Public Disclosure Copy The World Bank Implementation Status & Results Report Bangladesh - Health Sector Development Program (P118708) Bangladesh - Health Sector Development Program (P118708) SOUTH ASIA | Bangladesh | Health, Nutrition & Population Global Practice | IBRD/IDA | Sector Investment and Maintenance Loan | FY 2011 | Seq No: 8 | ARCHIVED on 21-Aug-2015 | ISR20400 | Implementing Agencies: Ministry of Health and Family Welfare Key Dates Key Project Dates Board Approval date:26-May-2011 Effectiveness Date:23-Oct-2011 Planned Mid Term Review Date:30-Oct-2014 Actual Mid-Term Review Date:30-Oct-2014 Original Closing Date:31-Dec-2016 Revised Closing Date:31-Dec-2016 Project Development Objectives Project Development Objective (from Project Appraisal Document) To enable the Government of Bangladesh to strengthen health systems and improve health services, particularly for the poor. Has the Project Development Objective been changed since Board Approval of the Project Objective? No PHRPDODEL Components Name Improving Health Services:(Cost $251.20 M) Strengthening health systems:(Cost $107.70 M) 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  Substantial Implementation Status and Key Decisions 8/21/2015 Page 1 of 10 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Bangladesh - Health Sector Development Program (P118708) The Project supports the implementation of the Government of Bangladesh (GOB)’s sector program (known as the Health, Population and Nutrition Sector Development Program, 2011 to 2016). The Project is co-financed by seven development partners (DFAT formerly known as AusAID, DFID, DFATD formerly known as CIDA, KfW, Sida, UNFPA and USAID) through trust funds administered by the World Bank. The Embassy of the Kingdom of the Netherlands (EKN) has recently joined the pool as the eighth co-financier. Resources are programmed in-line with the sector priorities and as a share of the overall Program of the Government. The Program is led and implemented by the Ministry of Health and Family Welfare (MOHFW). The Mid Term Review (MTR) of the Program was completed in November 2014 jointly with GOB and all development partners. The review included two days of policy dialogue between the development partners and the government. The process was guided and informed by an independent assessment performed by independent consultants as well as discussions held in the thematic task groups and field visits. This led to the development of an Agreed Action Plan which is being monitored at the Local Consultative Group meeting chaired by the Secretary. The MTR documented generally good implementation progress and the Program is on track to achieve its development objective. Two out of the three indicators used for measuring the Project Development Objective have already been achieved. Although the end-of-project target of 43.30% of children underweight has been achieved, with one in three children stunted, efforts to addressing malnutrition in Bangladesh will need to be scaled up. MoHFW and development partners have also agreed that fiduciary capacity related to procurement and financial management needs to be strengthened, and discussions are underway on a mitigation plan with detailed actions to address identified weaknesses. 8/21/2015 Page 2 of 10 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Bangladesh - Health Sector Development Program (P118708) Risks Systematic Operations Risk-rating Tool Risk Category Rating at Approval Previous Rating Current Rating Political and Governance  --  Substantial  Substantial Macroeconomic  --  Low  Low Sector Strategies and Policies  --  Low  Low Technical Design of Project or Program  --  Low  Low Institutional Capacity for Implementation and Sustainability  --  Moderate  Moderate Fiduciary  --  Substantial  Substantial Environment and Social  --  Moderate  Moderate Stakeholders  --  Moderate  Moderate Other  --  --  -- Overall  --  Substantial  Substantial Results Project Development Objective Indicators PHINDPDOTBL  Coverage of modern contraceptives in low performing areas of Bangladesh -- Sylhet (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 35.70 39.40 39.40 50.00 Date 31-Dec-2010 16-Nov-2014 04-Aug-2015 31-Dec-2016 8/21/2015 Page 3 of 10 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Bangladesh - Health Sector Development Program (P118708) PHINDPDOTBL  Coverage of modern contraceptives in low performing areas of Bangladesh -- Chittagong (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 46.80 43.90 43.90 50.00 Date 31-Dec-2010 16-Nov-2014 04-Aug-2015 31-Dec-2016 PHINDPDOTBL  Proportion of delivery by skilled birth attendant among the lowest two wealth quintile groups (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 11.50 16.70 16.70 15.00 Date 31-Dec-2010 16-Nov-2014 04-Aug-2015 31-Dec-2016 PHINDPDOTBL  Prevalence of underweight among children under 5 years of age among the lowest two wealth quintile groups (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 48.30 42.05 42.05 43.30 Date 31-Dec-2007 16-Nov-2014 04-Aug-2015 31-Dec-2016 Overall Comments Intermediate Results Indicators PHINDIRITBL  Proportion of physician positions vacant at upazila/district level and below (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 45.70 29.90 