The World Bank Implementation Status & Results Report Transforming Egypt's Healthcare System Project (P167000) Transforming Egypt's Healthcare System Project (P167000) MIDDLE EAST AND NORTH AFRICA | Egypt, Arab Republic of | Health, Nutrition & Population Global Practice | IBRD/IDA | Investment Project Financing | FY 2018 | Seq No: 6 | ARCHIVED on 30-May-2021 | ISR44779 | Implementing Agencies: Ministry of Investment and International Cooperation, Ministry of Health and Population Key Dates Key Project Dates Bank Approval Date: 27-Jun-2018 Effectiveness Date: 07-Sep-2018 Planned Mid Term Review Date: 14-Jan-2021 Actual Mid-Term Review Date: 15-Apr-2021 Original Closing Date: 31-Dec-2023 Revised Closing Date: 31-Dec-2023 pdoTable Project Development Objectives Project Development Objective (from Project Appraisal Document) The proposed Project Development Objective is to (i) improve the quality of primary and secondary health care services, (ii) enhance demand for health and family planning services, and (iii) support the prevention and control of Hepatitis C. Has the Project Development Objective been changed since Board Approval of the Project Objective? No Components Table Name Strengthen Primary Healthcare, Family Planning and Community Activities:(Cost $247.40 M) Strengthen Secondary Level Healthcare:(Cost $274.60 M) Institutional Capacity Building and Project Management:(Cost $8.00 M) Contingency Emergency and Response Overall Ratings Name Previous Rating Current Rating Progress towards achievement of PDO Satisfactory Moderately Satisfactory Overall Implementation Progress (IP) Moderately Satisfactory Moderately Satisfactory Overall Risk Rating Substantial Moderate Implementation Status and Key Decisions Project Implementation: A Mid-Term Review (MTR) to assess the progress under the Project was conducted during the period from December 20, 2020 to April 15, 2021. The MTR determined that the project has turned in a positive direction with substantial implementation progress over the last two years, despite the myriad of challenges posed by COVID-19. The disbursement rate is well ahead of schedule at 56% and a functioning Project Management Unit is in place. The screening of Hepatitis C and Non-Communicable Disease (NCDs) has exceeded its targets and been completed two years earlier than planned. Support to the Primary Healthcare sector, Family planning sector and institutional capacity building is ongoing. As part of the Contingent Emergency Response Component under the project, the World Bank approved on March 19, 2020 the reallocation of US$7,909 million to support the Government of Egypt in its early COVID-19 response. 5/30/2021 Page 1 of 8 The World Bank Implementation Status & Results Report Transforming Egypt's Healthcare System Project (P167000) Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance Substantial Substantial Moderate Macroeconomic Substantial Substantial Moderate Sector Strategies and Policies Substantial Substantial Substantial Technical Design of Project or Program Substantial Moderate Moderate Institutional Capacity for Implementation and Moderate Moderate Moderate Sustainability Fiduciary High High Substantial Environment and Social Moderate Moderate Moderate Stakeholders Substantial Substantial Substantial Other -- High Low Overall Substantial Substantial Moderate Results PDO Indicators by Objectives / Outcomes Improve the quality of primary health care services IN00931668 ►Number of PHCs passing Quality Services Index composite indicators list (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 113.00 600.00 Date 02-Jul-2018 17-Aug-2020 30-Apr-2021 31-Dec-2023 The QSI manual and action plan for the targeted PHCs staff training are completed and 113 PHCs are Comments: verified for phase one. Further 100 PHCs are being prepared for verification for phase 2. IN00931672 ►Percentage improvement in the average quality of clinical care score at all targeted PHCs, measured through independent direct observations (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 54.96 68.50 80.00 Date 02-Jul-2018 17-Aug-2020 30-Apr-2021 31-Dec-2023 5/30/2021 Page 2 of 8 The World Bank Implementation Status & Results Report Transforming Egypt's Healthcare System Project (P167000) Improve the quality of secondary health care services IN00931671 ►Percentage improvement in the average quality