals. Yr2: Contracts renewed and adjusted if needed with 20 rayon hospitals. Yr3: Contracts renewed and Public Disclosure Copy adjusted if needed with 20 rayon hospitals Proportion of Group 1 rayon hospitals (20) that Percentage Value 0.00 100.00 received quarterly performance-based Date 31-Dec-2015 payments in accordance to their level of Comments No performance based Yr1: 100% performance as per agreed Performance Contracts payments disbursed Yr2: 100% Yr3: 100% Page 3 of 5 The World Bank Report No: ISR13626 MOH/MHIF produce quarterly monitoring Number Value 0.00 4.00 reports within 2 weeks after the end of each Date 31-Dec-2015 quarter Comments No quarterly reports Yr1: 4 Public Disclosure Copy Yr2: 4 Yr3: 4 National RBF Steering Committee meets at Number Value 0.00 2.00 least twice a year Date 31-Dec-2015 Comments Yr1: 2 Yr2: 2 Yr3: 2 Extended RBF team meets at least every 2 Number Value 0.00 6.00 months Date 31-Dec-2015 Comments Yr1: 6 Yr2: 6 Yr3: 6 Data on Financial Performance (as of 00000000) Financial Agreement(s) Key Dates Disbursements (in Millions) 0.00 0.00 0.00 0.00 0.00 Disbursement Graph Public Disclosure Copy Page 4 of 5 The World Bank Report No: ISR13626 Public Disclosure Copy Key Decisions Regarding Implementation Not applicable Restructuring History There has been no restructuring to date. Related Projects There are no related projects. Public Disclosure Copy Page 5 of 5