29.90 22.80 Date 31-Dec-2009 16-Nov-2014 04-Aug-2015 31-Dec-2016 8/21/2015 Page 4 of 10 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Bangladesh - Health Sector Development Program (P118708) PHINDIRITBL  Proportion of nurse positions vacant at upazila/district level and below (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 24.70 12.80 12.80 12.40 Date 31-Dec-2009 16-Nov-2014 04-Aug-2015 30-Jun-2016 PHINDIRITBL  Proportion of births in health facilities (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 23.70 32.80 32.80 40.00 Date 31-Dec-2010 16-Nov-2014 04-Aug-2015 31-Dec-2016 PHINDIRITBL  Number of functional Community Clinics (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 10323.00 12577.00 12577.00 13500.00 Date 31-Jan-2011 16-Nov-2014 04-Aug-2015 31-Dec-2016 PHINDIRITBL  Coverage of Measles Immunization for children under 12 months of age (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 82.40 85.60 85.60 90.00 Date 31-Dec-2009 16-Nov-2014 04-Aug-2015 31-Dec-2016 8/21/2015 Page 5 of 10 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Bangladesh - Health Sector Development Program (P118708) PHINDIRITBL  Proportion of infants exclusively breastfed up to 6 months of age (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 43.00 60.00 60.00 50.00 Date 31-Dec-2007 16-Nov-2014 04-Aug-2015 31-Dec-2016 PHINDIRITBL  Proportion of postnatal care for women within 48 hours (at least 1 visit) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 20.90 28.60 28.60 50.00 Date 31-Dec-2010 16-Nov-2014 04-Aug-2015 31-Dec-2016 PHINDIRITBL  Proportion of annual work plans with budgets submitted by LDs by defined time period (July/Aug) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value -- 90.00 90.00 100.00 Date -- 16-Nov-2014 04-Aug-2015 31-Dec-2016 PHINDIRITBL  Proportion of health facilities, by type, without stock-outs of essential medicines (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 66.10 73.60 73.60 75.00 Date 31-Dec-2009 16-Nov-2014 04-Aug-2015 31-Dec-2016 8/21/2015 Page 6 of 10 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Bangladesh - Health Sector Development Program (P118708) PHINDIRITBL  Proportion of serious audit objections settled within the last 12 months (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 7.00 68.00 68.00 80.00 Date 31-Dec-2009 16-Nov-2014 04-Aug-2015 31-Dec-2016 PHINDIRITBL  Proportion of Operational Plans with expenditure > 80% of ADP allocation (annually) (Percentage, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 44.70 69.00 69.00 100.00 Date 31-Jan-2011 16-Nov-2014 04-Aug-2015 31-Dec-2016 PHINDIRITBL  Health personnel receiving training (number) (Number, Core) Baseline Actual (Previous) Actual (Current) End Target Value 59.00 852215.00 852215.00 3000.00 Date -- 16-Nov-2014 04-Aug-2015 31-Dec-2016 PHINDIRITBL  Births (deliveries) attended by skilled health personnel (number) (Number, Core) Baseline Actual (Previous) Actual (Current) End Target Value -- 190000.00 190000.00 -- Date -- 31-Dec-2016 04-Aug-2015 -- 8/21/2015 Page 7 of 10 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Bangladesh - Health Sector Development Program (P118708) PHINDIRITBL  Number of additional service providers trained in midwifery at district and upazila health facilities (Number, Custom) Baseline Actual (Previous) Actual (Current) End Target Value 0.00 1102.00 1102.00 3000.00 Date 01-May-2011 16-Nov-2014 04-Aug-2015 31-Dec-2016 PHINDIRITBL  Children immunized (number) (Number, Core) Baseline Actual (Previous) Actual (Current) End Target Value -- 2800000.00 2800000.00 -- Date -- 16-Nov-2014 04-Aug-2015 -- PHINDIRITBL  Children immunized - under 12 months against DTP3 (number) (Number, Core Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value -- 2800000.00 2800000.00 -- Date -- 16-Nov-2014 04-Aug-2015 -- PHINDIRITBL  Children immunized - under 5 years against Polio (number) (Number, Core Breakdown) Baseline Actual (Previous) Actual (Current) End Target Value -- 1.00 1.00 -- Date -- 16-Nov-2014 04-Aug-2015 -- Overall Comments Data on Financial Performance 8/21/2015 Page 8 of 10 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Bangladesh - Health Sector Development Program (P118708) Disbursements (by loan) Project Loan/Credit/TF Status Currency Original Revised Cancelled Disbursed Undisbursed Disbursed P118708 IDA-49540 Effective USD 358.90 358.05 0.85 329.44 13.57 92% P118708 TF-11556 Effective USD 262.42 261.71 0.71 224.53 37.18 86% P118708 TF-12281 Effective USD 28.04 28.01 0.03 19.67 8.34 70% Key Dates (by loan) Project Loan/Credit/TF Status Approval Date Signing Date Effectiveness Date Orig. Closing Date Rev. Closing Date P118708 IDA-49540 Effective 26-May-2011 12-Sep-2011 23-Oct-2011 31-Dec-2016 31-Dec-2016 P118708 TF-11556 Effective 28-Mar-2012 28-Mar-2012 28-Mar-2012 31-Dec-2016 31-Dec-2016 P118708 TF-12281 Effective 12-Sep-2012 12-Sep-2012 12-Sep-2012 30-Jun-2016 30-Jun-2016 Cumulative Disbursements Restructuring History Level 2 Approved on 25-Jun-2013 8/21/2015 Page 9 of 10 Public Disclosure Copy Public Disclosure Copy The World Bank Implementation Status & Results Report Bangladesh - Health Sector Development Program (P118708) Related Project(s) P151070-HSDP Additional Finance 8/21/2015 Page 10 of 10 Public Disclosure Copy