of clinical care score at all targeted hospitals measured through independent direct observations (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 66.00 93.00 80.00 Date 02-Jul-2018 17-Aug-2020 30-Apr-2021 31-Dec-2023 The total average quality of clinical care score in the four hospitals is 66%, with the highest score in the Aswan Specialized hospital with 78.24% and the lowest in the Alagamy Central hospital with 57.5%. The Comments: year 2 target is met. IN00931673 ►Percentage of blood units dispensed at MOHP affiliated hospitals that have been screened utilizing the Nucleic Acid test (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 90.00 Date 02-Jul-2018 17-Aug-2020 30-Apr-2021 31-Dec-2023 Procurement activities have been on hold since procurement is assigned to the Unified Procurement Comments: Agency (UPA). Enhance Demand for Health and Family Planning Services IN00931670 ►Contraceptive prevalence rate (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 58.00 58.00 58.00 65.00 Date 02-Jul-2018 17-Aug-2020 30-Apr-2021 31-Dec-2023 Data for this indicator is not required until year 3. Comments: Prevention and control of Hepatitis C IN00931669 ►Number of people screened for Viral Hepatitis C (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 49,931,654.00 49,931,654.00 35,000,000.00 Date 02-Jul-2018 17-Aug-2020 30-Apr-2021 31-Dec-2023 The end target for the screen of Hepatitis C has been met (and exceeded) 3 years earlier than planned. Comments: IN00931674 Percent Female (Percentage, Corporate Breakdown) 5/30/2021 Page 3 of 8 The World Bank Implementation Status & Results Report Transforming Egypt's Healthcare System Project (P167000) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 52.00 52.00 50.00 Date 02-Jul-2018 17-Aug-2020 30-Apr-2021 29-Dec-2023 IN00931675 ►Percentage of people who received treatment for Hepatitis C who have taken the final confirmation test for sustained virological response (SVR) using a random sampling methodology (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 79.00 72.80 80.00 Date 02-Jul-2018 17-Aug-2020 30-Apr-2021 31-Dec-2023 While the end target was met in the September 2019 ISR, the results is now slightly lower than the target at 72.8% (actual), with a target of 80%. This exceeds the target for this stage of project implementation Comments: (year 3 = 70%). The Ministry of Health and Population is actively working to ensure that patients who tested positive for Hep C receive the full treatment and final confirmatory test. Intermediate Results Indicators by Components Strenghten Primary Healthcare, Family Planning and Community Activities IN00931676 ►PHC mapping exercise, needs assessments and new accreditation tool completed. (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 2.00 3.00 4.00 Date 02-Jul-2018 17-Aug-2020 30-Apr-2021 31-Dec-2023 The PHC needs assessments and the mapping exercises have been completed and the accrediatation Comments: tool has been published. IN00931679 ►Increased household visits by CHWs (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 7.00 21.70 21.70 32.00 Date 02-Jul-2018 17-Aug-2020 30-Apr-2021 31-Dec-2023 This indicator is measured yearly. In light of COVID-19, visits can no longer be conducted at the household level but are taking place in markets, transportation stations and common public areas. While Comments: CHW visits are still documented, there is difficulty in documenting individual details at the household level. IN00931681 ►Percentage of participating districts certified for enhanced governance performance (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 21.30 36.00 100.00 5/30/2021 Page 4 of 8 The World Bank Implementation Status & Results Report Transforming Egypt's Healthcare System Project (P167000) Date 02-Jul-2018 17-Aug-2020 30-Apr-2021 31-Dec-2023 The curriculum for financial training (65 district) has been completed as well as the action plan for the training. 21.3 percent of participating districts have been certified for enhanced governance performance. Comments: As for the second year, the training and verification have been completeted. IN00931683 ►Client user satisfaction and utilization surveys conducted in project target areas (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1.00 1.00 5.00 Date 02-Jul-2018 17-Aug-2020 30-Apr-2021 31-Dec-2023 IN00931685 ►Grievances addressed in project target facilities using the GRM in accordance with the revised manual issued in 2017 (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 20.00 80.00 Date 02-Jul-2018 17-Aug-2020 30-Apr-2021 31-Dec-2023 The GRM manual has been completed and printed and training on the GRM delivered. The GRM manual Comments: has been distributed to all the governorates. IN00931687 ►Average patient satisfaction level (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 66.50 69.00 65.00 Date 02-Jul-2018 17-Aug-2020 30-Apr-2021 31-Dec-2023 A pilot study for the patient satisfaction tool was conducted. The average total patient satisfaction percent Comments: score in all pilot PHCs was 69%. IN00931688 ►Targeted people screened for NCDs (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 49,931,654.00 49,931,654.00 20,000,000.00 Date 02-Jul-2018 17-Aug-2020 30-Apr-2021 31-Dec-2023 IN00931689 Percent Female (Percentage, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 52.00 52.00 50.00 Date 02-Jul-2018 17-Aug-2020 30-Apr-2021 29-Dec-2023 IN00931690 5/30/2021 Page 5 of 8 The World Bank Implementation Status & Results Report Transforming Egypt's Healthcare System Project (P167000) ►Targeted PHCs applying environmentally-positive energy and water efficiency measures (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 113.00 600.00 Date 02-Jul-2018 17-Aug-2020 30-Apr-2021 31-Dec-2023 The Needs Assessment for energy saving lamps, has been completed for 113 PHCs. Comments: IN00931691 ►People who have received essential health, nutrition, and population (HNP) services (Number, Corporate) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 2,067,737.00 947,943.00 3,400,000.00 Date 02-Jul-2018 17-Aug-2020 30-Apr-2021 31-Dec-2023 IN00931692 Number of women and children who have received basic nutrition services (Number, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 2,067,737.00 947,943.00 3,400,000.00 Date 02-Jul-2018 17-Aug-2020 30-Apr-2021 31-Dec-2023 Strengthen Secondary Level Healthcare IN00931678 ►Targeted regional blood banks that have been connected to the national automated blood network. (Amount(USD), Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 11.00 Date 02-Jul-2018 17-Aug-2020 30-Apr-2021 31-Dec-2023 IN00931680 ►Targeted Hep C patients treated (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1,073,586.00 1,073,586.00 1,500,000.00 Date 02-Jul-2018 17-Aug-2020 30-Apr-2021 31-Dec-2023 IN00931682 Percent Female (Percentage, Corporate Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 45.00 45.00 40.00 Date 20-Jun-2018 17-Aug-2020 30-Apr-2021 29-Dec-2023 IN00931684 5/30/2021 Page 6 of 8 The World Bank Implementation Status & Results Report Transforming Egypt's Healthcare System Project (P167000) ►Number of PHCs receiving National Accreditation Certification for healthcare quality (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 113.00 600.00 Date 02-Jul-2018 17-Aug-2020 30-Apr-2021 31-Dec-2023 IN00931686 ►Number of Hospitals receiving National Accreditation Certification for healthcare quality in target governorates (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 0.00 0.00 27.00 Date 02-Jul-2018 17-Aug-2020 30-Apr-2021 31-Dec-2023 The tool for accreditation has been published for both hospitals and primary centers. It is currently being Comments: verified by IVA. Institutional Capacity Building ad Project Management IN00931677 ►Project results published regularly on external MOHP website (Text, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 Yes Yes Yes Date 02-Jul-2018 17-Aug-2020 30-Apr-2021 31-Dec-2023 Performance-Based Conditions Data on Financial Performance Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed % Disbursed P167000 IBRD-88950 Effective USD 530.00 530.00 0.00 294.15 235.85 56% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P167000 IBRD-88950 Effective 27-Jun-2018 10-Jul-2018 07-Sep-2018 31-Dec-2023 31-Dec-2023 Cumulative Disbursements 5/30/2021 Page 7 of 8 The World Bank Implementation Status & Results Report Transforming Egypt's Healthcare System Project (P167000) PBC Disbursement Achievement Disbursed amount in Disbursement % PBC ID PBC Type Description Coc PBC Amount Status Coc for PBC Restructuring History There has been no restructuring to date. Related Project(s) There are no related projects. 5/30/2021 Page 8 of 8